Time to renew your membership

By Sharon Siddique
MDS president

Dear MDS members,

It is time to renew your MDS membership and we hope you would continue to stay with us on this journey. MDS has grown steadily since its launch in June 2007. As of December 2008 we have 170 members. We hope that you have found our many MDS activities over the past 18 months informative and useful. You can find highlights on our website.

We are honoured to have our MDS Adviser, A/P Au Eong Kah Guan, as our first speaker of 2009. He has kindly agreed to give a talk on “Artificial Vision”. The talk will be held on Saturday, 28 February 2009 from 2pm to 4pm at Mount Elizabeth Medical Centre, Seminar Room 1, 2^nd Level. Check out our website for more information.

Alexandra Hospital has also again generously allowed MDS to use its Seminar Room for some of our 2009 activities. So please note the following Saturday afternoons from 2 – 5pm at the AH Seminar Room. Details of the topics will be announced on our website closer to the dates: 16 May; 15 August; 28 November.

In addition to our formal meetings, we hope to also arrange small group sharing sessions, as well as encourage active participation in this blog. A membership renewal form will be sent to you via snail mail. We look forward to seeing you again.

If you have any questions, please contact MDS at alleyes@singnet.com.sg. You can also telephone Anne at 6238-7387.

Year in review

When the Macular Degeneration Society (MDS) of Singapore took its baby steps into 2008, it was barely six months old and still feeling its way around. Yet 12 months later, it can confidently look back at a year when it managed to achieve what the non-profit organisation set out to do – simply offer support to macular degeneration patients in Singapore.

It was nothing spectacular. After the bang that came with the society’s launch in June 2007 and the comprehensive mass media coverage, 2008 was a quiet year of consolidation and reaching out to the 170 members who joined the outfit. So in many ways, it was a year for the members.

Ten events were organised, with different themes and settings, catering to different segments of our membership base. These include small, intimate sharing sessions like the ones held in January and May, when members gathered to simply share their experiences, tips, advice, worries, hope and even some donuts!

In April, we held a small computer tutorial to teach members how to adjust the computer settings, optimising the equipment to help failing sight. And there were also the popular talks by experts, including NeuroVision’s in October and Eu Yan Seng on traditional Chinese medicine a month later.

The year saw MDS collaborate with the Glaucoma Patients Association and the Retinitis Pigmentosa Society to jointly organise events for members of the three self-help groups. Of course, MDS continued its support for the nation-wide AMD Awareness Week in September, hosting two support groups sessions in English and Mandarin.

The society also held its inaugural annual general meeting, where it elected a new executive committee to serve for two years. Founding president Sam Fong, who helped set up the outfit in June 2007, stepped aside for Sharon Siddique, who was the secretary, to take over the top post.

Last, this blog was set up at the start of the year to better connect with the members. It is a portal for MDS members to enjoy worldwide news about macular degeneration, as well as updates on the society and its activities. This post, incidentally, is the 50th. A nice number to round off the year.

The new year, 2009, will see the society continue where it left off – more talks, more sharing sessions and more opportunities to get to know each other better. Because that is what it is all about at the end of it all – a support group for us.

To see photos of the events held this year, go to the MDS website and click on 2008 Events.

Have a Merry Christmas and Healthy New Year. See you very soon!

Do you have hallucinations?

If you see weird images, don't worry, you are not mentally ill or having dementia. It is actually your brain trying to make sense of the images sent to your brain, as a result of the damaged eyes. Experts call it the Charles Bonnet Syndrome - a purely medical condition.

Charles Bonnet (above) is the Swiss naturalist who first mentioned this syndrome in the 18th century.

In Britain, the Royal College of Ophthalmologists is issuing new guidelines to all eye specialists to explain the condition. This is to ensure that eye patients are correctly diagnosed and not sent for psychiatric treatment.

"People have been sent for psychiatric treatment as if they were beginning to suffer symptoms of dementia," Tom Bremridge, of the Macular Disease Society of UK, told the BBC.

"And no-one, neither the doctor nor the patient, knew that these were symptoms of macular degeneration. But it really is quite common and very distressing for people.

"Doctors will tell people they have an eye condition, what it is and what the result is as far as their vision is concerned, but they haven't considered the psychological effects - and especially hallucinations."

Dr Dominic Ffytche, a leading psychiatric specialist in the syndrome, said: "This is a very important new development. These hallucinations are often an unexpected consequence of the loss of vision, so the more knowledge that is out there the more patients will be able to talk about the phenomena and hopefully relieve the distress that they cause."

To read more, click here.

Charles Bonnet syndrome: It is named after the Swiss naturalist who described the condition in 1760. He first documented it in his 89-year-old grandfather, nearly blind from cataracts, who saw men, women, birds, carriages, buildings, tapestries and scaffolding patterns.

Don't lose sight

MDS adviser Au Eong Kah Guan has published an article in the Singapore Medical Journal. Associate Professor Au Eong wrote about the urgent need for increased awareness of macular degeneration in Singapore.

To read the article, click here.

Eye on TCM

MDS hosted its first bilingual talk last Saturday when physician Tang Yue presented an interesting talk on Traditional Chinese Medicine (TCM) and its approach towards eye care to more than 50 MDS members.

Physician Tang, who is from Eu Yan Sang, spoke in Mandarin with slides in English, while Widia Huang, also of Eu Yan Sang, and translator Tan Dan Feng provided English translations. This led to a very interactive session at the Alexandra Hospital for all.

The physician began by giving an overview of how eye diseases are diagnosed in TCM. She emphasised that TCM views the body as an organic whole. She elaborated the basic structure of the eye, and its relationship with other organs and meridians.

She then discussed three types of macular degeneration – hereditary MD; High Myopic MD; and AMD. She outlined TCM’s comprehensive approach, which can include acupuncture, herbal treatments, as well as consultation with Western doctors, particularly incorporating the results of Western diagnostic devices and tests.

She stressed that TCM does not have a “one size fits all” approach, and each patient’s treatment regime must be tailored to his/her own body. Therefore there are few off the shelf types of TCM medications for the eyes.

That said, she gave the MDS members interesting insights into TCM’s approach to nutrition. She also left us with several recipes, which are reproduced below. After a lively Q and A, the session closed at 4.30pm.

Physician Tang Yue is a graduate from Shanghai University of TCM with a Bachelor in Traditional Chinese Medicine and Pharmacology. She currently practices at the Eu Yan Sang Specialist TCM Centre, 290 Orchard Road #13-08/09 Paragon, Tower Lobby 1.

Recipe 1

Ingredients:

• Mulberry (Fructus Mori), 15gm 桑椹15克
• White Chrysanthemum (Dendranthemamorifolium), 9gm 白菊花9克
• Honey, to taste 蜂蜜少许

Cooking Method:
Boil with water, consume once daily.

Function:
Nourishes the kidney and improves eyesight.

Recipe 2

Ingredients:
Carrot, 6 sticks 胡萝卜6根

Cooking Method:
Boil with water, consume for 2 days.
If needed, continue consumption for 2 weeks.

Function:
Improves eyesight.

Recipe 3

Ingredients:

• 1 White fish (any white fish variant, cleaned) 白鱼一条，去鳞及内脏
• Chinese wolfberry (Fructus Lycii), 30gm 枸杞子30克
• Spring onion, ginger & salt (to taste) 再加调味料如葱，姜，盐少许

Cooking Method:
Cook as soup.

Function:
Strengthens spleen & stomach, nourish the lungs & kidneys and improves eyesight.

Recipe 4

Ingredients:
Chinese wolfberry (Fructus Lycii), 20gm 枸杞子20克

Method:
Consume by chewing once daily, for a period of 2 weeks.

Recipe 5

Ingredients:
Chrysanthemum 菊花

Cooking Method:
Mix in hot water, consume often.

Obama Win 'Sigh of Relief' for Stem Cell Research

Researchers Anticipate Lifting of Long-Standing Ban on Embryonic Stem Cell Exploration

By DAN CHILDS
ABC News Medical Unit

For Dr. George Daley, Sen. Barack Obama's recent victory in the U.S. presidential election was a hopeful sign for an issue he holds close to his heart - and which he believes has the potential to save lives.

The issue is stem cell research. And Daley, immediate past president of the International Society for Stem Cell Research, says that, since the election, hopes have been high that the next four years could signal an era of greater flexibility for scientists in the field.

"We are hopeful that removing restrictions on funding for stem cells will be one of the first acts of the Obama presidency," Daley said. "In the research community, we would all breathe a sigh of relief."

The restrictions, which have been in place since 1994, have been seen by many in the field as a stifling force. Though such research was still possible through private and state dollars, the creation of and experimentation on such lines quickly became taboo for many universities and other research centers under fear of scrutiny.

The first hint of a policy change came Aug. 30 when the group Science Debate 2008 received a response to questions they posed to both the Obama and McCain campaigns regarding their positions on federal funds for stem cell research.

"I strongly support expanding research on stem cells," the response from the Obama team reads. "I believe that the restrictions that President Bush has placed on funding of human embryonic stem cell research have handcuffed our scientists and hindered our ability to compete with other nations.

"As president, I will lift the current administration's ban on federal funding of research on embryonic stem cell lines created after Aug. 9, 2001 through executive order, and I will ensure that all research on stem cells is conducted ethically and with rigorous oversight."

Most researchers shared Daley's enthusiasm. "The next administration adopts the mainstream view of the majority of Americans: that stem cell research offers the best hope and potential for some of the desperately needed cures for currently untreatable diseases," said James Douglas Engel, professor and chair of the department of cell and developmental biology at the University of Michigan Medical School in Ann Arbor. "Obviously, if federal funds become available for this research it will hasten our goal of developing cures for these diseases."

Others said that such a move could put the United States on pace with Israel, Australia, Canada, Japan and a number of Western European countries that have adopted flexible policies to push embryonic stem cell research.

"Politically, this will have an important effect on providing an open policy for stem cell research in the U.S., and could help increase our country's status as a leader in the field," said Dr. Paul Sanberg, director of the Center of Excellence for Aging and Brain Repair at the University of South Florida in Tampa.

But not all agreed that such a reversal would have an immediate positive effect.

"This is principally form over substance," said Tim McCaffrey, director of The George Washington University Medical Center's Catherine Birch McCormick Genomics Center in Washington, D.C.

"The benefit to the health of the American public will result only from substantial and sustained increases to the NIH budget," McCaffrey said. "Simply changing a particular regulation about the use of federal funds to create new lines will have no impact whatsoever when the funding to take advantage of stem cells is quite limited."

Lifting a Longstanding Ban

The first executive branch move to block federal funding for the creation of embryos for stem cell research came in 1994 under the pen of President Bill Clinton. This position was reinforced by President George W. Bush, who, in August 2001, strengthened the ban on federal funding by barring federal funds for research on all but a few existing embryonic stem cell lines.

What should and should not happen to embryos remains a source of intense debate. Embryos, which are balls of cells created by putting a sperm cell and an egg cell together and allowing the result to divide, are valuable to researchers because they represent a source of undifferentiated cells not programmed to be any type of cell in particular.

In essence, an embryonic stem cell is a blank check; scientists hope we will eventually be able to control the development of these cells, making them into whatever tissues are needed.

While some maintain that research on new embryonic cell lines could one day yield treatments and cures for devastating illnesses, others say the embryos represent human life and should not be destroyed.

But with the adversity of the ban came some new approaches. Among these was the advent of induced pluripotent (iPS) cells -- cells which are nudged into a state from which they can differentiate into a limited number of different cell types. Researchers agree that these cells do not have the degree of flexibility afforded by their embryonic counterparts, but they have, nonetheless, allowed for limited therapeutic research.

Other research that has qualified for federal funding has focused on so-called adult stem cells -- cells which are extracted from adult tissues and tweaked to yield other cell types.

Dr. Neil Theise, an adult stem cell researcher and professor of pathology and medicine at the Beth Israel Medical Center of Albert Einstein College of Medicine in New York, said that a lifting of the embryonic stem cell research ban would "lift the need for political opposition to adult stem cell research, as well" and have benefits across the board for all forms of stem cell research.

"It is by pursuing both paths that practical therapeutic and industrial benefits can manifest in the swiftest, most safe and cost-effective manner," he said.

Lifting Ban May Not Mean More Money

But others believe that opening the gates to federal funds could have the exact opposite effect, actually decreasing the amount of money available to researchers.

"Unless there is a boost in funding for this research at the NIH, it is highly likely that funding for currently allowed research will actually decrease as the pool of funds gets diluted by new applications," Sanberg said. "Overall funding for stem cell research in our country could decrease if the states feel less inclined to fund their own stem cell initiatives in a downward economy, thinking that the federal government is now funding all stem cell research."

Groups opposed to embryonic stem cell research predicted such a slip in overall funding, as well.

"The concern with new federal policies is that any rush to create new lines from embryos will simply siphon valuable funds away from research with much greater potential, including iPS cells, and especially existing and developing adult stem cell therapies that are already treating patients for dozens of diseases," said David Prentice, senior fellow for life sciences for the Family Research Council, a Christian political organization that opposes embryonic stem cell research.

Copyright © 2008 ABC News Internet Ventures

MDS Talk on TCM

SPEAKER: Physician Tang Yue

DATE: Saturday, 15 November, 2008
TIME: 2 to 4pm (Presentation will be from 2.30 to 3.30pm, followed by tea and socialising)

VENUE: Alexandra Hospital, Seminar Room

The talk will provide an overview of TCM's (Traditional Chinese Medicine's) approach to the maintenance of healthy eyes, and the treatment of eye diseases, with special reference to macular degeneration. The presentation will be in Mandarin, with English language slides. A translator will facilitate the Q and A session.

Biodata of speaker: Physician Tang Yue graduated from Shanghai University of TCM (China) with a Bachelor in Traditional Chinese Medicine and Pharmacology. She is a
licensed TCM physician and acupuncturist and has more than 10 years of clinical practice. Her special areas of interest include acupuncture for various eye conditions, insomnia, depression, rheumatic pain, stroke as well as beauty and wellness. Physician Tang Yue practices at Eu Yan Sang Specialist TCM Centre at Paragon.

黄斑退化症协会很荣幸邀请到余仁生的医师为我们的会员讲 解中医中药对黄斑病的治疗，看法与研究。有意出席的会员请于Anne 联系。谢谢！

CONTACT: Anne at 62387387 or e-mail: Sharon alleyes@singnet.com.sg to register

Please note that this event is open only to MDS members, but non-members can sign up for membership at the door. Membership is only $10 per year.

Stem cells can preserve vision

A promising new study in the United States has shown that stem cells can prevent vision loss. A group of scientists in Oregon has found that the HuCNS-SC Cells can protect the retina from progressive degeneration when transplanted into a rat.

The cells were injected into a rat which has been genetically modified with degenerative retina. Only one eye was injected, while the other was not.

The evaluations showed that the cells survived the transplants and engrafted, and the eyes transplanted with the cells showed preservation of the photoreceptors and stabilisation of visual function. In simple English, that means that the cells have enabled the vision to remain stable and not deteriorate further.

"The HuCNS-SC cell has proven to have very robust survival, preserving vision in our rat model at time points beyond six months," commented Dr Raymond Lund, who was leading the research. "These data are very encouraging and suggest cell-based therapies for retinal degeneration can be a viable treatment approach."

"This study confirms the results of previously published academic studies evaluating neural stem cell transplantation into the retina and provides us with the rationale to pursue clinical testing of HuCNS-SC cells for retinal disorders," said Stephen Huhn, a vice president at StemCells, Inc.

To read more, click here.

NeuroVision & AMD

The MDS talk presented by NeuroVision Pte Ltd on Saturday, 18 October was attended by about 40 MDS members. Mr Nir Ellenbogen, CEO, provided an overview of NeuroVision and its activities.

He explained that NeuroVision Inc is a USA Delaware-registered company, founded in 1999. Company headquarters are located in Singapore, and the R&D, Sales and Marketing, and Operations are conducted by NeuroVision Pte Ltd, the Company's wholly-owned Singaporean subsidiary.

The Singapore Eye Research Institute (SERI) is NeuroVision's primary research and clinical partner. The Singapore National Eye Center (SNEC) is NeuroVision's first commercial provider of NeuroVision's treatments in Asia, and its reference centre. NeuroVision is best known for its programme designed to improve the vision of children with myopia.

Mr Ellenbogen explained that NeuroVision's NVCTM vision correction technology enhances eyesight without sugery or medication. It optimises the performance of the neural or "back end" of the visual system - nothing is changed optically. The technology has been developed through research focused solely on how the brain processes vision. Generally 30 to 40 sessions with a computer programme are required to yield positive results.

Dr Allan Fong of SERI is one of the clinical investigators of a new pilot study which is now in its formation. Dr Fong explained that the study will focus on AMD sufferers, who have reduced central vision. It will evaluate the efficacy of NeuroVisions NVCTM for AMD patients.

The study is now recruiting around 50 volunteers to participate in the study. Volunteers must be between 10 and 70 years old. Their eye pathology must be stable.


They must have best corrected vision ranging from 6/7.5 to 6/30. Participants will be given a course of NeuroVision treatment sessions (around 30 to 40 sessions in pace of 2-3 times a week) at the NeuroVision Centre located at SNEC. They will be followed up for 12 months after the treatment with quarterly vision tests. The treatment is free for those selected to participate in the pilot study.

During the lively Q and A, Mr Ellenbogen and Dr Fong explained that not all who apply will be selected. Persons will be required to be available to undergo the treatments without any breaks over a three-month period.

All interested individuals can call DEBBIE LOW at 6322-4502 for clarification, or to fix an appointment for screening. Debbie can also be reached at debbie.low.w.l@seri.com.sg. There are still places available, and MDS members who qualify are encouraged to volunteer.

Forseeing MD earlier

Macular degeneration patients usually rely on the Amsler Grid to test if their eyes have deteriorated. Now, a new computerised test can do the work and it is more accurate, sensitive and reliable.

It is called the Foresee PHP and it helps doctors treat the disease sooner.

It shows a series of linear dots in a pattern, and the patient has to point out if any are out of place. Then the computer registers the patient's eye sight.

"It is more accurate in that it has a higher sensitivity level. It will detect a change from the dry macular degeneration to the wet faster or at an earlier stage," said ophthalmologist Dr. William F. Varr.

"The problem with that test (Amsler Grid) is that the patient has to do it on their own and to get patient compliance sometimes is difficult. It's sometimes difficult for them to see a change."

The old test relies on patient's compliance, so it's hard for doctors to keep track from year to year. With this new test, a computer records the data and doctors will be able to detect even the smallest changes in a patient's macula over time.

- Article adapted from abc.com

Outdoor activities can prevent myopia in kids

户外活动时间长 孩童近视几率低

一组来自新加坡国立大学和新加坡眼科研究所（SERI）的研究员进行的调查显示，孩子在户外活动的时间越长，患上近视的几率也越低。由国大杨潞龄医学院的社区、职业与家庭医学系的苏祥美副教授领导的研究小组，在2006年针对1249名青少年进行的调查发现：计算了看书、看电视等近距离工作之后，每天花多一个小时进行户外活动，患上近视的可能性会减少10％。


研究也发现，接受调查的14岁至16岁的青少年当中，有78％已经患有近视，而且他们每天平均花3.24个小时进行户外活动，其中0.76小时是做户外运动。研究人员比较澳大利亚悉尼和新加坡的六、七岁华族孩童的近视率，发现澳大利亚孩童每个星期花13个小时参与户外活动，只有3％患有近视；新加坡孩童每星期花在户外活动的时间只有3个小时，29％已患有近视。

苏祥美告诉本报，新加坡和悉尼的华族孩童有许多相近之处，基因、饮食习惯和生活水平相似，看电视和看书的时间相距不远，而最大的差别就在教育体制。研究报告也指出，悉尼的孩童上小学之前，会接受至少一年的学前教育，主要目的是发展社交能力，孩子也有很多时间在户外活动。相比之下，新加坡孩子在三年的学前教育，着重开发阅读能力，加上孩子到补习班，户外活动的时间也较少。

有趣的是，悉尼孩童花在阅读和使用电脑的时间比新加坡的孩童稍微多出一些，但是近视患者的比例比新加坡孩童低。苏祥美分析说，模糊的视线会促使眼球的发育出现异常。医学界推测，人们集中精神看近距离物品的时候，周边视力其实是模糊的，促使眼部细胞增生，引起近视。不过，进行户外活动时，中心视力和周边视力都是清晰的。

此外，在户外活动时，由于光线较充足，瞳孔会缩小，聚焦在视网膜上面的影像较清晰。苏祥美说：“这两个调查结果证实户外活动有助于预防近视，同时说明孩子们在户外活动的时间不够。我们建议家长改变生活习惯，多陪孩子到户外走动和玩乐.”

本地的7岁孩童当中，有28％患近视。苏祥美和她的组员早在1999年就开始对这些孩童进行长期追踪调查。他们在过去8年，主要着重于找出环境因素和日常习惯如看书、使用电脑，对视力退化产生的影响。新加坡眼科研究所黄天荫教授答复本报询问时指出，我国建立亚洲最大的眼睛疾病研究计划，搜集了多种常见眼疾的资料，研究范围跨越了华族、马来族和印度族。他说：“我们的数据库目前搜集了1万5000人的资料，很快地会扩大到两万人.”

配合社区、职业与家庭医学系庆祝成立60周年，国大和新加坡眼科研究所的研究员昨天上午发表了调查结果。

本地孩童易患近视 有三个可能性
近视在我国非常普遍。新加坡眼科研究所大约四年前进行的调查显示，7岁学生有28％患近视，8岁有34％，9岁有42％，12岁则有62％。此外，7岁至9岁学生当中，有48.7％患有散光。医疗界目前还无法确定近视的确切病因，我国的眼科医生进行的研究，就试图找出近视为何在我国那么普遍。

1) 可能与遗传有关
本地研究人员对本地1979名介于7岁到9岁的孩童展开大规模调查，从他们的身上拿取DNA样本，以便对那些近视和非近视孩童的基因组进行比较，从而通过基因定位研究，找出近视和基因之间的关联。

2) 长得越高　近视越深？
四年前进行的一项本地研究针对1449名来自三所学校的小一至小三华族学生进行调查。研究员把学生按体高分四组比较后发现，长得越高的学生，近视越深，而长得最高的那组比最矮的平均高了50度。

3) 幼儿生活习惯
3000名6个月大到6岁之间的孩童参与一项为期3年的调查计划。研究人员为孩子验眼，邀请父母参与问卷调查，从中了解孩子什么时候开始出现近视，从生活习惯了解近视的原因。调查结果预计在明年出炉。

Testicles a source for stem cells?

Washington: Cells taken from men's testicles seem as versatile as the stem cells derived from embryos, researchers reported in what may be yet another new approach in a burgeoning scientific field.

The new type of stem cells could be useful for growing personalised replacement tissues, according to a study in yesterday's issue of the journal Nature. But because of their source, their highest promise would apply to only half the world's population: men.

Embryonic stem cells can give rise to virtually any tissue in the body and scientists believe they may offer treatments for diseases like Parkinson's and diabetes, and for spinal cord injuries.

The testicular cells avoid the ethical dilemma of embryonic stem cells, which are harvested in a process that destroys the embryos. For that reason, some people, including President George W. Bush, oppose their use on ethical or religious grounds.

'The advantage these cells have, in comparison to embryonic stem cells, is that there is no ethical problem with these cells and that they are natural,' said study lead author Thomas Skutella, a professor at the Center for Regenerative Biology and Medicine in Tuebingen, Germany.

The new study used cells taken from biopsied tissue from 22 different men undergoing various medical treatments. The men ranged in age from 17 to 81. Researchers found that after a few weeks of growth, the cells could differentiate into various types of cells just like those taken from embryos.

Using the new findings to treat patients could take years.

- Associated Press

Note: Stem cells is seen as one of the most exciting ways forward in the search for treatment for macular degeneration.

NeuroVision Talk for MDS

MDS TALK ON NEUROVISION & AMD

SPEAKERS: Nir Ellenbogen, CEO, NeuroVision Singapore and Allan Fong, Pilot Study Coordinator


DATE & TIME: Saturday, 18 October, 2pm – 3pm

VENUE: 19 Tanglin Road #05-23, Tanglin Shopping Centre, Singapore 247909

CONTACT: Anne at 62387387 or email: alleyes@singnet.com.sg to confirm attendence

The talk will cover the following topics:

EXPLANATION OF NEUROVISION

NeuroVision’s NVCTM vision correction technology enhances eyesight without surgery or medications. It optimizes the performance of the neural or “back end” of the visual system — nothing is changed optically.

The technology has been developed through research focused solely on how the brain processes vision, and is based on two decades of visual neuroscience research.

ABOUT NEUROVISION’S EYE PATHOLOGIES STUDY

With the mission to provide a better quality of functional vision, NeuroVision starts looking into ways to improve vision of individuals who are having reduced central vision due to various eye pathologies such as dry ARMD, Central Serous Retinopathy (CSR) and so on.

NeuroVision, in collaboration with Essilor International and the Singapore Eye Research Institute has started a pilot study to evaluate the efficacy of NeuroVision’s NVC TM – for the vision improvement of people with reduced visual acuity due to various eye pathologies.

Up to 50 participants; aged 10-70 years old; eye pathology stable; having best corrected vision range 6/7.5 to 6/30 due to eye pathologies will be recruited for the study.

Participants will be given a course of NeuroVision treatment sessions (around 30 to 40 sessions in pace of 2-3 times a week) at the NeuroVision Centre located at SNEC and will be followed up for 12 month after the treatment with quarterly vision tests. The study is currently recruiting participants.

Ageing eyes? Oranges and leafy vegetables can help

By Lee Hui Chieh
The Straits Times

Patients suffering from an age-related eye disease may be able to enhance their vision by eating more brightly coloured fruit and vegetables, a study here has found.

The study by Alexandra Hospital homed in on 46 patients with age-related macular degeneration (AMD), in which the centre of the retina called the macula - which enables the eye to see details - deteriorates, resulting in blurred vision and even blindness.

It found that patients who had higher levels of pigment in the macula, from having eaten foods with natural pigments, could see better than those with lower pigment levels.

On a 16-line eye chart, patients with higher pigment levels saw 12 lines on average; those with lower pigment levels saw an average of only seven.

The main researcher of the study, Dr Kumari Neelam, 37, said: 'The significance of this finding is that, for people with macular degeneration, their vision will be better if they have more pigmentation.'

Two yellow pigments found in the macula, known as lutein and zeaxanthin, have the job of filtering out damaging rays of light. If they are in short supply, the macula of the eye becomes more vulnerable to damage from ageing or severe myopia.

Their levels can be raised only through eating foods containing such yellow pigments, such as green leafy vegetables, maize, kiwi, grapes, oranges, pumpkins, and wolfberries.

To do the study, which was completed this month, Dr Neelam, a registrar of Alexandra Hospital's opthalmology and visual sciences department, measured the level of pigment in patients' eyes, as well as in the eyes of 14 healthy people.

To get more conclusive results, DrNeelam hopes to start a bigger study next year on 800 to 1,000 people, both AMD patients and those with healthy eyes.

She hopes that the bigger sample size will yield the normal range of pigment levels in healthy eyes here, the average amount of both pigments people consume in their diet and how this translates into the pigment level in their eyes.

All this data will in turn help determine the amount of certain foods or nutritional supplements that patients with low pigment levels should take, Dr Neelam said.

It is not known how many people here have AMD, but a community study on 574 people aged 60 and above in 1997 found that 27 per cent of them suffered from it.

To raise awareness of AMD, hospitals, eye clinics and optical centres here have banded together to run public forums and eye screenings for age-related eye diseases, including AMD, this week.

For $6, individuals can have their eyes screened at participating centres until this Friday.

A week of awareness

The MDS supported the annual nation-wide AMD Awareness Week by organising two support group sessions on Saturday.

After receiving a plaque of appreciation from guest of honour Minister Lim Boon Heng, who is in charge of ageing issues in Singapore, MDS got down to work at the Idea Lab of Alexandra Hospital.

MDS president Sharon Siddique hosted a session in English before secretary Peh Shing Huei chaired one in Mandarin together with Exco member Anny Leow. Exco member Sam Fong will also host a session on Wednesday.

This is the second year that MDS is a partner of the AMD Awareness Week.

Breakthrough lens for the VIPs

A new type of lens can now be inserted into the eye to help severe macular degeneration patients see better - giving much hope to sufferers.

This ground-breaking surgery in Britain is called the IOL VIP (intra-ocular lens for visually impaired people) procedure. It is very similar to a cataract removal, in which the ocular lens is replaced with an artificial one behind the iris.

For IOL VIP (see picture above), a second lens is also placed in front of the iris - creating a slightly magnified image much like a telescope. As a result, light entering the eye is directed to a healthy part of the retina and away from the macular scar, giving patients back some of their useful vision.

The procedure is painless and takes about 20-30 minutes under simple eyedrop anaesthesia. It is easy to carry out and the effects are almost immediate. It was first successfully carried out in March 2007.

Seventy-three-year-old grandmother Mary Johnson is one of the first patients to benefit. She said: "I noticed the difference more or less straightaway. When you have macular degeneration you no longer take your sight for granted, and being able to get out in the garden to pick up the weeds has meant so much to me.

"One day I was walking through town with my husband and I said: 'Look! I can see House of Fraser!' I was so excited that I was able to read the sign. Hopefully, with time, my sight will improve even more. But if I stay as I am now I will be satisfied."

But ophthalmic surgeon Sakkaf Ahmed Aftab, who runs a clinic from Grimsby's St Hugh's Hospital and was one of the first surgeons to be trained in the IOL VIP pointed out the surgery is not suitable for everyone.

It is also not a miracle cure and is only appropriate for patients who have lost a significant level of vision. However, it can restore enough of a patient's sight to drastically improve their quality of life.

"This is a procedure for people who cannot see," he said. "There's no way that after having this you would be able to read small print or start driving again. But that's why this work is so rewarding - because you are giving people back their vision when before they had none at all."

Click here to read the complete article and here to find out more about IOL VIP. See below for a video of how the procedure is carried out.

No more injections?

Uncomfortable, intimidating and regular injections into your eye could be a thing of the past if a tiny metal coil succeeds as the new drug dispenser for retinal problems.

The spiral-shaped coil (see below) - which looks just like the children's toy "slinky" - can be injected into the eye using a needle in a minimally invasive procedure that takes just 15 minutes.


After that ONE injection, no more is needed for two years. This is because the drugs are mixed into a material which coats the slinky. As the coating slowly dissolves, the drugs are released over a period of up to two years.

Now, the most effective drugs for macular degeneration patients, such as Lucentis, Avastin and Macugen, are all directly injected into the eyes. The injections often have to be repeated every month, something which patients find uncomfortable.

The new device, which is called I-Vation, is meant to stop this hassle and pain. It is made from a metal alloy. The Slinky is coated with a synthetic material that incorporates the drugs. As the coating breaks down, it releases drug particles into the eye.

The design and thickness of this material can be adjusted so it degrades at the required rate. The spiral shape means there is a large surface area available for the drug coating, allowing the release of drugs for up to two years.

The coiled shape also makes it possible to lodge the device against the white of the eye, without the need for stitches. It will be out of the line of sight of the patient, so it cannot be seen. It can also be easily removed and replaced.

Soon, you may be able to tell your children or grandchildren that you have something like Toy Story's Slinky Dog in your eye!

Please click here to read more.

From Sam to Sharon

Sharon Siddique has been elected as the new president of the Macular Degeneration Society of Singapore yesterday. The 61-year-old academic, writer and consultant replaces Sam Fong, who has led the society since its founding in June 2007.

Sharon was chosen as the president by a new seven-man executive committee, which was elected by MDS members in its inaugural Annual General Meeting last month.

Journalist Peh Shing Huei, the former treasurer, will take over as secretary - a position which was formerly occupied by Sharon. Lee Soo Mien, a lab technologist, is the new treasurer.

The other Exco members are former Ministry of Community Development deputy secretary Lim Hsiu Mei, nurse Anny Leow, former teacher Doreen Heng and Sam.

Sam, a retired engineer and a glaucoma patient, had asked to step down as president to concentrate on his volunteer work as the head of the Glaucoma Patients Association - a partner of MDS.

The MDS would like to thank him for his contributions to the society. Quite simply, he was the engine behind the society's formation - putting into reality the vision of our adviser Prof Au Eong Kah Guan, who first mooted the idea of setting up a macular degeneration support group in Singapore.

Sam gathered a team, courted sponsors to raise funds and drummed up the publicity to build awareness for macular degeneration and MDS. The 63-year-old even learnt how to set up a website from scratch in order to give the society a much-needed platform online.

Unknown to many, the grandfather of five often paid out of his own pocket to fund the society's activities and operations.

We look forward to his continued contributions to MDS as an Exco member and thank him, once again, for his hard work and dedication over the last two years.

Please click here to read the full bio of the Exco members.

The Last Lecture

Professor Randy Pausch may not suffer from macular degeneration, but his words, experiences and most of all, his life, is an inspiration to all - regardless of your medical condition. He has earned international fame for his "Last Lecture", which you can view below.

On July 25, at the age of 47, he died of pancreatic cancer. Before death, he said something which is a good motto for all of us - "You cannot change the cards you are dealt - just how you play the hand."

Do you have early treatment advice?

By Lim Kim Lan

An MDS member

Has anyone been given advice from an opthalmologist about early treatment regimes apart from not straining the eyes, taking nutritious food for eyes, etc? In my own experience, I would consider myself fully predisposed to MD since one of my eyes has been diagnosed with Myopic MD.

Yet no one (I have visited 3 different prominent specialists) has offered me any "early treatment regiment" so as to arrest MD developing in my remaining myopic eye (not yet affected by MD). All have just dismissed me with the info that they "can't do anything since yours is a "MYOPIC MD".

They merely prescribed some over-the- counter-eye drops for dry eyes and invited me to come back when when my eyes deteriorate!

Would love to hear from anyone with other experiences. Thank you.

Lim Kim Lan

Stem cells the answer?

Check out this informative video on how stem cells could be the answer to cure macular degeneration.

New test to predict AMD

Soon, a doctor could find out whether you are likely to have macular degeneration even before you have any inkling of the eye disease.

Scientists have developed a new test to identify people who are genetically predisposed to AMD, opening the way to earlier detection and treatment.

The test is called Macular Risk and has been developed by ArcticDX, a Canadian company, and Cambridge Enterprise, the commercial arm of Cambridge University. It will be available worldwide next year.

During the test, swabs of saliva will be analysed to look for genes which indicate that a patient has a high probability of developing the disease.

ArcticDX president Greg Hines said: "This will be the first time that clinicians will be able to diagnose the condition before symptoms arise.This provides the opportunity for targeted patient education and routine eye examinations that offer early detection and disease management.

"Macular Degeneration is a disease that can be arrested but it is not reversible. It is important to offer earlier treatment regimens that may arrest the disease before significant vision loss occurs."

ArcticDX has secured license for a single nucleotide polymorphism (SNP) located in the complement C3 gene that has been shown to be a predictive indicator for the genetic diagnosis of AMD.

This breakthrough came after six years of research. The manufacturers said that the ideal candidate for the test would be someone in their 50s with a family history of the condition.

New Exco for MDS

MDS held its first Annual General Meeting today at the Alexandra Hospital, with President Sam Fong presenting a report of the society's activities in the last year.

The society has a membership of more than 150 and events organised ranged from regular sharing sessions to talks by experts, as well as a roadshow and computer tutorial.

MDS has also been a key partner and supporter of the annual nationwide AMD Awareness Week in Singapore.

MDS also elected a new Executive Committee to serve a two-year term from July 2008 to June 2010. Sam Fong, Sharon Siddique, Peh Shing Huei and Anny Leow remained in the Exco, with Lee Soo Mien, Doreen Heng and Lim Hsiu Mei coming onboard. Doris Peh and Evelyn Chew have also been chosen as honorary auditors for the new term.

Below (from left): Shing Huei, Anny, Doris, Doreen, Sharon, Sam, Soo Mien. Hsiu Mei and Evelyn are not in the picture.


Former Exco member Steven Lo declined to stand for re-election and the MDS would like to express its sincere gratitude to him for his time and service. In particular, the computer tutorials he conducted both at his home and at the SNEC last month have been well-received and most helpful.

The new Exco will choose its office bearers of president, secretary and treasurer after their first meeting. Details will be posted here.

Revolutionary Microscopic Needles

Researchers in Georgia, United States have pioneered a new technique that effectively delivers drugs to the eyes using microscopic needles. It could be a big boost for macular degeneration patients.

These new needles penetrate the eye only as deep as half a millimetre into the eye tissue. This means that they do not penetrate far enough to cause as much damage as traditional needles. As a result, they can be applied to the eye using only local anaesthetic.

Traditional delivery methods such as eye drops have difficulty in efficiently delivering drugs to the back of the eye, and ordinary injections are invasive as the needle penetrates across eye tissues. Repeated injections with regular needles can also result in other serious complications to vision.

To read more, click here.

Painting macular degeneration

One of the biggest problems that macular degeneration sufferers confronts is trying to explain to the people around them just what they are suffering from. While simple blindness is easily understood, the degenerative nature and partial blindness of MD makes it less clear.

What does it mean to lose central vision and only have peripheral view? How does the world look like through the eyes of an MD sufferer?

To help answer these questions, a young artist in Scotland has painted portraits of macular degeneration patients, to show how MD sufferers see the themselves.

Mr Adam Hahn (below), whose late grandmother suffered from AMD, photographed each sitter and manipulated the image to represent how they would see it.

He then showed it to them and, by using their remaining peripheral vision, they suggested adjustments.

One of the sitters was Mr Don Curran, the past chairman of the charity AMD Alliance International. He called the portraits (below) "outstanding".

“One of the biggest difficulties we have lies in explaining its (macular degeneration's) impact to others. I spend a lot of time trying to show how difficult it is living with central-vision blindness, and how the condition varies between each individual,” he says.

“I am about to speak at an international congress in Hong Kong and I am going to use some of Adam's portraits on PowerPoint. Even clinicians and pharmaceutical companies don't understand how it can cause such depression. Simple blindness is far easier to comprehend than this kind of partial-sightedness.”

To read more, click here for the very well-written article on The Times of London.

Biting into Assistive Technology

This Jaws does not bite. Unlike the infamous sharks in Spielberg's blockbuster, Jaws the screen-reader software offers visually-impaired people the opportunity to work independently and traverse the wondrous world wide web with ease.

Dr Wong Meng Ee, president of the Retinitis Pigmentosa (RP) Society and who is visually impaired, showed today the workings of software Jaws, demonstrating its benefits and user-friendliness.

He typed in Microsoft Word and with each letter, Jaws echoed it back to him. And to audible gasps from the crowd of 60, he even set up a table in Word and effortlessly keyed in words into the individual cells of the table.

"Jaws is very useful for office work, since many of us use Word and Excel almost every day," said Meng Ee, who is also an assistant professor at the Nanyang Technological University. "It has allowed me to work in a mainstream environment, using things which are used by my colleagues. So I can read all documents, papers and e-mails sent to me."

He was speaking at a talk on Assistive Technology, organised by the Macular Degeneration Society, the RP Society and Glaucoma Patients Association. This is the second joint effort by the three organisations this year.

Getting the news, now

Besides using Jaws on Word and Excel, Meng Ee also used it to surf the Internet, searching for information through Google.

But while a sighted person can very quickly get to the information he wants on the website, going through Jaws takes a little longer because the software reads out all the text on screen. Still, with a little practice and some familiarity of certain websites, it gets faster and easier.

More importantly, Jaws allows a visually-impaired person to go online and "read" the news he wants, connecting to the world instantly and on his own demand. "In the past, we have to wait for someone to convert newspapers to braille and that takes time," he said. "By the time it is ready, it is old news. These days, we want news instantly."

Scanning documents

Since Jaws can only read out text that is already in the computer, that means that printed documents would be out of its reach. But he refers the audience to a product known as OpenBook, which scans printed documents and converts it into text format in computers, allowing Jaws to then do its magic.

"You can scan it, go for a cup of tea, come back and it is done. You can even save it into MP3 format," he shared.

Money no enough

But there is a downside to these products - cost. Jaws cost about S$2,500 and OpenBook is about S$1,500. The American company selling these products does not deliver to Singapore and so those who are interested would have to order through the Singapore Associated for the Visually Handicapped (Tel: 6251-4331).

For those who are unable to afford it, he suggests approaching the National Council of Social Service, which has an Assistive Technology Fund. It subsidises up to 90 per cent of the costs of the products. (AT Fund secretariat can be reached at 6210-2677 and ncss_rad@ncss.gov.sg)

He urged people to embrace assistive technology and invest in it, noting that an American colleague had remarked that while Singaporeans go for the biggest TVs and the latest mobile phones, we stint on the technology which can really change lives.

Increasing font sizes and magnifiers

Besides Meng Ee, MDS secretary Sharon Siddique and Exco member Steven Lo also offered tips on how to make technology work for the visually handicapped. After years experimenting with his computer settings, Steven showed how users can enlarge all the font sizes on screen, from the desktop icons to text on websites. This is to make it easier for MD sufferers who are no longer able to read small fonts.

Sharon, on the other hand, showed new magnifiers which are not only user-friendly, but portable and robust. She said: "Many of us here today do not need these equipment yet. But it is good to know that down the road, there are these innovations which can help with our lives. It gives me comfort."

* What is your view on assistive technology? Have you used any before? Share with other MDS members your experience. Click on the Comments tab.

Prof Leong: Prevent the preventable, delay the inevitable

By Sharon Siddique

MDS Secretary

About 45 of us gathered on Saturday afternoon to hear a lecture by Dr Leong Seng Kee on “Nutritional Supplements and AMD”. Before his retirement from the National University of Singapore, Dr Leong was Professor and Head of the Department of Anatomy.

One of his special research interests is the human nervous system, including the projection of the eye to the brain. This gives him a unique perspective on macular degeneration – its causes, its treatment, and its prevention.

According to Prof Leong, the causes of macular degeneration are multi-factoral, and can be divided into two categories – non-modifiable and modifiable. Non-modifiable factors include age, family history, genetic makeup. Amongst the most important modifiable factors are quitting smoking, including green leafy vegetables and fish in the diet and avoiding transfat, and controlling hypertension and other chronic conditions.

Reducing modifiable risk factors cannot cure macular degeneration, but there are studies to show that an antioxidant-rich diet, including nutritional supplements, can retard the rate of deterioration.

Taking a combination of antioxidants, including Vitamin C, Vitamin E, Vitamin A (betacarotine), zinc and copper, can stop the progress of macular degeneration at the mild stage in 28% of those on such supplements. Thus in terms of modifiable factors, good nutrition is critical, and nutritional supplements appear to help to prevent, or slow, the process of macular degeneration.

Dr Leong, however, also pointed out that there have been counter-studies, which have actually linked an intake of Vitamin A and E to an increase in mortality. Other studies find no relationship between high antioxidant intake and a slowing of macular degeneration. According to him, these studies are based on meta-analysis. No new research is undertaken, rather many existing studies are “trawled” for results. Such studies must be interpreted carefully because they are very selective in the cases they chose for comparative analysis.

He concluded his talk with several things to remember. First, nutrients work in synergy; they can’t be assessed in isolation; they must be taken in combination. Second, the power of nutrients is in prevention, not in cure. Third, quality control in supplements is very important. For example, always choose natural vitamin E, and not the synthetic vitamin E.

Dr Leong recommends the use of supplements, and he uses them himself. He sees nutritional supplements as having the ability to “prevent the preventable, and delay the inevitable”. An inspiring thought for all of us to take home and ponder.

Talk on Nutritional Supplements

TOPIC: Nutritional Supplements and Age-related Macular Degeneration

SPEAKER: Dr Leong Seng Kee

VENUE: All For Eyes

Tanglin Shopping Centre #05-23

19 Tanglin Road

Singapore 247909

DATE: Saturday, 21 June, 2008
TIME: 2:30pm to 4pm

As we have LIMITED SPACE, please ring Anne (62387387) to confirm your attendance, or send Sharon an email at alleyes@singnet.com.sg

All For Eyes is honoured to have Dr Leong Seng Kee to speak to us on the topic of nutritional supplements and AMD. Those of us with macular degeneration have certainly read many reports on the pros and con of vitamin and herbal supplements. Which ones, what dosages, and how often, are questions which we have all faced after our diagnosis.

We are all concerned with getting a clearer picture of current thinking on nutritional supplements, particularly from a more holistic perspective. We are therefore very grateful that Dr Leong has agreed to share his lifetime of insights with us.

Before his retirement from the National University of Singapore, Dr. Leong was Professor and Head of the Department of Anatomy. His special research interest is the human nervous system, including the projection of the eye to the brain. He has published more than 100 research papers in internationally refereed journals.

For many years Dr Leong has also maintained an interest in the area of nutritional supplements and general health. His friend of 40 years, Victor Wong (senior legal practitioner) said of him: "When Dr. Leong tells you something he means what he says and you will not regret taking him seriously".

Oily fish prevents MD

Australian scientists have found that eating foods rich in omega-3, such as oily fish, can help to prevent vision loss due to macular degeneration.

Oily fish are those fish which have oils throughout the fillet and in the belly cavity around the gut, rather than only in the liver like white fish. It does not refer to fish which are cooked in a lot of oil!

Omega-3 could cut down on the risk of people developing age-related macular degeneration (AMD) by as much as a third.

The researchers said that eating oily fish twice a week could help cut down on the chances of getting AMD as the body gets older.

Fish oil is oil derived from oily fish.