Resolve to See Better in 2009

MESSAGE FROM DR. LLOYD: This blog was originally posted years ago but the information remains accurate and timely.

'What can I do to see better or to protect my precious eyesight?'

My personal meta-analysis of our WebMD Vision & Eye Disorders message board has determined that to be the most commonly asked question.

There's no better time to make a resolution to keep your eyesight crisp and your eyes comfortable all year long.

Here's all you need to do:

• Everybody: Have regular eye exams
• Smokers: Stop smoking!
• Everybody: Watch your weight and your blood pressure
• Diabetics: Control your blood glucose
• Everybody: Take a daily multivitamin loaded with antioxidants
• Athletes: Use protective eyewear made of durable polycarbonate
• Everybody: Wear sunglasses with 100% UVA/UVB protection
• Young males: Stay away from firecrackers
• Everybody: Know your family history for glaucoma and other eye disorders
• Travelers: Frequently apply artificial tears when in-flight
• Everybody: Wash your hands frequently

By observing the above precautions you give yourself the best possible protection against the leading, treatable eye problems: refractive errors, glaucoma, cataract, age-related macular degeneration, eye trauma, pink eye (conjunctivitis), dry eyes, diabetic retinopathy, ischemic eye disease, and eyelid skin cancers.

WebMD wishes everybody a healthy and visually stimulating 2009!

Related Topics:

LASIK vs. LASEK: Both Safe, Effective

Technorati Tags: New Year, 2009, eye health

New World After Cataract Surgery

One of the most startling adjustments folks make after successful cataract surgery is the color of their new eyesight. Yes, the world looks very different once that cloudy lens is removed - and not just because things are clearer.

Lifelong sun exposure is a major contributor to cataract formation. Besides helping the eye with near focusing (accommodation) the crystalline lens is also an essential toxic light filter for the delicate retina. The lens blocks dangerous UVA and Infrared wavelengths from damaging the irreplaceable retinal cells. (In case you were wondering, most UVB is blocked by the clear cornea.)

50, 60, even 70 years of nonstop service comes with a price. Chemicals in the lens that participate in blocking dangerous light rays eventually metabolize. One waste product is urochrome pigment. Urochrome slowly turns the lens yellow, not unlike wearing a pair of yellow-tinted sunglasses. You know, those 'Blue Blockers' that appear in the TV informercials.

Wearing a yellow lens filters out the blue-green portion of the visible spectrum. Yellows, reds and oranges stand out but many other hues are muted. This lens discoloration is very gradual so the individual is unaware that their perception of the world has changed. Once that yellow, cloudy lens is replaced with a permanent transparent intraocular lens implant (IOL) the complete visible spectrum returns. WOW!

Reintroduction of blues and greens into the visible palette can be very jarring at first. The famous artist Claude Monet was so upset that he had his eye doctor prescribe him yellow spectacles to chromatically put things as they were before surgery.


'Bouquet of Sunflowers' (C. Monet, 1840-1926)

The 'color shock' passes a few days after cataract surgery. Patients candidly explain they didn't know what they were missing. Besides restoring crisp visual acuity, cataract removal and IOL implantation gives people a brand new appreciation of their colorful world.

Related Topics:

• Glaucoma: New Surgery May Offer New Hope
• Vision Problems in Aging Adults

Technorati Tags: eye surgery, cataracts

Type A Personality: New Biomarker

While performing background research on newly recruited Japanese baseball pitching prospect Daisuke Matsuzaka (will start for Boston Red Sox and eventually join the Yankees!) American sports journalists tumbled upon an interesting aspect of Japanese culture: Blood type plays a significant role in the individual's personality.

You don't need to qualify for the Hall of Fame to understand that not all human blood is identical. We possess specific antigens (proteins) on the surface of our blood cells, over 20 different categories of antigens. The most famous and most important are the ABO antigens, discovered and described in 1901 by Nobel Laureate Karl Landsteiner.

Depending on the DNA inherited from your parents, your blood is either Type O, Type A, Type B, or (rarely) Type AB. Your body creates antibodies to the other blood groups you do not posess, so compatibile blood transfusions must be from the same group. 45% of Americans are Type O and another 40% are Type A.

Some Japanese believe there is a direct link between blood type and personality. Blood type is similar to our use of astrological zodiac signs. This reminds me of a very dated joke:

Single woman in bar: "Hi, I'm Cancer!"
Bachelor: "Nice to meet you, I'm Herpes!"

Just as Westerners attribute different personality traits to Capricorns versus Libras, folks in Japan make a big deal about Blood Type:

• Type O are Warriors
• Type A are Farmers
• Type B are Hunters
• Type AB are humanists

In the Land of the Rising Sun blood group shows up everywhere: in celebrity gossip, on condom vending machines, even among the statsitics printed on Japanese baseball cards (most top pitchers have Type O blood). I'm not sure USA privacy laws would tolerate such disclosure; annual income and DUI records, sure, but not blood group information.

Must sociological research has gone into exploring the blood group/personality hypothesis in Japan. Millions are convinced the science is genuine.

I just have one question - it's about bone marrow transplantation (BMT). After total BMT the recipient will acquire the Blood Group antigen and autoantibodies of the bone marrow donor. Yes, a Type O recipient can become Type A. What happens to their personality?

Related Topics:

• Macho Attitude May Not Be a Risk to Men's Health
• Negative Personality May Hurt Heart

Technorati Tags: Japan, sports, baseball, blood type, personality type

Critical Preop Calculation

Millions of Americans have undergone refractive surgery (RK, PRK, LASIK, LASEK, INTACS, etc.) to reduce or eliminate their need for glasses and contact lenses.

Millions of other Americans receive cataract surgery every year for removal of a cloudy lens. An artificial intraocular lens (IOL) is implanted to substitute for the natural lens.

Now, these two groups of patients are beginning to collide and it's not very pretty!

Prior to cataract surgery precise measurements and calculations must be performed to determine the appropriate IOL lens power. Measurements include items like the current refractive error and the central corneal curvature. Data is entered into a sophisticated formula using customized computer software. These formulas assume the eye is healthy and has never had previous surgery.

Now, a backstage peek: IOLs are stored in cabinets and organized by different lens powers (+ or - diopters in nearly every power imaginable) just like a shoe store. Miscalculate the IOL power and the patient cannot see clearly afterwards - even if the surgery itself was flawless.

Over the past 25 years ophthalmologists have gotten very good at calculating the required IOL power so that the patient can drive without glasses following surgery.

Today, refractive surgery has changed the rules and lowered expectations.

Since refractive surgery changes the central corneal curvature the old formulas must be modified. Measurement devices are being updated to adapt to the increasing number of cataract patients who have had previous refractive surgery.

Patients need to adapt, too! Before consenting to undergo cataract surgery, folks with prior refractive surgery should carefully consider the surgeon's experience in managing these complex cases. Go ahead and ask, "Doctor, how many cases like mine have you performed and what were your results?" The next question to ask is, "How many times did you need to exchange the implant afterwards?"

Don't be hesitant. The surgical outcome will be yours for the rest of your life.

Related Topics:

• Preteens Can Wear Contacts Responsibly
• Cataract Surgery

Technorati Tags: LASIK, LASEK, cataract, eye surgery

More FUNGUS Among Us!

Alcon Laboratories has announced a voluntary recall of Systane Free LIQUID GEL lubricant eye drops. This product is distributed only in the United States, including Puerto Rico. No other formulations of Systane lubricant eye drops are included in this recall. This voluntary recall is in response to 11 consumer reports citing the presence of foreign material.

Alcon has distributed over 5 million bottles of Systane Free LIQUID GEL since its introduction in January 2006.

After testing particles from the opened, partially used bottles that were returned to Alcon, the company identified the foreign material as mold. However, because of the characteristics of these molds, the development of an infection is considered unlikely. In fact, Alcon has received no reports of fungal infections associated with the 11 reports. The company is taking this action to voluntarily recall Systane Free LIQUID GEL because eye drops that become contaminated after opening the bottle may cause eye infections. Alcon has notified the U.S. Food and Drug Administration of this voluntary action.

Alcon has tested returned product and retained samples from the lots with reports of mold and has conducted a comprehensive review of its manufacturing records. Based on this testing and analysis, Alcon has determined that the cause of the product problem is the specific formulation of Systane Free LIQUID GEL, and is not the result of any manufacturing processes. Therefore, the recall applies only to Systane Free LIQUID GEL.

Consumers can identify if their bottles are subject to the recall by locating the words "Free" and "LIQUID GEL" on the product box or bottle. If these words are not on the bottle or box, the product is safe for use and is not subject to this recall. The picture shows where these words are found on the bottle and box.

Consumers who are in possession of Systane Free LIQUID GEL should immediately discontinue use and call 1-866-608-3936 or visit www.systane.com for instructions. Reply cards and pre-paid mailing slips are being provided for product return.

To reduce the potential for contamination of eye drops, consumers should not touch the tip of the bottle to their eye, should not allow anything else to touch the tip of the bottle and should always put the cap on the bottle immediately after use. Consumers who have concerns about the health of their eyes or who experience unusual eye symptoms, such as severe pain, loss of vision, or significantly increased sensitivity to light, should consult with their eye doctor immediately.

SOURCE: Alcon Laboratories, Inc. and American Academy of Ophthalmology

Related Topics:

• Contact Lens Solution Recall
• Contact Lens Solution, Eye Fungus Link

Technorati Tags: systane, systane liquid gel, product recall, eye infections

Camera Instantly Eliminates "10 Pound" Weight Gain

People often hate to look at photographs of themselves. Maybe there's a crooked smile, flyaway hair (no problem for me!), or the photo simply makes them look heavier than they are.

Could a camera make someone appear heavier? Is it vanity or optics?

Reality check: many consumer grade cameras use cheaper molded lenses that generate all kinds of image distortions. Looking at a group photo or a pretty landscape such optical mistakes are rarely noticed, however, a nicely composed closeup can highlight these distortions.

One such troublemaker is spherical aberration which leads to nonuniform focusing power across the width of a lens: precise at the center, goofy at the periphery. The net effect can yield image distortion that stretches the dimensions of objects in the center of the viewfinder.

The geniuses at HP have introduced a new line of digital cameras that permit you to correct for any perceived "photoinjustice." Yes, after snapping the picture the photographer can make the subjects slimmer!

Don't have one of these cool cameras? For those who are exceptionally image conscious consider standing along the periphery of group photos so you are less likely to be victimized by a camera lens aberration.

I'm still waiting for the camera that reverses the optical phenomenon of "perceived hair loss!"

Related Topics:

• 8 Ways to Look Thinner - Right Now!
• What to Wear While You Lose Weight

Technorati Tags: hp, digital cameras, optics

P4P: Not Another Videogame System

Under our current health care system physician reimbursement is calculated under a fee-for-service system. Insurers decide how much they will pay for each visit, each test, and each procedure. The doctor then files for payment using codes for each charge.

Sounds simple but, like most things in life, it's quite complicated. Think about this: the physician is paid whether or not the patient improves or survives. The physician is paid even if the patient makes no effort to improve their health by losing weight or stopping smoking.

There is growing interest in P4P, an abbreviation for Pay-for-Performance. Instead of simply fixing broken bodies, doctors should be rewarded for improving health care, offering preventive services, and streamlining the delivery of services.

Some private insurers have begun implementing P4P but it's still too early to determine its impact. Some health policymakers want Medicare to incrementally switch to a P4P system. According to a recent report from the Institute of Medicine:

Improving quality of care has become a top priority for all stakeholders in the health care system. Performance measures are benchmarks by which health care providers and organizations can determine their success in delivering care - for example, regular blood and urine tests for diabetic patients, a facility's 30-day survival rate among cardiac bypass patients, or perceptions of care collected from patient surveys. The current system pays for treating injury and illness - and encourages use of new, high-tech interventions - but it does not generally reimburse for preventive services such as patient education. Nor does it pay for coordinating the care of patients whose conditions involve multiple providers, and it offers no incentives to improve patients' overall health status.

What would P4P mean for you? The most immediate benefits would likely include better access to your doctor, improved patient education, more preventive care, and better access (at least to your insurer) to individual ophthalmologist's surgery outcome data.

Nothing happens quickly, but when it comes to improving our health care system the P4P glacier is definitely picking up speed!

Related Topics: Old-Fashioned Medicine Back Again, Feds Launch Hospital Quality Comparisons, U.S. Health Care: Pay More, Get Less?

Technorati Tags: P4P, physician reimbursement, health care reform

Flex Accounts: Year-End Spending Spree

Nearly everyone could use a little extra money this time of year.

Where can you find some?

Have you forgotten about your Flexible Spending Account (FSA)? Millions of hardworking Americans contribute monthly to an employer-managed Flexible Spending Account.

Every FSA dollar is pre-tax money that can be spent on health-related purchases.

Depending on your income and tax rate using FSA funds can generate genuine out-of-pocket savings amounting to 30% or more. Who can turn-up their nose at 30% savings?

Here are some common examples of eligible health care expenses:

• Co-payments, co-insurance and deductibles
• Acupuncture
• Artificial reproductive technologies
• Childbirth classes
• Chiropractic care
• Contact lenses and contact lens solutions, cleaners, and cases
• Dental care (including crowns, endodontic services, implants, oral surgery, periodontal services, sealants.
• Diabetic supplies
  
• Expenses that exceed medical, dental or vision plan limits (including dollar or visit maximums or amounts that exceed plan allowances, such as out-of-network providers)
• Hearing aids (including batteries)
• Home medical equipment (e.g., crutches, wheelchairs**, canes, oxygen, respirators, etc.)
• Laser eye surgery
• Learning disability treatments and therapies (including speech therapy and remedial reading)**
• Mattresses and bed boards**
• Medical supplies
• Occupational therapy
• Orthodontia
• Orthotics
• Over-the-counter medicines (not including vitamins and dietary supplements)
• Physical therapy
• Prescription drugs
• Preventive care screenings
• Prosthetics**
• Psychiatric services and care
• Shipping and handling charges for medical needs, such as mail-order prescriptions and eligible over-the-counter items
• Smoking cessation programs (including over-the-counter treatments)
• Specialized equipment or services for disabled persons (e.g., automobile modifications; Braille books and magazines; guide, companion or service animals; home alert systems for visual/hearing impaired persons; note-takers or ASL interpreters; tape recorders and typewriters for the visually impaired; etc.)**
  
• Sunscreen
  
• Transportation expenses related to medical care
  
• Vision care, eyeglasses (including prescription sunglasses)
  
• Water fluoridation**
  
• Well-baby and well-child care
  
• Whirlpool baths**
  
• Wigs (for hair loss due to a disease)**

**These expenses require a letter of medical necessity from your health care provider in order to be considered eligible for reimbursement. The letter must include the diagnosis or symptoms for which you or your dependent are being treated, along with specific information on how the product or service will alleviate symptoms or improve function.

Some ineligible health care expenses include:

• Cosmetic procedures (unless required to restore
  
appearance or function due to disease or illness)

• Expenses you claim on your income tax return
  
• Expenses reimbursed by other sources, such as insurance plans
  
• Fitness programs (unless medically necessary)
  
• Hair transplants
  
• Illegal treatments, operations, or drugs
  
• Insurance premiums
  
• Physician retainer fees including boutique and concierge practice membership fees
  
• Prescription drug discount program fees
  
• Weight loss programs for general well-being

Remember, this is your money. It must be spent before March 15, 2007. Use it or lose it! Check with your Human Resources office for more specifics regarding how the FSA operates at your workplace.

Related Topics:

• Tips to Do Holiday Shopping the Healthy Way
  
• Get a New Look for the New Year

Technorati Tags: FSA, medical expenses, year end planning