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Eye Doctors Can Play a Key Role in Diagnosing Gut Disease

About 3.1 million people in the U.S. have IBD, which includes Crohn’s disease and ulcerative colitis.

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Optometrists can play an important role in helping patients who have inflammatory bowel disease, the American Optometric Association reports.

Inflammatory bowel disease can cause symptoms in the eye, which ODs can detect during during comprehensive eye examinations, according to a newly released AOA Health Policy Institute brief.

“Given that comprehensive eye examinations can lead to earlier, definitive diagnosis of IBD, patient outcomes improve with earlier treatment,” AOA reports.

“The clinical manifestations of common inflammatory bowel diseases (IBDs), including Crohn’s disease and ulcerative colitis, are not restricted to the gastrointestinal tract,” according to the Health Policy Institute brief. “IBDs have impact to other organs in a significant number of patients, including the eyes in 72.1 percent of patients with IBDs.”

The brief links IBD’s inflammation to a variety of ophthalmic conditions, including:

  • Episcleritis
  • Scleritis
  • Keratoconjunctivitis sicca (dry eye)
  • Retinal edema
  • Optic neuritis (swelling of the optic nerve)
  • Extraocular muscle nerve palsies.

According to the brief, about 3.1 million people in the U.S. have IBD, which includes Crohn’s disease and ulcerative colitis.

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“Evaluation of the eye should be a routine component of care in patients with IBD just as it is with similar chronic co-morbid systemic conditions like diabetes,” according to the paper.

Since launching in 2014, INVISION has won 23 international journalism awards for its publication and website. Contact INVISION's editors at editor@invisionmag.com.

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No Clear Image of This Eye Structure Existed ⁠— Until Now

Researchers at Indiana University took the first undistorted microscopic images of a part of the eye involved in glaucoma.

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(Press Release) BLOOMINGTON, IN — Using methods originally developed by astronomers to view stars more clearly through Earth’s atmosphere, optometry researchers at Indiana University have taken the first undistorted microscopic images of a part of the eye involved in glaucoma.

The ability to clearly view this structure — known as the trabecular meshwork — could help improve treatment for glaucoma, according to a press release from the university. The work is reported in the journal of Translational Vision Science and Technology.

“Normally, clear fluid circulates inside the eye to supply nutrition and keep it ‘inflated’ to its normal shape,” said Dr. Brett King, chief of advanced ocular care services and associate clinical professor at the IU School of Optometry, who co-authored the study. “Alterations of the trabecular meshwork, which allows fluid to drain, elevates pressure in the eye, leading to glaucoma. The problem is the meshwork can only be seen poorly with the normal instruments in your doctor’s office, due to its location where the iris inserts into the wall of the eye, as well as the near-total reflection that occurs when looking through the cornea.”

The result of this low visibility is a lack of understanding about why age appears to cause the trabecular meshwork to function poorly. It also makes it difficult to study why certain glaucoma treatments that target the trabecular meshwork — such as laser therapies or invasive surgical procedures — fail while others succeed.

More effective treatments for glaucoma are needed since the number of people with the condition worldwide is expected to rise from 76 million in 2020 to over 111 million in 2040, disproportionally affecting people in Asia and Africa. In the U.S., it’s estimated that over 3 million people currently have glaucoma, costing the economy over $1.5 billion annually.

To view the trabecular meshwork, IU researchers modified an existing ophthalmic laser microscope with a programmable mirror able to deform in real time to correct for the eye’s imperfections. The technology, called “adaptive optics,” is accurate within ten-millionths of a millimeter, which is precise enough to visualize single cells or measure blood flow inside the retina.

Designed by astronomers to correct for the same atmospheric distortions that make stars appear to twinkle, adaptive optics uses a real or artificial point of light — whether an illuminated spot on the retina or a “guide star” in astronomy — to rapidly compute distortion rate and then correct for it.

According to study co-author Stephen Burns, the technology is similar to “a very expensive and very versatile funhouse mirror.” An IU faculty member who was not involved in this study, Donald Miller, was among the first imaging scientists to adapt the technology to imaging the eye’s retina in the late 1990s. Burns has been working on the subject since the early 2000s.

The new study extends the method to a part of the eye beyond the retina. In the paper, IU researchers report that the use of adaptive optics successfully imaged the trabecular meshwork in nine study participants, including two with pigment dispersion syndrome, an eye disorder that can lead to a form of glaucoma.

“Thanks to this research, the ocular drainage area of the eye can now be seen with much-improved clarity, which will improve our understanding of how this essential drainage area is being altered or damaged with age,” King said. “We’re very hopeful that this technology may help improve understanding and management of glaucoma, since many members of our team are clinicians who’ve managed patients with this disease for years.”

Additional authors on the study are Dr. Thomas J. Gast, a senior scientist at the IU School of Optometry, and Ting Luo and Dr. Kaitlyn A. Sapoznik, both Ph.D. students in vision science. The work was funded in part by the National Institutes of Health’s National Eye Institute and an Allergan Foundation Research Grant from the American Academy of Optometry.

Credit: Indiana University

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Dark Chocolate May Not Help Eyesight After All, Study Finds

The new findings conflict with earlier research.

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A new study conflicts with earlier research that suggested that flavanol-rich dark chocolate helps with vision.

In the new study, German researchers selected 22 healthy participants to consume either 20 grams of dark chocolate (400 milligrams of flavanols) or 7.5 grams of milk chocolate, the American Optometric Association reports.

They evaluated the participants’ visual function and retinal perfusion two hours later.

The researchers found “no differences in the effect of dark vs. milk chocolate on subjective visual acuity or contrast sensitivity, no change in retinal vessel density and no difference in arterial pressure as measured by OCT angiography,” according to AOA.

The findings counter those of a 2018 study that showed a small improvement in visual function following consumption of 72% cacao dark chocolate. (That study did note that the effect was probably of little clinical relevance.)

The new research consisted of a small double-blind, randomized clinical crossover trial. It was published online on Sept. 26 in JAMA Ophthalmology.

The researchers say additional trials with larger sample sizes may help rule out or in possible long-term benefits of dark chocolate.

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Optical Retailer to Add 25 Stores, Expand Into 4 New States

It’s entering the Florida, Maryland, Pennsylvania and Wyoming markets.

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DALLAS –Dallas-based optical retailer Eyemart Express announced that it plans to have 25 new locations operating by the end up 2019.

The company currently owns and operates 206 stores in 38 states, according to a press release. It’s expanding into four additional states: Florida, Maryland, Pennsylvania and Wyoming.

“The drive behind our aggressive growth strategy is to make prescription eyewear accessible and convenient for more communities,” said Michael Bender, Eyemart Express CEO. “Seeing clearly should not be a burden or an excessive expense for any family. We work hard to make all our locations an affordable one-stop shop for all eyewear needs.”

Eyemart Express carries more than 2,000 frames for prescription glasses and sunglasses, ranging from exclusive private label brands to well-known brands such as Converse, Longchamp, Calvin Klein, Ray-Ban and Nike. Stores also feature onsite labs so 90 percent of glasses can be ordered and received on the same day.

“Eyemart Express’ growth helps entire communities as well. Job creation is an important factor in determining new store locations — we examine where Eyemart Express can make the biggest contribution to local economies with career opportunities,” said Bender.

More than 300 jobs will be created for hourly wage earners as a result of the optical retailer’s expansion.

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