Uveal melanoma can be very aggressive and metastasize from the eye to other organs, especially the liver. “Melanoma in general, and uveal melanoma in particular, is notoriously difficult to treat once it has metastasized and grown in a distant organ,” says principal investigator J. William Harbour, MD. “We previously identified an aggressive class 2 molecular type of uveal melanoma that, in most cases, already has metastasized by the time the eye cancer is diagnosed, even though imaging the body can’t detect it yet. This microscopic amount of cancer can remain dormant in the liver and elsewhere for several yea

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rs before it begins to grow and becomes lethal.”

Once this happens, the prospects for survival are poor, according to Dr. Harbour, the Paul A. Cibis Distinguished Professor of Ophthalmology and Visual Sciences and professor of cell biology and of molecular oncology.

Dr. Harbour’s new study shows that drugs known as histone deacetylase (HDAC) inhibitors alter the conformation of the DNA of the aggressive form of uveal melanoma, which changes the way key genes are expressed, rendering the tumor cells less aggressive.

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The Department of Health and Human Services (HHS) released a bulletin on Dec. 16 outlining proposed policies that will give states more flexibility and freedom to implement the Affordable Care Act, including how pediatric vision care would be provided as one of 10 “ essential health benefits.” According to the bulletin, HHS proposes that states should consider having pediatric vision care cover “routine eye examinations with refraction, corrective lenses and contact lenses.”

Under the intended approach announced by the HHS, states would have the flexibility to select an insurance plan that reflects the scope of services offered by a “typical employer plan” by using one of the following health insurance plans as a benchmark: one of the three largest small group plans in the state by enrollment, one of the three largest state employee health plans by enrollment, one of the three largest federal employee health plan options by enrollment, or the largest HMO plan offered in the state’s commercial market by enrollment. If states choose not to select a benchmark, HHS intends to propose that the default benchmark will be the small group plan with the largest enrollment in the state. Plans could modify coverage within a benefit category as long as they do not reduce the value of coverage.

“Not every benchmark plan includes coverage of all 10 categories of benefits identified [as essential health benefits],” according to the HHS bulletin, which added that among the most commonly non-covered categories of benefits among typical employer plans are pediatric vision services. To determine what pediatric vision services should be offered, HHS reviewed the Federal Employees Dental/Vision Insurance Program (FEDVIP). “The FEDVIP program is a standalone vision and dental program where eligible federal employees pay the full cost of their coverage,” stated the bulletin. “The FEDVIP vision plan with the highest enrollment in 2010 covers routine eye examinations with refraction, corrective lenses and contact lenses. For pediatric vision services we intend to propose the plan must supplement with the benefits covered by the FEDVIP vision plan with the largest enrollment. The rationale for a different treatment of this category is that CHiP [the Children’s Healthcare Program] does not require vision services. We also seek comment on an approach that lets plans define the pediatric vision services with required reporting as a transition policy.”

Public comments are due by Jan. 31, 2012 and can be sent to EssentialHealthBenefits@cms.hhs.gov.

Astronauts who are in space six months or longer may experience a variety of changes to their vision—some that last long after they return to Earth, according to a study in the October issue of Ophthalmology. A research team looked at seven astronauts who were about 50 years old and had spent at least six continuous months in space. All the astronauts reported blurry vision while on the space station.

These findings confirm an earlier NASA post-flight survey of about 300 astronauts. Those results showed that 50% of all astronauts who were involved in orbital missions longer than six months since 1989 complained of changes in near- and far-sightedness. A quarter of astronauts who flew less than six months also reported eye problems. Crewmembers over age 40 experienced issues more frequently, some of which remained unresolved years after the flight.

None of these observations surprised optometrist and astronaut Lawrence DeLucas, O.D., Ph.D., who saw evidence of vision changes in space two decades ago while he was aboard the space shuttle Columbia. “We did some retinoscopy up there and downlinked retinal images of different astronauts,” said Dr. DeLucas, a professor of optometry at the University of Alabama-Birmingham. “As soon as this article came out, one of my crew members e-mailed me saying we were way ahead of our time.”

Eight IAPB member organizations including WCO, have agreed to pool funding to support WHO’s work on the Action Plan. In 2012/13, $370,000 will be made available to contribute toward delivery of the 2009-13 Action Plan for the Elimination of Avoidable Blindness and Visual Impairment. An additional $340,000 is pledged in principle for 2013/14.

WCO president, Tone Garaas-Maurdalen said, “I am delighted that WCO, through funds from our partner Optometry Giving Sight, has been able to support WHO’s work on the Action Plan. This work is at the very heart of what WCO looks to achieve from our global health partnerships.”

The World Council of Optometry  is an international organization dedicated to the enhancement and development of eye and vision care worldwide. Collectively, the 150 organizations within our network represent over 300,000 optometrists, across six world regions. The World Council of Optometry is administered and hosted by the College of Optometrists in the U.K.

The International Agency for the Prevention of Blindness (IAPB) is the alliance which leads worldwide efforts in blindness prevention, with a membership of 117 organizations including virtually every major international eye health non-government organization (NGO), as well as global apex bodies for the eye health professions.

HealthDayreports, Daily aspirin use among seniors may double their risk of developing” the “wet” form of age-related macular degeneration (AMD), a significant cause of blindness in seniors, according to a study published in the January issue of the Journal Ophthalmology. In fact, daily aspirin use was associated with the onset of late-stage wet AMD, and to a lesser degree, the onset of early ‘dry’ AMD — even after the researchers took into account age and a history of heart disease, which in itself is a risk factor for AMD.

Specifically, “late-stage ‘wet’ AMD was 2.22 times more likely among daily aspirin users (95% CI 1.61 to 3.05) in a” study population of 4,691 European seniors, MedPage Today reports.

Medscape explains, “More frequent aspirin use was associated with higher grades of AMD. One third of the individuals with wet AMD consumed aspirin daily compared with only 16% of control participants.” Medscape adds, “Limitations of the study include its cross-sectional and retrospective nature, with the possibility of recall error about aspirin use and possible confounders,” such as the fact that aspirin is found in many over-the-counter drugs that study participants might not have recognized as containing it.

So is aspirin a miracle drug or a danger?

Aspirin is a two-edged sword. Its benefit may indeed be its liability in patients with macular degeneration. What this means is that while aspirin is not a prescription medicine, people should still be very aware of the potential side effects and use aspirin only if there is an indication.

If a patient does not have cardiac or blood clot problems that warrant blood thinning, a patient should think twice when popping that aspirin. My conclusion is that the saying “Take an aspirin and call me in the morning” should be replaced by the question “Is the heart risk greater than the blinding risk?”

We encourage computer users (read: everyone) to take a break for 20 sec after 20 minutes of work & look at 20 feet or further. I know, its tough to do. If you are a PC user here is a handy program to use www.workrave.org.((Windows and Linux)

If you are a mac user try http://www.dejal.com/timeout/

They are both freeware. Enjoy.

Readers Digest had an excellent list on ways to improve your vision

6. Move your computer screen to just below eye level. Your eyes will close slightly when you’re staring at the computer, minimizing fluid evaporation and the risk of dry eye syndrome, says John Sheppard, M.D., who directs the ophthalmology residency program at Eastern Virginia Medical School in Norfolk, Virginia.

Harris Corp., an international communications and information technology company, has been awarded a pair of contracts to help improve the prevention, diagnosis and treatment of eye-related injuries and diseases affecting active-duty service members and veterans.

The National Defense Authorization Act of 2008 directed the Department of Veterans Affairs (VA) and Department of Defense (DoD) “to establish a center of excellence in the prevention, diagnosis, mitigation, treatment and rehabilitation of military eye injuries.” For the past year, Harris has worked with the resulting Vision Center of Excellence and Defense Health Information Management System to design, develop and deploy a Defense and Veterans Eye Injury and Vision Registry to record the occurrence, treatment and outcomes of military eye-related injuries.

Under the first new contract, Harris will operate, maintain and enhance the registry for three years, working as a subcontractor to Pelatron, Inc. The total contract value for Harris is $2.8 million.

Under the second, five-year $14.3 million contract, Harris will populate the registry with information from medical records and other documentation for all eye injuries sustained by service members. DoD and VA medical researchers will mine this massive dataset for information on care and outcomes that will be used to improve eye-injury treatment protocols on and off the battlefield.

“As eye injury rates on the battlefield remain high, the Defense and Veterans Eye Injury and Vision Registry is a critically important new tool in the effort to improve care for our service members and veterans,” said Jim Traficant, president, Harris Healthcare, based here. “The work done by Harris to collect treatment and outcome information will allow the Vision Center of Excellence to conduct multidimensional studies to improve readiness, and enhance patient care and outcomes.”

Flaxseed oil and fish oil contain important dietary fatty acids that have multiple health benefits, including prevention or control of dry eyes. Daily supplements of flaxseed oil or fish oil, when used alone or in tandem with lubricating eye drops, appear to reduce dry eye symptoms, including burning, stinging, redness and intermittent visual disturbances. For this reason, many eye doctors now are recommending flaxseed oil and fish oil supplements for their patients who suffer from dry eyes.

The nutritional value of flaxseed oil (and fish oil) comes from its omega-3 fatty acids that are needed for optimum health. Flaxseed oil contains high levels of an omega-3 called alpha-linolenic acid (ALA). During digestion, ALA is converted into two different omega-3 fatty acids — called EPA and DHA — that are used throughout the body to protect cell membranes.

In a Consumer Reports test of fish oil supplements, most passed muster but some didn’t measure up on quality.

Lab test results on 15 top brands analyzed for amounts ofomega-3 fatty acids, disintegration, spoilage and contaminants. Researchers found that at least one sample from six brands didn’t meet all the standards set. The results were released Tuesday and are available on newsstands.

In brands that passed Consumer Reports’ tests, most contaminants were found in measurable levels, but those levels were not high enough to be a cause for concern, even though some labels stated the products were free of toxins.

“Fish oil is not a cure-all,” said Health and Family editorial director Ronni Sandroff in a news release. “If you’re considering a fish oil supplement, we recommend that you talk to your doctor first to find out if it’s the right treatment for you. In our recent tests, we found that some were not as pure as one might think.”

A pilot study in the August 30 online edition of PLoS Biology notes that  video game playing can help improve amblyopia in adults. Although there are several effective methods of amblyopia correction for pediatric patients, including occlusion therapy and atropine drops, there are no proven treatment options for adults.

In this study, researchers recruited 20 adults with amblyopia aged 15 to 61 years. The patients were randomized into one of three treatment arms: an “action” videogame group; a “non-action” videogame group; and a control group.

Patients in the action group were asked to wear an occlusion patch over their good eye and were instructed to play Medal of Honor: Pacific Assault, a fast-paced, first-person shooter.

Patients in the non-action group were asked to wear an occlusion patch over their good eye and were instructed to play SimCity Societies, a slower-paced, construction and management simulation.

Finally, patients in the control group received conventional occlusion therapy only. Patients in both gaming groups played for 40 total hours, two hours at a time, over the course of one month.

At one-month follow-up, the researchers determined that patients who spent 40 hours playing either game exhibited a 30% improvement (1.5 LogMAR lines) in visual acuity from baseline. In comparison, the researchers noted that patients often require a minimum of 120 hours of occlusion therapy alone to gain just one LogMAR line.

Additionally, patients in both gaming groups experienced average improvements of 16% in positional acuity, 37% in spatial attention and 54% in stereopsis.

“This study is the first to show that video game play is useful for improving blurred vision in adults with amblyopia,” said lead author Roger Li, O.D., Ph.D., research optometrist at the Helen Wills Neuroscience Institute and School of Optometry at University of California, Berkeley. “Very surprisingly, besides enhanced visual attention, all participants showed a remarkable improvement in amblyopic visual acuity following a short period of video game play.”

Despite these findings, Dr. Li noted that further research is required to determine the clinical safety of video game therapy. “It is very important that patients should not try self-treating amblyopia,” he said. “Patients should consult their eye doctors. Response to treatment must be closely monitored to avoid possible unwanted conditions, such as double vision, reverse amblyopia, eye strain and headache.”

Auto Refractometer: a highly accurate measurement of the size and shape of the eyes layers obtained by simply pushing a button. It also calculates the distance between the eyes called inter-pupillary distance. With dual CCD camera the measurement is a fast 0.3 seconds and averages multiple readings!

Retinal Camera: provides high-resolution color, red free, and fluorescein angiography imaging of the inner layers of the eye.

Perimetry: determination and mapping of the limits of the visual field

Since we started 3 years ago, we have had electronic medical records and have been associated with a leader in this area – Revolution Electronic Health Records (REV EHR). Ongoing upgrades to this system has now allowed us to provide you access to parts of the health record.

Currently available options are:

1. My Provider
• Shows a summary of your doctor, practice information, website, and contact information.
2. My Information
• Provides a summary of your demographic and contact information as recorded in your record
3. My Account
• Provides a summary of financial transactions with the practice including current account balances and the ability to view and print current and past invoices.
4. My Appointments
• A summary of past and future appointments.  Also allows access to clinical summary documents from past visits.
5. My Orders
• Provides a summary of product orders, their status, and delivery date.