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Saturday, October 20, 2018

NOTES FROM THE CHAIR & FOUNDER

Welcome and Introduction

It has been over a decade since a major international study stunned us with the news that two-thirds of the world’s blind and vision-impaired are women. Although alarming, this finding drew little public attention at the time.

That is why a small group of concerned and committed vision researchers and clinicians formed the Women’s Eye Health Task Force (WEHTF), now known as Women’s Eye Health.org, or WEH. Our mission is to increase awareness of this major global health problem and bring the best minds together to promote solutions. As part of our mission, we strive to alert and to educate women and viagra fast their families at the grassroots level with the goal of empowering people to make lifestyle changes that will improve their eye health.

In 2004, we held an international symposium in Boston, working with the local, regional and national media and the healthcare press to promote public awareness. We have brought the issue to academic conferences, created a public website and widely distributed information to professional and patient communities. We hope these efforts have, in part, influenced the World Health Organization (WHO) and other organizations to embrace women’s eye health as a priority.

There is still much to be done. That’s why we are thrilled to launch Women’s Eye Health News, a bi-annual publication designed to communicate Women’s Eye Health.org’s mission and outreach efforts and highlight the latest vision research on issues relating to women’s eye health. Each issue will focus on an aspect of eye health along with WEH news. This first edition features dry eye disease and our chapter efforts in China.

As we move forward with new leadership, our hope is to take WEH to the next level by forging global partnerships and creating WEH chapters to reach women at the most risk of vision loss. With the support of the Harvard Medical School Department of Ophthalmology, our goals are to:

  • Continue as a leading source of information regarding eye diseases that are more prevalent in women;
  • Raise awareness of the fact that two-thirds of blindness and vision impairment occurs in women;
  • Educate the public regarding good eye health practices through our web site, a growing social media following, and at public and professional eye care events;
  • Advocate for women’s vision research and public awareness in both developed and developing countries.

We hope that Women’s Eye Health News will not only inform you, but also inspire you to be part of our organization. We welcome your thoughts and feedback.

 

Dong Feng Chen, MD, PhD, Chair
Associate Scientist, Schepens Eye Research Institute/Mass. Eye and Ear
Associate Professor of Ophthalmology, Harvard Medical School, Boston, MA

 

Ilene K. Gipson, PhD, Founder
Senior Scientist, Schepens Eye Research Institute/Mass. Eye and Ear
Boston, MA and Professor of Ophthalmology, Harvard Medical School, Boston, MA

 

WEH-Logo

 

DRY EYE DISEASE

Something to Cry About

dry-eye-disease

For Dr. Ilene Gipson, Senior Scientist, Schepens Eye Research Institute/Mass. Eye and Ear and Professor of Ophthalmology, Harvard Medical School, Boston, MA, dry eye disease is not just an ailment she has studied for decades; it is also one she knows personally. As a dry eye patient herself, she has experienced firsthand the impact this disease can have on daily life. And, as a scientist, she understands that being a woman makes her twice as likely to develop the disease as her male counterparts.

“There were days when the irritation was so bad it was difficult to do anything,” says Gipson. “Reading, writing, and just focusing were challenging because my eyes were always irritated. That means dry eye affected my work, my driving, my social life, everything,” says Gipson.

In normal eyes, glands (meibomian and lacrimal) lining the eyelids secrete oils and water that blend with mucous to form the tear film. Every time you blink, the tear film spreads across the eye’s surface to protect and moisturize it. “When the tear film does not have an adequate amount of each ingredient, the tear film breaks up on the surface, causing dryness, itching, and pain,” says Gipson. 

Dry eye disease is caused by many factors that result in decreased quantity and/or quality of tear production, leaving the eyes dry and painful. Stress, environment, diet, hormones, and inflammation are just a few suspected culprits.

The Eye and Tear Production

Tears are composed of three layers: oil, water, and mucus. The outer layer (oil layer) is produced by the meibomian glands that line the edge of the upper and lower eyelids. The water layer is produced by the lacrimal gland located under the orbital rim bone just below the eyebrow. The mucus layer is produced by microscopic goblet cells in the conjunctiva.

While Gipson considers her dry eye to be episodic rather than chronic or severe, her symptoms are typical of those reported by most dry eye patients, including “burning, stinging and grittiness in my eyes that intensified throughout the day,” she says.

“Dry eye can also cause vision impairment,” according to Dr. Debra A. Schaumberg, Professor of Ophthalmology and Visual Sciences, University of Utah School of Medicine. “Although dry eye rarely leads to blindness, the breakup of the tear film can prevent light and images from being transmitted clearly through the cornea (the dome-like window of the eye) to the retina and the brain, causing constantly or intermittently blurred vision,” she says.

Schaumberg, who has been exploring the epidemiology of dry eye disease for nearly 15 years, says that while dry eye disease is one of the most frequent reasons for visits to eye specialists in the US, it still goes unreported and untreated in many parts of the world, because it is not considered a disease, but rather just a normal part of aging.

“Dry eye is a real disease,” she says. Schaumberg’s large-scale epidemiological studies of both women and men have shed light on some previously unknown aspects of the disease’s prevalence, including that women on hormone replacement therapy are 70% more likely to develop dry eye than women not taking hormones and that women whose diets are rich in omega-3 fatty acids from fish and nuts are less likely than those whose diets are high in omega-6 fatty acids from meats and dairy to develop dry eye.

Gipson, whose research has focused on the mucous layer of the tear film, believes that injury to the eye’s surface or to any one of the glands responsible for providing a tear film ingredient, could be a direct cause of dry eye. “Once there is an injury, it perpetuates itself,” she says. 

In answer to why more women than men, some researchers believe that male hormones known as androgens protect eyes against dry eye disease, and women lose much of these hormones at menopause. Therefore fewer men develop dry eye as they age.

pedram-hamrahCornea specialist Dr. Pedram Hamrah, Director, Ocular Surface Imaging Center at Mass. Eye and Ear, Assistant Professor of Ophthalmology at Harvard Medical School Department of Ophthalmology, Boston, MA continues to ponder the broader question. “We can measure the amount of tears, the amount of electrolytes in the tears and the amount of damage done. But the original underlying causes are another story,” he says. “We are still writing that story.”

Hamrah sees hundreds of dry eye patients each year, mostly women. He also sees the full range of severity, from mild forms to cases of corneal scarring and ulcers.

He believes in a broad approach to dry eye, including improving nutrition. Part of that is changing from what he calls a “fast food” diet of saturated fats to one that is rich in omega-3 fatty acids.

Over-the-counter artificial tears are also helpful for many patients, notes Hamrah.

In severe cases, such as dry eye related to autoimmune disease such as Sjögren’s Syndrome, additional anti-inflammatory agents are required. Further, Hamrah says there are new treatments such as meibomian gland probing that remove obstruction in oil glands and stimulates oil production. There are also tears that can be made from a patient’s blood, called autologous serum tears.

With over 50% of people, adults and kids, in the US spending more than 4 hours a day on a computer or smart phone, dry eye is increasingly affecting more people. Dry eye is considered a contributing factor to Computer Vision Syndrome (CVS) a condition associated with eye irritation due to computer screen use. There are several causes, including dry eye, problems with eye muscles, decreased blinking rate, and partial blinking.

Gipson, who feels lucky that her dry eye disease seems to be inactive at the moment, says that it took her a while to get treatment because her disease is sporadic. After her diagnosis it took her time to find what worked for her. “My advice to anyone who begins to notice dry eye symptoms: Don’t wait. See an eye care professional who can help you.”

 

News & Updates


WorldStudies consistently indicate that females of all ages and in every region have a significantly higher risk than men for being visually impaired. Reasons for this disparity are complex. It is estimated that up to 90% of the world’s blind and visually impaired live in developing nations. Women in the developing world struggle with issues significantly different from women in developed nations, including access to clean water and ophthalmologic health care. They have economic and cultural barriers to purchasing eye glasses.  In 2009, the first chapters of WEH were established in Utah, North Carolina, and Illinois as well as in China, Spain, and Portugal. Chapters offer insight into the local culture for our messaging to have the most effectiveness. Prevention through education is key.

 

Shanghai Chapter Brings “Little Eyeball, Big World” to Families in China

shanghai-tvFamilies in Shanghai, China will soon tune in to a new WEH-inspired television series. “Little Eyeball, Big World,” is a direct translation and the current working title of the series, which will go into production this spring. The series will consist of five programs, each devoted to a specific aspect of eye health – age-related macular degeneration (AMD), cataracts, dry eye, glaucoma, and low vision.

The hope is that knowledge gained from these programs, which will be filmed in Boston and in Shanghai, will inspire people suffering from eye disease to seek care.

Dong Feng Chen, MD, PhD, Chair, WEH, says that cataracts are the largest cause of blindness in China, for both women and men. Yet, only 10% of people who have cataracts seek treatment. “Many are resistant to going to a hospital and feel that family-passed-down and Chinese traditional medicines are enough,” says Chen.

“But the fact is, the only way to treat cataracts is through surgery, a treatment that can totally restore vision to a blind person,” says Chen.

 

Issue 1, Volume 1, May 2014

Women's Eye Health News is published by:
Women's Eye Health.org based at 
Schepens Eye Research Institute/Mass. Eye and Ear, 20 Staniford Street, Boston, MA 02114
Sponsored by Harvard Medical School Department of Ophthalmology

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