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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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The left image shows the trabecular meshwork as it can be seen in a doctor’s office. The right image shows a portion of the same part of the eye in much greater detail using methods developed at IU. Images courtesy the Indiana University School of Optometry

(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.

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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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LASIK Should Be Banned, Says FDA Adviser

He regrets voting to approve the treatment.

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A retired U.S. Food and Drug Administration adviser says LASIK eye surgery should be removed from the market.

Morris Waxler voted to approve to treatment, but now wishes he hadn’t, CBS News reports. He has re-examined the data.

“Essentially we ignored the data on vision distortions that persisted for years,” he told CBS.

His analysis suggests that 10 percent to 30 percent of patients experience complications. He asked the FDA in 2011 to issue a voluntary recall of the treatment, but the FDA declined to do so.

The FDA recently told CBS that it “has not found any new safety concerns associated with LASIK devices.”

CBS News quoted several patients saying they’d been harmed by LASIK.

Abraham Rutner, for example, said that he had double vision and that “around the lights [was] like having starbursts.” He notes, however, that his vision is improved by approximately 90 percent.

Experts say pre-surgical screening is crucial to avoiding LASIK complications.

The key lies in “knowing who to operate on and who not to operate on and there are people who really should not have this procedure,” Dr. Jules Winokur told CBS News.

The FDA has issued an advisory on risks and how to find find the right doctor for LASIK.

Read more at CBS News

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Video: Adorable Cat Melts Hearts By Trying on Eyewear for Children

Kids see that ‘if she can wear hers, they can wear them too.’

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A rescue cat in Pennsylvania is getting attention for her role in making children feel comfortable with their eyeglasses.

Truffles happily wears brightly colored frames to set a good example for the young patients of A Child’s Eyes in Mechanicsburg, the Daily Mail reports.

“If a child is feeling a bit nervous I ask Truffles if she wants to show them her glasses,” says Danielle Crull, owner of the business. “When they see Truffles wearing them it’s a really good thing and shows that if she can wear hers, they can wear them too.”

A video of the cat trying on eyewear has been viewed millions of times.

Watch the video:

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Several Eyecare Drugs in Short Supply, FDA Says

They include staple items.

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Thirteen ophthalmic drugs or products are currently in a state of shortage, according to the U.S. Food and Drug Administration.

They include solutions, ointments, emulsions, suspensions and injections, the American Optometric Association reports. Another four ophthalmic products were recently discontinued altogether.

The FDA claims in a new report that older, lower-cost drugs face supply troubles far more often than brand-name options, AOA reports. Among the ophthalmic drugs or products in shortage are staple items such as fluorescein strips and solutionsdilation dropsglaucoma medicationsantibiotics and antivirals.

According to AOA:

Published Oct. 29 by an FDA-convened inter-agency Drug Shortages Task Force, the report, “Drug Shortages: Root Causes and Potential Solutions,” analyzed 163 drugs that went into shortage from 2013 to 2017 and found the majority were “financially unattractive drugs” for manufacturers. Of the 163 drugs, 109 (67%) had generic versions on the market and had a median time since first approval of nearly 35 years. So many years off patent, these drugs sold for a median per unit price of only $8.73, the FDA notes.

AOA Chief Public Health Officer Michael Duenas, OD, said, “A doctor of optometry, in their public health role, should monitor services and needed supplies to determine that they are useful and accessible to all individuals within their community who may need that particular service or supply. Doctors of optometry are encouraged to report deficiencies to the AOA and agencies overseeing shortages, such as FDA’s Center for Drug Evaluation and Research (CDER) Drug Shortage Program at drugshortages@fda.hhs.gov.”

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