A note from Dr. Riggs:
I had the pleasure to attend the American Academy of Optometry’s annual meeting in Anaheim, California, from November 9-12. It had been several years since I had been to the academy meeting, and I had forgotten the high quality of education that they offer. One of the first classes that I attended was given by an ophthalmologist who performs research at Jules Stein and the Doheny Eye Institute in Los Angeles. This ophthalmologist is currently conducting research for NASA on the effects of space on vision. He showed slides by Elon Musk, and another by President Obama, which said “we will be going to Mars in 6 years,” but he said, “you can quote me, Alex Wong, that we will NOT be going to Mars in 6 years.” His research has shown that in a prolonged anti-gravity environment, fluids from the lower extremities raise to the upper extremities, resulting in a puffy face, a hyperopic shift in one’s glasses prescription, disc edema, choroidal folds, and cotton wool spots; all of which cause blurred vision. To combat this, his early research has shown that when he cuffs the legs with a pressure of 60mmHg, fluids stay in the lower extremities. This cuff was similar to a blood pressure cuff.
The next day I attended another lecture given by an OD obtaining a PhD at the University of Houston College of Optometry. He also conducted research on eyes in space, using both monkeys and astronauts. I saw a picture of a famous astronaut undergoing an OCT exam in space. The OCT measures the thickness of the retina and the optic nerve and produces a print out similar to an X-ray or an MRI. This procedure can be done at our office.
Other important points from my meeting include the following:
- Another lecture talked about alternative medicines for the eye. Green leafy vegetables and dual leucine zipper kinase are beneficial and act as protection for glaucoma.
- In the future, we will use a contact lens worn by the patient to obtain pressures of the eye 24/7, instead of several, single pressures a year, at the office.
- Visual field defects in ocular migraine and amaurosis fugax (TIA) are similar, the first lasting 20-30 minutes and the later, less than 15 minutes, and the visual defects from a TIA tends to not disappear. The migraine visual defect is transient.
- Monkeys have been trained to do visual fields (a side vision test), which helps with glaucoma research.
- Thyroid eye disease occurs more often in smokers.
- An eye that is down and out with the eyelid closed with a dilated pupil is an emergency. Twenty percent of these patients die within 48 hours. This is different than the same disease with normal pupil function which is not associated with mortality.
- Apraclonidine, a glaucoma drop, can be used to diagnose Horners Syndrome.
- Tattooed eyelids damage the meibomian glands, causing dry eye syndrome.
- Cat scratch disease can cause blindness from a scratch or a lick from a baby kitten. The treatment is strong oral antibiotics.
- After 6 months, less than 40% of glaucoma patients are using their medications as prescribed.
- Sleep apnea is a risk factor for glaucoma. A C-pap causes the pressure to go up by 2-3mmHg.
- When we lay down flat to sleep, eye pressure goes up 3-5mmHg. If we lay on our belly, our pressure goes up 9mmHg. If we lay on the side, the side closest to the pillow will have a higher pressure, an increase of 2-12mmHg. So if you have glaucoma, or are a glaucoma suspect, it is best to sleep on your back with your head raised using a wedge pillow or a hospital type bed. The goal is to have your head raised 30⁰.
- OCTs and visual fields performed twice a year will pick up glaucoma progression much faster than when performed once a year.
- There was a slide of George Clooney smiling. He has a slight asymmetric smile suggesting a past Bells palsy.