Posts Tagged ‘eye’

Last year, doctors of optometry detected more than 320,000 cases of diabetes. Imagine if they could make the same impact when it comes to exposing early signs of Alzheimer’s disease.

November is National Alzheimer’s Disease Awareness Month. An estimated 5.4 million Americans are affected by Alzheimer’s disease, according to the Centers for Disease Control and Prevention (CDC). Projections put the number at 13.8 million by 2050.

Maryke Nijhuis Neiberg, O.D., associate professor in the School of Optometry at Massachusetts College of Pharmacy and Heath Sciences, in Worcester, Massachusetts, considers this an unrealized patient education opportunity for doctors of optometry.

“The earlier diagnoses give doctors and patients a better chance at managing the progressive brain disease and preserving the patient’s quality of life,” Dr. Neiberg says. “There has been some increase in Alzheimer’s awareness over the years, particularly in the eye community, but not enough yet.

“Alzheimer’s is a significant future public health issue,” she adds. “It is still a terminal disease.”

Early intervention

Much of the research on Alzheimer’s disease seeks to slow the disease’s progression. For instance, a study in Biological Psychiatry on Nov. 6 by researchers at the University of Iowa and the University of Texas Southwestern Medical Center in Dallas reports that there may be a new treatment that can slow the depression and cognitive decline associated with Alzheimer’s disease, without affecting amyloid plaque deposits or reactive glia in rats.

Among the early signs of Alzheimer’s, the researchers say, are anxiety, depression and irritability-long before the devastating effects of memory loss.

“Thus, P7C3 compounds may form the basis for a new class of neuroprotective drugs for mitigating the symptoms in patients with Alzheimer’s disease by preserving neuronal cell survival, irrespective of other pathological events,” researchers say. “P7C3 compounds represent a novel route to treating depression, and new-onset depression in elderly patients may herald the development of Alzheimer’s disease with later cognitive impairments to follow.”

Another study in JAMA Ophthalmology in September by researchers at Stanford University and Veterans Affairs Palo Alto Health Care System linked visual impairment and cognition in older adults and also stressed the “potential importance” of vision screening in identifying these patients’ eye disease and cognitive deficits. The AOA strongly recommends comprehensive eye examinations and stresses the limitations of screenings.

Optometry’s role

According to the CDC:

The rate of Alzheimer’s jumped 50 percent between 1999 and 2014.

Americans fear losing their mental capacity more than losing their physical abilities.

More than $230 billion is estimated to be spent in 2017 on providing health care, long-term care, hospice plus unpaid care for relatives with Alzheimer’s and other dementias.

More large-scale research on Alzheimer’s needs to be done, but progress is being made. Dr. Neiberg pointed to research linking optical coherence tomography (OCT) of the macula to Alzheimer’s and Parkinson’s diseases.

“With the advent of OCT, we now know that the retinal ganglion cell layer thins and that the optic nerve cup-to-disc ratio increases in size, not unlike glaucoma,” Dr. Neiberg says. “Alzheimer’s produces visual field defects that are easily confused with glaucoma. What we need is large-scale research to determine how much of the normal tension glaucoma we diagnose and treat is ultimately related to Alzheimer’s disease.”

She adds, “The early perceptual changes that occur in early Alzheimer’s are startling and measurable. One of the earliest signs is a decline in the Benton Visual Retention Test, a test of visual memory. This test requires the duplication of shapes on paper with a pencil, and is scored.

“Research has shown that this test is able to predict high risk for Alzheimer’s 15 years before diagnosis,” she says. “It’s a simple test many developmental and pediatric optometrists already have on their shelves. If we combine that test and the ocular findings we see, we have a very strong indication that something is indeed amiss. Armed with this information, the patient can then consult with their primary care physician, initiate lifestyle modification and request a referral if necessary.”

There is no cure for Alzheimer’s disease. But doctors of optometry can engage patients in conversation about Alzheimer’s disease and how they can manage their own risk factors, including:

Smoking
Mid-life obesity
Sedentary lifestyle
High-cholesterol diet|
Vascular disease (i.e., diabetes and hypertension)

“Lifestyle modification and early access to medication, which can delay the progression of dementia, might be enough to keep the disease at bay for longer,” Dr. Neiberg says. “We should include the Alzheimer’s disease connection when we educate our patients about lifestyle diseases.”

https://finchannel.com/society/health-beauty/69483-doctors-of-optometry-can-spot-early-signs-of-alzheimer-s-disease

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Pupil dilation in reaction to negative emotional faces predicts risk for depression relapse, according to new research from Binghamton University, State University of New York.

Researchers at Binghamton University, led by PhD student Anastacia Kudinova, aimed to examine whether physiological reactivity to emotional stimuli, assessed via pupil dilation, served as a biological marker of risk for depression recurrence among individuals who are known to be at a higher risk due to having previous history of depression. Participants were 57 women with a history of major depressive disorder (MDD). The researchers recorded the change in pupil dilation in response to angry, happy, sad and neutral faces. The team found that women’s pupillary reactivity to negative (sad or angry faces) but not positive stimuli prospectively predicted MDD recurrence.

“The study focuses on trying to identify certain markers of depression risk using measures that are readily accessible, reliable and less expensive,” said Kudinova. “It is something we can put in any doctor’s office that gives us a quick and easy objective measure of risk.”

Additionally, the researchers found that both high and low reactivity to angry faces predicted risk for MDD recurrence. These findings suggest that disrupted physiological response to negative stimuli indexed via pupillary dilation could serve as a physiological marker of MDD risk, thus presenting clinicians with a convenient and inexpensive method to predict which of the at-risk women are more likely to experience depression recurrence.

“It’s a bit complicated because different patterns of findings were found for pupil reactivity to angry versus sad faces. Specifically, really high or really low pupil dilation to angry faces was associated with increased risk whereas only low dilation to sad faces was associated with risk (high dilation to sad faces was actually protective),” said Brandon Gibb, professor of psychology at Binghamton University and director of the Mood Disorders Institute and Center for Affective Science.

Other contributors to this research include Katie Burkhouse and Mary Woody, both PhD students; Max Owens, assistant professor of psychology at the University of South Florida, St. Petersburg; and Greg Siegle, associate professor of psychiatry at the University of Pittsburgh School of Medicine.
The paper, “Pupillary reactivity to negative stimuli prospectively predicts recurrence of major depressive disorder in women,” was published in Psychophysiology.

https://www.binghamton.edu/mpr/news-releases/news-release.html?id=2448

By Mo Costandi

It’s sometimes said that the eyes are windows into the soul, revealing deep emotions that we might otherwise want to hide. The eyes not only reflect what is happening in the brain but may also influence how we remember things and make decisions.

Our eyes are constantly moving, and while some of those movements are under conscious control, many of them occur subconsciously. When we read, for instance, we make a series of very quick eye movements called saccades that fixate rapidly on one word after another. When we enter a room, we make larger sweeping saccades as we gaze around. Then there are the small, involuntary eye movements we make as we walk, to compensate for the movement of our head and stabilise our view of the world. And, of course, our eyes dart around during the ‘rapid eye movement’ (REM) phase of sleep.

What is now becoming clear is that some of our eye movements may actually reveal our thought process.

Research published last year shows that pupil dilation is linked to the degree of uncertainty during decision-making: if somebody is less sure about their decision, they feel heightened arousal, which causes the pupils to dilate. This change in the eye may also reveal what a decision-maker is about to say: one group of researchers, for example, found that watching for dilation made it possible to predict when a cautious person used to saying ‘no’ was about to make the tricky decision to say ‘yes’.

Watching the eyes can even help predict what number a person has in mind. Tobias Loetscher and his colleagues at the University of Zurich recruited 12 volunteers and tracked their eye movements while they reeled off a list of 40 numbers.

They found that the direction and size of the participants’ eye movements accurately predicted whether the number they were about to say was bigger or smaller than the previous one – and by how much. Each volunteer’s gaze shifted up and to the right just before they said a bigger number, and down and to the left before a smaller one. The bigger the shift from one side to the other, the bigger the difference between the numbers.

This suggests that we somehow link abstract number representations in the brain with movement in space. But the study does not tell us which comes first: whether thinking of a particular number causes changes in eye position, or whether the eye position influences our mental activity. In 2013, researchers in Sweden published evidence that it’s the latter that may be at work: eye movements may actually facilitate memory retrieval.

They recruited 24 students and asked each one to carefully examine a series of objects displayed to them in one corner of a computer screen. The participants were then told to listen to a series of statements about some of the objects they had seen, such as “The car was facing to the left” and asked to indicate as quickly as possible if each was true or false. Some participants were allowed to let their eyes roam about freely; others were asked to fix their gaze on a cross at the centre of the screen, or the corner where the object had appeared, for example.

The researchers found that those who were allowed to move their eyes spontaneously during recall performed significantly better than those who fixed on the cross. Interestingly, though, participants who were told to fix their gaze in the corner of the screen in which objects had appeared earlier performed better than those told to fix their gaze in another corner. This suggests that the more closely the participants’ eye movements during information encoding corresponded with those that occurred during retrieval of the information, the better they were at remembering the objects. Perhaps that’s because eye movements help us to recall the spatial relationships between objects in the environment at the time of encoding.

These eye movements can occur unconsciously. “When people are looking at scenes they have encountered before, their eyes are frequently drawn to information they have already seen, even when they have no conscious memory of it,” says Roger Johansson, a psychologist at Lund University who led the study.

Watching eye movements can also be used to nudge people’s decisions. One recent study showed – maybe worryingly – that eye-tracking can be exploited to influence the moral decisions we take.

Researchers asked participants complex moral questions such as “Can murder ever be justified?” and then displayed, on a computer screen, alternative answers (“sometimes justifiable” or “never justifiable”). By tracking the participants’ eye movements, and removing the two answer options immediately after a participant had spent a certain amount of time gazing at one of the two options, the researchers found that they could nudge the participants to provide that particular option as their answer.

“We didn’t give them any more information,” says neuroscientist Daniel Richardson of University College London, senior author of study. “We simply waited for their own decision-making processes to unfold and interrupted them at exactly the right point. We made them change their minds just by controlling when they made the decision.”

Richardson adds that successful salespeople may have some insight into this, and use it to be more persuasive with clients. “We think of persuasive people as good talkers, but maybe they’re also observing the decision-making process,” he says. “Maybe good salespeople can spot the exact moment you’re wavering towards a certain choice, and then offer you a discount or change their pitch.”

The ubiquity of eye-tracking apps for smartphones and other hand-held devices raises the possibility of altering people’s decision-making process remotely. “If you’re shopping online, they might bias your decision by offering free shipping at the moment you shift your gaze to a particular product.”

Thus, eye movements can both reflect and influence higher mental functions such as memory and decision-making, and betray our thoughts, beliefs, and desires. This knowledge may give us ways of improving our mental functions – but it also leaves us vulnerable to subtle manipulation by other people.

“The eyes are like a window into our thought processes, and we just don’t appreciate how much information might be leaking out of them,” says Richardson. “They could potentially reveal things that a person might want to suppress, such as implicit racial bias.”

“I can see eye-tracking apps being used for, say, supportive technologies that figure out what phone function you need and then help out,” he adds, “but if they’re left on all the time they could be used to track all sorts of other things. This would provide much richer information, and raises the possibility of unwittingly sharing our thoughts with others.”

http://www.bbc.com/future/story/20150521-how-the-eyes-betray-your-thoughts

By Helen Thomson

“When the tide came in, these kids started swimming. But not like I had seen before. They were more underwater than above water, they had their eyes wide open – they were like little dolphins.”

Deep in the island archipelagos on the Andaman Sea, and along the west coast of Thailand live small tribes called the Moken people, also known as sea-nomads. Their children spend much of their day in the sea, diving for food. They are uniquely adapted to this job – because they can see underwater. And it turns out that with a little practice, their unique vision might be accessible to any young person.

In 1999, Anna Gislen at the University of Lund, in Sweden was investigating different aspects of vision, when a colleague suggested that she might be interested in studying the unique characteristics of the Moken tribe. “I’d been sitting in a dark lab for three months, so I thought, ‘yeah, why not go to Asia instead’,” says Gislen.

Gislen and her six-year old daughter travelled to Thailand and integrated themselves within the Moken communities, who mostly lived on houses sat upon poles. When the tide came in, the Moken children splashed around in the water, diving down to pick up food that lay metres below what Gislen or her daughter could see. “They had their eyes wide open, fishing for clams, shells and sea cucumbers, with no problem at all,” she says.

Gislen set up an experiment to test just how good the children’s underwater vision really was. The kids were excited about joining in, says Gislen, “they thought it was just a fun game.”

The kids had to dive underwater and place their heads onto a panel. From there they could see a card displaying either vertical or horizontal lines. Once they had stared at the card, they came back to the surface to report which direction the lines travelled. Each time they dived down, the lines would get thinner, making the task harder. It turned out that the Moken children were able to see twice as well as European children who performed the same experiment at a later date.

What was going on? To see clearly above land, you need to be able to refract light that enters the eye onto the retina. The retina sits at the back of the eye and contains specialised cells, which convert the light signals into electrical signals that the brain interprets as images.

Light is refracted when it enters the human eye because the outer cornea contains water, which makes it slightly denser than the air outside the eye. An internal lens refracts the light even further.

When the eye is immersed in water, which has about the same density as the cornea, we lose the refractive power of the cornea, which is why the image becomes severely blurred.

Gislen figured that in order for the Moken children to see clearly underwater, they must have either picked up some adaption that fundamentally changed the way their eyes worked, or they had learned to use their eyes differently under water.

She thought the first theory was unlikely, because a fundamental change to the eye would probably mean the kids wouldn’t be able to see well above water. A simple eye test proved this to be true – the Moken children could see just as well above water as European children of a similar age.

It had to be some kind of manipulation of the eye itself, thought Gislen. There are two ways in which you can theoretically improve your vision underwater. You can change the shape of the lens – which is called accommodation – or you can make the pupil smaller, thereby increasing the depth of field.

Their pupil size was easy to measure – and revealed that they can constrict their pupils to the maximum known limit of human performance. But this alone couldn’t fully explain the degree to which their sight improved. This led Gislen to believe that accommodation of the lens was also involved.

“We had to make a mathematical calculation to work out how much the lens was accommodating in order for them to see as far as they could,” says Gislen. This showed that the children had to be able to accommodate to a far greater degree than you would expect to see underwater.

“Normally when you go underwater, everything is so blurry that the eye doesn’t even try to accommodate, it’s not a normal reflex,” says Gislen. “But the Moken children are able to do both – they can make their pupils smaller and change their lens shape. Seals and dolphins have a similar adaptation.”

Gislen was able to test a few Moken adults in the same way. They showed no unusual underwater vision or accommodation – perhaps explaining why the adults in the tribe caught most of their food by spear fishing above the surface. “When we age, our lenses become less flexible, so it makes sense that the adults lose the ability to accommodate underwater,” says Gislen.

Gislen wondered whether the Moken children had a genetic anomaly to thank for their ability to see underwater or whether it was just down to practice. To find out, she asked a group of European children on holiday in Thailand, and a group of children in Sweden to take part in training sessions, in which they dived underwater and tried to work out the direction of lines on a card. After 11 sessions across one month, both groups had attained the same underwater acuity as the Moken children.

“It was different for each child, but at some point their vision would just suddenly improve,” says Gislen. “I asked them whether they were doing anything different and they said, ‘No, I can just see better now’.”

She did notice, however, that the European kids would experience red eyes, irritated by the salt in the water, whereas the Moken children appeared to have no such problem. “So perhaps there is some adaptation there that allows them to dive down 30 times without any irritation,” she says.

Gislen recently returned to Thailand to visit the Moken tribes, but things had changed dramatically. In 2004, a tsunami created by a giant earthquake within the Indian Ocean destroyed much of the Moken’s homeland. Since then, the Thai government has worked hard to move them onto the land, building homes that are further inland and employing members of the tribe to work in the National Park. “It’s difficult,” says Gislen. “You want to help keep people safe and give them the best parts of modern culture, but in doing so they lose their own culture.”

In unpublished work, Gislen tested the same kids that were in her original experiment. The Moken children, now in their late teens, were still able to see clearly underwater. She wasn’t able to test many adults as they were too shy, but she is certain that they would have lost the ability to see underwater as they got older. “The adult eye just isn’t capable of that amount of accommodation,” she says.

Unfortunately, the children in Gislen’s experiments may be the last of the tribe to possess the ability to see so clearly underwater. “They just don’t spend as much time in the sea anymore,” she says, “so I doubt that any of the children that grow up these days in the tribe have this extraordinary vision.”

http://www.bbc.com/future/story/20160229-the-sea-nomad-children-who-see-like-dolphins

by David Goldman

Google has patented a new technology that would let the company inject a computerized lens directly into your eyeball.

The company has been developing smart glasses and even smart contact lenses for years. But Google’s newest patented technology would go even further — and deeper.

In its patent application, which the U.S. Patent and Trademark Office approved last week, Google says it could remove the lens of your eye, inject fluid into your empty lens capsule and then place an electronic lens in the fluid.

Once equipped with your cyborg lenses, you would never need glasses or contacts again. In fact, you might not even need a telescope or a microscope again. And who needs a camera when your eyes can capture photos and videos?

The artificial, computerized lenses could automatically adjust to help you see objects at a distance or very close by. The lenses could be powered by the movement of your eyeball, and they could even connect to a nearby wireless device.

Google says that its patented lenses could be used to cure presbyopia, an age-related condition in which people’s eyes stiffen and their ability to focus is diminished or lost. It could also correct common eye problems, such as myopia, hyperopia, astigmatism.

Today, we cure blurry vision with eyeglasses or contact lenses. But sometimes vision is not correctable.

And there are clear advantages to being a cyborg with mechanical eyes.

Yet Google (GOOGL, Tech30) noted that privacy could become a concern. If your computerized eyes are transmitting data all the time, that signal could allow law enforcement or hackers to identify you or track your movements. Google said that it could make the mechanical lenses strip out personally identifying information so that your information stays secure.

Before you sign up for cyborg eyes, it’s important to note that Google and many other tech companies patent technologies all the time. Many of those patented items don’t end up getting made into actual products. So it’s unclear if Google will ever be implanting computers into your eyes — soon or ever.

http://money.cnn.com/2016/05/04/technology/google-lenses/index.html

by Elizabeth Preston

Amputees often feel eerie sensations from their missing limbs. These “phantom limb” feelings can include pain, itching, tingling, or even a sense of trying to pick something up. Patients who lose an eye may have similar symptoms—with the addition of actual phantoms.

Phantom eye syndrome (PES) had been studied in the past, but University of Liverpool psychologist Laura Hope-Stone and her colleagues recently conducted the largest study of PES specifically in patients who’d lost an eye to cancer.

The researchers sent surveys to 239 patients who’d been treated for uveal melanoma at the Liverpool Ocular Oncology Centre. All of these patients had had one eye surgically removed. Some of their surgeries were only 4 months in the past; others had taken place almost 4 and a half years earlier. Three-quarters of the patients returned the surveys, sharing details about how they were doing in their new monocular lives.

Sixty percent of respondents said they had symptoms of phantom eye syndrome. These symptoms included pain, visual sensations, or the impression of actually seeing with the missing eye.

Patients with visual symptoms most often saw simple shapes and colors. But some people reported more distinct images, “for example, resembling wallpaper, a kaleidoscope, or fireworks, or even specific scenes and people,” the authors write.

Then there were the ghosts.

Some people said they had seen strangers haunting their fields of vision, as in these survey responses:

A survey isn’t a perfect way to measure how common PES is overall. But Hope-Stone says there were enough survey responses to produce helpful data for doctors who treat patients with eye cancer.

“We can now tell whether certain kinds of patients are more likely to have phantom symptoms,” she says. For example, “PES is more common in younger patients, and having pain in the non-existent eye is more likely in patients who are anxious and depressed, although we don’t know why.”

About a fifth of PES patients, understandably, said they were disturbed by their symptoms. A similar number found them “pleasurable,” Hope-Stone says.

Doctors aren’t sure exactly why phantom eye syndrome occurs. Since different patients have different symptoms, Hope-Stone says, “I suspect that…there may be a range of causes.”

For that matter, phantom limbs are still mysterious to doctors too. “Human perception is a complex process,” Hope-Stone explains. Even when our sensory organs are gone—the vision receptors in our eyes, the pain and touch receptors in our hands—the nerves and brain areas that used to talk to those organs keep working just fine. “Interactions between [these systems] may contribute to phantom sensations,” she says, although “the exact mechanisms are unclear.”

Even if they don’t know why it happens, doctors can warn their patients about the kinds of symptoms they’re likely to experience—and the ghosts they might see.

Phantom Eye Patients See and Feel with Missing Eyeballs

Schizophrenia is associated with structural and functional alterations of the visual system, including specific structural changes in the eye. Tracking such changes may provide new measures of risk for, and progression of the disease, according to a literature review published online in the journal Schizophrenia Research: Cognition, authored by researchers at New York Eye and Ear Infirmary of Mount Sinai and Rutgers University.

Individuals with schizophrenia have trouble with social interactions and in recognizing what is real. Past research has suggested that, in schizophrenia, abnormalities in the way the brain processes visual information contribute to these problems by making it harder to track moving objects, perceive depth, draw contrast between light and dark or different colors, organize visual elements into shapes, and recognize facial expressions. Surprisingly though, there has been very little prior work investigating whether differences in the retina or other eye structures contribute to these disturbances.

“Our analysis of many studies suggests that measuring retinal changes may help doctors in the future to adjust schizophrenia treatment for each patient,” said study co-author Richard B. Rosen, MD, Director of Ophthalmology Research, New York Eye and Ear Infirmary of Mount Sinai, and Professor of Ophthalmology, Icahn School of Medicine at Mount Sinai. “More studies are needed to drive the understanding of the contribution of retinal and other ocular pathology to disturbances seen in these patients, and our results will help guide future research.”

The link between vision problems and schizophrenia is well established, with as many as 62 percent of adult patients with schizophrenia experience visual distortions involving form, motion, or color. One past study found that poorer visual acuity at four years of age predicted a diagnosis of schizophrenia in adulthood, and another that children who later develop schizophrenia have elevated rates of strabismus, or misalignment of the eyes, compared to the general population.

Dr. Rosen and Steven M. Silverstein, PhD, Director of the Division of Schizophrenia Research at Rutgers University Behavioral Health Care, were the lead authors of the analysis, which examined the results of approximately 170 existing studies and grouped the findings into multiple categories, including changes in the retina vs. other parts of the eye, and changes related to dopamine vs. other neurotransmitters, key brain chemicals associated with the disease.

The newly published review found multiple, replicated, indicators of eye abnormalities in schizophrenia. One of these involves widening of small blood vessels in the eyes of schizophrenia patients, and in young people at high risk for the disorder, perhaps caused by chronic low oxygen supply to the brain. This could explain several key vision changes and serve as a marker of disease risk and worsening. Also important in this regard was thinning of the retinal nerve fiber layer in schizophrenia, which is known to be related to the onset of hallucinations and visual acuity problems in patients with Parkinson’s disease. In addition, abnormal electrical responses by retinal cells exposed to light (as measured by electroretinography) suggest cellular-level differences in the eyes of schizophrenia patients, and may represents a third useful measure of disease progression, according to the authors.

In addition, the review highlighted the potentially detrimental effects of dopamine receptor-blocking medications on visual function in schizophrenia (secondary to their retinal effects), and the need for further research on effects of excessive retinal glutamate on visual disturbances in the disorder.

Interestingly, the analysis found that there are no reports of people with schizophrenia who were born blind, suggesting that congenital blindness may completely or partially protect against the development of schizophrenia. Because congenitally blind people tend to have cognitive abilities in certain domains (e.g., attention) that are superior to those of healthy individuals, understanding brain re-organization after blindness may have implications for designing cognitive remediation interventions for people with schizophrenia.

“The retina develops from the same tissue as the brain,” said Dr. Rosen. “Thus retinal changes may parallel or mirror the integrity of brain structure and function. When present in children, these changes may suggest an increased risk for schizophrenia in later life. Additional research is needed to clarify these relationships, with the goals of better predicting emergence of schizophrenia, and of predicting relapse and treatment response and people diagnosed with the condition.”

Dr. Silverstein points out that, to date, vision has been understudied in schizophrenia, and studies of the retina and other ocular structures in the disorder are in their infancy. However, he added, “because it is much faster and less expensive to obtain data on retinal structure and function, compared to brain structure and function, measures of retinal and ocular structure and function may have an important role in both future research studies and the routine clinical care of people with schizophrenia.”

http://www.eurekalert.org/pub_releases/2015-08/tmsh-rcm081715.php