Presidential Politics Not Always 20/20

Take a good look at the huge flock of presidential hopefuls: Democrat, Republicans, and other parties. They share markedly divergent opinions about the role of the federal government, foreign policy, the economy, homeland security - you name it.

Here's one thing that elicits unanimous consensus from the entire mob: "Don't wear any eyeglasses!"

Quick. Who was the last American president who routinely wore eyewear? You'll need to go back 40 years; it was Lyndon Johnson. By the end of his presidency he wore his bifocals everywhere, even on TV.

Campaign image consultants are down on eyewear. They claim it makes a candidate appear impaired, older than their age. Truth be told, some candidates might do better to appear a bit older.

Maybe they're all wearing multifocal contact lenses. That would be brutal given their 20-hour campaign days.

Back to the bifocals issue: since most candidates are age 50 or older they definitely need a little help reading the fine text. Okay, speeches today are delivered with the aid of a teleprompter with bright, JUMBO type. Skeptics will immediately pounce on this idea by claiming, "If the candidate is nearsighted (myopic) they can read for many extra years without needing bifocals!"

My response is that those applying for the most powerful job on earth are either seeing poorly at distance (can't get the big picture, can't see beyond their nose) - or - they may someday accidentally sign some blurry treaty or tiny-print legislation that could endager all of us. They can't have it both ways.

Oh, my bad!

They're politicians - of course they can!

Related Topics:

• WebMD Video: Age-Related Vision Loss
• WebMD Video: Permanent Contact Lens

Technorati Tags: vision, eyeglasses, eye care, bifocals, presidential candidates, health-and-wellness

Better Vision A "Swipe" Away?

I had the most amazing conversation the other day. The information was so remarkable I couldn't wait to share it with you.

Most of us (99.9%) are extremely naive as to what is going on about us. Are you surprised?

Speaking with a marketing expert/statistical analyst, I learned about something called predictive modeling. Never heard the phrase before but apparently it's been around a long time.

Predictive modeling is the science of developing mathematical constructs that enable reliable prediction of future events or measurements based on past information. Please, don't run away! It gets better, I promise!

Short version: predictive modeling uses data about you to predict your future.

Retailers rely heavily on predictive modeling. Every time I go to my favorite electronics store they already know how often I visit, what I usually purchase and what brands I prefer. This information is collected (mined) from previous credit card purchases. When sorted by zip codes and other criteria, local merchants know in advance what I'm more likely to buy (Bluetooth wireless remote for my laptop) and more likely to ignore (Borat DVD).

Predictive modeling is migrating over to other areas in our lives like healthcare.

Thoughtful analysis of patient care data (millions of records) can give health professionals a more precise view of an individual patient's medical status. Done correctly, predictive modeling can help doctors warn patients of imminent diabetes, heart disease, cancer, even stroke.

This approach can be more effective than the present model:

• "If you keep smoking there's a good chance you'll get lung cancer."

Instead, a discussion based on predictive modeling may sound like this:

• "When we compare information in our database to information about you and your eye exam we discover that there's a 95% chance that you will develop glaucoma before your 40th birthday. Let's talk about treatments that can prevent you from losing your precious eyesight."

Privacy concerns? This type of data mining can be performed anonymously. Paperless electronic health record systems are already collecting data that may one day allow you to know more about your future.

Did you buy the Borat DVD? Hope you paid cash for it!

Related Topics:

• WebMD Video: Detecting Early Glaucoma - Advanced Tests Help Save Eyesight
• WebMD Video: Glaucoma Detection

Technorati Tags: vision, eyesight, glaucoma, predictive modeling, health-and-wellness

Video-Gamers Make Better Surgeons

Twenty years passes quickly!

Maybe buying my son that Atari, then that Sega Genesis, then a Nintendo, then that PlayStation, followed that XBox weren't such bad ideas after all.

A new report recently published in the Archives of Surgery suggests that physicians perform faster and more accurate laparoscopic surgery if they have played lots of video games.

The authors of the study recruited 33 resident and attending surgeons as voluntary participants.

Participants tracked their video game playing time over a four month period before beginning laparoscopic training which used realistic computer aided simulator. This seems like a reasonable "surrogate experience" since real-world laparoscopic surgeons use fingertip controls and watch the instruments via a color monitor. Think of it like using a joystick to remove a gallbladder.

To nobody's surprise, laparoscopic performance among beginners correlated with past experiences playing video games. Here is a modified excerpt from the published paper:

Past video game play in excess of 3 hours per week correlated with 37% fewer errors and 27% faster completion. Overall procedure score (time and errors) was 33% better for video game players and 42% better if they played more than 3 hours per week. Current video game players made 32% fewer errors, performed 24% faster, and scored 26% better overall (time and errors) than their nonplaying colleagues. When comparing demonstrated video gaming skills, those in the top third made 47% fewer errors, performed 39% faster, and scored 41% better on the overall procedure score. Statistical analysis also indicated that video game skill and past video game experience are significant predictors of demonstrated laparoscopic skills.

Perhaps patients contemplating surgery ought to add a new question to the familiar preoperative discussion: Where did you train? How many of these procedures have you previously performed? What was your highest score on Legend of Zelda?

REFERENCE: Rosser JC, Lynch PJ: The Impact of Video Games on Training Surgeons in the 21st Century. Archives of Surgery 2007; 142:181-186.

Related Topics:

• WebMD Video: Laser Procedure to Treat Farsightedness
• WebMD Video: Tips for Better Vision

Technorati Tags: vision, video games, health-and-wellness

Turning to Rust?

How many times have we been told a specific tissue is composed of 99.8% water or this structure is 98.8% water? Okay, we're carrying lots of water around, but what about that other 1.2%? Our cells are loaded with proteins, chemicals and minerals. This applies to the eye as well.

Were you aware that the tears contain iron? We're not sure what role iron plays in the tear film, but we do know that nothing in nature happens by accident. Any clinical significance? Plenty!

The healthy ocular surface is smooth, uniform and evenly contoured. Anything that disrupts that healthy surface (bumps or divots) will cause the tears to become unevenly distributed along the ocular surface. Anybody driving on a rainy day with chewed-up wiper blades knows what I'm talking about. Small puddles of stagnant tears can collect and iron molecules in the tears can become deposited on the corneal surface. Elemental iron is attracted to epithelial cells and these are the exact cells that coat the outer cornea. The result is an iron deposition line.

Iron lines can be seen with the eye doctor's slit lamp biomicroscope. They have a brown or rust color. Here are some common iron lines seen on the cornea:

• Hudson-Stahli line: where lower lid (tear film strip) rests on the corneal surface


• Fleischer line: circular ring in folks with irregular astigmatism (keratoconus)


• Stocker's line: adjacent to encroaching pterygium


• Ferry's line: adjacent to the bump caused by a glaucoma filtering bleb


• Waring line: healed RK incisions

Don't freak if your doctor tells you that you have an iron line. None of these iron lines represent eye disease, merely a clinical finding caused by local iron deposition. No treatment is necessary.

Are there other minerals associated with the eye? Sure! There's copper, calcium, silver and many more! Visit us often to learn more.

Related Topics:

• WebMD Video: Contact Lenses Help Patients with Corneal Disease
• WebMD Video: Tips for Better Vision

Technorati Tags: vision, iron lines, cornea

Tell Me Again, What Are You Treating?

Traditional medicine works this way: patient has symptoms, physician performs exam and tests, diagnosis is established, and treatment is initiated. Simple enough, right?

More and more ophthalmologists are managing patients without symptoms, with normal or near-normal exams, and recommending treatments because they might have a problem.

This is the conundrum of Glaucoma Suspects, individuals who do not have active glaucoma but exhibit so many risk factors for the disease that doctors refuse to wait. Such impatience makes a great deal of sense because the damage that occurs once glaucoma begins is irreversible.

Chronic elevated pressure from untreated glaucoma permanently destroys the delicate nerve fibers that transmit the visual signal from the eye to the brain. The eye cannot regenerate these nerve fibers or make new fibers - they are gone forever! Patients are unaware that their intraocular pressure is abnormally high and visual symptoms typically do not emerge until very late in the disease.

Rather that wait for the patient to present with advanced glaucoma, eye specialists have decided to treat individuals with changes suggestive for glaucoma -- even if the vision is 20/20 and visual field testing is normal. Some of these warning signals include:

• Family history of glaucoma
• Borderline intraocular pressures (ocular hypertension)
• Small hemorrhages near the optic nerve
• Abnormal clinical appearance to the optic nerve itself
• Unusually thin central corneas

Remember, good doctors treat patients, not numbers. Given that the damage caused by glaucoma is irreversible it makes sense to treat the condition before any damage occurs.

Related Topics:

• WebMD Video: Are You at Risk for Glaucoma?
• WebMD Video: Detecting Early Glaucoma

Technorati Tags: glaucoma, vision, intraocular pressure

Videogames May Enhance Eyesight

Hey, it took over 30 years to identify some potential health benefits from playing videogames!

Thirty years ago (yes 1977) I was a first-year medical student and I already owned an obsolete PONG game system (manufactured by Atari!) No purported health benefits back then, simply a cool way to kill time.

Well, things have changed. Brain researchers from the University of Rochester claim that habitual videogame use may enhance the brain's visual processing capabilities by training the eyes to ignore noncontributory, distracting images.

Videogames appear sporadically in the health news. Some hand specialists worry that some gamers put themselves at risk for repetitive stress injuries - same for Blackberry addicts. Remember the false alarm about videogames and seizures? Only a rare few were susceptible and it appears that the monitors were likely more responsible, not the game content.

These researchers warn that any "improvement" is marginal, hard to appreciate in someone already seeing 20/20. Besides, 30 hours or more of playtime is needed to generate any measurable changes. They hypothesize that the real payoff may come in youngsters with lazy eye (amblyopia) by reawakening portions of the brain involuntarily inactivated so as to prevent a young child from having double vision. Imagine the bribes, "Timmy, you can play XBox all day so long as you keep your good eye patched!"

Hmmm. Maybe they are on to something!


Related Topics:

• Violent Video Games May Rev Teen Brain
• Video Game Technology and Targeting Cancer Tumors

Technorati Tags: xbox, wii, playstation, eyesight

Delaying Tactic Boosts Eyedrop Power

A recent visitor to our WebMD Eye Disorders Message Board asked about tasting her daily eyedrops. YECCHH!

Many of you experience the same situation. Now, think about this. If you can taste the medicine then those eyedrops drops must be in your mouth and no longer on the surface of your eye, right? It just takes three blinks for all of the medicine to be washed away... wasted!

Attention prospective pharmacologists. Eyedrops in the mouth have no beneficial effect on the eye. They are gone and unavailable to do the job for which they were prescribed: kill bacteria, lower intraocular pressure, quiet inflammation, etc.

Some eyedrops are prescribed for once-a-day use. That means 24 hours of effective drug activity hinge on that one eyedrop. If you can taste it then the eye has not absorbed it!

Here's how to maximize the effect of your eyedrops. As soon as the eyedrop is instilled (dropped!) close the eye and gently press the tip of your index finger against the inner corner of the eye. This will block normal tear drainage and keep the medicine available longer. Try to do this for two full minutes. Even if you taste the drug afterwards you will know that you gave the eye sufficient time to absorb an adequate dose of medication.

Related Topics:

• Dry Eye Syndrome
• Pinkeye

Technorati Tags: eyedrops, how-to