Study indicates women with diabetes may have increased risk of developing primary open-angle glaucoma.

HealthDay (5/2, Gordon) reported that "women with diabetes have about a 70 percent increased risk of developing...primary open-angle glaucoma," according to a study published in the journal Ophthalmology. Louis Pasquale, M.D., of the Massachusetts Eye and Ear Infirmary and Harvard Medical School, and colleagues, examined data on "more than 76,000 women enrolled in the 20-year-long Nurses' Health Study." Joel Schuman, M.D., of the University of Pittsburgh School of Medicine, who was not involved in the study, pointed out that "diabetes could increase the risk of glaucoma" by "causing elevation in pressure within the eye," or by "increas[ing] the susceptibility of the optic nerve to damage." In addition, neovascular glaucoma, which is "known to be directly related to diabetes," is caused by "a reduction of oxygen supply to the retina, which causes the retina to send out signals for more oxygen, and for new blood vessels to form." Therefore, Dr. Schuman emphasized that the "most important thing someone with diabetes can do to protect their eyes is to get regular eye exams."

Alternatives to LASIK may yield better results

Alternatives to LASIK may also help improve vision.

The AP (4/29, Neergaard) reports that for people wary of laser-assisted in situ keratomileusis (LASIK), other eye surgery alternatives, such as wavefront-guided photorefractive keratectomy (PRK), during which "a laser reshapes the cornea's surface," may help to improve vision. Conductive keratoplasty may also be used to correct "farsightedness or astigmatism by beaming radiofrequency waves around the cornea's edge." In addition, phakic intraocular lenses (hard plastic lenses) can "be implanted through a small incision in the eye, in front of the natural lens," to correct nearsightedness, while allowing patients "to retain close-up vision, too." Other options include a refractive lens exchange, during which the "patient's own lens" is replaced "with an artificial one," and intacs, corneal rings that "are transparent crescents about the thickness of a contact lens [which are] implanted to form a ring around the cornea's edge." They work by flattening "the cornea without permanently destroying tissue." The AP notes that these operations "all have their own risks," and patients should seek a "surgeon who...is qualified to evaluate [them] for all of the options, to find the best fit."

How LASIK and PRK procedures differ. Best Syndication (4/28) explained that LASIK and PRK "are types of refractive surgery" that "use an excimer laser to vaporize tiny pieces of unwanted tissue from the cornea, the front clear part of the eye." Both procedures "can improve vision only if the cause of poor vision is incorrect light refraction," such as myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. During LASIK, "a thin flap is cut in the corneal surface, to expose the layer beneath. It is folded back out of the way, while" a laser "reshapes the corneal curvature." Afterwards, the "flap is folded back, and smoothed down gently. It will heal without any sutures." With PRK however, the surgeon "remove[s] surface tissue altogether, with a special instrument," and following laser treatment, inserts "a bandage contact lens." After PRK, the "eyes take longer to heal," and patients "feel more discomfort." Nevertheless, PRK "avoids all the possible complications that the LASIK flap can cause." Consumers considering these procedures should "choose a highly trained and well-experienced eye surgeon who is thorough in screening patients."

Early Screening for Amblyopia May Yield Better Treatment Outcomes

Early screening for amblyopia may yield better treatment outcomes, researchers say. In continuing coverage from previous editions of First Look, MedPage Today (4/14, Smith) reported that "[s]creening infants and toddlers for amblyopia" may yield "better treatment outcomes than waiting until they are in the preschool years," according to a study published in the Apr. issue of the journal Archives of Ophthalmology. Robert Arnold, M.D., of Alaska's Ophthalmic Associates, and colleagues, "undertook a retrospective analysis of data from the Alaska Blind Child Discovery program, a charitable research effort to offer vision screening to children in both urban and rural areas of Alaska." The researchers analyzed data from "a 10-year period from Feb. 1, 1996, through Feb. 28, 2006," during which "lay screeners evaluated 21,367 children, about half of them younger than 48 months," and 6.9 percent of whom "were referred for a complete eye examination and treatment." The investigators found that youngsters "screened before the age of two" through a technique called photoscreening, "and found to have amblyopia,...had significantly better visual acuity at age six (P=0.04) than children screened later."

Retinopathy may double heart failure risk in patients with Type 2 diabetes, study indicates.

In continuing coverage from a previous edition of First Look, MedWire (4/18, Wilkinson) reported that "retinopathy may double the risk for heart failure (HF) in patients with Type 2 diabetes," according to a study published in the Journal of the American College of Cardiology. Researchers from the University of Melbourne, Australia, "studied 1,021 individuals with Type 2 diabetes from the Atherosclerosis Risk in Communities study, all of whom had normal renal function and were free of clinical CHD or HF at baseline." According to the researchers, diabetic retinopathy...was identified in 125 (12.8 percent) participants between 1993 and 1995." Over the course of "nine years of follow-up, 106...participants experienced incident HF events, and those with retinopathy were far more likely to develop HF than those without retinopathy." The authors also found that "after controlling for common HF risk factors, individuals with retinopathy remained more than twice as likely as others to develop HF."

Researchers link infantile esotropia and developmental delays.

Medical News Today (4/19) reported that ”Baies with an eye-alignment disorder called infantile esotropia have delays in motor development milestones, but development 'catches up' after corrective surgery," according to a study in the Apr. issue of the Journal of AAPOS (American Association for Pediatric Ophthalmology and Strabismus). James R. Drover, Ph.D., of the Retina Foundation of Southwest Texas, Dallas, and colleagues, "assessed developmental milestones in 161 infants with infantile esotropia, or crossed eyes."
Next, "the researchers had parents complete an infant development questionnaire before and/or after corrective surgery" that "assessed fine-motor skills (sensorimotor development)," and "large-muscle skills (gross motor development)." The investigators also examined a control "group of children with normal eye alignment." Prior to surgery, the babies "with esotropia had delays in both" sensorimotor and gross motor milestones. But, after surgery, the babies "had no delays in developmental milestones." Indeed, they "had a faster rate of sensorimotor development, suggesting that correcting their binocular vision helped their development to 'catch up' to that of normal infants."

Scientists unveil "bionic eye."

Australia's The Age (4/23, Miller) reports that earlier this week, "British surgeons announced they had implanted the country's first rudimentary device in human patients using technology developed by Second Sight, a private Los Angeles-based company backed by investors and the U.S. government."

News-Medical.net (4/22) noted, "The bionic eye, which is called Argus II, works via the camera to transmit a wireless signal to an ultra-thin electronic receiver and electrode panel that are implanted in the eye and attached to the retina." In turn, the "electrodes stimulate the remaining retinal nerves, allowing a signal to be passed along the optic nerve to the brain." So far, the "trial is testing the bionic eye on people who have become blind through retinitis pigmentosa." To date, 15 patients have received "the artificial retinas as part of a three-year trial in the U.S., Mexico, and Europe."