Embed Size (px)
Citation preview
AN iNdepeNdeNt SUppLeMeNt froM MediApLANet to tHe NAtioNAL poSt
No.1/April 2010We make our readers succeed!
There is always hope and possibility for Canadians like Betty Ann Baker.
EvEry 12 minutEs a Canadian losEs
thEir vision
VisioN cAre & eye heAlth
3sTeps
To Living wiTh Age-ReLATed
MAcuLAR degeneRATion
Vitamins Help control your AMd
diabetesWhat you need to know
Photo: istockPhotoPhoto: istockPhoto
ph
oto
: CN
IB
AN iNdepeNdeNt SUppLeMeNt by MediApLANet to tHe NAtioNAL poSt2 · ApriL 2010 AN iNdepeNdeNt SUppLeMeNt by MediApLANet to tHe NAtioNAL poSt
chAlleNges
seeing the future clearly: Vision health in canada
Canadian eye health is facing a “perfect storm.” With an aging population and the fact that all the major eye diseases are age-related, we’re on the cusp of a vision loss epidemic that’s almost unprecedented in history.
According to the most recent Statis-tics Canada vision health survey, there are 836,000 people in Canada with vision loss. This
number is expected to double over the next 25 years as our population ages.
The good news is that something can be done about it, as an estimated 75 percent of vision loss is either pre-ventable or treatable.
cost of vision lossBut before going into the solutions,
let’s take a deeper look at the prob-lem—and what it’s costing Canada both socially and economically.
Only 45 percent of children who are blind or partially sighted go on to graduate high school, according to Statistics Canada. Considering the availability of technology and aids that make information accessible to people who are blind or partially sighted, this number is completely unacceptable.
Statistics Canada also reports that just 35 percent of working-age adults are employed, and a recent study conducted by CNIB found that almost half of adults with vision loss reported gross annual incomes of $20,000 or less.
In spite of this, about 20 percent of working-age adults with blindness or partial sight have completed one or more university degrees—just five percent less than the national average.
Vision loss also has a number of direct health-related consequences. People who are blind or partially sighted have twice the risk of sus-
taining a serious fall, triple the risk of depression and quadruple the risk of incurring a hip fracture.
There’s also a huge financial cost associated with vision loss. In 2008, CNIB in collaboration with the Cana-dian Ophthalmological Society com-missioned a comprehensive study on the cost of vision loss in Canada and its impact on governments, employ-ers and all Canadians. This study found the annual price tag associated with blindness and partial sight in Canada is exceptionally large—much higher than previous estimates. At $15.8 billion (in 2007 Canadian dol-lars), the cost amounts to 1.19 percent of Canada’s GDP.
Yet still, someone in Canada begins to lose their vision every 12 minutes. Far too many of these people go on to live in social isolation, experience poverty, and face unemployment and discrimination.
The largest financial cost is associ-ated with direct expenditures in our health system, at $8.6 billion annu-ally. When placed alongside other diseases, vision loss has the highest direct health care costs of any dis-ease—more than diabetes, cancer, cardiovascular disease, mental disor-ders, respiratory diseases, arthritis or osteoporosis.
working for solutions The impacts of vision loss, both
social and financial, beg the question: What can be done?
First, Canada needs a national vision health plan. Unless we do some-thing to stem the tide of vision loss, the costs are only going to increase. In 2003, Canada made a commitment to
the World Health Organization under Vision 2020, the global initiative for the elimination of avoidable blind-ness, to develop and implement a national vision plan by 2005 and begin implementing the plan by 2007. To date, no such plan exists for Canada.
We also need to work with employ-ers to provide the necessary technol-ogy and accommodations to ensure Canadians who are blind and par-tially sighted have equal access to fulfilling careers.
There are also a number of things we can do to prevent vision loss before it starts. People who smoke are three to four times more likely than non-smokers to develop AMD (age-related macular degeneration), the leading cause of vision loss in Canada. Quitting can reduce one’s risk close to that of someone who has never smoked. A diet high in fruits and green, leafy vegetables can also reduce the risk of AMD; while avoiding overexposure to sunlight by wearing UV absorbing sunglasses or a wide-brimmed hat can reduce the risk of both AMD and cataracts.
But the most important thing we can do to prevent vision loss is to have regular eye examinations. Diseases like glaucoma have very few symp-toms, and one may lose significant amounts of vision without being aware of it. It’s therefore essential for people of all ages, but particularly those over 50, to see their eye doctor for an examination regularly.
We need to take care of our vision health in the same way we take care of other aspects of our physical health. If we don’t, we’re poised to walk directly into that perfect storm.
dr. Keith gordonVice president of research and Service Quality, CNib
“When you realize that the major causes of vision loss (besides not having spectacle correction for optical errors) are without a basic cure, you come to appreciate that research must play a major role in uncovering the insights that will save sight.”
vision ResearchMartin J. Steinbach, phd discusses new developments.
We reCommeNd
pAge 7
Laser eye surgery p. 3 1. Laser eye surgery has become so common that it’s easy to forget that it’s in its relative infancy.
Your guarantee p. 72. government health care policy is encouraging citizens to take charge of their own health.
ViSioN, 1St editioN, ApriL 2010
country Manager: Gustav [email protected] Manager: Jackie [email protected] Manager: Carrie [email protected]
responsible for this issuepublisher: darshan [email protected] 977 7100 ext 112 contributors: Stuart Foxman, Keith Gordon, Calvin W. Breslin, Neeru Gupta, Lee-Anne Cross, Glenn Campbell, martin Steinbach, mary Field
distributed within: National post, April 2010this section was created by mediaplanet and did not involve the National post or its editorial departments.
We make our readers succeed!
Mediaplanet’s business is to create new customers for our advertisers by providing readers with high-quality editorial content that motivates them to act.
That’s double what it is now! The implications for vision health are pro-found. This “graying sunami” will be associated with a potential epidemic of age-related eye disease (cataract, macular degeneration, diabetes and glaucoma). The vision health work-force, already in need of human and financial resources, will not be able to keep pace with the demand. Canadi-ans will find it difficult to access eye health and rehabilitation services in a timely fashion. Potentially avoid-able vision loss and blindness will increase dramatically.
Blindness and cancer are the two
most feared health conditions. Vision loss means loss of opportunities, independence, and dignity, and an increase in mortality. Vision loss is associated with a significant financial burden to governments as well as to the individual and their families.
The National Coalition for Vision Health (www.visionhealth.ca) believes that it is imperative that Canada have an action plan allowing for appropriate strategy changes and health care system modifications to effectively meet Canadians’ future vision needs. This would insure that all Canadians have equal access to vision health and rehabilitation ser-vices preventing erosion of our health care system and helping us maintain our relatively good health and quality of life.
The concept of a vision plan is not
new. In 2003 Canada endorsed the Global Initiative for the Elimination of Avoidable Blindness at the World Health Assembly (WHO). Imple-mentation was to begin in 2007 but Canada has not yet created a plan. In 2005 Australia adopted the National Eye Health Framework, a National Eye Health Plan for Australia. The United States and Great Britain are currently developing their own eye health plans.
A Pan-Canadian Vision Health Plan would be a comprehensive and cohe-sive plan involving Federal, Provincial and Territorial governments, health professionals, researchers, academics, non-governmental organizations and vision stakeholders. The goals would be to prevent diseases through long-term health promotion initiatives, to treat diseases through adequate
funding for eye care services for treat-able conditions and to substantially increase funding for research into causes of vision loss and blindness that at present cannot be prevented or treated.
In September of 2009 the National Coalition for Vision Health completed an “Environmental Scan of Vision Health and Vision Loss in the Prov-inces and Territories of Canada.” This report took one year to complete and was made possible by a grant from the Population Health Fund administered by the Public Health Agency of Can-ada. To learn more about vision health and vision loss in Canada please visit our website at www.visionhealth.ca.
canada needs a vision planour population is aging. we are living longer. it is estimated that by the year 2031 approx-imately 25 percent of canadi-ans will be aged 65 or older.
Calvin W. Breslin, MD
Chair, National Coalition for Vision Health
836,000 canadians
1 There are 836,000 Canadians living with significant vision
loss in Canada.
vision loss is avoidable
2 75 percent of all vision loss in Canada is avoidable.
vision loss costs
3 Vision loss costs Canadians $15.8 billion each year.
health care costs
4 In Canada, in 2007, vision loss had the highest direct health-
care costs of any disease over can-cer, cardiovascular diseases, and diabetes.
“yet still, someone in Canada begins to lose their vision every 12 minutes. far too many of these people go on to live in social isolation, experience poverty, and face unemployment and discrimina-tion.”
vISIoN heALth FACtS
4
Photo: cNiB
Many canadians live happy and healthy lives despite being visually impaired.Photo: cNiB
queStIoNNAIre
AN iNdepeNdeNt SUppLeMeNt by MediApLANet to tHe NAtioNAL poSt AN iNdepeNdeNt SUppLeMeNt by MediApLANet to tHe NAtioNAL poSt ApriL 2010 · 3
NeWs
When AMD strikes, your periph-eral vision can remain normal, but your central vision can become dis-torted or blurred.
what causes AMd?The macula, a pea-sized area in
the retina, can deteriorate with age. AMD may also be linked to infections, high blood pressure, hardening of the arteries, and diabetes, and other risk factors like obesity and smoking. Women are also more likely to develop AMD than men.
There are two types of AMD, wet and dry. The dry form makes up
about 85 percent of cases, is milder, and develops more slowly. The wet form, less common, is also more serious, can develop quickly and cause severe loss of sight.
Focus on supplementsThere’s no cure for AMD. While
people with AMD almost never go completely blind, the Canadian Ophthalmological Society (COS) says that the visual loss is rarely reversed. The best that most people can hope for is using their periph-eral vision and learning to “look around” the central blurry patch.
However, as the COS notes, it may be possible to significantly delay visual loss, for people with moder-ately advanced dry AMD, by taking a combination of vitamins C and E, beta-carotene and zinc. In the U.S., a study by the National Eye Institute found that a specific high-dose for-
mulation of antioxidants and zinc can be effective. Vitamin supple-ments with the right dosages are available without prescription; talk to your eye care professional to dis-cuss the appropriate regimen.
The possibility that vitamins can help thwart or slow vision is critical, as treatments for AMD are limited, and are usually for the advanced form. Sometimes, doctors can use thermal lasers to seal dam-aged blood vessels in cases of wet AMD. Drugs that shrink abnor-mal blood vessels are also being developed.
In the meantime, vitamins con-tinue to show promise. Last year, Harvard Medical School researchers reported on the results of a study that tracked women 40 and older who already had heart disease or at least three risk factors for AMD. The women in the study who took
supplements with a combination of vitamins B6 and B12 and folic acid had a 34 percent lower risk of any AMD, and a 41 percent lower risk of “visually significant” AMD.
An apple a dayBeyond supplements, the non-
profit AMD Alliance points to grow-ing evidence that eating fresh fruits and dark green, leafy vegetables —foods rich in vitamins C and E, sele-nium, and carotenoids—could delay or reduce the severity of AMD.
An optometrist or ophthalmolo-gist can conduct simple tests to detect AMD. They can be done rou-tinely during exams, but see an eye care professional if you notice any blurring or distortion of your central vision.
Problems like near-sightedness, far-sightedness and astigmatism (distorted vision at any distance) can be addressed through corrective lenses—or by altering that shape.
That’s what happens in laser eye surgery. The two main types—PRK (photo-refractive keratectomy) and LASIK (laser assisted in situ ker-atomileusis)—differ somewhat, but involve a computer-guided laser reshaping the cornea so you can see better.
Laser eye surgery has become so common that it’s easy to forget that it’s in its relative infancy. The pro-cedures were only introduced in the early to mid-1990s. In fact, Canada was one of the first countries where laser eye surgery was performed, even before the U.S.
The history of this breakthrough in vision correction may be short, but progress has been rapid. Just how has laser eye surgery improved lately, in safety and precision?
speed and comfortOne important addition is the Fem-
tosecond laser, which in LASIK sur-gery cuts a flap in the cornea before an Excimer laser removes tissue. Some clinics still use a metal blade to create the flap—cheaper for patients, but sometimes associated with com-plications, notes Dr. Raymond Stein, a leading Toronto laser eye surgeon. He says the Femtosecond has meant “a huge advance in quality of vision and outcomes.”
Speed and comfort have also improved, and are often related. In LASIK, a suction ring is placed on the eye to increase pressure, so the flap can be created. With the Femtosec-ond, speed has increased dramati-
cally in just the past six months, says Dr. Stein. The suction ring used to stay in place for a minute; that’s now down to 15 seconds or less.
Beyond technology, newer pro-tocols are making a difference. For PRK surgery, ice is now applied to the cornea after the laser to decrease corneal temperature, which hastens healing. A solution is also applied to decrease cellular growth and keep the cornea clear, avoiding the haze on the cornea that previously affected a small percentage of PRK patients.
customized process and tracking improve outcomes
Laser surgery has become more effective for a wider group with cus-tomized ablations notes Dr. Albert Cheskes, a Toronto eye surgeon. Using advanced mapping, surgeons can tailor the procedure for the 10 percent of patients with “higher order aberrations,” he says.
“In the past, they wouldn’t have had the same outcome,” says Dr. Cheskes. Now, the results are uni-form, and patients are reporting better night vision and fewer glares or halos (if any) than they even had with glasses or contacts.
To improve outcomes, surgeons also now use sophisticated devices that track the pupil with an infrared light during the cornea reshaping. If the eye moves just a fraction, the tracker ensures that the laser finds the precise spot to deliver a pulse. Previously, some pulses may have missed the intended spot, which meant a greater chance of requiring an enhancement.
Says Dr. Stein, “Before, five to ten percent of people needed an enhancement. Now, that’s probably around one percent.”
Advances in laser eye surgery improve outcomes
stuart FoxMan
stuart FoxMan
A big part of the eye’s ability to focus depends on the shape of the cornea.
■ Question: Can vitamins help to reduce the risk of vision loss?
■ Answer: that’s the evidence from several encouraging studies of Age-related Macular degene-ration (AMd).
Docket: BRCOX1002 Production Artist: GB ________
Project: National Post Ad Art Director: / ________
Client: Bochner Copywriter: / ________
Type Safety: / Prod. Manager: NA ________
Trim Area: 10.8" x 7" Account Manager: SH ________
Bleed: .0" Studio Manager: GB ________
Ad Number: BR-1002-N-3 Output % ___________
Colour(s) 4C: CMYK Build # E5 Date: Apr 20, 2010
WHY CHOOSE BOCHNER FOR YOUR LASER EYE SURGERY?
BECAUSE YOU ONLY HAVE ONE PAIR OF EYES.
DR. HAROLD STEIN • DR. ALBERT CHESKES • DR. RAYMOND STEIN
TORONTO40 Prince Arthur Avenue
Toronto, Ontario M5R 1A9Direct: (416) 960-2020
SCARBOROUGH2941 Lawrence Avenue East
Scarborough, Ontario M1P 2V6Direct: (416) 431-7449
UNIONVILLE147 Main Street
Unionville, Ontario L3R 2G8Direct: (905) 470-2020
bochner.com
Over 400 eye doctors from around the world have come to us for their own eye surgery. Now why would so many experts in our field do that?
Because we have the most experienced eye surgeons and the best laser technology in the world. Because we are recognized experts in ophthalmological care, and have been since 1929. Because we were pioneers in establishing laser eye surgery in North America. Because we are leading the way in treating keratoconus in Canada. And because, just like you, eye doctors only have one pair of eyes.
31844 BRCOX1002_National_Post_Ad_E5 1 4/20/10 6:58:45 PM
AMD is the leading cause of vision loss in Canada, affecting one million people—and with an aging population that number could double in the next 25 years, suggests CNIB (formerly the Canadian National Institute for the Blind).
Vitamins could fight vision loss neeru gupta, Md, phd, FRcsc
dorothy pitts Chair and professor ophthalmology & Vision Sciences director, glaucoma Unit Keenan research Centre at the Li Ka Shing Knowledge institute of St. Michael’s Hospital University of toronto
do you have glaucoma without knowing it?
■ Glaucoma is a progressive neu-rodegenerative disease that affects nerve cells responsible for vision. It is a leading cause of irreversible world blindness, affecting 67 mil-lion people. By 2020, an estimated 80 million individuals will have glaucoma, of which 11 million will be blind. The loss of sight is due to progressive damage to the optic nerve, the “cable” that the eye uses to communicate to the brain. Most glaucoma damage occurs painlessly, without warning, and over a period of years. This helps to explain why as many as one half of those with glaucoma do not know that they have the disease. The risk becomes greater with age and so the longer you live, the more likely you are to have glaucoma. Others at higher risk of developing glaucoma include those that are black, have high eye pressure, blood pressure abnormalities, or a family member with glaucoma.
Anyone can develop glaucoma. If you haven’t had your eyes exami-ned, you cannot know that you do not have the disease. Anyone over the age of 40 years should have a thorough eye examination for glau-coma at least every 2 years by an eye care specialist. Specific examina-tion of the optic nerve at the back of the eye with additional tests of eye pressure and field of vision are needed to make the diagnosis. For-tunately, there are effective treat-ments for glaucoma to preserve vi-sion. Eye medication or surgery to lower eye pressure, can help to pre-vent further optic nerve degenera-tion. As a reader, you may have glau-coma, or know someone who has glaucoma. If you have not had your eyes examined recently, take the first step. Detect glaucoma as ear-ly as possible and chances are good you will see for a lifetime.
MAnAgeYouR AMdMAnAgeAgeA
1sTep
AN iNdepeNdeNt SUppLeMeNt by MediApLANet to tHe NAtioNAL poSt4 · ApriL 2010 AN iNdepeNdeNt SUppLeMeNt by MediApLANet to tHe NAtioNAL poSt
‘One look inside my eye
and my optometrist said I had cataracts. They were treated, and what a difference. I see crystal clear now!’ Michelle, Ontario.
Vision is precious. And you can protect it. Serious eye disease often occurs without any symptoms or warnings and can only be detected in an eye examination. Your optometrist knows your eyes inside and out. Protect your vision. See your optometrist regularly for an eye health check-up.
An optometrist knows your eyes inside and out
This ad prepared by: ryan edwards ClienT: Canadian assoCiaTion of opTomeTrisTs file name: Cao TesTimonial ad april ad #: Cao-2010-01 publiCaTion: naTional posT - media planeT - Vision Care & eye healTh Trim size: 6.41 x 6.9 inChes (Three Column) Colours: CmyK
your eyes deserve an optometrist®opto.ca
When CNIB met Betty Ann Baker in 2003, she’d just been diagnosed with AMD, and her emotions were spiralling out of control. Like so many others facing vision loss for the first time, she just didn’t know what to do.
rediscovering life with vision loss
iNspirAtioN
AMD, or age-related macular degen-eration, is the leading cause of vision loss in Canada. More than one million Canadians are living with the chronic eye condition; 90,000 of them are blind or partially sighted, and without early detection and treatment, many more will experience significant vision loss.
More Canadians have AMD than have breast cancer, prostate cancer, Alzheimer’s and Parkinson’s combined. The number of people with AMD is expected to double in the next 25 years, reaching an all-time high of two million in 2035.
A shocking diagnosisWhen she was 54, Betty Ann noticed
that the vision in her right eye was blurry, no matter how much she rubbed it. A visit with her eye doctor confirmed it: Betty Ann had AMD.
She fell apart inside. “I was in a state of absolute panic,”
says Betty Ann. “After I got diagnosed, I lost three to four weeks of work.”
AMD symptoms run the gamut from blurred vision to sensitivity to light, a growing central blind spot, loss of colour perception, or the appearance of straight edges as wavy or crooked.
Without support, these symptoms can progress and wreak havoc on a person’s life, confidence and ability to be independent.
For Betty Ann, that thought was ter-rifying. A single mother and the sole breadwinner of her family, she panicked
at the idea of losing her job. After weeks of depression, Betty Ann
finally reached out for help. She saw an ad for CNIB and picked up the phone.
“I was in real trouble…real crisis,” she says.
understanding her conditionTammy, a CNIB specialist, spent an
hour on the phone with Betty Ann. The next day, she visited Betty Ann in her home—offering her a shoulder to lean on, as well as practical information to help her understand her condition and what she could expect in the future.
“I just remember feeling there was a lifeline,” says Betty Ann. “I can’t tell you what it meant to have someone from CNIB put a hand on my hand and say, ‘It’s going to be okay. You’re going to be okay.’”
Tammy also showed her simple tech-
niques for maximizing her vision, like putting her back to the light whenever possible. Betty Ann couldn’t believe it. When the light was behind her, she could suddenly read again. She attributes this simple technique to her ability to main-tain her career.
From that day on, life was different for Betty Ann. In CNIB, she found a sup-port system—a resource for services and products to help her regain control of her life, and a crew of enthusiastic friends to champion her progress.
“A new dawn comes for everyone—proper information and support breathes in new life. I encourage everyone to do whatever it takes to get that help,” she says.
hoW I mAde It
lee-anne Cross
director Service Quality, CNib
cope wiTh AMd
cope
2sTep
patient name: Betty Ann BakerAge: 60First diagnosed with wet AMd: 2003Photo: cNiB
“i can’t tell you what it meant to have someone from CNib put a hand on my hand and say, ‘it’s going to be okay. you’re going to be okay.’”Betty Ann Baker
■ Question: is there hope for those with AMd?
■ Answer: yes—it’s all about finding a support system.
doN’t mISS
All you need to know about cataracts and AMDcataract facts
■ Cataracts do not spread from one eye to the other, but they may develop in both eyes at the same time.
■ A cataract is not a film on the outside of the eye.
■ Cataracts are not caused by over-using your eyes, and using your eyes doesn’t make them worse.
■ Cataracts usually develop over many years, not over a few months.
■ Cataracts are not related to cancer.
■ Having a cataract does not lead to permanent blindness.
■ Cataracts are very common, especially in older people. Fortu-nately, they are treatable. Over 1.5
million cataract operations are performed every year in North America, and in most cases there are no complications.
general facts about AMd ■ AMD is the leading cause of
vision loss in Canada. AMD is the leading cause of vision loss in the developed world.
■ More Canadians have AMD than have breast cancer, prostate cancer, Alzheimer’s disease and Parkin-son’s combined.
■ People who smoke are three to four times as likely to develop AMD.
sourCe: CanaDian
ophthalMologiCal soCiety
anD the CniB
AN iNdepeNdeNt SUppLeMeNt by MediApLANet to tHe NAtioNAL poSt AN iNdepeNdeNt SUppLeMeNt by MediApLANet to tHe NAtioNAL poSt ApriL 2010 · 5
iNspirAtioN
independence restored
Polls have shown repeatedly that going blind is one of the disabilities Canadians fear most. It is devastating, so imagine what the relief must be like to lose your vision, but then regain it. Thanks to modern medicine, some Canadians are experiencing just that.
patient name: André LamotheAge: 70First diagnosed with wet AMd: october 2007Photo: FraNçois PiNard
diAgnose & TReAT AMddiAgnose & Agnose & A
3sTep
André Lamothe is one of them. Three years ago, Mr. Lamothe was making the most of an active retirement at his home in Quebec after a career as a woodworking teacher. He spent his days building furni-ture and enjoying his favourite outdoor activities. Life was good.
Suddenly, he began to realize that his vision was deteriorating at an alarming rate. In October 2007, he was diagnosed
with wet age-related macular degen-eration (AMD), the leading cause of blind-ness in people aged 50 and over. AMD is a degenerative eye disease that affects the macula, which provides the central vision needed to recognize faces and perform everyday tasks such as reading and driving.
Feeling trappedWithin just weeks, Mr. Lamothe’s
central vision worsened, turning his life into a nightmare. He was forced to stop most of his activities, including driving his car. It was overwhelming. “When my doctor told me I had to stop driving, I felt trapped,” he explains. “I’ve always hated having to depend on others. I’d not
Today, an estimated 125 million people around the world wear con-tacts. While contact lenses are well established, you may still have ques-tions. Are contacts right for you? What are your choices? And what are the pros and cons? Here are six things you need to know.
contacts or glasses?Contacts usually offer better vision
than glasses, don’t get in the way of activities (like sports), don’t fog, and to some people look better.
Consider though that contacts require more care, planning (for your wearing schedule), and follow-up visits to the eye doctor. Some contact lens users also complain of excess tearing, itching, burning, sensitiv-ity to light, dryness, and occasional
blurred or distorted vision —all of which can get worse with improper care or cleaning.
soft or gas permeable?Contacts generally fall into these
two groups. Soft lenses tend to be more comfortable, have extended wear and disposable options, are quicker to adjust to, and stay in place better. However, they’re less durable, must be replaced more often, and aren’t as good at correcting some vision problems.
Gas permeable lenses, meanwhile, offer the best correction for many conditions, are more durable, need to be replaced less, and are more breath-able. But they’re also less comfortable at first, and can slip off more easily.
do they make lenses for you?More people than ever can wear
contacts, with the availability of lenses for a wider variety of vision problems. For instance, there are lenses to correct presbyopia (the gradual loss of close-up vision), and
what are called scleral contact lenses for people with conditions like severe astigmatism, keratoconus, and cor-neal inflammation.
do contacts suit your lifest-yle?
As Health Canada says, anything that causes dry eyes—e.g. antihista-mines, birth control pills, alcohol and air travel—can make contact lenses uncomfortable and increase the risk of an eye infection. Environmental contaminants like dust (think of your workplace), smoke, sprays and pol-len can also irritate your eyes when you wear contacts. Lenses also usually aren’t pre-scribed if you don’t produce enough tears, or if you have a history of viral infec-tions of the cornea.
is extended wear wise?Certain contacts are designed for
continuous wear. Yet many doctors still question if that’s smart, notes
Health Canada, as overnight wear can lead to a buildup of micro-organ-isms on the lens, and could contrib-ute to eye infection and corneal complications.
do you have the right fit?Everyone’s eyes can respond dif-
ferently to contacts. Sometimes, the power, diameter, and curvature of your lens can only be tweaked just right for you after you’ve worn them for a bit. If
you’re experiencing discomfort, or your vision isn’t where it should be, talk to your eye doctor. A simple adjustment could put the solution you need within sight.
only lost my vision, I’d lost much of my independence.”
Restoring visionFortunately for Mr. Lamothe, there was
some hope. Over recent years, pharmaceu-tical research has provided a succession of treatments for AMD, the most recent of which is Lucentis, administered by injec-tions into the eye (which are not painful). It is the first AMD treatment proven to not just slow or stop the progression of the dis-ease, but actually to restore vision.
Over a number of months, Mr. Lamothe was treated with Lucentis and today his vision has returned almost to what it was before. Not long after receiving his initial treatments, he returned to woodwork-
ing and most of his day-to-day activities. Perhaps most impressive is that he’s now driving again, restoring that vital aspect of his independence.
In the past, the diagnosis of wet AMDv meant the great risk of imminent blind-ness. Now, there is hope that for many patients it can become manageable, with seemingly irreversible symptoms reversed, literally allowing those who had become blind to see again.
It is imperative that provincial drug plans reimburse new treatments and make it available. Almost 95 percent of Canadians have access to medication through provin-cial drug pans but Prince Edward Island is still studying the file and Nova Scotia is the only province to have said no.
ChANGe
“When my doctor told me i had to stop driving, i felt trapped.”André Lamothe
■ Question: does the diagnosis of AMd mean risk of imminent blindness?
■ Answer: No—there is hope for patients and it can be manageable.
Focus when buying contactscontact lenses are hardly new—Leonardo da vinci sket-ched an early idea for them 500 years ago, and contacts were successfully fitted as far back as the late 19th century.
stuart FoxMan
Photo: istockPhoto
AN iNdepeNdeNt SUppLeMeNt by MediApLANet to tHe NAtioNAL poSt6 · ApriL 2010 AN iNdepeNdeNt SUppLeMeNt by MediApLANet to tHe NAtioNAL poSt
pANel oF experts
Question 1:What steps can one take to protect their vision and keep their eyes healthy?
Question 2:What kind of support is availa-ble to people dealing with seri-ous eye diseases?
Question 3:Does vitamin supplementation play a key role in managing eye diseases?
daryan Angle, odvice president, professional relations IrIS
Keith gordonvp research & Service quality from the CNIB
eric Tourville, Md, FRcscteaching Faculty member at université Laval School of medicine
The first place to get support and advice is at your eye care professional’s office. Your eye care professional and his staff are trained to provide services that people with serious eye diseases need. Depending on the severity of your condition, they may refer you to orga-nizations such as the CNIB or other disease-specific support groups like the AMD Alliance (Age-related Macular Degeneration Alliance). These organizations can often provide sup-port to both the patient and their families or caregivers.
we are fortunate in Canada to have many options for people dealing with serious eye diseases thanks to provincial health care, social assistance and various charitable organizations. As the population ages, how-ever, the strain on these safety nets will be much greater which is why prevention is the best line of defence against eye diseases and vision loss. The place to start is through regular eye health and vision examinations with a Doc-tor of Optometry. At IRIS, we are committed to exploring and prescribing the best eye care solutions to optimize and protect the vision of our patients.
eye doctors provide vital support to peoplewith vision loss through regular eye exams; which may lead to early diagnosis of eye dis-ease and prescription of proper treatments. CNIB also offers a wide range of practical and emotional support that help people who are blind or partially sighted overcome the chal-lenges of vision loss and live life to the full-est. Whether you want to learn how to cook safely, deal with employment challenges or travel independently, CNIB specialists can help. We also have a vast library of alternative format books and a range of helpful vision loss products, designed to make everyday life easier. Facing the emotional challenges of vision loss can be difficult. CNIB’s one-on-one counselling can give you the tools to work through the many emotions associated with vision loss and move forward.
definitely for patients with advanced MD. This stage of the disease can only be estab-lished through examination of the retina by an eye specialist. Great clinical studies have shown high doses of specific antioxidant vitamins and minerals help prevent disease progression and preserve vision. However, obtaining these high doses is impossible through diet alone, which is why specialized ocular supplements such as PreserVision® Lutein have been developed. PreserVision® Lutein contains the adequate amounts of the specific antioxidant vitamins and miner-als, plus lutein, used in the studies showing vision preservation and prevention of AMD progression.It’s important to check with your eye care professional before using any supplement.
Yes, absolutely. Omega 3 Essential Fatty Acids are especially important to manage and prevent conditions like dry eye and macular degeneration. With many supplements on the market, it’s important for consumers to ask their eye care professional what prod-uct is safe and effective for them to take. For example, Omega 3 in capsule form may be an effective option for Canadians concerned about mercury levels in fresh fish sources.As part of our commitment to our customers to deliver only the highest quality products, at IRIS we have researched extensively what supplements will provide the safest and most effective results.
For people with dry AMD ocular vitamins can lower the risk of developing wet AMD. A specific high-dose formulation of vitamins was found to be effective in lowering the risk. Vitamin supplementation will not prevent the development of AMD itself. Ocular vita-mins are not the same as standard multivi-tamins. If someone has dry AMD they should speak to their eye doctor to determine if this special supplement is right for them.
in general, your eyes, like the rest of your body, will benefit from a healthy non-smok-ing lifestyle that includes getting regular exercise, eating a balanced diet containing lots of fresh fruits and vegetables and wear-ing sunglasses to limit exposure to the sun’s harmful UV rays. During leisure or work at high risk of eye trauma, wearing protective glasses is of paramount importance. Regular check-ups with an eye care professional to monitor the health of your eyes and for early detection of any eye diseases are especially important. More specifically however, your eyes have unique nutritional needs. To help ward off eye diseases such as Age-related Macular Degeneration (AMD), the leading cause of blindness in adults over age 50, your eyes need a constant supply of antioxidant vitamins and minerals. A diet that includes plenty of fresh fruits and vegetables is the best way to ensure you’re getting these important nutrients. Perhaps one of the most beneficial antioxidants for healthy eyes and in AMD prevention is the carotenoid lutein, which can be found in dark green leafy vegetables like spinach and kale. Lutein is essential for a healthy retina and can only be obtained through diet, as our bodies do not produce it on its own.
visit your optometrist regularly. Most eye diseases show no symptoms until it’s too late. For most people aged 19–65, this should be every two years. If you’re under 19, over 65, wear contact lenses or have other health issues, this should be at least once a year.
Protect your eyes from the sun: UV and Blue light radiation can increase
one’s risk of macular degen-eration, cataracts as well
as cancers and growths on the eye and eye-
lids. This is why it’s important to use a high quality pair of prescription or non-prescription sunglasses when outside—even on an
overcast day.
Protect Your Eyes from Sun DamageUltra violet radiation and high energy blue light can cause permanent eye damage and lead to severe vision impairment later in life. The damaging effects of sunlight are even more severe when reflected by water, sand, snow, or pavement. IRIS Sun Solutions block harmful UV rays, blue light, and reduce glare, so your eyes are protected and more comfortable in any light.
iris.ca
As unique as your eyes
®TM Trademarks of AIR MILES International Trading B.V. Used under license by LoyaltyOne, Inc. and IRIS The Visual Group.
Diabetes: Don’t turn a blind eyehow does it affect the eye?
■ diabetes can cause changes in nearsightedness, farsightedness and premature presbyopia (the inability to focus on close objects). It can result in cataracts, glaucoma, paralysis of the nerves that con-trol the eye muscles or pupil, and in decreased corneal sensitivity. Visual symptoms include fluctuat-ing or blurring of vision, occasional double vision, loss of visual field, and flashes and floaters within the eyes. The most serious eye problem
associated with diabetes is diabetic retinopathy.
what is retinopathy? ■ diabetic retinopathy occurs
when there is a weakening or swell-ing of the tiny blood vessels in the retina of your eye, resulting in blood leakage, the growth of new blood vessels and other changes. If it is left untreated, blindness can result.
how is it treated? ■ in the early stages, diabetic
retinopathy is monitored through eye health examinations. It may be treated with laser therapy. In other cases, surgery inside the eye may be necessary. Early detection of diabetic retinopathy is crucial, as treatment is much more likely to be successful at an early stage.
Are there risk factors for developing retinopathy?
■ Factors that increase the risk of developing retinopathy include smoking, high blood pressure,
drinking alcohol and pregnancy.
can vision loss from diabetes be prevented?
■ Yes your optometrist can diagnose potential vision threat-ening changes in your eye that maybe treated to prevent blindness. However, once damage has occurred, the effects are usually permanent. It is important to control your diabetes as much as possible to minimize your risk of developing retinopathy.
how can it be prevented? ■ Monitor and maintain control
of your diabetes. See your physi-cian and follow instructions about diet, exercise and medication. See your optometrist, for when you are first diagnose, and annually thereafter.
Question: What is diabetes?Answer: A disease that prevents your body from making or using insulin which in turn leads to increased sugar levels in your bloodstream.
glenn CaMpBell
executive director,
Canadian Association of optometrists.
eye exams are essential and early diag-nosis can lead to earlier treatments and a greater chance of limiting vision loss. This is important since eye diseases such as glau-coma have little or no symptoms. One can lose a significant amount of vision without even knowing it. Regular eye exams are keys to prevention and maintaining good eye health. Eating a diet high in leafy green vegetables and omega-3 fatty acids can help reduce the risk of developing vision loss i.e. age-related macu-lar degeneration (AMD) and control diabetes and vision loss i.e. diabetic retinopathy. Also wearing sunglasses with 99 percent UVA and UVB protection year round protects your eyes from the sun’s harm-ful rays.
AN iNdepeNdeNt SUppLeMeNt by MediApLANet to tHe NAtioNAL poSt AN iNdepeNdeNt SUppLeMeNt by MediApLANet to tHe NAtioNAL poSt ApriL 2010 · 7
Find relief from dry eyes
There wasn’t a dry eye in the house—the old saying
is hardly true. Studies show that about 20 percent of people will suffer from dry eye syndrome at some point.
While there’s no cure, the good news is that the discomfort can be managed.
Why are dry eyes such a prob-lem? In an “ask the expert” col-umn for CNIB (formerly the Cana-dian National Institute for the Blind), Dr. Desmond Fonn of the University of Waterloo’s School of Optometry notes that, “Over the course of a day, we blink nearly 12,000 times—for people with dry eye syndrome, each blink can be irritating and even downright painful.”
Symptoms of dry eye syndrome can include a gritty or burn-ing sensation, the feeling that something is in your eye, itchi-ness, blurred vision, sensitivity to light, and eyes that tire easily. It’s enough to drive someone to tears—except that’s the very prob-lem. Dry eye syndrome results from insufficient lubrication in the eye.
Age is the biggest cause
Anyone can have dry eyes sometimes, due to excessive
sun, too much time staring at the computer, or smoke.
But the symptoms are tempo-rary. Dry eye syndrome is chronic, and there are many possible causes:
■ Age, the most common cause, as tear production usually decreases as we get older.
■ Allergies. ■ Vitamin deficiencies. ■ Side effect of medications (e.g.
antihistamines, antidepressants, birth control pills).
■ Other diseases, like lupus or rheumatoid arthritis.
■ Long-term contact lens wear. ■ Living in a dusty, dry, or windy
climate—think winter in Canada.Your eye doctor can confirm dry
eye syndrome with simple tests and recommend care.
Treatments lubricate eyes
Treatments depend on your specific condition and sever-
ity, but can include artificial tears (a solution that restores the sta-bility of the eye’s natural “tearfilm”), lubricating oint-ments, and medicated eye drops.
If your contacts cause dry eyes, some lenses maintain a protective layer of water around the lens.
In more serious cases, another treatment is punctal occlusion—a procedure that keeps more tears on your eyes by blocking the ducts in your lids that drain tears away.
For dry eyes, Dr. Fonn cautions against using over-the-counter drops designed to “get the red out.” Many contain a vasocon-strictor, which constrict blood vessels to make your eyes whiter. While your eyes may feel better for a time, the dry eye syndrome remains, and your condition could actually worsen when you stop the drops.
Reduce the riskYou may not be able to change
some risk factors, like age, but you can reduce the chance of dry eyes by:
■ Staying hydrated. ■ Watching your intake of alcohol
and caffeine, which have a dehy-drating effect.
■ Using a humidifier. ■ Cleaning your contact lenses
daily and replacing them as directed.
■ Wearing close-fitting/wrap-around sunglasses, especially on windy days.
■ Positioning your computer monitor at or just below eye level to minimize eye strain.
All are simple steps that can avoid you being left high and dry.
doN’t mISS!
NeWs
When you realize that the major causes of vision loss (besides not hav-ing spectacle correction for optical errors) are without a basic cure, you come to appreciate that research must play a major role in uncovering the insights that will save sight.
Scientists in Canada and around the world are working to under-stand what causes the changes that occur with age-related macu-lar degeneration (AMD), diabetic retinopathy, glaucoma, and cataract. The research approaches involve many disciplines: anatomy, biology, genetics, engineering, psychology, just to name a few. There is excite-ment because the efforts are pro-viding glimmers of hope to people with some blinding conditions. For example, there are gene therapy tri-als ongoing involving people with a form of inherited retinal degen-eration. The basic research was first carried out on a breed of dogs, blind from a similar gene defect to that found in humans. The scientists fig-ured out a way to replace the defec-
tive gene, restoring sight in the dogs. When this technique was translated to people, the early results indicated a return of a little bit of vision. This “little bit,” when before there was NO vision, is a hopeful sign that further research will lead to a restoration of functional vision. And, since about 500 genes that contribute to inher-ited eye disease have been identified, the importance of the gene therapy
approach to treating blinding condi-tions is obvious.
In AMD, a specialized layer of cells underneath the photoreceptors (the rods and cones) dies off, leading to blindness. Stem cell therapy (replac-ing the damaged cells with those grown from progenitor cells) has been shown to recover vision in a mouse model of AMD and this is giv-ing hope that a human clinical trial
can begin soon. In glaucoma, the fibres in the optic
nerve carrying sight information from the eye to the brain are damaged and this causes the vision loss. Scien-tists are working on two approaches to prevent this loss. The first is called neuroprotection, and the work is aimed at protecting these fibres from deteriorating. Several drugs are in trials to test the effectiveness of this approach. A second potential way to recover vision following glaucoma damage is to regrow nerve fibres, an approach called neuroregeneration. While animal studies are promising, this remains an unrealized dream at present.
Having rational, innovative thera-pies for blinding eye diseases can only occur when we understand the underlying basic processes. There-fore, the research must continue.
Martin J. steinBaCh, phD,
Member Canadian ophthalmological Society
&National Coalition for Vision Health
You get to decide what service you need and from whom you wish to receive that service.
The government will make sure you have safe choices but will not prevent other choices from being available to you. How can you identify those safe choices? Regulation of health care professionals is designed to create a framework through which consum-ers can rest assured their interests are being protected. When you deal with a regulated professional you are certain that standards of performance are in place. You know that the professional
has met a level of academic and prac-tical excellence that is required. Most importantly you are assured that your health care professional is account-able. If you have problems evolving from the product or service from your health care provider you have recourse. There is a complaints resolu-tion mechanism.
We are living in a global market-place today. The Internet has made it possible for people to shop even for health care providers. People take for granted that regardless of where they purchase goods or services, there are standards in place to protect them and guarantee their investment. This is not the case. When it comes to health care that guarantee is increas-ingly important because the conse-quences of sub-standard products or service may be something you have to unnecessarily endure for the rest of
your life. In the case of vision care that could mean a compromise or even a loss of your sight.
Did you know that Licensed Opti-cians must be able to verify that the eyeglasses they provide you meet a standard of accuracy that includes about 30 items? How important is accuracy? In a 2008 Ipsos Reid poll 98 percent of consumers rated it as the most important thing. The measure-ments and calculations your Licensed Optician does when preparing your glasses or contact lenses are the basis upon which accuracy is achieved. They are not just educated guesses. The fitting of the product and follow-up consultation is your assurance that maximum visual acuity will be main-tained.
The successful wearing of a contact lens needs to be viewed as a process. The fitting itself takes several visits
because you’re dealing with the liv-ing tissue of the cornea. As you wear the contacts the corneal environment can change rather quickly and do-it-yourself diagnosis and treatment are dangerous. You need to establish and maintain a relationship with a regu-lated professional.
When you have that prescription filled you could take it on faith that wherever you get your eyeglasses or contact lenses and from whomever you get them there are standards in place and accuracy is a given. You would be wrong. When you opt for investing your time and money in see-ing a regulated professional you are making a safe choice.
The trend in government health care policy today is to encourage citizens to take charge of their own health by enabling a wider range of choi-ces in service providers.
your guarantee of a safe choice
“in glaucoma, the fibres in the optic nerve carrying sight information from the eye to the brain are damaged and this causes the vision loss.”
Martin J. steinbach, phdDiabetes: Don’t turn a blind eye
New developments in vision research
That’s astigmatism, a common condition that can be corrected with glasses, contact lenses, or laser eye surgery.
The extent to which astigmatism can be fixed surprises some, says Dr. Avi Wallerstein, a Montreal ophthal-mologist. He doesn’t characterize astigmatism as “worse” than other vision problems. Yes, astigmatism has special features, but it simply calls for another type of prescription. Many mild cases require no treatment at all.
Instead of a cornea that’s equally curved in all directions (like a sphere), people with astigmatism have a “warped” cornea, with more curve in one direction (like a football). Usu-ally, people with astigmatism are born with it (and can also be near- or far-sighted). In rarer cases, people
develop astigmatism later, often after an eye injury.
For those who are near-sighted or far-sighted only, the length of the eye is the issue; the corneal surface is still round. It’s the curved shape that makes astigmatism unique.
Signs include distorted vision, naturally, as well as headaches, exces-sive squinting, and eye strain. An eye doctor can assess the astigmatism and discuss corrective options.
solutions have pros and consOne solution is glasses, which are
ground in the opposite shape of the cornea. As the glasses’ shape coin-cides with the cornea’s abnormal curvature, any shift—and glasses do move—can make the correction less precise. The loss of some peripheral
field of vision, which can affect any-one with glasses, is also more pro-nounced with astigmatism.
Contacts are suitable too, contrary to one misconception. Hard lenses, which tend to work best, actually re-shape the uneven surface of the cornea. But they’re more difficult to tolerate. Soft lenses, to dispel another myth, are also effective for low and moderate astigmatism (and are more comfortable). Often, this requires “toric” lenses, which have a bevel. When the lens rotates, wearers can notice momentary blurriness, until the lens returns to its correct posi-tion.
Another option is laser eye surgery, which removes tissue to reshape the cornea. This procedure typically offers excellent results for astigma-
tism. “Today, the precision of laser surgery is better than ever, in terms of accuracy,” Dr. Wallerstein notes. “Less tissue than ever before needs to be removed, and can be as little as a fraction of the thickness of a human hair. This is really important to the correction of astigmatism.”
Many people with astigmatism mistakenly believe they aren’t can-didates for laser eye surgery. If any-thing, the improvement over glasses and contacts is more dramatic for them than for individuals with other vision problems. “Patients with astig-matism are the ones who are happi-est after laser eye surgery,” says Dr. Wallerstein.
clearing up the myths of astigmatism
stuart FoxMan
When you’re near-sighted, objects at a distance are blurry, and when you’re far-sighted nearby objects are blurry. But what if objects are blurry at any distance?
Mary FielD
Chief Administrative officer
opticians Association of Canada.
Ph
oto
: cN
iB
©2010 Bausch & Lomb Canada Incorporated. TM/® denote trademarks of Bausch & Lomb Incorporated or its affiliates. www.bausch.com
When it comes to Age-related Macular Degeneration (AMD)…
Preserving your vision
and maintaining your
independence are what matter most.
Ask your eye care professional if PreserVision® Lutein is right for you.
