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Recycled Glasses Not The Solution For Developing Communities

May 3rd, 2012

Thembani waits for an eye examination at the Umlazi community hall near Durban, South Africa (Photo by Dean Saffron; courtesy of International Centre for Eyecare Education)

You might feel good sending your old reading glasses to a developing country. But a recent international study, led by the International Centre for Eyecare Education (ICEE), a collaborating partner in the Vision CRC, in Sydney, suggests it is far better to give $10 for an eye examination and a new pair of glasses if you want to help someone in desperate need, and it is far better for building capacity in these communities.

The study, recently published in the journal Optometry and Vision Science, found that only 7% of a test sample of 275 recycled glasses were useable and that this pushed the delivery cost to over $20 per pair. There are a wide range of ready-made glasses available, which can be supplied for around half the cost. Over 600 million people are unnecessarily blind or vision impaired globally simply because they need an eye examination and appropriate glasses.

Dr David Wilson, Research Manager Asia-Pacific, International Centre for Eyecare Education (Photo courtesy of International Centre for Eyecare Education)

Dr David Wilson, Research Manager Asia-Pacific for ICEE and head author on the paper, says that although the intention is good, recycled glasses are not a cost-saving method of correcting refractive error and should be discouraged as a strategy for eliminating uncorrected refractive error in developing countries. “While this is not the first argument against the use of recycled glasses there has been no accurate costing of their delivery,” he said.

Only 7% of the 275 recycled glasses analysed in the study were suitable for use he said. “The relatively small proportion of useable glasses contributed to the high societal cost of delivering recycled glasses, which was found to be $20.49, close to twice that of supplying ready-made glasses,” Dr Wilson added.

Co-author of the paper Professor Brien Holden, CEO of the Brien Holden Vision Institute, says that recycled glasses have a feel-good attractiveness to those that hand in their old glasses. “Although well intentioned, recycled glasses will neither suit many of those affected by the most common forms of vision impairment, nor provide a cost-saving solution to the problem,” he said.

“They are expensive to sort, clean and deliver and, in addition, the power of the lenses in a pair of glasses can differ greatly, meaning that a pair of recycled glasses is rarely the same as another person’s prescription,” Professor Holden said. “This research is extremely valuable in understanding the most efficient method to utilise the limited funding and resources currently available to address this massive need.”

Dr Wilson said a preferable method is to provide an eye exam and use ready-made or, even better, inexpensive custom-made glasses. Making the glasses locally helps build sustainable supply and fitting services in communities in need. “The peak international body in blindness prevention efforts, the International Agency for the Prevention of Blindness (IAPB), recommends that groups involved in eye care should not accept donations of recycled glasses nor use them in their programmes,” he said.

“Quality glasses are now being delivered in developing communities through the training of skilled personnel to conduct eye examinations and dispense ready-made glasses or by trained people such as spectacle technicians to custom make glasses,” he said. “Not only does this provide quality eye care, it enhances local capacity and helps build sustainable eye care systems,” he said.

 

“If people would like to contribute to this global effort I would urge them to support organisations that are involved in the Vision 2020 initiative of the World Health Organization and IAPB, including ICEE, that are working to eliminate avoidable blindness and vision impairment worldwide.”

The paper ‘Real Cost of Recycled Spectacles’ appeared in the March 2012 edition of Optometry and Vision Science.

The authors are David Wilson, Sonja Cronje´, Kevin Frick and Brien Holden.

Author affiliations are:
International Centre for Eyecare Education (DW, SC, BH), Vision Cooperative Research Centre (DW, SC,BH), School of Optometry and Vision Science (SC, BH), University of New South Wales, Sydney, Australia, Johns Hopkins Bloomberg School of Public Health, Baltimore, U.S. (KF), and Brien Holden Vision Institute, Sydney, Australia (KF, BH).

Abstract:
David A. Wilson, Sonja Cronje´, Kevin Frick, and Brien A. Holden, Real Cost of Recycled Spectacles, Optom Vis Sci 2012;89:304–309

Purpose:
Many programs aimed at mitigating the problem of uncorrected refractive error and the resulting avoidable blindness use recycled (donated) spectacles as a seemingly inexpensive expedient. This article analyses the costs and benefits of recycled spectacles and compares them with alternative methodologies. Although well intentioned, it is argued that recycled spectacles will neither suit many of those affected by uncorrected refractive error nor provide a cost saving solution to the problem. Although this is not the first argument against the use of recycled spectacles, there has been no accurate costing of their delivery. This article assesses the real cost of delivery of recycled spectacles.

Methods:
The useable quantity of recycled spectacles was determined by examining two separate batches of donated spectacles. These data were used in the calculation of the cost of delivery. The metric used for comparison was only cost (i.e., it was a cost minimization analysis) because it was deemed that recycled spectacles and readymade spectacles were the same mode of correction fundamentally.

Results:
Only 7% of the 275 recycled spectacles analyzed were suitable for use. The relatively small proportion of useable spectacles contributed to the high societal cost of delivering recycled spectacles, which was found to be U.S. $20.49, more than twice the cost of supplying ready-made spectacles.

Conclusions:
Recycled spectacles are not a cost-saving method of correcting refractive error and should be discouraged as a strategy for eliminating uncorrected refractive error in developing countries.

For the full version of the paper click through to Optometry and Vision Science.

To find out more about Vision 2020: The Right to Sight go to: www.v2020.org


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Stem Cells Can Repair A Damaged Cornea

April 24th, 2012

A new cornea may be the only way to prevent a patient going blind – but there is a shortage of donated corneas and the queue for transplantation is long. Scientists at the Sahlgrenska Academy have for the first time successfully cultivated stem cells on human corneas, which may in the long term remove the need for donators.

Approximately 500 corneal transplantations are carried out each year in Sweden, and about 100,000 in the world. The damaged and cloudy cornea that is turning the patient blind is replaced with a healthy, transparent one. But the procedure requires a donated cornea, and there is a severe shortage of donated material. This is particularly the case throughout the world, where religious or political views often hinder the use of donated material.

Replacing donated corneas
Scientists at the Sahlgrenska Academy, University of Gothenburg, have taken the first step towards replacing donated corneas with corneas cultivated from stem cells.

Scientists Charles Hanson and Ulf Stenevi have used defective corneas obtained from the ophthalmology clinic at Sahlgrenska University Hospital in Mölndal. Their study is now published in the journal Acta Ophthalmologica, and shows how human stem cells can be caused to develop into what are known as “epithelial cells” after 16 days’ culture in the laboratory and a further 6 days’ culture on a cornea. It is the epithelial cells that maintain the transparency of the cornea.

Scientist Charles Hanson

First time ever on human corneas
“Similar experiments have been carried out on animals, but this is the first time that stem cells have been grown on damaged human corneas. It means that we have taken the first step towards being able to use stem cells to treat damaged corneas”, says Charles Hanson.

“If we can establish a routine method for this, the availability of material for patients who need a new cornea will be essentially unlimited. Both the surgical procedures and the aftercare will also become much more simple”, says Ulf Stenevi.

Few clinics conduct tranplants
Only a few clinics are currently able to transplant corneas. Many of the transplantations in Sweden are carried out at the ophthalmology clinic at Sahlgrenska University Hospital, Department of Ophthalmology, Mölndal.

The article “Transplantation of human embryonic stem cells onto a partially wounded human cornea in vitro” was published in Acta Ophthalmologica on 27 January.

www.sahlgrenska.gu.se

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The Eyes Are The Window Into The Soul—Or At Least The Mind

March 2nd, 2012

The eyes are the window into the soul – or at least the mind, according to a new paper published in Perspectives on Psychological Science, a journal of the Association for Psychological Science. Measuring the diameter of the pupil, the part of the eye that changes size to let in more light, can show what a person is paying attention to. Pupillometry, as it’s called, has been used in social psychology, clinical psychology, humans, animals, children, infants – and it should be used even more, the authors say.

Bruno Laeng

The pupil is best known for changing size in reaction to light. In a dark room, your pupils open wide to let in more light; as soon as you step outside into the sunlight, the pupils shrink to pinpricks. This keeps the retina at the back of the eye from being overwhelmed by bright light. Something similar happens in response to psychological stimuli, says Bruno Laeng of the University of Oslo, who cowrote the paper with Sylvain Sirois of Université du Québec à Trois-Rivières and Gustaf Gredebäck of Uppsala University in Sweden. When someone sees something they want to pay closer attention to, the pupil enlarges. It’s not clear why this happens, Laeng says. “One idea is that, by essentially enlarging the field of the visual input, it’s beneficial to visual exploration,” he says.

Sylvain Sirois

However it works, psychological scientists can use the fact that people’s pupils widen when they see something they’re interested in.

Laeng has used pupil size to study people who had damage to the hippocampus, which usually causes very severe amnesia. Normally, if you show one of these patients a series of pictures, then take a short break, then show them another series of pictures, they don’t know which ones they’ve seen before and which ones are new. But Laeng measured patients’ pupils while they did this test and found that the patients did actually respond differently to the pictures they had seen before. “In a way, this is good news, because it shows that some of the brains of these patients, unknown to themselves, is actually capable of making the distinction,” he says.

Gustaf Gredebäck

Pupil measurement might also be useful for studying babies. Tiny infants can’t tell you what they’re paying attention to. “Developmental psychologists have used all kinds of methods to get this information without using language,” Laeng says. Seeing what babies are interested in can give clues to what they’re able to recognize – different shapes or sounds, for example. A researcher might show a child two images side by side and see which one they look at for longer. Measuring the size of a baby’s pupils could do the same without needing a comparison.

The technology already exists for measuring pupils – many modern psychology studies use eye-tracking technology, for example, to see what a subject is looking at, and Laeng and his coauthors hope to convince other psychological scientists to use this method.


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Report Shows Risk of Blindness Halved Over Last Decade

February 21st, 2012

Age-related macular degeneration (AMD) is the most frequent cause of blindness in the Western World. A report from the University of Copenhagen and Glostrup Hospital in Denmark shows the number of new cases of blindness and severe visual loss in Denmark has been halved during the last ten years.

The study published in American Journal of Ophthalmology examined the records of 11,848 new cases of legal blindness. The rate of blindness from AMD fell from 522 cases per million inhabitants aged 50 years or older in 2000, to 257 cases per million in 2010, a reduction by over 50 per cent.

The bulk of the decrease occurred after 2006, following the introduction of new effective treatment for wet AMD, which is characterized by leaking blood vessels having formed under the fovea. The treatment consists of repeated injections into the eye of a medication that inhibits the signalling molecule vascular endothelial growth factor (VEGF).

Similar findings in Israel
The observations from Denmark were published together with a corroborating report from Israel that found comparable changes in the incidence of legal blindness in that country. Read the report “Time Trends in the Incidence and Causes of Blindness in Israel”.

Current treatment of wet AMD, also called neovascular AMD, consists of repeated injections into the vitreous, an inner compartment of the eye, of a medication designed to inhibit the action of VEGF. VEGF is a distress signal released from ailing cells of the aging retina. VEGF can cause formation of brittle blood vessels that leak blood and cause scar formation under the fovea. The fovea is central area of the retina where reading vision is located. Wet AMD is a very frequent cause of loss of reading vision.

Michael Larsen

Results show impact on public health
One of the authors behind the Danish study, Michael Larsen, Professor of Clinical Ophthalmology at the University of Copenhagen, is excited about the results.

“The massive implementation of modern wet AMD therapy has been a challenge. It is therefore very important that we can now show an impact on public health and it is wonderful to see a reduction in severe visual loss. The study did not examine moderate visual loss, but there are undoubtedly also a lot of people who avoided loosing their drivers license and their reading vision,” says Michael Larsen.

A turning point in eye care
The data for the study is provided by Danish Association of the Blind, which membership enrollment during the period of 2000-2010 was charted and categorized by diagnoses.

“The reduction in new cases of blindness is a turning point for eyecare in Denmark. We look forward to seeing further progress in eye research, especially in the hereditary eye diseases that cause blindness in children and young adults,” says Thorkild Olesen, Chairman of the Danish Association of the Blind.

www.ku.dk

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Exfoliation Syndrome Can Develop Based On Age, Gender and Where You Live

February 9th, 2012

When it comes to whether or not you will develop exfoliation syndrome (ES) – an eye condition that is a leading cause of secondary open-angle glaucoma and increased risk of cataract as well as cataract surgery complications – age, gender and where you live does matter.

“Although many studies from around the world have reported on the burden of the disease, some aspects of the basic descriptive epidemiologic features, which may help shed light on the cause, are inconsistent,” said Louis Pasquale, M.D., study co-author and director of Massachusetts Eye and Ear’s Glaucoma Center of Excellence. “In this study we found that women are more vulnerable to this disease then men, that ES is not a disease of Norwegian descent, and that where you live does matter when it comes to developing the disease.”

Louis Pasquale, M.D.

Researchers from the Mass. Eye and Ear, Harvard Medical School, Boston, Mass., Department of Medicine, Channing Laboratory, Brigham and Women’s Hospital, Boston, Mass., Department of Ophthalmology and Visual Sciences, and University of Michigan, Ann Arbor, Mich., set out to find out how demographic and geographic risk factors are associated with ES. Their study, the “Demographic and Geographic Features of Exfoliation Glaucoma in two United States-Based Prospective Cohorts” is published in the January 2012 issue of Ophthalmology.

Researchers used data from 78,955 women in the Nurses’ Health Study (NHS) and 41,191 men in the Health Professionals Follow-up Study (HPFS) residing throughout the continental United States who were prospectively followed for 20 years or more and who provided lifetime residence information to examine the descriptive epidemiologic features of ES or exfoliation glaucoma suspect (EGS).

This study confirmed established associations with age and family history and exfoliation glaucoma or exfoliation glaucoma suspect (EG/EGS), as well as provided new data on associations with gender, eye color and ancestry. “Importantly, those with a lifetime residential history of living in the middle tier and south tier of the United States was associated with 47% and 75% reduced risks, respectively, compared with living in the northern tier, and across the life span, residence at age 15 was the most strongly associated with risk, followed by current residence,” the authors wrote.

The study showed an increased risk in females, but it was unclear as if gender-specific differences in the eye, such as axial length differences or environmental factors related to lifestyle, account for why women are more at risk for this disease.

Other findings include:

  • A positive family history of glaucoma was associated with a more than doubling of risk.

  • Neither Scandinavian decent nor Southern European ancestry was associated with risk when compared with the larger reference group of mainly other white persons in the study, which indicates that there may be strong environmental factors that may increase risk among populations in Scandinavian countries. Overall the study lacked adequate power to determine whether incidence rates differed by minority groups.

  • Iris (eye) color did not seem to be a risk factor.

“This large prospective cohort study demonstrates that there is a positive association between latitude and ES risk that is robust and not related to demographic features or other systemic covariates,” Dr. Pasquale explained. “Another manuscript we published recently suggests that lower ambient temperature interacts with increased solar exposure to increase the risk of ES. This new work demonstrates a relation between increasing latitude and a condition with a strong predisposition to glaucoma. More work is needed to determine how environmental factors conspire to contribute to ES.”

According to the National Eye Institute, ES is the major known cause of open-angle glaucoma, and is one of the leading causes of blindness. With the rapid aging of the U.S. population, the number of individuals affected by the disease will increase to more than three million by 2020.

About Massachusetts Eye and Ear
Founded in 1824, Massachusetts Eye and Ear Infirmary is an independent specialty hospital providing patient care for disorders of the eye, ear, nose, throat, head and neck. Mass. Eye and Ear is an international leader in Ophthalmology and Otolaryngology research and a teaching partner of Harvard Medical School. Under the direction of Mass. Eye and Ear’s board of directors, the Massachusetts Eye and Ear and Schepens Eye Research Institute recently formed the world’s largest and most robust private basic and clinical ophthalmology research enterprise. For more information, call 617-523-7900 or visit http://www.masseyeandear.org/.

www.masseyeandear.org

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l.a.Eyeworks Announces Landmark Publication of FRAMED: Greg Gorman for l.a.Eyeworks

January 19th, 2012

l.a.Eyeworks announces the publication of FRAMED, an extensive, lavishly printed survey of photographer Greg Gorman’s timeless artistry, and a catalogue of the provocative personalities that have defined l.a.Eyeworks’ idiosyncratic take on contemporary culture from 1982 to the present. A fleet of 171 fabulous faces are gathered together for the first time in this much-anticipated hardcover volume. As a spectacular demonstration of Gorman’s signature command of the black and white portrait, FRAMED presents an astonishing array of bold personalities transformed by the groundbreaking eyewear designs of Barbara McReynolds and Gai Gherardi for l.a.Eyeworks. The iconic portraits that comprise the l.a.Eyeworks advertising campaign define both a significant chapter in the history of eyewear and an influential re imagining of the concept of celebrity endorsement. With portrait subjects ranging from mega-bright stars to the lesser-known orbits of the avant-garde, FRAMED is a compelling glimpse into three decades of culture, glamour, fashion, . . and great glasses. Or, as the legendary tagline states quite simply, “A face is like a work of art. It deserves a great frame.”

l.a.Eyeworks Campaign History

The portrait ad campaign launched in the early ‘80s when l.a.Eyeworks was generating waves of go-to buzz as a retail storefront on Melrose Avenue—a street that would map itself into history as the global focal point for the West Coast punk and new wave movements. At that time, Andy Warhol’s Interview magazine was the barometer of all things hip on the cultural radar. The l.a.Eyeworks ad campaign was born of the slightly outrageous idea of a single shop in Los Angeles taking a full-page ad in this notorious national magazine. Jeff Gorman and Gary Johns created the enduring tagline and the graphic layout (which has run largely unaltered since its inception). A photographer in rapidly growing demand, Greg Gorman shot his first portrait for the campaign in 1982. The subject was actor Paul Reubens from The Groundlings improv theater, (located just two blocks away from l.a.Eyeworks) who starred in the ad as his cult figure persona, Pee-wee Herman. The photo featured Herman wearing “The Beat,” McReynolds’ and Gherardi’s first frame design for l.a.Eyeworks. As the portrait ads began to appear in Interview and other periodicals, they created an instant sensation, and have since run continuously in print publications worldwide. With more than 200 subjects in its canon (171 are published in FRAMED), perhaps no other print campaign operating under a single tagline can lay claim to the diversity and duration of this unique legacy.

The Subjects

The combination of Greg Gorman’s artistry and l.a.Eyeworks’ iconoclastic frame designs creates a vibrant alchemy of generation-defining images. Celebration of the face guides the portraits and the campaign not only blurs the lines between high and low culture, pop and fine art, celebrity and the underground, but makes those distinctions irrelevant. Legends like Sharon Stone, John Waters, Iman, Pierce Brosnan, Frank Zappa and Grace Jones mingle on the same turf as Louise Lecavalier, Buck Henry, Patricia Hearst, John Sex, Elizabeth Streb and the Chinese women’s basketball player Zheng Haixa. The l.a.Eyeworks portrait ad campaign interrogated, as much as it celebrated, notions of fame, beauty, gender, and attraction-all seen through the prism of glasses. McReynolds and Gherardi note in their introductory essay to FRAMED,

“We have been guided less by celebrity and more by the exotic, the outrageous, the
re-invented, the overlooked, the idiosyncratic, the colorful, the uncensored, and the rule
breaking.”

Performer/artist John Kelly, fashion designer Phillipe Blond, model/media figure Jenny Shimizu, and Cirque du Soleil aerialists Kevin and Andrew Atherton are among the most recent additions to the campaign’s roster of participants.

The Publication

FRAMED is published by Grafiche Damiani in Italy in an exclusive hardcover edition. Greg Gorman personally supervised the printing of the photographs.

FRAMED: Greg Gorman for l.a.Eyeworks (Grafiche Damiani, 2011), hardcover, 192 pages. Foreword by Ingrid Sischy. Introductory essays by David Fahey, Greg Gorman, Barbara McReynolds & Gai Gherardi, Rose Apodaca, Jeff Gorman, Gary Johns. US $50; EU €35. Currently available for purchase in the U.S. at www.laeyeworks.com/framed and at l.a.Eyeworks retail stores in Los Angeles. For purchase inquiries worldwide, contact framed@laeyeworks.com.

 

About l.a.Eyeworks

Radically disrupting mere utility, the Women of l.a.Eyeworks reinvented the proportionality of the “Face.” Never again will the lines holding the ability to “see better” seem ordinary. — Elizabeth Streb

Established in 1979 as the first house of optical design in Los Angeles, l.a.Eyeworks’ imaginative and uniquely crafted frames—designed by co- founders Barbara McReynolds and Gai Gherardi—have changed the way people think about eyewear. In addition to its groundbreaking ideas for glasses, l.a.Eyeworks’ pursuit of “uncensored visions” has redefined perceptions with explosive marketing concepts, including its signature advertising campaign photographed by Greg Gorman. Known to frame lovers worldwide, the outrageous, expressive lexicon of l.a.Eyeworks has infiltrated the pop culture landscape from fashion to publishing to art and film.

 

About Greg Gorman

Greg Gorman and l.a.Eyeworks are a winning combination. Greg’s legendary images made you want to be a movie star, and in turn, his photos made movie stars. But that is just a small facet in the trajectory of a unique career that has withstood the test of time. Through his lens, Greg captures the beauty of the human face like no other. A photographic portrait artist who puts his heart and soul into his art, Greg lives his life with passion and grace, courage and compassion, and loves a good wine. — Pierce Brosnan

Over the past 40 years, Greg Gorman has photographed famous and infamous faces for film, music, politics, sports, advertising and pleasure. Greg continues to seek out projects worldwide that both grant him new experiences and provoke his inspiration. Between spending time at his homes in Los Angeles and Mendocino, where he also teaches, Greg conducts workshops and lectures internationally, and hosts exhibitions of his fine art photography. This compilation follows Greg’s previously published works Volume I, Volume II, Inside Life, Perspectives, As I See It, Just Between Us, The Odes of Pindar and In Their Youth.

www.laeyeworks.com

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Protein In Fruit Fly Eye May Shed Light On Blinding Diseases

December 23rd, 2011

Researchers at the University of Wisconsin-Madison and collaborators have discovered a powerful new protein in the eye of the fruit fly that may shed light on blinding diseases and other sensory problems in humans. Reporting in the Nov. 16, 2011, issue of Neuron, the scientists note that similar but yet-to-be-identified proteins in the eye and brain could help explain age-related macular degeneration and retinitis pigmentosa, as well as Huntington’s, Parkinson’s, Alzheimer’s and prion diseases.

The protein, which the scientists have named XPORT, serves as a molecular chaperone for two important proteins that are key to sensory activities in the eye. One protein, rhodopsin, is responsible for absorbing light, and the other protein, TRP, is a channel that plays a role in calcium influx into cells. XPORT guides the two proteins from the place where they are made in the cell to the location where they do their jobs.

Dr. Nansi Jo Colley

This intricate process of chaperoning includes synthesis, folding, assembly, quality control, transport and targeting of proteins to their appropriate locations, explains senior author Dr. Nansi Jo Colley of the UW School of Medicine and Public Health. The complex process is prone to error, and a malfunction in any of the steps can have dire consequences in tissues. Colley and her team discovered XPORT as a result of screening a collection of 900 fruit-fly mutants that undergo retinal degeneration. The XPORT mutant displayed retinal degeneration and defects in rhodopsin and TRP.

In their experiments, the scientists showed that XPORT forms a complex with rhodopsin and TRP, and is required to successfully transport the two proteins to a specific location on the cell surface. They also determined that XPORT is essential for cell survival-mutations in XPORT prevented the two proteins from moving through the trafficking pathway, and this ended in retinal degeneration and blindness in the fly. XPORT was also found to interact closely with another family of molecular chaperones called heat shock proteins, which are indispensable in the folding of newly synthesized proteins. While XPORT is an eye-specific protein that is expressed in flies and other insects, Colley expects that a protein very similar to XPORT exists in humans.


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Meet John Lennon’s Optometrist: The Man With Kaleidoscope Eyes

December 5th, 2011

I was John Lennon’s optometrist for the last four years of his life, when he and Yoko lived on the Upper West Side of New York City. Thirty years later, patients are still asking what he was like. Here are some of my memories.

A Day In The Life

I first met John and Yoko in 1975. I had opened my practice a year earlier, at 284 Columbus Avenue. Back then, the neighborhood was still kind of “iffy.”

One winter night near closing, I noticed a couple gazing into the store, their faces pressed against the window. Minutes later, my friend Neil, owner of the flower shop next door, stopped in to tell me “That was John Lennon and Yoko Ono!”

I was excited, but not shocked. John and Yoko had moved into the Dakota apartment building on West 72nd Street in 1973, and sightings of the famous couple on the Upper West Side were common.

The next night, again near closing, I was finishing up with a patient when I heard an unmistakable British-accented voice inquiring about an eye exam. My receptionist—a middle-aged woman from Guyana who didn’t recognize our new walk-in—replied that she would be glad to set up an appointment.

Immediately, I bolted from the examination to explain that I was nearly done. Could I examine him momentarily? John agreed.

Dr. Gary Tracy O.D.

I remember my heart pounding while thinking, “I’d better get this prescription right!” I imagined headlines: “John Lennon Trips During Concert, Blames Optometrist for Poor Prescription,” or “Ex-Beatle Now Blind—Optometrist Charged with Misdiagnosis.”

Despite my nervousness, I managed to get through the exam. John picked out some new frames. He always knew exactly what he wanted, staying true to the round or slightly off-round (P3) shapes he had made famous as a Beatle. He also insisted on cable temples (wraparounds), explaining they kept his frames on while jumping around on stage.

At the end of the visit, I asked John for his telephone number to let him know when his glasses were ready. He appeared hesitant. But he seemed pleased, even amused, when I offered to write it on the back of his file in code, and he gave me the number.

The Ballad of John and Yoko

John was a regular for the next four years. Between 1975 and 1979, John had two complete eye exams, purchased more than a dozen pairs of glasses, and dropped in frequently for adjustments and repairs.

John and Yoko almost always arrived around closing time. After taking care of business, they would sit and chat for a while. Just small talk, usually about things going on in the neighborhood.

During those four years, Yoko never availed herself of my services. She mostly stayed in the background, always quiet, polite and non-assuming. Although John often came in alone, I felt that when Yoko was present, she had a calming, soothing effect on him.

One day, John came with his son Julian, who was visiting from England. In a fatherly manner, he recommended that Julian should make sure that his frames had wraparound temples, similar to John’s preference. Julian selected an aviator shape that was popular at the time, and I managed to find one with the wraparound temples, so he could fulfill his father’s recommendation.

One day John and Yoko dropped by to pick up new eyeglasses. John was toting a tiny baby in a papoose carrier on his back. They told me that this was the first time they’d ventured out of the Dakota in public with their newly born son Sean.

Working Class Hero

I never asked John about The Beatles or being a celebrity. From what I learned later, he had an ordinary, blue-collar upbringing. I really think he enjoyed being in an environment where he was treated like an ordinary person.

Still, I remained somewhat in awe. One day, knowing John was coming in, I brought in a beat up copy of “A Spaniard in the Works,” an obscure book of John’s sketches and poems I’d purchased for 25 cents in one of the neighborhood antique stores. I was secretly hoping he would offer to sign it. He seemed pleased to see the book, but did not offer to autograph it—and I didn’t feel comfortable asking.

Another time, John and I were chatting in my office when he suddenly paused in mid-sentence: “Is that Paul?” I was taken aback, because there was no one else in the office or visible on the sidewalk outside the window. I asked John whom he meant. He had heard Paul McCartney’s voice singing from my radio upstairs. I wasn’t even aware the radio was on. I realized then how finely attuned John was to the music of his former band mate.

Several long-time patients fondly remember encountering John in my office, offering advice on the frames they were trying on. One patient recalls trying on contact lenses when John’s voice surprised him from behind: “I tried to wear them, but the only way I could keep them in my bloody eyes was to get bloody stoned first.”

Help!

One afternoon, walking back from lunch to my office on Columbus Avenue, I spotted John coming toward me. He seemed shaken. He told me that someone had been following him all morning, and asked me to accompany him. He thought that if we drew attention to this person, then he would leave. Pointing to a disheveled person with a trench coat, John started yelling, “That’s the person who’s been following me.” I joined John, pointing and yelling, “That’s the person!”

It worked. He sped up and disappeared around the corner. John and I walked to my office, where I locked the door. John stayed until he was sure the person was completely gone.

The cover of Yoko Ono’s 1981 album depicts John Lennon’s blood-spattered glasses. Dr. Gary Tracy believes these were a pair he ordered for John Lennon.

On one of his last visits to my office, John finally strayed from his usual metal round frame. Wanting something different for his new sunglasses, he selected a rectangular, clear plastic frame with dark gray lenses. I believe these are the glasses that appear in photographs with bloodstains on them, on the tragic night he was killed on December 8, 1980.

A couple of years after John’s death, Yoko came in for an exam. Seated in the examination chair, tears welled in her eyes as she reminisced about John, and expressed concern that Sean was now old enough to recognize and hear negative publicity about his father. She asked if I would meet with Sean to share my experience with the “real” John. I agreed, but a meeting was never arranged. I never saw or heard from Yoko again.

Years later, Sean did come in, with a prescription in hand. I made many pairs of glasses for him over the years.

When I was young, I sometimes questioned whether I’d made the right decision to become an optometrist and move to New York. But it has been a privilege to be a part of the Upper West Side for so many years.

Being an independent optometrist in New York City has given me the opportunity to know many fascinating and diverse people, both celebrities and non-celebrities. Where else would I have had the opportunity to meet someone like John Lennon?

by Gary Tracy, O.D.
Article Source: Review of Optometry

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Pharmaceutical Platform May Produce Unintended and Undesirable Effects on Eye Function

November 27th, 2011

According to new research by University of Kentucky investigators, an emerging pharmaceutical platform used in treating a variety of diseases may produce unintended and undesirable effects on eye function. The paper, “Short-interfering RNAs Induce Retinal Degeneration via TLR3 and IRF3″, appears in the current online edition of the journal Molecular Therapy, a publication of the Nature Publishing Group and the American Society of Gene and Cell Therapy.

“Short-interfering RNA (siRNA) technology has been regarded as one of the most exciting emerging platforms for new pharmaceuticals,” said Dr. Jayakrishna Ambati, professor of physiology, and professor and vice chair of ophthalmology and visual sciences at UK.

Prof. Dr. Ernst Bamberg

To this point, siRNA drugs have been the subject of clinical trials past and present for a variety of disorders including: cancers, viral respiratory infections, hypercholesterolemia, macular degeneration, diabetic retinopathy and glaucoma. Major obstacles to realizing the therapeutic potential of siRNAs include delivery of the drug into cells and a generic suppression of blood vessel growth through immune activation, as shown by a 2008 paper from the Ambati group in the journal Nature.

“We now show a new undesirable effect of siRNAs that are 21 nucleotides or longer in length: these siRNAs, regardless of their sequence or target, can cause retinal toxicity. By activating a new immune pathway consisting of the molecules TLR3 and IRF3, these siRNAs damage a critical layer of the retina called the retinal pigmented epithelium (RPE). Damage to the RPE cells by siRNAs can also lead to secondary damage to the rods and cones, which are light-sensing cells in the retina,” said Ambati.

The scientists’ findings indicate that caution should be applied when designing or using siRNAs intended for either direct application to the eye, or intended for use in a way that may allow the drug to access the eye.

“Another novel aspect of this research is that the RPE degeneration caused by siRNAs resembles the pathology seen in the advanced form of age-related macular degeneration called geographic atrophy, said Ambati. “As there are few models of geographic atrophy, which affects millions of people worldwide, this paper provides an important advance for research in developing new treatments for this disease.”

Because the research shows that siRNAs shorter than 21 nucleotides in length can evade the TLR3-IRF3 off-target immune response, it may be possible to achieve therapeutic effects without retinal damage by designing shorter siRNAs.


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Chlamydia Trachomatis Bacteria Used as a Vaccine To Prevent Trachoma, The World’s Leading Cause of Infectious Blindness

November 25th, 2011

An attenuated, or weakened, strain of Chlamydia trachomatis bacteria can be used as a vaccine to prevent or reduce the severity of trachoma, the world’s leading cause of infectious blindness, suggest findings from a National Institutes of Health study in monkeys.

Anthony S. Fauci, M.D.

“This work is an important milestone in the development of a trachoma vaccine,” noted Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID) at NIH. “If this approach demonstrates continued success, the implications could be enormous for the tens of millions of people affected by trachoma, a neglected disease of poverty primarily seen in Asia and sub-Saharan Africa.”

In their study, published in the Journal of Experimental Medicine online, scientists from NIAID, led by Harlan Caldwell, Ph.D., describe how they tested their vaccine concept in a series of experiments. First they infected six cynomolgus macaques with the strain of C. trachomatis that they had weakened by removing a small piece of DNA. The scientists observed that the monkeys spontaneously cleared the infection within 14 days with no or minimal signs of ocular disease. The animals then were exposed twice more to the weakened strain at four- and eight-week intervals, but the animals still showed no signs of trachoma despite being infected.

Harlan Caldwell, Ph.D.

According to Dr. Caldwell, this finding is particularly significant because repeated C. trachomatis infections typically lead to more severe eye disease in people. The infected animals did not develop eye disease, and they all mounted robust immune responses.

The same six macaques then were exposed to a highly virulent strain of C. trachomatis as were six other macaques in a control group that had not been vaccinated. Three of the macaques in the vaccine group showed no signs of infection or disease, and the three others showed greatly reduced infection compared with monkeys in the control group. All six macaques in the control group became infected and displayed moderate to severe eye disease that persisted for between two and four months.

Macaques are used in trachoma studies because their immune responses closely predict those of humans. The animals in the study were treated with antibiotics after completion of the experiments, and all recovered completely.

The NIAID researchers are currently exploring how they can move their vaccine into human clinical trials.

Tracomatous Scarring: The presence of scarring in the tarsal conjunctiva. Scars are easily visible as white lines, bands, or sheets in the tarsal conjunctiva.

If left untreated, prolonged trachoma infection can cause a person’s eyelids to fold inward, so that the eyelashes rub the eyeball and scar the cornea. This can result in impaired vision and sometimes blindness. Trachoma is treatable with antibiotics, although in many parts of the world people have limited access to treatment. Currently, there is no vaccine for trachoma. Trachoma experts estimate that approximately 1.3 million people are blind from trachoma, 1.8 million people have low vision as a result of the disease, and an estimated 40 million people have active trachoma. Trachoma is most often spread through direct personal contact, shared towels and other cloths, and flies that have come in contact with the eyes or nose of an infected person.

Chlamydia diseases include sexually transmitted infections, which can result in pelvic inflammatory disease that can cause infertility in women, as well as trachoma. According to the NIAID researchers, findings from this study also could lead to the development of a vaccine against sexually transmitted Chlamydia infections. The Centers for Disease Control and Prevention received more than 1.2 million reports of Chlamydia infections in 2009.


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