Learn risk factors for blinding eye disease

Approximately 2.7 million Americans have the potentially blinding eye disease glaucoma, but only half are aware of it. Meanwhile, glaucoma incidence is on the rise. Researchers predict that glaucoma will affect as many as 6.3 million Americas by 2050

During Glaucoma Awareness Month, the California Academy of Eye Physicians and Surgeons (CAEPS) and the American Academy of Ophthalmology (AAO) are sharing a list of disease risk factors.

“It is imperative that people understand the precursors to this debilitating disease,” said Troy R. Elander, MD, CAEPS President. “If you are at risk, then getting an exam from an ophthalmologist as soon as possible can help protect you from vision loss.”

Glaucoma is a group of eye diseases that damage the optic nerve, which links the eyes to the brain. It is most commonly associated with elevated pressure inside the eye, known as intraocular pressure, or IOP. Without treatment, glaucoma can cause irreversible vision loss in a person’s side vision, then in his or her central vision. With early diagnosis and treatment, sight can be preserved. However, glaucoma has no noticeable symptoms in its early stages, so it is imperative that people know the risk factors.

Certain factors can increase an individual’s risk of developing glaucoma, including:

  • Family History: Individuals with a parent or sibling with glaucoma have a nine times higher risk of developing the disease, according to one study.
  • Older Age: As people age, their risk for glaucoma increases. Because this is the case for several eye diseases, both Academies recommend that adults start getting regular comprehensive eye exams at age 40. This is the age when early signs of eye disease and changes in vision may first occur, even if you have seemingly perfect vision. So, it is important to get a comprehensive eye exam from an ophthalmologist, a physician specializing in medical and surgical eye care.
  • African, Hispanic or Asian Heritage: People of African and Hispanic heritage are three times more likely to have the most common form of glaucoma than Caucasians. Glaucoma-related blindness is at least six times more prevalent in African Americans than in Caucasian Americans. Additionally, people of Asian heritage are at an increased risk of a sudden and acute form of glaucoma known as angle-closure glaucoma.
  • Type 2 Diabetes: Having type 2 diabetes increases the risk of glaucoma. The longer a person has lived with diabetes, the greater their risk for glaucoma becomes.

Additionally, when the cornea – the clear, round dome on the front of the eye that covers the iris and pupil – is abnormally thin, IOP readings may be falsely low. This puts patients at increased risk for undiagnosed glaucoma. This is common among those who have had refractive surgery, such as LASIK or photorefractive keratectomy. Another risk factor associated with glaucoma is a history of eye trauma.

“Many of my patients are surprised to learn that one or more of these factors put them at an increased risk,” said Andrew Iwach, M.D., a clinical spokesperson for the AAO and a glaucoma specialist. “Being aware of your personal risk of glaucoma is the first step to saving your sight.”

Glaucoma treatment ranges from medicated eye drops to a variety of surgeries that can help reduce high IOP. This may involve procedures that make small changes in the eye to help fluid drain more easily. In some cases, small devices known as shunts or stents are inserted in the eye to increase the flow of the eye’s fluid out of the eye.

People age 65 or older and concerned about their eye disease risk may be eligible for a medical eye exam at no out-of-pocket cost through EyeCare America™, a program of the Foundation of the AAO. In addition, those who are at an increased risk for glaucoma may also qualify for a glaucoma exam through EyeCare America. This public service program matches volunteer ophthalmologists with eligible patients in need across the United States. To see if you, your friends or family members are eligible, visit www.eyecareamerica.org.

To learn more about glaucoma, its risk factors and its treatment, visit www.geteyesmart.org.


Keep eye safety in mind when choosing gifts for the holidays

As the holidays approach, parents across the United States are joining the rush to fulfill their children’s wish lists, but many might not realize some popular children’s toys can cause serious injuries related to vision. This shopping season, the California Academy of Eye Physicians and Surgeons (CAEPS) and the American Academy of Ophthalmology (AAO) are encouraging parents to be cautious when it comes to purchasing safe toys for their children.

According to the U.S. Consumer Product Safety Commission, nearly 252,000 toy-related injuries were treated in emergency rooms in 2014, and nearly half of these injuries affect the head or face. In fact, about 1 in 10 children's eye injuries treated in the emergency room trace back to toys. Some propelling toys, like airsoft guns, arrows, BB guns, paintball guns and darts can be particularly hazardous, with the potential to cause serious eye injuries such as corneal abrasion, ocular hyphema (blood inside the clear part of the eye that obscures the iris and pupil), traumatic cataract, increased eye pressure, and even permanent vision loss.

“For many, it’s merely a memorable scene in the holiday classic, A Christmas Story, in which Ralphie’s request for a Red Ryder Air Riffle is met with skepticism as his mother and others caution, ‘you’ll shoot your eye out, kid.’ But in reality, some hazardous toys are a real concern because they do cause countless eye injuries each year,” said Leah Levi, MD, CAEPS President. “When it comes to yours and your children’s vision, you can never be too careful, so we recommend playing it safe when it comes to toy shopping this holiday season.”

The good news is that most eye injuries can be easily prevented by following toy safety tips supported by both Academies:

  • Avoid purchasing toys with sharp, protruding or projectile parts.
  • Make sure children have appropriate supervision when playing with potentially hazardous toys or games that could cause an eye injury.
  • Ensure that laser product labels include a statement that the device complies with 21 CFR (the Code of Federal Regulations) Subchapter J.
  • Along with sports equipment, give children the appropriate protective eyewear with polycarbonate lenses. Check with your ophthalmologist to learn about protective gear recommended for your child's sport.
  • Check labels for age recommendations and be sure to select gifts that are appropriate for a child's age and maturity.
  • Keep toys that are made for older children away from younger children.

If your child experiences an eye injury from a toy, seek immediate medical attention from an ophthalmologist – a medical doctor specializing in the diagnosis, medical and surgical treatment of eye diseases and conditions. For more information about keeping eyes healthy during the holidays and all year round, visit the AAO's public education website at www.geteyesmart.org.

Regular Eye Exams Can Help Save Sight of Diabetics

One in four Americans age 65 or older has d
iabetes, putting them at increased risk for vision loss and blindness. Fortunately, diabetes-related vision loss is largely preventable with regular care.
Yet studies have found a majority of Medicare beneficiaries with diabetes do not get the necessary eye exams despite the fact that the exams could be covered under their existing insurance.

The California Academy of Eye Physicians and Surgeons (CAEPS) and the American Academy of Ophthalmology (AAO) are reminding older Americans with diabetes that they should obtain these critical eye exams each year.

“When it comes to diabetes-related vision loss, the good news is it is largely preventable. Unfortunately, many seniors in California are simply not aware that they need these eye exams,” said Leah Levi, MD, CAEPS president. “We are encouraging seniors—indeed, all Californians with diabetes—to take a minute to think about whether they have had an exam within a year, and if not, to make an appointment as soon as possible.”

Both type 1 and type 2 diabetes can affect the small blood vessels in the eyes, causing them to leak and grow irregularly. This leads to vision loss if left untreated. This condition is known as diabetic retinopathy and affects about 30 percent of people living with diabetes. It can also lead to other blinding ocular complications, such as diabetic macular edema. In this disease, the macula—the part of the eye responsible for detailed vision—swells, damaging vision and leading to blindness. Risk for these complications increases with age and duration of diabetes.

To prevent diabetes-related vision loss, both Academies recommend people with diabetes get a dilated eye exam each year. Getting these exams can help prevent 95 percent of this type of vision loss. The exams are performed by ophthalmologists—physicians that specialize in medical and surgical eye care—and optometrists. For those with Medicare, because plans vary, people with diabetes should talk with their primary care doctor to determine the best process for setting up an eye exam. Those with Medicare Advantage may have different benefits from those with only Medicare Part B, which is traditional Medicare. Those with commercial insurance would need to check their specific policy.

Comprehensive eye exams include putting dilating drops into the eyes to help the pupil expand. This allows a better view of the retina—the light-sensitive tissue lining the back of the eye—and makes it easier to see early signs of diabetic retinopathy. Cameras may also be used to record any disease progression. These special cameras include a microscope to get close-up images of the retina.

These eye exams allow early detection, monitoring and, if needed, treatment of diabetic eye disease. This can prevent unnecessary vision loss, enabling people with diabetes to continue to live full and productive lives. Such exams also allow checking for conditions such as glaucoma and cataracts, for which people with diabetes are at an increased risk.

“It is essential for people with diabetes to get eye exams every year,” said Rahul N. Khurana, MD, a clinical spokesperson for the American Academy of Ophthalmology, a member of the CAEPS Board of Councilors, and a retina specialist. “Sometimes my patients are surprised to find that Medicare or other insurance covers these sight-saving exams, which are simply one of the best steps a person can take toward preventing vision loss.”

For those with Medicare, the program covers 80 percent of the cost of eye exams for people with diabetes and the remaining 20 percent is typically paid for by the patient. If this cost is a concern, EyeCare America may be able to help. This is a public service program of the Foundation of the American Academy of Ophthalmology. It can help older Americans get a comprehensive eye exam and up to one year of care at no out-of-pocket cost. Learn more or see if you or your loved one qualifies at www.eyecareamerica.org. 


Patient Safety Message Carries

Please THANK legislators for protecting patient safety by clicking HERE to send an email using our contact system.

Thanks to the strong advocacy efforts of CAEPS, the California Medical Association, the American Academy of Ophthalmology, and other specialty societies including the California Academy of Family Physicians, bills that  would have given California Nurse Practitioners and Optometrists sweeping new privileges failed to advance from the Assembly Business and Professions Committee at its final meeting for the year on July 14th. The bills are therefore no longer eligible for consideration in 2015, but can be heard again next year.

All the above listed groups opposed the bills based on patient safety concerns.

SB 323  (Hernandez) would have allowed Nurse Practitioners the ability to practice without physician supervision in some settings and to  perform procedures "recognized by the nursing profession as appropriate,"  without any specific training requirements. 

SB 622 (Hernandez), would have allowed pathways to optometric surgery, with unacceptable amounts of training:

  • Scalpel eyelid surgeries to remove, destroy, or drain lesions of the eyelid and adnexa "clinically evaluated by the optometrist to be noncancerous," with certain limits after a 25-hour course and as few as 32 cases on humans.

  • Glaucoma laser surgery (SLT and ALT) and YAG capsulotomy after a 25-hour course and as few as 24 cases (8 of each type) on humans.

  • Intraocular (and other) injections.

Please THANK legislators for protecting patient safety by clicking HERE to send an email using our contact system.

Thank you for your efforts to help us protect patient safety.

For more information, contact CAEPS at CaEyeMDs@aol.com.

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