Human Volunteers Test Implantable Vision Chip

(Image courtesy IMI)

Clinical research to develop artificial vision devices has accelerated greatly over the past 3 years. American researchers first introduced a retinal chip with 16 electrodes called Second Sight back in 2003. German scientists have recently reported their success with an innovative 50-electrode retinal chip they call the Learning Retinal Implant (LRI).

The normal visual pathway consists of light rays that stimulate the retina which, in turn, transmits a neural signal to the brain. People with hereditary and degenerative eye disorders have a problem with the conversion of the light impulse into an electrical charge. They lack a healthy supply of vision cells called photoreceptors. This is where the retinal chip does its job.

So far, four blind human volunteers have received LRIs. Customized spectacles have a miniature camera mounted in the frame that transmits the camera image to a tiny computer carried in a fanny pack (the developers use a more sophisticated name). The computer sends a wireless digital signal to the chip. Electrodes inside the chip directly stimulate the retinal ganglion cells and a visual 'image' is sent to the brain.

Retinal chip recipients report the presence of lights and shapes. True, this new 'vision' is very crude compared to your ability to read this blog, however, for individuals denied all eyesight most of their lives the recovery of any visual stimulation is a remarkable achievement. The inventors behind both of these retinal chips forecast continued success as optoelectronic technology evolves.

Related Topics: Diet, Lifestyle May Affect Eye Health, Blind Sleep Disorders

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Eyestrain from Tiny Type?

If you are reading this blog on a handheld device then you already have firsthand experience with the topic of this post. Keep reading, if you can.

So much written information in our lives is being presented to us via dimly lit miniature screens. Just walking around my house I was kept squinting by looking at the coffee maker, the video recorder, a digital camera, several iPods, my beeper, two cell phones, a larger PDA, as well as our home security keypad and a state-of-the-art oven. Even the lawn sprinkler timer has a teeny-weeny digital readout!

More and more people are complaining about text displays. There are two main concerns:

1. The characters are just too darn small; and
2. The screen illumination is inadequate. Not long ago novice computer users had the same problems but hardware manufacturers were able to enhance screen resolution and text readability.

Don't you hate it when you get beeped in daylight and you cannot see the characters on the digital readout? You tilt it every way possible to catch a glimpse of the screen - it's most annoying while trying to drive and still carry on a cell phone conversation!

Eyestrain is a big problem because most of these devices are intended to be held within arms distance - up close. The closer you hold it the more your eyes will need to accommodate (boost near-focusing power). Continuous accommodation is uncomfortable so take frequent rest breaks and simply 'stare off into the distance'. Beyond age 40 many adults have lost so much of their accommodative reserve they need bifocals to compensate (presbyopia). That makes a difficult task unbearable.

Before you invest in another new digital gadget make sure you test drive it in the store and, hopefully, outdoors in the parking lot. Do not expect your eyes to eventually adapt. What you see (or don't see) is what you get. If you cannot read the screen display clearly you should consider an alternate model. Once again, you get what you pay for. Cheaper units typically have weaker, shorter-life batteries and that means uncomfortable squinting.

Read the fine print. You'll enjoy your new electronic gizmo more if you can see what it is you are doing.

Related Topics: Setting Up Your Office For Minimum Injury, Clean that Computer Keyboard

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Vitamin A: Malnourished in the USA

The healthy eye needs to be able to deliver focused rays of visible light through various transparent media (cornea, crystalline lens, vitreous gel), so that those rays strike the retina and transmit a visual image to the brain.

Like other organs in the body, the eyes need a variety of specific nutrients in order to do their job. Vitamin A is critical to good vision. Vitamin A is a fat-soluble vitamin. That means it is absorbed into the bloodstream and stored in the liver, (the same is true for Vitamins D, E, and K). Vitamin A can be stored but those stores can also become depleted.

Vitamin A is essential for producing tears and keeping the surface of the eye moist and free of infection. Inadequate Vitamin A levels will also damage the clear cornea. Nearly everyone knows that carrots (loaded with Vitamin A) are healthy for the retinal cells - the photoreceptors. Poor vision in dim light (nyctalopia) is one of the earliest symptoms of Vitamin A deficiency, hypovitaminosis A. High-dose supplemental Vitamin A is prescribed as a treatment for some hereditary retinal disorders.

People tend to think of underserved Third World populations when the subject of malnutrition is discussed. It might surprise you to know that many Americans are malnourished, deficient in the key nutrients, minerals and vitamins essential for healthy living.

Malnourishment occurs in one of three situations: when a person fails to consume an adequate quantity of a necessary nutrient; when an individual's digestive tract cannot properly absorb the nutrition; or when a person's metabolism cannot correctly convert and store the digested products. Folks who have low Vitamin A levels can fit into each of these categories. I've got a few examples to share.

Patients who have undergone weight-loss surgery, like those popular gastric bypass procedures, are at risk of Vitamin A deficiency because their reconfigured anatomy short-circuits the absorption pathway. Anyone with liver problems is also at risk. Combine those people with the hordes who observe quirky exclusionary diets that deny the body of a healthy balance of vitamins and minerals. Your primary care doctor can help you determine if you are at risk.

Preserving your eyesight is a daily responsibility. Consuming a balanced diet rich in essential nutrients is an important part of maintaining healthy vision. It begins with Vitamin A.

Related Topics: Fruits, Veggies May Help Avoid Cataracts, Madonna's Fountain of Youth

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Rapid Recovery Predicted for Teri Hatcher

Good news from Hollywood. Teri Hatcher, star of ABCs 'Desperate Housewives' suffered an accidental eye injury when a light bulb exploded on-set. A glass fragment struck her eye and may have become embedded in her clear cornea. She has been successfully treated and will soon be able to resume work.

The eye has remarkable protective properties. The blink reflex is faster than a deploying airbag (faster than 50 milliseconds). Teri's blink reflex likely protected her from multiple injuries to both eyes. The clear cornea is also a remarkably durable tissue. It's made of pure collagen and its outer layers are most dense - trapping fragments at more superficial layers.

After applying an anesthetic eyedrop the eye surgeon can gently retrieve the piece of debris with a fine-tipped forceps (you call 'em tweezers!)

Corneal healing is not like skin. Since the transparent cornea has no blood vessels the corneal tissue will heal without bleeding, scarring or serious inflammation. In a matter of days the injury site will likely become invisible.

TV fans around the world are relieved that Teri Hatcher is safely recovering from this accident and excited that she will soon be back on Wisteria Lane flashing those voluptuous peepers!

Related Topics: Eye Injuries Twice as Common in Men, First Aid for Eye Injuries

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Most New MDs Lack Eye Exam Skills

Sad but true, most medical school graduates have had little formal instruction regarding eye exam techniques and even less clinical experience. Your family's medical care may suffer down the road because of this serious shortcoming in medical education.

This problem is not confined to one medical school or to a particular region. Recently the AUPO (Association of University Professors in Ophthalmology) held a symposium to raise awareness of this serious concern and to develop strategies to restore ophthalmology into the medical school curriculum.

In a country with 23 million diabetics many of our newest MDs are unable to determine if a patient has experienced bleeding inside the eye. How did things get this way?

Since the advent of managed care so much emphasis has been placed on primary care medicine that most medical specialties (like ophthalmology, ENT, and urology) have been given less emphasis. There goes the baby with the bath water...

Here's the problem in a nutshell. Basic clinical skills like ophthalmoscopy are practiced by nearly all doctors regardless of specialty. The ability to look inside the eye and to identify problems is comparable to interpreting an EKG or listening to breath sounds with a stethoscope. Patients have no way of knowing whether or not their doctors are truly proficient in all examination skills. Most of us equate medical licensure with medical proficiency.

National and state medical regulatory boards recognize this problem and have begun incorporating eye exam skills in the mandatory practical examinations needed for medical licensure. This forces the young doctors and their medical schools to reassess what is taught - if it's not enough become better physicians at least it's enough to pass the stupid test!

Related Topics: Common Vision Problems, Diet, Lifestyle May Affect Eye Health

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Getting the Most from Your Prescription Eyedrops

Taking a once-a-day pill to control your blood pressure or cholesterol level is a very efficient way to manage a health problem. Once the pill is swallowed your metabolism takes over - it's a closed system. That's not the same with eyedrops.

There are a variety of once-a-day drops to help control intraocular pressure for folks with glaucoma, but the eye relies on that one drop of medication to work continuously for 24 hours. Unlike swallowing a pill, instilling an eyedrop is a more risky proposition. The eye medication can disappear.

It only takes three blinks for all of the medicine to be washed away by the tears, long before the clear cornea can adequately absorb the drug. Three blinks.

If you are taking prescription eyedrops there are some simple steps you can take to maximize drug availability and minimize drug washout.

First, once the eyedrop is instilled close your eyes. If you do not blink the medication can linger. At the same time gently apply fingertip pressure for 2-3 minutes to the skin between the inner eyelid corner (medial canthus) and the bridge of the nose. This is especially valuable for anyone taking once-a-day eyedrops. Get the full value of your medication.


Finally, if you need to take more than one eyedrop in any eye allow five minutes to pass between doses to keep the second drop from washing away the first drop.

Related Topics: Eye Health Center, Eye Problems

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Doubly-Satisfying Communications

Next time you have an important doctor's visit, and not just the eye doctor, bring along a partner. It doesn't have to be a spouse or immediate relative - sometimes a good friend is best.

How many times have you had a key question pop into your head as soon as you depart the clinic? I frequently receive distressed messages from visitors to our WebMD Eye & Vision Disorder Community who seek clarification regarding proposed surgery, treatment alternatives, or suspected complications. Here's why having that third person in the room optimizes the physician-patient encounter:

Accurate recollections- "Did she say once- or twice-a-day?" Having a partner handy with a notepad improves compliance with the doctor's recommendations. The two of you can debrief each other afterwards to resolve any misunderstandings.

All points get covered - In the middle of a focused dialogue it's easy to overlook other concerns. Your partner can help keep the conversation on track.

All questions get asked - Having a second brain and another pair of ears in the room doubles the chances that all of your concerns are mentioned and thoroughly discussed.

Calmer interactions - People are more civilized when observers are present. Your partner can speak on your behalf if you get too emotional or simply call for a 'timeout'.

Sure, you have to accept personal responsibility for preserving your own good health, but that does not mean you have to go it alone!



Related Topics: Integrative Medicine Resource Center, 7 Key Traits of an Ideal Doctor

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When New Eyeglasses No Longer Work

Lately I've been dealing with some dissatisfied patients. No, not angry patients - just puzzled because new eyeglasses prescribed just a month ago no longer work.

Whenever I hear that a large alarm goes off inside my head: Put on your thinking cap, doc!

Although it is true that refractive errors like nearsightedness or farsightedness gradually change throughout life, a significant shift occurring within weeks or a few months deserves careful attention. Three common situations ought to be explored.

1. It is possible that the original prescription did not completely correct the optical error. This can happen with farsighted hyperopes. Initially the patient may have been able to compensate by accommodating (borrowing near-focusing power to see at distance) but eventually the person can no longer tolerate such 'optical embezzlement'. A dilated cycloplegic refraction will quickly unmask any hidden refractive errors.
   
   If the new glasses no longer work ask the eye doctor if you were prescribed the full correction.



2. Progressive corneal thinning, as happens in keratoconus, can generate all kinds of wacky focusing problems. As a young ophthalmologist-in-training I encountered a patient who had purchased four pairs of glasses over six months before his keratoconus was recognized. Corneal topography can confirm the presence of keratoconus.
   
   If the new glasses no longer work ask the eye doctor if there is any chance you have keratoconus.



3. Finally, untreated (or inadequately treated) diabetics experience wide fluctuations in blood glucose levels. The body responds by altering the chemical pathway used for energy metabolism. This shortcut causes the crystalline lens to swell and distort the optics of the diabetic eye. Simple blood tests can verify the presence of diabetes or a pre-diabetic state.
   
   If the new glasses no longer work ask the eye doctor if you might be glucose intolerant.

In general, the more questions you ask the better health care you will receive.

Related Topics: Diabetes Control Benefits Surgery, Healthy Diet May Help Seniors' Vision

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FAT Scans Improve Care

Most folks know about CAT Scans (Computer Assisted Tomography) that capture thin x-ray images of specific areas of the anatomy. Maybe you haven't done a FAT Scan. FAT stands for Family Album Tomography. Yep, use your family album to get better medical care.

Here's how FAT Scans work.

If you need to see the doctor for any kind of symptom that involves a change in your physical appearance (like a mild eyelid droop or change in the size of an unwanted freckle) bring some old photographs with you to the clinic for the doctor to examine. Expect a hearty "Thank You!" from the physician for actively participating in your own care - for being such a helpful partner.

Depending on the specifics of your problem, utilizing the FAT Scan can spare you unnecessary tests and additional visits. At the same time it can accelerate treatment decisions. That will save you time, money and worry.

Related Topics: Skin Cancer Exam, Drooping Eyelid

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Problems with Prescription Eyewear

A new spectacle prescription can be exciting because you expect to see better and it's an opportunity to update the style of your eyeglass frames. There are times, however, when those new glasses disappoint. "Did the doctor make a mistake?"

Information about your refractive error (and its correction) is transcribed by hand many times by different people before you pickup those prescription spectacles: the eye doctor verbally dictates refraction measurements to the technician, the data is then entered into patient record, a handwritten Rx is issued, an optical shop prepares new spectacle work order, and the optician fabricates new lenses. For most eyewear prescriptions 6 different numbers are recorded and 4 require (+) or (-) signs. Yeah, there's room for plenty of errors! Some studies note that new prescription spectacles deviate significantly from the doctor’s refraction more than 20% of the time.

Here's how to make sure you get what you deserve. Always keep a photocopy of the original prescription; that will protect you from misrepresentation by others. If you cannot see clearly in your new specs you should ask the optician to verify the lens powers right there in the store. Those numbers should match the original written prescription.

If the prescription was correctly fabricated and you remain dissatisfied visit the prescribing eye doctor. Ask to have the prescription of your new eyeglasses verified with the eye doctor's original refraction. The clinic may uncover a reversed number or minus sign. In that situation the clinic will issue a corrected prescription and you should not be charged to have the eyeglass error corrected.

Now, if the eyeglass shop did not make a mistake, and the eye clinic did not make a mistake you likely need to adapt to the new eyewear (especially if there is new or changed correction for astigmatism). Otherwise, you may have a fluctuating refractive error due to a related eye disorder like diabetes or keratoconus. Bottom line - if those new glasses don't work right make sure you notify your eye doctor.

Related Topics: Vision Tests, Reading Your Eyeglass Prescription

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Omega-3: Vital Vision Nutrient

One of the neat things about being part of the WebMD team is the advance access I receive to all kinds of information. Yes, news before it happens! Having that peek gives me a chance to rebut or reinforce these 'breakthroughs'.

Over the next several days you are likely to hear a lot about the benefits of Omega-3 fatty acids. Omega-3...sounds like a destination on the TV series 'Battleship Galactica'!

Fatty acids are naturally-occurring chemicals that are found in various foods. They are also synthetically manufactured in pill form as a daily nutritional supplement. Fatty acids are an unfortunate name because they are not fat and Omega-3 actually lowers the bad cholesterol levels in your body.

Omega-3 is a key ingredient in many cell activities, including vision and brain function. A diet rich in Omega-3 fatty acids leads to preservation of vision as one matures as well as sustained memory and other cognitive activities. Guess what? Omega-3 will also enrich your immune system, help control diabetes, and relieve many chronic skin conditions.

Fresh fish is the best source of dietary Omega-3 (tuna, mackerel, and salmon lead the list). You can also find butter substitutes that offer this vital nutrient. 500-1,000mg per day is recommended. Remember, don't overdo it - megadosing can be dangerous! Three ounces of fresh fish twice a week ought to do it. I'll enjoy mine with some homemade coleslaw!

Related Topics: B Vitamins May Not Cut Heart Risk, Rare Reactions Reported with Macugen

Editor's Note: For more information on Omega-3 Fatty Acids, watch Dr. Lloyd's interview on CNN tomorrow, April 15,2006 at approximately 4:40 PM EDT.

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Vision Chart Often Unhelpful

"Damage to my eye? How can that be if I can still see 20/20?"

Seems contradictory, doesn't it? 20/20 vision is the traditional standard for healthy eyesight, but in 2006 we know better.

Truth be told, most folks with fully corrected refractive errors ought to see 20/15, one full line better (smaller) than the 20/20 line. More importantly, there are other, more sensitive techniques to accurately gauge visual function. There are simple tests that can indicate an abnormal condition long before problems pop-up reading the eye chart.

Cold fact: the Snellen eye chart is a very crude means to assess visual performance. '20/20 eyesight' doesn't guarantee that there is no problem.

Let's read between the lines. Delicate nerve fibers transmit the visual image from the eye to the brain. Since so many of the eye's 1.5 million nerve fibers serve the critical central retina (macula), there can be extensive damage beyond the macula and the patient may have no symptoms whatsoever. They may still be able to nail the 20/20 line. The problem comes when irreversible nerve fiber loss eventually involves the macula (and symptoms begin) it may already be too late to make a difference.

Don't freak! Eye doctors know about this cruel trick of nature and have developed useful tests that accurately assess the earliest possible changes. Pupil reactivity, light and color desaturation, contrast sensitivity, and blue-yellow perimetry are just a few techniques that alert the examiner to serious problems in time to help patients preserve crisp eyesight.

Remember, visual acuity is just the beginning of the eye exam!

Related Topics: Innovations in Hearing, 4 Big Advances Changing Medicine

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Contact Lens Solution May Be Source of Fungal Infections

Just last week I shared with you the three rules to protecting yourself from serious corneal ulcers caused by nasty bugs like the fungus Fusarium:

1. Wash your hands regularly with soap and water
2. Do not abuse your contact lenses
3. Wash your hands regularly with soap and water

Now the outbreak is larger than imagined involving people in 17 states in all regions of the country.

Did you know that there are over 35 million contact lens wearers in America? The average age is 34 and two-thirds are female.

In my practice I have the opportunity to examine many infected corneas. The eye hurts, looks inflamed, and the vision is crud. Clearing the infection is merely the beginning. Scarring and corneal infiltration by new blood vessels may subsequently doom this transparent structure.

The FDA just released a fact sheet describing the problem and recommended preventive measures. Here is an excerpt:

Of the 30 patient cases fully investigated so far, 28 wore soft contact lenses and two reported no contact lens use. Twenty-six of the soft contact lens users who remembered which solution they used during the month prior to the infection onset reported using a Bausch & Lomb ReNu brand contact lens solution or a generic brand manufactured by the same company. Five case-patients reported using other solutions in addition to the ReNu brand, and 9 patients reported wearing contact lenses overnight, a known risk factor for microbial keratitis.

"It is important to note that some of the affected patients had used other solutions in addition to the ReNu brand, and that the source of this fungus has not yet been identified. But we're working with CDC and Bausch & Lomb -- and we're investigating other possible causes -- to prevent these infections," Dr. Schultz added.

For now, nobody needs to throw away their stockpile of unused lenses, but all need to be extra careful about contact lens cleaning and handling.

Executive summary: Now more than ever, if you overwear or otherwise abuse your contact lenses you may risk permanent vision loss.

Related Topics: Caring For Your Contact Lenses, New Contact Lenses, Old Eye Infection Risk

Technorati Tags: eye fungus, contacts, ReNu, keratitis

Springtime Ritual: New Sunglasses

At long last there is a break to the weather. Sunny, mild days will lure more of you outdoors.

The smart ones will remember to apply sunblock every morning (keep a bottle on your bathroom sink and use it as a daily moisturizer - men, women, and children). Next, you'll start to look for those sunglasses you wore last summer. "I know I put them somewhere!" (I currently have three pairs hiding on me). Before long you are off to the store to buy another pair of sunglasses. Will you make a savvy purchase?

One of the great things about a WebMD membership is having access to lots of 'behind the scenes' health consumer information. This applies to everyday purchases like sunglasses, too.

Here's a quick breakdown on what to look for in your new sunglasses:

• Demand 100% UV protection - protect your eyes from dangerous ultraviolet rays that will age your eyelid skin, accelerate cataract formation, and contribute to vision loss later in life from Age-Related Macular Degeneration.
• Tint is irrelevant - The intensity of the dark tint (or mirror coating) does not correlate with filter strength.
• Stare from glare? Ask about polarized lenses to reduce or eliminate harsh glare
• Wraparounds - Give yourself complete protection
• Durability - Whether prescription or OTC, make sure the lenses are made of polycarbonate.

Finally, remember that ordinary sunglasses are not the same product as protective sports eyewear. If you plan to be involved in outdoor athletics or extreme activities it is wise to invest in a high quality pair of indestructable sunshades that will protect your eyes from the seen and the unseen!

Related Topics: Summer Skin Care, Spring Break for your Body

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Eyewear Innovation: Autofocus Lenses?

The basic design for eyeglasses has been around since antiquity. Altering the shape of a spectacle lens bends incoming light rays so that, upon entering the eye, an image lands precisely on the retina. Nearsighted myopes wear lenses with concave surfaces that generate minus focusing power, whereas farsighted hyperopes are corrected with convex lenses that provide plus focusing power.

Here's a quick quiz: Do you recall who is credited with inventing bifocal spectacles? (answer posted below).

Optical scientists at the University of Arizona (a major vision research institute) have announced a novel spectacle lens design that requires no lens grinding and permits prescription updates to be programmed with a computer. Researchers have applied the physics of the familiar liquid crystal display (LCD) to prescription eyewear.

Similar to a laptop computer screen (like the one being used to compose this blog,) UA inventors created a sandwich made of two pieces of flat glass separated by an ultra-delicate film of liquid crystal. This inner layer is only one twentieth the width of a human hair.

Light rays penetrating this transparent 'sandwich' are bent depending on the orientation of the liquid crystal molecules. It only takes a tiny bit of electricity to manipulate these molecules and customize the specific optical qualities of these remarkable 'liquid lenses'.

The first prototype was designed to be used as a bifocal - flick the switch to see at near. In the future UA researchers hope to develop a full-time LCD spectacle that will continuously autofocus in response to the wearer's instantaneous visual requirements. Very cool, indeed!

(Quiz answer: Benjamin Franklin invented bifocal spectacles in 1785).

Related Topics: Common Vision Problems , Vision Problems in Aging Adults

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Apertures

Does anybody still use a 35mm camera - the kind that uses film?

For those of you under 21, photographic film is an expensive light sensitive medium used to store camera images. Film was purchased in rolls of 24 or 36 exposures and brought to a retail outlet in order to chemically develop the film and to generate prints.

Wow, how quickly things have changed!

Digital cameras have revolutionized photography. Most folks simply point-and-click. My daughter creates beautiful 4x6 prints in her bedroom.

Even if cameras have changed, eyeballs remain the same. Interestingly, both rely on apertures for acquiring clear images.

Aperture refers to the size of the hole that permits light to enter, whether the camera's lens diaphragm or the human pupil. Large aperatures let in excess light whereas a small aperature restricts light rays. But it is a bit more involved than that.

Amateur photographers no longer pay attention to the f-stop, an archaic aperture measurement that is now calculated by a digital chip in point-and-shoot cameras. F-stop was the ratio of the focal length of a lens or lens system to the effective diameter of its aperture. Think inversely! A large F-stop (11,16) meant a small aperture and less light. More was less; I nearly always got it backwards.

Nowadays, when you select from a digital camera's preset menu to shoot, let's say, an indoor portrait, you abdicate control of the aperture to the camera's electronic brain (often a wise choice!)

Cameras are beginnig to approach the exquisite functionality of eyes. Well, almost. The pupil provides the aperture for human vision. In bright light the healthy pupil automatically shrinks without altering the perceived visual image. Guess what? The pupil will also automatically shrink as a visual target gets closer to the eye. As the pupil shrinks its F-stop enlarges and the depth of focus lengthens, greatly helping us thread that needle!

Fortunately for us, vision has always been a point-and-click proposition.

Related Topics: Diet, Lifestyle May Affect Eye Health, Squint at Computer Screen: Eye Risk?

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A Fungus Among Us: Prevention

Have you seen the recent reports regarding serious infections of the clear cornea caused by common fungal organisms? A corneal ulcer is a medical emergency. Treatment is complex and expensive. Surgery is often necessary to save the eye and the visual prognosis is often pessimistic.

Here are three essential keys to keeping your eyes safe from such a blinding infection:

1. Wash your hands regularly with soap and water
2. Do not abuse your contact lenses
3. Wash your hands regularly with soap and water

The eyes are continuously bombarded by all kinds of bugs: bacteria, viruses, and fungi. Anyone doing yardwork who has operated a leaf blower without protective goggles knows what I mean. So, why don't we all have these serious eye infections?

The anatomy of the eye is designed to protect the eyesight. Did you know that the healthy tear film has antimicrobial properties? Next, there's layer of delicate cells, the corneal epithelium, that coats the outer corneal surface. So long as these cells remain intact the eye will successfully resist infection. Injury to these epithelial cells exposes the naked cornea and it becomes vulnerable to contamination. That's the gist behind those scary reports out of Miami regarding corneal ulcers due to infection by the common fungus Fusarium.

Contact lens wearers are at risk 24/7 because they touch their eyes frequently, apply and remove their contact lenses, clean and maintain those lenses, and they occasionally overextend their lens schedule. Contact lens overwear damages the epithelial cells and a critical barrier to infection is lost.

Are you one of the millions who wear contact lenses? Take a moment to review your contact lens care plan. Still using ancient bottles of wetting solutions? How old is that case? There's never been a better time to do some spring cleaning and replenish your contact lens supplies.

Related Topics: Vision Problems in Aging Adults, Caring For Your Contacts


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The Option to Tell the Truth?

Every so often I drift away from eyeballs and optics to discuss other dimensions of medical care. This is one of those times.

This week I am assigned to give a medical ethics lecture to the resident physicians in our department. The topic is 'Truth-Telling' in the clinical environment.

Did you know that the Hippocratic Oath does not obligate the physician to tell the truth? Centuries ago healers were actually encouraged to dispense falsehoods lest the patient give up any hope. Many modern Codes of Ethics still avoid use of the word 'truth'.

I find this all very confusing, but that may be because of my background.

As a West Point cadet I pledged not to lie, cheat or steal, nor tolerate anyone who did. It was our Honor Code. Yes, I probably see too many things as black or white because of that pledge.

Contemporary medical ethicists have redefined truth and non-truths. Supposedly, doctors are not always obligated to tell the truth. All falsehoods are not lies! The truth is required only if the listener has the right to the truth and the person has a reasonable expectation of being told the truth. I guess the second part explains why used-car dealers don't perform surgery.

Click here to review a well-circulated essay about medical truth-telling.

Call me old-school, but my life is far too busy to microdissect such truth-telling ground rules. Everybody gets the truth from me. If it is bad news I deliver it gently with compassion. I leave time for questions and I make myself accessible afterwards.

Long ago my father told me, "If you are going to be a successful liar you'll have to have a powerful memory." That leaves me out. I can't remember who won last year's Final Four!

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