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The Best Way to Clean Your Glasses

Pair of eyeglasses and cleaner

Nearly 50% of Americans wear corrective glasses, according to the trade group Vision Council. And most of them are guilty of the biggest crime in lens care: Exhaling onto their lenses, then wiping the fog off with their shirt sleeves. But does this really damage your lenses? Teri Geist, an optometrist in Omaha, Neb., and chairwoman for the American Optometric Association, weighs in.

Simple Solution

Though there are countless products on the market claiming to wipe streaks away, the AOA recommends the most basic of options: kitchen-sink soap. The best way to clean your glasses, says Dr. Geist, is to run them under warm water and put a tiny drop of dishwashing detergent on the tip of your fingers to create a lather on the lens. Then rinse with warm water, and dry with a clean, soft cotton cloth.

“Everyone uses their shirt cloth—worst thing!” she says. “Your shirttail almost certainly carries dust, and that has the potential of scratching your lens.”

Glass vs. Plastic

Of the 69.1 million Americans who bought prescription spectacles last year, most purchased plastic lenses; glass has gone out of fashion as safety concerns have arisen. Unlike that hard surface, plastic is soft and can scratch easily.

Once lenses are scraped up, “there is no way to buff that scratch out,” says Dr. Geist. Attempting to clean glasses when dry only exacerbates the problem, since a wet surface is slicker than a dry one. “People breathe on their glasses then grab a Kleenex or paper towel or napkin because they’re convenient, but the rough fibers that they’re comprised of might leave debris behind,” Dr. Geist says. She adds that special microfiber cloths are good for dry touch-ups during the day, but aren’t a stand-in for a thorough, soapy cleaning. Neither is your breath.

Reflecting on the Problem

Lenses typically have some form of protective coating and should never come into contact with ammonia, bleach, vinegar or window cleaner. “Those chemicals can break down the coating or just strip them,” says Dr. Geist. “You know those bubbles you sometimes see on your lens? Those are caused by ‘cleansing’ solutions.” Avoid the problem by requesting anti-glare and UV coatings that are embedded within the lens, which can cost about $100 more than regular-coated lenses.

Clean Lines

Natural oils from your hands, eyelashes and face can lead to a lot of buildup each day, reducing lenses’ effectiveness. Leaving spectacles on a sink or vanity, where hair spray and perfume can fly through the air, adds to the residue. The AOA recommends washing glasses every morning, paying special attention to the frames and earpieces, where hair product and makeup tend to rub off. Whatever you do, don’t use the most handy form of water to clean your lenses. “Some people use spit, but don’t,” urges Dr. Geist. Though dirty glasses won’t cause an eye infection, saliva “is not the best hygiene method, and it just won’t work very well,” she says. Soap, warm water and a dry cloth are all you need, once a day, to keep glasses optimally clean and functional. “I have had patients who say they can’t see well, but it turns out it is just the scratches,” says Dr. Geist.

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Mother’s Milk May Help Prevent Blindness In Preemies

Premature baby boy in Intensive Care Unit at hospital

If Stevie Wonder had been born three decades later, we might never have gotten “Superstition” and “Isn’t She Lovely” — but the musician might never have gone blind, either. Born premature, Wonder developed retinopathy of prematurity, an eye disease that afflicts more than half of babies born before 30 weeks of gestation.

Though treatments were developed in the 1980s, about 400 to 600 U.S. children and 50,000 children worldwide still go blind every year from the condition. Now a study suggests that number could be slashed by more than half if all those preemies received their mothers’ milk.

“It makes sense that human milk can be protective against retinopathy of prematurity because we know it’s protective against abnormal neurological outcomes in tiny babies,” said Susan Landers, a neonatologist in Austin, Texas, and a member of the American Academy of Pediatrics Section on Breastfeeding Executive Committee. “Retinal tissue is just like neural tissue embryologically; it grows from the same immature cells.”

The study, actually a combined analysis of five studies from 2001 through 2013, found that preemies receiving human milk from their mothers had 46 to 90 percent lower odds of retinopathy of prematurity (ROP), depending on how much milk they received and how severe the ROP was. The studies were observational, so they cannot show that breast milk directly caused the lower risk.

“This is a very provocative study, and it does open new questions in new areas for research, but I think it’s too early to conclude that breast milk prevents ROP,” said Michael Chiang, a professor of ophthalmology and medical informatics at Oregon Health & Science University’s Casey Eye Institute who was not involved in the study. It was published online Monday in the journal Pediatrics.

Of the infants who develop ROP, most recover and develop well without treatment, but about 10 percent develop severe ROP, increasing their risk of blindness, Chiang said. About half of those infants need treatment, which will prevent blindness in 80 to 90 percent of them.

The new research analyzed the outcomes of 2,208 preterm infants based on whether they received exclusive human milk, any human milk, mainly human milk (more than 50 percent), exclusive formula, any formula or mainly formula. The study did not include donor milk, so all the milk was the mother’s pumped or hand-expressed breast milk.

Infants who exclusively received breast milk had 89 percent reduced odds of severe ROP compared to infants who received any formula. Infants who received a mixture of breast milk and formula had roughly half the odds of developing severe ROP compared to infants exclusively receiving formula. The analysis included a very large older study that had found no reduced risk for ROP from breast milk, but most infants in that study received less than 20 percent breast milk.

“Despite including a negative study with large numbers, the results are still very, very significant,” said Landers, who was not involved in the study. “That strengthens this study considerably.”

Until the 1940s and 1950s, ROP did not exist because infants born prematurely rarely survived, Chiang said. As doctors learned to how to keep these tiny babies, usually little more than 3 pounds at birth, alive, they discovered that the blood vessels in their retinas would often start to grow out of control. If the abnormal growth continued, their retinas detached, causing blindness.

The first treatment developed in the 1980s was cryotherapy, which slowed blood vessel growth. Laser treatments later replaced cryotherapy and have remained the standard of care since. The newest treatment is bevacizumab, a drug made from humanized antibodies that slows the growth of new blood vessels.

The cause of ROP isn’t entirely understood, but scientists believe oxidative stress can stimulate the abnormal growth of the blood vessels. Providing preemies with oxygen is often key to their survival, but that oxygen exposure might lead to ROP, according to Jianguo Zhou, a neonatologist in Shanghai, and lead author of the study.

The antioxidants in breast milk offer one possible way that breast milk could prevent ROP, Zhou explained in an email. But the preventive mechanism could be indirect as well.

“Breast milk, specifically maternal breast milk, has been shown to be associated with reduced risk of many severe complications of prematurity, including a severe gastrointestinal disease called necrotizing enterocolitis,” said Tarah Colaizy, an associate professor of pediatrics and neonatology at the University of Iowa Carver College of Medicine. “It has also been shown to decrease the risk of potentially life-threatening blood infections, and there is some evidence that the severity of lung disease due to prematurity is reduced in infants fed maternal milk.”

Infants without these complications may receive less oxygen therapy, thus lowering the incidence of ROP, Zhou pointed out. Among 2 million infants born before 32 weeks each year worldwide, Zhou estimates that a tenth of them could develop severe ROP.

“Theoretically, exclusive human milk feeding could potentially prevent 8 percent (160,000) very preterm infants from severe ROP globally,” Zhou wrote. “That is an enormous influence and prevents thousands of preterm infants from blindness or visual impairment.”

ROP is still rare in places with the poorest health infrastructure because very premature infants still do not survive, but in China, India, Latin America and Eastern Europe, the problem is growing as doctors keep the infants alive but lack the neonatology and ophthalmology expertise to screen for and treat ROP. Even in the US where treatment is more available, screening may not be.

“Especially in rural and medically underserved areas, there’s not enough supply of ophthalmologists to do these exams,” Chiang said. “It’s a huge problem in the US and internationally.”

But providing exclusive maternal milk to preemies is easier said than done, Landers said. The biggest barrier is adequate lactation support for mothers in the NICU as well as the psychological complexity of the issue for mothers themselves.

“It’s a very stressful time, and expressing milk is the only thing that moms can do, so we put a lot of pressure on them,” Landers said. Some mothers don’t fare well under that pressure. The mothers need to start pumping within 12 hours of birth, as well as instruction in expressing milk and support and encouragement over the three or so months she will need to pump before her baby can breast-feed. “As hard as it is to get them started on pumping, it’s harder still to keep them going,” Landers said.

Even greater cultural obstacles exist among poor and African-American mothers, Landers said, but donor milk may not offer the same benefits, possibly because of its processing and storage needs.

“To give these mothers the best chance of providing milk, the health care system needs to provide them with professional help in the form of lactation consultants with specific expertise in preterm infant-mother pairs, the appropriate breast pumps and supplies to collect and store milk and assistance in transportation to get the milk to the NICU for the baby,” Colaizy said. “For these extremely fragile infants, maternal breast milk is a potentially life-saving intervention, and we should do everything possible for mothers to help them provide it.”

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Dealing with pink eye: 7 tips to keep the lid on conjunctivitis

Three Year Old Little Girl With Conjunctivitis (Pink Eye)

As children are hard at work at school, viruses and bacteria are also toiling industriously, spreading from one child to another. One of the most contagious ailments is pink eye. Though not life-threatening, this sticky infection is a hassle for parents, teachers and students.

“This common medical condition is around all year,” said Khalilah Babino, D.O., an Immediate Care physician at Loyola University Health System, Maywood, Ill. “Since it can spread so easily, it’s more common when school is in session and kids are in close contact and touching similar surfaces.”

Pink eye, or conjunctivitis, occurs when the conjunctiva, a very thin membrane that lines the inner surface of the eyelids and white portion of the eye, gets inflamed and causes the lining to become red and swollen.

“Contrary to popular belief, pink eye is not always due to a bacterial infection. It can also be caused by viruses, allergens and irritants. These types of conjunctivitis will typically resolve spontaneously without additional treatment,” Babino said.

Still, bacteria can be the cause of the infection. Bacterial conjunctivitis is extremely contagious and can quickly spread through a household or classroom. It typically causes eye redness, irritation, pain and/or thick, discolored drainage initially in one eye. It’s common for a person’s eyelids to be “stuck” shut upon awakening due to drainage.

“Bacterial conjunctivitis can be the result of infection from one of several bacterial organisms. Transmission is from person-to-person contact, secretions from an affected person or infected surfaces. If you suspect you have this type of infection, it’s best to see your medical provider as soon as possible,” Babino said.

Babino gives the following tips for dealing with bacterial pink eye:

1. Wash your hands frequently for at least 15-20 seconds with warm soapy water.

2. Use alcohol sanitizer when water and soap are not available to clean your hands.

3. Avoid eye makeup during an infection and discard any open eye makeup, as it’s likely to be contaminated.

4. Remove contact lenses and wear glasses until the infection is cleared.

5. Thoroughly clean your contact lens case frequently and discard disposable contacts.

6. Avoid touching your eyes with your fingers. Conjunctivitis is commonly transmitted from one eye to the other this way.

7. Avoid school and/or work until you’ve undergone at least 24 hours of antibiotic treatment.

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What to Expect From a Dilated Eye Exam

Optometrist diopter with girl.

In this eye exam, a doctor dilates your eyes to check for problems that can be complications of diabetes. Here’s what to expect during a dilated eye exam.

Your eyes may be a “window to your soul,” according to Shakespeare, but medical experts today know they can be a window to your health if you have type 2 diabetes.

Eye doctors use a dilated eye exam to check your eye health. People with diabetes in particular need this exam each year to detect early signs of diabetes-related eye problems, according to the American Diabetes Association (ADA). The most common eye complication from diabetes is diabetic retinopathy, which is damage to the blood vessels in the retina that can cause blurred vision or even blindness. People with diabetes are also more likely than people without diabetes to develop cataracts and glaucoma, the ADA reports.

A dilated eye exam is part of a comprehensive eye exam, says Natasha Herz, MD, an ophthalmologist in Kensington, Maryland, and a spokesperson for the American Academy of Ophthalmology (AAO). A comprehensive eye exam may also include a visual acuity test, a visual field test, and refraction assessment, among other tests. During the dilated eye exam your doctor will put special drops in your eyes to dilate them, which means enlarging the pupils. This allows your doctor to see the optic nerve, blood vessels, retina, and macula, the cells in the center of the retina, Dr. Herz says. “If there’s a problem, such as damage from diabetes, this is where your doctor would see it.”

What You Need to Know

You might see three types of eye healthcare specialists if you have diabetes, but not all of them do dilated eye exams, according to the American Association for Pediatric Ophthalmology and Strabismus. These eye specialists may include:

Ophthalmologists. These are medical doctors who focus on eye health. They can do a dilated exam, find signs of diabetes damage in the eye (as well as other eye conditions), and prescribe treatment.

Optometrists. These are eye professionals who focus on changes in vision and corrective lenses. They can also do a dilated eye exam and find signs of diabetes damage, but they can’t treat it. They’ll refer you to an ophthalmologist for treatment.

Opticians. These are eye professionals who fit corrective lenses. They don’t perform dilated eye exams.
You don’t need to do much to prepare for a comprehensive eye exam, even one that includes a dilated exam, but there are a few things you should bring:

Your list of medications. Write it down or keep it on your smartphone. Be sure to include all vitamins, supplements, and over-the-counter medications you take.

Your blood sugar numbers. An ophthalmologist will find your A1C and recent blood sugar numbers important for assessing your eye health. Herz says that these numbers are significant to an eye doctor whether you’re meeting your diabetes treatment goals or not.

Your glasses. “People often want to know if their prescription has changed,” Herz says. Your glasses can be assessed to determine your current prescription.

It might also be wise to take sunglasses because you may want them when you leave your doctor’s office. Some eye drops that dilate the eyes take two to four hours to wear off, Herz says. Stronger ones might take longer. Until then, your eyes might feel irritated or teary, and they’ll be sensitive to light.

The drops affect your close-up vision more than your long-distance vision, so it’s OK to drive, but you’ll need to wear sunglasses to do so, Herz says. Reading and writing aren’t recommended until the drops wear off. The exception, she says, are people who have bifocals because the magnifying lenses can help them.

After a Dilated Eye Exam: What’s Next?

Once you’ve had a dilated eye exam, plan on having one each year — or more often if your doctor finds signs of damage from diabetes. Depending on the results of your dilated eye exam, you might also need to come back for glasses, more tests, or treatments.

“It’s important to know that many eye diseases and conditions don’t have noticeable signs or symptoms,” Herz says. “If you wait until you see warning signs or vision changes, you might already have eye damage. It’s a good idea to get your comprehensive eye exam even if you feel well.” Early diagnosis and treatment of eye problems can help maintain eye health and protect your vision.

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8 Ways to Protect Your Eye Health With Diabetes

Selective focus on the word "Diabetes",shot with very shallow depth of field.

When your blood sugar levels soar, the tiny blood vessels in your eyes can suffer serious damage. Over time, diabetes that is not well controlled can lead to permanent vision loss from diabetic retinopathy, in which damage to blood vessels in the retina causes fat, fluid, and blood to leak out. You can lower your risk of eye complications, however, by practicing good diabetes management and taking other self-care steps, says Catherine Meyerle, MD, assistant professor of ophthalmology at the Johns Hopkins Wilmer Eye Institute in Baltimore. Here’s what you need to know to keep your eyes healthy and prevent vision loss if you have diabetes.

Partner With Your Eye Doctor on Diabetes Care

An eye doctor who knows you have diabetes will be better prepared to offer appropriate screenings to look for any changes caused by diabetes and treatment to reduce your risk for vision loss. “Good communication with your eye doctor is essential to detect the source of visual changes and to initiate timely treatment to preserve vision,” Dr. Meyerle says. Develop a good relationship with your eye doctor and inform him or her immediately if you notice any changes in or problems with your vision.

Have Regular Dilated Eye Exams

Talk to your eye doctor about how frequently you should have a dilated eye exam — an exam in which your pupils are dilated to allow for better visualization of the retinas — to uncover any diabetes-related eye problems. “Once-a-year dilation is sufficient for some people with diabetes, but those with diabetic retinopathy may require more frequent dilated examinations, particularly if they’re receiving treatment for the retinopathy,” Meyerle says. Work with your eye doctor to develop and stick to a regular schedule, because early detection can mean better treatment results.

Keep Blood Sugar in Check

High blood sugar levels are responsible for the damage caused to blood vessels in the retina. When your blood sugar is under control, your retinas — and your vision — are protected. According to the American Diabetes Association (ADA), people with uncontrolled blood sugar levels are four times more likely to develop retinopathy. So monitor your blood sugar regularly, follow a healthy diet and exercise regimen, and take your diabetes medication as directed by your doctor.

Manage Blood Pressure and Cholesterol

“Elevated blood pressure is similar to turning up the faucet and creating more leakage from the damaged blood vessels in the eye,” Meyerle says. “When cholesterol levels are high in the blood, more fatty deposits can leak from the damaged blood vessels.” If your doctor has prescribed cholesterol medication, take it as directed, and remember to follow a heart-healthy diet as suggested by the ADA — one that’s low in salt and fat and rich in whole grains, fruits, and vegetables.

Boost Eye Health With Your Diet

Sticking to a well-balanced, nutrient-rich diet can protect eye health as well as overall health. In particular, leafy greens and foods rich in omega-3 fatty acids are beneficial for eye health, says Jennifer Loh, MD, chief of endocrinology at Kaiser Permanente in Hawaii. Antioxidants such as flavonoids can also help protect vision. Eating a diet high in flavonoid-rich fruits and vegetables can reduce the risk for diabetic retinopathy by 30 percent, according to the results of a study published in the November/December 2014 issue of the Journal of Diabetes Complications.

Don’t Smoke

Quitting smoking is at the top of the list for preventing diabetes eye problems, Dr. Loh says, because “smoking can accelerate the development of diabetic retinopathy and make it more difficult to control blood sugar.” Not to mention that it can increase your chances of having a heart attack or stroke, and people with diabetes are already 1.8 times more likely to have a heart attack and 1.5 times more likely to have a stroke than people without diabetes are, according to the ADA.

Move it, Move it

Your body is made to move, so give it regular exercise. “Exercise can help your body use insulin, which controls your blood sugar, burn extra body fat, strengthen muscles and bones, lower blood pressure and cholesterol, improve blood circulation, decrease stress, and boost energy and mood,” Loh says. If you have proliferative retinopathy — a more serious form diabetic retinopathy in which fragile new cells form on the retinas — avoid vigorous physical activity and heavy weight lifting, both of which can raise blood pressure and cause hemorrhaging.

Wear Shades

Sunglasses are more than stylish — they protect eyes from ultraviolet (UV) rays that can cause damage and raise the risk for cataracts, Loh says. People with diabetes are already 60 percent more likely to develop this eye condition, according to the ADA. “Wear sunglasses with 100 percent UV protection whenever you step outside even if it’s cloudy, because UV rays can pass through haze and thin clouds,” she says. This eye protection is even more important when you’re at high altitudes and during the afternoon hours, when UV rays are more intense.

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