Category Archives: Eyes & Vision

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Women’s Health – Week 17: Complications of Diabetes

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From the Office of Research on Women’s Health

Complications of diabetes

If you have diabetes, you may be at greater risk for many serious health problems. But if you follow your treatment plan and make lifestyle changes, you may be able to prevent or delay serious health problems. Some common complications of diabetes are below.

Eye disease

Damage to the eyes can lead to severe vision loss or even blindness. Eye problems may include:

  • Retinopathy: damage to the blood vessels in the retina. Diabetic retinopathy gets worse with time. You may not notice vision changes at first. Timely treatment and follow-up care help prevent serious vision loss. Diabetic retinopathy usually affects both eyes and is a leading cause of blindness in adults.
  • Cataract: clouding of the eye’s lens. Cataracts develop at an earlier age in people with diabetes.
  • Glaucoma: increase in fluid pressure inside the eye, which leads to optic nerve damage and loss of vision. A person with diabetes is nearly twice as likely to get glaucoma as other adults.

Kidney failure

Diabetes is the most common cause of chronic kidney disease (CKD) and kidney failure, though most people with diabetes do not develop CKD that is severe enough to progress to kidney failure.

People with kidney failure undergo dialysis, an artificial blood-cleaning process, ortransplantation to receive a healthy kidney from a donor.

Researchers have found that high blood pressure and high levels of blood sugar increase the risk that a person with diabetes will develop kidney failure. Controlling your blood pressure and blood sugar may reduce your risk.

Nerve disease

Diabetes can cause serious nerve problems, or neuropathies. People with diabetes can develop nerve damage throughout their body. Some people with nerve damage have no symptoms. Others may experience pain, tingling, or numbness – loss of feeling – in the hands, arms, feet, and legs. Nerve problems can occur in every organ system, including the digestive tract, heart, and sex organs. People with diabetes can develop nerve problems at any time, but risk rises with age and the longer a person has diabetes. Neuropathies also appear to be more common in people who have problems controlling their blood sugar as well as those who are overweight or who have high blood pressure or high levels of blood fat.

Foot ulcers and amputations

People with diabetes need to take special care of their feet. The nerves to the feet, the longest in the body, are most often affected in diabetes. Loss of sensation in the feet means that sores or injuries may go unnoticed and may become ulcerated or infected.

Circulation problems also increase the risk of foot ulcers. More than half of all lower-limb amputations in the United States occur in people with diabetes – 86,000 amputations per year.

Health care providers estimate that nearly half of the amputations caused by neuropathy and poor circulation could have been prevented by careful foot care.

Periodontal disease

People with diabetes are at higher risk for developing infections, including periodontal, or gum disease. For more information on dental health, please see Week 13.

For more information: www.ndep.nih.gov

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Women’s Health – Week 16: Diabetes: Type 1 and Type 2

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From the Office of Research on Women’s Health

Glucometer showing a blood sugar of 105Diabetes is a disease in which your blood glucose, or sugar, levels are too high. Glucose comes from the foods you eat. Your blood always has some glucose in it because your body needs glucose for energy. Too much glucose, however, is not good for your health.

Insulin, a hormone produced by the pancreas, helps the glucose from food get into your cells. If your body does not make enough insulin, or if the insulin does not work the way it should, glucose cannot get into your cells for energy. It stays in your blood instead. Your blood glucose levels then get too high, causing diabetes.

With type 1 diabetes, the pancreas no longer makes insulin. People with type 1 diabetes need to take insulin every day. Type 1 diabetes accounts for about 5 to 10 percent of diagnosed diabetes in the United States. Children and young adults most often develop type 1 diabetes, but it can appear at any age.

With type 2 diabetes, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood. People with type 2 diabetes often need to take pills or insulin. Type 2 diabetes is the most common form of diabetes and can occur at any age, even childhood.

Having a parent, brother, or sister with diabetes, or being overweight and inactive increases the chances of developing type 2 diabetes.

Pregnant women can also develop diabetes, called gestational diabetes (see Week 18 for more information). Gestational diabetes often goes away after the baby is born. But having gestational diabetes can place you and your child at increased risk for developing diabetes later in life.

Symptoms of diabetes may include fatigue, thirst, weight loss, blurred vision, and frequent urination. With type 2 diabetes, some people have no symptoms at all. A blood test can show if you have diabetes.

Over time, having too much glucose in your blood can cause serious problems. It can damage your eyes, kidneys, heart, gums, teeth, and nerves. It can lead to blindness, kidney failure, and the loss of a foot or a leg. The most serious problem caused by diabetes is heart disease. If you have diabetes you are more than twice as likely as people without diabetes to have a heart attack or a stroke.

The good news is that if you have diabetes, you can take steps to manage the disease. Learn how to manage the ABCs of diabetes. A is for the HbA1C test, which shows you what your blood glucose has been over the past 3 months. B is for blood pressure and C is for cholesterol.

You can lower your chances of developing serious health problems by keeping your blood glucose, blood pressure, and cholesterol levels in the target range your health care provider gives you. You can manage your diabetes by being active every day and keeping your weight in a healthy range. Follow your meal plan, take your medications, and check your blood glucose as directed by your health care provider.

For more information: www.yourdiabetesinfo.org

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Lack of eye contact in early infancy may be sign of autism, study

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From the National Institutes of Health

Eye contact during early infancy may be a key to early identification of autism, according to a study funded by the National Institute of Mental Health (NIMH), part of the National Institutes of Health.

Published this week in the journal Nature, the study reveals the earliest sign of developing autism ever observed — a steady decline in attention to others’ eyes within the first two to six months of life.

“Autism isn’t usually diagnosed until after age 2, when delays in a child’s social behavior and language skills become apparent. This study shows that children exhibit clear signs of autism at a much younger age,” said Thomas R. Insel, M.D., director of NIMH. “The sooner we are able to identify early markers for autism, the more effective our treatment interventions can be.”

autism eye

Decline in eye fixation reveals signs of autism present already within the first 6 months of life. Data from a 6-month-old infant later diagnosed with autism are plotted in red.

Data from a typically developing 6-month-old are plotted in blue. The data show where the infants were looking while watching a video of a caregiver. Source: Warren Jones, Ph.D., Marcus Autism Center, Children’s Healthcare of Atlanta, and Emory University School of Medicine.

Typically developing children begin to focus on human faces within the first few hours of life, and they learn to pick up social cues by paying special attention to other people’s eyes.

Children with autism, however, do not exhibit this sort of interest in eye-looking. In fact, a lack of eye contact is one of the diagnostic features of the disorder.

To find out how this deficit in eye-looking emerges in children with autism, Warren Jones, Ph.D., and Ami Klin, Ph.D., of the Marcus Autism Center, Children’s Healthcare of Atlanta, and Emory University School of Medicine followed infants from birth to age 3.

The infants were divided into two groups, based on their risk for developing an autism spectrum disorder. Those in the high risk group had an older sibling already diagnosed with autism; those in the low risk group did not.

Jones and Klin used eye-tracking equipment to measure each child’s eye movements as they watched video scenes of a caregiver. The researchers calculated the percentage of time each child fixated on the caregiver’s eyes, mouth, and body, as well as the non-human spaces in the images. Children were tested at 10 different times between 2 and 24 months of age.

By age 3, some of the children — nearly all from the high risk group — had received a clinical diagnosis of an autism spectrum disorder. The researchers then reviewed the eye-tracking data to determine what factors differed between those children who received an autism diagnosis and those who did not.

“In infants later diagnosed with autism, we see a steady decline in how much they look at mom’s eyes,” said Jones. This drop in eye-looking began between two and six months and continued throughout the course of the study.

By 24 months, the children later diagnosed with autism focused on the caregiver’s eyes only about half as long as did their typically developing counterparts.

This decline in attention to others’ eyes was somewhat surprising to the researchers. In opposition to a long-standing theory in the field — that social behaviors are entirely absent in children with autism — these results suggest that social engagement skills are intact shortly after birth in children with autism. If clinicians can identify this sort of marker for autism in a young infant, interventions may be better able to keep the child’s social development on track.

“This insight, the preservation of some early eye-looking, is important,” explained Jones. “In the future, if we were able to use similar technologies to identify early signs of social disability, we could then consider interventions to build on that early eye-looking and help reduce some of the associated disabilities that often accompany autism.”

The next step for Jones and Klin is to translate this finding into a viable tool for use in the clinic. With support from the NIH Autism Centers of Excellence program, the research team has already started to extend this research by enrolling many more babies and their families into related long-term studies.

They also plan to examine additional markers for autism in infancy in order to give clinicians more tools for the early identification and treatment of autism.

Grant: R01MH083727

About the National Institute of Mental Health (NIMH): The mission of the NIMH is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and care. For more information, visit http://www.nimh.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

NIH…Turning Discovery Into Health®

Reference

Jones W, Klin A. Attention to eyes is present but in decline in 2-6-month-old infants later diagnosed with autism. Nature, Nov. 6, 2013.

 

 

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This National Diabetes Month: remember to keep an eye on your eyes

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From the National Institutes of Health

If you are one of more than 25 million Americans with diabetes, you may already know the importance of watching your diet and keeping track of your blood sugar. But did you know it’s also important to have regular eye exams?

In the United States, diabetic eye disease is the leading cause of vision loss among working-age adults. Diabetic retinopathy is the most common form of this disease, and affects about 28.5 percent of Americans with diabetes age 40 and older. That’s more than 7 million people, and the number is expected to reach more than 11 million by the year 2030.

The condition can creep up quietly. It gradually weakens small blood vessels in and around the retina, the light-sensing layer of tissue at the back of the eye. If the disease progresses, these vessels may rupture and leak blood into the eye; they can also spread and grow on the surface of the retina and cause scarring.

Typically, diabetic retinopathy has no symptoms until it reaches an advanced stage. But the disease can be detected early through a comprehensive dilated eye exam. In this procedure, an eye professional will put drops in your eye to dilate (widen) the pupil, which allows a closer look at the retina.

The good news is that with early detection, timely treatment, and appropriate follow-up, the risk of severe vision loss from diabetic retinopathy can be reduced by 95 percent.

There are several effective treatment options including laser surgery and injections of anti-VEGF drugs. These drugs block the actions of a protein that can cause abnormal blood vessels to grow and leak fluid.

 

A comprehensive dilated eye exam can catch diabetic eye disease early, before symptoms appear.

November is National Diabetes Month. If you have diabetes, it’s a good time to remember these health tips:

  • Get a comprehensive dilated eye exam at least once a year.
  • Control your blood sugar, blood pressure and cholesterol levels. By controlling your diabetes, you’ll reduce your risk of diabetic eye disease.
  • Talk to your eye care professional about diabetic retinopathy.
  • Learn more about diabetic eye disease from the National Eye Institute, part of the National Institutes of Health.

NEI’s Diabetic Retinopathy Clinical Research Network (DRCR.net) conducts large multi-center trials of new therapies for diabetic eye disease; it comprises nearly 1000 investigators at sites in 48 states.

Many of the sites are private practice eye clinics, enabling the network to quickly bring innovative treatments from research into community practice. An ongoing trial is comparing three anti-VEGF drugs for macular edema, a complication of diabetic retinopathy that causes central vision loss. For more information, please see trial NCT01627249 at http://www.clinicaltrials.gov.

The National Eye Institute, part of the National Institutes of Health, leads the federal government’s research on the visual system and eye diseases. NEI supports basic and clinical science programs that result in the development of sight-saving treatments. For more information, visit http://www.nei.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

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Dental and vision care part of ‘essential benefits’ for kids – FAQ

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Eye-chartBy Marissa Evans
KHN Staff Writer

One part of the Affordable Care Act is intended to improve dental coverage for children, an extension of effort by public health advocates that followed the 2007 death of a Maryland boy named Deamonte Driver, who was killed by a bacterial infection that spread from an abscessed tooth to his brain.

The 12-year-old’s family was uninsured, and the family had lost its Medicaid coverage. His mother focused on getting his brother’s six rotting teeth taken care of before turning to Deamonte’s dental care, but by then the infection had spread. After two surgeries and weeks of hospital care, he died.

Supporters of better dental care for children fought to have dental and vision services for children included as part of pediatric services, one of 10 categories of essential benefits.

With the Affordable Care Act, more Americans will have the opportunity to purchase dental insurance on the new health care exchanges starting Oct. 1.

Here are some basic questions and answers about dental and vision coverage.

Q. Will I be required to buy pediatric dental care if I purchase insurance on the exchange?

A. Most likely, no. Children’s dental care may be included in some plans offered on the marketplaces as part of the medical coverage you are required to buy.

But many insurers may offer it as a stand-alone policy, which you are not required to buy under byfederal law but may be required by states.

At least two — Nevada and Washington — are requiring this coverage. For children the insurance will help pay for the cost of visits to a dentist for basic or preventive services, like teeth cleaning, X-rays and fillings and medically necessary orthodontics.

Q. Will I be required to buy pediatric vision coverage by the Affordable Care Act?

A. Yes, it will be included in the Medical plan, and at least partially covers vision care, like eye exams and glasses.

Q. Are adults required to get dental coverage?

A. No, but insurers may offer stand-alone dental policies for adults and families. These will not be subsidized, however.

Q. Is it common for health insurers to not offer dental care as part of comprehensive health insurance?

A. Overwhelmingly, dental benefits are contracted and sold separately from medical plans in the current market. The National Association of Dental Plans says 99 percent of dental benefits are sold under a policy that is separate from medical coverage, according to its July 2013 ACA and Dental Coverage report.

Q. How likely are buyers to add stand-alone dental coverage for children to their purchase of a medical policy?

A. It’s hard to say how it will play out. Consumers will be looking for dental plans that best meet their own needs and those of their children at the right price.

If purchased from a federally run exchange as a stand-alone policy, pediatric dental care can include out-of-pocket expenses as high as $700 per child or $1,400 per family, according to Colin Reusch, a senior policy analyst with the Children’s Dental Health Project.

And the cost of stand-alone coverage won’t count toward the medical out-of-pocket limit built into the health care insurance policy, nor will the premium tax credits families receive to help them purchase coverage be calculated to include premiums for stand-alone plans.

Those costs may cause families to go without coverage, advocates fear.

However, the Delta Dental Plans Association notes that stand-alone dental plans are likely to have much lower deductibles than medical plans that also include child dental care, or possibly no deductibles.

They will also have a lower limit on out-of-pocket expenses than plans that combine medical and pediatric dental care.

That might benefit many families, particularly those that include children with acute dental care needs or those who want paid preventive care without waiting to spend enough to meet a higher deductible.

Q. How many children may benefit from expanded coverage?

A. Approximately 8.7 million children are expected to gain some form of dental benefits by 2018 as a result of the ACA. This will reduce the number of children without dental benefits by about 55 percent compared with 2010, according to a report from the American Dental Association.

About a third of these children will be covered through their parents’ employer-sponsored insurance, while about another third will be covered through Medicaid. The remainder will be covered by new policies from  the health insurance exchanges.

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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Xmas toy safety tips from Seattle Children’s

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Toys that pose choking and other hazards to childrenDoctors’ toy safety tips for the holidays from Seattle Children’s On the Pulse blog

With an abundance of toys to choose from this holiday season, many parents may find themselves asking which toys are best for their young kids.

Pediatricians encourage parents – and anyone buying a gift for a baby or child – to think safety first.

Tony Woodward, MD, MBA, medical director of the division of emergency medicine at Seattle Children’s Hospital, says parents should read toy labels, remove possible hazards, and expect the unexpected when it comes to kids and toys.

“Parents should remember that children don’t perceive toys the same way we do and often don’t use them as we might expect,” says Woodward. “If a toy can be misused, chewed on, eaten, swallowed or thrown at someone, it will be. Parents should ensure that if those things do happen, the child won’t be injured.”

According to the U.S. Consumer Product Safety Commission (CPSC), there were more than 262,000 toy-related emergency room visits in the United States in 2011.

Woodward suggests parents keep these tips in mind when choosing toys for small kids:

Choking Hazards

Choking is the leading cause of toy-related deaths, according to the CPSC. In 2011, there were 13 reported toy-related deaths among children younger than 15 years in the United States, most from asphyxiation.

When choosing toys for small children, bigger is usually better:

  • Stay away from toys that contain many or small parts if there are small children in the household.
  • Be sure to read warning labels for age recommendations. Toys are age-graded to reflect safety risks, including choking hazards. A toy that may be appropriate for an older child can be potentially life-threatening for a baby or toddler.
  • Small balls are also particularly dangerous because they can block a child’s airway completely. “Water Balz,” for example, recalled earlier this week, absorb water and expand to 400 times their original size.

Woodward suggests this rule of thumb to help prevent choking: If a toy can fit inside a paper towel roll, the toy can obstruct the airway of a small child and prevent breathing.

Magnets

Toys that contain small magnets are especially dangerous for young kids. If swallowed, magnets can attract to one another in a child’s intestine and cause serious complications. Woodward says parents should look out for products like “Snake Eggs,” small magnets shaped like eggs that are marketed to children.

Button Batteries

Many toys and gadgets require button batteries, which can pose fatal risks for young kids. If a battery is swallowed, it can cause life-threatening injuries. Be sure batteries cannot be removed easily from toys.

Strangulation

Some toys have strings or cords that can become wrapped around a child’s neck and cause strangulation. Use caution with mobiles or pull toys with long string, and remove long ribbons from kids’ play areas.

Toys containing lead and other chemicals

Just like checking a food’s ingredient list, parents should read toy labels. Avoid products that contain PVC plastic, xylene, toluene, or dibutyl phthalate. Play cosmetics can be particularly hazardous.

Avoid toys and clothes that could contain lead paint or high levels of lead, such as vinyl lunch boxes or rain gear. To test products for lead, parents can purchase home testing kits, available at most local hardware shops. Buy paints, crayons and markers that say “non-toxic” on the label.

More toy safety tips

  • Include safety equipment with toys such as bikes, snowboards or skateboards. Helmets, elbow pads and knee pads make great stocking stuffers.
  • Avoid stuffed animals with buttons or removable parts.
  • Be cautious of toys that make loud noises. Toys that omit noise above 85 decibels can cause gradual hearing loss.
  • Consider the physical skills a child needs to play with a particular toy, and how well the child can understand how to use the toy.

Before wrapping presents this year, Woodward suggests parents review this checklist to help keep their kids safe: “Potential choking hazards should be removed, batteries and magnets should be inaccessible, toys that are sharp or can be used as weapons or projectiles should be removed and easily broken toys should be discarded.”

Toy safety resources:

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The ups & downs of blood pressure

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Anusha Iyer, MD

By Anusha Iyer, MD
Valley Medical Center Fairwood Clinic

Is my blood pressure high?

I get asked this question time and again: what is considered normal blood pressure and what is high?

Generally speaking, in healthy adults a normal blood pressure (BP) is less than 120 systolic (the pressure on the arteries as the heart contracts (squeezes)), and less than 90 diastolic (the pressure on the vessels as the heart relaxes).

In common terms this BP would be expressed as 120 over 90. We call it high blood pressure or hypertension if the BP is greater than 140 systolic and greater than 90 diastolic.

What causes high blood pressure?

Genetics plays an important role. Obesity, weight gain, excessive alcohol use, high cholesterol, excessive use of salt (sodium), not enough activity and a sedentary lifestyle, and type A or having an aggressive personality have all been linked to high blood pressure.

Medications such as oral contraceptive pills, certain cold remedies, anti-inflammatory drugs and many other common medications can increase blood pressure.

Also certain medical conditions such as kidney disease, thyroid and adrenal gland disorders, and sleep apnea can lead to secondary hypertension.

Why is knowing my blood pressure important?

High blood pressure is a major risk factor for heart disease and stroke. Also, untreated hypertension can lead to damage to the eyes and kidneys.

What should I do if my blood pressure is high?

Eat less salt. Most patients don’t realize the high salt content of common foods like certain types of breads and canned soups. Be sure to read labels and choose items with lower sodium content.

Eat more servings of vegetables and fruits. Limit the amount of alcohol you consume. Try to get some cardio-exercise into your weekly schedule. And try to decrease your stress level. (Yeah right! That’s easier said than done!)

If you can you set aside 15 minutes in your day here is a simple meditation exercise to relax your mind and reduce your stress: sit in a quiet place, close your eyes and take slow deep breaths in and out; meditate on peace (choose a person, place or object that makes you feel calm and happy).

I believe that a peaceful and strong internal environment is as essential to a woman’s survival and success as is her external environment.

Keep track of your BP numbers and follow your doctor’s recommendations. You can check your BP with your own blood pressure cuff if you have one, or you can check it by using the free automatic blood pressure monitor available at many large pharmacies. Write down your numbers in a log book and show it to your doctor when you go for your appointment.

Discuss your blood pressure goals with your doctor and write it down. If you are taking medication to lower your BP, don’t forget to take your medication and report any side effects or concerns to your doctor.

Almost 30% of the US population is reported to have high blood pressure. Take control of your blood pressure and work towards a healthier you by adopting healthy habits and setting the right goals.

Dr. Iyer is a Internal Medicine physician in VMC’s Kent Clinic, located at 24920 104th Ave SE in Kent. Phone: 253.395.2000.

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Heather

Finding cures for rare diseases: Film and discussion, Dec. 13th

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NWABR’s Community Conversation Series this month will include a showing of excerpts from the soon to be released film RARE, a documentary about the struggle to find new treatments for Hermansky-Pudlak Syndrome (HPS), a rare genetic disorder.

Heather Kirkwood, a HPS patient who stars in the film and serves as Director of Outreach/VP for the HPS Network, will facilitate our discussion and take questions following the film.

When:

  • Tuesday, December 13, 5:30 to 7:30 P.M.

Where:

  • 415 Westlake at Kakáo Chocolate & Coffee, Seattle.

Cost: 

  •  $10 at the door

Note: Attendance by RSVP

Click here to RSVP or call 206-957-3337×306,

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Decorative contact lenses: Is your vision worth it?

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A Consumer Update from the FDA

Wouldn’t it be cool to have Twilight vampire eyes for Halloween?

Or deep violet eyes to match your purple sweater?

How about your favorite sports team’s logo on your eyes just for fun?

You can have all of these looks with decorative contact lenses (also called fashion contact lenses or color contact lenses, among other names). These lenses don’t correct vision—they just change the appearance of the eye.

But before buying decorative lenses, here’s what you should know:

They are not cosmetics or over-the-counter merchandise. They are medical devices regulated by the Food and Drug Administration (FDA). Places that advertise them as cosmetics or sell them without a prescription are breaking the law.

They are not “one size fits all.” An eye doctor (ophthalmologist or optometrist) must measure each eye to properly fit the lenses and evaluate how your eye responds to contact lens wear. A poor fit can cause serious eye damage, including:

    • scratches on the cornea (the top layer of your eyeball)
    • corneal infection (an ulcer on the cornea)
    • conjunctivitis (pink eye)
    • decreased vision
    • blindness

Places that sell decorative lenses without a prescription may give you few or no instructions on how to clean and care for your lenses.

Failure to use the proper solution to keep contact lenses clean and moist can lead to infections, says Bernard Lepri, O.D., M.S., M.Ed., an optometrist at FDA. “Bacterial infections can be extremely rapid, result in corneal ulcers, and cause blindness—sometimes within as little as 24 hours if not diagnosed and treated promptly.”

“The problem isn’t with the decorative contacts themselves,” adds Lepri. “It’s the way people use them improperly—without a valid prescription, without the involvement of a qualified eye care professional, or without appropriate follow-up care.”

Where NOT to Buy Contact Lenses

FDA is aware that many places illegally sell decorative contact lenses to consumers without valid prescriptions for as little as $20.

You should never buy lenses from:

  • street vendors
  • salons or beauty supply stores
  • boutiques
  • flea markets
  • novelty stores
  • Halloween stores
  • record or video stores
  • convenience stores
  • beach shops
  • Internet (unless the site requires a prescription)

These are not authorized distributors of contact lenses, which are prescription devices by federal law.

How to Buy Decorative Contact Lenses Safely

Get an eye exam from a licensed eye doctor (ophthalmologist or optometrist), even if you feel your vision is perfect.

Get a valid prescription that includes the brand name, lens measurements, and an expiration date. But don’t expect your eye doctor to prescribe anime, or circle, lenses. These bigger-than-normal lenses that give the wearer a wide-eyed, doll-like look have not been approved by FDA.

Whether you go in person or shop online, buy the lenses from a seller that requires you to provide a prescription.

Follow directions for cleaning, disinfecting, and wearing the lenses, and visit your eye doctor for follow-up eye exams.

See your eye doctor right away if you have signs of possible eye infection:

  • redness
  • eye pain that doesn’t go away after a short time
  • decrease in vision

High Price for Fashion

Laura Butler paid $30 for her decorative lenses and $2,000 in medical bills. And she nearly lost an eye.

While at the beach in July 2010, Butler of Parkersburg, W.Va., bought a pair of blue contact lenses at a souvenir shop. The brown-eyed Butler was on vacation and just wanted to try a different eye color for fun, she says.

No instructions came with the lenses and the store didn’t sell contact lens solution. “They felt fine, but they moved around on my eyes and I had to adjust them with my finger,” says Butler.

As she was driving home the next day, Butler felt a sharp pain in her left eye. “It was such excruciating pain, I had to quickly pull over on the side of the road.” It took her 20 minutes to remove the contacts, she says, which had stuck to her eyes like suction cups. She drove home “with pain that was indescribable.”

A trip to the ER and then to an ophthalmologist gave Butler a diagnosis: corneal abrasion. “The doctor said it was as if someone took sandpaper and sanded my cornea,” she says. “He said he wasn’t going to sugar-coat it, that I could lose my eyesight or could lose my eye.”

Butler saw the doctor every day for 10 days and was under his care for seven weeks. “He took really good care of me and I didn’t get an infection,” says Butler. “But the pain was agonizing. I used to lay on the floor and roll back and forth in a fetal position for hours.”

Butler couldn’t see well enough to drive for eight weeks, had a drooping eyelid for five months, and still has decreased vision in her eye, she says. And she found out her optometrist could have ordered two sets of lenses for $50 and charged $60 for an eye exam.

Her advice: Don’t buy fashion lenses. If you do, “Take the time to go to the doctor, pay the extra money, and save yourself the agony.”

This article appears on FDA’s Consumer Updates page, which features the latest on all FDA-regulated products.

October 12, 2011

To learn more:

For related FDA Updates 

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Your aging eyes: how you see as time goes by

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A close-up photo of a blue irisYou may barely notice the changes at first. Maybe you’ve found yourself reaching more often for your glasses to see up close. You might have trouble adjusting to glaring lights or reading when the light is dim. You may even have put on blue socks thinking they were black. These are some of the normal changes to your eyes and vision as you age.

As more Americans head toward retirement and beyond, scientists expect the number of people with age-related eye problems to rise dramatically. You can’t prevent all age-related changes to your eyes. But you can take steps to protect your vision and reduce your risk for serious eye disease in the future. Effective treatments are now available for many disorders that may lead to blindness or visual impairment. You can also learn how to make the most of the vision you have.

“Vision impairment and blindness are among the top 5 causes of disability in older adults,” says Dr. Cynthia Owsley, an eye researcher at the University of Alabama at Birmingham. Vision changes can make it difficult to perform everyday activities, such as reading the mail, shopping, cooking, walking safely and driving. “Losing your vision may not be life-threatening, but it certainly affects your quality of life,” Owsley says.

The clear, curved lens at the front of your eye may be one of the first parts of your body to show signs of age. The lens bends to focus light and form images on the retina at the back of your eye. This flexibility lets you see at different distances—up close or far away. But the lens hardens with age. The change may begin as early as your 20s, but it can come so gradually it may take decades to notice.

Eventually, age-related stiffening and clouding of the lens affects just about everyone. You’ll have trouble focusing on up-close objects, a condition called presbyopia. Anyone over age 35 is at risk for presbyopia.

“You might find you’re holding your book farther away to read it. You might even start thinking your arms just aren’t long enough,” says Dr. Emily Chew, a clinical researcher at NIH’s National Eye Institute. “A good and simple treatment for presbyopia is reading glasses.”

Cloudy areas in the lens, called cataracts, are another common eye problem that comes with age. More than 22 million Americans have cataracts. By age 80, more than half of us will have had them. Some cataracts stay small and have little effect on eyesight, but others become large and interfere with vision. Symptoms include blurriness, difficulty seeing well at night, lights that seem too bright and faded color vision. There are no specific steps to prevent cataracts, but tobacco use and exposure to sunlight raise your risk of developing them. Cataract surgery is a safe and common treatment that can restore good vision.

The passage of time can also weaken the tiny muscles that control your eye’s pupil size. The pupil becomes smaller and less responsive to changes in light. That’s why people in their 60s need 3 times more light for comfortable reading than those in their 20s. Smaller pupils make it more difficult to see at night.

How to protect Your Vision

  • Have a comprehensive eye exam each year after age 50.
  • Stop smoking.
  • Eat a diet rich in green, leafy vegetables and fish.
  • Exercise.
  • Maintain normal blood pressure.
  • Control diabetes if you have it.
  • Wear sunglasses and a brimmed hat any time you’re outside in bright sunshine.
  • Wear protective eyewear when playing sports or doing work around the house that may cause eye injury.

Trouble seeing at night, coupled with a normal loss of peripheral vision as you age, can affect many daily activities, including your ability to drive safely. Loss of peripheral vision increases your risk for automobile accidents, so you need to be more cautious when driving.

“Keeping older adults active and on the road as drivers, as long as they’re safely able to do so, is considered important to their health and psychological well-being,” says

Owsley. But she notes that tests for motor vehicle licenses tend to focus on visual acuity—how well you can read the letters on an eye chart.

“Visual acuity tests may not be the best way to identify drivers at risk for crashes,” she says. “Other issues are also important, like contrast sensitivity, your peripheral vision and your visual processing speed—how quickly you can process visual information and make decisions behind the wheel.”

To find better ways to assess driver safety, Owsley and her colleagues are giving 2,000 older drivers different types of vision screening tests, including tests of visual processing speed. By tracking their driving records for several years, the scientists can figure out which tests were best at predicting safe or dangerous driving, including car crashes. These findings might eventually lead to more accurate screening tests to identify potentially unsafe drivers.

If you’re not convinced you should have regular eye exams, consider that some of the more serious age-related eye diseases—like glaucoma, age-related macular degeneration (AMD) and diabetic eye disease—may have no warning signs or symptoms in their early stages.

Glaucoma comes from increased fluid pressure inside the eye that damages the optic nerve. “Glaucoma can slowly steal your peripheral vision. You may not notice it until it’s advanced,” says Chew. It can be treated with prescription eye drops, lasers or surgery. If not treated, however, it can lead to vision loss and blindness.

People who eat diets rich in green, leafy vegetables—such as kale and spinach—or fish are less likely to have advanced age-related macular degeneration.

AMD causes gradual loss of vision in the center of your eyesight. “AMD is the leading cause of blindness in Americans over age 65,” says Chew.

A large NIH-supported clinical study by Chew and others found that a specific combination of vitamins and minerals can prevent AMD from progressing to a more severe form. Scientists also found that people who eat diets rich in green, leafy vegetables—such as kale and spinach—or fish are less likely to have advanced AMD. A larger study of 4,000 AMD patients is now testing to see if fish oil or a vitamin/mineral combination might slow progress of the disease.

Diabetic eye disease, another leading cause of blindness, can damage the tiny blood vessels inside the retina. Keeping your blood sugar under control can help prevent or slow the problem.

The only way to detect these serious eye diseases before they cause vision loss or blindness is through a comprehensive dilated eye exam. Your eye care professional will put drops in your eyes to enlarge, or dilate, the pupils and then look for signs of disease. “Having regular comprehensive eye care gives your doctor a chance to identify a problem very early on and then treat it,” says Owsley. Annual eye exams are especially important if you have diabetes.

“Many of the healthy behaviors that help reduce your risk for long-term diseases, like heart disease and cancer, can also help to protect your eyesight,” says Owsley. These include not smoking, eating a healthy diet and controlling conditions like diabetes and high blood pressure. “It’s nice to know that healthy living not only adds years to your life, but also protects your vision as you get older,” Owsley says.

To learn more:

Visit these NIH eye-health webpages:

NIH News in Health is a monthly newsletter from the National Institutes of Health, part of the U.S. Department of Health and Human Services, To visit the newsletter’s website go here.

Editor: Harrison Wein, Ph.D.
Assistant Editor: Vicki Contie

Contributors:

  • Vicki Contie
  • Alan Defibaugh (illustrations)
  • Bryan Ewsichek (design)
  • Harrison Wein
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‘Lucky 13’ Tips for a Safe Halloween

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Whether you’re goblin or ghoul, vampire or witch, poor costume choices—including decorative contact lenses and flammable costumes—can haunt you long after Halloween if they cause injury.

With Halloween approaching, the Food and Drug Administration (FDA) joins eye care professionals—including the American Academy of Ophthalmology, the American Association for Pediatric Ophthalmology and Strabismus, the Contact Lens Association of Ophthalmologists and the American Optometric Association—in discouraging consumers from using decorative contact lenses.

These experts warn that buying any kind of contact lenses without an examination and a prescription from an eye care professional can cause serious eye disorders and infections, which may lead to permanent vision loss. Despite the fact that it’s illegal to sell decorative contact lenses without a valid prescription, FDA says the lenses are sold on the Internet and in retail shops and salons—particularly around Halloween.

The decorative lenses make the wearer’s eyes appear to glow in the dark, create the illusion of vertical “cat eyes,” or change the wearer’s eye color.

Safe Costumes

“Although unauthorized use of decorative contact lenses is a concern year-round, Halloween is the time when people may be inclined to use them, perhaps as costume accessories,” says FDA eye expert Bernard Lepri, O.D., M.S., M.Ed.. “What troubles us is when they are bought and used without a valid prescription, without the involvement of a qualified eye care professional, or without appropriate follow-up care. This can lead to significant risks of eye injuries, including blindness.”

Enjoy a safe and happy Halloween by following the “lucky 13” guidelines from FDA, Consumer Product Safety Commission, and the Centers for Disease Control and Prevention:

  • Wear costumes made of fire-retardant materials; look for “flame resistant” on the label. If you make your costume, use flame-resistant fabrics such as polyester or nylon.
  • Wear bright, reflective costumes or add strips of reflective tape so you’ll be more visible; make sure the costumes aren’t so long that you’re in danger of tripping.
  • Wear makeup and hats rather than masks that can obscure your vision.
  • Test the makeup you plan to use by putting a small amount on your arm a couple of days in advance. If you get a rash, redness, swelling, or other signs of irritation where you applied it, that’s a sign you may be allergic to it.
  • Check FDA’s list of color additives to see if additives in your makeup are FDA approved. If they aren’t approved for their intended use, don’t use it.
  • Don’t wear decorative contact lenses unless you have seen an eye care professional and gotten a proper lens fitting and instructions for using the lenses.

Safe Treats

Eating sweet treats is also a big part of the fun on Halloween. If you’re trick-or-treating, health and safety experts say you should remember these tips:

  • Don’t eat candy until it has been inspected at home.
  • Trick-or-treaters should eat a snack before heading out, so they won’t be tempted to nibble on treats that haven’t been inspected.
  • Tell children not to accept—or eat—anything that isn’t commercially wrapped.
  • Parents of very young children should remove any choking hazards such as gum, peanuts, hard candies, or small toys.
  • Inspect commercially wrapped treats for signs of tampering, such as an unusual appearance or discoloration, tiny pinholes, or tears in wrappers. Throw away anything that looks suspicious.

For partygoers and party throwers, FDA recommends the following tips for two seasonal favorites:

  • Look for the warning label to avoid juice that hasn’t been pasteurized or otherwise processed, especially packaged juice products that may have been made on site. When in doubt, ask! Always ask it you are unsure if a juice product is pasteurized or not. Normally, the juice found in your grocer’s frozen food case, refrigerated section, or on the shelf in boxes, bottles, or cans is pasteurized.
  • Before bobbing for apples—a favorite Halloween game—reduce the amount of bacteria that might be on apples by thoroughly rinsing them under cool running water. As an added precaution, use a produce brush to remove surface dirt.

This article appears on FDA’s Consumer Updates page, which features the latest on all FDA-regulated products.

Revised October 20, 2010

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Eye

Light & Depression: How eyes can make us happier — free lecture

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Free lunch-time lecture: “Light & Depression – How Eyes Can Make Us Happier”

UW Professor of Ophthalmology Dr. Russell N. Van Gelder, who is internationally known for his work on how light and our eyes can affect our moods, will talk about research that has implications for depression, seasonal affective disorder (SAD), and even jet lag.

The lecture is a part of the UW Medicine Eye Institute monthly, free brown bag lectures.

When:

  • Tuesday, October 12, noon

Where:

  • UW Medicine Eye Institute (7th Floor, Ninth and Jefferson Building at Harborview Medical Center).

For more information or to RSVP, please call 206-685-2314.

Image Credit: JDrewes in Wikipedia under Creative Commons Attribution-Share Alike 3.0 Unported license.


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