Tag Archives: Lenox Hill Hospital

New Surgery For AMD Patients

An innovative form of eye surgery is offering hope to the estimated three million sufferers of age-related macular degeneration (AMD), the most common cause of blindness in people over 55 in the UK.
…………………...CLICK & SEE
The technique, known as IOL VIP – Intra-Ocular Lenses for Visually Impaired People, is similar to cataract surgery. Developed in Milan by low-vision specialists and ophthalmologists, it was first made available in the UK about 18 months ago and is now performed in private hospitals, although it isn’t currently available on the NHS.

AMD damages the macula – the central part of the light-sensitive retina at the back of the eye – causing scarring, and preventing images being sent to the brain. This damage causes the gradual deterioration, or even loss, of central vision used for activities such as reading, writing, driving and recognising faces.
Eye

Hope: Treatment is now available for ‘dry’ AMD

There are two types of AMD: ‘dry’, the most common form, in which the cells of the macula disintegrate gradually; and the more aggressive ‘wet’ form. The latter is caused by the growth of new blood vessels behind the retina, which can leak, causing scarring and leading to loss of sight.

About ten per cent of people with AMD develop the ‘wet’ form, which can be treated with eye injections. But, until recently, there has been no effective treatment for the majority, who suffer from ‘dry’ AMD.

In the pioneering IOL VIP procedure, two artificial lenses are inserted into the eye. The natural lens behind the iris is removed and replaced with an artificial one, which diverts images from the scarred macula to healthy retinal tissue.

A second lens is then placed in front of the iris. Together, the two lenses act as a telescope, allowing the images to be focused and processed to the optic nerve and sent to the brain. The procedure can last as little as 30 minutes. It then takes approximately 12 weeks for sight to stabilise.

After the operation, computer vision training is vital to train the eye and get the best possible outcome.

Richard Newsom, a consultant ophthalmic surgeon, says: ‘The IOL VIP procedure is an exciting new innovation. It’s not appropriate for every patient with AMD and further studies are required but when it works, it works well and for some patients it can make a significant improvement to their vision.’

Brendan Moriarty, consultant eye surgeon at Leighton Hospital in Crewe, Cheshire, who was the first to perform the operation in the UK, says: ‘If you select patients correctly, the vast majority will at least double their near and distance vision.’

The Royal College of Ophthalmologists agrees further studies are required, stating that it is difficult to determine who will benefit and by how much.

The Macular Disease Society says it is not ‘a miracle cure’ and ‘has worked successfully for some but can’t be regarded as a regular new treatment for widespread use in MD patients’.

One patient who has benefited from the pioneering procedure, however, is 68-year-old Evelyn Dean.

Having suffered from ‘dry’ AMD for two-and-a-half years, Evelyn’s sight had deteriorated so much that she couldn’t read a book or newspaper-without a strong magnifying glass. To her dismay, it also got so bad she was told that she could no longer drive.

But, following an IOL VIP operation in November 2008 at Spire Hull and East Riding Hospital, Evelyn has been given the all-clear to get back behind the wheel.

She says: ‘ I can even read the labels on supermarket shelves properly, which I couldn’t before. I still wear glasses for long distances and reading but the best thing is being able to drive again after almost 15 months.

‘I feel like I have my freedom back.’

Sources: http://www.dailymail.co.uk/health/article-1200549/New-surgery-save-thousands-blindness.html#ixzz0LiXZkEUz

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Congenital Blindness

Vision plays a very important part in the early development of a child. Impaired vision at birth will cause serious delay in development and is likely to lead to learning disabilities, particularly when associated with other problems, such as congenital deafness.

………………………………………………Jyotindra Mehta
Congenital blindness due to Retinitis Pigmentosa (RP) took away Jyotindra Mehta’s power of sight at a very young age. Emigration to the US on scholarship, coupled with a readiness to take up any challenge, resulted in Jyotindra’s quick success there.

and Nevy George
Congenital blindness due to Retinitis Pigmentosa (RP) took away thir eye sight at very early age.

About 9 in 10 children who are considered blind from birth have some vision, even though it may be only recognition of light and dark or shapes…..CLICK & SEE

Causes:
There are several causes including microphthalmos, cataracts, bilateral pseudogliomatous retinal detachments, and phthisis bulbi. OPPG is usually not suspected until fractures occur, frequently after seemingly minor trauma.

In the developed world, half of all cases of congenital blindness run in families and therefore may be due to a genetic disorder. another important cause is congenital infection such as the protozoal infection toxoplasmosis and the viral infection rubella. These infections are transmitted from the mother to the developing fetus during pregnancy and may lead to impaired vision in the newborn baby. congenital rubella is now rare in the developed world due to routine immunization. The baby’s eyes may also be affected by cataracts, in which the lenses are opaque, or glaucoma, in which the optic nerve is damaged due to increased pressure in the eyes. Congenital blindness may also be caused by damage to the brain as a result of lack of oxygen during birth.

Symptoms:
Parents usually become aware that their have a vision problem within a few weeks. he or she may less responsive than other babies, lying quietly to make the most of his or her hearing. parents may also notice that their baby:

· Is unable to fix his or her eyes on a close object.
· Has random eye movements.
· Does not smile by the age of 6 weeks.
· Has abnormally large, cloudy eyes if glaucoma is present.

Parents may find it difficult to bond with a quiet baby who does not smile.

Diagnosis:
If congenital blindness is not suspected by a baby’s parents, it will probably be picked up during a routine examination in infancy. A child suspected of having an impaired vision will be referred to a specialist for an examination and tests. His or her hearing will also be tested because, if the child is severely visually impaired, he or she will rely more on hearing.

Treatment:
It is possible to improve vision in only a smaller number of babies, such as those with cataracts or glaucoma. Early treatment of these conditions is important. cataracts are usually removed surgically within the first month of life. glaucoma may also be treated surgically to allow fluid to drain from the eye.

If vision cannot be improve, much can be done to help a child make maximum use of other senses or what little vision he or she has. if your child is diagnosed as blind, a team of specialist, including a teacher for the blind, will be able to give you and your child support and care. You will also be given advice on how to stimulate your child, by using your speech, sounds, and touch and how to adapt your home so that your child can explore it safely and develop self-confidence. Some children will require special schooling to learn braille, a system of raised dots that allows blind people to read.

Genetics counseling is available for parents of an affected child who wish to have more children or for prospective parents who are blind.

Click to see :
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Preventable Causes of Congenital Abnormalities
Enzyme Responsible For Congenital Blindness
Prognosis :
Children treated for cataracts or glaucoma will probably still have impaired vision but often have enough sight to perform most activities unaided. Many blind or visually impaired children with no other disabilities go on to have successful personal and professional lives.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://www.charak.com/DiseasePage.asp?thx=1&id=338
http://www.blonnet.com/ew/2005/03/07/stories/2005030700230200.htm

Gene test for lung cancer

A new gene test developed by Taipei researchers can predict a lung cancer patient’s  outcome after surgery and the survival time……... Sanjit Bagchi reports.

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85% OF LUNG CANCER DEATHS ARE ATTRIBUTABLE TO SMOKING.

Lung cancer is the most common cancer affecting people, especially in big cities. It is treatable, depending on the type, stage and severity, but researchers have always been on the lookout for a measure to predict or tailor the treatment of the disease.

Recently, researchers in Taiwan came up with a simple but effective gene test, which can work wonders in the treatment of lung cancer. The study has been published in the New England Journal of Medicine.

Based on the biology, therapy and prognosis, lung cancer is broadly divided into two classes  non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), explains Dr A.K. Pathak and associates at the All India Institute of Medical Sciences (AIIMS), New Delhi. Three types of lung cancer    squamous cell carcinoma, adenocarcinoma and large cell carcinoma    are classified as NSCLC and account for 75-80 per cent of all lung cancer cases.

The clinical profile of lung cancer in India differs from that in the West. Generally, in India, the disease sets in in the fifth or sixth decade of a person’s life, almost 15-20 years earlier than in the West, the AIIMS researchers write in Indian Journal of Chest Diseases and Allied Sciences. Squamous cell carcinoma continues to be the commonest type in India whereas adenocarcinoma is gradually becoming the predominant subtype in the Western world,   they add. Dr Pathak and co-workers also note that  of all lung cancer deaths, 85 per cent are attributable to smoking tobacco, which contains harmful carcinogens.

Hsuan-Yu Chen of the National Taiwan University College of Public Health, Taipei, and his team studied more than 600 genes, which seem to influence survival in NSCLC patients. Of these, they singled out five genes   together called the  5-gene signature   which could significantly predict the patient’s outcome after surgery.

The new 5-gene test indicates if there is a need for chemotherapy. Patients belonging to the high-risk  group have a shorter overall survival (20 months) rate than those in the low-risk group (40 months).   This signature could be useful in stratifying patients according to risk in trials of treatment of the disease,   the researchers write, adding it   may reveal targets for the development of therapy for lung cancer.

After surgical resection, adjuvant chemotherapy is often administered  by chemotherapeutic drugs like cisplatin,   says Prof. Kalyan Dasgupta, former head of the department, chest medicine, Calcutta Medical College, Calcutta. However, it’s difficult to determine which patient is an ideal candidate for chemotherapy, as chemotherapy is helpful in only those who are at a high risk of cancer recurrence.  According to Chen and colleagues, The identification of the 5-gene signature has clinical implications. Cisplatin-based adjuvant chemotherapy is effective in some patients with NSCLC. We propose that patients who have tumours with a high-risk gene signature could benefit from this type of therapy, whereas those with a low-risk gene signature could be spared what may be called unnecessary treatment.

Prof. Dasgupta explains, Unnecessary use of chemotherapy may lead to side effects such as bone marrow suppression, fever, nausea and vomiting. Cost is another important factor.  He adds,  The new gene test can solve this problem. Since it can predict the patient’s surgery outcome and survival, it can determine if he/she needs chemotherapy or not. Treatment can thus be tailored accordingly.

The 5-gene test developed by Chen and co-workers is carried out through a technique known as reverse-transcriptase polymerase chain reaction (RT-PCR). This test needs a small number of genes for analysis, a very small amount of specimen (of the tumour) and yields accurate results.

Dr Bikram Saha, assistant professor of medicine, North Bengal Medical College and Hospital, Darjeeling, says, As the test profiles gene expression, it may be relied on. Moreover, it seems to be acceptable in clinical practice since it does not involve complicated procedures. However, further studies are needed before it can be implemented in general clinical practice.

Source:The Telegraph (Kolkata,India)