What is an OCT and do I need to have one?

OCT stands for Optical Coherence Tomography. This scanning technology allows us to ‘see’ tissue behind the visible retina inside the eye. In the past 5 years OCT has changed the way we
can assess eyes, becoming invaluable in management of conditions such as Macular Degeneration (MD) and Glaucoma.

When we see signs of MD in a regular examination we can take an OCT scan to ‘see’ what is happening in the underlying retina. In particular we want to spot Wet MD which can cause more devastating vision changes. When there is fluid  accumulating in the macula the OCT shows us where this is - very important to make timely referrals for treatment.

The detailed measurements of the nerve fibre layer in the retina are particularly helpful when we are looking for Glaucoma. Starting with signs in a routine examination, OCT is often the next step. Careful monitoring over time allows us to see changes, possibly before these have caused any vision loss, which is early detection.

But OCT is not a magic bullet, and it cannot stand alone. It’s a tool and interpreting the results needs careful consideration along with all other clinical findings. Recently there has been promotion of OCT at every examination and the benefits this will bring. At the end of the day an OCT scanner is not an optometrist. Scans should be recommended when they will provide useful additional information.

We are committed to using all our available diagnostic tools and we strongly believe the best place to start is our comprehensive eye examination. The simple, vital step of spending time to collect relevant history, which requires careful listening and no technology, guides us to the best combination of diagnostic testing needed including OCT.

Meditation Linked to Helping Glaucoma Patients

We are always keen to hear ways our lifestyle can positively benefit our health, read on. A study by doctors at the All India Institute of Medical Sciences (AIIMS) has found that lowering eye pressure in people with glaucoma can be achieved by meditating.

Glaucoma, a disease which damages the optic nerve of the eye, is the leading cause of blindness in India, impacting over 12 million people.

“Lowering eye pressure is the only proven therapy for glaucoma and this is currently achieved with eye drops, laser therapy or surgery. Like all medications, eye drops have a cost and side effects, and many struggle with drops as a lifelong therapy,” said Dr. Tanuj Dada, Professor of Ophthalmology at the RP Centre, AIIMS.

90 glaucoma patients were selected and randomly divided into two groups. One group was required to perform meditation and breathing exercises, as instructed by a yoga instructor, for an hour each morning over 21 days as well as take their glaucoma medications. The second group only took glaucoma medications.

After three weeks the results showed significant reduced eye pressure (mean pressure falling from 19 mmHg to 13 mmHg) in the meditation group. Changes to stress hormones and improved wellbeing were also recorded for this group.

Positive changes were also seen in the expression of retinal ganglion cell and optic nerve genes, which could potentially protect the eye from future damage and blindness.

“We know that glaucoma patients have high levels of anxiety and stress as they suffer from a potentially blinding disorder. We also are aware of the fact that stress leads to elevation of blood pressure but seldom think about its impact on eye pressure,” said Dr. Raj Kumar Yadav, Professor in-charge of Integral Health Clinic, Department of Physiology at AIIMS.

“This is the first study in the world which offers robust scientific evidence for lowering eye pressure with meditation, by targeting the brain and improving both the eye condition as well as general health of the patients,” he said.

The meditation technique is simple and can be easily learnt by all glaucoma patients. It is important to remember that patients should not stop using their glaucoma medications, and regular eye checks should continue as usual.

The study was funded by the Ministry of AYUSH.

What are the side effects of my glaucoma eye drops?

Most medications have some side effects, which are balanced against the health benefits. Fortunately serious side effects from eye drops are very uncommon. One of the fact sheets published by Glaucoma NZ outlines Eye Drop Side Effects - it is a good reference. This is part of their drive to support and inform people with glaucoma.

Ginkgo Biloba - a natural approach to glaucoma

Many of us are keen to make choices which have a positive impact on health, and there is always interest in alternative treatments. In glaucoma the most widely known alternative treatment is ginkgo biloba.

Glaucoma treatment largely focuses on lowering eye pressure. But it is accepted that other risk factors besides eye pressure are involved - even an ideal eye pressure does not stop glaucoma progressing for all people. If you are looking at the clinical studies, lowering eye pressure is the only treatment which has high levels of scientific evidence to support its efficacy. However there are many studies which have tried to identify other treatments for glaucoma.

Used in Chinese traditional medicine for centuries, extracts of ginkgo biloba leaves have been suggested to treat various conditions, including dementia, tinnitus, and circulatory problems.

For glaucoma different studies have shown that gingko biloba extracts (GBE) may have the following potential benefits:

1. Improved blood flow: Studies in humans have demonstrated improved blood flow near the optic nerve.

2. Neuroprotective effects: Studies have shown that mitochondrial function improves with ginkgo biloba.

3. Antioxidant effect: Ginkgo contains several different flavonoids, which have shown antioxidative properties by delivering electrons to free radicals. Compounds, such as vitamins E and C, also have antioxidative properties. The difference is ginkgo biloba extract flavonoids are able to act at the mitochondrial level.

4. Anti-inflammatory: Gingko has been shown to decrease reactive oxygen species.

Read more about the science in Glaucoma New Zealand’s fact sheet Glaucoma and Ginkgo Biloba.