Wise to the World

By Erin Murphy, Associate Editor

Does Glaucoma Begin in the Brain?

In recent years, the focus in glaucoma screening has shifted from increased intraocular pressure to a sign that may precede it — changes in the retinal nerve fiber layer. But is there another, earlier sign?

At the Vanderbilt Eye Institute, a recent study using animal models showed that the earliest sign of vision loss related to glaucoma involved neuronal injury in the mid-brain, resulting in “the loss of communication between the optic nerve and the mid-brain, where sensory information about sound, heat, cold, pain and pressure originate.” Researchers are working to find drugs to improve or restore this communication.

The full study appears in the March 5, 2010 issue of Proceedings of the National Academy of Sciences.

Source: Vanderbilt University Medical Center. Vanderbilt Study Shows That First Signs of Glaucoma Injury Occur In The Brain, Not The Eyes. News release, March 1, 2010.
Available at: http://www.mc.vanderbilt.edu/news/releases.php?release=1582

Without Treatment, Vision Problems Play a Role in Dementia

How does poor vision factor into a diagnosis of dementia? According to a recent study, poor vision among elderly patients correlates with a higher risk of developing the disease.

Researchers took a retrospective look at data for 625 elderly Americans whose cognition was normal at baseline. Comparing the vision status of these patients with their dementia diagnoses over time (dementia, cognitively impaired but no dementia, or normal cognition), they found that over 8.5 years, people whose vision was very good or excellent at baseline were 63% less likely to be diagnosed with dementia.

What's more, patients were more likely to be diagnosed with dementia if their vision problems went untreated. Those with poor vision at baseline who didn't see an eye doctor were 9.5 times more likely to be diagnosed with Alzheimer's disease and 5 times more likely to be “cognitively impaired but no dementia.” Among patients aged 90 or older, 77.9% with normal cognition over time had at least one eye procedure, whereas just 51.7% of patients diagnosed with Alzheimer's disease had undergone a procedure.

Source: Rogers M, Langa K. Untreated poor vision: A contributing factor to late-life dementia. Am J Epidemiol. E-pub ahead of print. Feb. 11, 2010.

EHR Preparedness Program

Electronic health records (EHRs) are part of health care's evolving landscape. The EHR Preparedness Program from the AOA aims to ensure that optometric practices adopt these records early and help shape them. The AOA says the program will help optometrists:

■ Become eligible for the federal in centive program starting Jan. 1, 2011, called the American Recovery and Reinvestment Act

■ Join the U.S. Department of Health & Human Services Nationwide Health Information Network, scheduled to launch in 2014

■ Avoid Medicare payment penalties in 2015 for those who don't use EHRs.

To learn more, visit aoa.org/EHR.xml.

What's Living in Her Eyeliner?

British department store Debenhams surveyed 1,000 women aged 18 to 70 about their makeup habits, with a focus on health considerations. They found:

■ 81% sleep in their makeup at least once a week

■ 72% never clean makeup applicators

■ 68% don't replace makeup when it gets old — only when it runs out

■ 60% of women share makeup with others.

This survey proves that patients should be reminded to replace makeup regularly to ensure good hygiene and eye health.