Keratoconus Project Update

The Keratoconus Research Group, which is based at the Sydney Eye Hospital Campus, is made up of scientists and clinicians whose focus is on unlocking the cause of keratoconus. Keratoconus is a very common eye condition that results in a distortion of the window of the eye and is a major cause of visual impairment in Australia. In fact, it is the most common reason that people undergo corneal transplantation in Australia.

The Sydney Eye Hospital Foundation has been the major financial supporter of our research for the last 3 years. During this time we have identified a number of problems in patients with keratoconus at a molecular level. These scientific discoveries are world first and have opened up a whole new area of research into the causes of this disease.

Apart from 5 major publications in highly regarded journals, we have presented our research at 10 major national and international meetings. Our most recent paper was published in “Plos” in August 2013. We are zeroing in on the superficial area of the cornea (the window of the eye) as the primary problem area in keratoconus. Our current hypothesis is that the problem lies in the cell communication and protein excretion within this layer. We are now undertaking further work to confirm this hypothesis. If proved correct, it will point to
therapeutic options for the treatment of this disease.

Dr JingJing Yu is a PhD scientist who works fulltime thanks to the support of the Foundation. She is ably supported in the lab by MS Li Wena dn Associate Professor Michele Madigan. Professor John McAvoy provides valuable scientific advice on the Wnt pathway and Chris Hodge and I provide
the clinical input. Chris is currently completing his PhD in Keratoconus.

Without the support of the Sydney Eye Hospital Foundation and its generous donors this work would
not be possible. We as a team are determined to uncover the secrets of this disease and we are very
grateful for the Foundation’s support in this endeveour. I look forward to updating you on our continued progress.

Professor Gerard Sutton

Professor Sutton has co-authored a book on keratoconus which has proven useful for many sufferers.

Books are available from kati.kenny@visioneyeinstitute.com.au or the Foundation office. Small profits from these sales are put back into ongoing keratoconus research.

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Update on the Keratoconus Project

The Keratoconus Research Group, which is based at the Sydney Eye Hospital, is fortunate enough to receive funding from the Foundation. Without the funding and support of the Sydney Eye Hospital Foundation, the Keratoconus Research Group would not be able to continue its exploration into the causes of keratoconus.

Keratoconus is a common condition which causes significant visual disability and loss of sight of Australians. It is the most common indication for a corneal transplantation. Recent studies are suggesting that keratoconus is much more
common than previously thought and often runs in families.

Our research team includes Dr Jing Jing You, Dr Li Wen, Associate Professor Michele Madigan, Professor John McAvoy, Mr Chris Hodge and Professor Gerard Sutton (team leader). Our work has resulted in a number of new fi ndings in the
underlying cellular problems of keratoconus. We have published our fi ndings in prestigious journals such as Clinical & Experimental Ophthalmology and Experimental Eye Research. We have two further publications that we expect to be in press early in 2013.

In addition to the publications, the research has been presented at meetings around the world, including the Australasian Ophthalmic and Visual Sciences meeting in Melbourne, the Asia-Pacific Academy of Ophthalmology in Korea, the World Cornea Congress in Boston, the Keratoconus Research Meeting in France and the most esteemed ophthalmic research meeting in the world Association of Research in Vision and Ophthalmology in the United States of America.

Our papers and lectures have sparked further research in the area, with our publications forming the basis of other scientists’ work around the world. Our team has also established the fi rst-ever Australian registry for patients with
keratoconus, which will form part of an Ethics Committee-approved ongoing review of patients with keratoconus. Without the support of the Sydney Eye Hospital Foundation and donors in the community, this work would not be possible.

Our research is receiving international recognition and a new collaboration with Professor Charles McGhee at Auckland University has been established for further international research projects.

We are pleased to say that a book co-authored by Professor Gerard Sutton on keratoconus has been very useful for many sufferers of keratoconus. The small profits from the sale of books are put back into ongoing research in keratoconus.

Books available from kati.kenny@visioneyeinstitute.com.au or the Foundation office.

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New Intraocular Endoscopy Equipment Puts us at the Forefront

Every now and then we come across patients with complicated eye health problems which are particularly difficult to treat. Thankfully, as new technology develops, we are given the opportunity to meet these challenges more effectively.

We have just purchased the Intraocular Endoscopy Equipment for the Eye Hospital Theatres. Pictured, right, are doctors using this equipment, which now makes it possible for us to handle cases that would traditionally be considered inoperable.

Endoscopic vitreo retinal surgery is a rarely indicated procedure. Some cases involve eyes that have multiple problems and a poor prognosis. On other occasions, endoscopy makes it possible to salvage vision where other techniques cannot. It can lead to a simple solution for what otherwise would be a complicated problem.

Clearly the team were keen to acquire the equipment but the biggest challenge was fi nding the funds to add it to their arsenal. Thanks to your support, we have been able to provide $43,000 to purchase the actual equipment that was used in the trial for Sydney Eye Hospital (at considerable discount). We believe the system, which includes numerous state of the art components, is the only one of its kind in Australia, once again placing Sydney Eye Hospital at the absolute forefront of eye surgery.

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Eye Disease-Macular Degeneration

Macular degeneration is an eye disease that affects the macula and it is known to destroy the central vision system. It develops when part of the retina is dented causing progressive vision loss. This type of eye disease is known to be the leading cause of total blindness in Australia. It is classified into two major categories, and they are dry and wet Macular degeneration. This eye disorder occurs due to various factors such as aging, prolonged exposure to ultra violet rays, smoking, obesity, myopia, sleep apnea and certain medications such as drugs for osteoporosis.

Macular degeneration is categorised into two forms i.e. the dry and wet forms. The dry type is also known as the atrophic form, it occurs after the macula cells breakdown. During eye examination the condition is identified when yellow white spots known as dursens are seen around the retina. This condition is the most common and if it advances there will be changes in the nerves and sensory parts of the retina. The wet type is also referred to as exudative or neuro-vascular form.

Development of this condition leads to leaking of the blood vessels which scars the retina hence damaging the eyes central vision. This eye problem is more rapid than the dry type therefore vision loss may occur more rapidly.

Patients with Macular degeneration present themselves with the following symptoms. Blurred vision, objects appearing to be small, viewing straight lines as irregular lines, decreased central vision and blind spots. In order to avoid total blindness patients are advised to consult eye doctors for regular check-ups and if the above symptoms arise he or she should seek medical treatment. Macular degeneration can be treated via use of antioxidants that prevent unstable oxygen that damages the retina. Laser treatment reduces vision loss during the early stages of the condition. Photodynamic therapy; that involves the use of the drug verteporfin; the drug is administered intravenously to close the leaking blood vessels.

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Blindness-What causes Blindness?

What causes blindness is an important topic to discuss as far as Australians are concerned. Many people in Australia tend to ignore various factors that may lead to complete loss of vision. Some of the leading causes of blindness include: diabetes, traumatic injuries, herpes simplex virus, and eye diseases such as glaucoma, retinitis pigmentosa, cataracts and macular degeneration. Blindness may affect one eye or both eyes and may not cause total darkness since some people who are blind can see shadows and some beams of light.

What causes blindness in most people begins with an eye disease that advances into complete vision loss. Cataract is a clouding of the eye lens that makes an individual’s vision to be blurred and it develops a problem of seeing through glare. It is known to be the leading cause of blindness all over the world if left untreated. Individuals who have the following symptoms (bury vision, glare, and double vision) are unable to see well at night as well as perceive faded colours; ideally, such people are advised to seek treatment. Glaucoma is an eye problem that deteriorates the optic nerve, this causes fluid build up and increased eye pressure. It leads to gradual loss of the peripheral vision. It is also a leading cause of blindness and immediate treatment after diagnoses is important.

What causes blindness in many adults is an eye condition known as macula degeneration. This eye disorder is mainly associated with aging and it damages the macula. Macula deterioration leads to loss of the central vision system and blurred vision arises. Diabetic retinopathy is an eye disease that is caused by diabetes. It mainly affects blood vessels that nourish the retina and it causes leaking hence vision loss. Retinitis pigmentosa is an eye problem that begins during childhood and the infected person becomes blind at adulthood. Individuals with this eye disease have a problem of perceiving objects at night.

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What is macula, its Functions and Clinical Significance?

What is macula? The macula is located near the central portion of the human eye retina that is described as a yellowish oval shaped spot that is highly pigmented. The macula enables the eye to view detailed central vision that is sharp, to perceive colours and to carry out tasks like reading that is tasks that require central vision.

The macula consists of two ganglion cell layers and at the centre it comprises of the fovea. The fovea is a pit made up of cone cells and has no rods; the fovea’s function is to ensure that the eye provides a central vision of a high resolution. The fovea is also responsible for individuals colour perception ability. The macula is also made up of the peri-fovea and para-fovea.

What is macula and how is it adopted to its functions? The macula comprises of light sensitive photoreceptors that are densely packed together. This enables the macula to be in control of the central vision and the ability to do tasks like reading, distinguishing faces or details and driving. Having numerous cones in the macula enables the eye to have a sharp vision especially in bright light. It is yellow in colour since it is made up of lutein and zeaxanthin. Due to this it is able to absorb excess ultraviolet light and it also blocks entry of excess sun light.

What is macula and its clinical significance? If the macula is tampered with various eye diseases can develop. Macular degeneration can occur if the macula breaks down. This condition leads to the decreased ability of the eye to see clearly due to either partial or complete vision loss. Macula degeneration can also develop due to aging hence the elderly are at a higher risk. Destruction of the macula can also lead to formation of macula holes which are caused by trauma and if severe the entire macula can be damaged.

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What is Amblyopia? Its Causes, Symptoms and Treatment

What is Amblyopia? Amblyopia is an eye disorder of the visual system also referred to as the lazy eye. Amblyopia is described as vision deficiency that leads to loss of the eyes’ ability to see details in objects. The affected eye will look physically normal but it does not function normally since the brain is coordinating with the other eye.

This condition develops when the nerve pathway to the brain of one eye does not fully develop during childhood. The affected or abnormal eye tends to send blurred or incorrect images to the brain. When this occurs the brain becomes confused hence it learns how to ignore images from the abnormal eye. The lazy eye may also develop when one eye has a better focus than the other that is one eye might have a lot of astigmatism or it may also be too near-sighted or farsighted.

What is Amblyopia most common cause? Strabismus is the common cause of the lazy eye. It is mainly an imbalance in the positioning of both eyes. It is characterized as an ocular misalignment that leads to one eye either turning inward that is esotropia or turning outwards that is exotropia. This deteriorates the eyes ability to focus on an image which may lead to development of double vision. Other causes of Amblyopia are certain conditions such as cataracts, blood or material at the back of the eye which block entry of light.

Its symptoms and forms of treatment include: Signs and symptoms presented by patients with this vision problem are such as poor vision in one eye, inability to perceive depth, eyes turning in or out and lastly both eyes working together. It can be treated by making the individual’s brain to use the weaker eye. This is achieved via correcting eye problems that cause Amblyopia such as removal of a cataract and then placing a patch on the normal eye and also use of atropine drops.

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Various Types of Eye Exercises

Eye exercises are part of vision therapies that are meant to improve vision skills such as eye focusing, moving and coordination. Exercising the eyes will enable them to be healthy in order for the visual system to work normally. Working out the eyes will improve the functionality of the eye muscles hence a good vision is obtained. These exercises are of different techniques and they have been proven to improve vision hence patients negating corrective lenses. If you wish to perform these techniques you can consult with an eye doctor or do some research in the internet.

Here are some of the best Eye exercises that you can opt to engage. Blinking is a simple technique that will help you keep your eyes fresh and able to focus on objects for long durations. By doing this exercise your eyes are able to discharge previous info and get ready to perceive new info. Moreover, you will be reducing eye strain and your eyes will be relaxed. Blinking is also a sign of good communication skills.

Individuals who blink after every three seconds are termed to be friendly unlike those who stare.

Zooming is a technique that requires you to follow the following steps. First sit in a comfortable position, stretch your arms and ensure that the thumb is in a hitchhike position. Focus on the thumb and bring it closer to your eyes. Focus until the thumb is about four inches away from your face. Move the thumb away until your arm is outstretched fully. Do this exercise for a few minutes each and every day. Palming is also a simple eye exercise that helps to relieve stress around the eye region and to relax them instead. This is done by leaning on a desk and resting your elbows on your knees then placing your hands over your eyes to cover them. This is useful during computer breaks.
In conclusion, Eye exercises will definitely make you feel relaxed.

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Prevention of Eye Diseases

Eye diseases may cause damage to the visual system and may lead to total blindness. There are several eye disorders that affect many Australians and they include the following: glaucoma, cataract, macular degeneration, diabetic retinopathy, amblyopia, conjunctivitis among others. In order to avoid losing your vision either partially or completely there are a few tips one can follow. Maintaining healthy eyes is important since our daily activities are dependent on our vision.

Eye doctors in Australia have time and again urged Australians to seek for eye check-ups in order to avoid any chances of eye blindness. This will help in the diagnoses of eye diseases earlier before they deteriorate the entire visual system. Eye check-ups will involve procedures such as pupil dilation and screening. Through screening conditions such as diabetes and glaucoma are diagnosed earlier hence early treatment is provided. This is important, since many eye disorders do not have warning signs and symptoms. Detection of such diseases will ensure there is early treatment hence prevention of vision loss.

Australians should find out their family eye health history in order to determine any history of eye diseases. This will enable eye doctors to determine whether or not you are at a high risk of developing an eye problem. Proper diets rich in vegetables and fruits are essential for strengthening your eye muscles. Ensure that you obtain enough sleep, this will avoid eye strain. Doing various eye exercises will ensure that your eye muscles are relaxed hence able to focus properly.
Individuals diagnosed with eye diseases should not use eye drops or ointments without consulting an eye doctor. Ocular hygiene is important for consistent eye health. Moreover, ocular hygiene requires a person to do the following: do not share items such as towels and use disposable wipes to clean the eyes-this will ensure that there is no spread of eye diseases due to contamination.

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Conjunctivitis Treatment Options

Conjunctivitis or pink eye is an eye disease that causes an inflammation on the eyes conjunctiva. It is a highly contagious infection that is common in children. It manifest itself through the following signs and symptoms: photophobia, crusts on the eyelids, blurred vision, excess tear production, eye redness and production a yellow-green discharge. It is classified into three forms depending on the main cause, the forms include: viral conjunctivitis, bacterial conjunctivitis and allergic conjunctivitis.

Conjunctivitis Treatment is differs among the three types of conjunctivitis, since their sources of infection also differs. In order to avoid contamination between infected people; normal people are urged to avoid sharing items such as towels. Moreover, people are urged to wash their hands after touching their eyes. Conjunctivitis can also be treated at home by using over the counter lubricant eye drops to reduce discomfort. One may clean the discharge present on the eyelids via use of a soaked cotton wool. To avoid reinfection, patients using contact lenses should discard them if they had been contaminated.

Antibiotics such as eye drops and eye ointments are known to be the most effective form of Conjunctivitis Treatment. Viral conjunctivitis can be treated via use of artificial cold packs in order to get rid of the swelling. If the condition is severe for example conjunctivitis caused by herpes simplex virus doctors are known to prescribe antiviral medications. In bacterial conjunctivitis, topical antibiotics such as eye drops and eye ointments are used. Inflammation and eye dryness is relieved via use of artificial tears and cold compresses.

Allergic conjunctivitis develops when an individual comes into contact with an allergen or irritant. This condition can either be seasonal, perennial, giant papillary or contact dermato-conjunctivitis. Treatment is through use of allergy medications, including antihistamines and mast stabilizers like steroids and decongestants. These two forms of medication act by reducing the inflammation. But the best Conjunctivitis Treatment for allergies is to avoid the irritant.

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