StemCell Therapy

News Release

Thursday, June 2, 2022

After 10 years, AREDS2 formula shows increased efficacy compared to original formula, benefit of eliminating beta-carotene.

The Age-Related Eye Disease Studies (AREDS and AREDS2) established that dietary supplements can slow progression of age-related macular degeneration (AMD), the most common cause of blindness in older Americans. In a new report, scientists analyzed 10 years of AREDS2 data. They show that the AREDS2 formula, which substituted antioxidants lutein and zeaxanthin for beta-carotene, not only reduces risk of lung cancer due to beta-carotene, but is also more effective at reducing risk of AMD progression, compared to the original formula. A report on the study, funded by the National Institutes of Health, published in JAMA Ophthalmology.

Because beta-carotene increased the risk of lung cancer for current smokers in two NIH-supported studies, our goal with AREDS2 was to create an equally effective supplement formula that could be used by anyone, whether or not they smoke, said Emily Chew, M.D., director of the Division of Epidemiology and Clinical Application at the National Eye Institute (NEI), and lead author of the study report. This 10-year data confirms that not only is the new formula safer, its actually better at slowing AMD progression.

AMD is a degenerative disease of the retina, the light-sensitive tissue at the back of the eye. Progressive death of retinal cells in the macula, the part of the retina that provides clear central vision, eventually leads to blindness. Treatment can slow or reverse vision loss; however, no cure for AMD exists.

The original AREDS study, launched in 1996, showed that a dietary supplement formulation (500 mg vitamin C, 400 international units vitamin E, 2 mg copper, 80 mg zinc, and 15 mg beta-carotene) could significantly slow the progression of AMD from moderate to late disease. However, two concurrent studies also revealed that people who smoked and took beta-carotene had a significantly higher risk of lung cancer than expected.

In AREDS2, begun in 2006, Chew and colleagues compared the beta-carotene formulation to one with 10 mg lutein and 2 mg zeaxanthin instead. Like beta-carotene, lutein and zeaxanthin are antioxidants with activity in the retina. The beta-carotene-containing formation was only given to participants who had never smoked or who had quit smoking.

At the end of the five-year AREDS2 study period, the researchers concluded that lutein and zeaxanthin did not increase risk for lung cancer, and that the new formation could reduce the risk of AMD progression by about 26%. After the completion of the five-year study period, the study participants were all offered the final AREDS2 formation that included lutein and zeaxanthin instead of beta-carotene.

In this new report, the researchers followed up with 3,883 of the original 4,203 AREDS2 participants an additional five years from the end of the AREDS2 study in 2011, collecting information on whether their AMD had progressed to late disease, and whether they had been diagnosed with lung cancer. Even though all the participants had switched to the formula containing lutein and zeaxanthin after the end of the study period, the follow up study continued to show that beta-carotene increased risk of lung cancer for people who had ever smoked by nearly double. There was no increased risk for lung cancer in those receiving lutein/zeaxanthin. In addition, after 10 years, the group originally assigned to receive lutein/zeaxanthin had an additional 20% reduced risk of progression to late AMD compared to those originally assigned to receive beta-carotene.

These results confirmed that switching our formula from beta-carotene to lutein and zeaxanthin was the right choice, said Chew.

The study was funded by the NEI Intramural program (EY000546) and through contracts (AREDS2 contract HHS-N-260-2005-00007-C; ADB contract NO1-EY-5-0007; AREDS Contract NOI-EY-0-2127, and contract HHS-N-263-2013-00005-C). The AREDS2 contracts were supported by the NIH Office of Dietary Office of Dietary Supplements, the National Center for Complementary and Integrative Health, the National Institute on Aging, the National Heart, Lung, and Blood Institute, and the National Institute of Neurological Disorders and Stroke. The study took place at the NIH Clinical Center.

NEI leads the federal governments research on the visual system and eye diseases. NEI supports basic and clinical science programs to develop sight-saving treatments and address special needs of people with vision loss. For more information, visit https://www.nei.nih.gov.

About the National Institutes of Health (NIH):NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.

NIHTurning Discovery Into Health

Chew EY, Clemons TE, Agron E, Domalpally A, Keenan TDL, Vitale S, Weber C, Smith DC, Christen W, for the AREDS2 Research group. Long-term outcomes of adding Lutein/Zeaxanthin and Omega-3 Fatty Acids to the AREDS Supplements on Age-Related Macular Degeneration Progression: AREDS2 Report #28. JAMA Ophthalmology. June 2, 2022.

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Link:
NIH study confirms benefit of supplements for slowing age-related macular degeneration - National Institutes of Health (.gov)

Engineering | News releases | Technology

June 1, 2022

University of Washington researchers worked with screen-reader users to design VoxLens, a JavaScript plugin that with one additional line of code allows people to interact with visualizations. Millions of Americans use screen readers for a variety of reasons, including complete or partial blindness, learning disabilities or motion sensitivity. Shown here is a screen reader with a refreshable Braille display.Elizabeth Woolner/Unsplash

Interactive visualizations have changed the way we understand our lives. For example, they can showcase the number of coronavirus infections in each state.

But these graphics often are not accessible to people who use screen readers, software programs that scan the contents of a computer screen and make the contents available via a synthesized voice or Braille. Millions of Americans use screen readers for a variety of reasons, including complete or partial blindness, learning disabilities or motion sensitivity.

University of Washington researchers worked with screen-reader users to design VoxLens, a JavaScript plugin that with one additional line of code allows people to interact with visualizations. VoxLens users can gain a high-level summary of the information described in a graph, listen to a graph translated into sound or use voice-activated commands to ask specific questions about the data, such as the mean or the minimum value.

The team presented this project May 3 at CHI 2022 in New Orleans.

If Im looking at a graph, I can pull out whatever information I am interested in, maybe its the overall trend or maybe its the maximum, said lead author Ather Sharif, a UW doctoral student in the Paul G. Allen School of Computer Science & Engineering. Right now, screen-reader users either get very little or no information about online visualizations, which, in light of the COVID-19 pandemic, can sometimes be a matter of life and death. The goal of our project is to give screen-reader users a platform where they can extract as much or as little information as they want.

Screen readers can inform users about the text on a screen because its what researchers call one-dimensional information.

There is a start and an end of a sentence and everything else comes in between, said co-senior author Jacob O. Wobbrock, UW professor in the Information School. But as soon as you move things into two dimensional spaces, such as visualizations, theres no clear start and finish. Its just not structured in the same way, which means theres no obvious entry point or sequencing for screen readers.

The team started the project by working with five screen-reader users with partial or complete blindness to figure out how a potential tool could work.

In the field of accessibility, its really important to follow the principle of nothing about us without us,' Sharif said. Were not going to build something and then see how it works. Were going to build it taking users feedback into account. We want to build what they need.

To implement VoxLens, visualization designers only need to add a single line of code.

We didnt want people to jump from one visualization to another and experience inconsistent information, Sharif said. We made VoxLens a public library, which means that youre going to hear the same kind of summary for all visualizations. Designers can just add that one line of code and then we do the rest.

The researchers evaluated VoxLens by recruiting 22 screen-reader users who were either completely or partially blind. Participants learned how to use VoxLens and then completed nine tasks, each of which involved answering questions about a visualization.

Participants learned how to use VoxLens and then completed nine tasks (one of which is shown here), each of which involved answering questions about a visualization. Each task was divided into three pages. Page 1 (labeled with a) presented the question a participant would be answering, page 2 (b) displayed the question and the visualization and page 3 (c) showed the question with four multiple choice responses.Sharif et al./CHI 2022

Compared to participants from a previous study who did not have access to this tool, VoxLens users completed the tasks with 122% increased accuracy and 36% decreased interaction time.

We want people to interact with a graph as much as they want, but we also dont want them to spend an hour trying to find what the maximum is, Sharif said. In our study, interaction time refers to how long it takes to extract information, and thats why reducing it is a good thing.

The team also interviewed six participants about their experiences.

We wanted to make sure that these accuracy and interaction time numbers we saw were reflected in how the participants were feeling about VoxLens, Sharif said. We got really positive feedback. Someone told us theyve been trying to access visualizations for the past 12 years and this was the first time they were able to do so easily.

Right now, VoxLens only works for visualizations that are created using JavaScript libraries, such as D3, chart.js or Google Sheets. But the team is working on expanding to other popular visualization platforms. The researchers also acknowledged that the voice-recognition system can be frustrating to use.

This work is part of a much larger agenda for us removing bias in design, said co-senior author Katharina Reinecke, UW associate professor in the Allen School. When we build technology, we tend to think of people who are like us and who have the same abilities as we do. For example, D3 has really revolutionized access to visualizations online and improved how people can understand information. But there are values ingrained in it and people are left out. Its really important that we start thinking more about how to make technology useful for everybody.

Additional co-authors on this paper are Olivia Wang, a UW undergraduate student in the Allen School, and Alida Muongchan, a UW undergraduate student studying human centered design and engineering. This research was funded by the Mani Charitable Foundation, the University of Washington Center for an Informed Public, and the University of Washington Center for Research and Education on Accessible Technology and Experiences.

For more information, contact Sharif at asharif@cs.washington.edu, Wobbrock at wobbrock@uw.edu and Reinecke reinecke@cs.washington.edu.

See the original post:
VoxLens: Adding one line of code can make some interactive visualizations accessible to screen-reader users - University of Washington

Exclusive:

Cataracts - the world's leading cause of blindness - see the small transparent disc develop cloudy patches that become bigger causing blurry, misty vision and eventually blindness

Image: Getty Images)

People with failing eyesight have been forced to wait more than a year for NHS operations to remove cataracts, official figures reveal.

Cataracts are the worlds leading cause of blindness affecting more than half of Brits over 65.

Charities warn huge delays could leave many elderly people losing their ability to live independently.

Patients in North Warwickshire waited on average 377 days in 2020/21 for the procedure according to new NHS Digital data for the last three years released to the Mirror.

This is more than double the waits at the regional clinical commissioning group (CCG) with the longest average waits in 2017/18 which was around four and a half months.

Provisional data for 2021/22 shows at least four CCGs covering millions of patients where average waits are longer than six months.

Image:

Caroline Abrahams, Charity Director at Age UK said: Cataracts are a hazard of later life that left untreated can make older people anxious and depressed, rob them of confidence and put them at increased risk of falls.

They also make it much more difficult for older people to get out and about, or to read, and are generally hugely disruptive for any sort of normal life.

These long waits mean that huge numbers of older people are living with pain, discomfort and stress not knowing when they will get the help they need.

We know the NHS is under intense pressure and doing its level best to catch up post pandemic but the truth is that for many older people there is no relief immediately in sight, making this a really tough time for them.

Cataracts see the small transparent disc develop cloudy patches that become bigger causing blurry, misty vision and eventually blindness.

In young people lenses are usually like clear glass allowing us to see through them. As we get older, they start to become frosted, like bathroom glass and limit our vision.

Average waits overall for cataracts improved in latest 2021/22 data but still saw patients waiting over seven-and-a-half months.

Patients in Leicester waited longest last year at 229 days on average.

Its CCG was followed by Somerset at 224 days, Shropshire, Telford and Wrekin at 222 days, West Suffolk at 219 days and Stoke-on-Trent at 161 days.

Louise Gow, eye lead at the Royal National Institute of Blind People, said: Were concerned by data that shows patients in some trusts are now waiting longer for ophthalmology procedures than they were two years ago during the height of the pandemic.

While we understand that ophthalmologists have worked extremely hard to ensure patients are seen as quickly as possible, for patients and their families. Being on a waiting list for any length of time brings anxiety and uncertainty.

Although those facing a delay for cataract surgery are not at risk of permanent loss of vision, they are losing out on improved quality of life, greater independence and are at increased risk of falls due to poor vision and people also share with us the knock-on effect this can have on their mental well-being.

The provisional data for the most recent financial year of 2021/22, which did not include all CCGs, suggested improved average cataract surgery waits overall in the NHS.

The average wait for the procedure was just over two-and-a-half months - or 79 days - compared to 115 days in 2020/21.

Following the year-long cataract waits Coventry and Warwickshire CCG was formed from Warwickshire North and two neighbouring CCGs in April 2021.

A spokesman for Coventry and Warwickshire CCG said: The pandemic meant that unfortunately we had to pause many non-emergency operations while we responded to the immediate challenges of Covid-19.

Restoring our services is a priority for us and average waiting times for cataract operations have now significantly reduced in our area.

A spokesman for Leicester, Leicestershire & Rutland (LLR) healthcare said: Responding to Covid meant that some operations were postponed during the pandemic.

We know that waiting for treatment is frustrating for patients and understand the impact it has on them. We are now fully focused on reducing waiting times as local services move back to pre-pandemic levels.

To help improve the situation we are also increasing the availability of cataract treatments through other providers.

The RNIBs Sight Loss Advice Service on 0303 123 9999 can provide support and practical advice about coping with reduced sight the support available.

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See the original post here:
Patients with cataracts forced to wait for a year to get NHS surgery during Covid - The Mirror

In May, an interdisciplinary MUSC research team won an inaugural Blue Sky Award, which provided $100,000 in funding for its project to restore vision in patients with age-related macular degeneration (AMD) by recharging the eye cells batteries. The Blue Sky Award was created to encourage high-risk, high-reward research that has the potential to make a profound impact on patient care but is unlikely to attract traditional funding due to the difficulties of the projects.

The team is led byBaerbel Rohrer, Ph.D., of the College of Medicine, andAndrew Jakymiw, Ph.D., of the College of Dental Medicine, and included their graduate students Kyrie Wilson and Charles Holjencin. Rohrer is the Endowed Chair of Gene and Pharmaceutical Treatment of Retinal Degenerative Disease. Jakymiw is an expert in developing cell-penetrating peptides for drug delivery.

Together, they intend to tackle a disease that affects more than 10 million Americans: AMD. The disease causes vision to worsen slowly and eventually leads to blindness. Current therapies are inadequate, as they can only lessen the symptoms and aim, at best, to postpone the loss of vision. Existing therapies also require patients to return again and again for treatment.

Team members werent satisfied with just slowing down the disease. They wanted to develop a curative therapy that could protect and even restore vision.

We knew that if we could treat the disease at the root cause, and not just the symptoms, that would be a huge step forward in regenerative medicine, said Wilson.

At its root, AMD is caused by an insufficient supply of energy to eye cells.

Every single activity of a cell requires energy, said Rohrer. Once you lose that energy, you will lose proper function of the cells. That will eventually lead to disease and vision loss.

Mitochondria are the batteries that supply energy to cells, and they have their own DNA mitochondrial DNA or mtDNA to help them to do that. When their DNA becomes damaged, mitochondria cease to function properly and cannot provide cells with the energy they need.

Over time or because of stress, errors can be introduced into mtDNA as it copies itself.Rohrer likens the process to the game of telephone. In the game, a person whispers a word into the ear of another person. That person then whispers the word into the ear of the next person and so on down the line.

Whatever ends up after five people is probably not the word that you picked to start with, said Rohrer. And its pretty much the same thing with copying mtDNA.

Instead of trying to target and fix many copy errors, Rohrer and Wilson wondered whether a better approach would be to prevent the mistakes in the first place. They could do so by providing the mitochondria a new blueprint, or template, for copying their DNA, essentially resetting the word in the telephone game.

You need a new template, said Wilson. You need to go back and have the perfect words again and know what youre trying to say.

Rohrer and Wilson realized that they would need a vehicle to deliver the template to the mitochondria. It would have to be able to dodge the bodys immune system and be accepted by the mitochondria. They reached out to Jakymiw, who had expertise with small nucleic acid-based drug delivery.

We had actually never delivered anything that large to that point, said Jakymiw. I mean were talking about like 16 kilobases, which is a pretty big molecule.

Although the two laboratories had had initial discussions, it was the announcement of the Blue Sky Award that solidified the collaboration and jump started the project.

Some outcomes of the preliminary work that has evolved over the last few months suggest that we can potentially deliver this large amount of DNA and target it efficiently enough to restore vision for individuals affected by AMD, continued Jakymiw.

Jakymiw and Holjencin decorate the surface of the mtDNA with small proteins that carry instructions for the cells and mitochondria on how to take up this newly formed nanoparticle.

Essentially, we have a delivery mechanism that carries its own instructions for cell delivery, said Holjencin, who is creating the nanoparticles being used in the project.

You can also design the small proteins so that they can recognize a particular zip code and deliver the cargo to that particular site within the cell, said Jakymiw.

These small proteins also provide a potential invisibility cloak to protect the nanoparticles from the bodys immune system.

To date, the team has shown that the small proteins can package the mtDNA within nanoparticles and deploy it to the struggling mitochondria. They have also shown that it persists there for at least four weeks. In previous studies, mtDNA disappeared after just 48 hours.

We will eventually end up looking for the presence of mtDNA at probably eight weeks, maybe even out to 16 weeks, said Wilson.

And obviously what we would want for humans is that that this translates into many years as opposed to having to repeat these treatments on a regular basis, said Rohrer.

The hope is that introducing the template would set off a series of events that could lead to restored vision. The mitochondria might share the template with its neighbors, which could, likewise, pass it on. As the quality of mtDNA improves in more and more mitochondria, they could again supply sufficient energy to eye cells, restoring vision.

This new approach is like a quantum leap. If this were to work, it would just significantly change not just the trajectory of my lab but the trajectory of treatment for AMD, said Rohrer.

Continue reading here:
Restoring vision by recharging cells' batteries | MUSC | Charleston, SC - Medical University of South Carolina

This is a developing story. We will provide updates as more information becomes available.

On the heels of the ongoing COVID-19 pandemic, a zoonotic virus seems to be spreading across the globe.

Since early May, Monkeypox has been making headway across at least 30 countries, including the United Kingdom, Spain, Portugal, Australia, and the United States. The number of cases has increased to more than 550 worldwide as of June 1, according to the World Health Organization (WHO).

In the U.K., nearly 200 monkeypox cases have been confirmed since May 7. During a press conference on May 17, WHO officials said that these are mostly separate occurrences except for a family cluster with two confirmed cases and one probable case[].

Recently, Canada and the U.S. joined these nations in tracking and tracing the virus.

As of May 19, Canada confirmed two monkeypox cases and said it was investigating more than a dozen suspected cases. The Massachusetts Department of Health also announced a single case in an individual who had recently been in Canada. Several Canadian cases have been linked to this person.

On May 18, Scott Pauley, press officer at the Centers for Disease Control and Prevention (CDC), told Medical News Today:

The U.K. notified the U.S. of 8 people in the U.S. who might have been seated near the U.K. traveler when they flew from Nigeria to London [on May 3-4, 2022]. Of these, one is no longer in the U.S., and one was not a contact. The remaining six are being monitored by their respective state health departments. None of these six travel contacts have monkeypox symptoms and their risk of infection is very low.

The WHO officials have been tracking monkeypoxs path through Europe and North America for several weeks. However, with the data available so far, they do not know long the virus has been spreading.

On May 30, the agency said during a public webinar that while it cannot rule out the risk, it is unlikely the outbreak will turn into a global pandemic.

Monkeypox is a zoonotic virus, which transmits disease from animals to humans. Cases typically occur near tropical rainforests, where animals that carry the virus live.

The monkeypox virus is a member of the orthopoxvirus family. It also has two distinct genetic strains or clades: the Central African (Congo Basin) clade and the West African clade. The Congo Basin clade is known to spread more easily and cause more severe symptoms.

Monkeypox naturally occurs in Africa, especially in west and central African nations. Cases in the U.S. are rare and associated with international travel from places where the disease is more common.

Monkeypox symptoms and signs include headache, skin rash, fever, body aches, chills, swollen lymph nodes, and exhaustion. It produces symptoms similar to smallpox, but milder.

The time from infection to the onset of symptoms, which is referred to as the incubation period, can range from five to 21 days. The illness typically resolves within two to four weeks.

Severe cases are more common among people with underlying immune deficiencies and young children. In recent times, the case fatality ratio of monkeypox is around 3-6%.

Transmission of the monkeypox virus among humans is limited, but it can happen through close skin contact, air droplets, bodily fluids, and virus-contaminated objects.

Most of the recent cases of monkeypox in the U.K. and Canada have been reported among attendees of sexual health services at health clinics in men who have sex with men.

Regarding this trend, Dr. I. Soc Fall, the regional emergencies director for the WHOs Health Emergencies Program, cautioned:

This is new information we need to investigate properly to understand better the dynamic of local transmission in the U.K. and some other countries.

During a press conference on May 17, Dr. Fall acknowledged that public health officials still have much to learn about the monkeypox virus.

But the most important thing is we really need to invest in understanding the development of monkeypox because we have so many unknowns in terms of the dynamics of transmission, the clinical features, the epidemiology. In terms of therapeutics and diagnostics also, we still have important gaps, he said.

WHO experts believe that solutions for monkeypox calls must go beyond addressing the disease.

During the press conference, Dr. Michael Ryan, executive director of the WHOs Health Emergencies Program, said: [G]etting answers isnt just about getting answers about the virus. Weve got to get answers about the hosts, weve got to get answers about human behavior and practice, and weve got to operate at all levels to try and ensure that human populations are protected.

For more insight, Medical News Today spoke with Dr. Kartik Cherabuddi, clinical associate professor in infectious diseases and director of the Global Medicine and Antimicrobial Management Program at the University of Florida.

Being aware of the rash of monkeypox which presents as vesicles is very important. Additional measures include vigilance in those who have traveled in the past 30 days to countries that have reported cases of monkeypox [and] who have contact with a person who is confirmed or suspected of monkeypox. Dr. Kartik Cherabuddi

Dr. Cherabuddi mentioned that smallpox vaccinations offer some protection against monkeypox. He said the Democratic Republic of Congo is currently employing ring vaccination for close contacts of confirmed cases.

The U.K. is also using ring vaccination, in addition to contact and source tracing, case searching, and local rash-illness surveillance, he added.

Dr. Cherabuddi believes that more cases will arise in the U.S., but its difficult to predict how many.

He said he was concerned that with fewer people in the U.S. having had smallpox vaccinations, this could be putting a majority of the population below the age of 40-50 years at risk for infection[]

Dr. Ryan also noted that preventing the disease may not entirely rest on vaccines. He pointed out that the protection offered by previous smallpox vaccination also has reduced[]

He said there might be a need to change agricultural, social, and food storage practices to prevent further outbreaks. Officials hope to help communities understand how the virus spreads so they can address it at its sources.

Dr. Cherabuddi told MNT that vaccines for monkeypox have also been approved for limited circulation.

An approved vaccine for monkeypoxMVA-BNis not widely available. Tecovirimat (TPOXX), as both oral and IV medication is approved in the U.S. for treating smallpox and oral form in Europe to treat cowpox, monkeypox, and smallpox. The FDA also approved brincidofovir (Tembexa) in 2021 to treat smallpox. These medications are not widely available, he said.

Link:
Monkeypox outbreak: What to know about symptoms, threat - Medical News Today

(June 6, 2022 / Jewish Journal) All of life is a footnote to love and death. These two poles of existence overshadow everything else; love creates life and death takes it away, filling our lives with joy and sorrow in unending succession.

It is easiest to consider love and death separately, as two very different chapters of life; and emotionally, they are worlds apart. Halachah is a reflection of this instinct, treating mourning and celebration as irreconcilable opposites. Mourners dont attend celebrations and parties, and the joy of the holidays terminates shiva. The heart cannot accommodate both joy and grief at the same time, because both love and death inspire intense, all-encompassing emotions.

Love is intoxicating. Shir Hashirim, the Song of Songs, portrays the exceptional power of love through a depiction of couples who are lovesick and unable to act rationally. And this reality repeats itself over and over in history. When Jacob falls in love with Rachel, he dramatically overpays for her dowry, offering to work seven full years for her hand. Even so, Jacob imagines that he is the one who is getting a bargain because he is so much in love with Rachel; the seven years seem like a small price to pay for Rachels hand in marriage. Jacob is blinded by love.

William Blake captures this mindless blindness in a short poem: Love to faults is always blind, Always is to joy inclind, Lawless, wingd and unconfind, And breaks all chains from every mind. Love hatches remarkable dreams that fly in every direction; with love nothing seems impossible. Lovers are oblivious to reality and live in their own two-person universe, just like Adam and Eve in the Garden of Eden.

Death brings a blindness of its own. When King Solomon writes the book of Kohelet, Ecclesiastes, he begins with a lament about the pointlessness of life. As Rashi puts it, The author of Kohelet issues a complaint against the seven days of creation, that [the world] is all a vanity of vanities. Death, the question without an answer, confounds him. What point does life have, Kohelet asks, if the righteous man meets the same end as the wicked, and the wise man has the same fate as an animal? (The bitter, skeptical tone of Kohelet seems out of place in the Tanakh. I sometimes wonder if the purpose of Kohelet is to expose us to our own bitterness and cynicism, to recognize that hope will disintegrate without faith.)

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Whenever one looks death in the eye, optimism and joy quickly evaporate. Franz Rosenzweig notes how life stands in the shadow of death, and all that is mortal lives in fear of death each newly born waits with fear and trembling for the day of its passage into the dark every new birth multiplies the fear for it multiplies that which is mortal. When one enters the realm of death, a cold cynicism descends, choking off any experience of joy.

The poetry of Shir Hashirim and the acerbic philosophy of Kohelet each deserve their own book. They faithfully explore the experiences of passion and despair. And because the emotions of joy and grief are opposites, we assume that the experiences of love and death are utterly incompatible. But they are not.

A third biblical book, the Book of Ruth, brings death and love together. In it, a family moves from Israel to Moab, where the sons take Moabite wives for themselves. In short succession, this family is devastated by death with the father and his two sons passing away at a young age. Alone and impoverished, one of the sons wives, Ruth, returns with her beloved mother-in-law, Naomi, to Israel, abandoning her homeland to remain with her. Ruth persists despite discrimination and desperation, and insists that she will perpetuate her husbands familys legacy; and in the end, she does just that. She marries a relative of her husbands, Boaz, and the family continues: Their great-grandson is King David.

The Book of Ruth is not just a book of love and death; it is a book about a different type of love, love in the shadow of death. After the familys tragedies, Naomi succumbs to cynicism; she even suggests she should rename herself bitter. Ruth refuses this path; she battles with the angel of death. Ruth teaches us how to pursue redemption in the valley of the shadow of death.

The Hebrew word for redemption, gaal, appears multiple times in the book of Ruth because it is a book about redemptions, both large and small. By remarrying and bringing grandchildren to Naomi, Ruth redeems and rebuilds a once broken family. And later, her descendant King David will be the very symbol of Messianic redemption and bring redemption to the nation as a whole.

Ordinarily, death erases life and destroys all that love has built. But in redemption, it is love that gets the final word, staying one step ahead in a cosmic wrestling match. It is when you continue to love after a tragedy, when you courageously pour your broken heart into rebuilding a broken world, you have taken the first steps on the road to redemption.

The very foundation of Jewish history is redemption; it is the story of a people who, despite having every reason to be bitter and cynical, continued to rebuild and repair. This has never been more evident than in the past century. Crushed by the Holocaust, it would have made sense for the Jews to give up. Instead, following Ruths example, they built the State of Israel, a modern-day miracle of redemption.

Last week I joined the Ramaz Upper School mission to Israel, together with nearly 500 students and teachers. Israel is filled with stories of redemption, both large and small. At Tel-a-Sakithe sight of one of the fiercest battles of the Yom Kippur Warwe were told about the heroism of the soldiers who fought there. Three tanks, under the command of Yoav Yakir, held off hundreds of Syrian tanks for nearly two days, giving the army precious time to reinforce their defenses on the Golan Heights. Even after it became clear that they were no longer able to hold off the Syrians, Yoav chose to fight as long as possible and fell in battle.

After the war, a member of Yoavs unit, Yitzchak Nagarker, had a baby boy. (Yitzchak is a war hero in his own right, with his own incredible story of courage.) At the brit, Yitzchak invited Yoavs father to be the sandak and named his first born Yoav, in honor of his fallen comrade. Love is as strong as death, and is the very instrument of redemption, and Yoavs legacy continues to live on in Yitzchaks son.

Our mission prayed at the Kotel on Friday night, just a day before Yom Yerushalayim, Jerusalem Day. Through hundreds of years of exile, the passion the Jewish people had for Jerusalem never wavered. They continued to dream of this place, to declare Lshanah habaah byerushalayim,next year in Jerusalem. And on June 7, 1967, for the first time in 1900 years, that dream came true. An Israeli flag was raised over the Kotel. With tears in their eyes, the exiles had returned to Zion. The Kotel is the ultimate monument to redemption, and its stones whisper, Am Yisrael Chai, the Jewish people live on.

After services on Friday night, the Ramaz students gathered in the plaza, waiting to walk together as a group to Shabbat dinner. Then something remarkable happened. They gathered together in one large circle, singing Jewish songs for half an hour; other visitors came over to watch this moment of inspiration. At that moment, the students were making Ruths legacy their own. They were singing the song of redemption, continuing an undying love story that has lasted for thousands of years.

Rabbi Chaim Steinmetz is the senior rabbi of Congregation Kehilath Jeshurun in New York.

This article was originally published by theJewish Journal.

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Love in the shadow of death: The story of Ruth - JNS.org

ALBANY, N.Y., June 7, 2022 /PRNewswire/ -- TMR study for eye care surgical devices market projections estimates the said market to peg a CAGR of 5.5% for the forecast period from 2022 to 2031. Demand for eye care surgical devices has been rising significantly due to increase in incidence of ophthalmic disorders such as cataract, glaucoma, and other vision-related disorders that are leading causes of blindness and visual impairment. Eye care surgical devices range include both non-invasive and invasive diagnostic devices and instruments such as contact lenses, glaucoma stents, and intraocular lenses.

Eye care surgical devices market outlook is promising with the availability of technologically advanced cataract surgery equipment resulting in improved clinical outcomes. Emerging trend of advancements in cataract surgery equipment has led to improved safety and effectiveness of common procedures.

In general, for clinical purposes, ophthalmology and its subspecialties are at the forefront embracing rapid technological advancements. For example, apodization has resulted in intraocular lens technology to progress from refractive to diffractive to result in fewer and less severe visual side effects.

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Eye Care Surgical Devices Market Key Findings of the Report

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Eye Care Surgical Devices Market Growth Drivers

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Eye Care Surgical Devices Market Key Players

Some of the key players operating in the eye care surgical devices market are;

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The eye care surgical devices market is segmented as follows;

Eye Care Surgical Devices Market, by Product Type

Eye Care Surgical Devices Market, by End-user

Eye Care Surgical Devices Market, by Application

Eye Care Surgical Devices Market, by Region

Modernization of healthcare in terms of both infrastructure and services have pushed the healthcare industry to new heights, Stay Updated withLatest Healthcare Industry Research Reportsby Transparency Market Research:

Ophthalmic Surgical Devices and Therapeutics Market: Increase in prevalence and incidence rates of eye-related disorders, high unmet needs in patients with ocular diseases, increased geriatric population, and raised awareness about eye diseases in developing countries are expected to boost the ophthalmic surgical devices and therapeutics market during the forecast period.

Vascular Stents Market: Rise in prevalence of cardiovascular diseases and increase in demand for minimally invasive surgeries are anticipated to drive the global vascular stents market from 2019 to 2027. The global vascular stents market is responding positively to new and innovative coronary stents, with increasing uptake of technologically advanced coronary stents.

Dry Eye Disease Market: The growing prevalence of these diseases has urged many researchers and developers to discover good treatment options, which has eventually accelerated the growth prospects of the dry eye disease market.

Dry Eye Disease Diagnostic Devices Market: Surge in the geriatric population and rise in prevalence & incidence rates of dry eye disease in the U.S. are projected to drive the dry eye disease diagnostic devices market.

Dry Eye Disease Treatment Market: Rise in reported cases of dry eye disease, increase in the number of surgical procedures such as LASIK surgery, adverse effects of rising pollution levels, advances in treatment of dry eye, and introduction of new therapies are projected to drive the global dry eye disease treatment market.

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BROSSARD, Quebec, June 07, 2022 (GLOBE NEWSWIRE) -- DIAGNOS Inc. (DIAGNOS, the Corporation or we) (TSX Venture: ADK) (OTCQB: DGNOF) a leader in early detection of critical health issues through the use of its FLAIRE platform based on Artificial Intelligence (AI), is pleased to announce the deployment of its Age-Related Macular Degeneration detection application into the optometry clinics of IRIS The Visual Group.

It is with great pleasure that DIAGNOS is announcing the deployment of its Age-Related Macular Degeneration (AMD) detection application into the optometry clinics of IRIS The Visual Group (IRIS). With over 1,250 patients having received this new test already, we can see that the demand is great for this application in clinical optometry and optical retail. This deployment of this application represents an important milestone in the Artificial Intelligence Technology Implementation Program announced in June 2021 by the two groups.

We are thrilled by the addition of the AMD detection application into our portfolio as it further expands the value our company offers to eyecare providers, an important segment of our market expansion strategy. saysMr. Yves-Stphane Couture, Vice-President of DIAGNOS. The quality of the relationship we developed with IRIS throughout this project and the constant spirit of collaboration and desire to improve patient outcomes shared by our respective organizations have been decisive in the development of this new tool, it positively and directly contributed to the deployment we are doing today.

AMD is a leading cause of visual deterioration and legal blindness in people over 60 years of age. The loss of central vision and high-resolution visual acuity from untreated AMD can lead to irreversible loss of reading, depression, reduced facial recognition ability, and disqualification from driving. Regular screening for eye diseases is of the utmost importance to enable early detection of eye disease and prevent major alterations in quality of life from occurring.

The deployment of this new application in our clinics is perfectly aligned with IRIS desire to be at the forefront of technological advances in its clinical optometry and optical retail operations. We strive to provide our customers with the most effective cutting-edge technologies, with tools that enhance the healthcare experience we provide and improve clinical outcomes. Artificial Intelligence solutions like that of DIAGNOS raise the bar in terms of quality of care and perfectly illustrate of the benefits of our collaboration with this company. said Dr. Jahel St-Jacques, Optometrist and Vice-President of IRIS.

DIAGNOS is currently putting the finishing touches on several Artificial Intelligence Deep Learning algorithms focused on disease detection and aimed to improve clinical operations and patient outcomes. The launch of the AMD detection application is the first in a series of important launches planned soon, that will ensure the success and sustainability of the organization.

About IRISIRIS was founded in 1990 in Quebec. Since that time, IRIS has developed into the largest network of optometrists, opticians and ophthalmologists operating under the same banner across Canada. The companys locations combine clinical optometry and optical retail to provide a unique concept and a commitment to offering top quality products and services in the field of eyecare.

Additional information is available at http://www.iris.ca

About DIAGNOSDIAGNOS is a publicly traded Canadian corporation dedicated to early detection of critical health problems based on its FLAIRE Artificial Intelligence (AI) platform. FLAIRE allows for quick modifying and developing of applications such as CARA (Computer Assisted Retina Analysis). CARAs image enhancement algorithms provide sharper, clearer and easier-to-analyze retinal images. CARA is a cost-effective tool for real-time screening of large volumes of patients. CARA has been cleared for commercialization by the following regulators: Health Canada, the FDA (USA), CE (Europe), COFEPRIS (Mexico) and Saudi FDA (Saudi Arabia).

Additional information is available atwww.DIAGNOS.com andwww.sedar.com

This news release contains forward-looking information. There can be no assurance that forward-looking information will prove to be accurate, as actual results and future events could differ materially from those anticipated in these statements. DIAGNOS disclaims any intention or obligation to publicly update or revise any forward-looking information, whether as a result of new information, future events or otherwise. The forward-looking information contained in this news release is expressly qualified by this cautionary statement.

Neither the TSX Venture Exchange nor its Regulation Services Provider (as that term is defined in the policies of the TSX Venture Exchange) accepts responsibility for the adequacy or accuracy of this release.

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Prevent Blindness provides free, dedicated resources to encourage proper eye protection from negative effects of UV

CHICAGO, April 25, 2022 /PRNewswire-PRWeb/ -- As the warmer weather begins to encourage more outdoor activities, Prevent Blindness, the nation's oldest eye health and safety organization, has declared May as Ultraviolet (UV) Awareness Month. The nonprofit group is seeking to educate the public on the negative effects of UV exposure to the eyes and vision, offering a dedicated webpage, PreventBlindness.org/sun-and-vision, downloadable fact sheets and shareable social media infographics.

There are two types of UV rays: UV-A and UV-B. Over time, the effects of UV rays may help cause a number of eye problems. UV-A rays may affect central vision. They can damage the macula, a part of the retina at the back of the eye. The front part of the eye (the cornea and the lens) absorbs most UV-B rays, but these rays may cause even more damage to the eyes than UV-A rays.

According to the Wilmer Eye Institute and Johns Hopkins Medicine, corneal damage, cataracts and macular degeneration are all possible chronic effects from UV exposure and can ultimately lead to decreased vision. Additionally, UV light is associated with skin cancers including squamous cell carcinomas, basal cell carcinomas, and cutaneous melanoma. Squamous cell carcinoma can occur not just on the skin, but on the conjunctiva and invade the cornea and inside of the eye, in some cases necessitating removal of the entire eye.

The Hidden Dangers of UV: Keeping Your Eyes Safe report from The Vision Council lists factors that put people's eyes at greater risk of damage from UV exposure, including:

Prevent Blindness strongly recommends wearing UV-blocking sunglasses as well as a brimmed hat to provide the best protection against UV rays. Sunglasses should:

"Spending time outdoors offers many health benefits. We encourage adults and children to wear the proper UV protection for their eyes to keep them safe and healthy today, and in the years to come," said Jeff Todd, president and CEO of Prevent Blindness.

For more information on UV eye protection, please visit the Prevent Blindness dedicated webpage at PreventBlindness.org/sun-and-vision, or call (800) 331-2020.

About Prevent Blindness

Founded in 1908, Prevent Blindness is the nation's leading volunteer eye health and safety organization dedicated to fighting blindness and saving sight. Focused on promoting a continuum of vision care, Prevent Blindness touches the lives of millions of people each year through public and professional education, advocacy, certified vision screening and training, community and patient service programs and research. These services are made possible through the generous support of the American public. Together with a network of affiliates, Prevent Blindness is committed to eliminating preventable blindness in America. For more information, visit us at preventblindness.org, and follow us on Facebook, Twitter, Instagram and LinkedIn.

Media Contact

Sarah Hecker, Prevent Blindness, 312.363.6035, shecker@preventblindness.org

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May is Ultraviolet Awareness (UV) Month at Prevent Blindness, Designed to Educate the Public on the Best Ways to Keep Eyes Safe from UV Damage -...

ANN ARBOR, MI -Irreversible blindness affects at least 11 million Americans and 170 million across the world, according Michigan Medicine officials.

One of the leading factors of this condition is a disease called age-related macular degeneration, and an $11.5-million gift to the health system seeks to make the irreversible reversible.

The philanthropy from James Grosfeld, former chairman and CEO of PulteGroup Inc., goes toward research at the University of Michigan Kellogg Eye Center to develop effective treatments for the dry version of AMD, which affects up to 90% of those affected, officials said.

Grosfelds gift will support two endowed professorships at UM dedicated to dry AMD research, as well as increased laboratory staff. Other funded items include:

Increasing the speed and the breadth of discovery in dry AMD can make a significant difference in peoples lives, Grosfeld said in a statement.

Grosfelds enthusiasm and generosity has been greatly appreciated, said Dr. Paul Lee, director of the Kellogg Eye Center. The AMD research initiative will be led by Dr. Jason Miller, who will assume the title of the Grosfeld Professor of Ophthalmology and Visual Sciences.

We have made several discoveries that have given us a clear direction toward potential treatments, Miller said in a statement. At the same time, we have been building partnerships that will both accelerate our work and enable us to translate our efforts into clinical applications.

The AMD disease specifically attacks the part of the eye that houses the retinas light-sensitive photoreceptors. Millers research addresses how to limit the accumulation of lipids that affect these areas of the eye.

In catalyzing work across disciplines, we are enabling the creative application of a wide range of scientific techniques and approaches to the challenges of dry AMD, Dr. Marschall S. Runge, CEO of Michigan Medicine, said. Mr. Grosfelds visionary support will enable us to make important advances toward saving sight today and will create a legacy of sight-saving achievement.

Read more from The Ann Arbor News:

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These are 10 historic buildings still standing on the University of Michigan campus today

Innovative allergy testing device earns University of Michigan student $25K

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An end to blindness? $11M gift to Michigan Medicine researches eye treatments - MLive.com

Dynamic Culturing Process Developed by Lineage Offers Path to Clinical- and Industrial-Scale Production of Photoreceptors

CARLSBAD, Calif., April 25, 2022--(BUSINESS WIRE)--Lineage Cell Therapeutics, Inc. (NYSE American and TASE: LCTX), a clinical-stage biotechnology company developing allogeneic cell therapies for unmet medical needs, today announced a new cell therapy development program: photoreceptor neural cell (PNC) transplants for the treatment of vision loss due to photoreceptor dysfunction or damage. Similar to the companys recently announced pipeline expansion into auditory neurons for the treatment of hearing loss, Lineage has filed for intellectual property protection covering the composition and methods for generating PNCs. Based on recent in vivo data generated using the companys PNCs, these cells may be capable of forming reconstructed retina with high survivability and neural connectivity to surrounding functional layers. Notably, Lineage has demonstrated feasibility which could support a large-scale method for producing both types of photoreceptors, known as rods and cones.

"It is natural that, on the heels of the announcement of our alliance with Roche and Genentech for our RPE cell therapy, a deal worth up to $670 million dollars plus double-digit royalties if certain development, approval, and sales milestones are achieved and other conditions are met, that we also would pursue treatments for vision loss through the other major cell type of the retina, the photoreceptors," stated Brian Culley, Lineages CEO. "Our fundamental technology and accumulated know-how give us the opportunity to make many different cell types, and we have demonstrated our ability to create new programs rapidly and efficiently in two distinct areas, expanding our cell therapy pipeline to five separate preclinical and clinical programs, while still maintaining what we believe is an appropriate and responsible rate of investment for a company of our size. This latest program is part of our long-term planning for clinical and commercial success and serves as another example of the capability of our technology platform. We believe our ability to, in just a matter of months, advance from a product concept to generating new intellectual property and manufacturing the desired cell types, is illustrative of the power and efficiency of our platform. We believe the combination of our capital discipline and current balance sheet will support multiple years of further progress, during which we anticipate reaching achievements with each of our clinical and preclinical programs."

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Dr. Rami Skaliter, who leads the manufacturing function for Lineage, added, "Im exceptionally proud of the teams success at overcoming obstacles related to the limited scale of photoreceptor production. Building upon our experience with other cell lineages, we have developed intellectual property, and filed for patent protections, on a manufacturing process which is compatible with large-scale production of photoreceptors in a closed system, improvements which could enable industrial manufacturing. We believe this accomplishment will provide new opportunities for clinical, and ultimately commercial, production of photoreceptors in areas of large unmet need such as Retinitis Pigmentosa, Stargardts Macular Dystrophy, and retinal detachments, either independently or through strategic alliances."

As part of a scientific collaboration with Professors Benjamin Reubinoff, M.D., Ph.D. and Eyal Banin, M.D., Ph.D., of the Hadassah-Hebrew University Medical Center, the differentiation of pluripotent cells into photoreceptors with clinically compatible characteristics was established utilizing a novel differentiation protocol which generated positive identity of key markers of both rods and cones photoreceptor populations. The data generated by the company further demonstrated that a single cell suspension of photoreceptor precursor cells has the potential to survive and mature post-transplantation in a rodent model of retinal degeneration.

About Lineage Cell Therapeutics, Inc.

Lineage Cell Therapeutics is a clinical-stage biotechnology company developing novel cell therapies for unmet medical needs. Lineages programs are based on its robust proprietary cell-based therapy platform and associated in-house development and manufacturing capabilities. With this platform Lineage develops and manufactures specialized, terminally differentiated human cells from its pluripotent and progenitor cell starting materials. These differentiated cells are developed to either replace or support cells that are dysfunctional or absent due to degenerative disease or traumatic injury or administered as a means of helping the body mount an effective immune response to cancer. Lineages clinical programs are in markets with billion dollar opportunities and include five allogeneic ("off-the-shelf") product candidates: (i) OpRegen, a retinal pigment epithelium transplant therapy in Phase 1/2a development for the treatment of dry age-related macular degeneration, which is now being developed under a worldwide collaboration with Roche and Genentech, a member of the Roche Group; (ii) OPC1, an oligodendrocyte progenitor cell therapy in Phase 1/2a development for the treatment of acute spinal cord injuries; (iii) VAC2, a dendritic cell therapy produced from Lineages VAC technology platform for immuno-oncology and infectious disease, currently in Phase 1 clinical development for the treatment of non-small cell lung cancer (iv) ANP1, an auditory neuronal progenitor cell therapy for the potential treatment of auditory neuropathy, and (v) PNC1, a photoreceptor neural cell therapy for the treatment of vision loss due to photoreceptor dysfunction or damage. For more information, please visit http://www.lineagecell.com or follow the company on Twitter @LineageCell.

Forward-Looking Statements

Lineage cautions you that all statements, other than statements of historical facts, contained in this press release, are forward-looking statements. Forward-looking statements, in some cases, can be identified by terms such as "believe," "aim," "may," "will," "estimate," "continue," "anticipate," "design," "intend," "expect," "could," "can," "plan," "potential," "predict," "seek," "should," "would," "contemplate," "project," "target," "tend to," or the negative version of these words and similar expressions. Such statements include, but are not limited to, statements relating to (i) the potential amount of payments to Lineage under the alliance with Hoffman-La Roche Ltd. ("Roche") and Genentech, Inc., (ii) the potential for new opportunities for clinical, and ultimately commercial, production of photoreceptors in areas of large unmet need, (iii) Lineages position to become a leader in the emerging field of regenerative medicine and anti-aging technology, and (iv) future areas of potential treatment using PNC transplant. Forward-looking statements involve known and unknown risks, uncertainties and other factors that may cause Lineages actual results, performance or achievements to be materially different from future results, performance or achievements expressed or implied by the forward-looking statements in this press release, including, but not limited to, the risk that competing alternative therapies may adversely impact the commercial potential of OpRegen, which could materially adversely affect the payments payable to Lineage under the Roche/Genentech collaboration and license agreement, the risk that Roche/Genentech may not be successful in completing further clinical trials for OpRegen and/or obtaining regulatory approval for OpRegen in any particular jurisdiction; the risk that Lineage might not succeed in developing products and technologies that are useful in medicine and demonstrate the requisite safety and efficacy to achieve regulatory approval in accordance with its projected timing, or at all; the risk that Lineages intellectual property may be insufficient to protect its assets; risks and uncertainties inherent in Lineages business and other risks discussed in Lineages filings with the Securities and Exchange Commission (SEC). Lineages forward-looking statements are based upon its current expectations and involve assumptions that may never materialize or may prove to be incorrect. All forward-looking statements are expressly qualified in their entirety by these cautionary statements. Further information regarding these and other risks is included under the heading "Risk Factors" in Lineages periodic reports with the SEC, including Lineages most recent Annual Report on Form 10-K and Quarterly Report on Form 10-Q filed with the SEC and its other reports, which are available from the SECs website. You are cautioned not to place undue reliance on forward-looking statements, which speak only as of the date on which they were made. Lineage undertakes no obligation to update such statements to reflect events that occur or circumstances that exist after the date on which they were made, except as required by law.

View source version on businesswire.com: https://www.businesswire.com/news/home/20220425005336/en/

Contacts

Lineage Cell Therapeutics, Inc. IR Ioana C. Hone(ir@lineagecell.com)(442) 287-8963

Solebury Trout IR Mike Biega(Mbiega@soleburytrout.com)(617) 221-9660

Russo Partners Media Relations Nic Johnson or David SchullNic.johnson@russopartnersllc.com David.schull@russopartnersllc.com (212) 845-4242

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The Russian invasion of Ukraine appears, on the surface, to be a land war. Newspapers lead with photographs of burned-out tanks, and on television and online we hear about the Belorussian border and truck convoys and listen to the expert commentary of generals. But this is a naval war as well.

Fighting has taken place both around the inland capitol of Kyiv, but also on the coast and over control of key port cities. While Russian explanation for new drive in the east focuses on the Russian-speaking population and territorial expansion, there is also a second and more strategic reason: the desire for a land bridge to Crimea, which would reduce the vulnerability of the Russian naval base at Sevastopol. When examining the maritime elements of the war, three points of analysis are worth consideration: first, the nature of conflict at sea and its existence out of sight of land and in a different domain which confounds our understanding; second, how the Russian navy pursued the basic elements of naval strategy reflects their continued relevance in this century; and third, the ways in which Ukraine has adapted to the conflict, and how it might make future adjustments, requires understanding of the naval past and creative thinking about the naval future.

Sea Blindness in Theory and in Practice

Over a decade ago, Butch Brakenel and James Kraska wrote that the United States suffers from a kind of sea blindness an inability to appreciate the central role the oceans and naval power have played in securing our strategic security and economic prosperity. Most use of sea blindness has tended to be metaphorical or focused on the grand economic and security connections between nations and the sea. Yet, in the Russo-Ukrainian war, the United States is experiencing sea blindness in a literal sense.

As various observers scroll through social media in search of open-source intelligence on the war, we are presented with a wealth of information that we then assess for validity and usefulness. However, very little of it is focused on the seas. Photos of burned-out T-72 tanks and trucks, video clips from targeting drones, or after-action threads that summarize changes in the fighting fill our feeds. For the most part, those of us who rely on open sources are blind to what is happening on the Ukrainian coast and in the Black Sea. The exceptions, like the final stand on Snake Island or the sinking of a Russian Alligator-class LST at the pier in Berdyansk, prove the rule. The early reports of the events surrounding the sinking of the cruiser Moskva illustrate this point also. These were based on the reposting of dueling press releases or online press reports rather than imagery, video, or on-scene information, which did not start to come until well after the fact.

A handful of media outlets and online trackers are trying to keep up with the maritime war. H.I. Sutton has been keeping the Covert Shores maritime open-source intelligence outlet going with information and writes reports for USNI News when they can confirm details. But an accurate picture of what is happening at sea is difficult. Truly actionable intelligence requires more than an occasional commercial satellite image or screenshots of maritime transponders. They involve electronic intercepts, radar, sonar, and elaborate collation and analysis efforts. All of these realities mean that while the NATO navies and Russian navy are actively producing their own maritime awareness, most of the rest of us are left in the dark about the conflict at sea.

But the fact that our Twitter feeds and Instagram scrolls are not filled with naval or maritime news does not mean that nothing is happening. It is important to remember that any war which takes place in a coastal territory (and many which take place in landlocked territory) have naval elements. The Russian invasion and Ukrainian defense of their sovereignty are no different, regardless of our sea blindness.

Retrospect: Naval Strategy in Action

As Bernard Brodie reminded us, boiled down to its simplest ideas, naval strategy can be described in a clear way. It begins with the need to establish command of the sea. It is taken further by determining what to do with the control that command of the sea offers.

Establishing command of the sea does not have to be global or even regional, but could simply be local to the area of operations. There tend to be two main ways to establish command. The first is to defeat the opponents navy or main battle fleet. By sinking the enemy, you keep them from being able to stop your use of the sea. But theres a second way to establish command, and that is to keep your opponents navy from ever putting to sea. Whether through blockade or by conducting strikes that sink them or limit their mobility while still in port, this can be equally effective.

Using the control created when you gain command of the sea is generally done in three ways. These operations are what I have previously called the 3 Bs of naval strategy: blockade, bombardment, or putting boots on the ground via amphibious landing. Naval strategy is the mixing and matching of these operations to achieve the political ends which are the purpose of the war. This effort to establish command of the sea, and then to use it, can offer us a good way to look at Russian naval operations in the first phase of the current war.

From the earliest days of the Russian invasion, the Russian navy has largely followed a classical strategy. When Russia annexed Crimea in 2014 and retook complete control of the then divided naval base at Sevastopol, where they leased facilities from Ukraine. It also took possession of nearly three quarters of the Ukrainian navy. When the Russian invasion began earlier this year, there was little more than a mosquito fleet of patrol boats to stand in their way. Russian naval forces out of Sevastopol include missile corvettes and frigates as well as some Kilo-class submarines, joined by the old Slava-class cruiser Moskva as the flagship. These were reinforced by amphibious ships from the Baltic Fleet and Northern Fleets before the invasion began. These ships largely bottled up the smaller Ukrainian patrol forces in port at the start of the war and established command of sea via blockade and strikes on Ukraines ports.

Russians quickly created a blockade of Ukraine by closing the Kerch Strait, which connects the smaller Sea of Azov to the Black Sea and established complete control of the Sea of Azov, and stationing ships off Odessa and other Ukrainian ports. The blockade remains unannounced, and therefore legally unofficial, but is in force with a de facto status. This status quo has remained unchallenged, though the wider maritime community has pointed out the negative effects on trapped neutral vessels and ships that have come under fire in the Black Sea. The resulting commercial blockade has ensured that Ukraine is cut off from the economic lifelines necessary to support its war, making the country entirely reliant on direct financial support from the West. Secondly, it eliminated the ability to resupply the Ukrainian military via the sea, which could have moved far more material far more quickly toward the fighting in the east than trucking it from the Polish border across the entire length of the country.

With total control of the Sea of Azov and the blockade holding, the Russian navy launched its first amphibious landings as a part of the offensive against Mariupol. Russian naval doctrine is designed to avoid contested amphibious landings, instead looking for a safe place to insert troops and equipment. This landing was no different, occurring approximately 30 miles southwest of the port city, away from defenders and closer to the safety of the Crimean Peninsula.

Amphibious assaults, landings made in the face of enemy defenses, are enormously difficult. The small craft used to connect amphibious ships to the shore, as well as amphibious ships like tank landing ships which can steam right up onto the beach, are enormously vulnerable to the kinds of light anti-tank weapons which have become ubiquitous in the Ukrainian defenses. Additionally, Russian amphibious forces are designed around surface landings and do not involve vertical envelopment doctrine with helicopters like many western naval services. With these limitations in mind, Russians began making pier-side reinforcement of their ground forces until the Ukrainians sank the Alligator-class amphibious ship Saratov while she was offloading at a pier in Berdyansk. The results of this attack may have made the Russians more cautious about these kinds of amphibious reinforcements, though the Pentagon spokesman has suggested resupply via sea continues.

Mariupol represents two elements that made it a key maritime target for the Russians. First, it is a significant port on the Sea of Azov and controlling it would continue to solidify that sea as a Russian lake. Second, control of Mariupol is vital to establishing a land bridge between Russian territory and the island of Crimea which is surrounded by Ukrainian territory. The Sevastopol naval base, which has been fought over for centuries as the key to the northern Black Sea, remains vulnerable so long as it is cut off from Russia itself. Annexing not only the Crimean Peninsula, but also the territory that connects it with the rest of Russia, is a classical naval mission since it secures the safety of Sevastopol.

In addition to the blockade and putting boots on the ground, from the earliest days of the invasion, Kaliber land-attack cruise missiles launched from Black Sea Fleet were a part of the bombardment. With over a thousand missiles launched into Ukraine by Russian forces it is safe to say that several hundred of those were naval strike missions, particularly around Odessa and coastal targets. Questions remain about Russian magazines of the missiles, and their ability to reload them. The loss of the Moskva, armed entirely with anti-ship and anti-air missiles, is far less significant in this regard than the Turkish closing of the Bosporus to warships, which keeps the Russians from reinforcing their fleet.

The establishment of command of the sea was followed rapidly by using the Sea of Azov and the Black Sea for operations affecting events ashore. The Sea of Azov was closed off and Ukrainian ports were blockaded, sealing off both military and commercial traffic. The Russian navy used the Sea of Azov to reinforce operations ashore and contributed to the brutal and ongoing assault on Mariupol. And the Black Sea Fleet fired hundreds of missiles in a wide-ranging bombardment that contributed to both tactical effects but also the indiscriminate destruction of civilian targets. Regardless of the legitimacy of the Russian aggression, the legality of the maritime operations, and clear movement toward war crimes, through the lens of naval strategy and in dramatic comparison to the failures of the Russian army, the Russian navy did its job effectively.

Prospect: Sea Denial and Contesting Command of the Sea

And yet, the relative success of the Russians at sea does not mean that their naval strategy is complete. Strategy is an activity that never ends. The realities of war, the contingency of human interactions, and the shifting context of conflict in an international space, all mean that the successful execution of a navys strategy can shift rudder in an instant. More often than not, that comes from a change in the enemys approach.

The trouble with command of the sea is that while it ideally would be complete and at the very least regionally enforceable, it is never totally achieved. Alfred Thayer Mahan and Julian Corbett were clear on this in their writing. They explained that while navies and naval strategists were right to aspire to a complete or total establishment of a general command of the sea, it would almost never happen in reality. In the particular case of a coastal nation fighting an expeditionary navy on its own shores, a country like Ukraine does not need to establish command of the sea for itself, it only needs to deny it to the enemy.

Despite his reputation for being focused exclusively on battleships and the battle fleet, a caricature of his actual naval writing, Mahan wrote extensively on the need for solid coastal defense as a joint army and navy mission as a part of any nations naval strategy. He broke coastal defense down into three key capabilities: shore-based gunnery, the use of mines, and small attack craft which meant torpedo boats at the dawn of the 20th century. As Jason Lancaster has written elsewhere, our modern versions of these remain available avenues of operations for Ukrainian forces as the Russian invasion shifts phases.

Today, coastal defense gunnery comes in many forms. The most obvious modern version of what used to be heavy artillery guns built into coastal fortifications are coastal defense cruise-missile systems. Rather than fixed weapons built into the stone or concrete of a coastal fort, they are often mobile and tied into a network of targeting data from radars and manned and unmanned intelligence collection systems. On April 13, 2022, Ukrainian forces reported their first successful cruise missile attacks on the Moskva. Details are unconfirmed, but we do know that the ship sank hours later while being towed to Sevastopol. While the Ukraine has a limited number of the indigenously produced Neptune missile systems, the United Kingdom has promised coastal defense cruise missiles as part of their most recent aid package. And cruise missiles are not the only weapons available for taking enemy ships under fire. The Bayraktar drones which have been used successfully against Russian armor also exist in a maritime version used by the Ukrainian navy and represent a capability that can be used against Russian warships. Additionally, munitions like the American Switchblade drones and laser-guided mortars have a more limited range but could be useful in the near littoral.

Mine warfare remains available to the Ukrainian navy as well. It is unclear to what extent it may have been used already to close off Russian operations close to shore. Russians have claimed that Ukrainians are using mines, and some have been found drifting in the Black Sea. Yet the source of those weapons is unclear, and the Russians could be using mines themselves to enhance their blockade, keeping ships from leaving port just as easily as they keep ships from entering. Mine warfare is a double-edged sword, because mining your own waters will require you to sweep them back up to make your harbors safe for commerce again, or to make them safe for resupply via sea. Ukraine may elect to use sea mines, but will likely do so in specific ways and in particular maritime geography where they are more likely to help than hurt.

Finally, coastal defense small craft remain an open question for Ukraine. The patrol vessels in its navy have already been targeted by the Russians, sinking the Solviansk in the first week of March. However, when it comes to small craft, the conversion of civilian vessels to military purposes is far easier than with medium to larger vessels. While it would likely be too difficult to mount British-supplied Harpoon missiles on small craft, the mortar tubes used to launch Switchblade drones and laser-guided mortars would be rather easy to bolt onto the aft deck of a civilian fishing or pleasure craft repurposed as naval raiders. Additionally, a recent list of new security assistance assets from the U.S. government includes Unmanned Coastal Defense Vessels. What these vessels look like, or their capabilities, are not clear since the U.S. Navy does not actively deploy anything that fits that description. It appears that the sinking of the Moskva has caused Russian warships to push themselves further offshore in order to avoid missile attacks. This transitions what had been a relatively close blockade to a far blockade and potentially opens up the seas for Ukrainian small craft to begin operating.

Naval Warfare in the Black Sea

In the first phase of the Russian war on Ukraine, the Russian navy largely succeeded in the basics of establishing a coherent naval strategy. It quickly established command of the sea by keeping Ukrainian ships from sailing. Once control of the waters of the southern coast of Ukraine and the Sea of Azov was established, the Russians began using it for their military purposes by blockading the coast, launching naval bombardments of targets both on the coast and well inland, and by landing boots on the ground with amphibious reinforcements of existing operations. Attempts to resupply Russian forces via the sea have been a mixed bag, with some success and some spectacular failures like the sinking of a Russian amphibious ship pier-side at Berdyansk. But the war on shore has entered a second phase. As Ukraine begins amassing more sophisticated and capable weapons, Russian forces face limitations due to the limited Turkish closure of the Bosporus under the terms of the Montreux Convention. The war at sea can shift as well.

The adoption of the classical methods of coastal defense, through the use of coastal gunnery and strike capabilities, careful employment of mine warfare, and adopting a creative approach to small craft, might allow Ukrainian forces to challenge Russian command of the sea. While they do not need to gain command for themselves, the ability to deny Russia easy and open use of the Black Sea and Sea of Azov could provide Kyiv with major benefits. The stunning sinking of the Moskva may be the turning point: As the Russian warships pull back from the coast to better protect themselves, they open more littoral maneuver space for Ukrainian forces. The adoption of greater coastal defense measures, combined with a limited guerre de razzia strategy that might even put the facilities as Sevastopol at risk, offers a clear naval strategy that will both limit the advantages the Russians established in the early weeks of the war while at the same time giving Ukrainian naval forces the opportunity to impose costs on Russian forces.

BJ Armstrong is a contributing editor with War on the Rocks and is the principal associate of the Forum on Integrated Naval History and Seapower Studies. His fourth book, Developing the Naval Mind, coauthored with John Freymann, was published in November. Opinions expressed in his article are offered in his personal and academic capacity, and do not reflect the positions or policies of the U.S. Naval Academy, the Department of Defense, or any other agency.

Image: Government of Ukraine

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The Russo-Ukrainian War at Sea: Retrospect and Prospect - War on the Rocks

Museum guests who are red-green colour blind can now borrow special EnChroma glasses from the Chau Chak Wing Museum and experience exhibitions for example the vast array of blue hues in theCoastlines exhibition in clear, vibrant colour for the first time.

The accessibility of art and design is always top of mind at the Chau Chak Wing Museum and we are very pleased to be the first venue in Australia to offer this technology through EnChromas Colour Accessibility Program, said DrPaul Donnelly, Deputy Director of the Museum.

This partnership is another important step forward in our inclusivity goals, helping people who are colour blind to experience the full wonder and vibrancy of the exhibitions we have on offer.

One in 12 men (8 percent) and one in 200 women (0.5 percent) arecolour vision deficient; an estimated 350 million people worldwide.More than one million Australians are colour blind, as are over 3,500 of the 83,000 students and staff at the University of Sydney.

While people with normal colour vision see overone million shades of colour, those with colour visiondeficiencyonly see an estimated 10 percent of hues and shades.As a result, colours can appear dull, indistinct, and difficult to discern.

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Glasses bring colour to the museum - University of Sydney

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As they age, animals can experience a decline in their eyesight, but occasionally, some animals lose their vision altogether. This can be particularly distressing for the animal and owner if it occurs suddenly, as animals do not have time to adapt. Sudden, total vision loss is not typical of ageing and often indicates underlying disease that needs treatment. Animals that become blind suddenly may exhibit obvious behavioural changes, and appear disoriented. There are many causes of blindness. These include diseases that affect the surface of the eye (like dry-eye), the front chamber of the eye (like cataracts), the retina (like glaucoma or retinal detachment), the optic nerves (like infection or inflammation), and those impacting the brain (like stroke or organ failure). Blindness can also occur secondary to ingestion of toxins (for example, an overdose of ivermectin) or certain cancers (particularly eye and brain tumours). Some conditions, such as diabetes, predispose animals to developing cataracts. If you suspect that your pet has gone blind, it is important to seek veterinary attention as soon as possible. It is useful for your veterinarian to know whether you have observed a change in the appearance of the eyes, any changes in the overall health of your pet, and any recent medications they have been on, as well as any changes you have noted in their behaviour. Your veterinarian will conduct a physical examination and may perform additional tests, such as blood tests and blood pressure measurement. Your pet may be referred to a veterinary ophthalmologist for further evaluation and treatment. In some cases, blindness can be reversed with treatment. For example, it is possible for detached retinas to be surgically reattached. Similarly, cataracts may be removed. My late dog Phil was almost entirely blind when cataract surgery restored his vision. Interestingly, the first thing he did with his brand new eyes was walk up to the cat's food bowl and pee in it, as if he had been waiting for the opportunity to do so for some time. Because some conditions must be treated in a narrow window of time to ensure vision can be restored, it is important to see your veterinarian early if you suspect that your pet's vision has deteriorated. Dogs and cats can adapt well to loss of vision over time, with most able to successfully navigate their way around their home. If you do live with a blind or vision-impaired dog or cat, there are a number of steps that you can take to make life easier for them: REFERENCE BIONDI, V., PUGLIESE, M., VOSLAROVA, E., LANDI, A. & PASSANTINO, A. 2022. Animal Welfare Considerations and Ethical Dilemmas Inherent in the Euthanasia of Blind Canine Patients. Animals, 12. DOI: 10.3390/ani12070913 Dr Anne Quain BVSc (Hons), MANZCVS (Animal Welfare), Dip ECAWBM (AWSEL) is a lecturer at the Sydney School of Veterinary Science and a practising veterinarian.

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As they age, animals can experience a decline in their eyesight, but occasionally, some animals lose their vision altogether.

This can be particularly distressing for the animal and owner if it occurs suddenly, as animals do not have time to adapt.

Sudden, total vision loss is not typical of ageing and often indicates underlying disease that needs treatment.

Animals that become blind suddenly may exhibit obvious behavioural changes, and appear disoriented.

There are many causes of blindness.

These include diseases that affect the surface of the eye (like dry-eye), the front chamber of the eye (like cataracts), the retina (like glaucoma or retinal detachment), the optic nerves (like infection or inflammation), and those impacting the brain (like stroke or organ failure).

Blindness can also occur secondary to ingestion of toxins (for example, an overdose of ivermectin) or certain cancers (particularly eye and brain tumours).

Some conditions, such as diabetes, predispose animals to developing cataracts.

If you suspect that your pet has gone blind, it is important to seek veterinary attention as soon as possible.

It is useful for your veterinarian to know whether you have observed a change in the appearance of the eyes, any changes in the overall health of your pet, and any recent medications they have been on, as well as any changes you have noted in their behaviour.

Your veterinarian will conduct a physical examination and may perform additional tests, such as blood tests and blood pressure measurement.

Your pet may be referred to a veterinary ophthalmologist for further evaluation and treatment.

In some cases, blindness can be reversed with treatment.

For example, it is possible for detached retinas to be surgically reattached. Similarly, cataracts may be removed.

My late dog Phil was almost entirely blind when cataract surgery restored his vision.

Interestingly, the first thing he did with his brand new eyes was walk up to the cat's food bowl and pee in it, as if he had been waiting for the opportunity to do so for some time.

Because some conditions must be treated in a narrow window of time to ensure vision can be restored, it is important to see your veterinarian early if you suspect that your pet's vision has deteriorated.

Dogs and cats can adapt well to loss of vision over time, with most able to successfully navigate their way around their home.

If you do live with a blind or vision-impaired dog or cat, there are a number of steps that you can take to make life easier for them:

BIONDI, V., PUGLIESE, M., VOSLAROVA, E., LANDI, A. & PASSANTINO, A. 2022. Animal Welfare Considerations and Ethical Dilemmas Inherent in the Euthanasia of Blind Canine Patients. Animals, 12. DOI: 10.3390/ani12070913

Dr Anne Quain BVSc (Hons), MANZCVS (Animal Welfare), Dip ECAWBM (AWSEL)is a lecturer at the Sydney School of Veterinary Science and a practising veterinarian.

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Lifting the lid on eye health and sight loss in your pets - Daily Liberal

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Dogs' eyes are not that different from our own. They have pupils, corneas, lenses, rods, and cones that work similar to ours, although they see things a little differently.

Since their eyes are similar, they can develop some of the same eye conditions that we do. One of the eye conditions our canine friends share with us is cataracts or clouded eye lenses.

Its important to know what cataracts are, how dog cataracts are caused, and what veterinarians can do to treat them. This way, you can take measures to reduce the chances of your dog developing cataracts and get them the treatment they need.

As they age, dogs develop cataracts in much the same way that humans do. A cloudy film sets into the eyes lens and keeps light from entering.

Your dog's eyes have water and proteins in them. Cataracts form when the proteins begin to clump together and form into a cloud-like substance in the eyes lens.

More and more proteins gather, eventually clouding the entire lens. Cataracts can start small and grow large, or they can appear overnight and completely blind your dog.

Cataracts are an inheritable trait, so if a dog is one of the breeds known for cataracts, there is a good chance they might develop them.

Diabetes Mellitus (sugar diabetes) can also cause cataracts in dogs.

Its also possible for eye injuries, which can cause inflammation, to lead to cataracts. Age is another leading cause of cataract development, appearing suddenly without an underlying condition.

It's important to know that another condition is similar to cataracts nuclear sclerosis, or hardening of the lenses as your dog ages.

This condition causes their eyes to become more cloudy but does not cause blindness. Your dog can see even though their eye lenses have changed. Your veterinarian will examine your dogs eyes to determine if they have nuclear sclerosis or cataracts.

Dogs eye structures change as they age, much like ours do. If your dog is aging and begins to develop a cloudy look in their eyes, or if they have an underlying eye disease cataracts can start to appear.

They might stay small or grow, depending on the condition that has caused them and where they are in the lens. If cataracts develop because your dog has diabetes, they might expand rapidly to cover the entire lens.

When a dog with cataracts is left untreated, they can become blind. The cataract completely blocks light from entering the eye through the lens and keeps your dog from seeing. The condition is still treatable at that time with surgery, but without treatment, it can develop into glaucoma.

Glaucoma is a condition where there is too much pressure in the eye, which damages the optic nerve. If the nerve is damaged, your dog will be permanently blind in the eye where the nerve sustained the damage.

Its important to note that not all cataracts can lead to glaucoma or blindness. Sometimes, they develop only enough to cause some reduction in sight.

Glaucoma isnt the only condition that can be caused by untreated cataracts. Another is lens luxation, or a condition where the lens can float around out of place. Cataract dissolution, where the cataracts dissolve on their own, can cause deep inflammation within the eye and lead to uveitis or glaucoma.

Uveitis is an inflammatory condition within the eye that is painful for your dog and can cause blindness.

All dogs can develop cataracts, but some breeds are more prone to the condition because of genetic traits.

Some of these are:

Your veterinarian will examine your dogs eyes using a light. Veterinarians also use blood tests to determine if any underlying conditions might have caused your dog's cataracts.

In most cases, you cannot prevent cataracts, but there are ways to ensure that your dogs vision is preserved, especially if a medical condition like diabetes causes it. These include:

One of the goals of cataract surgery in canines is to return functional vision. There are no known remedies that can reverse the forming of a cataract surgery is the only option for cataracts once they have formed.

Cataracts are removed with a surgical procedure under general anesthesia. The lens is removed, and the veterinarian replaces it with a lens made from plastic or acrylic. There may only be a need to operate on one eye, or the veterinary ophthalmologist may need to perform the procedure on both eyes.

Veterinarians also run tests to look for underlying conditions that are known to cause cataracts. Treating any conditions that can cause cataracts to form is essential because it reduces the chances that those conditions might cause further health issues.

Your dogs eyes will be sensitive after the surgery, so they have to be placed into a protective collar to keep them from rubbing them and causing damage. Veterinarians also give you eye drops to put in your dogs eyes a few times per day to keep them moisturized and let them heal correctly.

Your pet will need to rest and stay in a calm environment for a few weeks as their eyes heal. If you notice any complications, notify your veterinarian immediately.

Surgery for canine cataracts can be costly. The procedure itself can cost up to a few thousand dollars per eye. If your dog has any underlying conditions, the costs continue to rise as you continue visiting the office and your veterinarian prescribes medications for them.

Depending on the severity of your dogs health and cataracts, you might face medical bills of over $5,000. In general, pre-operative costs are between $500 and $1,000, while the price of surgery ranges from $3,000 to $4,500.

While this might seem steep, when everything is complete, your dog will see you again and be able to enjoy time with you to the fullest. Be sure to monitor your dog's eye after cataract procedure, because they can still develop glaucoma and other eye conditions after surgery.

WebMD Medical Reference Reviewed by Vanessa Farner, DVM on February 10, 2021

Sources:

American College of Veterinary Ophthalmologists: Cataracts.

American Kennel Club: Cataracts Can Occur as Your Dog Ages.

American Kennel Club: Cloudy Eyes in Dogs.

American Kennel Club Canine Health Foundation: 2061: Emergence of Pigmentary Uveitis as a Potential Cause of Cataracts and Glaucoma.

National Eye Institute: Cataracts.

The Royal Society Publishing: Colour cues proved to be more informative for dogs than brightness.

UC Davis Veterinary Medicine Veterinary Genetics Laboratory: Hereditary Cataracts in Australian Shepherds.

Veterinary Partner: Cataracts in Dogs and Cats.

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Cataracts in Dogs: Symptoms, Treatment, Prevention & More

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Diabetic eye disease is a group of eye problems that can affect people with diabetes. These conditions include diabetic retinopathy, diabetic macular edema, cataracts, and glaucoma.

Over time, diabetes can cause damage to your eyes that can lead to poor vision or even blindness. But you can take steps to prevent diabetic eye disease, or keep it from getting worse, by taking care of your diabetes.

The best ways to manage your diabetes and keep your eyes healthy are to

Photo courtesy of the National Eye Institute, NIH.

Often, there are no warning signs of diabetic eye disease or vision loss when damage first develops. A full, dilated eye exam helps your doctor find and treat eye problems earlyoften before much vision loss can occur.

Diabetes affects your eyes when your blood glucose, also called blood sugar, is too high.

In the short term, you are not likely to have vision loss from high blood glucose. People sometimes have blurry vision for a few days or weeks when theyre changing their diabetes care plan or medicines. High glucose can change fluid levels or cause swelling in the tissues of your eyes that help you to focus, causing blurred vision. This type of blurry vision is temporary and goes away when your glucose level gets closer to normal.

If your blood glucose stays high over time, it can damage the tiny blood vessels in the back of your eyes. This damage can begin during prediabetes, when blood glucose is higher than normal, but not high enough for you to be diagnosed with diabetes. Damaged blood vessels may leak fluid and cause swelling. New, weak blood vessels may also begin to grow. These blood vessels can bleed into the middle part of the eye, lead to scarring, or cause dangerously high pressure inside your eye.

Most serious diabetic eye diseases begin with blood vessel problems. The four eye diseases that can threaten your sight are

The retina is the inner lining at the back of each eye. The retina senses light and turns it into signals that your brain decodes, so you can see the world around you. Damaged blood vessels can harm the retina, causing a disease called diabetic retinopathy.

In early diabetic retinopathy, blood vessels can weaken, bulge, or leak into the retina. This stage is called nonproliferative diabetic retinopathy.

If the disease gets worse, some blood vessels close off, which causes new blood vessels to grow, or proliferate, on the surface of the retina. This stage is called proliferative diabetic retinopathy. These abnormal new blood vessels can lead to serious vision problems.

Photo courtesy of the National Eye Institute, NIH.

Photo courtesy of the National Eye Institute, NIH.

The part of your retina that you need for reading, driving, and seeing faces is called the macula. Diabetes can lead to swelling in the macula, which is called diabetic macular edema. Over time, this disease can destroy the sharp vision in this part of the eye, leading to partial vision loss or blindness. Macular edema usually develops in people who already have other signs of diabetic retinopathy.

Glaucoma is a group of eye diseases that can damage the optic nervethe bundle of nerves that connects the eye to the brain. Diabetes doubles the chances of having glaucoma, which can lead to vision loss and blindness if not treated early.

Symptoms depend on which type of glaucoma you have. Learn more about glaucoma.

Photo courtesy of the National Eye Institute, NIH.

The lenses within our eyes are clear structures that help provide sharp visionbut they tend to become cloudy as we age. People with diabetes are more likely to develop cloudy lenses, called cataracts. People with diabetes can develop cataracts at an earlier age than people without diabetes. Researchers think that high glucose levels cause deposits to build up in the lenses of your eyes.

Photo courtesy of the National Eye Institute, NIH.

About one in three people with diabetes who are older than age 40 already have some signs of diabetic retinopathy.1 Diabetic retinopathy is the most common cause of vision loss in people with diabetes. Each persons outlook for the future, however, depends in large part on regular care. Finding and treating diabetic retinopathy early can reduce the risk of blindness by 95 percent.

Your chances of developing glaucoma or cataracts are about twice that of someone without diabetes.

Anyone with diabetes can develop diabetic eye disease. Your risk is greater with

High blood cholesterol and smoking may also raise your risk for diabetic eye disease.

Some groups are affected more than others. African Americans, American Indians and Alaska Natives, Hispanics/Latinos, Pacific Islanders, and older adults are at greater risk of losing vision or going blind from diabetes.

If you have diabetes and become pregnant, you can develop eye problems very quickly during your pregnancy. If you already have some diabetic retinopathy, it can get worse during pregnancy. Changes that help your body support a growing baby may put stress on the blood vessels in your eyes. Your health care team will suggest regular eye exams during pregnancy to catch and treat problems early and protect your vision.

Diabetes that occurs only during pregnancy, called gestational diabetes, does not usually cause eye problems. Researchers aren't sure why this is the case.

Your chances of developing diabetic eye disease increase the longer you have diabetes.

Often there are no early symptoms of diabetic eye disease. You may have no pain and no change in your vision as damage begins to grow inside your eyes, particularly with diabetic retinopathy.

When symptoms do occur, they may include

Talk with your eye doctor if you have any of these symptoms.

Call a doctor right away if you notice sudden changes to your vision, including flashes of light or many more spots (floaters) than usual. You also should see a doctor right away if it looks like a curtain is pulled over your eyes. These changes in your sight can be symptoms of a detached retina, which is a medical emergency.

Having a full, dilated eye exam is the best way to check for eye problems from diabetes. Your doctor will place drops in your eyes to widen your pupils. This allows the doctor to examine a larger area at the back of each eye, using a special magnifying lens. Your vision will be blurry for a few hours after a dilated exam.

Your doctor will also

Your doctor may suggest other tests, too, depending on your health history.

Most people with diabetes should see an eye care professional once a year for a complete eye exam. Your own health care team may suggest a different plan, based on your type of diabetes and the time since you were first diagnosed.

Eye exam guidelines for diabetes 2,3,4:

Women who develop gestational diabetes dont usually need an eye exam because they dont develop diabetic eye disease during pregnancy. If you have any questions, ask your doctor.

Your doctor may recommend having eye exams more often than once a year, along with management of your diabetes. This means managing your diabetes ABCs, which include your A1c, blood pressure, and cholesterol; and quitting smoking. Ask your health care team what you can do to reach your goals.

Doctors may treat advanced eye problems with medicine, laser treatments, surgery, or a combination of these options.

Your doctor may treat your eyes with anti-VEGF medicine, such as aflibercept, bevacizumab, or ranibizumab. These medicines block the growth of abnormal blood vessels in the eye. Anti-VEGF medicines can also stop fluid leaks, which can help treat diabetic macular edema.

The doctor will inject an anti-VEGF medicine into your eyes during office visits. You'll have several treatments during the first few months, then fewer treatments after you finish the first round of therapy. Your doctor will use medicine to numb your eyes so you dont feel pain. The needle is about the thickness of a human hair.

Anti-VEGF treatments can stop further vision loss and may improve vision in some people.

Laser treatment, also called photocoagulation, creates tiny burns inside the eye with a beam of light. This method treats leaky blood vessels and extra fluid, called edema. Your doctor usually provides this treatment during several office visits, using medicine to numb your eyes. Laser treatment can keep eye disease from getting worse, which is important to prevent vision loss or blindness. But laser treatment is less likely to bring back vision youve already lost compared with anti-VEGF medicines.

There are two types of laser treatment:

Vitrectomy is a surgery to remove the clear gel that fills the center of the eye, called the vitreous gel. The procedure treats problems with severe bleeding or scar tissue caused by proliferative diabetic retinopathy. Scar tissue can force the retina to peel away from the tissue beneath it, like wallpaper peeling away from a wall. A retina that comes completely loose, or detaches, can cause blindness.

During vitrectomy, a clear salt solution is gently pumped into the eye to maintain eye pressure during surgery and to replace the removed vitreous. Vitrectomy is done in a surgery center or hospital with pain medicine.

In a surgery center or hospital visit, your doctor can remove the cloudy lens in your eye, where the cataract has grown, and replace it with an artificial lens. People who have cataract surgery generally have better vision afterward. After your eye heals, you may need a new prescription for your glasses. Your vision following cataract surgery may also depend on treating any damage from diabetic retinopathy or macular edema.

To prevent diabetic eye disease, or to keep it from getting worse, manage your diabetes ABCs: your A1c, blood pressure, and cholesterol; and quit smoking if you smoke. Read more information on how to manage diabetes.

Also, have a dilated eye exam at least once a yearor more often if recommended by your eye care professional. These actions are powerful ways to protect the health of your eyesand can prevent blindness.

The sooner you work to manage your diabetes and other health conditions, the better. And, even if youve struggled in the past to manage your health, taking better care of yourself now can protect your eyes for the future. Its never too late to begin.

Ask your eye care professional to help you find a low vision and rehabilitation clinic. Special eye care professionals can help you manage vision loss that cannot be corrected with glasses, contact lenses, medicine, or surgery. Special devices and training may help you make the most of your remaining vision so that you can continue to be active, enjoy hobbies, visit friends and family members, and live without help from others.

[1] Centers for Disease Control and Prevention. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta, GA: U.S. Department of Health and Human Services; 2014.

[2] Diabetic retinopathy preferred practice pattern guidelines. American Academy of Ophthalmology website. https://www.aao.org/preferred-practice-pattern/diabetic-retinopathy-ppp. Updated January 2016. Accessed June 2, 2017.

[3] Fraser CE, DAmico DJ. Diabetic retinopathy: prevention and treatment. UpToDate website. https://www.uptodate.com/contents/diabetic-retinopathy-prevention-and-treatment. September 28, 2016. Accessed June 2, 2017.

[4] American Diabetes Association. Standards of medical care in diabetes2016 abridged for primary care providers. Clinical Diabetes. 2016 Jan;34(1):321.

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Diabetic Eye Disease | NIDDK

Glaucoma is one of the leading causes of blindness in the world.  |  Photo Credit: iStock Images

In a world that is witnessing rapid progress in the arena of science and technology, one hopes that researchers can find answers to some of the most vexing medical maladies. Glaucome or Kala Motiya Bindu is one of them. Glaucoma is the second leading cause of blindness in the world.

What is Glaucoma?Glaucoma is a general term used to describe a group of eye disorders that damage the optic nerve. Damage to the delicate optic nerve leads to vision loss. In most cases of Glaucoma, fluid builds up in the front part of the eye -- putting pressure (intraocular pressure (IOP)/eye pressure) on the eye, gradually damaging the optic nerve.

Left untreated, this eye pressure can permanently affect vision. Treatments including eye drops, laser treatments and surgeries can slow down vision loss and save your sight.

What causes Glaucoma?According to Cleveland Clinic, glaucoma can occur without any cause but is affected by many factors. The most important of which is the intraocular eye pressure. Your eyes produce a fluid called aqueous humor that nourishes them. This liquid flows through the pupil to the front of the eye. In a healthy eye, the fluid leaves through a drainage canal located between the iris and cornea.

Is Glaucoma curable? If not now, maybe in the near future?At the moment we have no treatment that can restore the lost vision. We will need to insert new nerve cells, reconnect the new cells to the cells that are still there, and make those connections work with the existing connections in the way that they did originally. Doctors and researchers across the world have taken the first steps in this process, it will be years before the successful restoration of vision in a human eye is possible

Why is glaucoma not caught early?One of the reasons that glaucomas damage is not noticed early on is that it typically affects only one eye at first. The other eye is still fully functional. Since the brain converts the two separate signals from both eyes into a single picture, we see it and we think nothing is missing. Until of course, too late.

Can glaucoma affect both eyes?Most people develop glaucoma in both eyes, although the disease initially may be worse in one eye. Certain types of glaucoma appear to cause moderate or severe damage in one eye initially, while the other eye may be mildly affected. Over time, the disease damages both eyes. People with closed-angle glaucoma in one eye have a raised likelihood of developing the same type of glaucoma in the other eye within five to 10 years.

Which hospitals are the finest in glaucoma treatment?According to the Global Clinic Rating (GCR) website, the Wilmer Eye Institute at the Johns Hopkins Hospital, the Cleveland Clinic's Cole Eye Institute, the Jules Stein Eye Institute, and the Ahad Mahootchi, MD, PA are the four top-most among the best all-around ophthalmology centres in the United States. These are also top-ranked clinics for glaucoma treatment. ()

Indian-origin Dr Pradeep Ramulu, MD, PhD is the Chief of the Glaucoma Division at the Johns Hopkins -- Wilmer Eye Institute.

How to prevent glaucoma:Early detection of glaucoma through routine eye exams is the best way to protect eye health and prevent vision loss. Make sure that you have eye health checkups periodically, just as one sets the calendar for a dental check-up and other health issues. Cleveland Clinic suggests that you must visit your ophthalmologist as per the table suggested below:

Disclaimer: Tips and suggestions mentioned in the article are for general information purpose only and should not be construed as professional medical advice. Always consult your doctor or a dietician before starting any fitness programme or making any changes to your diet.

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Glaucoma: How to defeat this leading cause of blindness before it strikes; treatment, future - Times Now

University of Virginia School of Medicine researchers have made a discovery linking lupus, a potentially debilitating autoimmune disorder, and macular degeneration, a leading cause of blindness.

The two diseases share a common contributor to harmful inflammation, the scientists found. The insights could let researchers develop new treatments for those diseases and other conditions driven by the newly discovered inflammation source.

We were quite surprised at the common link between lupus and macular degeneration, said Dr. Jayakrishna Ambati of UVAs Department of Ophthalmology and the founding director of UVAs Center for Advanced Vision Science. It appears that the new inflammatory pathway we identified could be therapeutically targeted for many chronic diseases.

Ambati and his collaborators have discovered an unknown role for an inflammasome an agent of the immune system called NLRC4-NLRP3. Inflammasomes play an important role in marshaling the bodys defenses to protect it from invaders such as viruses and bacteria.

In lupus and atrophic macular degeneration, however, it appears that NLRC4-NLRP3 contributes to harmful inflammation, the UVA researchers found. In lupus, it helps drive the hyperactive immune response that leads to symptoms such as joint pain, rash, fever and more. In macular degeneration, meanwhile, NRC4-NLRP3 appears to contribute to inflammation that destroys the vital light-sensing cells in the eyes retina.

Ambatis new work helps explain why. The inflammasome, he found, is sent into action by a special class of genetic material calledshort interspersed nuclear element RNAs,or SINE RNAs. This type of RNA makes up more than 10% of our genomes, and it activates in response to cell stresses such as infection, genetic damage and aging. The resulting inflammation caused by SINE RNAs can be harmful in many chronic diseases.

SINE RNAs are elevated in both macular degeneration and lupus, Ambati found. In addition to discovering the role of SINE RNA in the two diseases, Ambati and his colleagues identified an unknown receptor for the SINE RNAs called DDX17. Scientists have been looking for this receptor for decades, and the new discovery helps them better understand the process that leads to the harmful inflammation.

These findings indicate that blocking a single inflammasome might not be enough, and that targeting both the NLRC4 and NLRP3 inflammasomes would be a superior strategy, Ambati said.

Using this new information, scientists may be able to target the source of harmful inflammation in lupus, macular degeneration and other diseases driven by SINE RNAs. That could lead to new treatments to benefit patients, the UVA researchers say.

Were excited to have developed drugs called Kamuvudines that block this dual inflammasome, which we anticipate will be in clinical trials next year, Ambati said.

The researchershavepublished their findings in the scientific journal Science Immunology. The work is featured on the journals cover. The research team consisted of Shao-bin Wang, Siddharth Narendran, Shuichiro Hirahara, Akhil Varshney, Felipe Pereira, Ivana Apicella, Meenakshi Ambati, Vidya L. Ambati, Praveen Yerramothu, Kameshwari Ambati, Yosuke Nagasaka, Dionne Argyle, Peirong Huang, Kirstie L. Baker,Kenneth M. Marion, Kartik Gupta, Bo Liu, David R. Hinton,Scott W.Canna, Tamer Sallam, Srinivas R. Sadda, Nagaraj Kerur, Bradley D. Gelfand and Jayakrishna Ambati.

Jayakrishna Ambati is a co-founder of iVeena Holdings, iVeena Delivery Systems and Inflammasome Therapeutics and has done consulting work unrelated to the research. A full list of the authors disclosures is included in the paper.

The study was supported by the National Institutes of Health, grantsDP1GM114862, R01EY028027, R01EY29799, R01EY031039, R01AI148741, R00EY024336, R21EY030651, R01EY028027, R01EY031039 and R01EY032512. It was also supported by the John Templeton Foundation, grant 60763; the UVA Strategic Investment Fund; the DuPont Guerry III professorship; a gift from Mr. and Mrs. Eli W. Tullis; the BrightFocus Foundation; and the Owens Family Foundation.

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UVA Discovers Harmful Inflammation Trigger in Lupus, Macular Degeneration | UVA Today - University of Virginia

Ever been told to properly eat your carrots and spinach because theyre good for your eyes? If yes, chances are you are familiar with the many benefits of the wonder nutrient - Vitamin A. Abundantly available in carrots, tomatoes, bell peppers, and broccoli, Vitamin A is required by the human body for normal functioning. Its deficiency can also cause a range of problems ranging from vision, immune function, reproduction and skin health.

Benefits of Vitamin A

Vitamin A helps vital organs like the heart, kidneys, and lungs function optimally. When it comes to eyes, it helps them adjust to dim light conditions. Its benefits are more easily understood if one knows what insufficient Vitamin A could translate to, health-wise. A mild vitamin A deficiency could be behind dry skin, fatigue, vulnerability to infections, and even infertility. If one is seriously deficient in this essential micronutrient, they could majorly undermine eye health, and experience issues such as severe eye dryness, night blindness and irregular patches on the white of the eyes. According to the World Health Organisation, Vitamin A deficiency contributes to maternal mortality and other poor outcomes of pregnancy and lactation. Insufficient Vitamin A diminishes the ability to fight infections.

What does Vitamin A help with?

Better overalleye health

Lessening the risk of blindness, including night blindness, and vision loss due to macular degeneration

Development of immune cells and strengthen bodys ability to fight infections

Supporting a healthy pregnancy and fetal growth

Treating acne and supporting skin health, to some extent

Reducing the risk of some types of cancers, such as lung and prostate cancers

Sources of Vitamin A

As a rule of thumb, no matter the health goal, a balanced diet plan should factor in all nutrients according to the daily requirement of the specific micronutrient. Coming from both animal sources (called retinoids and including retinol) and plant sources (called carotenoids and including beta-carotene), Vitamin A is formed within the human body by the conversion of beta-carotene into vitamin A.

The provitamin Vitamin A can be naturally obtained from green leafy vegetables like broccoli and spinach, bright-coloured vegetables like sweet potatoes, pumpkin, carrots and squash, as well as bell peppers, tomatoes, apricots, mangoes, and dairy products like milk. It is also found in certain kinds of cheese.

One can also find a type of this vitamin, called preformed Vitamin A, from meat, poultry, fish, and dairy products. If you are keeping your meals balanced, theres a strong possibility that you are meeting the recommended daily allowance (RDA) of Vitamin A which is about 600 micrograms for both men and women.

These limits, however, have recently been revised by the Food Safety and Standards Authority of India (FSSAI) to about 1000 micrograms for men and 840 micrograms for women, applicable from 2023. In addition to filling up your plate with healthier food choices, one way of upping your daily Vitamin A intake could be oral supplements. However, one must be aware of the amount of every micronutrient going inside the body, so it does not cause exceed the tolerable upper level (UL) intake.

(The writer is a nutrition specialist)

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The many benefits of Vitamin A - Deccan Herald

With AQI values in the majority of Indias major cities reaching dangerously high levels, it is taking a big toll on our eyes, posing a significant risk to our eye health and eyesight in general. Air pollution has been linked to an increased risk of age-related macular degeneration (AMD), a progressive and irreversible visual loss that can lead to blindness.Also Read - Air Pollution Latest Update: Air Quality Panel Orders Immediate Closure of Industries in NCR For Not Using Cleaner Fuels

AMD is the major cause of permanent blindness among those over the age of 50 in high-income nations, with 300 million people expected to be afflicted by 2040. Also Read - Can Air Pollution Cause Vision Loss? Expert Answers

Certain people, such as elderly patients, smokers, Covid patients, and people with heart and lung problems, are especially vulnerable to high amounts of pollution. Also Read - Delhi Metro Presses 14 Anti-Smog Guns Into Service at Project Sites to Curb Air Pollution, to Install More

Individuals who travel in highly polluted areas, as well as those who stay outside for a lengthy amount of time, are equally at risk.

Fine ambient particulate matter with an aerodynamic diameter of 2.5 micrometres, nitrogen dioxide, and sulphur dioxide are all associated with an increased risk of self-reported age-related macular degeneration (AMD).

Air pollution is a global issue that many people cannot avoid, with the World Health Organization (WHO) claiming that more than 99 per cent of the worlds population lives in areas where air quality levels exceed the limits established for chemicals that pose health concerns.

Dry Eye Disease, watering and burning sensations, impaired vision, cataracts, irritation, allergies, and even glaucoma are some of the symptoms that are commonly noticed following ocular exposure to air pollution.

While long-term solutions are required to reduce air pollution, eye specialists feel that some preventive actions, such as wearing sunglasses and limiting eye contact with airborne contaminants, can assist. Artificial tears and eye drops can help lubricate the eyes and keep irritation at bay.

In the absence of an infection or allergy, the treatment for the ocular symptoms of air pollution exposure is simply to cool the eyes by using a cold compress.

Cosmetics and contact lenses should be avoided in the event of pain until the eyes have totally recovered. If any symptoms continue, a complete eye examination should be undertaken to determine the underlying reason.

In addition, one must also practise preventive maintenance by seeing an eye doctor on a regular basis, which can help reduce the likelihood of getting an eye ailment. Furthermore, having a diet rich in important vitamins and minerals, staying healthy, quitting smoking, and maintaining hand cleanliness will aid in taking early precautions.

(Authored by Dr Hem Shah , Senior Consultant, Sharp Sight Eye Hospitals)

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Air Pollution Causes Irreversible Damage to The Eyes - India.com