Weekly Glance for August 13th

What's new in optometry, week by week.

This week is brought to you by 


Researchers say glaucoma may be an autoimmune disease.

A group of researchers at MIT asked, "why can glaucoma continue to get worse even after the IOP is controlled?" 

Their theory?
It's an autoimmune disease.

Here are the steps they discovered in the study.
It all starts with a transient increase in IOP. Normally the eye is an immune-privileged site, meaning there shouldn't be immune cells in the retina. Immune cells (i.e. T-cells) are kept out by the blood-retina barrier to suppress the inflammatory response in the eye. However, the researchers found that a transient increase in IOP allowed for infiltration of T-cells in the retina - this was seen in both mice and humans in this study. These T-cells then attack heat shock proteins in the retina, which also shouldn't happen because this is a host protein, meaning the T-cells are attacking it's own body. The theory is that this causes progressive neurodegenerative changes in glaucoma. (via)


There may be another reason your patient is taking Viagra.

A research team at Columbia University in New York published a small study showing Viagra may have vision benefits in AMD. Related, Viagra just recently became available over-the-counter in Britain. (via)


Will working on a computer all day make me go blind?

A press release on this new study caught fire last week. Several news outlets reported on it (here, here, here, here etc.) so get ready to field some questions from patients.

What were the headlines?
All were some variation of "blue light emitted from computers will accelerate blindness."

Strong headline, right? Let's break it down.
A study out of the University of Toledo published exactly how blue light is damaging to the retina. To explain this, we need to dip our toe back into biochem...
Let's start with 11-cis retinal which is a photoreceptor chromophore and all-trans retinal is the photoproduct. Let's simply call both of them retinal. Retinal is found in high concentrations in the retina, specifically in the photoreceptors. You need a continuous amount of retinal in order for photoreceptors to work. 

What did the research team find?
They found that when they shined blue light on retinal, it disrupted the function of the cell-signaling phospholipid resulting in an increase in cytosolic calcium and then cell death.

To say all of that a simpler way...
Retinal is a molecule necessary for photoreceptor function. When this team shined blue light on retinal, it resulted in cell death. When photoreceptors die, they don't regenerate and diseases like macular degeneration are the result of photoreceptor death.

How much blue light from devices is too much?
That is still up for debate. However, the authors suggest wearing sunglasses with a blue light filter and not looking at your devices in the dark.

Is there a silver lining to this study?
Yes. The researchers found that "a molecule called alpha tocopherol, a Vitamin E derivative and a natural antioxidant in the eye and body", stops the cells from dying. This finding gives hope for new therapies to treat diseases like AMD. 

Here is a great article summarizing common blue light questions.



OD save.

Great story about a Delaware OD that saved a man's life.

Contact Lens Health Week.

Mark your social media calendars. August 20-24th is contact lens health week. The CDC has some good resources here.
This is sponsored content by Vision Expo!

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I bet you never thought you would read the word 11-cis retinal so early in the morning, did you? But now you're ready for the week! Great work this morning!
See you next week!
Jackie Garlich
Editor & Founder // 20/20 Glance

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