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‘Wandering Eyes’ May Raise Risk of Falls for Older Adults


(Reuters Health) – Older people with strabismus, where one eye points slightly inward or outward affecting vision, are about 27 percent more likely than people without the condition to be injured by a fall, according to a new study.

The disorder, often called “wandering eye,” becomes more common with age and can cause double vision or depth perception problems because the two eyes are not pointing in the same direction.

Previous studies have shown that having other eye disorders like cataracts, glaucoma or age-related macular degeneration increases the risk of injuries, fractures or falls, the study team writes in JAMA Opthalmology. But this is the first to examine whether so-called binocular vision problems have the same effect.

“Strabismus in adults is becoming more prevalent as the aging population increases and we do not know the impact of strabismus on patient quality of life and morbidity,” lead author Dr. Stacy Pineles told Reuters Health in an email.

“We hypothesized that strabismus could cause double vision or diminished depth perception, and we wanted to see whether this was associated with injuries such as falls, fractures, and musculoskeletal injuries,” said Pineles, an ophthalmologist with the Jules Stein Eye Institute at the University of California, Los Angeles.

Pineles and her colleagues looked at a random sample of Medicare claims for more than two million beneficiaries over the years 2002 to 2011.

They found almost 100,000 diagnoses of binocular vision problems. The great majority were either strabismus or diplopia, meaning double vision, which often goes along with strabismus. On average the patients were older, white, were more often male and had other health problems like diabetes and heart disease.

About 75 percent of those with binocular vision problems had also reported some type of musculoskeletal injury, fall or fracture during that 10-year time span, compared to about 60 percent of patients without a binocular visual disorder.

After taking into consideration age, region and other potential contributors to falling, such as other illnesses, the researchers calculated that people with binocular vision disorders had a 27 percent higher risk of falls, fractures and injuries overall.

For people with a specific diagnosis of diplopia, the risk was 36 percent higher.

The study team cautions that they don’t know if the injuries occurred before the vision problems were diagnosed or afterward, so they can’t say for certain that the eye disorders are to blame for the falls. They also don’t know which patients were being treated for their vision problems.

Still, Pineles said that elderly patients with vision problems should be sure they optimize lighting in their homes, get help when navigating unfamiliar areas and use low-vision aids if necessary.

Dr. Jamie Rosenberg, an ophthalmologist at Montefiore Medical Center in New York who specializes in strabismus, said that eye problems can sometimes seem less important to elderly patients compared to other illnesses they may have. But “they can affect their life in a significant way and keeping them safe from falls is a huge part of keeping older people healthy.”

Rosenberg, who wasn’t involved in the new study, said there are treatment options for strabismus, such as wearing special glasses with prisms that help align the double images seen by people with diplopia.

“Even though the eyes aren’t straight the two images that are being processed by the brain will be one,” she said.

Surgery may also be an option. “A lot of people think that older people can’t have strabismus surgery to straighten their eyes but that’s actually not true at all,” Rosenberg said.

The new study may underestimate the magnitude of the problem, noted Priscilla Rogers, an aging and vision loss expert at the American Foundation for the Blind’s Vision Aware program.

“Only people who seek medical care from a fall would be included, so the problem is probably bigger and greater than this study suggests,” she told Reuters Health in an email.

Access to eye care may be one obstacle keeping older people from getting help for vision disorders, she noted. “Medicare does not pay for new glasses and people on a fixed income may not want to buy new glasses because they cost too much,” Rogers said. “They can, after all, see – they just may not see well enough to avoid a trip or fall.”

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Halloween Hazard: The Hidden Dangers of Buying Colored Contact Lenses Without a Prescription

Oeil arc-en-ciel

It started as an impulsive buy from a souvenir shop, but 10 hours after she first put in a pair of colored contact lenses, Laura Butler of Parkersburg, W.Va., had “extreme pain in both eyes,” she said. “Because I had not been properly fitted by an eye care professional, the lenses stuck to my eye like a suction cup.”

Halloween is a popular time for people to use colored contact lenses to enhance their costumes. From blood-drenched vampire eyes to glow-in-the-dark lizard lenses, costume contacts can certainly add a spooky, eye-popping touch. But colored contact lenses are popular year-round, not just at Halloween.

But few know the risks associated with these lenses. “Most people believe that decorative lenses do not require the same level of care or consideration as a standard contact lens because they can be purchased over-the-counter or on the Internet,” says Thomas Steinemann, MD, professor of ophthalmology at Case Western Reserve University in Cleveland. “This is far from the truth.”

In fact, it is illegal to sell colored contact lenses without a prescription in the United States. All contact lenses are medical devices that require a prescription and proper fitting by an eye-care professional. Retailers that sell contacts without a prescription are breaking the law, and may be fined $11,000 per violation. “Many of the lenses found online or in beauty salons, novelty shops or in pop-up Halloween stores are not FDA-approved and are being sold illegally,” Dr. Steinemann said.

Never buy colored contact lenses from a retailer that does not ask for a prescription. There is no such thing as a “one size fits all” contact lens. Lenses that are not properly fitted may scratch the eye or cause blood vessels to grow into the cornea. Even if you have perfect vision, you need to get an eye exam and a prescription from an eye-care professional in order to wear any kind of contact lens. In Butler’s case, the lenses caused an infection and left her with a corneal abrasion. “I was in severe pain and on medication for four weeks, and couldn’t see well enough to drive for eight weeks,” she said. “I now live with a corneal scar, vision damage and a drooping eyelid.”To safely wear costume contact lenses for Halloween or any time of year, follow these guidelines:

Get an eye exam from a licensed eye care professional such as an ophthalmologist — an eye medical doctor — who will measure each eye and talk to you about proper contact lens care.

  • Obtain a valid prescription that includes the brand name, lens measurements, and expiration date.
  • Purchase the colored contact lenses from an eye product retailer who asks for a prescription.
  • Follow the contact lens care directions for cleaning, disinfecting, and wearing the lenses.
  • Never share contact lenses with another person.
  • Get follow up exams with your eye care provider.

If you notice redness, swelling, excessive discharge, pain or discomfort from wearing contact lenses, remove the lenses and seek immediate medical attention from an ophthalmologist.

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Breast Cancer Awareness and the EYES?!


As many individuals are “making strides” this month to raise awareness and research dollars for breast cancer, we thought it appropriate to talk about eyes.

You, however, are probably confused. What do breasts have to do with eyes?

It just so happens that breast cancer, followed by lung cancer, is the most common metastasis to the eye. Following the detection and diagnosis of an ocular metastasis, the question we must make sure we know the answer to is: Is there is a history of cancer? If the answer is “no” an immediate referral to an oncologist is indicated where a chest x-ray and mammogram should be performed.

On the other side of the token, if you have ever been diagnosed with breast cancer or have any history of cancer, the value of a dilated eye exam yearly CAN NOT be overstated. A reoccurrence or metastasis to the eye may give us clues to the activity of the cancer.

Additionally, the association between intraocular, brain, and central nervous system metastases is high, therefore full imaging of the brain is also indicated should any ocular metastases be detected.

The ocular manifestations are the only place in the body that we can measure and document with photography the appearance of said metastases. Often, after undergoing the appropriate systemic treatment (chemo or hormone therapy) the oncologist may refer back to an optometric physician to compare size and appearance of metastasis.

Breast cancer metastases differ in appearance to a primary ocular melanoma and tend to be multiple, thinner, and yellow in appearance, without disruption to the overlying retinal pigmented epithelium. An annual dilated eye exam is imperative as most ocular metastases are asymptomatic with no loss of vision.

When there are no symptoms involved and no loss of vision the primary goal is to systemically manage the condition with the oncologist with a thorough monitoring process of the ocular manifestations, but no specific treatment. Should the tumor threaten vision, radiation therapy is typically instituted.

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Toy-Related Eye Injuries: Toys to Avoid to Keep Your Child’s Eyes Safe

mess in child's room

What child doesn’t like toys? And what parent or grandparent doesn’t enjoy buying a fun gift for their young loved ones?

But some toys that look really fun can pose a serious risk of eye injuries — including serious injuries that can result in permanent vision loss.

Toy-Related Eye Injuries

According to the U.S. Consumer Product Safety Commission, roughly a quarter of a million children are seen in the nation’s hospital emergency departments each year due to toy-related injuries.

Nearly half of these injuries are to the head and face, and many are eye injuries. And about 35 percent of toy-related injuries are sustained by children under age 5.

But eye safety is often the last thing on people’s minds when buying toys for children.

Online surveys conducted recently by revealed that 41 percent of parents either “rarely” or “never” considered eye safety when choosing toys for their kids.

At the same time, when asked whether any of the toys their children own could cause harm to their eyes, 54 percent of parents responded “definitely,” and 22 percent said “possibly.”

Common eye injuries caused by mishaps with toys can range from a minor scratch to the front surface of the eye (called a corneal abrasion) to very serious, sight-threatening injuries such as corneal ulcers, traumatic cataracts, bleeding inside the eye and retinal detachment.

Clearly, it’s time for some rethinking about how we buy toys, to protect children’s eyes from damage.

Six Kinds of Toys That Pose a High Risk for Eye Injuries

Here’s a list of six types of toys you might want to cross off your list when buying gifts for young children. Each has a high potential risk for eye injuries — especially if used by young children without adult supervision and guidance:

  • Aerosol string that hits the eye can cause a painful irritation of the eye called chemical pink eye. Toy fishing poles can be especially dangerous to the eyes of nearby children.
  • Party foam can cause a chemical burn to the eyes that can result in red eyes, blurred vision and eye infections.
    Guns that shoot ANY type of projectile. This includes toy guns that shoot lightweight, cushy darts. You might think these soft projectiles would pose little or no risk, but toy guns of this type can shoot up to distances of 75 feet, and the darts move at speeds fast enough to cause a serious eye injury — especially when used at close range indoors. Examples: Nerf Vortex Nitron; Nerf Rebelle Sweet Revenge Dart Kit (both by Hasbro).
  • Water balloon launchers and water guns. Water balloons can cause serious blunt trauma to the eye that can cause a retinal detachment and permanent vision loss. Even toy guns that shoot a stream of water can cause serious eye damage, especially when used at close range. Examples: SuperSoaker Scatter Blast Water Blaster (SuperSoaker); Nerf Super Soakers (Hasbro); Water Sports TL-500 Stream Machine (Water Sports); Water Blaster XLR Water Cannon (Water Blaster).
  • Games that include toy fishing poles. The end of a toy fishing pole or objects secured to the end of the fishing line can easily end up in a playmate’s eye. Examples: Ertl John Deere Electronic Fishing Pole (Tomy); Catch of the Day (Small World Toys).
  • Toy wands, swords, sabers or guns with bayonets. There’s really no need to explain why these are a bad idea, right? Examples: Deluxe Ninja LED Sword (FlashingBlinkyLights); Rapid Fire Machine Gun with Revolving Bullet Belt, Bayonet, Lights & Sounds (Combat 3); Rapid Fire Machine Gun with Lights & Sound (Forces of Valor).
    Aerosol string. The chemicals in these products can cause eye irritation and a type of pink eye called chemical conjunctivitis. When used at close range, aerosol string also can cause a corneal abrasion that could lead to serious eye infections. Examples: Silly String (Silly String Products); Streamer String (Amscan); Turbo Spackle String Blaster (Big Time Toys).
  • Laser pointers and bright flashlights. Though technically not toys, many children love to play “laser tag” or “flashlight tag.” Portable laser pointers, like those used for business presentations, should never be used by children, as the light intensity of these devices is sufficient to cause permanent vision loss. Even high-powered LED flashlights can be dangerous, because they can cause temporary blindness, putting children at risk of a fall or other accident.

Eye-Safe Toy Shopping Tips

If you are buying toys for grandchildren or the children of other relatives or friends, ask for suggestions from the child’s parents. Discuss any toys you are thinking about purchasing before doing so, to make sure the child’s parents are okay with the type of toy you are considering.

Also, it’s usually best to shop for children’s toys in a store rather than online so you can see the toy’s features up close to help you decide if it’s safe enough for a young child.

Although toy packaging usually includes a recommended age range of children for whom the toy was designed, keep in mind that these are general guidelines only. A toy that may be appropriate for one child may not be safe for another child of the same age, depending on their level of maturity and personality.

In fact, age ranges on toy labels often defy common sense. We saw a pointy toy sword online that was labeled as suitable for 3-year-olds!

Also, keep in mind when buying toys for older children that they may have younger siblings who could have access to the toys. So a new toy may not end up in the hands of the child you bought it for.

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Baby’s Eye Safety: Protecting Your Baby’s Vision

portrait of two years aged blonde happy baby yellow shirt with white kid sunglasses and blue sky background

September is Baby Safety Month so we thought it would be fitting to post some information about eye safety for your little one.

It’s never too early to be concerned about your baby’s eye safety. They’re naturally curious. It’s your baby’s job to learn all about the world around them—and your job to protect them.

How Can I Make My House Safe for My Baby’s Eyes?
When there’s a baby in your house, scissors, paper clips, thumbtacks, coat hangers, pens and pencils, and all kinds of other sharp objects, large and small, become potential hazards for your crawling child. Equally treacherous are aerosol sprays, perfumes, and chemicals.

It’s not easy to keep your baby’s eyes out of harm’s way. Here are some tips and ideas to make your home, your car, and even the playground as safe as possible for your baby’s developing eyesight:

  • Avoid toys with sharp points – and keep toys for older children away from infants.
  • Examine all the items in playgrounds.
  • Keep chemicals securely out of harm’s reach, up high.
  • Use safety gates at the top and bottom of stairs.
  • Place pads over sharp corners on furniture.

Can I Treat an Eye Injury Myself?
Despite every precaution, accidents happen. If your baby’s eye is injured, you should always get immediate, professional medical attention. It’s the best way to safeguard your baby’s vision.

Here are some tips in the event of an eye injury (these tips are not meant to replace professional medical attention).

Trauma to the Eye: If your baby is hit in the eye, rest a protective shield—such as a Styrofoam cup—on the bone around the eye. Make sure there is no pressure on the eye itself. Get immediate, professional medical attention.

Foreign Body: If an object has entered the eye, do not try to remove it; you may tear delicate tissue or force the object in deeper. Rest a protective shield—such as a Styrofoam cup—on the bone around the eye, making sure there is no pressure on the eye itself. Get immediate, professional medical attention.

Black Eye: If your baby is hit in the eye area, place an ice pack or cold cloth over the eye. Get immediate, professional medical attention.

Chemical Burn: If your baby’s eye has sustained a chemical burn, rinse it with fresh water for at least 20 – 30 minutes. Hold their head under the tap or use a clean container to pour water into their eye. As you rinse, use your fingers to hold their eye open as wide as possible to ensure the greatest possible coverage. Get immediate, professional medical attention.

How Can I Protect My Baby’s Eyes in the Sun?
The sun’s rays can be tough on a baby’s eyes. Take simple precautions to keep your baby’s eyes safe outdoors:

Sunglasses with UV protection will help to protect your baby’s eyes. Choose sunglasses with both UVA and UVB protection, to block both forms of ultraviolet rays.

A hat with a brim will help block indirect sun, which can come into the eyes around the edges of sunglasses.

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Moreland EyeCare
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Anna, IL  62906
Phone: (618) 833-9208

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