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	<title>vision problems &#8211; Eyezone International</title>
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		<title>Healing Eyes with Contact Lenses</title>
		<link>https://eyezoneinternational.com/healing-eyes-with-contact-lenses/</link>
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		<dc:creator><![CDATA[Staff Writer]]></dc:creator>
		<pubDate>Thu, 25 Apr 2024 07:53:11 +0000</pubDate>
				<category><![CDATA[Optical Sciences]]></category>
		<category><![CDATA[Contact Lens]]></category>
		<category><![CDATA[Eye Health Matters]]></category>
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		<category><![CDATA[clear contact lenses]]></category>
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					<description><![CDATA[A cross-disciplinary University of Waterloo team has developed a new contact lens material that could act as a bandage for corneal wounds while releasing drugs in a controlled manner to help the eye heal faster. Typically, corneal abrasion patients spend seven to 10 days wearing a clear, oxygen-permeable bandage contact lens, often instilled with eyedrops [&#8230;]]]></description>
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									<h4>A cross-disciplinary University of Waterloo team has developed a new contact lens material that could act as a bandage for corneal wounds while releasing drugs in a controlled manner to help the eye heal faster.</h4><p>Typically, corneal abrasion patients spend seven to 10 days wearing a clear, oxygen-permeable bandage contact lens, often instilled with eyedrops containing antibiotics.</p><p>However, the one-time antibiotic application makes it difficult to ensure enough drugs stay on the eye for sustained treatment.</p><p>&#8220;It&#8217;s a targeted-release drug delivery system that is responsive to the body,&#8221; said Dr. Lyndon Jones, a professor at Waterloo&#8217;s School of Optometry &amp; Vision Science and director of the Centre for Ocular Research &amp; Education (CORE). &#8220;The more injured you are, the more drug gets delivered, which is unique and potentially a game changer.&#8221;</p><p>Jones knew there was a market for a drug-delivering bandage contact lens that could simultaneously treat the eye and allow it to heal.</p><p>The question was how to develop it.</p><p>As the University of Waterloo has several researchers and entrepreneurs building technology to disrupt the boundaries of health, Jones was able to team up with Dr. Susmita Bose (PhD&#8217;23), Dr. Chau-Minh Phan (PhD&#8217;16) and Dr. Evelyn Yim, an associate professor of chemical engineering working on collagen-based materials.</p><p>Rounding out the team were Dr. Muhammad Rizwan, a former postdoctoral fellow, and John Waylon Tse (MASc&#8217;18), a former graduate student, both with Yim&#8217;s lab.</p><p>Collagen is a protein naturally found in the eye that&#8217;s also often involved in the wound healing process &#8212; however, it&#8217;s too soft and weak to be a contact lens material.</p><p>Yim found a way to transform gelatin methacrylate, a collagen derivative, into a biomaterial 10 times stronger.</p><p>One unique property of collagen-based materials is that they degrade when exposed to an enzyme called matrix metalloproteinase-9 (MMP-9), which is naturally found in the eye.</p><p>&#8220;These enzymes are very special because they&#8217;re involved in wound healing, and when you have a wound, they&#8217;re released in greater quantity,&#8221; Phan said.</p><p>&#8220;If you have a material that can be degraded in the presence of this enzyme, and we add a drug to this material, we can engineer it so it releases the drug in a way that is proportional to the amount of enzymes present at the wound. So, the bigger the wound, the higher the amount of drug released.&#8221;</p><p>The team used bovine lactoferrin as a model wound-healing drug and entrapped it in the material.</p><p>In human cell culture study, the researchers achieved complete wound healing within five days using the drug-releasing novel contact lens material.</p><p>Another benefit of the material is that it only becomes activated at eye temperatures, providing an inbuilt storage mechanism.</p><p>The next step is fine-tuning the material, including entrapping different drugs in it.</p><p>The scientists believe their material has great potential &#8212; not only for the eye but potentially for other body sites, especially large skin ulcers.</p><p>A study outlining the researchers&#8217; work was recently published in the journal <em>Pharmaceutics</em>.</p><p> </p><p><strong>Journal Reference</strong>:</p><ol><li>Susmita Bose, Chau-Minh Phan, Muhammad Rizwan, John Waylon Tse, Evelyn Yim, Lyndon Jones. <strong>Fabrication and Characterization of an Enzyme-Triggered, Therapeutic-Releasing Hydrogel Bandage Contact Lens Material</strong>. <em>Pharmaceutics</em>, 2023; 16 (1): 26 DOI: <a href="http://dx.doi.org/10.3390/pharmaceutics16010026" target="_blank" rel="noopener">10.3390/pharmaceutics16010026</a></li></ol><p> </p>								</div>
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		<title>Children with &#8216;Lazy Eye&#8217; are at Increased Risk of Serious Disease in Adulthood</title>
		<link>https://eyezoneinternational.com/children-with-lazy-eye-are-at-increased-risk-of-serious-disease-in-adulthood/</link>
					<comments>https://eyezoneinternational.com/children-with-lazy-eye-are-at-increased-risk-of-serious-disease-in-adulthood/#respond</comments>
		
		<dc:creator><![CDATA[Staff Writer]]></dc:creator>
		<pubDate>Thu, 25 Apr 2024 07:31:26 +0000</pubDate>
				<category><![CDATA[Children's health]]></category>
		<category><![CDATA[Children's Vision]]></category>
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		<category><![CDATA[lazy eye]]></category>
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					<description><![CDATA[Adults who had amblyopia (&#8216;lazy eye&#8217;) in childhood are more likely to experience hypertension, obesity, and metabolic syndrome in adulthood, as well as an increased risk of heart attack, finds a new study led by UCL researchers. In publishing the study in eClinicalMedicine, the authors stress that while they have identified a correlation, their research does [&#8230;]]]></description>
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									<p>Adults who had amblyopia (&#8216;lazy eye&#8217;) in childhood are more likely to experience hypertension, obesity, and metabolic syndrome in adulthood, as well as an increased risk of heart attack, finds a new study led by UCL researchers.</p><p>In publishing the study in eClinicalMedicine, the authors stress that while they have identified a correlation, their research does not show a causal relationship between amblyopia and ill health in adulthood.</p><p>The researchers analysed data from more than 126,000 participants aged 40 to 69 years old from the UK Biobank cohort, who had undergone ocular examination.</p><p>Participants had been asked during recruitment whether they were treated for amblyopia in childhood and whether they still had the condition in adulthood. They were also asked if they had a medical diagnosis of diabetes, high blood pressure, or cardio/cerebrovascular disease (ie. angina, heart attack, stroke).</p><p>Meanwhile, their BMI (body mass index), blood glucose, and cholesterol levels were also measured and mortality was tracked.</p><p>The researchers confirmed that from 3,238 participants who reported having a &#8216;lazy eye&#8217; as a child, 82.2% had persistent reduced vision in one eye as an adult.</p><p>The findings showed that participants with amblyopia as a child had 29% higher odds of developing diabetes, 25% higher odds of having hypertension and 16% higher odds of having obesity. They were also at increased risk of heart attack &#8212; even when other risk factors for these conditions (e.g. other disease, ethnicity and social class) were taken into account.</p><p>This increased risk of health problems was found not only among those whose vision problems persisted, but also to some extent in participants who had had amblyopia as a child and 20/20 vision as an adult, although the correlation was not as strong.</p><p>Corresponding author, Professor Jugnoo Rahi (UCL Great Ormond Street Institute for Child Health, UCL Institute of Ophthalmology and Great Ormond Street Hospital), said: &#8220;Amblyopia is an eye condition affecting up to four in 100 children. In the UK, all children are supposed to have vision screening before the age of five, to ensure a prompt diagnosis and relevant ophthalmic treatment.</p><p>&#8220;It is rare to have a &#8216;marker&#8217; in childhood that is associated with increased risk of serious disease in adult life, and also one that is measured and known for every child &#8212; because of population screening.</p><p>&#8220;The large numbers of affected children and their families, may want to think of our findings as an extra incentive for trying to achieve healthy lifestyles from childhood.&#8221;</p><p>Amblyopia is when the vision in one eye does not develop properly and can be triggered by a squint or being long-sighted.</p><p>It is a neurodevelopmental condition that develops when there&#8217;s a breakdown in how the brain and the eye work together and the brain can&#8217;t process properly the visual signal from the affected eye. As it usually causes reduced vision in one eye only, many children don&#8217;t notice anything wrong with their sight and are only diagnosed through the vision test done at four to five years of age.</p><p>A recent report from the Academy of Medical Sciences* involving some researchers from the UCL Great Ormond Street Institute for Child Health, called on policymakers to address the declining physical and mental health of children under five in the UK and prioritise child health.</p><p>The team hope that their new research will help reinforce this message and highlight how child health lays the foundations for adult health.</p><p>First author, Dr Siegfried Wagner (UCL Institute of Ophthalmology and Moorfields Eye Hospital), said: &#8220;Vision and the eyes are sentinels for overall health &#8212; whether heart disease or metabolic disfunction, they are intimately linked with other organ systems. This is one of the reasons why we screen for good vision in both eyes.</p><p>&#8220;We emphasise that our research does not show a causal relationship between amblyopia and ill health in adulthood. Our research means that the &#8216;average&#8217; adult who had amblyopia as a child is more likely to develop these disorders than the &#8216;average&#8217; adult who did not have amblyopia. The findings don&#8217;t mean that every child with amblyopia will inevitably develop cardiometabolic disorders in adult life.&#8221;</p><p>The research was carried out in collaboration with the University of the Aegean, University of Leicester, King&#8217;s College London, the National Institute for Health and Care Research (NIHR) Biomedical Research Centre (BRC) at Moorfields Eye Hospital and UCL Institute of Ophthalmology and the NIHR BRC at UCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital.</p><p>The work was funded by the Medical Research Council, the NIHR and the Ulverscroft Foundation.</p><p> </p><p><strong>Journal Reference:</strong></p><p>Siegfried Karl Wagner, Vasiliki Bountziouka, Pirro Hysi, Jugnoo Sangeeta Rahi, Naomi Allen, Tariq Aslam, Denize Atan, Konstantinos Balaskas, Sarah Barman, Jenny Barrett, Paul Bishop, Graeme Black, Tasanee Braithwaite, Roxana Carare, Usha Chakravarthy, Michelle Chan, Sharon Chua, Alexander Day, Parul Desai, Bal Dhillon, Andrew Dick, Alexander Doney, Cathy Egan, Sarah Ennis, Paul Foster, Marcus Fruttiger, John Gallacher, David (Ted) Garway-heath, Jane Gibson, Jeremy Guggenheim, Chris Hammond, Alison Hardcastle, Simon Harding, Ruth Hogg, Pirro Hysi, Pearse Keane, Sir Peng Tee Khaw, Anthony Khawaja, Gerassimos Lascaratos, Thomas Littlejohns, Andrew Lotery, Robert Luben, Phil Luthert, Tom Macgillivray, Sarah Mackie, Savita Madhusudhan, Bernadette Mcguinness, Gareth Mckay, Martin Mckibbin, Tony Moore, James Morgan, Eoin O&#8217;sullivan, Richard Oram, Chris Owen, Praveen Patel, Euan Paterson, Tunde Peto, Axel Petzold, Nikolas Pontikos, Jugnoo Rahi, Alicja Rudnicka, Naveed Sattar, Jay Self, Panagiotis Sergouniotis, Sobha Sivaprasad, David Steel, Irene Stratton, Nicholas Strouthidis, Cathie Sudlow, Zihan Sun, Robyn Tapp, Dhanes Thomas, Emanuele Trucco, Adnan Tufail, Ananth Viswanathan, Veronique Vitart, Mike Weedon, Katie Williams, Cathy Williams, Jayne Woodside, Max Yates, Yalin Zheng, Mervyn Thomas. <strong>Associations between unilateral amblyopia in childhood and cardiometabolic disorders in adult life: a cross-sectional and longitudinal analysis of the UK Biobank</strong>. <em>eClinicalMedicine</em>, 2024; 102493 DOI: 10.1016/j.eclinm.2024.102493.<br /> </p><p><span style="color: #333333;">Originally published in <em>Science Daily</em>.</span></p>								</div>
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		<title>Myopia Control Solutions</title>
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		<dc:creator><![CDATA[Staff Writer]]></dc:creator>
		<pubDate>Thu, 25 Apr 2024 07:21:39 +0000</pubDate>
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					<description><![CDATA[By Sarah McGoldrick Myopia has reached epidemic proportions. Once seen as an eye condition mainly experienced by children, it now affects approximately 25 percent of a quarter of young adults. A 2022 report in “Front Public Health, Prevalence and Risk Factors of Myopia in Young Adults: Review of Findings From the Raine Study” (ncbi.nlm.nih.gov/pmc/articles/PMC9092372) found [&#8230;]]]></description>
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									<p>By Sarah McGoldrick</p><p>Myopia has reached epidemic proportions. Once seen as an eye condition mainly experienced by children, it now affects approximately 25 percent of a quarter of young adults. A 2022 report in “Front Public Health, Prevalence and Risk Factors of Myopia in Young Adults: Review of Findings From the Raine Study” (ncbi.nlm.nih.gov/pmc/articles/PMC9092372) found that by age 28, myopia prevalence had increased to more than 33 percent. As people lead a more digital lifestyle and perform more near tasks, this number is expected to continue to increase globally. A study in “Ophthalmology, Global Prevalence of Myopia and High Myopia and Temporal Trends” from 2000 through 2050 (pubmed.ncbi.nlm.nih.gov/26875007), reports that nearly 50 percent of the world population will have myopia by 2050, of which 938 million people will have high myopia.</p><p>Without adequate treatment, myopia can lead to a host of other serious vision problems, including myopic macular degeneration (MMD), glaucoma, cataracts and retinal detachment. Treatment options vary from country to country, with both spectacle lenses and contact lenses available in many parts of the world.</p><p>In the United States, the Food and Drug Administration (FDA) has approved myopia control contact lenses such as CooperVision’s MiSight and Johnson &amp; Johnson Vision’s Acuvue Abiliti. Yet the agency has yet to approve any myopia control spectacle lenses. (The FDA has granted Essilor’s Stellest spectacle lenses the Breakthrough Device designation. The FDA’s Breakthrough Devices Program is intended to provide patients and health care professionals with timely access to medical devices that offer more effective treatment or diagnosis of life-threatening or irreversibly debilitating diseases or conditions by speeding up their development, assessment and review.)</p><p>In Canada, both contact lenses and spectacle lenses are approved for treating myopia. Canadian ECPs report having significant success with a variety of products. 20/20 spoke with four Canadian optometrists about their experiences prescribing and dispensing myopia control lenses. Their observations provide a window for U.S. practitioners who wish to glean some insights of their own as they await FDA approval of myopia control spectacle lenses.</p><p>Tina Goodhew, OD, and Jeff Goodhew, OD, own Abbey Eyecare in Oakville, Ontario. In addition to their regular practice, they run a large myopia management practice that utilizes several lens options for patients.</p><p>“We currently use Hoya MiYOSMART, SightGlass, Zeiss MyoCare and Essilor Stellest. The scientific data has shown a significant reduction in refractive error and axial progression with these lenses,” explains Dr. Tina Goodhew. “I have been using MiYoSmart and SightGlass for the longest period of time, and clinically, I have seen similar results to the published data.”</p><p>Dr. Goodhew says that when discussing options with patients, she leads with SightGlass. “It is the only lens studied on 6-year-olds, and we have seen excellent clinical results with treating children with this design. However, the effectiveness of the MiYOSMART, Stellest and MyoCare lenses is also strong for children, so we also use these lenses as our initial recommendations.”</p><p>She adds that the experience with prescribing these lenses has been “outstanding,” and they have seen a notable myopia and axial length reduction clinically. “Kids have adapted to the lenses very well. Parents have been quick to understand the use of and importance of this technology for their children. Prescribing myopia control ophthalmic lenses has been a game changer in the myopia management space.”</p><p>Prior to the introduction of these technologies, Dr. Jeff Goodhew notes they were able to prescribe contact lenses and atropine for myopia management. However, for some younger children, parents were hesitant about the concept of putting something in their child’s eyes. “This issue does not exist with myopia control glasses. We can more easily put children in myopia management therapy than we ever have before because parents easily accept these devices for their children,” he adds.</p><p>The overall results of using myopia lenses have been positive, with the office monitoring children every six months to check for refractive errors and axial length. Dr. Goodhew says that in most cases, there is a significant reduction in the progression of myopia and axial length. “I have seen some cases where the refractive error change has halted after prescribing these lenses,” he notes. “The vast majority of patients are able to adapt to the lenses immediately. The only time that I have seen issues is when children have sensory issues or when they are allowing the lenses to slip down their nose and essentially only look through the treatment area. Even in these situations, adaptation complaints are rare.”</p><p>The Goodhews report that treatment areas of each lens are highly effective, noting that the MiYOSMART lens peripheral defocus is accomplished through the use of defocus segments in the periphery of the lens. Each of these segments is +3.50 D with the space between the segments while still carrying the distance power, allowing the child to see clearly peripherally as well as centrally. Meanwhile, they say the Stellest lens design utilizes lenslets in concentric rings to accomplish a volumetric myopia defocus, which is very effective in the treatment of myopia. “The child is also able to see the distance between these lenslets,” says Dr. Tina Goodhew. “Zeiss MyoCare uses cylindrical annular refractive elements to introduce a peripheral add power. Interestingly, studies have shown that a different peripheral add power is optimal for younger children ages 7 to 9 versus older children ages 10 to 12.”</p><p>She adds that the SightGlass lens has a completely different treatment design where the contrast has been reduced peripherally. Through the use of Diffusion Optics Technology (DOT), a technology that uses thousands of microscopic light scattering elements, contrast signaling is reduced. “This treatment design is also highly effective and has been studied on children as young as 6 years old.”</p><p>At Vaughan Vision Care in Vaughan, Ontario, Vishakha Thakrar, OD, FAAO, FSLS, and her team put innovation first to ensure that patients get the best treatment options. Thakrar was one of the first eye doctors in Canada to utilize myopia control therapies. She believes putting the needs of the patients first is key to clinical efficacy in the areas of myopia control. She noted this allows her office to achieve the best outcomes for patients. “One needs to look at efficacy in both reduction in spherical error and axial length; they are not always correlated. Many of the lenses such as MiYOSMART, MyoCare and Stellest, I believe fall into this category with nearly equal efficacy,” she says. “Secondly, what is best for my practice? I prioritize collaborating with companies that engage with independent eyecare professionals. It’s important to me that these companies assist my team with training, provide educational resources for my patients and importantly, support independent eyecare without aligning with large corporate entities that could potentially undermine the value of independent practices.”</p><p>Dr. Thakrar strongly endorses the Canadian Association of Optometrists’ stance that myopia control is a standard care practice. She believes in broadening patient access through independent eyecare providers rather than through large discount retailers offering the same products at significantly lower prices. “Contact lens manufacturers have exemplified this approach for years by offering rebates through independent eye-care professionals, which reduces costs for consumers and enhances access to these products in independent eyecare,” she notes. “I feel the true winner in this category is Zeiss with their MyoCare lens, as they have not positioned themselves in corporate big-box entities with a strategy that fosters the undercutting of independent eyecare.”</p><p>Dr. Thakrar adds that it is also crucial for practices to consider what is most advantageous for the industry. She says this involves identifying which company is effectively promoting the integration of myopia control products with the service of closely monitoring and managing patient progression. “It’s important to recognize who is best positioning patients for success by facilitating access to both quality products and expert management of their myopia, including comprehensive monitoring and assessments,” she says. “Placing these products in large-scale retail environments risks severing this vital connection between product and service, which can be particularly harmful in a relatively new field like myopia control. Given the extensive education required about both the condition itself and the products used to manage it, separating the two can lead to significant errors and misunderstandings.”</p><p>She notes that in her opinion, Zeiss MyoCare has taken the lead on this as they have not aligned themselves with mass retail, adding that overall, they have had excellent success with the MyoCare lens. “Patients adapt extremely well; aesthetically, the lenses look great on the patient, and we are using a high-quality lens company. Zeiss lenses were used to document the first moon landing and are used in the Google Earth satellites.”</p><p>Response to treatment has also been good, according to Dr. Thakrar, with very minimal progression in patients. She says patients adapt nearly as quickly as they do with regular single vision lenses, adding that the clinical evidence supports the efficacy of MiYOSMART, MyoCare and Stellest as leaders.</p><p>Wes McCann, OD, is a noted expert in myopia management and treatment. At his London, Ontario-based clinic Central Optometry, he has worked with countless children and adults to help them find the right solution. His education-focused approach means both the parents and children are part of the treatment journey. Dr. McCann says his team currently offers three options: Zeiss MyoCare, Essilor Stellest and SightGlass. “We did use Hoya MiYOSMART in the past but feel that lenses that provide a treatment zone which encompasses the entire periphery of the lens are apt to work better than lenses that have a limited treatment zone size,” he says. Dr. McCann says he is happy with the ease of prescribing. He says success is based on the ability to specify monocular OC heights and monocular PDs and try to have pupils centered in the frame as much as possible. “The results have been fantastic. We have noted a significant slowdown in the progression of myopia with all three lenses. Zeiss MyoCare and Essilor Stellest lenses appear to work on par with each other. This makes sense as they are both based on peripheral defocus theory, and both lenses provide a treatment zone that spans the entire periphery of the lens.”</p><p>Dr. McCann notes that SightGlass has had the best results with children between the ages of 6 and 8, adding the mechanism of action for SightGlass is contrast reduction theory, which allows his team to try a different lens if the first choice does not give them the control they desire. “We have never had a non-adapt, and most children adapt to their lenses within the first week. Children are highly adaptable.”</p><p>To ensure they were moving in the right direction when it comes to treatment options, the office conducted a one-month survey on all children who began wearing myopia management lenses when they first began describing them. Dr. McCann says they realized the surveys were not necessary as everyone had adapted to the lenses, saw clearly and were happy with their performance. “Having a lens with a treatment zone that spans the entire periphery is more effective. This is because the child will not be able to ‘look above or around’ the treatment zone. These lenses work, but they must be worn full time (12 hours a day) to be most effective. We have had cases where a child stopped wearing their glasses full time, and the myopia control fell drastically.”</p><p>Dr. McCann adds that the best results are a team effort on the part of the eyecare provider, parents and children. “Children must wear their glasses full time and look through the treatment zones for the most effective myopia control,” he concludes.</p><p><span style="color: #808080;">Originally published in <em>20/20 Magazine</em>.</span></p>								</div>
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		<title>Researchers Develop First Model of Human Conjunctiva</title>
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		<dc:creator><![CDATA[Staff Writer]]></dc:creator>
		<pubDate>Tue, 23 Apr 2024 09:08:29 +0000</pubDate>
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					<description><![CDATA[The Organoid group at the Hubrecht Institute produced the first organoid model of the human conjunctiva. These organoids mimic the function of the actual human conjunctiva, a tissue involved in tear production. Using their new model, the researchers discovered a new cell type in this tissue: tuft cells. The tuft cells become more abundant under [&#8230;]]]></description>
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									<h5>The Organoid group at the Hubrecht Institute produced the first organoid model of the human conjunctiva. These organoids mimic the function of the actual human conjunctiva, a tissue involved in tear production. Using their new model, the researchers discovered a new cell type in this tissue: tuft cells. The tuft cells become more abundant under allergy-like conditions and are therefore likely to play a role in allergies. The organoid model can now be used to test drugs for several diseases affecting the conjunctiva. The study was published in Cell Stem Cell on 11 January 2024.</h5><p>Our eyes produce tears to protect themselves from injuries and infections. The conjunctiva, a tissue that covers the white of the eye and the inside of the eyelids, is partially responsible for the production of these tears. It participates in tear production through the release of mucus. This mucus allows the tears to stick to the ocular surface and protects it from pathogens.</p><h6>Limited Treatment Options</h6><p>Several diseases and disorders affect the conjunctiva, such as dry eye disease, cancer, allergies and infections. In severe cases, disfunction of this tissue can lead to blindness. Until now, there has not been a good model of the human conjunctiva, which limits research into its function in sickness and in health. Consequently, there are limited treatment options for diseases affecting the conjunctiva.</p><h6>First Model</h6><p>To gain more insight into the composition and functioning of the conjunctiva, the Organoid group set out to develop the first human model of this type of tissue. They used cells from an actual human conjunctiva and grew them into 3D structures in a dish. These miniature structures are called organoids and function as real human conjunctiva.</p><p>“Once we had these functioning organoids, we wanted to know how the conjunctiva is involved in the production of tears,” Marie Bannier-Hélaouët, lead researcher in the project, explains. </p><p>“We discovered that the conjunctiva makes antimicrobial components and therefore contributes to tear production in more ways than by simply making mucus.”</p><h5>Allergies</h5><p>The researchers then altered the conditions in the dish with the miniature conjunctivae to mimic allergies. “The organoids started to produce completely different tears: there was more mucus but there were also more antimicrobial components,” says Bannier-Hélaouët. Under these conditions, they also found a new cell type in the organoids: tuft cells.</p><p>Bannier-Hélaouët continues: “Similar cells have been discovered in other tissues, but not in the human conjunctiva.” The tuft cells became more abundant under the allergy-like conditions, suggesting they play a role in the eye’s reaction to allergies.</p><h5>Drugs</h5><p>The newly developed organoid model opens the door for research into diseases affecting the conjunctiva. “We can use our model to test drugs for allergies or dry eye disease, for example,” says Bannier-Hélaouët. In the long term, it may even be possible to make replacement conjunctivae for people with ocular burns, ocular cancers or maybe even genetic disorders.</p><p>“We are now running preclinical studies in rabbits to assess whether this approach is feasible and helpful,” Bannier-Hélaouët concludes.</p><p><strong>Journal Reference:</strong></p><p>Marie Bannier-Hélaouët, Jeroen Korving, Ziliang Ma, Harry Begthel, Amir Giladi, Mart M. Lamers, Willine J. van de Wetering, Nobuyo Yawata, Makoto Yawata, Vanessa L.S. LaPointe, Mor M. Dickman, Rachel Kalmann, Saskia M. Imhoff, Johan H. van Es, Carmen López-Iglesias, Peter J. Peters, Bart L. Haagmans, Wei Wu, Hans Clevers. <strong>Human conjunctiva organoids to study ocular surface homeostasis and disease</strong>. Cell Stem Cell, 2024; DOI: 10.1016/j.stem.2023.12.008.</p><p><span style="color: #808080;">Originally published in <em>Science Daily</em>.</span></p><p> </p>								</div>
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		<title>Detecting Vision Problems in Children</title>
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		<dc:creator><![CDATA[Staff Writer]]></dc:creator>
		<pubDate>Sun, 14 Apr 2024 08:29:19 +0000</pubDate>
				<category><![CDATA[Blog]]></category>
		<category><![CDATA[Children's health]]></category>
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		<guid isPermaLink="false">https://eyezoneinternational.com/?p=12214</guid>

					<description><![CDATA[P VIJAYALAKSHMI &#124; Senior Paediatric Ophthalmologist and Chief of Vision Rehabilitation Center: Aravind Eye Care System, Madurai, India. Screening can detect eye conditions early – which is especially important in children, who need good vision in order to develop. The purpose of screening the eyes of children is to detect specific conditions in as many [&#8230;]]]></description>
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									<h5>P VIJAYALAKSHMI | <span style="color: #333333;">Senior Paediatric Ophthalmologist and Chief of Vision Rehabilitation Center: Aravind Eye Care System, Madurai, India.</span></h5>								</div>
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									<h3>Screening can detect eye conditions early – which is especially important in children, who need good vision in order to develop.</h3><p>The purpose of screening the eyes of children is to detect specific conditions in as many children in the population as possible, as soon as possible. The types of eye conditions that benefit from screening are those for which early detection and treatment improves visual or health outcomes, and for which there are reliable screening tests that are simple to use, and safe.</p><p>Screening on its own is not enough, however. There must also be eye care services where the children who fail screening tests can undergo a comprehensive eye examination to diagnose why they failed the test, and where they can receive effective treatment.</p><p>The eye conditions in children that can usefully be screened for are summarised in Table 1.</p><p><strong>Table 1</strong> Eye conditions which can be screened for in children and adolescents in different age groups</p><div class="table-container-outer"><img fetchpriority="high" decoding="async" class="aligncenter size-full wp-image-12238" src="https://eyezoneinternational.com/wp-content/uploads/2024/04/Screen-Shot-2024-04-04-at-10.53.31-AM.png" alt="" width="1291" height="2012" srcset="https://eyezoneinternational.com/wp-content/uploads/2024/04/Screen-Shot-2024-04-04-at-10.53.31-AM.png 1291w, https://eyezoneinternational.com/wp-content/uploads/2024/04/Screen-Shot-2024-04-04-at-10.53.31-AM-768x1197.png 768w, https://eyezoneinternational.com/wp-content/uploads/2024/04/Screen-Shot-2024-04-04-at-10.53.31-AM-986x1536.png 986w, https://eyezoneinternational.com/wp-content/uploads/2024/04/Screen-Shot-2024-04-04-at-10.53.31-AM-600x935.png 600w, https://eyezoneinternational.com/wp-content/uploads/2024/04/Screen-Shot-2024-04-04-at-10.53.31-AM-32x50.png 32w" sizes="(max-width: 1291px) 100vw, 1291px" /></div><div> </div><div><p>The screening tests listed in Table 1 may also detect conditions which are not treatable. However, <strong>all</strong> children who fail <strong>any</strong> screening test must be referred for examination by an eye care professional. For example, torchlight examination of a newborn may detect microphthalmos, and fundal (red) reflex testing may detect choroidal coloboma. Neither of these conditions need immediate intervention, but it is important to make the diagnosis.</p><h3>Newborn Screening</h3><p>Screening the eyes is now recommended by the World Health Organization as part of the general examination of all newborns.<sup><a href="https://www.cehjournal.org/article/detecting-vision-problems-in-children/#ref" target="_blank" rel="noopener">1</a></sup> This can be done by the same person who carries out the general newborn examination, once they have received some additional training.</p><p>There are two parts to newborn eye screening:</p><ol><li>Using a torch to look at the eyelids, to check the size of the eyes and the clarity of the corneas.</li><li>Eliciting the fundal (red) reflex, which can be done with a direct ophthalmoscope such as the Arclight. Sometimes, the eyelids of newborns are a bit swollen and red reflex testing is difficult; the test can then be delayed until the baby is 6–8 weeks old.</li></ol><p>Arclights can easily be attached to a smartphone, which means you can take a video or photographs (Figure 1b). This is useful if you want to discuss what you have seen with somebody else.</p><p>Arclights have a small solar panel and batteries are not necessary; they are very light and inexpensive (US $10–15) and come with a lanyard and an otoscope for examining ears. Fundal reflex testing can also be undertaken in young children (and people of any age).</p><p>Teaching videos can be found here <a href="https://tinyurl.com/CEHJarclight" target="_blank" rel="noopener">https://tinyurl.com/CEHJarclight</a></p><p>Screening <strong>preterm babies</strong> for retinopathy of prematurity is covered in detail in an earlier issue of the Journal (<a href="https://tinyurl.com/CEHJretinopathy" target="_blank" rel="noopener">http://tinyurl.com/CEHJretinopathy</a>).</p><figure id="attachment_12220" aria-describedby="caption-attachment-12220" style="width: 300px" class="wp-caption alignleft"><img decoding="async" class="size-full wp-image-12220" src="https://eyezoneinternational.com/wp-content/uploads/2024/04/Common8-Edit-copy-300x270-1.jpeg" alt="" width="300" height="270" srcset="https://eyezoneinternational.com/wp-content/uploads/2024/04/Common8-Edit-copy-300x270-1.jpeg 300w, https://eyezoneinternational.com/wp-content/uploads/2024/04/Common8-Edit-copy-300x270-1-56x50.jpeg 56w" sizes="(max-width: 300px) 100vw, 300px" /><figcaption id="caption-attachment-12220" class="wp-caption-text">A child with retinoblastoma in the left eye, visible when using a torch light or ophthalmoscope to elicit the red reflex. INDIA © Shilpa Sonarkhan CC BY-NC-SA 4.0</figcaption></figure><h3>Preschool-age screening</h3><p>The same screening tests as for newborns can be used for preschool-aged children.</p><p>Whether preschool-aged children should also be screened for amblyopia (‘lazy eyes’) is controversial, as this would require measuring their visual acuity, which can be very difficult.</p><p>A torchlight examination and fundal reflex testing should detect squint – a common cause of amblyopia. There is also very limited evidence on whether the management of amblyopia due to uncorrected refractive error (such as intermittent patching of the ‘good’ eye before the age of 5 years) has better outcomes than management after the age of 5 years.<sup><a href="https://www.cehjournal.org/article/detecting-vision-problems-in-children/#ref" target="_blank" rel="noopener">2</a></sup></p><p>Screening preschool-aged children for refractive errors is also controversial, as they are too young to have developed myopia (short sightedness). Hyperopia (longsightedness), if present, resolves spontaneously in most young children.</p><h3>Children aged 6 years and above (including adolescents)</h3><p>The main purpose of screening school-age children is to detect and manage <strong>uncorrected refractive errors</strong>. The most common screening test is a visual acuity measurement during which only one line of the Snellen chart needs to be used – either the 6/9 line or the 6/12 line. Each eye is tested separately.</p><p>All children who fail the screening test should undergo refraction by an experienced optometrist who then also measures the corrected visual acuity. If the vision does not improve, the child needs to be examined to rule out other causes of vision impairment.</p><p>If correction does improve the vision, it is important to follow the prescribing guidelines drawn up by IAPB (<a href="https://tinyurl.com/ypnja65y" target="_blank" rel="noopener">https://tinyurl.com/ypnja65y</a>). Children whose vision only improves by one line of acuity are very unlikely to wear their spectacles, for example.<sup><a href="https://www.cehjournal.org/article/detecting-vision-problems-in-children/#ref" target="_blank" rel="noopener">3</a></sup></p><p>Autorefractors and other technology can aid the screening process, but more evidence is needed on their effectiveness.</p><p>The age at which vision screening should start is very context-specific and depends on the age at which myopia commonly starts to develop in the child population in that country or region. For example, in China and southeast Asian countries, myopia can start at primary school age, and screening younger children is, therefore, warranted. However, in other parts of the world, myopia doesn’t usually start until the age of 9 to 11 years.</p><p>School eye health programmes should not focus solely on detecting uncorrected refractive errors, as some children will have other conditions which need treatment, such as infective or allergic conjunctivitis, squint, or cataract.</p><h3>Summary</h3><p>Screening, using the range of methods outlined above, can detect eye conditions early. For all age groups of children, it is very important that processes are put in place to ensure that children who fail a screening test are examined by an eye health professional for a diagnosis, and that treatment is provided as soon as possible, whether it is spectacles, cataract surgery, or treatment of retinoblastoma or amblyopia.</p></div><p><img decoding="async" class="aligncenter size-full wp-image-12240" src="https://eyezoneinternational.com/wp-content/uploads/2024/04/Screen-Shot-2024-04-14-at-11.22.16-AM.png" alt="" width="1276" height="1751" srcset="https://eyezoneinternational.com/wp-content/uploads/2024/04/Screen-Shot-2024-04-14-at-11.22.16-AM.png 1276w, https://eyezoneinternational.com/wp-content/uploads/2024/04/Screen-Shot-2024-04-14-at-11.22.16-AM-768x1054.png 768w, https://eyezoneinternational.com/wp-content/uploads/2024/04/Screen-Shot-2024-04-14-at-11.22.16-AM-1119x1536.png 1119w, https://eyezoneinternational.com/wp-content/uploads/2024/04/Screen-Shot-2024-04-14-at-11.22.16-AM-600x823.png 600w, https://eyezoneinternational.com/wp-content/uploads/2024/04/Screen-Shot-2024-04-14-at-11.22.16-AM-36x50.png 36w" sizes="(max-width: 1276px) 100vw, 1276px" /></p><p><img loading="lazy" decoding="async" class="aligncenter size-full wp-image-12241" src="https://eyezoneinternational.com/wp-content/uploads/2024/04/Screen-Shot-2024-04-14-at-11.22.53-AM.png" alt="" width="1280" height="1107" srcset="https://eyezoneinternational.com/wp-content/uploads/2024/04/Screen-Shot-2024-04-14-at-11.22.53-AM.png 1280w, https://eyezoneinternational.com/wp-content/uploads/2024/04/Screen-Shot-2024-04-14-at-11.22.53-AM-768x664.png 768w, https://eyezoneinternational.com/wp-content/uploads/2024/04/Screen-Shot-2024-04-14-at-11.22.53-AM-600x519.png 600w, https://eyezoneinternational.com/wp-content/uploads/2024/04/Screen-Shot-2024-04-14-at-11.22.53-AM-58x50.png 58w" sizes="(max-width: 1280px) 100vw, 1280px" /></p><h3>References</h3><p>1 WHO recommendations on maternal and newborn care for a positive postnatal experience. Geneva: World Health Organization; 2022. Licence: CC BY-NC-SA 3.0 IGO</p><p>2 Ameenat Lola Solebo, Phillippa M Cumberland, Jugnoo S Rahi. Wholepopulation vision screening in children aged 4–5 years to detect amblyopia. Lancet 2015 385: 2308–19</p><p>3 IAPB School Eye Health Work Group 2018. Standard school eye health guidelines for low and middle-income countries <a href="https://tinyurl.com/cvxejtrj" target="_blank" rel="noopener">https://tinyurl.com/cvxejtrj</a></p><p><span style="color: #808080;"><span style="color: #333333;">Featured image:</span> <span style="color: #333333;">Using the Arclight ophthalmoscope to examine a child’s eyes. TANZANIA © Aeesha Malik CC BY-NC-SA 4.0</span></span></p><p>Originally published in <em><a href="https://www.cehjournal.org/" target="_blank" rel="noopener">Community Eye Health Journal</a>.</em></p>								</div>
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