Insight July 2016

7/20/2016

If you or someone you love has recently experienced a serious loss of sight, this issue of Insight is for you…  

Thank you, Bayer and Alcon!

This issue of Insight has been generously sponsored by Bayer and Alcon.


5 questions to ask when you're diagnosed with an eye disease

Woman sitting with an eye doctor  Learning you have a serious eye disease can be overwhelming. It's not unusual to feel a lot of competing emotions at once when you get this kind of news – whether it's fear, worry, confusion or even anger.

At that moment, when you're sitting in your eye doctor's office and you're told there's something wrong with your vision, all those feelings can make it hard to hear anything else the doctor has to say.

But remember, knowledge is power. The more you understand about your eye disease, the better off you'll be. Here are five questions to ask your eye doctor if you're diagnosed with an eye disease…

  • What is the proper name of my eye disease?

    This may sound like an obvious question, but you'd be surprised how many people walk away from a diagnosis of an eye disease, unsure of the name of the disease itself. Sometimes the emotions of learning you might lose your vision can keep you from remembering important information like this, especially if the name of your eye disease is long and complex. So ask your doctor to write it down if you need to.

  • How does the disease work?

    Your eye doctor might tell you that you have a disease like glaucoma, for instance, but that shouldn't be the end of the conversation. Ask yourself: Do I understand how glaucoma works? If the answer is no, don't be afraid to ask the question – and ask for any brochures or other literature your eye doctor might have about the disease. You have the right to know what's happening to your vision.

  • How can I expect my vision to change in the future?

    Every person's experience of vision loss is different, even if they have the same eye disease. Your eye doctor can explain to you how your vision might change in the future, and that'll help you prepare for it. For instance, with AMD (age-related macular degeneration), there are two stages: dry AMD and wet AMD. Understanding how your vision could be affected if you progress from one stage to the next can help you adapt to it more confidently.

  • What, if any, treatments are available to me?

    This question is a big one. There are so many different eye disease treatments out there – so many different options and so much debate about which ones work better than others. That's why it's important for you to get as much information about the treatments available to you as possible. Ask your eye doctor lots of questions: how each treatment differs from another, how each treatment works, how much each one costs, whether it's covered by health care and what kind of success rates each one has. Remember, when it comes to your treatment options, you have choices and you should be the one who makes the decision about what's right for your eyes.

  • Can you refer me to CNIB for help?

    When you're diagnosed with an eye disease, it's common to focus on the medical side of things (like the treatments and medications you're learning about), so you may forget about the practical and emotional side of things. You may not think about all the other kinds of help that are available to you. That's where CNIB comes in. So if you or someone you love has been diagnosed with an eye disease, we're here to help. Ask your doctor to give you a referral for our support, or give us a call yourself at 1-800-563-2642.

Image of the Canadian Patient Charter for Vision Care   Know your rights as a patient

Whether you're fully sighted, partially sighted or totally blind, every Canadian has rights when it comes to your vision care experience. We all have the right to seamless patient care, ample information and comprehensive support at every step of our vision care journey… from prevention, to diagnosis, to treatment and rehabilitation.

That's why CNIB joined forces with the Canadian Ophthalmological Society, the Canadian Association of Optometrists and the Opticians Association of Canada to create the first ever Patient Charter for Vision Care in Canada. Give it a read and get to know your rights!

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How AMD treatments work

Woman being examined by an eye doctorIf you've been diagnosed with AMD, take heart: You're not alone. In fact, AMD (age-related macular degeneration) is the most common eye disease in Canada, affecting one million Canadians. It's a progressive disease that impacts a person's central vision, meaning that a lot of people who have it end up using more of their remaining peripheral vision as the disease progresses.

But with the right management, regular eye exams and the help of your health care team, you may be able to slow down or even stop the progression of vision loss caused by AMD. Here's a little primer on AMD treatments and how they work…  

What treatments exist for AMD?

The treatment options for AMD depend on what type of AMD you have, wet or dry. Dry AMD is the milder form of the condition, which accounts for about 90% of AMD cases, and wet AMD is the more severe form. 

Dry AMD treatments

Unfortunately, there are no treatments that have been proven effective for dry AMD as of yet. But a study from the National Eye Institute has found that a special formulation of vitamins and zinc (known as the AREDS formulation) may help people who have intermediate dry AMD lower their risk of developing an advanced form of dry AMD.

Clinical research is also currently happening around dry AMD and stem cells. This research is in very early days, but it appears promising when stem cells are implanted into the retina. You can hear more about this from Dr. Keith Gordon on the CNIB YouTube channel.

Screen shot of YouTube video of Dr. Keith Gordon talking about stem cells and AMD 

Wet AMD treatments

Anti-angiogenic treatment is commonly used to help slow down vision loss and, in some rare cases, restore vision for people who have wet AMD. This treatment works through anti-angiogenic drugs (drugs that help block the growth of new blood vessels), which are injected into the eye to stop the growth of abnormal blood vessels that cause vision loss. This treatment can sometimes take many sessions, covering two years or more.

The three most common drugs used in this therapy are Lucentis (also known as Ranibizumab), Eylea (also known as Aflibercept) and Avastin (also known as Bevacizumab). Only the first two, Lucentis and Eylea, have been approved by Health Canada for the treatment of AMD, and are currently reimbursed in the majority of provinces and territories. Each person's medical situation is unique, so it's important to speak with your eye doctor to discuss which of these drugs might be best for you.

There are also two other types of treatments for wet AMD, but they're used extremely rarely. One is called laser photocoagulation therapy, which involves using a laser to remove abnormal blood vessels in a person's eye. The other is called photodynamic therapy, where a doctor injects a light-sensitive dye into a person's bloodstream, then activates the dye with a laser over the eye, causing blood to stop leaking into the retina.

It's important to remember that treatments for AMD are always changing. You should consult regularly with your eye doctor to learn about the latest developments and ask any questions you have.

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So you're losing your sight… now what?Glasses sitting on an eye chart

If you've started to lose your vision and you're not sure what to do, please read this article.

  • If you haven't been to an eye doctor yet, go now.

    Before you do anything else: If you've noticed that your vision is changing and you haven't had an eye exam yet, book an appointment as soon as you can. It's possible that you have an eye condition that can be treated, which means you might be able to slow the progression of further vision loss. A speedy diagnosis can make a difference.

    If you don't have an optometrist, you can find one in your local area by using this online tool from the Canadian Association of Optometrists.

  • Two women smilingYou're not alone. We're here to support you.

    Whether you've experienced a partial loss of vision or have been blind all your life, our services can help you live more independently and meet your goals – whether that means learning to use a computer without vision, meeting new people, overcoming emotional challenges you might be facing, finding assistive tools and products, or learning simple techniques to help you do things on your own.

    If you'd like to receive support from CNIB, you can start by asking your eye doctor to send us a referral on your behalf. It's important that we're able to tailor the support we provide you to your own unique needs. Your eye doctor will give our staff vital information about your vision health, which allows us to provide just the right services to help you. (And no, you don't need to be completely blind to come to CNIB for help; our services are available to people with various degrees of vision loss.)

    To learn more about the support we offer in your region, give us a call at 1-800-563-2642.

  • Clock Don't wait to ask for help. Do it today.

    It's not unusual for people to want to forget about their vision loss when it happens, as though everything is just like it was before. We understand. It can be a very difficult thing to accept.

    But sometimes it takes months or even years before people share their vision loss with family and friends, and even longer before they'll come to CNIB for our support.

    The sooner you can put yourself on the path to accepting your vision loss and moving forward, the better your life will be. So if you've experienced a serious loss of sight, don't wait. Tell your loved ones. Share what you're experiencing with them. And ask your eye doctor to refer you to CNIB for support right away.

  • Woman smiling while walking with guide dogThere is life after vision loss. Lots of it.  

    The good news is: You can still lead an active and independent life, even without normal vision.

    There are a lot of misconceptions about what people can do after they've lost their sight. If you're someone who thinks that people with vision loss can't have full lives – that they can't do things on their own, enjoy meaningful careers, raise children, run marathons or do just about anything else they want to – we're happy to tell you that nothing could be farther from the truth.

    People who are blind or partially sighted can do almost everything sighted people can do; they just do it in a different way. If you've experienced vision loss and you need to feel inspired, here are just a few video stories about people who are leading full, active lives, despite blindness or vision loss…  

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The 411 on cataract lenses

Close-up image of an eyeEven though 3.2 million Canadians have cataracts, many people don't know a lot about cataract lenses, which can be implanted in the eye to replace the natural lens and, hopefully, improve vision. So if you or someone you care about has cataracts, here's a primer on what cataract lenses are all about…

Cataract lenses, also referred to as intraocular lenses (IOLs), are implanted during surgery. They're made of a flexible, foldable material and are built to the patient's prescription to offer the best vision possible.

There are four main types of lenses:

  • Monofocal lenses correct for distance vision, allowing the person to do activities like driving or going to the movies, but they'll need glasses for intermediate or near distance activities, like reading a book or working on a computer.
  • Aspheric lenses provide correction for both distance and contrast. These improve night vision and the ability to distinguish colours, as they reduce the occurrence of glare and halos. Similar  to monofocal lenses, the patient will still need to wear glasses for near and intermediate distances.
  • Toric lenses help people who have cataracts and astigmatism, which is caused when the cornea is irregularly shaped. With these lenses, the patient won't have to wear glasses for distance, but similar to monofocal and aspheric lenses, they'll need them for near and intermediate distances.
  • Multifocal lenses, also known as accommodating lenses, help correct vision for all distances. However, they may temporarily cause patients to experience halos around lights when driving at night. A small number of patients who have had these implants reported some difficulty with intermediate vision. Multifocal lenses may also incorporate toric lenses to help with astigmatism.

While almost all cataract lenses include UV-B-filtering, which is designed to protect eyes against UV-B light damage, Alcon's lenses are the only ones in Canada that also have blue light-filtering. These filtering lenses can add protection from high-energy blue light.

And although they're currently not available in Canada, trifocal lenses, which provide fuller distance vision, have recently come onto the market in Europe and South America. Research is still in its early days, but there have been advancements in the adaptability of the lenses themselves, including changing their shape similar to the natural lens.

If you're considering cataracts surgery, make sure you talk to your doctor about the differences between each kind of lens and which one's right for you.

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Note: The information provided in this issue of Insight is for awareness purposes only, and should not replace the expertise of an eye doctor. CNIB recommends that you visit your eye doctor regularly for thorough eye exams, up-to-date medical information and advice tailored to your own unique vision health and family history.

 

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