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All Posts in Category: Eye Disease

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Diabetic News from Stockholm

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This week the American Society of Retina Specialists (ASRS) is meeting in Stockholm, Sweden, and we are following the news closely. One of the most important pieces of research presented on behalf of the DRCR (The Diabetic Retinopathy Clinical Research Network, of which Marianas Eye Institute was a member for some years), is related to treatment of diabetic eye disease in older adults. As many of you know, diabetes affects the inner layers of the eye, the retina, often causing swelling, which results in poor vision. We can use lasers and injections to decrease the swelling. The research presented by DRCR showed that vision can improve in all age groups with treatment, but as people get older, the visual improvement is less. While there is nothing we can do about growing older, this research helps us better understand what kind of vision improvement to expect with treatment of diabetic eye disease with injections as we grow older. DRCR continues to produce important research which guides us in staying on the leading edge of treatment and knowledge for you.

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School Success with an Eye Exam

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Help your kids be successful in school by making sure they can see clearly. This starts with an eye exam at Marianas Eye Institute. Nearsightedness has risen dramatically over the last 50 years. If nothing is done to help slow the increase, half the world’s population may be nearsighted by the year 2050. That means much more than a lot of people in glasses. It means a lot of kids today are at risk of developing vision-threatening eye conditions tomorrow. That’s why we at Marianas Eye Institute and the American Academy of Ophthalmology are sharing information about myopia and its progression.

People who have myopia, also known as nearsightedness, can see close-up objects clearly, but objects farther away, like the board at school, are blurry. Myopia that begins in early childhood often worsens as the child grows. If these changes are too extreme, it can be hard to correct the blurriness with glasses or contact lenses and the risk of potentially blinding eye conditions rises, including retinal detachment, glaucoma, early cataracts and myopic maculopathy, a leading cause of blindness world-wide.

Make sure your child sees their best as school starts. New treatments are available to slow down myopia progression, and new glasses can give your child their best chance of school success.

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Marijuana and Glaucoma?

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(News from the American Academy of Ophthalmology)

Glaucoma is an eye condition in which the optic nerve becomes damaged over time, first reducing peripheral vision before possibly leading to total blindness. One cause of optic nerve damage in glaucoma is higher-than-normal eye pressure (also called intraocular pressure or IOP).

Cannabis Isn’t a Practical Way To Treat Eye Conditions — Here’s Why

Glaucoma and other eye conditions cannot be treated with cannabis or other compounds derived from marijuana, such as CBD. That’s because eye pressure must be managed 24 hours a day to effectively treat glaucoma. It’s simply not practical to use marijuana constantly.

To reduce eye pressure in a noticeable way — and maintain that reduction — you would have to ingest about 18 to 20 mg of THC six to eight times a day, every day. Ingesting such a large amount of cannabis would dramatically affect your mood, mental clarity and (if smoked) lung health. You would not be able to drive, operate machinery or engage in many daily activities. Not to mention the cost of using marijuana every three to four hours, every day. Most patients could not afford this.

Marijuana Could Damage the Optic Nerve in People with Glaucoma

It’s not well understood how cannabis affects eye pressure and glaucoma. It’s possible that long-term use of cannabis could damage the eyes or worsen vision in some patients.

It’s become clear that high eye pressure is not the only cause of optic nerve damage. The optic nerve can also be damaged by low blood flow. This is a problem because marijuana not only lowers eye pressure — it lowers blood pressure throughout the body. It’s possible that marijuana could lower blood flow to the optic nerve, effectively canceling out the benefit of lowered eye pressure.

Until more research is done, the American Academy of Ophthalmology does not recommend marijuana or other cannabis products for the treatment of glaucoma. The American Glaucoma Society and the Canadian Ophthalmological Society agree.

Marijuana’s History as a Purported Glaucoma Remedy

As marijuana has been legalized for medical or recreational use in more U.S. states and Canada, it has become more visible and discussed as a possible treatment for many health conditions. Research in the 1970s and 1980s did show a measurable decrease in intraocular pressure for three or four hours after smoking cannabis or ingesting THC as a pill or injection.

But consider this: Alcohol also lowers eye pressure for an hour or so after a drink. Yet no doctor would recommend that you drink alcohol every hour to treat glaucoma. Many other effective treatments are available that don’t have the side-effects of alcohol.

There’s No Evidence That THC Benefits People with Glaucoma

Studies have been done on THC eye drops, pills and cigarettes. Eye drops led to burning, irritated eyes and were shown to not lower eye pressure. A sublingual (placed in the mouth under the tongue) THC compound found no reduction in intraocular pressure.

In another study, glaucoma patients were offered THC-containing pills and/or cigarettes. Within nine months all of them asked to stop due to side effects.

Could CBD Help With Glaucoma?

There’s been a lot of attention on CBD, a derivative of cannabis that doesn’t have mood-altering effects. But just like cannabis that’s smoked or eaten, there is no compelling research that shows CBD to be an effective treatment for glaucoma. In fact, one recent study showed that CBD may actually increase eye pressure, which could make glaucoma worse.

Scientists are exploring whether the active ingredients in marijuana may yet offer a glaucoma treatment. If the effects of cannabis compounds can be isolated, made to be long-acting, and the side effects eliminated, they may lead to new treatments in the future. However, such developments require more research and are years away from becoming a reality.

The Bottom Line About Marijuana and Glaucoma

  • The largest association of eye physicians and surgeons in the world does not endorse cannabis or its derivatives as a glaucoma treatment.
  • Do not self-medicate with marijuana in an attempt to treat glaucoma. You can lose your vision if you don’t have a reliable, effective treatment for glaucoma.
  • Speak with your ophthalmologist to find the glaucoma treatment option that’s best for you.
  • Tell your doctor if you do use marijuana regularly.

Currently, the only way to control glaucoma and prevent vision loss is to lower the pressure in your eye. Several current, effective treatments for glaucoma are more reliable and safer than marijuana.

Your ophthalmologist can treat glaucoma with medication, such as prescription eye drops, or surgery, depending on the type of glaucoma and how severe it is. If you have glaucoma, follow your ophthalmologist’s advice to get the treatment that’s right for you.

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7 Things To Know about Your Baby’s Eyes

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As children grow, their eyes change quickly. Being vigilant about eye health is important to help identify and address problems early, while children’s eyes are still developing. For 2020: Year of the Eye, the American Academy of Ophthalmology presents 20 important things to know about kids’ eyes. Let’s start off with 7 things to know about babies eyes.

1. Smoking can harm an unborn child’s eyes. Smoking during pregnancy increases the risk for premature birth. Preemies are more likely to have permanent vision loss or even blindness. Smoking while pregnant also leads to a five-fold higher risk of the baby getting bacterial meningitis. Bacterial meningitis can cause severe vision loss.

2. For preemies, measure the baby’s vision milestones from their due date — not their date of birth. Your pediatrician should check your infant’s vision at each well-baby visit to make sure it is developing as it should.

3. During a baby’s first months, their central vision is still developing. A newborn baby can see, but they are still forming connections between their retina and their brain. As central vision develops, a baby may begin to focus on objects dangled right in front of them.

4. By age 3 months, a baby’s eyes should focus and follow objects. In the first two months of life, an infant’s eyes may appear to cross or wander out to the sides. This is usually normal. As visual coordination improves, the baby’s eyes will work together to focus and follow a moving object. If you do not notice this happening consistently by age 3 months, talk with your pediatrician.

5. By age 5 months, babies are seeing in three dimensions. At this age, babies get better at reaching for objects because they can see how far an object is from them. They are developing depth perception. They may even remember what an object is if they only see part of it.

6. Around age 9 months, babies’ eyes have turned their final color. Eye color depends on the amount and distribution of a brown pigment called melanin in the iris. Light-colored eyes at birth may darken if melanin develops. It is not uncommon, however, to see slight changes in eye color during the first three years of life.

From the American Academy of Ophthalmology. Written By: Reena Mukamal; Reviewed By: Stephen N Lipsky MD

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Cataract Surgery in Saipan May Improve Brain Health

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A recent study from England has found that people who have had cataract surgery have better mental function in later life. The report joins a growing body of research that suggests that taking care of vision has benefits for older adults beyond just improving sight.

Researchers compared the rates of cognitive (thinking) decline before and after patients had cataract surgery. The researchers found the rate of cognitive decline was slowed by 50 percent following cataract surgery over 13 years of follow-up. The rate of decline among people who had cataract surgery was slower after the surgery compared with beforehand and became similar to the decline among those with no cataracts. 

“Cataract surgery is very commonly performed in the CNMI, and there are thousands of patients who have received this excellent surgery at Marianas Eye Institute,” said Russ Quinn, CEO of the Saipan eye clinic.

The researchers note that scientists still don’t know why vision problems affect cognitive decline. But they think that the isolation, embarrassment and lack of physical activity from vision problems may contribute to the problem.

“There is little doubt that cataract surgery is very likely to improve a person’s vision, which can allow people to stay active and independent,” said Thomas Steinemann, MD, professor of ophthalmology at Case Western University and an ophthalmologist at MetroHealth Medical Center in Cleveland. Dr. Steinemann wasn’t involved in the English study. “If you can’t do things for yourself because you can’t see well, it’s easy to fall into a depression and withdraw from activities. This could affect a person’s cognitive abilities.”

Marianas Eye Institute uses advanced surgical techniques for the removal of cataracts. If your vision is blurry, it may be from cataracts, which can be treated. Make an appointment today, or just walk in.

(Adapted from the American Academy of Ophthalmology)

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Too Much Screen Time?

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A recent study found that the average office worker spends 1,700 hours per year in front of a computer screen. And that doesn’t include our addiction to phones and other digital devices. All this screen time has led to an increase in complaints of eye strain, dry eye, headaches and insomnia. During Workplace Eye Wellness Month in March, Marianas Eye Institute joins the American Academy of Ophthalmology in offering tips to desk workers everywhere whose eyes may need relief from too much screen time.

Why does computer use strain the eyes more than reading print material? Mainly because people tend to blink less while using computers. Focusing the eyes on computer screens or other digital displays has been shown to reduce a person’s blink rate by a third to a half, which tends to dry out the eyes. We also tend to view digital devices at less than ideal distances or angles.

Simple Tips

You don’t need to buy expensive computer glasses to get relief. In fact, a study published last month concluded that blue light filters are no more effective at reducing the symptoms of digital eye strain than a neutral filter. Instead, try altering your environment with these simple tips:

  • Keep your distance: The eyes actually have to work harder to see close up than far away. Try keeping the monitor or screen at arm’s length, about 25 inches away. Position the screen so your eye gaze is slightly downward.
  • Reduce glare: Glass screens can produce glare that can aggravate the eye. Try using a matte screen filter.
  • Adjust lighting: If a screen is much brighter than the surrounding light, your eyes have to work harder to see. Adjust your room lighting and try increasing the contrast on your screen to reduce eye strain.
  • Give your eyes a break: Remember to blink and follow the 20-20-20 rule. Take a break every 20 minutes by looking at an object 20 feet away for 20 seconds. Looking into the distance allows your eyes to relax.
  • Keep eyes moist: Keep artificial tears at hand to help lubricate your eyes when they feel dry. Consider using a desktop humidifier. Office buildings have humidity-controlled environments that suck moisture out of the air. In winter, heaters on high can further dry your eyes.
  • Stop using devices before bed: There is evidence that blue light may affect the body’s circadian rhythm, our natural wake and sleep cycle. During the day, blue light wakes us up and stimulates us. So, too much blue light exposure late at night from your phone or other devices may make it harder to get to sleep. Limit screen time one to two hours before bedtime. Use nighttime settings on devices and computers that minimize blue light exposure.

When to visit Marianas Eye Institute

“Eyestrain can be frustrating. But it usually isn’t serious and goes away once you rest your eyes or take other steps to reduce your eye discomfort,” said Dianna L. Seldomridge, M.D., clinical spokesperson for the American Academy of Ophthalmology. “If these tips don’t work for you, you may have an underlying eye problem, such as eye muscle imbalance or uncorrected vision, which can cause or worsen computer eyestrain.”

Those experiencing consistently dry red eyes or eye pain should visit one of the specialists at Marianas Eye Institute.

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eye worm

Saipan Eye Clinic Discovers Eye Worm

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(From the Marianas Variety)

Eye Worm Discovered

Marianas Eye Institute has made a significant discovery — a new live eye worm infiltrating the eyes of three residents of Saipan.

Any new parasite infecting humans is important, and the clinic’s findings were recently published in one of the premier scientific journals, American Journal of Ophthalmology, under the title, “A New Worm Infiltrating the Human Cornea.” Fortunately, it is a very rare condition, with only three patients having been found to have the worm over the past twenty years.

“This is a fascinating series of cases,” said Dr. David Khorram, the co-founder and prior ophthalmologist at Marianas Eye Institute.  “When the first patient came into us in 1997 with a live worm in their eye, we knew we were seeing something never seen before.  We weren’t sure what to do.  We tried removing the worm which didn’t work; we tried killing the eye worm with a laser, but it didn’t die.  Finally, with the help of Dr. Stephen Gee in Hawaii, a special technique was used to successfully extract the worm.”  The doctors knew that it was an important case.  But when the eye worm was handed off to the pathologist for analysis and identification, it was lost.  “We were very disappointed, because we knew it was a new discovery. However, without the specimen, we could not identify the worm,” said Dr. Khorram.

Some years later, a second patient was found to have a similar worm — only 1.5 millimeters in size — living within the layers of the cornea, and causing redness and irritation of the eye.  “The worm was successfully removed, but it was not intact, and again, we were unable to analyze or identify it,” said Dr. Khorram.

Marianas Eye Institute is contributing to scientific knowledge that helps doctors and patients all around the world. MEI photo

The third and final case came into Marianas Eye Institute in 2008.  This time, the worm was removed intact, and successfully sent for analysis and identification.  Because of the highly specialized nature of the case  —  a new unknown worm in the eye  —  the doctors sent the eye worm to the Armed Forces Institute of Pathology in Washington, D.C., and collaborated closely with the doctors there.  “After the analysis, as well as after consultation with experts in human and veterinarian parasites, it became clear that this type of worm had never been seen in humans or animals before,” said Dr. Khorram.

The paper that the doctors published describes the details of each of the three cases, and shows that each eye worm was an isolated finding, with no other worms living in other parts of the body.  All of the patients were young and healthy.  It is not known how the worm entered the eye, but is speculated that it was likely introduced through an insect bite and grew within the body, migrating to the cornea.

The Saipan eye clinic has been preparing the paper for publication for over a year.  “It has been a wonderful collaboration with five other doctors and experts from across the United States,” said Dr. Khorram. “We are very pleased that the American Journal of Ophthalmology accepted the paper for publication,” he said.

Dr. Khorram discussed the importance of the publication.  “It is important for several reasons.  First, the patients came to us with mild redness of the eye, irritation, and inflammation.  These are very common symptoms.  And before the publication of this paper, it was not known that a microscopic eye worm could be a cause of these symptoms.  So when no other cause is identified, doctors will know to look carefully to ensure that there is not a worm causing the symptoms.”  Dr. Khorram went on to explain further, “Second, the worms were all microscopic, and very difficult to see.  We include photographs in the paper we published.  Although these are the first three reported cases in the world, now that doctors know that a tiny worm can live in the cornea, we are certain that more cases will be found.”

(Click here to read the original article and more photos in the American Journal of Ophthalmology.)

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Eye Tattoos Cause Complications

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Go ahead, express yourself.  But please don’t do it by getting an eye tattoo!  The eye is a delicate structure, you’re only got two of them, and ink injected around the structures of the eye can cause some very serious problems.  A picture is worth a thousand words, and so we reluctantly share with you this photo of a 26 year old man who decided to get an eye tattoo.  You can see the massive inflammation that occurred as a result of the tattoo, and the green discoloration of the eye.  This case was reported in the American Journal of Ophthalmology this month.  Be smart, be safe.  Don’t ink your eye.

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Diabetes in Saipan

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Did you know that diabetes is the leading cause of vision loss and blindness on Saipan (and the entire CNMI)?

Getting an eye exam is the first step to preventing vision loss, and keeping your vision for life.

Click here to make your appointment now with our convenient online form.  Delaying can make things worse.

At Marianas Eye Institute, we know that diabetes is hard to live with.  You already know that diet, exercise, and controlling your blood sugar are important.  Those will help you keep your vision.  But there is something even simpler that you can do:  get an eye exam.

You see, diabetes can damage your eyes without you even knowing about it.  We see so many people at our Saipan eye clinic, who come in after they notice vision problems.  We can help them.  But we can help you even more before things get bad.

If you have diabetes, getting an eye exam is the first step to keeping your vision.  Click here to book now.  Don’t put it off.  We’re here to help you.

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Saipan Women Face Higher Risk of Blindness Than Men

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Saipan Women Face Higher Risk of Blindness Than Men

American Academy of Ophthalmology urges women to make eye health a top priority

Studies show there is a gender gap in eye disease. Women are more likely than men to suffer from sight-threatening conditions such as age-related macular degeneration(AMD), cataracts and glaucoma. In support of Healthy Vision Month in May, Marianas Eye Institute and the American Academy of Ophthalmology remind women to make vision a top priority.

Women make up 65 percent of macular degeneration cases; 61 percent of glaucoma and cataract patients are women, and 66 percent of blind patients are women. Why the inequity? There are a few theories. On average women live longer and many eye problems are age-related. Some eye conditions, such as dry eye, are more common in women, young and old. Social and economic factors affect women’s access to eye care, especially in developing countries. Whatever the cause, there are a few unique vision problems women need to watch out for more than men. Dry eye occurs at double the rate in postmenopausal women. In general, women are more susceptible to autoimmune diseases than men, many of which affect vision, such as lupus, Sjogren’s syndrome and hyperthyroidism. Also, pregnancy can cause vision changes due to the hormones pregnant women experience.

The good news is most vision loss is preventable. Marianas Eye Institute and the Academy offers five simple steps to take control of your eye health today:

  • Get a comprehensive medical eye exam at age 40. Early signs of disease or changes in vision may begin at this age. An exam by one of Marianas Eye Institute’s specialists is an opportunity to carefully examine the eye for diseases and conditions that may have no symptoms in the early stages.
  • Know your family history. Certain eye diseases can be inherited. If you have a close relative with macular degeneration, you have a 50 percent chance of developing this condition. A family history of glaucoma increases your glaucoma risk by four to nine times. Talk to family members about their eye conditions. It can help you and your eye specialist evaluate your risk.
  • Eat healthy foods. A diet low in fat and rich in fruits, vegetables, and whole grains, benefits the entire body, including the eyes. Eye-healthy food choices include citrus fruits, vegetable oils, nuts, whole grains, dark green leafy vegetables and cold water fish.
  • Stop smoking. Smoking increases the risk for eye diseases such as cataract and age-related macular degeneration. Smoking also raises the risk for cardiovascular diseases which can indirectly influence your eye health. Tobacco smoke, including second-hand smoke, also worsens dry eye.
  • Wear sunglasses. Exposure to ultraviolet UV light raises the risk of eye diseases, including cataract, fleshy growths on the eye and cancer. Always wear sunglasses with 100 percent UV protection and a hat while enjoying time outdoors.

“Eye exams aren’t only about checking a person’s visual acuity or sharpness, but also determining the overall health of their eyes,” said Rebecca J. Taylor, M.D., clinical spokesperson for the American Academy of Ophthalmology. “We encourage women as well as men to get regular eye care. By making vision a priority today, we can help protect our sight as we age.”

“We know that women in the CNMI drive most of their family’s healthcare decisions. They are often the leaders in their families,” said Russ Quinn, CEO of Marianas Eye Institute. “Yet the statistics clearly show that women are at higher risk for eye disease, and we encourage them all the CNMI’s women to make sure their own care receives priority,” he said.

Marianas Eye Institute is known as a regional leader in eye care, providing total eye care for the family, including express glasses, contact lenses, medical eye care, surgery and laser. Marianas Eye Institute is staffed by Dr. Dennis Williams, who has been listed in “America’s Top Ophthalmologists”, and Dr. Mark Robertson, a magna cum laude optometrist, along with eight other highly talented and nationally certified eye care ophthalmic technicians, opticians, and contact lens technicians. Located on Beach Road in Garapan, across 13 Fishermen Monument, Marianas Eye Institute is open Monday through Saturday and accepts new patients as well as walk-ins. Anyone interested in women’s eye health can call 235-9090.

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