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Kate Zukowski, a certified veterinary technician at Tufts at Tech Community Veterinary Clinic, has a passion for your pets pearly whites.

Veterinary technicians are the nurses of veterinary care, and many go through rigorous specialty training to better serve clients. Zukowski recently became certified for dentistrya professional calling that began many years ago.

Before arriving at Tufts five years ago, Zukowski spent fifteen years at a busy, multi-doctor veterinary practice in Shrewsbury, where she had the opportunity to work in pretty much every department. I was very interested in anesthesia and surgery, and then dentistry, she said. I kind of just ran with the dentistry part. (Read Five Ways to Keep Your Pet's Teeth Healthy with advice from Zukowski.)

Noticing a need for higher-quality dental care, she spent hundreds of hours trainingporing over complex cases and attending conferencesto become a veterinary technician specialist in dentistry.

Having Kate here as a technician with the high specialty interest in dentistry makes the entire dental service here at Tufts at Tech better and easier on the doctors, says veterinarian Gregory Wolfus, V98, who oversees the clinic, which is based at Worcester Technical High School and run by Cummings School of Veterinary Medicine at Tufts University. Once we figured out the gift that Kate brought with her, it very quickly pigeonholed her in a position that 80 percent of her time is doing dental work. Shes the first and only boarded dental technician in New England at this point.

So far, Zukowski has assisted on some interesting cases, including a root canal for a police dog and oral surgery on a red fox. The nearby Southwick Zoo once called on her and Wolfus to do dental work on a ring-tailed lemur and a patas monkeyand did you know dogs can wear braces?

However, most clients at Tufts at Tech have more common issues, such as periodontal disease and fractured teeth, as well as tooth resorption in cats. More than 80 percent of dog and cats over age three will be affected by periodontal disease, she said.

At Tufts at Tech, we see a lot of periodontal disease thats been neglected for a decade, Zukowski said. We see a lot of dogs and cats with horribly infected painful mouths and at the end, we've removed all of that and they are happy and pain-free. Every single one of those cases is important to me because we've made such a huge impact on the quality of life for those patients.

Tufts at Tech, which serves low-income pet owners, currently averages about 500 clients a month, with 15 to 20 dental procedures a month. For now, shes focused on the critical work of educating veterinary students at Cummings School to follow in her pioneering footsteps.

She and Wolfus collaborated on a week-long intensive dental training course in February for 100 veterinary students at Cummings. They taught students how to take dental x-rays, perform extractions, treat diseaseall procedures that the students may perform during their primary-care rotation at Tufts at Tech. The Dental Week course was the first of its kind at Cummings School, and such a success that theyre already planning another session.

If you have individuals who are willing to pour their heart and soul in bettering themselves so that they can information share and help, teach, and support others, aren't those the most important commodity of people? Wolfus said. Kate is not just information-sharing, she's a critical part of the veterinarian-teaching university.

Angela Nelson can be reached at angela.nelson@tufts.edu.

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This Veterinary Technician Is Obsessed with Teeth - Tufts Now

Carpinteria Veterinary Hospital on Walnut Avenue welcomed a new veterinarian this month, Dr. Amy Belanger. Belanger holds a doctorate from Texas A&M College of Veterinary Medicine and a bachelors in biology from the University of Arkansas at Fort Smith. In addition to caring for dogs and cats, Belanger also has a special interest in birds, rodents and reptiles.

Belanger was drawn to exotics as a child. I have always loved our small feathered, furred and scaled friends and had many exotic pets growing up, said Belanger. Peoples special bond and commitment to their pets, no matter their size or species, has always inspired me. They present unique challenges and often require creative thinking to solve problems. I believe any animal is entitled to good veterinary care no matter its species.

Born and raised in Austin, Texas, Belanger grew up surrounded by all kinds of animals, from hermit crabs and tortoises to cockatiels and horses. I spent as much time in the sun as possible enjoying the parks, rivers and springs around Austin, she said. Belanger was also a competitive tennis player and traveled the U.S. for tournaments.

Belangers mother is a veterinarian in Austin and for many years worked for the Austin Zoo. During that time, Belanger had the opportunity to help her mother with exams on lions, kinkajous, birds of prey and other exotic species.

I grew up having a strong appreciation for the highs and lows of the job, said Belanger, and the commitment required in order to excel. I knew I wanted to be a veterinarian for as long as I can remember. My mothers love of her work inspired me to pursue my own passion to help people and their pets. I cannot imagine myself in any other field.

For Belanger, there are many reasons to love being a veterinarian, but what she loves most is making meaningful lifelong connections with people and their pets I take great joy in guiding people through the struggles, delights and victories of animal ownership.

In Carpinteria, Belanger has found a community of people dedicated to caring for their animals. I could not be happier with the community I now serve, she said.

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New Carpinteria veterinarian has special interest in birds, rodents and reptiles - Coastal View News

On a small, unassuming German island called Riems lies one of the oldest virus research institutes in the world. And also one of the most dangerous.

The Friedrich Loeffler Institute is closed to the public. To access the island, approved visitors must first cross a small stretch of the Baltic Sea via a dam, which can be closed immediately in case of an outbreak. To enter the facility, they must take a shower and put on protective clothing. Inside, scientists study some of the world's most deadly viruses, including bird flu, Ebola and mad cow disease.

One of their many focuses is zoonoses, which are diseases that can be spread from animals to humans, or vice versa. But the facility was originally founded in 1910 to study foot-and-mouth disease. Over the following decades, the Friedrich Loeffler Institute was used for various purposes, including the development of chemical weapons during World War II, vaccine research during the Cold War, and the study of animal welfare and husbandry. It eventually earned the nickname the "island of plagues."

In 2010, the Friedrich Loeffler Institute completed construction on a series of new laboratories that are classified as biosafety level 4, one of the most dangerous distinctions. Today, there are only a handful of level-4 facilities worldwide.

Map of level-4 facilities

The institute is also one of only two facilities worldwide with the ability to conduct large-scale animal studies, such as with swine and cattle. Robin Holland, a student in the Veterinary Medical Scholars Program at the University of Illinois College of Veterinary Medicine, described her experience studying pathology at the Friedrich Loeffler Institute like this:

"I learned how these diseases are managed, controlled, and diagnosed in real-world scenarios, their prevalence globally, and their potential for economic impact if outbreaks were to occur in a nave population."

University of Greifswald

Holland also described the containment procedures at the institute.

"Alongside engineers and biorisk officers, I saw the massive infrastructure of the FLI, including HEPA filtration of exhaust air, room decontamination by dry fogging, waste water treatment, and carcass rendering to animal byproducts. I learned how the level 2 through 4 facilities are managed, protocols for containment in the event of an emergency, and how facilities are designed and personnel are trained in order to ensure thatespecially considering work with highly contagious pathogens such as FMDVall pathogens are contained within the facility."

Zoonoses pose a major threat to humans. From malaria to rabies, they account for about 60 percent of all infectious diseases contracted by humans, and the Centers for Disease Control and Prevention estimates that "3 out of every 4 new or emerging infectious diseases in people are spread from animals." But as scientists continue to study how to treat, prevent and contain these infectious diseases, it's also worth noting the threats they pose to animals.

"The animal toll has been much greater," neurobiologist and public health physician Professor Charles Watson from Curtin University told Abc.net. "When the Nipah virus broke out in Malaysia in the late 1990s there were relatively few human deaths but five million pigs had to be slaughtered in order to wipe it out."

One reason zoonoses are so deadly for animals is that some mysteriously don't hurt humans, even when we contract them.

"It is really unpredictable, however many viruses are successful because they do not kill their human hosts and therefore get better transmission from person to person."

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Scientists are producing deadly zoonoses on this tiny German island - Big Think

Kristen Capen, who graduated from the University of Minnesotas College of Veterinary Medicine in the spring, has seen the rough side of the profession. Euthanizing a beloved family pet is hard, she said, even if the animal is elderly or sick.

I feel bad for the family, especially if it's an older dog, if there are kids, if the dad is there, said Capen, who now works at an emergency animal hospital in Arizona. If everyone in the room is crying, sometimes I also cry, out of basically empathy for what they're going through.

Capen said the worst part of her job is when she has to euthanize an animal because the owner can't afford the care or isn't willing to take it on.

It's awful. There's no real way to describe it, she said. It's not murder. But it feels bad, and sometimes it feels wrong, even though it's the only option.

Experts say those stresses help explain why veterinarians have disproportionately high suicide rates. Female vets are three-and-a-half times as likely to die of suicide than the general population, and men are more than twice as likely, according to a study published this year by Journal of the American Veterinary Medical Association. The study also noted the total number of suicides among female veterinarians has been going up.

There are other complicating factors about the job. Being a veterinarian is one of those careers people dream of their whole lives; it can be disappointing to reach the goal and have it not look the way you imagined. Tuition at vet school is expensive, which means that people often graduate with loads of student debt. And vet salaries often dont keep pace with it.

Besides the headache of dealing with distraught or angry clients, the business model can be difficult to handle, too. While a physician in private practice usually has somebody to handle billing, scheduling, and other tasks, vet practices are often so small that the doctor is managing all of it. And while even general practitioners can refer their patients to specialists, veterinarians are often left doing the job of radiologist, orthopedist, dentist, and every other specialist for their patients.

Acutely aware of these challenges and the increased risk of suicide vet schools are trying to help.

Athena Diesch-Chham has been a clinical veterinary social worker at the vet school at the University of Minnesota for the last seven years. She works with students on both the daily stresses of being in veterinary school and in preparing coping skills for the job. (Diesch-Chham worked with Kristen Capen until Capen graduated last year.)

Some students are really struggling with I hate to say small but smaller stuff of I'm having a really hard day and I just need to get my emotions out, get re-regulated and then get back into class, Diesch-Chham said.

But especially by their fourth year, vet school students are starting to get a real taste of the stresses of the job. That can mean dealing with things like a euthanasia procedure the vet doesnt think needs to be done.

What I have really started to tell our students is, If you don't agree with it, don't do it, because what that does to your psyche and what that does to you emotionally, we're talking years of therapy, she said.

Veterinarian Suzanne Tomasi, an epidemiologist for the Centers for Disease Control and Prevention, did one of the recent studies that looks at veterinarian suicides. She's also looked at ways to prevent suicide. Some of it is pretty obvious work-life balance stuff, she said, like trying to schedule shorter work shifts.

Other suggestions are more industry-specific ways of making it harder for people with suicidal thoughts to actually hurt themselves. Because of their jobs, veterinarians have access to the chemicals used to put animals down, and studies have found they often use the drugs on themselves.

The other recommendation we've made is looking at checks and balances to help manage euthanasia solutions, Tomasi said.

Other people are working on this, too. There's an organization of veterinarians that runs a support group on Facebook. It just announced a partnership with a company to provide veterinarians with online counseling.

This reporting is part of Call to Mind, our MPR initiative to foster new conversations about mental health.

If you are having thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 or go to SpeakingofSuicide.com for more resources.

Read more:
Veterinarians are dying of suicide at high rates, and the U of M is addressing it - West Central Tribune

When it comes to diabetes, control is the goal

More than 30 million people in the United States have diabetes, according to the Centers for Disease Control and Prevention . However, a quarter of them have not been diagnosed.

That matters because, when controlled, diabetes is a condition you can live with. However, to control it, you must know you have it.

Diabetes occurs when your hormones dont regulate blood sugar appropriately.

Type 2 diabetes is characterized by cells that dont respond to insulin as they should. They dont absorb glucose appropriately, leading to fatigue, weight loss, excessive thirst, frequent urination and itchiness. As the disease progresses, your body may produce insufficient levels of insulin.

Type 1 diabetes shows signs in childhood or early adulthood. Your pancreas does not make insulin, necessitating continuous insulin therapy to help the cells learn to use sugar effectively.

When you have diabetes, you face a lifelong balancing act of maintaining healthy blood sugar and insulin levels. It can be a struggle to keep that balance, which is why diabetes specialists, like those at the Providence Endocrinology, Diabetes and Nutrition Center, exist.

I tell every patient theyre the boss, and Im just here to help guide them, endocrinologist Meredith Roth says. I want to know what their goal is when they come in. For a patient, that might be them saying, Im ready to get my blood sugars under control, and I can help give them a framework and make that into an objective goal that we can work towards together.

Many of the techniques for controlling diabetes are similar to habits people should have, anyway, but some are unique.

Test your blood sugar

How often you need to test depends on the type of diabetes you have, how often you eat and exercise, how recently you were diagnosed, whether youre ill, and the medications you take. On average, you may test your blood sugar one to seven times a day, according to Everyday Health .

Eat a balanced diet

Avoiding processed foods and foods high in sugars or carbohydrates helps prevent blood sugar spikes. The better part of your diet should be made up of fruits, vegetables, fish, nuts, whole grains, and lean meats. Aim for snacks with high fiber, healthy fats, and protein.

Recognize the signs of low blood sugar

Low blood sugar, or hypoglycemia, happens when blood sugar levels fall below normal, usually anything less than 70 milligrams per deciliter. Symptoms include shakiness, abnormal nervousness, sweatiness, confusion, lightheadedness, a fast heartbeat, pale skin, hunger, tingling or numbness in your face, clumsiness, nausea, and hunger, according to the American Diabetes Association .

Maintain a healthy weight

The healthier your weight, the easier it will be to control blood sugar levels. If you need to lose weight, it doesnt have to be a dramatic amount, as WebMD reported. It takes only a seven percent loss to improve insulin sensitivity by 57%.

One simple way to cut calories and, therefore, pounds is to replace foods like white bread and pastries that are high in carbs but low in fiber. Choose healthy fats that come from foods like avocado, flaxseeds, canola oil and nuts.

For more information on how to control your diabetes, call or visit a Providence Health & Services location near you.

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When It Comes To Diabetes, Control Is The Goal - KPAX-TV

BETHESDA, Md., Nov. 1, 2019 /PRNewswire/ -- The American Podiatric Medical Association announced today a new public education campaign, Don't Lose Your Nerve to Diabetes. The campaign will educate the public about the importance of preventing diabetic peripheral neuropathy (nerve damage) before it happens and will underscore the critical role podiatrists play in treating diabetes and complications such as neuropathy.

Neuropathy is caused by blood sugar levels that get too high or too low, damaging the nerves that lead to the feet and preventing them from functioning properly. The result could be anything from intensely painful burning, tingling sensations to numbness and heaviness in the feet. Those who lose sensation altogether may not notice an injury or sore, which could lead to a serious infection. Numbness can also lead to balance problems or cause a fall.

Startling statistics indicate as many as 70 percent of people with diabetes suffer from neuropathy, and the nerve damage is most often permanent. Visiting a podiatrist regularly can help patients avoid peripheral neuropathy and address the symptoms if nerve damage does occur.

"Pain or numbness in your feet is never normal," said APMA President David G. Edwards, DPM. "What you can't feel can hurt you. Daily self-exams are critical for people with diabetes, but if you notice any changes in sensation in your feet, don't wait to see your podiatrist!"

The Don't Lose Your Nerve to Diabetes campaign, which takes place during November's Diabetes Awareness Month, features educational material geared toward the public and a depth of materials for health-care providers. To learn more about the campaign, and to find a podiatrist in your area, visit http://www.apma.org/diabetes.

The American Podiatric Medical Association (APMA) is the nation's leading professional organization for today's podiatrists. Doctors of Podiatric Medicine (DPMs) are qualified by their education, training, and experience to diagnose and treat conditions affecting the foot, ankle, and structures of the leg. APMA has 53 state component locations across the United States and its territories, with a membership of more than 12,500 podiatrists. All practicing APMA members are licensed by the state in which they practice podiatric medicine. For more information, visit http://www.apma.org.

Contact: Kevin Hessklhess@apma.org(301)-581-9221

View original content to download multimedia:http://www.prnewswire.com/news-releases/nerve-damage-in-the-feet-a-prominent-consequence-of-diabetes-300939938.html

SOURCE American Podiatric Medical Association

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Nerve Damage in the Feet a Prominent Consequence of Diabetes - BioSpace

November 01, 2019 -With news that the Medicare Diabetes Prevention Program isnt drawing a crowd, lawmakers are urging federal officials to add telehealth to the program.

A group of 19 senators has written a letter to Health and Human Services Secretary Alex Azar and Centers for Medicare & Medicaid Services Administrator Seem Verma, asking them to make virtual care part of a Medicare-backed service that aims to improve health and wellness for roughly 84 Americans at risk of developing type 2 diabetes.

And theyre arguing that connected health could turn the program around.

A Medicare beneficiarys access to the life-improving program should not, and cannot, be determined solely by the zip code in which he or she lives, the senators wrote. Furthermore, lack of access for eligible beneficiaries has the potential to not only depress enrollment, but also to reduce potential cost savings.

CMS has done outstanding work developing online resources to show where MDPP suppliers are located, but these resources make clear that there are geographic regions where eligible beneficiaries lack reasonable access to a qualified supplier, the letter continues. Including virtual providers could empower these beneficiaries with feasible options for preventive, value-based care.

READ MORE: Brigham and Womens to Use Telehealth Platform in Dementia Study

The original Diabetes Prevention Program was developed by the National Institutes of Healths National Institute of Diabetes and Digestive and Kidney Disease (NIDDK), and focused on in-person classes and one-on-one coaching. Based on that model, which is administered by the Centers for Disease Control and Prevention, CMS created the National Diabetes Prevention Program for Medicare beneficiaries and launched that program in 2018.

But the Medicare model does not reimburse care providers for using telehealth or mHealth tools. And thats keeping a lot of healthcare providers and public health programs from adopting the program.

Some 70 healthcare providers are now listed on the CDCs DPP website, though only a handful have been recognized as offering proof that their online programs reach recognized benchmarks for activity and weight loss. A growing number of programs are using virtual care as a means of expanding the programs reach and making the most of limited resources, and theyre asking CMS to cover those services.

Federal officials have long argued that virtual programs havent proven enough value to be included as a covered resource. Acknowledging that pressure, CMS did announce plans to include a telehealth model as a demonstration project, but hasnt offered an update yet on that model.

In the event that your agency believes it needs additional authority to include virtual providers in the MDPP expansion, we request additional information on the statutory changes that would be necessary, the senators wrote. In the meantime, we also ask you to update us on the status of your consideration for a virtual MDPP demonstration. While our preference is the inclusion of virtual providers in the existing model expansion, if an additional demonstration project is required, we request information on the plan for the launch of this demonstration project.

READ MORE: CMS Under Pressure to Cover mHealth Tools for Diabetes Management

The senators have the support of the American Medical Association, which issued a statement backing the letter. This past January, the AMA launched its own lobbying effort in support of adding connected health resources to the program, arguing that digital health access to coaching and health and wellness resources could help roughly 84 million Americans avoid diabetes.

Although the DPP lifestyle change program has strong evidence to support its effectiveness in preventing type 2 diabetes, many of the 84 million patients with prediabetes arent able to participate in an in-person program, the AMA said in an article posted in January on the organizations website. Some patients may not have the time or resources to attend weekly or monthly classes, or they may prefer an on-demand interaction at their convenience. Digital health, and specifically virtual diabetes prevention LCPs (lifestyle change programs), offer a way to overcome those barriers and connect more patients with programs to improve their health.

Theres also support from the American Diabetes Association, which this past June unveiled a study that found that a DPP enhanced with digital health tools can engage participants for an extended period of time and encourage healthy behaviors, including sustained weight loss and lower blood pressure.

In its latest letter, the AMA urged federal officials to recognize the value of connected health in efforts to promote value-based care.

We recognize that scaling an ambitious new model takes time, the organization wrote. Early returns suggest that a few changes would expand the programs reach. Allowing Medicare patients to virtually access this program, as many patients with private insurance are doing, would benefit the most underserved and vulnerable patients, as well as those in remote areas, who cannot access the program without this option. Here is an opportunity for Medicare to encourage a practical use of digital health tools.

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Could Telehealth Save the Medicare Diabetes Prevention Program? - mHealthIntelligence.com

Study suggests BPA exposure make increase risk of type 2 diabetes

Researchers in the study said the link remained after adjusting for traditional diabetes risk factors.

MELBOURNE, Australia - A new study found that exposure to chemicals commonly found in plastics, food and beverage can linings and other consumer products may be associated with an increased risk of developing type 2 diabetes.

The study, conducted by Australian and French researchers published Wednesday in Environmental Health Perspectives, found associations between exposure to bisphenol A, commonly known as BPA, and the incidence of type 2 diabetes.

The same result was found for bisphenol S, a common BPA replacement known as BPS.

Researchers said the findings add to a growing body of evidence that indicates that these chemicals might play a role in increasing the risk of type 2 diabetes.

BPA is a chemical commonly used in the production of polycarbonate plastic and epoxy resins and is found in consumer products such as food and beverage containers and thermal cash register receipts.

Plastic bottles are shown in a file image. (Photo by Karol Serewis/SOPA Images/LightRocket via Getty Images)

The study tracked data from 755 people without diabetes over a nine year period. The participants BPA levels were tested at the start of the study and three years later.

Researchers found that those with higher levels of BPA in their fasted urine samples had a near doubling of the risk of type 2 diabetes, compared to those with the lowest average exposure. Additionally, the study found that those with detectable levels of BPS were also associated with an increased diabetes risk.

The link remained after adjusting for weight, diet and physical activity, researchers said.

The present study adds to the limited literature on the prospective relationship between BPA exposure and diabetes risk and contributes to the growing body of evidence that BPA exposure may be a risk factor for diabetes independent of traditional diabetes risk factors, the study authors note.

According to Professor Dianna Magliano, one of the study authors from the Baker Heart and Diabetes Institute in Australia, the association was not as strong as some other risk factors for diabetes such as obesity but there is mounting evidence to warrant caution.

I would advise people to use glass where they can or better quality plastic and if there is an alternative to BPA receipts such as electronic receipts, I think we should consider it, Magliano said.

Magliano said the study is one of the first to look at BPS as a substitute for BPA and further research is needed to confirm the results.

BPA has been used in food packaging since the 1960s, according to the U.S. Food and Drug Administration.

Some research has shown that BPA can migrate into food or beverages from containers that are made with the chemical. Concern of possible health effects on fetuses, infants and children led to a ban of BPA in baby bottles, sippy cups and infant formula packaging in the United States.

However, the FDA has said that BPA is safe at the low levels that occur in some foods and is continuing its review of ongoing research.

We cannot completely eliminate BPA. But we can live a bit cleaner, Magliano told the Sydney Morning Herald. Limit your exposure to crappy plastic. Buy decent water bottles. And chuck out your takeaway plastics.

This story was reported from Cincinnati.

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Exposure to chemicals in plastic linked to increased risk of type 2 diabetes, study finds - FOX 10 News Phoenix

Andre Doctor Dre Brown, who used to co-host the music video show Yo! MTV Raps with Ed Lover,talked about having diabetes during a recent visit to ABCs Here and Now.

Dre was diagnosed with the disease in 2007, and he revealed that he lost much of his sight because of it.

Im a Type 2 diabetic who has lost his vision, he explained. I have a foundation called the Doctor Dre VIC, which is called the Visually Impaired Can Foundation, and basically Ive been going through a whole different resurgence of my life.

I stopped at one point, and now Im doing this, and through the blessings of the late, great Dick Gregory and some people hes known, Ive worked through different holistic doctors out there to change what goes in my body and actually work with trying to do the best. We can treat diabetes, added the 56-year-old.

Dre then said hes working on putting an event together for men, so they can do things like test their blood sugar to determine if theyre at risk of having diabetes.

He also said there will be performances there, and the whole idea behind the event is to get men to take their health seriously.

Without your health, youre not wealthy, said the Long Island, New York, native.

But even though Dre doesnt have full use of his sight, hes able to see on occasion. And he also said his issues with vision didnt come solely from diabetes.

I had my retinas reattached, so I really didnt go blind just from the diabetes but in the reattachment, he explained. I have what you call scar tissue behind my eyes, so when that kind of fluctuates my vision comes back.

At the end of his interview, Dre said hes looking to create an army of people to help better treat Type 2 diabetes. And before the discussion concluded, the former TV host gave one piece of simple but crucial advice.

Drink water, he urged. Thats the first big start.

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Former MTV Host Doctor Dre's Battle With Diabetes Resulted in Him Losing Much of His Vision, He Reveals - Atlanta Black Star

Your eye health may be the furthest thing from your mind if you have diabetes, but what you might not know is that the disease can directly impact your vision. According to the Centers for Disease Control and Prevention, diabetic retinopathya vision complication from diabetes leading to damage or swelling of blood vessels in the retinais the most common cause of vision impairment and blindness in adults in the U.S. and by 2050 will affect roughly 14.6 million people.

That's not the only diabetes-related condition that can damage eye health. "Diabetic eye diseases can affect almost all parts of the eye and surrounding structures," says Matthew Gorski, M.D., a Northwell Health ophthalmologist at the Ophthalmology and Ocular Surface Center in Great Neck, NY. "The lens of the eye (where cataracts form) and the retina, the inside wallpaper where light rays are absorbed, are the most common areas where diabetes can cause eye problems."

Here, experts explain the main types of diabetic eye disease, the role glucose plays in the severity of these conditions, and most importantly, how people living with diabetes can protect their vision.

High blood sugar can damage the pancreas, harden blood vessels, and over time, increase your risk of heart attacks and kidney disease. But in addition to these health risks, glucose that spikes too high can also harm your sight. "Fluctuations of blood-glucose levels significantly affect vision in both the short term and long term," says Orlin Sergev, M.D., Ph.D., owner of Equilibrium Endocrinology & Diabetes Center in Ladson, SC.

"In the short term, both high and low blood-glucose levels (especially with sudden changes) can cause vision to become blurry [due to fluid moving in and out of parts of the eye]," he says. "Long-term mismanaged glucose affects the blood vessels in the retina, which can cause permanent vision damage, including blindness."

This is why it's important for people with diabetes to see their eye doctor at least every nine to 12 months even if they have no symptoms, says Dr. Gorski, as the earliest stages of diabetic eye disease can often be asymptomatic.

Think of DR as the gateway condition to all other diabetic eye diseases. "With DR, elevated blood-glucose levels progressively damage the vessels in the retina, leading to swelling and bleeding that ultimately damages vision," says Dr. Sergev. "The severity is usually dependent upon the length of disease and the level of [glucose] control."

So while high glucose levels initially wreak havoc on blood vessels surrounding the eyes, affecting your vision by increasing blurriness or interfering with your ability to distinguish between colors, it's the continuous swelling and leaking of these vessels that can lead to other conditions like cataracts, glaucoma, and DME (more on that below).

How many people are affected by DR? The overall prevalence of diabetic retinopathy in adults with diabetes in the U.S. is 28.5%. There's also a class of diabetic retinopathy called vision-threatening diabetic retinopathy, and that's about 4.4% of diabetic adults.

"This means almost one-third of all diabetics have some form of diabetic retinopathy, and about five percent of them are going to have it severely affect their vision," says Dustin French, Ph.D., associate professor of ophthalmology at Northwestern University Feinberg School of Medicine in Chicago.

Currently, there's no known cure for diabetic retinopathy. However, retinal specialists can preserve sight and may reverse vision loss from diabetic retinopathy through various methods. Those might include injecting medication into the back of the eye, performing laser procedures, and/or retinal surgery.

According to the Mayo Clinic, symptoms of DR include:

One of the most common eye conditions people with DR encounter (especially those with type 2 diabetes) is DME, which happens when uncontrolled blood sugar causes swelling of the retina, says Dr. French. This causes vessels in the eye to leak out or restrict blood flow, leading to a loss in the central-most part of your vision.

"Over time, this creates black spots in a person's vision as their vessels begin to deteriorate," says Dr. French. And while the thought of your vision being taken away can be terrifying, DME can be easily treated, says Dr. French. (Yet another reason to stay on top of those checkups.) Eye injections with anti-VEGF medications can manage the abnormal vessels and help prevent blindness. (OK, yes, they do require shots into your eye, but we can help you prepare for that.)

According to the American Academy of Ophthalmology, symptoms of DME include:

Even if you aren't dealing with conditions like DR and DME, it's important to get your eyes checked regularly to stay on top of other eye conditions like cataracts (a clouding of the eye lens) and glaucoma (a group of conditions that damage the optic nerve). "Cataracts are five times more frequent in diabetics and glaucoma is two to three times more frequent," says Dr. Sergev.

Although the link between diabetes and cataracts is still murky, Dr. French says cataracts or glaucoma are often diagnosed at the same time a person gets screened for diabetic retinopathy, and this diagnosis may be due to certain lifestyle risk factors (such as smoking, excessive alcohol intake, or obesity) in addition to being diabetic.

What's more, the symptoms of cataracts and glaucoma, like blurry vision, distortion, and other eyesight changes, can often overlap with more serious conditions like DR and DME. This is why in addition to maintaining your glucose levels, eating a well-balanced diet, and not smoking, people with diabetes should closely monitor their eye health with a yearly dilated eye exam to help decrease the chances of developing diabetic eye diseaseas well as get proper treatment for any eye issues that do arise as quickly as possible.

See more helpful articles:

9 Tips to Prevent Eye Problems When You Have Diabetes

Watch Out! Home Hazards for People With Diabetes

Here Come the Sunnies: The Best Shades for People With Diabetes

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Everything You Need to Know About Diabetic Eye Disease - HealthCentral.com

Aaron Hudson, PhDvice president and general manager of global marketing, SCIEX

Glaucoma is called the silent thief of sight because in its most common form, there are usually no symptoms until the disease has insidiously progressed to the point of irreparable optic nerve damage and irreversible sight loss.1,2 If left untreated, the initial loss of peripheral vision will continue to become tunnel vision, which will then shrink down until all sight is lost.

The thought of being blind sent me into a deep depression.3

Looking back, I could find out that there were many times, and a couple of auto accidents, in which I didnt see cars coming from the left or the right sideand that was a consequence of losing that peripheral vision. But you never know that when you dont know you have any disease.4

I find myself, since Im half-blind, constantly worrying about: what if I lost the vision in my right eye? Because that would change everything about my life. It would change my dreams, it would change my relationships, it would change everything.5

These quotes, all shared by glaucoma patients, dramatize how people who lose their vision also lose peace of mind. Even eye diseases that do not impair vision can be devastating.

After getting dry eyes, I became very frustrated and almost depressed for a while. Its hard to deal with.6

The most common form of glaucoma, open-angle glaucoma, is also the most mysterious. Although a strong hereditary component has been implicated, the underlying disease mechanisms remain largely a mystery.2

To unravel the mystery and to identify biomarkers for the diagnosis and stratification of patients for precision medicines, researchers in Finland and Singapore are working together to analyze the proteome of tears from individuals with eye disease. Specifically, the researchers are using advanced analytics techniques with liquid chromatography (LC) triple time-of-flight (TOF) mass spectrometry (MS) and SWATH Acquisition to rapidly obtain complete data on tear samples from individual patients.

Tear fluid is especially useful because it is a more accessible and less complex body fluid than serum or plasma, and sampling is much less invasive. Using the SWATH Acquisition method enables the capture of a wealth of information from each sample in one go, meaning that researchers can go back to interrogate their data time and time again as more information emerges about the biology of the eye and tears. The advantage of the MS method is that it allows researchers to process samples from individual patients quickly, sensitively, and precisely, eliminating the need to pool samples.711 With MS, it is possible to analyze the proteomic profiles of individual patients, even in large clinical trials. Eventually, it may bring proteomic analysis to clinical practice. It has the precision needed to achieve precision/stratified therapy.7,11

In one clinical study, LC-MS and the TripleTOF system were used to evaluate the expression levels of proteins in tears between patients with glaucoma. People with glaucoma are prone to getting concomitant ocular surface disease, such as dry eye disease. During a year-long study of patients with glaucoma who were experiencing dry eye symptoms, the researchers were able to identify protein biomarkers that predicted which patients would benefit most from a switch of eye drop medication from one with preservatives to one without preservatives.7

Using SWATH Acquisition, the researchers discovered that the dry eye symptoms of patients with increased levels of proinflammatory proteins and decreased levels of protective proteins improved more after the medication switch than those of other patients. The study went on to define three subpopulations based on these and other biomarkers: a group that did not respond to the medication switch, a group that had moderate improvement in symptoms in response to the switch, and a group that benefitted the most from the medication switch.7

Another study using the TripleTOF system with SWATH Acquisition to examine the proteomic expression of tears has found proteins that could be used as biomarkers to stratify patients with dry eye disease, identifying those who would benefit most from treatment with flourometholone, as opposed to polyvinyl alcohol.8 Similarly, studies using SWATH Acquisition have revealed proteins that may be potential biomarkers for predicting progression to severe thyroid eye disease in patients with autoimmune thyroid disease,9 whereas other proteins have been discovered that may be indicative of aging and the effects of aging in eye tissues and functions.10

Tears are also being analyzed to understand a host of other eye diseases and infections, such as diabetic retinopathy, peripheral ulcerative keratitis, aniridia, ocular allergies, and trachoma.12 Research continues apace to better understand the physiology and pathophysiology of the eye and eye diseases, particularly over time, as many eye diseases occur more often with older age.

The increasingly common utilization of advanced analytical technologies such as MS to better interrogate biological samples from individual patients and healthy controls means that we are getting ever closer to the identification and use of biomarkers to predict and diagnose disease, as well as to monitor patient responses to therapeutic agents, marking progress in the field of predictive, preventive, and personalized medicine, both in general and in terms of addressing eye disease. Precision medicine promises to revolutionize healthcare for many people, not only those with eye disease but also individuals with other diseases, such as cancer and cardiovascular disease.

References1. University of Utah Health. Glaucoma: The Silent Thief of Sight.2. National Eye Institute, National Institutes of Health. Glaucoma: The Silent Thief Begins to Tell Its Secrets. 01/12/14.3. Nttinen J, Jylh A, Aapola U, et al. Patient Stratification in Clinical Glaucoma Trials Using the Individual Tear Proteome. Sci. Rep. 2018; 8: Article 12038.4. Glaucoma Australia. My Glaucoma Story. Victorias Story.5. Glaucoma Research Foundation. Art Takahara: Learning about Glaucoma.6. Glaucoma Research Foundation. Personal Story: Hannah Eckstein.7. Cook N, Mullins A, Gautam R, et al. Evaluating Patient Experiences in Dry Eye Disease Through Social Media Listening Research. Ophthalmol. Ther. 2019; 8(3): 40720.8. Nttinen J, Jylh A, Aapola U, et al. Topical fluorometholone treatment and desiccating stress change inflammatory protein expression in tears. Ocul. Surf. 2018; 16: 8492.9. Chng CL, Seah LL, Yang M, et al. Tear Proteins Calcium Binding Protein A4 (S100A4) and Prolactin Induced Protein (PIP) are Potential Biomarkers for Thyroid Eye Disease. Sci. Rep. 2018; 8: Article 16936.10. Nttinen J, Jylh A, Aapola U, et al. AgeAssociated Changes in Human Tear Proteome. Clin. Proteomics 2019; 16: 11.11. Jylh A, Nttinen J, Aapola U, et al. Comparison of iTRAQ and SWATH in a Clinical Study with Multiple Time Points. Clin. Proteomics 2018; 15: 24.12. Hagan S, Martin E, Enrquez-de-Salamanca A. Tear Fluid Biomarkers in Ocular and Systemic Disease: Potential Use for Predictive, Preventive and Personalised Medicine. EPMA J. 2016; 7: 15.

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Surveying the Tear Proteome to Stratify Glaucoma Patients - Genetic Engineering & Biotechnology News

RICHMOND, Va.(WRIC)Conexus needs your help this Fall to help give area children the gift of sight. The non-profit goes into schools to give children eye tests. 80% of what a child learns in school is through vision, and 1 in 4 school children have a vision problem significant enough to impact learning, and in Greater Richmond, that number is closer to 1 in 3. Studies indicate that children with uncorrected vision of less than 20/20 are 3 times more likely to fail a grade in school. Undetected and untreated vision problems impact incidences of juvenile delinquency, adult illiteracy, and unreached potential.

During the 2018-2019 school year, Conexus screened over 54,000 children across the Commonwealth and 16,959 were referred for additional exams; a rate of 31.2%. The national average is 25%. In Greater Richmond, 12,006 children were screened by Conexus with a referral rate of a staggering 39%.

Through the Conexus Gift of Light campaign, you can help the organization get into schools and help children. For a charitable gift of $10, Conexus can provide a child a VisioCheck screening; for a charitable gift of $50, Conexuscan provide an eye exam and glasses for a child; for a charitable gift of $150, Conexus can provide screening for anentire classroom; and for a larger charitable gift of $500, Conexus can provide an entire day of Mobile Vision Clinicservices. You can donate online here.

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Conexus needs help to give the gift of clear sight to kids across RVA and beyond - 8News

BALTIMORE, Oct. 31, 2019 /PRNewswire/ --Deadly. Blinding. Costly. Epidemic. These are the words used to describe diabetes, a devastating condition affecting more than 30 million Americans (about 9.4% of the population). Of those, nearly 30 percent (or 10 million people), have diabetic retinopathy, a potentially blinding disease that costs Americans more than $500 million every year.

The new Versant Health white paper, The health and financial costs of diabetic retinopathy, outlines the toll both physically and financially that diabetic retinopathy can take on a person. Not only can the disease have a debilitating impact on vision, but medical costs associated with diabetic retinopathy are higher than with other diabetes-related conditions, including neuropathy and chronic kidney disease.

"Early intervention is critical when it comes to the successful treatment of diabetic retinopathy," says Mark Ruchman, MD, Chief Medical Officer at Versant Health and contributor to the white paper "In its early stages, when treatment has the greatest likelihood of success, patients are typically asymptomatic. Thus, a regular eye exam is a critical component of any health and wellness program to reduce blindness from this disease."

Versant Health supports the overall health of its diabetic members in several ways, striving to reduce the risk for and/or severity of diabetic eye disease, including Diabetic Outreach, medical management, and detailed provider portal questionnaires. To learn more, download the health and financial costs of diabetic retinopathy white paperfrom the Versant Health website.

About Versant HealthVersant Health is one of the nation's leading managed vision care companies serving more than 33 million members nationwide. Through our Davis Vision plans and Superior Vision plans, we help members enjoy the wonders of sight through healthy eyes and vision. Providing vision and eye health solutions that range from routine vision benefits to medical management, Versant Health has a unique visibility and scale across the total eye health value chain.As a result, members enjoy a seamless experience with access to one of the broadest provider networks in the industry and an exclusive frame collection.Commercial groups, individuals, third parties, and health plans that serve government-sponsored programs such as Medicaid and Medicare are among our valued customers.

For more information visitversanthealth.com.

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Versant Health releases white paper: The health and financial costs of diabetic retinopathy - Herald-Mail Media

For many of us, our eyesight is something we take for granted until we start getting older.

And then, suddenly we think, Oh, I might need glasses to read, and we accept thats part of the process. But theres more to it.

Eye health is something you can actually help controlas you get older, especially to reduce your risk ofAge-related Macular Degeneration (AMD) which can lead to low vision and blindness.

Anyone whos caring for a parent or grandparent would want the best for their eyesight too. So, we all need to know what we can do and there arepreventative measures that go beyond just wearing sunglasses to block UV rays.

Here are four facts about your eyes that can help protect your vision, and the vision of those you care for, for years to come.

You may already know that smoking can increase your risk of developing an eye condition. But did you know that high cholesterol and high blood pressure can too?

High cholesterol and high blood pressure can damage the blood vessel walls, increasing the likelihood of things like blood clots.

Take note also if you have an older person in your life who may need help getting on top of these things.

No, we dont mean just eating lots of carrots!

To help reduce the risk of developing an eye condition, Macular Disease Foundation Australia (MDFA) recommends that we adopt the following simple practices as a normal part of our diets:

Now, what about carrots? It turns out theyre not thenumber one food for eye health, despite what were told as kids.

MDFA notes that while carrots are a good source of vitamin A, which is important for general health, you should choose dark leafy greens as your main eye health vegetable.

For recipes that are tailored to improving your eye health, check out their free Eat For Your Eyes electronic cookbook on theirwebsite.

AMD is a chronic eye disease, which if left unchecked, may cause blindness. Its also the leading cause of blindness in Australia.

The macula is the part of your eye used for sharp, central vision. AMD causes the macula to deteriorate, and over time leads to blurred sight, and even black spots in your central vision.

This makes it hard to drive, read and recognise peoples faces. Its a scary thought for a lot of us, isnt it? And its particularly hard to watch a loved one going through it.

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4 facts you need to know about your eyes as you age. - Mamamia

Nicole Cicchetti said she felt instantly isolated when she covered her eyes with a black mask at Dining in the Dark. Of course I couldnt see, but my hearing was affected too: it was like the conversation at the table became muffled, explained Cicchetti, one of 180 guests at Vision Loss Alliance of New Jerseys annual fundraiser on Oct. 24.

Across The Meadow Wood ballroom, VLANJ participant and line dance instructor Harry Buddy Bradley coached Jill McNeil as she struggled to slice her chateaubriand. The next challenge was eating the small-cut pieces. She laughed when she brought an empty fork to her mouth. Ive done that three times! she said. Fourth try was a charm.

Held during Blindness Awareness Month, Dining in the Dark gave sighted guests a glimpse of what life is like for people who are blind or have significant vision loss. It also showcased the fulfilling lives people with vision loss enjoy.

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I never lost my vision; I lost my eyesight! said Joseph Ruffalo Jr., president of the New Jersey affiliate of the National Federation of the Blind. Ruffalo and the Morristown Medical Center Community Health Committee received VLANJs Founders Award, while VLANJ honored Senior Program Manager Linda Groszew for 15 years of service.

VLANJ is one of the states longest-serving nonprofits for adults with vision loss. Created in 1943 as a social club in Newark, it relocated to Denville in 1955 and operated as a summer camp for women. It evolved into the only comprehensive, nonresidential vision rehabilitation program for adults in New Jersey. VLANJ provides direct services in three counties to 225 adults, and another 1,000 participate in outreach programs.

I am inspired daily by the individuals who attend the programs that we offer. They refuse to let vision loss define who they are and what they can accomplish, VLANJ Executive Director Kris Marino said.

Longtime newspaperman and book author Mark DiIonno, who emceed the event, told guests how impressed he was by the camaraderie he witnessed at VLANJ. That sense of community is paramount to what this organization is all about, DiIonno said.

Vision Loss affects 1 out of 40 adults in New Jersey, and the numbers are expected to increase significantly as the population ages. The National Eye Institute projects the number of people with visual impairment or blindness in the U.S. will double to more than 8 million by 2050.

Dining in the Dark guests watched three videos of VLANJ participants describing how the nonprofit has impacted their lives. They also heard from VLANJ trustee Claudia Schreiber, who became blind more than a decade ago, when her two children were still in elementary school.

Devastated, she turned to VLANJ, and learned skills that helped her reclaim her independence.

This was the beginning of my journey back, Schreiber said. Slowly, slowly, I started to feel like the person I was before. A sculptor, Schreiber returned to her art, and has become a mentor and advocate for others with vision loss. I am happier today than I ever have been in my whole life! she said.

Dining in the Dark, which included a silent auction and a wine pull, raised more than $50,000 to provide services at the nonprofits center in Denville and at locations in Montclair in Essex County and Ridgewood in Bergen County.

The event was sponsored by: Aegis Capital Corp.; Williams Jones Wealth Management; Paramount Assets, LLC; Peapack Private; Carl Stahl Sava Industries, Inc.; Thatcher McGhees; Summit Lions Club; Mynt Properties, LLC Commercial Real Estate; The Church of the Saviour; Norman Dean Home for Services; Anthony Felicetta; and Florio Management. Joseph and Antoinette Cicchetti chaired the event, and members of the Chester Lioness Club volunteered.

ABOUT VISION LOSS ALLIANCE OF NEW JERSEY

Vision Loss Alliance of New Jersey is a 501(c)(3) that provides practical training and emotional support to help those who have experienced profound vision loss regain self-esteem and self-reliance. Since its founding in 1943, Vision Loss Alliance of New Jersey has used a holistic approach to empower those with profound vision loss to live engaged, productive and independent lives. Go to vlanj.org for more information.

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180 Guests at Dining in the Dark Glimpse Life with Low Vision - TAPinto.net

Potentially the most successful coach in the history of rugby union is hiding in plain sight. Maybe it is because she is a woman and gives relatively few interviews. More likely it is because people do not see her on the touchline or in the coaching box each week. Whichever it is, her visionary work will be staring everyone in the face in Saturdays World Cup final.

Should England win she will also be entitled to a unique place in rugby history. Only a handful of oval-ball legends Richie McCaw, Steve Hansen, Kieran Read have shared in two World Cup triumphs. No one, male or female, has ever achieved three. Step forward Englands unobtrusive secret weapon, Dr Sherylle Calder, now just 80 minutes away from an unprecedented global hat-trick.

Sixteen years ago, when many were dismissing the concept of a vision specialist as a gimmick, Calder was a valued member of Clive Woodwards backroom staff during Englands lengthy climb to 2003 success. In 2007, in the green and gold tracksuit of her native South Africa, she helped the Springboks conquer the world. And now here she is again, back in the red rose fold at the behest of Eddie Jones, who knows a winner when he sees one.

Have you ever wondered exactly why, say, Jonny May looks a more rounded, confident player; why Henry Slade is snaffling more interceptions, or noted the increasingly deft handling of Maro Itoje and Englands other big forwards? A significant part of the explanation can be traced back to the regular eye exercises Calder has conducted with Joness squad for almost three years.

In her previous role with the Springboks she turned the winger Bryan Habana into world rugbys greatest try poacher to the point where Habana was still going through last-minute reflex-sharpening work with her just seconds before the 2007 final against England kicked off. As a former South African hockey international, Calder is that rarest of mentors: someone who both understands the psyche of top athletes and can provide specific tools to help them improve on a daily basis.

Her EyeGym programmes have helped improve the performance of everyone from the golfer Ernie Els to the Mercedes F1 driver Valtteri Bottas but, having grown up in Bloemfontein, rugby has always been on her radar.

As a kid I used to watch South Africa in the early hours of the morning with my parents when they played the All Blacks. If youd told me then Id ever be involved in a World Cup I wouldnt have believed you, Calder says.

If youd told me Id be involved in three World Cups Id have said: Youre dreaming. If you told me Id win even two World Cups Id have said you were completely crazy.

Famously, Calder is on record as saying that spending too long on mobile devices, not least on match days, hinders athletic performance because it does not encourage peripheral vision, spatial awareness or increase eye movement. Her focus, instead, is on helping players to train their instincts and, as a result, make more effective decisions under pressure. Handling is only one aspect. Your eyes will show you, for example, which running line to take or where not to go. Timing of tackles, timing of runs, judgment of kicks and passes . . . people forget that for the past three years the players have been training that.

So when Itoje scoops a ball improbably off his toes or Tom Curry emerges almost overnight as a top-class lineout option, it is not quite the happy accident it might appear at first glance.

Habana, for one, felt Calders exercises made a massive difference to his game. He used to say to me: Thanks for making my eyes as fast as my feet. He felt that even though he was really quick that didnt mean his timing of runs and tackles would be correct. Timing comes from what you see. High balls? I believe all players should be able to take them. When commentators say: Thats a great catch, I think: Thats what he should be doing.

Calder is adamant her techniques can be applied to every walk of life and all ages. We do a lot of work with young kids. Parents started coming back to us saying: Our kids academic results have improved. If you can read information quickly, comprehend it immediately and then use it effectively . . . thats exactly what happens on a sports field as well. Its about picking up information early and then being able to execute it.

The proof of her worth will be even more glaring if England can replicate their 2003 triumph this weekend. Calder still has fond memories of that era, having been convinced for a long while that Martin Johnsons squad would rule the world.

They were definites to win, I always knew that. But they also did the right things, both as a management and as a player group. Thats what wins World Cups. I remember talking to Jonny Wilkinson on the field afterwards. Wow, fantastic I said. Well done. He replied: Thank you for what youve done for my game. For him, at that moment, to have the presence of mind to say that shows what a quality bunch they were. They were an amazing combination of people together.

Winning with the Boks in 2007 and subsequently at the Suntory club in Japan also cemented her professional respect for Jones. I see him as a rugby mastermind. Thats my experience of him. Hes great at what he does.

She also knows the Springbok coach Rassie Erasmus but any split national loyalties will disappear out of the window should the Webb Ellis Cup once again find its way into Englands and her own hands.

It would be marvellous. Words probably couldnt describe it but Im not a person who counts their chickens before theyre hatched. Im just blessed. I created the science, I love what I do and I know it makes a difference. Guardian

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The eyes have it: England vision coach Calder closing in on unique prize - The Irish Times

Aniridia is a congenital disorder that causes severe eye problems, and also affects metabolism sometimes resulting in severe obesity. It is associated with mutation of a major developmental gene, called PAX6. People born with aniridia have no irises in their eyes, often are legally blind, and whatever eyesight they have continually worsens with age. The disease is uncommon, but disorders associated with genetic mutations can involve common eye problems, including cataracts and glaucoma.

To better understand and treat aniridia and other disorders involving the PAX6 gene, researchers and clinicians at the University of Virginia are combining clinical research, patient treatment and powerful basic science investigations.

They have organized for this weekend a major symposium focused on congenital eye disorders and the PAX6 gene, bringing together top researchers from the University and around the nation and Europe, along with patients living with aniridia and their families.

The organizers are Rob Grainger, W.L. Lyons Brown Professor of Biology, and Dr. Peter Netland, Vernah Scott Moyston Professor and Chair of Ophthalmology. Both are members of UVAs Brain Institute, and are research collaborators.

In his studies, Grainger uses frogs that are mutated to mimic aniridia and other eye disorders. Netland treats congenital eye disorders and conducts clinical research.

Here, the two colleagues explain for UVA Today readers their research and the goals of the 2019 John F. Anderson Symposium, Aniridia-PAX6 and Beyond

Q. Why did you organize this particular kind of symposium, connecting how eyes develop before birth and genetic diseases that can follow?

Grainger: Each of us works on different perspectives concerning eye formation. In my lab, we focus on how the eye is constructed during embryonic development; in Peter Netlands practice, on how to treat diseases that affect these processes.

These are complementary approaches two sides of the same coin. In one case we focus on the assembly of the eye, and in the other, what occurs when the eye is not constructed properly, leading to multiple serious consequences for the patient.

This interplay highlights the importance of looking at these two perspectives together, a collaboration in this case between the two of us (one in the School of Medicine and the other in the College of Arts & Sciences) each providing insights for the other.

Netland: The value of this kind of interaction has motivated us to bring together many of the worlds experts who pursue these two perspectives, including as well a third group: patients and their families who want to learn more about these diseases and treatments. There are few meetings held with this sort of three-way interaction in mind, and we anticipate that many fruitful insights and collaborations will emerge.

Q. Dr. Netland, why is aniridia an area of particular interest to you?

Netland: More than 20 years ago, I spent an extended period of time in the Middle East and India, where there are high rates of consanguinity and congenital eye disorders, which led to a book I produced about pediatric glaucomas, other scholarly contributions and development of my clinical skills. About 20 years ago, I cared for an infant with aniridia and the family of that patient. The potentially disabling issues for the patient, which involved all parts of the eye, and the compelling issues that the family were dealing with drew me toward this condition.

Another patient was very influential to me, because she was a patient advocate and mother of an affected child. I began to see increasingly larger numbers of patients with congenital eye disorders and aniridia, and I developed further clinical and academic interests in the topic.

Around 20 years ago, we started biannual meetings with the patient advocacy group Aniridia Foundation International, and developed connections with other patient support groups, which helped shape the direction of our efforts. With increasing contact with the patients and their families, I became deeply interested in trying to help these patients.

About 20 years ago, I cared for an infant with aniridia and the family of that patient. The potentially disabling issues for the patient, which involved all parts of the eye, and the compelling issues that the family were dealing with drew me toward this condition.

- Dr. Peter Netland

This is a disease that results from damage to the gene PAX6, already known to be perhaps the most fundamental gene involved in eye formation overall and consequently affecting the entire visual system. However, we knew much less about how to treat the many facets of this disorder; for example, cataract, glaucoma and corneal opacification (scarring), which are frequently acquired by patients. Some of these problems are common in the general population, and have broad significance. Many advances have been made in the past, but there is much more progress that is needed for the future.

Q. Why do you use frogs in your eye research, Professor Grainger?

Grainger: We have been examining eye development in frog embryos for over 20 years in my lab, initially because so much embryology, going back to the beginning of the 20th century, was done on these large, easy-to-obtain-and-raise embryos.

In the early days, we were learning how the different parts of the eye, notably the lens and retina, are formed by interactions between parts of the embryo to form a coordinated whole organ exactly the interactions that are disturbed when things go awry in aniridia patients.

Q. Six years ago the Grainger lab developed a gene-editing technique that allows you to mimic human lesions. How is this advancing eye research?

Grainger: While the utility of the frog system for understanding embryological processes is undisputed, during the decades that we have been doing research, the techniques allowing us to manipulate and understand gene function have blossomed, including genome projects and more recently gene editing the ability to inactivate genes of interest to learn how they function during normal development.

In 2013, we published our first paper using this new technology to inactivate genes critical for eye formation in frogs and to follow in precise detail how things go awry. This has allowed us to make important clarifications in how these genes contribute to development of the eye. Because the frog eye develops much as the human eye, these mutations help us look in detail in a way not feasible in human embryos; thereby allowing us to understand how these genetic errors lead to the problems that occur in human patients. Specifically, we have made mutations in frogs in the PAX6 gene that lead to frogs having aniridia, with features of the animals strikingly similar to those in human patients.

These are complementary approaches two sides of the same coin. In one case we focus on the assembly of the eye, and in the other, what occurs when the eye is not constructed properly, leading to multiple serious consequences for the patient.

- Robert Grainger

Q. What kind of clinical research and therapies are UVA conducting that connect with the basic research?

Netland: We have looked at many of the vision-threatening eye problems in our aniridia patients. We have also found that their mutation is linked with obesity, and have performed clinical trials to evaluate the causes of this. We have performed studies to better understand the mechanisms for some of their clinical problems, such as glaucoma.

We are excited about precision medicine trials identifying patients who can benefit from a specific gene-based therapy and we recently completed a two-year clinical trial evaluating targeted gene therapy. In parallel, similar problems are under study in the frog to complement and build on the work with human patients.

Q. What future do you see for patients with eye disease as this research moves forward?

Netland: We are working with patients with known mutations of a specific gene, so naturally we are excited about precision medicine approaches to these patients. We believe that genetic-based approaches will continue to increase understanding of these diseases and will provide the basis for rational therapy for affected patients, and more broadly for others in the general population who are suffering from the same clinical problems. We believe that new imaging techniques will produce new insights in this area.

Grainger: In the frog, our lab has developed a method for efficiently creating exact patient mutations, again amplifying the opportunities for an integrated approach to precision medicine. There are opportunities with in situ gene modification and other gene-based therapies for addressing problems and improving the quality of life of patients.

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Patients, Physicians and Researchers Gather to Probe Genetic Eye Disorders - University of Virginia

After an Ohio mom's daughters, who were born deaf, receivedcochlear implants, a device that provides those with moderate to profound hearing loss with a modified sense of sound, they were thriving. Shortly after the procedure, however, the then five- and two-year-old girls lost their father a pilot in theUnited States Air Force in a plane crash. Not long after that, both daughters failed a vision screening at their school.

Anna Chambers's daughters, Ava and Stella Rose, were diagnosed with a rare genetic disorder,Usher syndrome, the leading cause of combined deafness and blindness. With no cure, Ava, 14, and Stella Rose, 11, will ultimately be robbed of their sight.

With their diagnosis and the death of their father, Capt Jeff Haney, the "holidays had lost the sparkle, according to Anna.

The diagnosis was a curveball I was not expecting after the tragic loss of their father," Anna tells Yahoo Lifestyle, adding that the family had left Alaska where Haney was stationed, to move to Ohio, after his death.

"It was overwhelming for me as a mother, and I just knew I needed to start some new traditions for our new life," Anna says. "To bring back a little joy."

Ava and Stella Rose, sisters who have Usher syndrome, were born deaf. Now, their mother, Anna, is ensuring they have "visual memories" as their eyesight deteriorates. (Photo: Anna Chambers)

Growing up, her girls had always asked their mom to dress up with them on Halloween. Typically, without having the time to put together a costume for two young children and herself, she'd toss on a simple item, like a cowboy hat, to go trick-or-treating.

Anna tells Yahoo Lifestyle that dressing up was "always something I said 'no' to," but following her daughters diagnosis, she "wanted to start saying 'yes' more."

The sisters' eyesight has already begun to deteriorate, causing night blindness and other issues.

"After realizing their vision would slowly keep deteriorating, creating visual memories and new traditions for our new life became so important to me," Anna says. "This is where my idea of dressing up to surprise them for Halloween came to me."

Even though Ava and Stella Rose are entering eighth and sixth grade, respectively, and they may be a bit embarrassed by their mom putting together an epic costume, they still talk about what Anna will surprise them with during the months before Halloween.

This year, Anna dressed as Lady Gaga, with the help of her friendMegan Massingill Engelmann.

"I think Lady Gaga was the perfect choice this year. We all love her," Anna tells Yahoo Lifestyle. "My focus with them this year is to make sure they know that God made them perfectly. God makes no mistakes. I hope they will always be true to who they are, no matter what."

Anna, the founder ofSisters for Sight, hopes to raise awareness of her daughters' type of Usher syndrome (Type 1B) and has recently teamed up withSave Sight Now, a foundation dedicated to finding a cure or treatment for childhood blindness related to Usher syndrome Type 1B.

She also hopes that this tradition will always be a happy moment for her daughters.

"I hope that when they are grown, they will look back and it will be a really special memory for them," Anna says. "If they do lose their sight, I hope they will always keep a visual memory of this tradition."

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Mom dresses up as Lady Gaga to 'create visual memory' for her daughters losing their sight - Yahoo Food

UK police are helping to make the roads safer by enforcing vision standards for driving.

Figures released to OT through the Freedom of Information Act reveal that since 2017 police have referred 801 drivers to the Driver and Vehicle Licensing Agency (DVLA) after they failed roadside eyesight checks.

In September last year, road safety charity Brake partnered with police forces in Thames Valley, Hampshire and West Midlands on a month-long campaign to raise awareness about vision and driving.

Drivers had their licence revoked if they could not pass the 20m number plate test.

Brake senior public affairs officer Samuel Nahk highlighted that good eyesight is fundamental to safe driving.

Any driver who gets behind the wheel with poor eyesight is not only putting themselves but all other road users in grave danger. That's why it's vital for drivers to get their eyes professionally checked at least every two years eyesight can deteriorate rapidly without someone noticing, Mr Nahk emphasised.

He shared that the current licensing system does not do enough to protect the public from drivers with poor eyesight.

It is of huge concern that there is no mandatory requirement on drivers to have an eye test throughout the course of their driving life, other than the 20m number plate test when taking the driving test. Only by introducing compulsory professional eye tests can we fully tackle the problem of poor driver vision on our roads, Mr Nahk said.

The DVLA has confirmed that 61,526 motorcycle and car drivers have had their licences revoked since 2012 as a result of poor vision, while 9941 bus and lorry drivers also lost their licences due to poor vision over the same period.

The rest is here:
Laying down the law - AOP

Last year a drunk pigeon won New Zealand Bird of the Year. It's time for our nation's staunchest bird of prey to take out the title, writesVICKI ANDERSON.

On the back country roads of NorthCanterbury, the sun dapples pleasantly through a lush green canopy of trees.Elbow out the window, travelling at a steady 100kmh,suddenly around a gentle blind corner you're confronted with life and death.

Staunchly hunched over acarcass, extracting the dead creature's organs with brutal and determined precision, the swamp harrier aka theharrier hawkor khu doesn't flinch when it spots the vehicle bearing down.

Scott Bowman

Oscar is a little blind owl ''who who who'' visits Christchurch schools and rest homes to teach people about wildlife.

Defiantly the hawk raises its angular head like a thug in an alleyway with a "what are you looking at?" vibe, a rabbit liver or heart dangling from its sharp beak.

READ MORE:*Bird of the Year campaigns to ruffle feathers*Oscar the blind owl winning hearts*Bird is the word - meet the everyday Kiwis saving feathered lives

These birds have "killer vision" so focused on their prey they often don't see cars until it's often too late.

But this time, with an exaggerated pause to gulp down the bloody morsel, the bird slowly and effortlessly unfurls its huge wings and saunters off into the sky with a wild elegance.

You cannot help but stare in awe as it returns to cruisinghigh above paddockand farmland.

The near miss story causes Scotty Bowman of Oxford Bird Rescue, a non-profit organisation dedicated to wildlife rehabilitation,to bury his face with both hands in genuine horror.

"Vehicle strikes are the biggest threat to harrier hawks in New Zealand," he says solemnly.

Beside him, wife and fellow "bird rehabber"Traceynodsin agreement.

JOHN KIRK-ANDERSON/STUFF

This harrier hawk is in rehab at Oxford Bird Rescue. Hawks often blink one eye at a time.

Every year during autumn, winter and early spring the Bowmans end up nursing many harriers back to health from vehicle-inflicted injuries.

New Zealanders value our wildlife, as evidenced by the continued public interest in the winner of the Bird of the Year competition.

The couple are among a growing number volunteering their time to care for injured wildlife.They run their bird rehab centre alongside regular jobs.

Bowman is also the campaign managerfor the harrier hawk in this year's Bird of the Year competition.Harrier (Khu) | Bird of the Year 2019

"On Facebook the campaign managershave been giving each other a bit of stick," he says. "Come on... adrunk pigeon won last year."

Why do our birds need our help to survive?

Clumsy kerer become drunk on fermented berries and crash into things trying to find their nests while our cheeky and photogenic kea get lead poisoning after nibbling just one roof too many.

Forget the cuddly image you've been sold ofpenguins via the sweet dance moves of Happy Feet.Unlike swans, which form monogamous bonds,penguins are the shaggers of the bird world.

Notoriously promiscuous, penguins have sex up to 50 times a day and are essentially riddled with sexually transmitted diseases. They are typically rescued after being bitten by peckish sharks, barracuda or becoming entangled in set nets.

The Bowmans specialise in caring for raptors - harrier hawks and little owls.

WReNNZ Wildlife Rehabilitators Network of New Zealand is a society dedicated to bird rehabilitation. It has been operating for more than 25 years and is open to anyone interested in New Zealand wildlife rescue, rehabilitation and release.

Khuare the largest of the 16 species of harrier. Mori believed them to be a messenger from the gods.

Boasting extremely sharp vision, they can spot the slightest movement from vast distances.

JOHN KIRK-ANDERSON/STUFF

Scotty Bowman, of Oxford Bird Rescue, is the campaign manager for the Harrier Hawk in the New Zealand Bird of the Year 2019. He is rehabilitating this bird after it flew into a front-end loader.

An opportunistic bird, they prefer to hunt live prey such as rabbits, hares, waterfowl, smaller birds, the occasional pkeko, rats and mice.

Scotty Bowman's life as a bird rehabber began in 2012when he hit a harrier hawk driving home from work.

After many phone calls, he found a bird rehabber who took it in and followed itsprogress until it was healed and returned to the wild.

"I got hooked in that way."

Early on,he found himself in some interesting situations.

"There was a hawk on the side of the road injured. I went to pick it up and it got a talon embedded in my hand," he says. "Itried to get it out but I couldn't.

"Eventually I drove home with one hand withthe bird on the passenger seat with the talon still in my other hand and when I got home I called out to Tracey to give me some help to free it."

He turns his hand over to reveal a small white scar.

Other people wear gloves to handle birds of prey but Bowman just reaches around themand deftly swoops them up, secures them and cradles them like an angry baby in his arms.

Fiercely blinking one eye at a time, a tawny-coloured bird stares stoically from its spot under Bowman's wing.

"That bird came from the Department of Conservation in Greymouth. He head-butted a front-end loader. They put him up on a bank and he sat there for two days and they realised something was wrong. I was in Queenstown and drove all the way through to Haast to go and get him."

JOHN KIRK-ANDERSON/STUFF

Bowman checks a Harrier Hawk that was injured after headbutting a front-end loader.

On average only onein 10 birds can be saved and successfully released into the wild.

"It's not the best in terms of figures," he says.

"They eat carrion all year around, but they much prefer fresh and to hunt. They only resort to carrion or roadkill during the colder months when other food becomes more scarce. Roadkill is their last choice basically. If they're eating that you're looking at a starving bird."

This year he has been on a campaign in the Oxford area to help change these statistics.

"Wherever safe to do so, we encourage people to stop and move carrion to the verge to provide a safe meal for these stunning raptors and save a life. It has been incredibly successful and we have had far less birds than usualbeing hit locally."

Natives, their conservation status is "not threatened". If anything some joke these savvy hunting birds are more likely to add to endangered lists, but they play an important part in our environment by both hunting pest species and cleaning up dead animals on farmland.

Each spring the hawks' mating dance is "incredibly dramatic".

Theaerial courtship is often called "sky dancing" and involves plunging u-shaped dives around each other and distinctive loud calls.

The bloke bird apparently offers a loud "kee-a", and maybe even a whistle,to which the female, if keen, responds with a "kee-o".

Ground nesters, they prefer to build nests in swamps and wetlands to lessen access by predators but will also nest in long grass and crop paddocks.

Keenly intelligent, these birds shrewdly selectand strategically placestones warmed by the sun to ensure the nest is kept warm while the motherhunts dinner.

"These birds are just so incredibly clever," says Bowman.

When he talks about hawks, he becomes increasingly animated.Just don't mention falconry. He is not a fan.

"No, don't get me started on that," he says, turning the palms of his hands up apologetically. "I'll get cross... it's not about the birds with them."

As we talk, the hawk which hit the front-end loader is unusually still. Its bright yellow eyes blink as it observes us. its tail feathers are incredibly beautiful up close.

"Most people don't get a chance to see them. They fly away so fast when you see them, it's really hard to get photos of them as anyone who has tried knows.Their eyesight is so fantastic they see you a mile away and move away, that's why it's so hard to get close to them,"Bowman says.

"He's quite unusual because he's so calm. He is probably still recovering from concussion. This bird is not stressed. If they are stressed they open their beaks and leave them open."

JOHN KIRK-ANDERSON/STUFF

Scotty Bowman with a harrier hawk that was injured after headbutting a frontend loader. Bowman is the campaign manager for the harrier hawk in the New Zealand Bird of the Year 2019.

He doesn't give the birds names because it "pays not to get too attached".

"Now and again a bird comes along that you can't help but name, like Hollywood the owl last year Tracey looks after the owlsbut we try not to as a rule."

Bowman gently weighs the stunned bird, which still has a dangling piece of meat in its beak,and then carries it to an outdoor aviary.

"He was very thin when he got here. I had to hand feed him for two days until I finally got him eating. He wasn't happy."

When rescued, the bird also had a "funny stance". Further X-rays showed one leg had an old break which had already fused.

The bird naturally stands with one leg forward like a footwear model.

"There is no nerve damage and he can still use his leg. I just need to build up his muscles."

As hawks age they lighten in colour, changingfrom a richchocolate brown as a juvenile to a mix of white and light tan.

Their eye colour also changes, starting out dark and turningyellow.

HARASSED HAWKS

While the native bush falcon is today considered a threatened species, retreating as forests have been cleared, the harrier hawk is more widespread than ever. According to conservation experts, the khuis "doing OK". This is quite impressive considering their haters.

Depending on what theyfarm, farmers adore and deplore hawksin equal measure.

Its fair to say many landowners have a complicated relationship with them.

Harrier hawks were once treated as vermin and suspected of stealing baby lambs but were given partial protection status in 1986.

However, landowners were still permitted to kill birds threatening their domestic birds and animals specifically "cattle, sheep, horses, mules, asses, dogs, cats, pigs or goats".

Butif a hawk is stalking your alpaca or your pet guinea pig, you can't shoot them without a special permit from DOC.

There are many other curious technicalities in the law when dealing with the hawks,Bowman says.

"Fish and Game decided to target harrier hawks a few years ago, 2014, and now they've almost got no protection. I think the Department of Conservation supported the law change because they cull them over areaswhere the black-billed gulls are. It makes it easier for them to run their culling programmes."

It is illegal to take any feathers from a hawk killed on the road.The fine for killing harrier hawks other than in accordance with the law is $5000 or $10,000 for a body corporate.

The Bowmans appreciate DoC's workbut also negotiatetheir own difficulties withsome of the regulations.

In 2016 they rescued a blind, tiny German owlfound beside a chicken coop by a young child. His mother called the Bowmans to help save his life and Oscar has lived with them ever since.

It is believed Oscar's blindness is a result offlying into the wire fence.

The disabled bird has since become an online hit and won hearts around Canterbury as fans follow his deeds on the Oxford Bird Rescue Facebook page.

Now an advocacy bird, he regularly visits schools, rest homes and other groups to raise awareness.

"We don't technically have a permit for Oscar. If they wanted to, technically DOC could say he needs to be culled," Bowman says.

"If he can't be returned to the wild he should be culled, that's typically what the rules say. It's always black and white for government departments. If Oscar could see we could release him back into the wild but we can't do that as he wouldn't survive. Why does he need to be killed? He's a beautiful bird. Life has a lot of grey areas and sometimes the rules don't fit that."

WILDERNESS REHAB

Seven hawks in various stages of rehabilitation are dangling on the aviary netting as far away from us as they can get, giant wings flapping frantically.

Their beaks are open slightly. We don't want to stress them out so we retreat to until their beaks close again.

Bowmanpoints out onebird. "He is just about ready to be returned to the wild. He was in a bad way when he came in here and now he's nearly fully healed. That's the best part of it, releasing them back where they came from. We always try to return them to the spot they were found."

Across the sprawling paddocks, magpies call to one another.

"That family of magpies has been living in those trees for decades," Bowman pointinto the distance. "They co-exist with these hawks but there was one hawk I rehabilitated and released. He left and then turned up one day about a year later. Everything was going well but then he ate one of the magpies' babies and they forced him out. He shouldn't have done that."

Two years ago the couple were caring for so many birds in their home shelter that it began to take a toll on their health.

A Massey University survey in 2017 looked at compassion fatigue exhaustion from prolonged exposure to the stresses of caring for sick and vulnerable wildlife among New Zealand wildlife rehabilitators.

It found most were able to keep a healthy balance, despite the pressures of the role, but this wasn't the case for the Bowmans.

"Because we are doing this around our 9-5 jobs and it is in our home, we took on too much, but now we have scaled it back to primarily concentrating on raptors to make it more manageable so we can keep going.Bird rescue is a lot of work and a big commitment but it is all worth it when you watch that effort result in a wild bird flying free."

Koshy Yohannan

Fran, aka Miss December in the 2017 Wingspan Calendar, is an adult female harrier hawk.

See the article here:
Khu vision: Why this harrier hawk is New Zealand's swaggiest bird - Stuff.co.nz