VR Goggles

VR Goggles for Glaucoma Diagnosis

VR Goggles for Glaucoma Diagnosis

A wearable brain-based device called NGoggle that incorporates virtual reality (VR) could help improve glaucoma diagnosis and prevent vision loss. The device consists of head-mounted VR goggles that use light to stimulate targeted areas in a patient’s visual field. Its portability means it could be used in a variety of environments such as in an eye care professional’s office, community centre, or at home.

The VR goggles are integrated with wireless electroencephalography (EEG), a series of electrodes that adhere to the scalp to measure brain activity in response to signals received from the eyes. Within a few minutes, the NGoggle algorithm captures and analyses enough data to report how well each eye communicates with the brain across the patient’s field of vision. Diminished activity may indicate functional loss from glaucoma.

Dr Felipe Medeiros, a co-founder of NGoggle, Inc., and a professor of ophthalmology at Duke University School of Medicine, said the device’s VR capabilities can be greatly leveraged – people could be tested for glaucoma as they play a VR-based video game or explore a virtual art gallery for instance. 

“The possibilities are endless for making it an engaging experience, which would go a long way toward ensuring that people use it and receive the treatment they need,” he said.

In a partnership with Duke University, a study is being conducted to validate the diagnostic accuracy and reproducibility of the device. In addition to comparing NGoggle to standard automated perimetry, they will look at how well NGoggle discriminates among different stages of disease by comparing its assessments of the neural damage in glaucoma with standard imaging techniques such as optical coherence tomography. The investigators also plan to conduct longitudinal investigations to validate the ability of the device to detect disease progression. Results will inform an application to the U.S. Food and Drug Administration to market the device.

Article appeared on mivision, February 28 2019

dry eye

From Gut to Eye: New Approaches to Dry Eye Disease

From Gut to Eye: New Approaches to Dry Eye Disease

Scientists are embracing novel approaches to treating disease – the use of faecal implants and tablets to treat gut problems and serious conditions such as depression, Parkinson’s disease and multiple sclerosis, was one of the big medical stories in 2018. Now both the gut and ocular surface microbiomes are being explored by researchers chasing a cure for one of the most common and persistent eye conditions – dry eye.

Dr Judith Flanagan, Leader of Ocular Therapeutics at Brien Holden Vision Institute, says studies have demonstrated a link between the immune system and dry eye disease, prompting them to investigate whether probiotics taken orally will reestablish proper immune system function and combat the problem.

“There is substantial evidence associating the gut microbiome with systemic inflammation in disease states such as diabetes, irritable bowel syndrome and dermatitis,” she said. “It’s also been found that taking probiotics, which act to help restore a disrupted bacterial community in the gut, can have a positive effect on both systemic and localised immune system function.

(an) avenue being explored is the use of topical treatments at the ocular surface in an attempt to ‘rebalance’ the ocular microbiome

“So, working within an ecological framework, we’re investigating whether these probiotic supplements can reconstitute a healthy microbiome, either at the site of the disease or enterically, and act to reduce the severity of signs and symptoms of dry eye disease. Along these lines, another avenue being explored is the use of topical treatments at the ocular surface in an attempt to ‘rebalance’ the ocular microbiome.

“It’s possible that the microbial community on the eye’s surface plays a role in the development of meibomian gland dysfunction. A change to the balance of this commensal community may lead to eyelid inflammation, changes to the composition of the eye’s tears or to the quality of the meibomian lipids that form the upper most layer of the tear film.

Dr Flanagan said research has shown that low dose oral antibiotics are useful in treating meibomian gland dysfunction but the concentrations used are below levels needed to eliminate bacteria and the effects are instead, anti-inflammatory.

“Another benefit of low dose antimicrobials is that they inhibit bacterial lipase production, reducing the concentration in the tear film of these enzymes that can act to degrade the lipid layer of the tears.”

We’re currently recruiting participants for this trial of the topical ointment

However, with concerns that long term oral antibiotic use can diminish our bacterial communities, and that exposing bacteria to non-biocidal levels of these drugs can induce antibiotic resistance, the researchers are proposing an alternative approach.

“Rather than using antibiotics to target the lipase enzymes, we are developing a bacterial lipase inhibitor ointment derived from natural products (coconut oil) that can work to rebalance a healthy ocular microbiome and deliver increased ocular comfort and reduced dry eye disease,” said Dr Flanagan.

“We have already shown in the lab that our novel agent can inhibit production of bacterial lipase without being antimicrobial. It has also been shown by others that bacteria never develop resistance to this agent and that this lipase inhibitor does not affect the healthy bacteria that we need on the ocular surface. We hope, through a clinical trial, to provide initial evidence that this approach can reduce the signs and symptoms of dry eye disease by naturally allowing the bacterial community to find an ecological balance.

“We’re currently recruiting participants for this trial of the topical ointment (which is applied on the skin around the eye rather than in the eye) and planning for an oral probiotics study in the near future, so if there are optometrists working in the inner Sydney area who have patients that might be interested we would love to hear from them,” said Dr Flanagan.

Article appeared on mivision, 28th February 2019

Computers Digital Devices and Eye Strain

Computers Digital Devices and Eye Strain

Staring at your computer screen, smartphone or other digital devices for long periods won’t cause permanent eye damage, but your eyes may feel dry and tired. You may develop blurry vision, fatigue or eye strain. Some people also experience headaches or motion sickness when viewing 3-D, which may indicate that the viewer has a problem with focusing or depth perception.

What causes digital related eye strain?

Normally, humans blink about 15 times a minute, but studies show we blink half to a third that often while using computers and other digital screen devices, whether for work or play. Extended reading, writing or other intensive “near work” can also cause eye strain.

Eye Ergonomics Tips 

  • Sit about 25 inches, or arm’s length, from the computers screen. Position the screen so your eye gaze is slightly downward.
  • Many devices now have glass screens with considerable glare. Reduce glare by using a matte screen filter if needed.
  • Take regular breaks using the “20-20-20” rule: every 20 minutes, shift your eyes to look at an object at least 20 feet away, for at least 20 seconds.
  • Use artificial tears to refresh your eyes when they feel dry. Consider using a humidifier.
  • 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.

A note to contact lens users: Contact lenses can exacerbate eye dryness and irritation common to heavy users of computers and other digital devices often. Some tips: 

  • Give your eyes a break by wearing your glasses. 
  • Don’t sleep in your contact lenses, even if they are labeled “extended wear.”
  • Always use good cleaning practices.

If your eyes are consistently red, blurry or watery, or they become sensitive to light or painful, see an ophthalmologist. 

Article appeared on American Academy of Ophthalmology, March 1st 2016

world glaucoma week 2019

World Glaucoma Week 2019

World Glaucoma Week 2019 (10 – 16 March)

During World Glaucoma Week (10 – 16 March) Glaucoma Australia will launch a new risk awareness campaign targeting people who are at greater risk of developing glaucoma to encourage them to get their eyes tested.

Glaucoma is the leading cause of avoidable blindness worldwide, affecting over 300,000 Australians1, yet it is estimated that 50% of those living with glaucoma are undiagnosed1.

While nine out of 10 Australians say that sight is their most valued sense 2, over 8 million Australians are still not having regular eye tests3.


Who is at risk?

Although anyone may develop glaucoma, some people have a higher risk – they are people who:

  • have a family history of glaucoma
  • have high eye pressure
  • are aged over 50
  • are of African or Asian descent
  • have diabetes
  • have myopia (nearsighted)
  • have been on a prolonged course of cortisone (steroid) medication
  • experience migraines
  • have had an eye operation or eye injury
  • who have a history or high or low blood pressure

Abridged: NHMRC Guidelines, 2010


Get tested

Glaucoma Australia recommends all Australians 50 years or older visit an optometrist every 2 years for a comprehensive eye exam, and if you have a family history of glaucoma or are of Asian or African descent we recommend you get your eyes checked every 2 years from the age of 40.


Did you know?

  • Glaucoma is a progressive eye disease and is the leading cause of irreversible blindness in Australia
  • Known as the ‘silent thief of sight’ glaucoma develops slowly and often without any symptoms, leaving people undetected until the disease reaches an advanced stage. Left untreated, it can cause vision loss and may even lead to blindness.
  • While vision loss can’t be restored, early diagnosis and treatment can delay or halt the progression of the disease. That is why it’s so important to detect the problem as early as possible.
  • It is estimated that there are 300,000 Australians living with glaucoma, but over 50% are unaware they have it, thinking they have healthy eyes.
  • Glaucoma is hereditary – you are 10x more likely to have glaucoma if you have a direct family member with glaucoma.
  • First degree relatives of a person with glaucoma have an almost 1 in 4 chance if developing glaucoma in their lifetime, and that risk increases to 56% if their glaucoma is advanced. So knowing your family health is important.

How to get involved

Start a conversation

  • Encourage people at risk of developing glaucoma to get their eyes checked at least every 2 years.
  • Remind anyone with glaucoma to alert first-degree relatives of the benefits of early and regular eye checks.

More information

World Glaucoma Week 2019

laser eye surgery myths

10 Laser Eye Surgery Myths

10 Laser Eye Surgery Myths

1. It cannot correct long-sightedness

2. It cannot correct astigmatism

3. It cannot correct the need for reading glasses as you get older – Presbyopia

4. It hurts – it’s pain free!

5. If you blink or move during the procedure it can go wrong

6. It doesn’t last very long and needs redoing

7. If you get a cataract later on in life, you can’t have that done anymore

8. Contact lenses are safer than laser eye surgery

9. Night vision is harmed by laser eye surgery (it can be fixed by laser eye surgery)

10. My prescription is too high to be corrected (98 percent of all prescriptions can be corrected)

So guess what? None of these are true!

Contact FOCUS Eye Centre on 02 9663 3927 to book your consultation today with our friendly team to find out if you are suitable for SMILE, LASIK or PRK laser eye surgery.

tissue created from stem cells

Tissue created from stem cells used to improve vision successfully

Researchers have claimed a breakthrough following the successful use of stem cells to repair eye tissue and improve vision among patients with limbal stem cell deficiency. As part of the project, organ donor stem cells were used to create tissue, which was then transplanted to patients as part of a randomised clinical trial.

Led by the University of Edinburgh and the Scottish National Blood Transfusion Service, researchers began by isolating stem cells from the corneas of people who donated their eyes after death. The stem cells were then grown into tissue, which was then transplanted to eight people of a 16-person group. Both groups were given eye drops and medication to suppress their immune system.

Over the course of 18 months, patients who received the stem cell implants showed signs of significant repair of the ocular surface, which was not seen among the control patients. Both groups showed improved vision, which researchers say warrants further investigation.

“The findings from this small study are very promising and show the potential for safe stem cell eye surgery as well as improvements in eye repair.”Baljean Dhillon, The University Of Edinburgh

Researchers on the project have claimed that this is a landmark study, and paves the way for further donor trials to be planned. Researchers also claimed this is also the first time that stem cells have been used this way in a randomised, clinical trial.

“The findings from this small study are very promising and show the potential for safe stem cell eye surgery as well as improvements in eye repair,” Professor Baljean Dhillon, Centre for Clinical Brain Sciences, at The University of Edinburgh, said.

The next step for researchers will be to further examine how stem cells could promote tissue repair for other ocular conditions.

The research was published in STEM CELLS Translational Medicine, and was funded by UK Stem Cell Foundation, Scottish Enterprise and the Chief Scientist Office, part of Scottish Government Health Directorates.

Article appeared on INSIGHT

20/02/2019

laser eye surgery

Am I a Candidate for Refractive or Laser Eye Surgery?

Refractive or laser eye surgery is not right for everyone. The qualifications of a good candidate for refractive or laser eye surgery generally include:

  • At least 18 years of age
  • Stable eyeglass and contact lens prescription for at least 2 to 3 years
  • Stable vision over at least the past year
  • No history or findings of active corneal disease
  • No significant medical or eye problems, such as previous corneal ulcers, keratoconus (a progressive thinning of the cornea), diabetic retinopathy, macular degeneration, or glaucoma
  • Not pregnant or nursing
  • Eyeglass prescription within certain limits set by your eye surgeon

A good candidate is also one who, despite expecting improved vision, will still be OK with the idea of having to wear glasses under certain situations, such as when driving at night.

Article appeared on WebMD

colour changing CL

Colour changing CL to aid drug delivery into eye

Chinese scientists have engineered drug-delivering contact lenses that change colour to report exactly how much medicine has been released to the eye.

The research was conducted by a team from China Pharmaceutical University and the State Key Laboratory of Bioelectronics at Southeast University. They believe their work will help eye doctors accurately treat eye diseases with drugs.

Due to improved drug residence time and bioavailability, contact lenses have emerged as a potential alternative to delivering drugs directly to the eye. However, monitoring drug release in real time has been a challenge for ophthalmologists.

The major drawbacks of eye drops have been well-documented in previous studies, including the fact that often fewer than 5% of drugs end up being absorbed via this method. Much of it also ends up in the bloodstream instead of the eye, causing side effects.

However, the six-strong Chinese research group believes it may have at least partly overcome these issues by engineering a fabricated contact lens for sustained release of the drug timolol – used to treat increased eye pressure in ocular hypertension and glaucoma.

The colour-sensitive contact lens uses molecular imprinting, a technique that creates molecular cavities in a polymer structure that match the size and shape of a specific compound, such as a medicine, according to Sci-News.

In lab experiments, the molecularly imprinted contact lenses were loaded with timolol, before the scientists exposed the lenses to a solution of artificial tears, which was used as a stand-in for the eye.

As the drug was released from the contact lenses, the architecture of the molecules near the drug changed, which also changed the colour in the iris area of the lenses. No dye was involved in the process, reducing possible side effects.

The researchers could see this shift with the naked eye and with a fibre optic spectrometer.

“The fascinating contact lens can be further used for controlling release of a large number of ophthalmic drugs and has high potential to be a new generation of functional contact lenses,” the researchers concluded.

Article appeared on INSIGHT
03/12/2018

AMD

Mediterranean Diet Prevents AMD

Evidence is mounting that a poor diet plays an important role in the development of agerelated macular degeneration (AMD). A large collaboration of researchers from the European Union investigating the connection between genes and lifestyle on the development of AMD have found that people who adhered to a Mediterranean diet cut their risk of late-stage AMD by 41 per cent. This research expands on previous studies and suggests that such a diet is beneficial for everyone, whether you already have the disease or are at risk of developing it.

A Mediterranean diet emphasises eating less meat and more fish, vegetables, fruits, legumes, unrefined grains, and olive oil. Previous research has linked it to a longer lifespan and a reduced incidence of heart disease and cognitive decline. But only a few studies have evaluated its impact on AMD. Some studies showed it could help with certain types of AMD, or only at different stages of the disease.

I believe this is a public health issue on the same scale as smoking

When this earlier research on AMD was combined with the latest data, researchers said a clear picture emerged: diet has the potential to prevent a blinding disease.

AMD is a degenerative eye disease that causes loss of central vision. Around one in seven Australians – or 1.29 million people – over the age of 50 years has some evidence of this disease.

For this latest study, researchers analysed food frequency questionnaires from nearly 5,000 people who participated in two previous investigations – the Rotterdam Study, which evaluated disease risk in people age 55 and older, and the Alienor Study, which assessed the association between eye diseases and nutritional factors in people aged 73 and older.

Patients in the Rotterdam study were examined and completed food questionnaires every five years over a 21 year period, while patients in the Alienor Study were seen every two years over four years. The researchers found that those who closely followed the diet were 41 per cent less likely to develop AMD compared with those who did not follow the diet.

They also found that none of the individual components of a Mediterranean diet on their own – fish, fruit, vegetables, etc. – lowered the risk of AMD. Rather, it was the entire pattern of eating a nutrient-rich diet that significantly reduced the risk of late AMD.

“You are what you eat,” said Dr. Emily Chew, a clinical spokesperson for the American Academy of Ophthalmology, who serves on an advisory board to the research group conducting the study. “I believe this is a public health issue on the same scale as smoking. Chronic diseases such as AMD, dementia, obesity, and diabetes, all have roots in poor dietary habits. It’s time to take quitting a poor diet as seriously as quitting smoking.”

The new research was published online in Ophthalmology, the journal of the American Academy of Ophthalmology.

Article appeared on mivision

31st October 2018

Australian tech could end need for daily eye drops

Australian tech could end need for daily eye drops

A clinical-stage Australian biotechnology company, PolyActiva, has recruited patients into its Phase I clinical trial for a new ocular implant that could improve the daily lives of millions of glaucoma patients.

PolyActiva has used its proprietary polymer prodrug technology to develop ocular implants that, when placed in the eye, provide sustained treatment over a six-month period, compared to current glaucoma treatment where patients often need to administer eye drops daily. The revolutionary technology could in the future mean millions of people with open-angle glaucoma no longer need to use daily eye drops.

The potential of removing the reliance on the patient to remember to use eye drops, and the associated difficulty in administering them from the paradigm of glaucoma treatment, is being heralded as major potential health breakthrough by ophthalmologists. Several studies have demonstrated that up to 46 percent of patients have been found not to remember to use their drops or administer them poorly1. Failure to adhere to treatment can lead to faster progression of glaucoma, one of the most common causes of blindness.

“This product is designed to make the lives of glaucoma sufferers easier by removing the need for daily drop administration and thus improving treatment management,” says PolyActiva CEO Dr Russell Tait. “The implant is designed to deliver treatment for six months after which it will disappear without further intervention. We’re excited about starting our first clinical study and look forward to seeing how our lead candidate performs.”

Glaucoma is the second leading cause of irreversible blindness globally, affecting 300,000 Australians and is expected to affect approximately 80 million people worldwide by 2020. Increased intraocular pressure (IOP) in the major risk factor for the optic nerve damage that results in blindness. Treatment is designed to reduce IOP. Eye drop therapy is the mainstay of glaucoma treatment however there are two main deficiencies associated with drop therapy – poor patient adherence resulting from the need to administer drops daily and local side-effects resulting from the topical administration of the drug to the eye. Alternative methods of delivering drugs to the eye are required to increase patient adherence to treatment.

PolyActiva’s first clinical candidate is designed to provide a constant daily therapeutic dose of latanoprost free acid for at least 26 weeks, which is the active ingredient of a commonly prescribed glaucoma eye-drop (Xalatan®).

The clinical trial will assess the safety and tolerance of the implant when administered to glaucoma patients. The implant is also designed to biodegrade within 90 days after the treatment period and is capable of being administered in an ophthalmologist’s office under a slit-lamp using a custom-designed administration device.

One of the lead investigators, renowned ophthalmologist and cataract surgeon, Dr Nathan Kerr says, “PolyActiva’s treatment approach offers significant potential benefits for patients, addressing adherence and improving treatment of this disease. The bespoke administration device is simple to use and intuitive to operate.”

The Phase I clinical trial is being conducted under the Therapeutic Goods Administration Clinical Trial Notification (CTN) scheme at the Royal Victorian Eye and Ear Hospital in Melbourne, Australia, through the Centre of Eye Research Australia (CERA). The Phase I clinical trial will see seven glaucoma patients enrolled to evaluate the safety and tolerability of its PA5108 ocular implant, with initial results expected in Q1 2019.

 

1 Laura E. Dreer, Christopher Girkin and Steven L. Mansberger. Determinants of Medication Adherence to Topical Glaucoma Therapy. J Glaucoma. 2012 Apr; 21(4): 234–240.

 

Article appeared on Glaucoma Australia