Focus on Eyes

What’s new and notable in vision care

BY JOANN PETASCHNICK

The science behind vision care for both the diagnosis and treatment of eye diseases has become increasingly sophisticated, making a visit to the eye doctor easier and faster than in the past. That’s good news, as computers, tablets, smartphones and other electronic devices with visual displays cause many of us to seek relief from tired eyes, digital eye strain and what’s come to be known as computer vision syndrome.  

According to a 2015 survey by The Vision Council, 65 percent of American adults reported having symptoms of digital eye strain. “We see a lot of people with eye strain. They’re on the computer 10 hours a day, most days,” says Dr. Brian McGinley, an optometrist and the owner of Optix on Downer. “People need to remember to take breaks every 20 minutes and refocus on something farther away.” He’s referring to the 20/20/20 rule, which suggests that every 20 minutes a computer user should take a break for at least 20 seconds and look at objects that are 20 feet away.

Dilation Frustration
Perhaps you’ve been putting off an eye exam because you hate taking the time for the dilated eye exam. Nobody can honestly say they enjoy those annoying eyedrops and the time you must wait for the drops to take effect — not to mention needing an escort because you will have difficulty driving after the test. Truth is, however, dilation of the eyes is the most important part of a comprehensive eye exam. By dilating the eyes, a doctor can get a much better view of the retina, optic nerve and vessels in the back of the eye.

Fortunately, technology has been developed that may allow you to have a comprehensive retinal exam without the use of dilating drops. Optomap, a retinal imaging product, gives doctors a view of the retina without the drops. The test is noninvasive and takes only seconds to complete. The image can be viewed on a computer monitor and stored for future comparisons. “This technology is not necessarily a replacement for the dilated eye exam, but it does give the doctor a good view of the back of the eye,” says Dr. Logan Kiekhafer, an optometrist with Wisconsin Vision. Both Wisconsin Vision and Optix on Downer offer the Optomap.

For those who can’t help blinking from the “puff of air” test for glaucoma, there’s an alternative to that too. “The tonometer gently touches your eye to flatten the cornea and test for intraocular pressure,” Kiekhafer says.

Advancements in Clinical Treatment
Certain eye diseases, such as macular degeneration, glaucoma and diabetic retinal disease, are commonly treated by physicians known as ophthalmologists, but your optometrist can screen for them. “We are the first line of triage for our patients. If we see something that needs further evaluation, we refer patients to a physician,” McGinley says.

Glaucoma is a group of eye conditions that damage the optic nerve, which is vital to good vision. This damage is often caused by an abnormally high pressure in your eye. New advances aim to make glaucoma treatment easier and more effective. Now there is minimally invasive or micro-invasive glaucoma surgery. These procedures involve implanting a tiny device to allow fluid to drain from the eye, reducing internal pressure.

Macular Degeneration
Macular degeneration, the leading cause of blindness in the U.S., is the result of abnormal growth and leakage of blood vessels in the retina. Many people develop this disease as they age. Macular degeneration has two forms: dry and wet. “Right now, there is only FDA-approved treatment for the wet form,” according to Dr. Nicholas H. Tosi, an ophthalmologist with Retina and Vitreous Consultants of Wisconsin Ltd. “Prior to 2006, there were not many good treatment options. Now there are three drugs — Lucentis, Avastin and Eylea— that can be injected into the eye over a period of time to stop new blood vessels from forming and block the leaking from the abnormal vessels that cause wet macular degeneration.”

The newly approved drug Eylea offers the effectiveness of the other drugs, but with less frequent injections and no monitoring requirements. This could reduce the number of office visits for patients.

Diabetic Retinal Disease
Diabetic eye disease comprises a group of eye conditions that affect people with diabetes. “There are two main ways diabetes can damage vision. These conditions include diabetic retinopathy and diabetic macular edema,” Tosi explains. “Diabetic retinopathy involves changes to retinal blood vessels that can cause them to bleed or leak fluid, distorting vision. With macular edema, there is swelling within the eye.”

Many good options exist for treatment of diabetic eye disease, Tosi says. “We can use injections with the same drugs that are used for macular degeneration. Or there are laser treatments to stabilize the disease process,” he says. The National Eye Institute reports that recent studies have shown that injections are not only effective for treating diabetic macular edema, but also effective for slowing progression of diabetic retinopathy, so the injections are increasingly used as a first-line treatment.

“Modern techniques continue to evolve and have gotten better and better,” Tosi adds.

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