Think Globally, Wink Locally

A great reason to stop smoking

by: Dr. Liz

I found this great article by doingyoudamage.com  I need to share.  This should give smokers a real reason to stop smoking.

Smoking and eye damage

Macular degeneration is the result of damage inside the eye that can lead to irreversible blindness. It can occur in one or both eyes and cause a permanent ‘blind spot’ directly in the line of sight (the opposite effect of tunnel vision). It has a direct effect on peoples’ daily lives, severely limiting their ability to carry out everyday tasks such as driving, reading, writing or even recognizing faces.

Smoking leads to oxidative or other damage to the macula (this is the part of the retina at the back of the eye that we use when we look directly at someone or when reading). It may also constrict blood vessels to this area. There are two types of macular degeneration. In the first, critical parts of the macula may die (atrophy) or, in the second type (which is more common), critical parts of the macula are weakened, allowing abnormal new blood vessels to break through and bleed. This second type of macular degeneration leads to scarring of the macula and severe loss of the central area of vision. People may initially notice distortion of straight lines and then a dark or greyish patch develops in the centre of vision, completely obscuring what they are looking at.

Smoking may cause both types of macular degeneration and the resulting blindness is irreversible. The process can be stopped using laser treatment only if the condition is caught in its early stages.

Some interesting facts on smoking and macular degeneration:

• Macular degeneration is the leading cause of blindness and is the major preventable cause of this condition.
  
• The chemicals in cigarette smoke (around 4000 of them) get into the bloodstream of smokers and may induce the damage to the macula, at the back of the eye. This damage results in macular degeneration and blindness over time.
  
• The damage from macular degeneration limits the ability of a person to see what they are looking directly at (such as the face of someone they are talking to).
  
• Macular degeneration also limits color vision.
  
• Laser surgery cannot reverse the damage resulting from macular degeneration (except in a minority of cases detected in the very early stages). However, laser surgery may retard and or prevent the progression of the disease and reduce the visual loss. Recurrence of the condition occurs in about half of those who have initial successful laser treatment. For people who continue to smoke, almost all develop a recurrence.
  
• Many people with macular degeneration do not realize that they have the condition until their second eye starts to deteriorate, as one eye can compensate for the other.
  
• Up to two thirds of people with macular degeneration in one eye will ultimately lose sight in both eyes from this condition.
  
• When a smoker quits, the recovery process in some other parts of the body can begin almost immediately. Although it is not known whether stopping smoking reduces the risk to the second eye, it seems likely given evidence that links current smoking to development of macular condition.
  
• Providing they live long enough, one in four people will lose vision because of macular degeneration. Smoking increases this risk dramatically and may cause the loss of vision at an earlier age than it might otherwise occur

Smoking and eye damage — questions and answers

How does smoking damage my eyes?

When you inhale cigarette smoke thousands of chemicals get into your bloodstream and can travel throughout your body. These chemicals cause damage to the macula (the most sensitive part of the retina, at the back of your eye). Tiny blood vessels can burst through the macula, leading to irreversible damage, or alternatively, the cells of the macula slowly die. Both ultimately lead to loss of vision.

Can this damage be reversed?

No. Laser treatment can sometimes kill the new blood vessels before they hit the macula. However, most people are not able to be helped this way because the blood vessel has already involved the very centre of the macula, and even after treatment, the condition recurs in half the cases and in almost all those who continue to smoke. A new treatment, photodynamic therapy (PDT) may be able to help some to reduce the severity of vision loss, but the majority of people with macular degeneration will still not be able to be treated.

How long does it take for my eyes to become damaged?

At this stage, there is no research to confirm at what point the damage occurs, however it is known that the process of macular degeneration is the result of progressive damage over many years. The condition is not usually detected until people are in their fifties or are older.

If I quit smoking will my eyes recover?

Your risk of macular degeneration will be reduced if you quit smoking, however existing damage to the eyes cannot be repaired, particularly once vision is affected.

Is there a test to tell if my eyes are damaged?

Your general practitioner or optometrist may be able to perform a simple test to indicate if your eyes are damaged. An ophthalmologist will be able to determine the extent of the damage. You need to be seen urgently by an ophthalmologist if you suddenly become aware of distorted vision in one eye or if you notice a dark or grayish patch near the center of your vision in one eye.

Chemicals in cigarette smoke get into the bloodstream and cause damage to the macula (part of the retina in the eye).

There is no cure for macular degeneration and not smoking or stopping smoking is one way to decrease the chances of developing this eye disease.

For more information about smoking and eye disease click here.

Dry as a bone

by: Dr. Liz

I think the front range has the best year round climate except for the dryness!   Raise your hand if you feel like your skin cracks and bleeds in the winter or you wake up in the morning with a strange sandpaper feeling in your eyes?    

Healthy eyes have a constant tear film that is designed to remain stable between blinks. This films job is to prevent dry eyes and allow you to maintain clear vision.  A decrease in tear film production or an increased level of evaporation can cause a destabilization of the three tear layers in your eyes. 

Decreased production of fluids from your lacrimal glands (where your tears come from) can destabilize the tear film, allowing it to break down rapidly and create dry spots on the surface of your eyes. An imbalance of proteins that make up the tear film can contribute to dry eyes. 

I have many patients tell me that they are using eye drops that get the red out of their eyes.   First and foremost please don’t use products that get the red out!  Many of these drops have tetrahydrozaline in them which causes constriction of the blood vessels in the white part of your eye.  These drugs decrease the size of the blood vessels so that your eyes look whiter.  If you use these drops too much rebound can happen.  What would I do?  Solve the underlying redness problem.  What could cause chronic redness in the eyes?  Dry eyes!

My preference is to use Fish Oil capsules daily that contain Flaxseed Oil and Vitamine E.  Second, start on rewetting drops first thing in the morning, middle of the day and then right before bed.  This will keep your eyes moist during your waking hours.  Remember to drink plenty of water and stay away from too much caffeine and alcohol.  If you have had a big night out on the town make sure to rehydrate with water.

There are other things you can do if these products don't work.  I will be talking about some of these treatments in future blog posting.