Simple Adjustments Around the Home Can Help Those with Low Vision

July 22, 2015

The American Assoc of Ophthalmologists recommends the following.

A common condition among seniors, low vision can make everyday activities difficult, increasing reliance on loved ones and caregivers while increasing the risk of falls and depression. However, here are a few simple adjustments around the home that can lessen this dependency for those with less severe forms of low vision.

1.  Place furniture in small groupings so less distance vision is required during a conversation

2.  Set brightly colored accessories around the home to help with locating the items around them.

3.  Brighter lighting can help with reading and activities such as sewing or cooking.

4.  Embrace technology. There are a variety of technology-based tools for smartphones and tablets designed to aid people with low vision.

5.  Tape down area rugs and remove electrical cords from pathways to decrease risk of falling and injury.

6.  Keep up with eye exams.

For more info:


Consumer Reports gives clear advice on glaucoma, cataracts, and macular degeneration

May 11, 2015


The only way to cure cataracts­—a clouding of the lens of the eye that impairs vision­—is with surgery to replace the bad lens with an artificial one. Though the procedure is very safe and effective, some doctors recommend needless tests or push newer types of lenses that pose risks.

Skip unneeded presurgery tests

Cataract surgery, usually performed as an outpatient procedure, requires only a local anesthetic to numb your eye. Research shows that for most people the only pre-op requirements are that you be free of infection and have normal blood pressure and heart rate. Yet many doctors routinely order other tests, including blood counts and electrocardiograms, as would be necessary before a major procedure. That’s overkill, according to the American Academy of Ophthalmology (AAO). Those tests can come with high co-pays and lead to false alarms that may delay surgery or force you to undergo additional tests, such as a chest X-ray or ultrasound. So ask whether your doctor plans to recommend such tests and, if so, whether you can skip them.

Be wary of premium lenses

In standard cataract surgery, doctors remove the clouded lens and replace it with an artificial, monofocal lens, which provides clear images at either near or far vision. There are multifocal lenses that do both, so you don’t also have to wear glasses.

But multifocal lenses cost up to $4,000—and usually aren’t covered by insurance. More worrisome, a 2012 review found that while the lenses provided better near vision, they also produced more complaints of halos and glare. Other research shows that people with multifocal lenses are also more likely to need repeat surgery.

One time you might consider a premium intraocular lens: if you have an astigmatism, or an irregularly shaped cornea. Special lenses, called toric lenses, can correct that problem, says David Sholiton, M.D., an ophthalmologist at the Cleveland Clinic. And studies reveal that most people who get them are satisfied. But you will probably have to pay $1,000 or more out of your own pocket, because insurance rarely covers them.


More than 2.2 million Americans have glaucoma, but only half know it. That makes screening important. Treatment is key, too, because glaucoma can lead to permanent vision loss. But treatment, which often requires several different daily eyedrops, can be expensive and complicated.

Get the right tests

Glaucoma often goes undiagnosed because it causes no symptoms until vision declines, at which point treatment no longer helps. So people ages 40 to 60 should consider being examined by an ophthalmologist or optometrist every three to five years; those over 60 need an eye exam every one to two years.

Know you may need more than one test

Though many eye doctors screen for the disease with tonometry—a test that measures eye pressure—that’s not enough. Relying only on intraocular pressure when screening for glaucoma could miss up to half of all cases, research suggests, says San Francisco ophthalmol­ogist Andrew Iwach, M.D., a spokesman for the AAO. So the exam should also include an ophthalmoscopy, which involves examining your optic nerve. If you have elevated eye pressure but no other signs of glaucoma, you may not need to start treatment, which can be expensive. Instead, your doctor might screen you more often.

Go for generics

The most common treatment for glaucoma is eyedrops known as prostaglandin analogs (PGAs), which lower eye pressure. Generic versions of most of those drugs are much cheaper than the brand-name versions. And per­haps because of the lower cost, patients taking them tend to do a better job of using the drops on schedule, which is important, according to an April 2015 study in the journal Ophthalmology.

Know you may need more than one drug

Many people need several drugs to control glaucoma, which usually means adding a beta-blocker drop. In that case, ask your doctor about drugs that combine medications, minimizing the number of drops.

Use proper eyedrop technique

Tilt your head back and pull down the lower lid with your finger to form a pocket. Hold the dropper tip close to the eye without touching it, and squeeze one drop into the pocket. Close your eye for 2 to 3 minutes, tip your head down, and gently press on the inner corner of the eye. Try not to blink. If you need more than one drop in the same eye, wait at least 5 minutes between drops to let the first drop absorb.

Macular degeneration

Age-related macular degeneration, the leading cause of vision loss in the U.S. for people 50 and older, damages the macula, the small area near the center of your retina, causing vision loss in the center of your visual field. The advanced disease comes in two main forms: dry AMD, the more common variety, which is treated mainly with dietary supplements; and wet AMD, the more serious form, which requires monthly injections from an ophthalmologist with one of three drugs. There are controversies about both the supplements and the drugs.

Get the right supplement

Research funded by the National Institutes of Health has shown that a specific blend of vitamins and minerals known as AREDS—vitamins C and E, plus copper, lutein, zeaxanthin, and zinc—cuts the risk by about 25 percent that dry AMD will progress. “It’s really the only treatment,” says Neil Bress­ler, M.D., chief of the retina division at Johns Hopkins University in Baltimore.

But not all eye supplements contain the proper formulation. In January 2015 CVS was sued for incorrectly market­-ing its Advanced Eye Health supplement as comparable to the formula used in published studies. And in an analysis of 11 eye-health supplements in the March 2015 issue of Ophthalmology, only four contained the right mix: PreserVision Eye Vitamin AREDS Formula, PreserVision Eye Vitamin Lutein Formula, PreserVision AREDS2 Formula, and ICAPS AREDS.

Be wary if your doctor suggests a genetic test to determine which supplement is best for you. Remember: Those supplements have only been shown to help treat people diagnosed with AMD. Don’t bother taking any supplement with the hope that it will prevent the disease.

Consider inexpensive drugs

Each of the three drugs used to treat wet AMD—aflibercept (Eylea), bevacizumab (Avastin), and ranibizumab (Lucentis)—work equally well in slowing vision loss. But Avastin costs just $50 per month, compared with $2,000 for the others. So experts recommend Avastin as the first choice for most people with wet AMD. But some doctors resist that advice.

First, Avastin is officially approved only as a cancer drug and doesn’t come in appropriate doses for AMD. So doctors need to get the medicine from a compounding pharmacy, which combines, alters, or—in this case—repackages ingredients. That poses some risk of contamination, and there have been reports of people being harmed by bacteria that got into Avastin. So some doctors, especially those without access to a reliable compounding pharmacy, may hesitate to prescribe the drug.

Some other physicians may have a financial reason for skipping Avastin: Medicare reimburses doctors less for it. That might help your doctor’s wallet, but it can hurt yours: People without sup­plemental Medicare may pay up to $400 out of pocket for Lucentis, compared with just $10 for Avastin.

Our advice: Consider Avastin, especially if you don’t have supplemental Medicare coverage. But ask whether your doctor’s compounding pharmacy is accredited by the Pharmacy Compounding Accreditation Board, which means it must adhere to quality standards.

Micro-Pulse Laser – alternative to Anti-VEGF Injections

April 26, 2014

 IRIDEX Corporation (IRIX) announced that an educational story based on its innovative MicroPulse technology for the treatment of diabetic macular edema (DME) and age-related macular degeneration (AMD), was recently featured on the Washington, D.C. edition of “American Health Front,” a health news program focused on advances in medical techniques and technologies.


At the American Academy of Ophthalmology seminar in New Orleans, a busy booth was Iridex (Mountain View, California), which has recently been showing robust sales growth and improving profitability under the astute management of CEO Will Moore. The company, which has a sterling reputation in the ophthalmic laser space for two decades, sponsored a series of informative talks at its booth on the myriad applications for its laser products.

David Dickman, MD, of the Universal Eye Center (Rolesville, North Carolina) discussed Iridex’s 532 nm micropulse laser in a talk titled “A Comprehensive Laser for the Comprehensive Ophthalmologist: Clinical and Economical Advantages.”

MicroPulse technology is a promising, tissue-sparing laser therapy that allows the tissue to cool between laser pulses, minimizing or preventing tissue damage. Drugs injected directly into the eye have a role in treating retinal diseases, but there are serious issues in terms of costs and logistics due to the need for continuous injections for the rest of one’s life. This is just not a sustainable model in today’s value-based medicine world. MicroPulse offers powerful advantages, in terms of durability, economics and logistics for payors and patients.

For more info:



New hand-held device to catch early signs of eye disease

December 28, 2013

 MIT researchers have developed a new hand-held device that scans a patient’s entire retina in seconds to detect a host of retinal diseases including diabetic retinopathy, glaucoma and macular degeneration. The MIT group, in collaboration with the University of Erlangen and Praevium/Thorlabs, has developed a portable instrument that can be taken outside a specialist’s office.

To deal with the motion instability of a hand-held device, the instrument takes multiple 3-D images at high speeds, scanning a particular volume of the eye many times but with different scanning directions.

By using multiple 3-D images of the same part of the retina, it is possible to correct for distortions due to motion of the operator’s hand or the subject’s own eye.



According to study author James Fujimoto of MIT, the next step is to evaluate the technology in a clinical setting.

But the device is still relatively expensive, he added, and before this technology finds its way into doctors’ offices or in the field, manufacturers will have to find a way to support or lower its cost.

For more info:


DigiGlasses design survey

September 15, 2012

The DigiGlasses Project is  working on a project called DIGIGLASSES, funded by the EU. This development aims to help people with low vision in everyday life. We have started a survey to identify the needs of people with low vision, please help us by completing the survey.
The homepage with more info is:
Survey for experts:
Survey for people with low vision:

Thank you in advance!
Miklós Budai
Project coordinator

Stargazing Science Used to See Inside the Human Eye

May 14, 2012

A technique originally developed to see distant stars now allows researchers to diagnose eye diseases such as age-related macular degeneration months to years sooner than possible with other current methods.

When ophthalmologists and vision scientists try to look deep into our eyes, distortions within the cornea and lens impair light as it travels through the eyeball, frustrating their efforts. Lately, a growing group of vision scientists have turned to a solution pioneered by astronomers—adaptive optics, originally developed by the military and used by astronomers such as Scot Olivier at California’s Lawrence Livermore National Laboratory to produce clear images of faraway stars. Applied to looking into the human eye, the technique allows researchers to view minute details never before seen and to diagnose blinding disease like macular degeneration months to years before current methods allow.

Read more: Stargazing Science Used to See Inside the Human Eye – Popular Mechanics

Preserving your Vision at the People’s Pharmacy

May 14, 2011

Dr. Robert Abel, Ophthalmologist, was the guest on the People’s Pharmacy on Staurday, May 14, 2011. It was Show # 813, Preserving Your Vision.

Most of us take our vision for granted until it starts to give us trouble. Dry eyes can be a consequence of too much time in front of a screen. Are there other lifestyle factors putting us at risk for vision problems?

Cataracts, glaucoma and macular degeneration are major causes of vision loss. What can we do to prevent their development?

Guest: Robert Abel, Jr., MD, is an ophthalmologist with Delaware Ophthalmology Consultants. His books include The Eye Care Revolution and The DHA Story and most recently the novel Lethal Hindsight. His website is

He gave excellent advice on Glaucoma, Macular Degeneration, eye nutrition and Cataracts.

The podcast of this program will be available the Monday after the broadcast date. Podcasts can be downloaded for free for six weeks after the date of broadcast. After that time has passed, digital downloads are available for $2.99. CDs may be purchased at any time after broadcast for $9.99.