What You Need To Know About Measles

Courtesy of the Gates Foundation

One of the more impossible-to-miss news stories right now is the measles outbreak that started at Disneyland. Since measles is an airborne virus that can last up to two hours, and because Disneyland attracts guests from all over the world, this was a perfect spot for the virus to spread. At this time, approximately 60-70 persons in California have contracted the virus.

Interestingly, if we take a trip back in time to the year 2000, the CDC declared that the United States had achieved measles elimination. So what happened and why are we hearing about a second outbreak in as many years? Well, in 1998 a study of 12 children by a former doctor, Andrew Wakefield, demonstrated a link between autism and the measles, mumps, rubella vaccination. Since then, this study has been shown to be fraudulent and Andrew Wakefield was stripped of his medical license. Despite evidence to the contrary, many well meaning and intelligent parents began declining vaccinations for their children. As a result, school districts in our state have up to 14.5% of students who are unvaccinated – the majority of whom are from affluent, coastal communities.

So what should we look out for in our friends, families and patients? First of all, a fever, head cold, and red rash are all signs of measles. Additionally, conjunctivitis (pink eye) is also very common as 65% of all measles patients develop this malady. Be especially careful if you have family members that are unvaccinated or have only received a single dose. Patients who have received two doses have less than a 1% chance of getting measles.

While measles is still relatively rare in the United States, 20 million people are infected worldwide and according to the World Health Organization 145,700 children died from measles worldwide in 2014. As a parent, I understand the apprehension many of us have about the numerous shots our kids get at such a young age. However, the evidence clearly demonstrates that vaccines save lives. So, I encourage every parent and unvaccinated person to do your part to eradicate this illness from the planet and get vaccinated or have your child vaccinated.

~ David C. Ardaya, O.D.
California Optometric Association
http://www.coavision.org
http://www.eyehelp.org

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Glaucoma: Irreversible but preventable blindness

glaucoa visual field defect - croppedAfter reading Dr. Weiss’ article last week on early detection of glaucoma, I was back in my office seeing one of my patients that drives this point home. My patient, let’s call him Jim, is a 59 year old gentleman who has lost vision from glaucoma. My partner and I had been seeing Jim for his annual exams and providing glasses to correct his vision since 1999. Beginning in about 2004, the pressure in his eyes started to increase. Normal intraocular pressure (IOP) is between the range of 10 to 20 millimeters of mercury (mmHg). Over a few years, his IOP slowly increased until they were running in the 20 to 21 range – not too bad – but enough that we discussed that we needed to monitor this more closely. In 2008 Jim’s IOP was 20, so he decided to skip his 2009 exam.

When, Jim came in for his “annual” exam in 2010, he had a very different complaint. He complained that if he covered his right eye, he could not see the lower part of his vision.  This fast loss of vision could be caused by a retinal detachment, but would be a very unusual symptom for glaucoma.

Vision loss with glaucoma usually takes years, or decades to advance to the point where it is noticeable to the patient. After ruling out a retinal tear or detachment, I took some time to look at glaucoma. The pressure in his eyes was up to 30mmHg, and close examination of the back of the eye showed glaucomatous damage to the optic nerve consistent with his visual field loss. We started treatment right away, and luckily stopped the progression of vision loss.

Over the years, my partners and I have created a large practice with increasing population of glaucoma patients. I am always amazed with the fact that no two patients progress in the same way. I have seen “normal pressure” glaucoma patients who have damage to their optic nerves even with “normal” pressures. I have patients with significantly high pressures who have no damage to their optic nerves. I have patients that we are able to control with eye drop medications that are only used one time each day. And, I have patients that need surgery to lower their eye pressure to prevent blindness. I am treating as many patients who have a family history of glaucoma as who have no family history. I have patients with glaucoma from 21 to 94 year old. The only way to prevent blindness from glaucoma is to catch it early with annual eye exams.

~ Steven Sage Hider, OD
California Optometric Association
http://www.coavision.org
http://www.eyehelp.org

Blindness & Glaucoma: Early detection and treatment is the key

Photo of listentothemountains on Flickr

Photo of listentothemountains on Flickr

I often hear from patients- “Why do I need to come in each year, I see fine!”

Well, there are many reasons to follow your Optometrist’s yearly examination recommendation. One of them is for the early detection and treatment of glaucoma.  Glaucoma is a disease that affects the optic nerve in the eye- the structure responsible for conveying visual information from your eye to your brain.  The progression of glaucoma is very slow and hardly noticeable to the patient in the early stages, but causes blindness in the later stages.  It starts with peripheral vision loss and progresses centrally.  Once the cells in the optic nerve are lost, they do not regenerate. That is why early detection and treatment is the key.

In order to screen patients for glaucoma, optometrists with begin with a thorough health and lifestyle history. Family history of eye disease and lifestyle factors such as smoking and exercise can be risk factors for the development of the disease. The optometrist will most likely perform basic glaucoma screening tests including eye pressures and visual fields and sometimes more advanced imagery such as retinal photos, Optomap, or optic nerve imaging. All of these tests can aid in the early detection of the disease.

Each year, your optometrist can compare the new results of these tests with the tests from the previous years to determine if glaucoma exists and if so, is it progressing, and how quickly.  A determination can be made if treatment is necessary.

There is no cure for glaucoma, but treatment with eye drops, surgery or a combination can prevent the permanent vision loss.

Just remember, early detection is the key. Visit your optometrist regularly!

~ Lisa M. Weiss, O.D.
California Optometric Association
http://www.coavision.org
http://www.eyehelp.org