Visualize Your Safest July 4th Ever!

Do you savor irony?

Recently I've been bombarded by email messages from the Parents Club that provides financial support to my daughter's athletic team. The club is managing one of those portable booths that sells fireworks along the highway - apparently it is a hugely successful fundraiser.

"So, Doc, can we put you down for a four-hour shift?"

My unapologetic reply, "Sorry, I'll probably be busy salvaging someone's eye from a fireworks injury!"

The upcoming 4th of July holiday is one of the busiest days of the year for eye surgeons and others who treat victims of accidental trauma. Fireworks are best enjoyed at a community display, not in your backyard.

The American Academy of Ophthalmology has launched a vigorous campaign to discourage the purchase and use of fireworks by amateurs - folks like you, me, and our children. Here are some powerful numbers about fireworks injuries:

• There are approximately 8,500 fireworks-related injuries each year in the United States. Of these, about 2,000 are eye injuries.
• One-third of these injuries result in permanent eye damage and one-fourth in permanent vision loss or blindness.
• Almost one in 20 victims lose all useful vision or require the removal of the injured eye.
• 25% of all eye injuries caused by consumer fireworks happen to bystanders.
• 75% of all fireworks-related eye injuries happen to boys between the ages of 13 and 15.

Did you know that the most dangerous fireworks are bottle rockets? Bottle rockets fly erratically, often causing bystander injuries. The bottles and cans used to launch bottle rockets often explode, showering fragments of glass and metal.

Sparklers account for three-quarters of all firework injuries in preschoolers. Young children find these sticks of fire - burning as hot as 1,800 degrees Fahrenheit - irresistible to touch. Eye safety experts make these suggestions:

• Never let children play with fireworks of any kind, including sparklers.
• View public fireworks displays from at least 500 feet away or up to a quarter of a mile.
• Respect safety barriers set up to allow pyrotechnicians to do their jobs safely.
• Leave the lighting of fireworks to trained professionals.
  

If you find unexploded fireworks, don't touch them! Immediately contact your local fire or police department.

Nope, you won't find me hawking any firecrackers along the highway. Fireworks injuries are so devastating and yet so preventable. Control your urges and make it a safe Independence Day for all!

(Portions excerpted from American Academy of Ophthalmology Fact Sheet)

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• WebMD Video: July 4th Grilling
• 5 Ways to Protect Your Eyes in Summer

Technorati Tags: fireworks, sparklers, bottle rockets, injuries, eye injuries, safety, summer

Going on Vacation?

I just read a report that claimed Americans, in general, are lousy vacationers. We are so imprisoned by work and other responsibilities we do not treat ourselves well when it comes time to relax.

They say it takes 3 days just to begin to unwind. Many Europeans vacation the entire month of August and think it is uncivilized to schedule anything less!

I hope you get to enjoy some vacation time over the summer. Here are a few travel tips to consider while you are waiting for your new passport to arrive:

• See the dentist before leaving and have any dental problems fixed beforehand.


• Make sure you have some type of health insurance coverage. Check with your current insurer - buy additional coverage if needed.


• Split your prescription medications into two separate supplies: half for carry-on luggage, pack the remainder. That way you never lose ALL of your medicines.


• Have your doctor write new prescriptions for all of your medications (including eyedrops) and treat them as valuable travel documents (like your travelers' checks).


• Bring extra contact lenses and lens solutions; you don't want to be stranded squinting.


• Older travelers might consider a second cheap pair of reading glasses.


• Commercial aircraft cabins are arid! Drink plenty of water during your flight and frequently apply artificial tears to keep your eyes moist.


• Contact the nearest US Embassy or Consulate if you experience any health or vision problems.

Most important of all, make sure friends and loved ones back home know your itinerary and whereabouts throughout your trip. Email any changes in your travel plans.

Perhaps you won't be able to take four weeks off this summer but a little careful preparation will help you make the most of your hard-earned vacation!

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• 4 Tips for a Less Stressful Vacation
• Health Spa Vacations: Something for Everyone

Technorati Tags: vacation, travel, health and wellness, tips

LASIK Software Recalled After Unexpected Results

For eye doctors and their patients this has been a wild year for recalls. First, two different brands of contact lens solutions were yanked off shelves due to concerns about serious corneal infections.

Now the FDA has told the manufacturer of a laser refractive surgical device that its results are unacceptable. This latest Class 1 recall involves the software, an algorithm, used by the LADAR6000 lasers made by Alcon.

The LADAR6000 is used to correct myopia with and without astigmatism. The algorithm uses specific information about the patient's eye measurements and quickly compares that data to thousands of previous surgeries in order to calculate the precise laser treatment to be applied. This specific algorithm left patients with inaccurate outcomes - some unfixable with additional surgery.

According to the FDA, Class I recalls are the most serious type of recall and involve situations in which there is a reasonable probability that, should this particular malfunction occur, use of the affected product may cause serious injury or death if the problem is not corrected.

The LADAR6000 manufacturer reports that all USA units have been shut down until this problem is fixed

Concerned consumers can call 1-877-523-2784 for additional information.

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• Implantable Contacts: Hope for Extreme Myopia
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Technorati Tags: LASIK, Alcon, LADAR6000, product recall

If You Know Me, You Already Know My Dad

Many of you have already met my father. He's the balding fellow on the left. I took this picture during a visit to the Ringling Museum of Art in Sarasota, Florida.

Several months ago I posted a WebMD blog about his pending cataract surgery. Imagine, an ophthalmologist's father having eye surgery! (By the way, patient privacy rules notwithstanding, my Dad had a great outcome and enjoys excellent vision).

Like I said, you probably know him. That's because for the past 5 years WebMD members have gotten to know much about me, my beliefs, and my passions. So much of who I am was generously passed down from my father.

Dad has a phenomenal sense of humor. It's incredible how such a small figure can make an entire room erupt in laughter. That's why I like making people smile.

Dad served as Sergeant in the 82d Airborne throughout World War II and was decorated for heroic service. That's why I applied to West Point.

Dad was my Cubmaster. That's why I became my son Will's Assistant Cubmaster. (Nasty power struggle, the existing Cubmaster refused to step down!)

Dad had me jumping off the high-dive at age 5. That's why all my children are expert swimmers.

Dad continued to run well past retirement. Yup, I finished one of those marathons with my sister.

Dad made sure we never skipped Sunday church services. That record remains unbroken for another generation.

Dad finished every project he started. This blog is almost complete.

Dad always told the truth. Dad, I love you for being the wonderful man you are and the father you taught me to be.

Happy Father's Day!

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Technorati Tags: Fathers Day, dad, health and wellness

Nag-A-Tronic: Boost Medication Compliance

We hear it all the time, America is getting older.

The over-85 age group is our country's fastest growing demographic. Most are taking three or more prescription medications - pills and eyedrops - and half the time they are doing it incorrectly (if at all!)

34 million Americans are involved in caring for older family members and things can get very complicated when trying to make sure the right medicine is being dispensed in the right dose at the right time. Did you know that 15% of caregivers live at least an hour away from the person in need?

WARNING! If you cannot program the clock on your DVD player you should click-away immediately!

Electronic medication dispensers have been around hospitals for a decade or so. They resemble a computerized vending machine on wheels. The nurse travels from room to room and the dispenser keeps things organized. Between shifts the pharmacy reloads the device. It tracks medication doses to improve patient safety and, lest we forget, to optimize billing.

Electronic pillboxes for consumers have arrived and more are on the way. There are four important functions:

• remind the patient to take their drugs
• organize the medications to prevent mistakes
• dispense accurate doses, and
• monitor consumption

The more features you want the more expensive/complicated things get.

Simple models merely nag a person to take their medication and that alone may be sufficient to assure compliance with the doctor's instructions. Alerts can be transmitted with beepers, email, customized telephone rings, and even onscreen messages over the TV.

More advanced electronic medication managers can notify the caregivers as well. That's likely the most powerful innovation because family members can confirm if the drug schedule is being accurately followed.

Models that automatically dispense medications still require a human to properly load the device's different compartments and input the dosing schedule (remember that DVD timer?)

Here are some popular devices:

• Medication reminder pager
• Medication reminder wristwatch
• Automatic pill dispenser
• Voice-command medication manager

Time will tell if consumers adapt to the potential benefits of this helpful technology. Simpler, less-expensive devices will likely gain popularity whereas the more sophisticated gizmos may end up with a blinking 12:00 AM just like your DVD player.

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• WebMD Video: Pharmacy System to Eliminate Medication Misuse
• Medication Safety Tips: Dos and Don'ts

Technorati Tags: medication, pill box, health and wellness

Blindness Cured in 2012 - We'll See!

Photo Credit: Eli Duke

Optimistic claims from across the Big Pond.

Researchers at Moorfields Eye Hospital in London have announced an ambitious plan to surgically implant embryonic stem cells in eyes with advanced age-related macular degeneration (ARMD).

By the way, have you noticed how ARMD keeps popping-up on this blog? There must be a reason. Since ARMD is the most common cause of acquired irreversible vision loss in adults over 50, and since we are all living longer, there is enormous interest (read "money") in finding a treatment that works. A cure for ARMD will be bigger than the discovery of Viagra - yes, the pun was intended!

Anyway, back to science. The core problem with ARMD is damage and eventual loss of RPE cells (retinal pigment epithelium). RPE cells do not regenerate - once gone, they are gone forever. Healthy RPE cells reside underneath the photoreceptor layer of the retina and if the RPE cells suffer so do the photoreceptors.

Eye specialists in England want to repopulate the lost RPE cells with genetically-trained embryonic stem cells that are painlessly introduced with a tiny needle.

Other investigators have already attempted autologous RPE cell transplants in ARMD patients: transferring healthy RPE cells from a noncritical area of the retina to the RPE-poor macula. The method shows some promise but none of the volunteers are threading needles yet.

Forgive any perceived cynicism (what, me cynical?) but the bold promise to have this experimental treatment available for mainstream use in 5 years is a stretch. Predictions like these have not been kept since JFK promised to land astronauts on the moon before the end of the 1960s.

It is great to be enthusiastic about your research and it is important to share hope. It is another thing to create unrealistic expectations. Have these researchers ever heard about the FDA?

Related Topics:

• WebMD Video: Macular Degeneration Gene Sheds New Light
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Technorati Tags: ARMD, macular degeneration, stem cells, vision loss, eye disease, health and wellness

Treating Blood Vessels as the Enemy

Cancer and macular degeneration have more in common than you may suspect.

The connection is blood supply. In order for malignant tumors to grow they need to create new blood vessels to provide oxygen and nutrients to the enlarging mass. If circulation is interrupted the tumor cells will eventually suffocate and die.

The wet form of age-related macular degeneration involves abnormal blood vessels proliferating underneath the retina where they do not belong. These new blood vessels are substandard, they leak and cause bleeding, fluid accumulation and eventual scarring (subretinal fibrosis). This explains why folks with wet form ARMD see so poorly.

In both situations, cancer and ARMD, therapies which inhibit blood vessels can hopefully stop the disease in its tracks - or at least slow it down so that other treatments can work.

Avastin (Bevacizumab) is an injectable genetically-engineered treatment that stops abnormal blood vessels from growing. Originally it was offered as a primary form of cancer chemotherapy. Vision researchers tinkered with its formula so it could be injected into eyes with wet form ARMD and marketed it as the drug Lucentis. FDA approval for Lucentis is approaching its first anniversary.

Lucentis is very expensive and regular repeat injections are required. Some eye specialists offered the cheaper Avastin to ARMD patients as an alternative treatment. The final word has not been written whether or not Avastin is comparable to Lucentis for ARMD. For now it is recognized as "off-label" use.

Well, Avastin is back in the news again regarding its usefulness in fighting cancer. It seems that adding Avastin to an established cancer chemotherapy regimen significantly boosts the survivorship of patients with metastatic colorectal cancer. These findings were recently presented at the Annual Meeting of the American Society of Clinical Oncology in Chicago. Previous researchers made similar Avastin claims in patients with advanced breast cancer.

So, what does this news mean? Whenever new treatments are introduced it is only the beginning chapter. Many medical discoveries find alternate uses that may surpass its original intended design. When fighting disease, just like when you're healthy, always be ready for surprises!

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• WebMD Video: Macular Degeneration Treatment
• WebMD Video: Coping With Depression When Eyesight is Failing

Technorati Tags: macular degeneration, age-related macular degeneration, ARMD, Avastin, bevacizumab, Lucentis, vision, eye disease, health and wellness