At Spectrum Eyecare in Peachtree City, Dr. John Henahan is committed to reducing the number of people losing vision or becoming legally blind from macular degeneration (AMD). Please read this important information and discuss it with your doctor if your regularly take aspirin.

Discussing the new study, HealthDay (1/6, Mozes) reports, “Daily aspirin use among seniors may double their risk of developing” the “wet” form of “age-related macular degeneration (AMD), a significant cause of blindness in seniors,” according to a study published in the January issue of the journal Ophthalmology. In fact, “daily aspirin use was associated with the onset of late-stage” wet AMD, “and to a lesser degree, the onset of early ‘dry’ AMD — even after the researchers took into account age and a history of heart disease, which in itself is a risk factor for AMD.”

Specifically, “late-stage ‘wet’ AMD was 2.22 times more likely among daily aspirin users (95% CI 1.61 to 3.05) in a” study population of 4,691 European seniors, MedPage Today  (1/6, Phend) reports.

Medscape  (1/6, Keller) explains, “More frequent aspirin use was associated with more severe levels of AMD. One third of the individuals with wet AMD consumed aspirin daily compared with only 16% of control participants.” Medscape adds, “Limitations of the study include its cross-sectional and retrospective nature, with the possibility of recall error about aspirin use and possible confounders,” such as the fact that aspirin is found in many over-the-counter drugs that study participants might not have recognized as containing it. “In addition, there were no data on the doses of aspirin or the use of other antiplatelet or anticoagulant drugs” taken by study participants.

According to Dr. Henahan, the most recent data suggests a strong link between wet AMD and frequent Aspirin use.  ”I do NOT recommend that anyone discontinue aspirin use without consulting their physician or cardiologist” says Dr. Henahan.  ”The benefits of aspirin therapy must be balanced with the increased risk of wet AMD.  Consulting with your physician can help you decide what to do.”

If you or a loved one is concerned about the health of your eyes and live in the Peachtree City area, feel free to contact our office if you would like an appointment. You may also call us at 770-487-0667.

NOVEMBER IS AMERICAN DIABETES MONTH

At Spectrum Eyecare in Peachtree City, Dr. John Henahan considers educating diabetic patients one of his most important missions.  That is because diabetes is the single leading cause of irreversible vision loss in Americans under 70 years of age.  During this month, please visit stopdiabetes.org to learn more about this disease.  As for preserving your vision, below are Dr. Henahan’s top tips to prevent vision loss if you are diabetic.

 1)    Annual Eye Exams

Seeing well into the future is no big trick — as long as you have regular vision and eye health examinations.  There are many disorders and diseases that can have long lasting affects on your eyes if not diagnosed early.  One disease that can be detected during a thorough eye examination is diabetic eye disease. Yet, less than 50% of diabetics have an annual diabetic eye examination.  That is unfortunate, as early detection and treatment can prevent vision loss in the majority of people suffering from diabetic eye disease.  Studies have repeatedly shown that early detection of diabetic eye disease is essential for the prevention of vision loss.  Once vision loss occurs, it is unlikely that full function can be recovered.

2) Retinal Photography

Be sure that your eye examination includes a dilated eye examination and photography of the retina (the part of the eye where most vision loss in diabetes occurs). Retinal photography has been shown to detect diabetic eye disease in more people than an eye examination alone.

Note blood spots and white swollen areas (click to enlarge)

3)   Control Blood Sugar

The two main risk factors for diabetic eye disease are how long you have been diabetic and how well you control your blood sugar.  Since you cannot control how long you have been diabetic, it is imperative that you control your blood sugar. The most important measure of control is a blood test called an “A-1-C” test. This test measures how well you have controlled your blood sugar for the past 90 days or so.  “I often tell my patients that this test is the best way to know if you are winning or losing your battle with diabetes”, says Dr. Henahan. It is critical to have this test done by your doctor as directed (typically every three months).  Also you need to know your doctor’s goal for your score (typically in the 6.0-7.0 range).  If you don’t know your score, you need to find out.

Dr. Henahan and Spectrum Eyecare are emphasizing the importance of annual dilated eye examinations during American Diabetes Month in November.  As a diabetic, or a person at risk, seeing your optometrist is as important as visiting your physician regularly and following instructions about proper diet, exercise, and medication.

Remember, if you are diabetic your medical insurance will cover an eye examination, so you do not need vision insurance to have an exam (you may still have a deductible or co-pay, check with your insurance company).

Schedule an annual eye examination today if it has been more than a year or if your blood sugar control has been deteriorating. Dr. Henahan is a resident of Peachtree City and founder of Spectrum Eyecare.  You may reach his office at 770-487-0667 or on the web at SpecEye.com.

After this father’s day weekend, I have been contemplating the unhappy news I had to deliver to my own father last week.

I discovered that his age-related macular degeneration (ARMD) had converted from the “dry” type to the “wet” type.  It was personally very difficult for me to deliver this news to my dad. It has also resulted in a lot of questions from my siblings about the nature of this condition.   I thought I would write the answers to their most frequently asked questions here, so they might be of some help to others as well.

What is ARMD?

ARMD is a deterioration of the central detail vision as a result of degeneration of the retina in the macular area.  The retina can be thought of as the film in the camera of the eye.  No matter what kind of lenses you have in the camera, if the film is damaged, you cannot take a clear picture.

Does ARMD cause blindness?

Since ARMD only affects the central detail vision, you can never go blind from ARMD.  However, you can lose your ability to see details.  For example, you could see the newspaper on the table but would struggle to read it.

How does someone get ARMD?

As the name implies, macular degeneration is age-related.  The prevalence increases steadily in each decade after age 60, with a prevalence of nearly 25% in those over age 90.

When other family members have/had ARMD you are more likely to develop ARMD yourself.  Other risk factors include a history of smoking, lots of sun exposure without the use of UV sunglasses and lightly colored eyes.

What is the difference between dry ARMD and wet ARMD?

Dry ARMD is by far the more common type.  It is characterized by the accumulation of creamy yellow deposits in the retina called drusen.  They eventually interfere with retinal function and can result in blurred central vision.

About 15% of the time, these same drusen can coalesce and then damage the layer of tissue underneath the retina, which causes the body to develop abnormal blood vessels in that area.  These blood vessels tend to bleed and leak (hence the “wet” in wet ARMD).  As this blood spills into the macular area of the retina, the retina swells.  The swelling impairs the function of the retina, causing a sudden deterioration in the central vision in that area.  In most cases, you would know right away that something was wrong when the blood vessels leak and bleed, because the change in vision is pronounced and sudden.

What is the Treatment for ARMD?

At this time there is no treatment for the dry type of ARMD.  Prevention is your best option (see below).

Until recently the treatment for wet ARMD involved the use of lasers to destroy the unwanted blood vessels.  The problem is that lasers create a lot of heat to do that, which invariably destroyed the retina above the vessels.  This left scar tissue and blind spots.  Now we have a new way of treating wet ARMD with medications that cause the blood vessels to regress and disappear.  As the blood vessels regress, the swelling in the retina would go down, often leading to modest improvements in vision.  More importantly, the treatment tends to prevent worsening of vision.

Can I prevent ARMD?

Since there is no treatment available for the more common dry ARMD, prevention is your best option.

A lifetime of sunglasses usage is a great starting point.  You can also take a multivitamin.

Additionally a supplement called Lutein has been shown to cut ARMD risk by 25-30%.  I recommend 20mg per day of natural form Lutein.

A large study of nurses completed in 2010 showed that those with the highest fish intake had the lowest reported severity of ARMD.  As such, I recommend 3000mg of high quality fish oil supplements per day.  (Take two capsules with breakfast and one with dinner).  Keep in mind that fish oil is very difficult to manufacture and lower quality fish oils are more likely to be rancid (if the pills stink, that is a sign they are rancid).

Finally if you smoke, quit.

How can I make the most of my remaining vision?

If you have have lost vision due to ARMD, you might benefit from low vision aids.  These specialized devices allow you to make the most of the vision you have left and can often help ARMD patients read better.  If the ARMD has only affected one eye, then low vision aids are not typically used.  They are usually only used when your vision is impaired in both eyes.

If you have questions about your vision, ARMD, or would like to find out if you are a candidate for low vision aids, feel free to contact Dr. Henahan at Spectrum Eyecare.  The website is www.speceye.com and the phone number is 770-487-0667.

“A young man came into my office with a painful red eye after leaving his warehouse job.  He had been using a staple gun to attach labels to crates.  I expected a simple scratch on the cornea, but instead was shocked to see a portion of the staple had lodged itself deeply in his eyeball.”

Upon further questioning the young man revealed that he believes the staple hit something buried in the wood of the crate, and the staple ricocheted back into his eye.

“Upon examination, I was able to see that one of the tines of the staple had broken off and shot back into the eye, piercing it like a mini spear.  Because of the high velocity it easily ripped through his cornea and iris (the colored part of the eye)”, continued Dr. Henahan.

“I was fearful that if I attempted to extract the staple that it would further damage the sensitive inside of the eye.  I referred him to a specialist in Atlanta who performed emergency surgery to remove the staple.”

Often in these cases, the sensitive film in the back of the eye (called the retina) or other eye tissues are irreparably harmed often resulting in blindness, and even loss of the eye.

Luckily for this young man, the specialist, Dr. Evan Loft of Eye Consultants of Atlanta, was able to carefully extract the object with no apparent permanent damage.  “The patient may require a second surgery if the lens inside the eye becomes cloudy with a traumatic cataract, but even then he should have a full visual recovery”, reported Dr. Loft.

Dr. Loft that he sees up to 10 patients per year with a penetrating eye injury.  “He is just one specialist of the many in Atlanta”, reminds Dr. Henahan.  That means in Atlanta alone, there are hundreds of such injuries per year, often with much worse outcomes.

When using any type of power tool or even a tool that strikes with force (such as a hammer), always wear safety glasses.

Dr. John Henahan has practiced for 20 years and has been living and practicing in Peachtree City since 1999.  If you would like to contact Dr. Henahan or make an appointment you can call 770-487-0667 or contact us here.

The Los Angeles Times (8/11, Maugh) reports, “Nearly three in 10 Americans with diabetes over the age of 40 suffer from vision impairment caused by diabetic retinopathy, and about 4.4% have a form of the condition so severe it threatens their eyesight,” according to a study published in the August 11 issue of the Journal of the American Medical Association.

HealthDay (8/10, Gordon) reported that “the news wasn’t all bad, however. The findings suggest that good control of blood sugar, blood pressure, and cholesterol can go a long way toward preventing or slowing diabetic eye disease.” For the study, CDC researchers “reviewed data from the National Health and Nutrition Examination Survey from 2005 to 2008, which included nearly 7,000 people over age 40,” 1,006 of whom had diabetes.

Focusing on specific gender and ethnic/racial demographics, WebMD (8/10, Woznicki) reported that “31.6% men and 25.7% of women over age 40 who have diabetes are estimated to have diabetic retinopathy,” while “38.8% of non-Hispanic blacks were estimated to have diabetic retinopathy, 34% of Mexican-Americans, and 26.4% of non-Hispanic whites.” Interestingly, “age was not a major factor among the study group.”

“Independent risk factors for diabetic retinopathy included male sex, higher hemoglobin A1c level, longer duration of diabetes, and higher systolic blood pressure, with respective odds ratios of 2.07, 1.45, 1.06 per year of duration, and 1.03 per millimeter of mercury,” MedPage Today (8/10, Smith) reported. Reuters (8/11, Peeples) also covers the story.

While taking all possible steps to prevent diabetic retinopathy, an annual eye exam with dilated pupils is essential according to Dr. John Henahan of Spectrum Eyecare in Peachtree City, GA.  ”At Spectrum Eyecare, we take finding diabetic retinopathy very seriously.  Early diagnosis greatly reduces the chance that vision loss will occur, so we dilate the eyes and take high resolution photographs of the retina to make sure we don’t miss even the slightest changes from diabetes.”  If you or a loved one are diabetic and have not had an eye exam in the past year, then please contact us or your local eye doctor for an exam.

In fact, according to the AOA American Eye-Q survey, only one-third of Americans said UV protection is the most important factor they consider when purchasing sunglasses.

Whether it’s cloudy or sunny, summer or winter, the AOA urges Americans to take measures to protect their eyes from the sun’s UV rays in order to decrease the risk of eye diseases and disorders.  “Over-exposure to UV rays is quite serious and can lead to cataracts, macular degeneration, or, in some cases, skin cancer around the eyelids,” said Sarah Hinkley, O.D., the AOA’s UV protection expert. “Other disorders that can occur are abnormal growths on the eye’s surface and even sunburn of the eyes. These conditions can cause blurred vision, irritation, redness, tearing, temporary vision loss and, in some instances, blindness.”

Even more troubling is the lack of awareness surrounding the potential effects of overexposure to UV radiation. According to the American Eye-Q survey, 35 percent of adults are unaware of the eye health risks associated with spending too much time in the sun without the proper protection.

The following top five tips from the AOA may help prevent eye and vision damage from over-exposure to UV radiation:

• Wear protective eyewear any time the eyes are exposed to UV rays.
• Look for quality sunglasses or contact lenses that offer good protection. Sunglasses should block 99 to100 percent of UV-A and UV-B radiation and screen out 75 to 90 percent of visible light.
• Check to make sure sunglass lenses are perfectly matched in color and free of distortions or imperfections.
• Purchase gray-colored lenses for the brightest conditions because they reduce light intensity without altering the color of objects to provide the most natural color vision. Choose brown or amber-colored lenses for variable light conditions, overcast days or times when you will be in and out of the shade such as hiking, golf or mountain biking.
• Don’t forget protection for young children and teenagers, who typically spend more time in the sun than adults and are at a greater risk for damage.

Children need UV Eye protection too

“The lenses of children’s eyes are more transparent than those of adults allowing shorter-wavelength light to reach the retina,” said Dr. Henahan. “Because the effects of solar radiation are cumulative, it’s important to develop good protection habits early, such as purchasing proper sunglasses for young children and teenagers.”

According to the AOA, parents should purchase sunglasses for all children, including infants.

The American Eye-Q survey found 66 percent of Americans purchase sunglasses for their children, but more than one in four parents do not check to make sure the lenses have proper UV protection. Additionally, less than one third (29 percent) of parents make sure their child wears sunglasses while outdoors.

Apart from an annual eye exam, the most important thing you can do to protect your eyes is to where quality polarized sunglasses, according to Dr. Henahan.  ”While I was director of Low Vision at LSU the majority of patients with vision impairment suffered from macular degeneration, which is caused in part by excess UV exposure.”  For maximum protection, Dr. Henahan recommends polarized lenses which have the added benefit of being much more effective at cutting glare.  ”When you are driving, on the water or participating in sports, the additional glare reduction afforded by polarized sunglasses is huge”, continues Dr. Henahan.  When purchasing sunglasses, you pay more for higher quality lenses, such as those made by Costa del Mar, Columbia and others.

If you would like more information or to see Dr. Henahan, click here or call the office at 770-487-0667.  He sees patients in Peachtree City every Monday, Wednesday, Friday and two Saturdays per month.

Every year, more women than men are diagnosed with eye diseases such as dry eye, glaucoma, cataracts, macular degeneration and diabetic retinopathy, according to Dr. John L Henahan, of Spectrum Eyecare in Peachtree City, GA.

Of the many health differences between men and women, many may not be aware of the fact that women are more affected by eye disease and other eye conditions than men.

The 2008 “Vision Problems in the U.S.” study from Prevent Blindness America and the National Eye Institute consistently shows that more females are diagnosed with major eye diseases. Of the more than 3.6 million Americans age 40 and older suffering from visual impairment, including blindness, 2.3 million are women.

Women are also more susceptible to dry eye syndrome, a condition where not enough natural tears are produced.

Approximately 6 million women and 3 million men have moderate to severe symptoms of dry eye syndrome, according to the National Women’s Health Resource Center. It is more frequent in post-menopausal and pregnant women, due to hormonal fluctuations.

Women who are pregnant or receiving fertility treatments may experience changes in their vision. Because of an increase in hormones, some may notice refractive changes, dry eyes, puffy eyelids that obscure side vision and sensitivity to light due to migraine headaches.

Some vision changes in pregnant women, such as blurred vision and seeing spots, may be signs of a more serious problem and should be discussed with a doctor immediately as this may be a sign of pregnancy related diabetes or high blood pressure.

If you or someone you love  is diabetic and pregnant or  planning to become pregnant should get a full eye exam.

For older women, a recent study published in the March 2010 issue of Ophthalmology showed that women who are post menopausal and receiving Hormone Replacement Therapy (HRT) treatments may be at an increased risk for cataracts.  The study by Birgitta E. Lindblad, M.D., Sundsvall Hospital, Sweden, as part of the Swedish Mammography Cohort (SMC), states that of the more than 30,000 post- menopausal Swedish women studied who were using or had used HRT had significantly higher rates of cataract removal compared with women who had never used HRT. The “Hormone Replacement Therapy in Relation to Risk of Cataract Extraction: A Prospective Study of Women” data showed the risk for cataract removal was increased by 14 percent in women who had never used HRT and by 18 percent in current HRT users. And, longer duration of HRT use correlated with increased risk.

“Although more research needs to be completed regarding linking cataract increases with HRT, the message is clear that all women need to take the time to take care of their eyes today in order to maintain healthy vision in the future,” said Hugh R. Parry, president and CEO of Prevent Blindness America. “No matter what age you are, it’s never too early to start visiting your eye doctor and scheduling regular dilated eye exams.”

For more information, visit speceye.com or call 770-487-0667.

As the former director of Low Vision Services at LSU Medical school, Dr. John Henahan has always been passionate about helping the blind and those with visual impairments.  Fifteen years ago, that meant assisting patients to read printed material and move about without harming themselves.  An increasingly connected world risks leaving these patients further and further behind.

“It’s a visual digital divide”, says Dr. Henahan who still works with the visually impaired at Spectrum Eyecare in Peachtree city. “Although these patients have the means, they are being shut out of the opportunities presented by technologies like the Blackberry.  That is why I am so excited by the steps that Apple is taking with their ‘Accessibility‘ campaign.”

Apple computer, Inc. has long been an innovator in the personal computer, MP3 and more recently mobile phone space.  With the growing popularity of iPhones, touch screen iPods and the new iPad, Apple has quietly worked to enable their devices for those with visual impairments, such as macular degeneration, glaucoma, diabetic retinopathy, retinitis pigmentosa and Stargardt’s macular dystrophy among others.

At it’s heart, Apple has worked to create a series of simple to remember gestures that allow information on the screen of their Mac computer or Apple branded mobile device to be read aloud (This technology only works with Apple devices).  Apple has also ingeniously developed ways for the visually impaired to navigate the maze of applications, emails and other information on these devices.

If you know of someone who is visually impaired, take the time to learn more about Apple’s VoiceOver technology.  You can also click here to directly to a video demonstrating the VoiceOver on an iPhone. For those looking for a solution for their desktop Mac or Mac laptop, this video demonstrates how it works on a computer

For those in the Atlanta area looking for someone to evaluate and provide low vision services, feel free to contact us, or call 770-487-0667.

Among the leading causes of vision loss and blindness are diabetes, high blood pressure and high cholesterol, according to Dr. John Henahan, optometrist at Spectrum Eyecare in Peachtree City.  ”As the incidence of these diseases is climbing, so too are ocular complications, including cataracts, diabetic retinopathy and other retinal problems.”, according to Dr. Henahan.

In fact, ABC World News (4/26, story 7, 1:20, Sawyer) reported that “almost half of American adults, 45% of us, now have high blood pressure, high cholesterol, or diabetes,” according to researchers from the national Centers for Disease Control and Prevention.

The Los Angeles Times (4/27, Maugh) reports that “one in eight Americans has at least two of the conditions and one in 33 has all three, sharply increasing their risk.” These “data come from the ongoing National Health and Nutrition Examination Survey.” While “researchers should be able to use the new data to plan interventions, ‘the main thing here is for people to be aware that they have these conditions and know that lifestyle modifications and medications can control them and reduce their risk for cardiovascular disease,’ said epidemiologist Cheryl D. Fryar of the CDC’s National Center for Health Statistics, one of the study’s authors.”

WebMD (4/26, Woznicki) reported that “the study shows that about 8% of adults have undiagnosed high blood pressure, 8% have undiagnosed high cholesterol, and 3% of have undiagnosed diabetes.”

HealthDay (4/26, Edelson) reported that “blacks had a particularly high incidence of hypertension, 42.5 percent, compared to 29.1 percent of non-Hispanic whites and 26.1 percent of Mexican-Americans.” The report indicated that “high blood cholesterol was more common among non-Hispanic whites (26.9 percent) than among blacks (21.5 percent) and Mexican-Americans (21.8 percent), while diabetes was more common among blacks (14.6 percent) and Mexican-Americans (15.3 percent) than among non-Hispanic whites (8.3 percent).”

According to Dr. Henahan, “If you or someone you care about has one of these conditions, it is critical to get annual eye exams with your pupils dilated, even if you have perfect vision.  It’s less about eyeglasses for these patients than it is about the medical health of the eyes.”

At Spectrum Eyecare, all diabetics receive retinal photos to ensure that no diabetic retinopathy is present.  That helps preserve vision by finding problems early so treatment can prevent vision loss.

Many patients do not understand that in most cases they can have an eye exam covered by their medical insurance if they have one of these medical conditions.  ”You do not need vision insurance to have an eye exam if you are diabetic, hypertensive or have high cholesterol”, reports Dr. Henahan. Although you may have a copay or deductible to meet, the exam can be filed through your medical insurance.

If it has been more than one year since your last eye exam, or if you are newly diagnosed with one or more of these conditions, contact us to schedule your medical eye exam.  At Spectrum Eyecare, we schedule just two full eye exams per hour so we can be thorough in evaluating the total health of your eyes.

After all, you only have one set of eyes.

Type 1 Diabetes is an autoimmune disease whereby a person’s own immune system attacks the cells that produce insulin, destroying them.  When insulin is not produced, the person cannot control their blood sugar and it climbs ever higher without use of synthetic insulin from shots or a pump. In many patients with diabetes, vision loss and even blindness can result.

HealthDay (4/8, Gordon) reported that, according to a study published online April 8 in the journal Immunity, researchers from the University of Calgary “have successfully reversed type 1 diabetes in mice using a new vaccine technology that appears to solely target the immune system cells responsible for the disease.”

By “using a ‘nanotechnology-based’ vaccine, the researchers were able to boost the effects of the weaker immune cells, which allowed them to stop the damaging immune cells from attacking.” So, “instead of directly attacking the stronger cells, the autoregulatory T cells turn off the signal that tells the stronger immune cells to attack, effectively stopping the destruction of the beta cells that allow the body to produce it’s own insulin.”

According to Reuters (4/9, Steenhuysen), the study’s findings may help researchers find new ways how to manage other autoimmune conditions, such as rheumatoid arthritis.

Diabetes is the number one cause of vision loss in children and adults under age 65, according to optometrist Dr. John Henahan.  Therefore, any movement toward a cure for diabetes represents reason for celebration for health care workers and patients alike.

At Spectrum Eyecare in Peachtree City, Dr Henahan reports that all patients are screened for diabetes (and high blood pressure) during their annual eye exam.  Any patients with diabetes receive special additional testing during their exam, including high quality retinal photography to look for signs of this condition.

In diabetic retinopathy, the blood vessels in the retina (which is similar to the film in a camera), begin to bleed and leak.  As blood and other fluid spill into the retina, the fluid is absorbed causing the retina to swell. Just as a swollen ankle does not function properly, a swollen retina does not function properly.  However, using the analogy of the ankle swelling, as the swelling there goes down, the ankle function returns to normal.  However, in the retina, as the swelling goes down, the retina never functions normally again.  A malfunctioning retina means blurred vision….permanantly.

That reiterates the importance of regular eye exams in patients with diabetes.  It is imperative to catch problems early and to use appropriate treatments to seal off leaking blood vessels BEFORE vision loss occurs.

If you or a loved one has diabetes, either type 1 or type 2 and you have not had a complete eye exam with eye health assessment in the past year, please contact us.  We would be glad to see you and we accept almost all medical insurance plans.  As an aside, when you are diabetic, you do not need a vision plan in order to have an eye examination.  We can file the exam through your medical insurance (co-pays and deductibles still apply, however).