The Importance of Back to School Eye Exams

Pop quiz time: What’s one of the most important things you need to do as a parent before the new school year rolls around? The answer: Schedule back to school eye exams for your whole family!

 

Back to School Eye Exams are a Must

There’s little question about it: Back to school eye exams are a critical component to your child’s health and quality of life. Why? Because your child’s vision will affect virtually every aspect of academics, athletics, and extracurricular activities.

 

Interestingly, many common eye problems first develop in young, school-aged children. If left undiagnosed and untreated, these visual problems can disrupt your child’s ability to pay attention in class. Unfortunately, in some cases, children with visual problems end up being misdiagnosed with ADD/ADHD or another type of learning disorder. Hence, it is essential to make sure that your child’s eyesight is in top condition. This ensures that all of their unique needs are met, and that they are able to participate to the best of their ability in school.

 

So, what kind of eye problems will an eye care provider look for in your child?

 

— Myopia, or nearsightedness: This makes it difficult to see things far away, like a whiteboard in the classroom.

 

— Hyperopia, or farsightedness: This makes it difficult to see things close up, like words in books or images on a smart phone.

 

— Amblyopia, or “lazy eye”: Essentially, one eye has poorer vision compared to the other eye. But this shouldn’t be confused with another common childhood eye problem called strabismus, or “crossed eye,” in which one eye deviates in a different direction compared to the other eye.

 

These and other conditions often develop anywhere between the ages of 6 to 13, and can quickly change as your child grows – much more quickly than they typically change in adults. This is why regular, comprehensive eye exams are so important for children, especially if a specific eye health condition has been detected. Prescription eyewear and other treatments – like medicated eye drops, vision therapy, and patching – will need to be adjusted in order to match the developmental progress of your child.

 

Regularity is key: The American Optometric Association recommends a comprehensive eye exam for your child at 6 months of age, 3 years of age, 5 or 6 years of age, and then once every 2 years until age 18 or once every year if your child requires any vision correction treatment.

 

In addition to looking at the inside of your child’s eye, your eye care provider will likely perform a few other tests of your child’s vision during a back to school exam, including:

 

— Visual acuity tests

 

— Binocular vision

 

— Eye tracking skills

 

— Eye-hand coordination skills

 

— Peripheral vision

 

The Benefits of an optomap Eye Exam

Everyone should have their eyes regularly examined by an eye care professional who uses optomap® technology. optomap is the only technology that can show up to 200⁰ of the retina which will facilitate early detection of eye health diseases, but it can also help protect you or your loved ones from developing a preventable eye health disease in the first place, since early warning signs can be more easily detected and rectified.

 

Getting an optomap image is fast, painless, and comfortable. Nothing touches your eye at any time, making it suitable for your whole family. During the exam, you’ll look into the device one eye at a time, like looking through a keyhole, and a comfortable flash of light will let you know the image of your retina has been taken.

 

The capture takes less than half a second, and images are immediately available for review. You’ll be able to see the whole retina – exactly what your eye care provider sees – even in a 3D animation!

Set your children up for success this school year by scheduling their annual or semi-annual back to school eye exams! To find an eye care professional near you who uses optomap technology, click here.

 

Sources:

  1. https://www.aao.org/eye-health/tips-prevention/common-childhood-diseases-conditions
  2. http://yoursightmatters.com/make-eye-exams-back-school-tradition/
  3. http://www.allaboutvision.com/eye-exam/children.htm

 

UWF Imaging Supports Early Diagnosis of Dry Age-related Macular Degeneration

Age-related macular degeneration (AMD) is one of the world’s leading causes of central vision loss in industrial nations, causing significant visual morbidity. Non-exudative AMD accounts for approximately 90% of all reported cases.

peripheral changes found in 67% of patients with AMD imaged with optomap

There is a growing body of evidence suggesting that there may be early indicators preceding the development of AMD. Over 30 years ago, while investigating reticular degeneration of the pigment epithelium (RDPE), Lewis et al, discovered a correlation between the characteristics of macular degenerative changes and RDPE. One of their recommendations supported the value of observing the peripheral retina, when assessing patients with macular degenerative abnormalities1.

 

Understanding the relevance of peripheral retinal abnormalities, to disease progression relating to AMD and other retinal conditions, continues to evidence the value of ultra-widefield (UWF) imaging in this process. In the 12-year follow-up of subjects from the Reykjavik Eye Study, Lengyel et al2 evaluated subjects using optomap® color and autofluorescence (AF) imaging.

 

The peripheral retina was phenotyped using categories defined in the International Classification of AMD which was developed to characterize the macula. The population sample was 576 subjects. Of the eyes examined, 81.1% had AMD-like changes in the macula. From this sample, 13.6% of subjects were noted to have AMD-like changes in the macula alone, 10.1% in the periphery alone, and 57.4% of subjects in both periphery and macula. UWF (up to 200°) color and autofluorescence images were obtained using the Optos laser scanning ophthalmoscope (Optos plc, Dunfermline, Scotland).  Authors concluded that the International Classification scale should be reevaluated to include these pan-retinal changes.

 

In the Optos Peripheral Retina (OPERA) study, conducted in Croatia3, Friberg et al, found a significant relationship between the presence of peripheral reticular pigmentation (PREP) and the presence of AMD.

 

In the Croatian OPERA study, 150 subjects with AMD, in one or both eyes, had both eyes imaged with UWF. Both ultra-widefield fluorescein angiography (UWF-FA) and color images were taken. AMD was defined according to the International ARM (Age-related maculopathy) Study guidelines. The control group contained 150 matched subjects without AMD, who were photographed in a similar way, but without angiography. Masked readers identified the presence or absence of PREP for all study subjects, making note of the number of quadrants of pigmentation in each eye. Other morphological parameters were noted, which included drusen, paving stone degeneration, white-without pressure, and lattice degeneration.

 

Findings demonstrated the presence of PREP in 8.1% of control eyes compared to 40.6% of eyes in subjects with AMD. UWF-FA increased the sensitivity of the assessment of PREP where it was found in 46.3% of eyes in subjects with AMD. Authors identified a strong correlation between subjects with AMD and those presenting with PREP.

 

The recent use of UWF imaging in an Age-Related Macular Degeneration Study 2 (AREDS2) sub-study OPERA4, included 484 subjects who were imaged with color and AF UWF.  It was observed that peripheral retinal changes were more prevalent (97%) in eyes that have AMD in comparison to the control group, further supports previous indications. In this study, Domalpally et al submit, “Age-related macular degeneration may be more than a “macular” condition but one that involves the entire retina.” The authors of the study encourage further investigation in to this finding and are beginning a longitudinal study using Optos UWF imaging for peripheral retinal assessment in AMD subjects.

 

For patients who are identified as predisposed to developing AMD, the integration of optomap imaging has the potential to be an invaluable clinical workflow technology to support the early detection of peripheral changes, map disease trajectories, engage patients with a visual representation of real time images of their eyes, and give them an opportunity to become more invested in their eye health, with the ultimate goal of sight preservation.

 

Sources:

  1. Hilel Lewis. MD, Bradley R. Straatsma.MD, Robert Y. Foos. MD , David O. Lightfoot. (1985) Reticular Degeneration of the Pigment Volume 92, Issue 11, November 1985, Pages 1485-1495 Ophthalmology
  2. Lengyel I, Csutak A, Florea D, Leung I, Bird AC, Jonasson F, Peto T.(2015) A Population-Based Ultra-Widefield Digital Image Grading Study for Age-Related Macular Degeneration-Like Lesions at the Peripheral Retina. Ophthalmology. 2015 Jul;122(7):1340-7. doi: 10.1016/j.ophtha.2015.03.005. Epub 2015 Apr 11.
  3. Vesna Jurisic Friberg, Biljana Andrijevic Derk , Tamara Kenezevic, Mia-Zoric-Geber, Goran Bencic, Zoran Vatavuk, Thomas R. Friberg.(2013) OPERA (Optos Peripheral Retina AMD) Study in Croatia: Reticular Pigmentation in Age-Related Macular Degeneration vs. Control Methods. University Department of Ophthalmology – Zagreb Croatia, University of Sarajevo, UPMC Eye Center Pittsburgh USA.
  4. Amitha Domalpally, MD, Traci E. Clemons, PhD, Ronald P. Danis, MD SriniVasR.Sadda, MD Catherine A. Cukras, MD, PhD Cynthia A. Toth, MD Thomas R. Friberg, MD Emily Y. Chew, MD (2017) Peripheral Retinal Changes Associated withAge-Related Macular Degeneration in the Age-Related Eye Disease Study 2 Age-Related Eye Disease Study 2 Report Number 12 by the Age-Related Eye Disease Study 2 Optos PEripheral RetinA (OPERA) Study Research Group

 

optomap 200° Imaging of the Retina May Show More Diabetic Changes Earlier Than Other Imaging Technologies

Building upon two previous studies regarding the use of optomap images for studying diabetic retinopathy (DR) where optomap was found to be equivalent to Early Treatment Diabetic Retinopathy Study (ETDRS)1, and where there was the presence of predominantly peripheral lesions, they were associated with an almost 5-fold risk in the progression of DR over 4 years2, a recent study from the American Academy of Ophthalmology concludes that there is a good to excellent agreement between ultra-widefield (UWF™) images and ETDRS standard photos in determining H/Ma (hemorrhage/microaneurysm) severity, with excellent correlation of H/Ma counts within ETDRS photo fields. Utilizing the full capability of UWF peripheral fields however, produced identification of 49.8% more H/Ma suggesting a more severe H/Ma in 12.7% of eyes.

Dr. Paolo Silva, Beetham Eye Institute, Boston MA

Dr. Paolo Silva, Beetham Eye Institute, Boston MA

Retinal hemorrhage and/or H/Ma are critical clinical signs of early DR; similarly, the presence and severity of H/Ma are considered reliable markers for the level and risk of progression in DR. Ma (microaneurysm) counts and level also may indicate critical progression of proliferative DR and macular edema.

 

The objective of the study was to evaluate detection of H/Ma and/or hemorrhage comparing the two aforementioned modalities. When first evaluating a similar retinal scope of the two modalities, both UWF imaging and ETDRS revealed similar numbers of H/Mas.

 

The subsequent study protocol, utilizing the full scope of UWF retinal imaging, provided 4x more visualized area in comparison to the ETDRS 7 standard fields. This expanded view revealed up to 50% more H/Ma in the 126 eyes of the 69 evaluated patients.

 

The peripheral lesions that were identified on UWF images were primarily H/Mas which have been clinically noted to indicate an increased risk for DR progression and are also associated with retinal nonperfusion.

 

Results of the study offer a tremendous indication that the 200° visualization of 50% more H/Ma potentially provides a more accurate assessment of disease activity, than does the ETDRS current gold standard.

 

“The use of a retina wide quantification of H/Mas using UWF images may provide a more accurate assessment of the overall DR severity, and a more accurate prediction of DR progression and/or DME development. If these findings persist across a broad diabetic population, these noninvasive measures of posterior and peripheral retina may further improve our ability to identify eyes at risk for retinopathy progression, aiding in monitoring and administration of timely treatment.” – Paolo S. Silva, MD

 

In summary, of the 126 eyes of 69 evaluated patients the following comparisons between ETDRS and optomap UWF imaging were observed and documented:

 

– A total of 748 of 756 fields were gradable for H/Mas on ETDRS and UWF images with overall exact agreement in 81.3% and within one step in 97.9% of fields.

 

–  A greater proportion of fields was graded a more severe H/Ma level in UWF images than in ETDRS photos. Simply comparing comparable fields between the two modalities resulted in 42.8% H/Mas in ETDRS and 48.8% in UWF.  However, an additional 21.3% H/Mas were identified in the peripheral fields of the UWF images.

 

– 49.8% more H/Mas were identified in the optomap UWF images than with ETDRS photos

 

Sources:

  1. Nonmydriatic Ultra-wide Field Retinal Imaging Compared with Dilated Standard 7-Field 35-mm Photography and Retinal Specialist Examination for Evaluation of Diabetic Retinopathy, Silva, Cavellerano, Sun, Noble, Aiello, American Journal of Ophthalmology. 2012.
  2. Peripheral Lesions Identified by Mydriatic Ultrawide Field Imaging: Distribution and Potential Impact on Diabetic Retinopathy Severity. Ophthalmology. 2013
  3. Hemorrhage and/or Microaneurysm Severity and Count in Ultrawide Field Images and Early Treatment Diabetic Retinopathy Study Photography. Silva PS1, El-Rami H2, Barham R2, Gupta A2, Fleming A3, van Hemert J3, Cavallerano JD4, Sun JK4, Aiello LP4.Ophthalmology. 2017 Jul;124(7):970-976.

What is Diabetic Retinopathy?

Diabetic retinopathy is one of the leading causes of vision loss and blindness around the globe, and affects approximately one-third of people with diabetes. Because the number of people with diabetes is expected to rise to more than 438 million worldwide by 2030, it can be assumed that the prevalence of diabetic retinopathy can be expected to rise, as well.

 

diabetic retinopathy optomap optos

In this optomap image, you can see that the leaky vessels denoting the presence of diabetic retinopathy, often seen far out on the edges, where they may go undetected using traditional retinal imaging methods.

For individuals with diabetes, certain risk factors can be reduced by focusing on key elements such as education, early detection, and early treatment.

 

What Is Diabetic Retinopathy?

Diabetes impairs the body’s ability to control blood sugar. Because sugar can promote inflammation, a person with diabetes may experience inflammatory damage to various tissues within their body, including the retina, which is located on the inside back of your eye. High blood sugar causes damage to the blood vessels in the retina, where the small blood vessels that supply blood to their retinal tissue become leaky and irritated. Over time, this can lead to complete vision loss if not treated properly.

 

Why Is Early Diagnosis of Diabetic Retinopathy So Important?

The critical challenge with diabetic retinopathy is that retinal damage often begins long before symptoms ever develop. As such, individuals with diabetes could be heading toward vision loss without even knowing.

 

In addition, it’s not always possible to reverse tissue damage and/or vision loss that occurs due to diabetic retinopathy. However, with appropriate diagnosis and treatment, eyecare professionals may be able to help prevent further deterioration. For this reason, early detection of diabetic retinopathy is critical.

 

The Role of optomap® in the Diagnosis of Diabetic Retinopathy 

Eyecare professionals can greatly enhance their ability to provide early detection of diabetic retinopathy and other eye conditions with the use of advanced ultra-widefield (UWF™) diagnostic technology like optomap®.

 

optomap is specifically designed to provide an ultra-widefield image of the retina, and it is the only technology that captures a 200 degree image of the retina in a single scan and in less than ½-second. Because optomap can image so far out in the periphery, where the damage from diabetic retinopathy often begins, it allows eyecare professionals to get a clear look at the health of the retina and determine if there are any early warning signs of diabetic retinopathy. optomap can also be used to confirm a diagnosis, allowing eyecare professionals to initiate a plan of care as soon as possible.

 

What Is the Prognosis for People with Diabetic Retinopathy?

Factors that influence an eyecare professionals clinical decision-making about the best treatment options will include considerations such as overall health status; how well the underlying diabetes is controlled; the severity, type, and duration of any symptoms; and age.

 

Prognostic research suggests great variability in outcomes for people with diabetic retinopathy. However, the majority of patients who receive the gold standard of care for diabetic retinopathy can generally expect to see some improvement in their eyesight following treatment, if not a slowing of the disease process altogether.

 

The bottom line is that people with diabetes are best served by eyecare professionals who use optomap in order to improve the chances of early detection and early treatment of any diabetes-related eye diseases. As always, it is critical to work closely your eyecare provider and primary care doctor to ensure everything is being done to manage the ancillary impacts that diabetes can have on your health.

 

To find an eyecare professional near you who uses optomap technology, visit: www.optomap.com. 

 

Source:

  1. Diabetic Retinopathy: Essentials for Fast Diagnosis, Prognosis and Choice of Treatment, Parodi, Cicinelli and Rabiolo. Department of Ophthalmology, University Vita-Salute, Ospedale San Raffaele, Milan, Italy

July is National UV Safety Month

It’s summertime – which means spending a lot more time outdoors. But while most of us will remember to wear sunscreen to protect our skin, it may be a little harder to remember that your eyes need protection, too.

UV Safety Awareness Months

Ultraviolet (UV) rays are invisible beams of light emitted by the sun. North of the equator, they’re strongest during the late spring and early summer. These rays can cause inflammation, tissue damage, and cellular injury when they comes in contact with the delicate structures within your eyes.

 

In fact, excessive sun exposure and UV-related damage can lead to a variety of eye disease, such as:

  1. Photokeratitis, which is essentially an eye sunburn
    1. Inflammation of the cornea – appearing within a few hours of exposure
    2. Can be very painful, but damage isn’t usually long-term
  2. Pterygium, or “surfer’s eye”
    1. Growth of the conjunctiva on the surface of the eye
    2. May extend over the center of the cornea and reduce vision
    3. Can be removed with surgery
  3. Cataracts
    1. Leading cause of blindness in the world
    2. Enhanced by exposure to UV rays
  4. Cancer of the eye
    1. Scientific evidence suggests links between different forms of ocular cancer and life-long sun exposure

 

For the health of your eyes and the integrity of your vision, it’s important to take eye sun safety seriously. Fortunately, there are many things you can do to protect your eyes from harmful UV radiation.

 

UV Safety Tips to Protect Your Vision & Eye Health

  1. Whenever you go outside, be sure to wear sunscreen on your face to protect the delicate skin around your eyes and reduce your risk of skin cancer. You should also consider wearing a wide-brimmed hat and sunglasses that offer broad-spectrum protection against UV radiation. If you normally wear glasses or contacts, ask your eye doctor about getting prescription sunglasses so that you can still see clearly and protect your eyes.
  2. Avoid being outside for too long in bright sunlight, and be sure to never look directly at the sun — even during an eclipse.
  3. Know your risk. If you have light-colored irises, fair skin and/or spend a lot of time outside because of your occupation or hobby (e.g., surfing, farming, landscaping, skiing, fishing), then you may be more at risk for developing vision problems.

Remember, UV rays from the sun can still reach your body even when it’s cloudy. Keep your sunglasses handy on overcast days and especially on days when you are out on the water where glare from the sun can cause even more damage.

 

If you haven’t had a comprehensive exam in the past two years, we encourage you to schedule one with an eyecare professional who uses optomap® technology. To find an eyecare professional who hass optomap in your area, visit our website today: www.optomap.com

 

Sources:

  1. https://www.aao.org/eye-health/diseases/photokeratitis-snow-blindness
  2. https://www.aao.org/eye-health/tips-prevention/sun
  3. http://www.who.int/uv/faq/uvhealtfac/en/index3.html