by Maureen Duffy
Although there have been a number of significant advances in the treatment of diabetic eye disease, including Avastin, Lucentis, and Eylea injections, this approach has not proven to be effective in preventing the development of diabetic eye disease and proliferative diabetic retinopathy (explained below).
Recently, however, a research group from the United States and China has discovered a new protein that, when used in combination with current treatments for diabetic eye disease, may prove to be effective in the treatment and possibly prevention of proliferative diabetic retinopathy and other retinal diseases.
From Proceedings of the National Academy of Sciences
The research, entitled Angiopoietin-like 4 is a potent angiogenic factor and a novel therapeutic target for patients with proliferative diabetic retinopathy (all explained below) has been published in the May 26, 2015 Early Edition of Proceedings of the National Academy of Sciences. Proceedings, first published in 1915, is the official journal of the National Academy of Sciences of the United States. It publishes research reports, commentaries, and reviews that span the biological, physical, and social sciences.
The authors are Savalan Babapoor-Farrokhran, Kathleen Jee, Brooks Puchner, Syed Junaid Hassan, Xiaoban Xin, Murilo Rodrigues, Fabiana Kashiwabuchi, Tao Ma, Ke Hu, Monika Deshpande, Yassine Daoud, Sharon Solomon, Adam Wenick, Gerard A. Lutty, Gregg L. Semenza, Silvia Montaner, and Akrit Sodhi, who represent the following institutions: Johns Hopkins University School of Medicine, Baltimore, MD; the University of Maryland, Baltimore; and Chongqing Medical University, China.
About Diabetic Eye Disease and Diabetic Retinopathy
Although people with diabetes are more likely to develop cataracts at a younger age and are twice as likely to develop glaucoma as people who do not have diabetes, the primary vision problem caused by diabetes is diabetic retinopathy, the leading cause of new cases of blindness and low vision in adults aged 20-65:
- "Retinopathy" is a general term that describes damage to the retina.
- The retina is a thin, light-sensitive tissue that lines the inside surface of the eye. Nerve cells in the retina convert incoming light into electrical impulses. These electrical impulses are carried by the optic nerve to the brain, which interprets them as visual images.
- Diabetic retinopathy occurs when there is damage to the small blood vessels that nourish tissue and nerve cells in the retina.
- "Proliferative" is a general term that means to grow or increase at a rapid rate by producing new tissue or cells. When the term "proliferative" is used in relation to diabetic retinopathy, it describes the growth, or proliferation, of abnormal new blood vessels in the retina. "Non-proliferative" indicates that this process is not yet occurring.
- Proliferative diabetic retinopathy affects approximately 1 in 20 individuals with the disease.
Four Stages of Diabetic Retinopathy
According to the National Eye Institute, diabetic retinopathy has four stages:
- Mild non-proliferative retinopathy: At this early stage, small areas of balloon-like swelling occur in the retina's tiny blood vessels.
- Moderate non-proliferative retinopathy: As the disease progresses, some blood vessels that nourish the retina become blocked.
- Severe non-proliferative retinopathy: Many more blood vessels become blocked, which disrupts the blood supply that nourishes the retina. The damaged retina then signals the body to produce new blood vessels.
- Proliferative retinopathy: At this advanced stage, signals sent by the retina trigger the development of new blood vessels that grow (or proliferate) in the retina and the vitreous, which is a transparent gel that fills the interior of the eye. Because these new blood vessels are abnormal, they can rupture and bleed, causing hemorrhages in the retina or vitreous. Scar tissue can develop and can tug at the retina, causing further damage or even retinal detachment.
In addition, fluid can leak into the macula, the small sensitive area in the center of the retina that provides detailed vision. This fluid can cause macular edema (or swelling), which can occur at any stage of diabetic retinopathy, although it is more likely to occur as the disease progresses.
Anti-Angiogenic Drugs and Anti-VEGF Treatments
Angiogenesis is a term used to describe the growth of new blood vessels and plays a crucial role in the normal development of body organs and tissue. Sometimes, however, excessive and abnormal blood vessel development can occur in diseases such as cancer (tumor growth) and retinal disease.
Substances that stop the growth of these excessive blood vessels are called anti-angiogenic (anti=against; angio=vessel; genic=development), and anti-neovascular (anti=against; neo=new; vascular=blood vessels).
The focus of current anti-angiogenic drug treatments for retinal disease is to reduce the level of a particular protein (vascular endothelial growth factor, or VEGF) that stimulates abnormal blood vessel growth in the retina and macula; thus, these drugs are classified as anti-VEGF treatments and are administered by injection directly into the eye after the surface has been numbed.
At present, these anti-VEGF drugs (Lucentis, Avastin, and Eylea) require monthly injections or a pro re nata [meaning "as needed"] (PRN) regimen, with monthly controls and injections for recurrent or persistent blood vessel growth and retinal bleeding.
About the Research
Excerpted from New way to prevent diabetes-associated blindness, via R&D Magazine:
Reporting on their study with lab-grown human cells, researchers … say that blocking a second blood vessel growth protein, along with one that is already well-known, could offer a new way to treat and prevent [diabetic retinopathy] a blinding eye disease caused by diabetes.
Sealing eye blood vessels with laser treatment can save central vision, but this often sacrifices peripheral and night vision, according to [contributing author] Akrit Sodhi, MD, PhD. Several recently developed drugs—Lucentis, Avastin, and Eylea—can help treat these blood vessels by blocking the action of VEGF, a so-called growth factor released as part of a chain of signals in response to low oxygen levels, which stimulates the growth of new, often abnormal, blood vessels. But studies have shown that although these drugs slow progression to proliferative diabetic retinopathy, they do not reliably prevent it.
Looking for an explanation, [the researchers] tested levels of VEGF in samples of fluid from the eye taken from (a) healthy people; (b) people with diabetes who did not have diabetic retinopathy; and (c) people with diabetic retinopathy of varying severity.
While levels of VEGF tended to be higher in those with proliferative diabetic retinopathy, some of their fluid had less VEGF than did the healthy participants. But even the low-VEGF fluid from patients with proliferative diabetic retinopathy stimulated blood vessel growth in lab-grown cells. "The results suggested to us that although VEGF clearly plays an important role in blood vessel growth, it's not the only factor," Sodhi says.
A series of experiments in lab-grown human cells and mice revealed a second culprit, a protein called angiopoietin-like 4 (ANGPTL4). When the researchers blocked the action of both VEGF and angiopoietin-like 4 in fluid from the eyes of people with proliferative diabetic retinopathy, it markedly reduced blood vessel growth in lab-grown cells.
If a drug can be found that safely blocks the second protein's action in patients' eyes, it might be combined with the anti-VEGF drugs to prevent many cases of proliferative diabetic retinopathy, Sodhi suggests. The research team is now investigating whether angiopoietin-like 4 might also play a role in other eye diseases, such as macular degeneration.
More about the Study from Proceedings of the National Academy of Sciences
Excerpted from the abstract of the full article (pdf):
Diabetic eye disease is the most common cause of severe vision loss in the working-age population in the developed world, and proliferative diabetic retinopathy (PDR) is its most vision-threatening sequela [i.e., aftereffect of a disease, condition, or injury].
Therapies targeting vascular endothelial growth factor (VEGF) delay the development of neovascularization in some, but not all, diabetic patients, implicating additional factor(s) in PDR.
Here we demonstrate that the angiogenic potential of aqueous fluid from PDR patients is independent of VEGF concentration, providing an opportunity to evaluate the contribution of other angiogenic factor(s) to PDR development. We identify angiopoietin-like 4 (ANGPTL4) as a potent angiogenic factor.
Expression of ANGPTL4 was increased in the aqueous and vitreous of PDR patients, independent of VEGF levels, correlated with the presence of diabetic eye disease, and localized to areas of retinal neovascularization.
Collectively, our results suggest that targeting both ANGPTL4 and VEGF may be necessary for effective treatment or prevention of PDR and provide the foundation for studies evaluating aqueous ANGPTL4 … to help guide individualized therapy for diabetic eye disease.
Optogenetics: Can This Innovative Gene Therapy Treat Degenerative Retinal Disease and Possibly Restore Sight?Posted on 5/19/2015 at 8:39 PM
by Maureen Duffy
A research group of Swiss and German scientists has restored vision to mice with a condition similar to retinitis pigmentosa (RP) by introducing engineered light-sensing proteins into their eyes, via a process known as optogenetics. Optogenetics is a still-experimental treatment for a variety of blinding retinal disorders that uses gene therapy to enable retinal and brain cells to respond to light.
According to the researchers, "… optogenetic gene therapy, which selectively introduces genes encoding light-sensitive proteins into surviving retinal cells to act as "replacement light sensors," holds considerable therapeutic potential: treatment is ambulant [i.e., enabling the person move about while being treated], long-lived, and has the theoretical potential to recover high-resolution vision across the entire visual field."
As explained by IFL Science, "When people lose light-sensing cells over a period of time … vision cells in deeper layers of the eye remain intact. While these cells cannot sense light, many of the signaling pathways are the same. It is in these deeper cells—known as retinal cells—that the researchers were able to insert the new light-sensing proteins, which can then use the already existing pathways to allow the cells to sense light."
This "proof of concept" research is in its earliest stages and has been conducted only with laboratory mice. Nevertheless, this concept shows promise for persons with RP, macular degeneration, and diabetic retinopathy.
About the Research
The study, entitled Restoring the ON Switch in Blind Retinas: Opto-mGluR6, a Next-Generation, Cell-Tailored Optogenetic Tool (explained below), has been published in the May 7, 2015 edition of PLoS Biology, an international, peer-reviewed, open-access online journal, published monthly by the Public Library of Science (PLoS). The PLoS is a non-profit organization of scientists and physicians who are committed to making the world's scientific and medical literature a freely available public resource.
The authors are Michiel van Wyk, Justyna Pielecka-Fortuna, Siegrid Löwel, and Sonja Kleinlogel, from the University of Bern, Switzerland and the University of Göttingen, Germany.
About Retinitis Pigmentosa
Retinitis pigmentosa (RP) is part of a large group of hereditary retinal conditions or dystrophies, involving one or several layers of the retina. RP occurs in approximately 1 in 4,000 people in the United States. At present, there is no cure.
Most individuals with RP initially experience difficulty with night vision and in low light levels. Central (straight ahead) vision is usually retained until late in the course of the disease, while peripheral (or side) vision becomes progressively more constricted, resulting in "tunnel vision" (pictured above).
Primarily, the retinal rod cells – light-sensitive, specialized retinal receptor cells that activate at low light levels and provide night vision – are involved, but there may also be some involvement of the retinal cone cells, which function best in relatively bright light and provide color vision and greater visual acuity than do rod cells.
More about the Research
From Optogenetics Restores Vision of Lab Mice, Could Soon Cure Acquired Blindness in Humans, via Medical Daily:
What our brains interpret as vision is actually the response of specialized cells in the eyes, known as retinal cells, to light stimuli. In those who were not born blind but rather acquired blindness over their lifetime, these retinal cells no longer function correctly because their light-sensing proteins are damaged. In the study, currently published in PLOS Biology, a team of researchers from the University of Berne in Switzerland attempted to replace the non-functioning cell parts with their own lab-engineered proteins, which they named Opto-mGluR6.
What sets Opto-mGluR6 apart from light-sensitive proteins occurring naturally in the eye is that these are particularly resilient to the effects of light. This means that their strength remains constant regardless of how much or how often they are hit with light. While Opto-mGluR6 is not the first lab-engineered light-sensitive protein, it differs from past models because it does not require a potentially damaging amount of light intensity in order to function.
Along with working under normal light stimuli, this novel protein also differs from past models because it is likely to be "invisible" to the host's immune system, iflscience reported. This invisibility is advantageous because it means that the host's body will likely not recognize the protein as an invading entity and unleash an attack.
The team introduced the engineered proteins into the eyes of blind mice using a modified virus. This method ensured that the protein could go directly to the surviving vision cells located deep within the eye. Opto-mGluR6 then replaced the no longer functioning photoreceptors and, in turn, restored the animals' vision. The results are promising and the team hopes to reproduce the effects in human subjects.
More about the Study from PLoS Biology
From the article Discussion:
An ideal therapy for patients suffering from photoreceptor degeneration will not only restore the light sensitivity of the retina but will (a) also function at environmental light intensities, (b) be physiologically compatible with the surviving inner retina, (c) conserve a natural range of retinal ganglion cell (RGC) trigger features, and (d) be devoid of toxic and immunogenic [i.e., generating an immune response] side effects.
[Editor's note: Retinal ganglion cells (RGCs), are neurons, or nervous system cells. They are located near the inner surface of the retina and give rise to optic nerve fibers that transmit information from the retina to several regions in the brain.]
All of this should be accomplished with a minimally invasive and safe clinical technology. Opto-mGluR6, which overcomes most shortfalls of existing optogenetic tools, meets most of these criteria and enhances the clinical feasibility of optogenetic vision recovery.
We showed that Opto-mGluR6 targeted to retinal [cells] of mice suffering from photoreceptor degeneration not only recovers light sensitivity in RGCs at moderate light intensities but also reestablishes diverse RGC light responses comprising ON, OFF, ON-OFF, sustained, and transient responses.
- Researchers Create Light-Sensitive Retinal Cells for Potential Retinitis Pigmentosa Treatment
- Optogenetics: The Next Frontier in Vision Research? The Foundation Fighting Blindness Explains
- Can Gene Therapy Provide a Cure for Retinal Disease [Choroideremia]? An Early-Stage Clinical Trial Says "Maybe"
by Maureen Duffy
The treatment of wet age-related macular degeneration (AMD) has – by all accounts – been revolutionized by the successful use of the injectable drugs Eylea, Lucentis, and Avastin. Successful treatments for dry AMD remain more elusive, although stem cell clinical trials in progress show promise. Despite these impressive treatment gains, however, methods for the prevention of AMD remain elusive.
At the 2015 Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO), a group of American researchers presented data suggesting that L-DOPA (levodopa), a drug used to treat Parkinson's disease, may be useful in both preventing and delaying AMD. ARVO is an international organization that encourages and assists research, training, publication, and dissemination of knowledge in vision and ophthalmology, including low vision.
About the Research
This poster presentation at the ARVO annual meeting, entitled Inverse [i.e., the opposite or reverse] association between L-DOPA and age-related macular degeneration, was authored by Kamyar Vaziri, Stephen G. Schwartz, Thomas B. Connor, Andrew A. Moshfeghi, Darius M. Moshfeghi, Krishna S. Kishor, Harry W. Flynn, Joseph Carroll, Murray Brilliant, and Brian S. McKay, who represent the following institutions: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine; Medical College of Wisconsin; Retina Associates of Kentucky; Stanford Byers Eye Institute, Palo Alto, CA; University of Wisconsin, Marshfield; and the University of Arizona.
About Dry Macular Degeneration
The dry (also called atrophic) type of AMD affects approximately 80-90% of individuals with AMD. Its cause is unknown, it tends to progress more slowly than the wet type, and there is not – as of yet – an approved treatment or cure. "Atrophy" refers to the degeneration of cells in a portion of the body; in this case, the cell degeneration occurs in the retina.
In dry age-related macular degeneration, small white or yellowish deposits, called drusen, form on the retina, in the macula – the small sensitive area in the center of the retina that provides clear central vision – causing it to deteriorate or degenerate over time.
A retina with drusen
Drusen are the hallmark of dry AMD. These small yellow deposits beneath the retina are a buildup of waste materials, composed of cholesterol, protein, and fats. Typically, when drusen first form, they do not cause vision loss. However, they are a risk factor for progressing to vision loss.
Geographic atrophy is the most severe and advanced form of dry AMD, involving patches of cells in the retina that have degenerated or died off. "Atrophy," in this case, refers to the degeneration of the deepest cells of the retina, called the retinal pigment epithelium (RPE). "Geographic" refers to any condition whose shape resembles the irregular outline of a land mass, such as the atrophied portion of the retina.
Current treatments for dry AMD include a number of non-drug-related measures, including (a) nutritional supplements recommended by the Age-Related Eye Disease Study 2 (AREDS2), and (b) controlling a range of lifestyle factors, including diet, weight, blood pressure, smoking, and ultraviolet light exposure.
About Wet Age-Related Macular Degeneration (AMD)
In wet, or exudative, macular degeneration (AMD), the choroid (a part of the eye containing blood vessels that nourish the retina) begins to sprout abnormal new blood vessels that develop into a cluster under the macula, called choroidal neovascularization or CNV (neo = new; vascular = blood vessels).
The macula is the part of the retina that provides the clearest central vision. Because these new blood vessels are abnormal, they tend to break, bleed, and leak fluid under the macula, causing it to lift up and pull away from its base. This damages the fragile photoreceptor cells, which sense and receive light, resulting in a rapid and severe loss of central vision.
The focus of current drug treatments for wet AMD is to reduce the level of a particular protein (vascular endothelial growth factor, or VEGF) that stimulates abnormal blood vessel growth in the retina and macula; thus, these drugs are classified as anti-VEGF treatments and include Lucentis, Eylea, and Avastin. They are administered by injection directly into the eye after the surface has been numbed.
Drugs to Treat Parkinson's Disease
The following definitions of substances and drugs related to Parkinson's disease are relevant to this research:
- Amino acids: The building blocks of protein. They carry out many important bodily functions, such as giving structure to cells and transporting and storing nutrients.
- Dopa: An amino acid that is formed in the liver and converted to dopamine in the brain
- Dopamine: A form of dopa that acts as a neurotransmitter in the brain, carrying a signal from one nerve cell to the next
- Levodopa, or L-DOPA: A medication used to treat Parkinson's disease, which is associated with low levels of dopamine. Levodopa is converted to dopamine in the brain. The resulting increase in dopamine improves nerve signal conduction and lessens the movement disorders associated with Parkinson's, including stiffness, tremors, spasms, and poor muscle control.
About the Research
From Parkinson's disease drug delays onset of age-related macular degeneration, via Medical News:
L-DOPA, a routine drug taken by patients with Parkinson's disease, has been found to delay the onset of age-related macular degeneration. The research [was] presented at the 2015 Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO) Denver, Colorado.
In a study investigating over 15 million people, individuals taking L-DOPA were significantly less likely to develop AMD, and when they did, the age of onset was significantly later. These results suggest L-DOPA may be useful in both preventing and delaying the disease.
More from The ARVO Conference Presentation
From the presentation abstract:
Methods: Using the International Classification of Diseases, Ninth Revision codes (ICD-9), we retrospectively compared the age of first diagnosis of AMD between patients taking or not taking L-DOPA, utilizing cohorts of patients from two Marshfield Clinic Research databases (including 20,000 and 17,000 patients) and the insurance claim-based Truven MarketScan databases from the years 2007-2011 (approximately 87 million outpatient individuals).
In addition, a retrospective cohort of 2,006 AMD patients was reviewed, and a prospective cohort of 47 Parkinson's disease patients treated with L-DOPA were given comprehensive eye examinations; both cohorts were at Medical College of Wisconsin.
(Note: A retrospective study has limitations because it collects data from past records and does not follow up with patients in the present. A prospective study, on the other hand, studies and measures a group of individuals over time and follows up with study patients in the future.)
Results: In the two Marshfield Clinic samples, the mean ages of first AMD diagnosis in patients not treated with L-DOPA were 71.2 years and 71.1 years, and the mean ages of first AMD diagnosis in patients treated with L-DOPA were 79.3 years and 79.3 years respectively.
From the MarketScan databases, the mean age at first AMD diagnosis in patients not treated with L-DOPA was 71.4 years, and the mean age of first AMD diagnosis in patients treated with L-DOPA was 79.3 years.
Using the subpopulation of patients with ophthalmic ICD-9 codes, it was found that after controlling for age and gender, patients with a prescription history of L-DOPA were significantly less likely to have a diagnosis of AMD. In the retrospective cohort of 2,006 AMD patients, only 19 were using L-DOPA, and all 19 were diagnosed with AMD prior to initiating L-DOPA. In the prospective cohort of 47 Parkinson's disease patients, 7 patients with early AMD were diagnosed, which is fewer than expected for this age group.
Conclusion: Collectively, these results suggest an inverse [i.e., the opposite or reverse] relationship between L-DOPA treatment and incidence of AMD. If these results can be confirmed, L-DOPA and its intermediaries may provide future drug targets in the prevention or treatment of AMD.
VisionAware will provide updates on this important research as they become available.
by Maureen Duffy
This month, The Hadley School for the Blind is launching the innovative and highly anticipated Low Vision Focus @ Hadley program for older adults who have low vision. The mission of Hadley is to promote independent living through lifelong distance education programs for people who are blind or visually impaired, their families, and blindness and low vision service providers.
A newly-revised series of 10 audio lessons is the core component of the Low Vision Focus @ Hadley program. Each lesson is approximately 30 minutes long and available on a CD (pictured below), which is mailed directly to the person with low vision after speaking with a Hadley intake coordinator to determine which lesson(s) best meet his or her needs. The CDs are free for each person to keep. The initial mailing is limited to two CDs, with additional lessons available upon request.
The audio lessons include the following topics of interest:
- Making the Kitchen User-Friendly
- Getting Around in the House
- Basic Tactile Marking
- Going Out with a Friend
- Doing Simple Kitchen Tasks
- Keeping Prescriptions in Order
- Low Vision Cooking
- Looking Your Best
- Going Out for a Meal
- Simple Home Modifications
More about the Low Vision Focus @ Hadley Program
From the Low Vision Focus @ Hadley website:
Did you know that one out of every six seniors experiences age-related vision loss due to conditions such as macular degeneration, glaucoma, diabetes, or cataracts? These conditions often result in low vision. As your vision loss progresses, it often becomes necessary to relearn how to conduct normal daily activities such as reading the mail, shopping, cooking, watching TV and paying the bills.
The great news is that there are lots of techniques that can help you in managing your low vision. These include adjusting lighting; using contrasting colors, sounds and smells; magnification; tactile (by touch) markings; and simple safety precautions.
The Low Vision Focus @ Hadley program is designed to help you maintain your independence in your home by sharing practical ways to address daily living skills made difficult by low vision. Hadley is a nonprofit organization that has been supporting people with vision loss for nearly a century.
We are pleased to offer a series of free audio recordings available on CD that provide you with the tips and tricks needed to continue living well with low vision. They range from marking your stove or oven and managing medications to indoor mobility and using adaptive devices.
The Low Vision Focus @ Hadley program is designed to help older adults living with low vision maintain their independence by sharing practical ways to address daily living skills made difficult by vision. The program is unique in that it offers adults with low vision the opportunity to learn, and take advantage of, these resources from the comfort of their own homes, at a time that is convenient for them, with the benefit of one-on-one counseling and support, at no cost.
In addition, adult children of parents who are living with low vision are encouraged to take advantage of the resources offered by the program to aid their parents in the adjustment process. While many of the people who are living with low vision are seniors, the program is open to any individual who is experiencing sight loss. Adults with low vision and professionals also are encouraged to use the program to develop new low vision support groups in local communities or to sustain existing support group networks.
For More Information
For additional information about the Low Vision Focus @ Hadley program, you can visit the program website at www.lowvisionfocus.org or call toll-free at 1-855-830-5355.
More about Hadley School for the Blind from VisionAware
by Maureen Duffy
Editor's note: One of the many benefits associated with an online information center and website, such as VisionAware, is the ability to track readers' search terms [i.e., information readers are seeking as they search the Internet]. Since the earliest days of VisionAware.org, the following questions about eye doctors and eye care consistently rank within the top ten searches and are especially relevant during Healthy Vision Month:
- What are the different kinds of eye doctors?
- What is the difference between an ophthalmologist and an optometrist?
Ophthalmology and Ophthalmologists
What is ophthalmology?
Ophthalmology is a branch of medicine that specializes in the anatomy, function, and diseases of the eye.
What is an ophthalmologist?
- An ophthalmologist is a medical or osteopathic physician who specializes in the medical and surgical care of the eyes and the prevention of eye disease. An ophthalmologist diagnoses and treats refractive, medical, and surgical problems related to eye diseases and disorders.
- Ophthalmologists are licensed by state regulatory boards to practice medicine and surgery, as well as deliver routine eye care.
- An ophthalmologist will have the initials "M.D." (Doctor of Medicine) or "D.O." (Doctor of Osteopathy) after his or her name.
What does an ophthalmologist do?
- Ophthalmologists are trained to provide the full spectrum of eye care, from prescribing glasses and contact lenses to complex and delicate eye surgery.
- Ophthalmologists treat eye diseases, prescribe medications, and perform all types of surgery to improve, or prevent the worsening of, eye and vision-related conditions.
How is an ophthalmologist educated and trained?
- In addition to four years of medical school and one year of internship, all ophthalmologists spend a minimum of three years of residency (hospital-based training) in ophthalmology.
- During residency, ophthalmologists receive specialized training in all aspects of eye care, including prevention, diagnosis, and medical and surgical treatment of eye conditions and diseases.
- Often, an ophthalmologist spends an additional one to two years training in a subspecialty, or a specific area of eye care, such as glaucoma or pediatric ophthalmology.
- All ophthalmologists are required to fulfill continuing education requirements to stay current regarding the latest standards of care.
More Information about Ophthalmology
- For more information, you can visit the American Academy of Ophthalmology website.
- The EyeSmart® public awareness campaign, sponsored by the American Academy of Ophthalmology, helps Americans to take charge of their eye health; know their risk factors for eye diseases; and understand how ophthalmologists can help prevent, diagnose, and treat eye conditions.
Optometry and Optometrists
What is optometry?
Optometry is a vision care specialty that is concerned with the health of the eyes, the visual system, and related structures.
What is an optometrist?
- An optometrist is a health care professional who specializes in function and disorders of the eye, detection of eye disease, and some types of eye disease management. An optometrist conducts eye examinations, prescribes corrective contact lenses and glasses, and diagnoses and treats eye diseases and disorders.
- Optometrists are licensed by state regulatory boards that determine their scope of practice, which may vary from state to state.
- An optometrist will have the initials "O.D." (Doctor of Optometry) after his or her name.
What does an optometrist do?
- Optometrists are trained to examine the eyes for visual defects, diagnose problems or impairments, prescribe corrective lenses, and provide certain types of treatment.
- Many (but not all) U.S. states have passed legislation that allows optometrists to perform certain surgical procedures, such as laser treatment; administer injections, such as local anesthesia or treatment for macular degeneration; and prescribe additional diagnostic, therapeutic, and oral medications. Visit the American Optometric Association website to determine if your state permits optometrists to perform these additional procedures.
How is an optometrist educated and trained?
- Prior to admittance into optometry school, optometrists typically complete four years of undergraduate study, culminating in a bachelor's degree.
- Optometrists then complete a four-year postgraduate program in optometry school to earn the Doctor of Optometry degree.
- Some optometrists go on to complete one- to two-year residencies with training in a specific sub-specialty area, such as pediatric or geriatric eye care, specialty contact lens, ocular disease, or neuro-optometry.
- All optometrists are required to fulfill continuing education requirements to stay current regarding the latest standards of care.
More Information about Optometry
- For more information, you can visit the American Optometric Association and American Academy of Optometry websites.
Low Vision Specialist
- Many optometrists and some ophthalmologists have additional credentials or specialization in low vision testing, diagnosis, and treatment, and are trained to conduct low vision eye examinations and prescribe special low vision optical devices.
- If you're experiencing significant vision loss, a low vision specialist can determine whether special optical and non-optical devices, improved lighting, or other types of specialized services and equipment can help make the best use of your remaining vision.
- You can find a listing of low vision specialists in the "Low Vision Services" category in the VisionAware Directory of Services.
In addition to the low vision professionals in the Directory listings, you can find low vision providers through the following directories:
- The American Academy of Ophthalmology directory. Use the subspecialty category "Low Vision Rehab."
- The American Optometric Association database. Use the "Advanced Search" function and look for members of the Vision Rehabilitation Section.
Locate an Eye Care Professional in Your Area
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- Avastin (20 posts)
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- Macular Degeneration (88 posts)
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