Tuesday 27 December 2011

The man who taught himself to see

This is an amazing inspirational story to round off the year. Daniel Kish has been sightless since he was a year old. Yet he can mountain bike. And navigate the wilderness alone. And recognize a building as far away as 1,000 feet. How? The same way bats can see in the dark.



Click here to read the full article. It is a long piece, but well worth your time. 

Merry Christmas and Happy 2012!

Wednesday 14 December 2011

Eylea approved in US

The United States has approved the use of Eylea, a new drug to treat age-related macular degeneration. It adds an important new weapon to the ongoing battle against the eye disease. 


Eylea is similar to the other two main drugs in the market, Lucentis and Macugen. It inhibits a factor that makes unwanted blood vessels grow in the retina. The blood vessels can leak blood and fluid, causing damage to the retina. Eylea blocks all forms of this factor, called VEGF, and also blocks a second similar factor.

But compared to Lucentis and Macugen, Eylea requires fewer injections and is hence cheaper for patients. Lucentis is given once every month, although some patients may need treatment only once every three months. Macugen is given every six weeks. Eylea is given once every two months after three once-a-month injections. All three of these drugs are given by injection into the eye with a tiny needle.

In clinical trials, Eylea has worked as well as Lucentis. But the drug can cause some side effects. In clinical trials, the most common were bleeding in the white part of the eye at the site of injection, eye pain, cataracts, detachment of the gel part of the eye (vitreous) from the retina, floating spots in the vision, and increased pressure within the eye.

Saturday 19 November 2011

Wondrous paths of Botanic Gardens

By Sharon Siddique
MDS President

About 30 of our “regular” MDSers gathered at the Botany Centre, Green Pavilion for our annual outing on Nov 5. At 10am we were offered a fascinating tour of “Edible and Medicinal Plants, which was conducted by Botanic Garden staff.




They were so well informed, that we all picked up numerous bits of information – rather than walking through “trees and bushes”, we actually were introduced to them, and I don’t think any of us will again walk through the garden ignorant of how dependent we are upon these many “edible and medicinal” plants.


To give just a few examples:

We were introduced to a nutmeg tree – fascinating to see the flowers, the fruits, and to actually see the connection to the tree itself. Now nutmeg has much more meaning than powder in a spice bottle! Or the introduction to a kaffir limebush (limau purut in Malay). The pungent leaf is so familiar to anyone who cooks or indulges in Southeast Asian dishes, but to break off a fresh one for a smell was quite an experience.

Question: And did you know the difference between wild and cultivated bananas?

Answer: wild banana bunches grow down, while cultivated ones grow up.


Multiply these insights by 100, and you have some idea of what knowledge we acquired. Our one and a half hour tour wound around the wondrous paths, ending up at the ginger garden, our next-to-last edible stop. We then retired to the benches outside the Orchid Pavilion for a VERY edible, delicious box lunch, and welcome drinks. (Yes, it was HOT!) We wrapped up at 12pm, with loads of good fellowship, and much food for thought.

For those of you who missed this tour, we would highly recommend it. The tours run every first Saturday of each month, - one at 9am and another at 10am.


They are free of charge, and you can sign up on the spot at the Green Pavilion at the Botany Centre, near the main Holland Road entrance. In addition we found lots of other tours and classes offered on the Botanic Garden website, so those of you who would like to follow-up, you can do so.



We will be holding our next MDS meeting in February 2012, after Chinese New Year, which falls on the Jan 23-24. We wish all MDSers a very happy holiday season, and don’t forget to check the website, blog or facebook for updates and informative entries. Look forward to seeing you all next year!

Friday 11 November 2011

Phone check-ups for cataract

The Straits Times
Nov 5, 2011
By Fiona Low

Patients recovering from cataract surgery could be given follow-up consultations over the telephone under an initiative by Tan Tock Seng Hospital. Its eye centre is exploring ways to cut the number of return visits by those who have had the operation.



The idea is to make life more convenient for patients, who will be spared a journey, and free up doctors to focus on more complicated cases. Only patients whose surgery had gone without a hitch and who are deemed to be at low risk of complications are eligible for phone consultations.

Trained nurses will call them and go through a list of eight questions designed to check they are recovering smoothly and are free of problems such as infections. The initiative follows a successful pilot study in 2009. Phone consultations have been used to follow up cataract surgery in places such as the United States and Europe. However, this is the first time the system has been implemented here.

Patients who undergo the operation normally have to return to the hospital for three follow-up visits. The first is the day after surgery, the next is a week later and the third is a month after that. The phone consultations replace only the first visit. Dr Wong Hon Tym, head of the hospital’s ophthalmology department, said the questionnaire used by nurses is a safe way to pick up complications because they are usually easy to identify. Signs include obvious pain, blurry vision and redness in the eye.

Cataracts occur when the crystalline lens in the eye becomes cloudy, blurring the patient’s vision. The surgery involves removing it and replacing it with an artificial lens. Seven of the hospital’s 26 consultants routinely use phone consultations with their patients, and there are plans for all to do so eventually. Cataract surgery is the most commonly performed operation in the department. It is carried out on between 4,000 and 6,000 patients a year.

By the time the programme is implemented fully, about 1,000 10-minute clinic slots will be saved in a year. The eye centre is also looking into using telemedicine to reduce the number of follow-up visits by cataract patients. 

This means that instead of returning to the hospital, they can go to an optometrist at a polyclinic instead. Pictures and videos are taken of the eye and sent to the consultant at the hospital, who then conducts the check remotely.

Findings from a pilot study of the technique this year have been encouraging. It found that advances in technology mean the transmitted images are nearly as clear as if the doctor was examining the patient in the flesh. Telemonitoring is intended to be used with the patient’s third follow-up visit. Dr Wong said that although larger studies are needed, the promising data indicates that in future, post-operation visits will be carried out in a non-hospital setting.

fionalow@sph.com.sg

Friday 14 October 2011

Blindness is avoidable

Press release by WHO
Oct 13, 2011

MANILA - The World Health Organization (WHO) today said that blindness could be avoided in eight out of 10 cases with appropriate treatment or early prevention.

Worldwide, WHO estimates that 246 million people have low vision and 39 million are blind, with cataracts as the leading cause of avoidable blindness, particularly in developing countries.

At the same time, cataract blindness in most cases can be treated by a 15-minute medical intervention. Other preventable causes of blindness include diabetic retinopathy and uncorrected refractive error. Trachoma remains the main infectious cause of avoidable blindness and is still common in parts of the Western Pacific Region, including Australia and the Pacific islands.

On 13 October, the international community marks World Sight Day to raise awareness of avoidable blindness and visual impairment. World Sight Day is held annually on the second Thursday of October.

Aside from the substantial impact that blindness or low vision has on a person’s quality of life, there is also a strong economic impact, not only for the person affected but also for the family and community giving support, said WHO. Reducing blindness, therefore, alleviates household, community and national poverty and is linked to improving access to educational and employment opportunities.

Surveys indicate that 90% of people with blindness or low vision live in low-income countries. In the Philippines, for example, an estimated half a million people are blind.

In more developed countries, however, there has been a reduction in visual impairment and blindness as a result of investment and the work of governments and international partners in developing national eye-health systems, including the improvement in the quality and quantity of eye-care services.

WHO is coordinating international efforts in reducing visual impairment, with a focus on building and strengthening health systems:
  • strengthening country-level efforts to eliminate avoidable blindness;
  • helping national health-care providers treat eye diseases;
  • expanding access to eye-health services; and
  • increasing rehabilitation for people with residual visual impairment.
In response to the increasing burden of chronic eye disease, WHO is now developing policies and guidelines for diabetic retinopathy, glaucoma, age-related macular degeneration and refractive errors.

In the last 10 years, WHO has been working with the International Agency for the Prevention of Blindness in the global initiative "Vision 2020: the Right to Sight". WHO, in partnership with Lions Clubs International, also established in 2004 a global network of 35 childhood blindness centres in 30 countries for the preservation, restoration or rehabilitation of sight in children. Fifteen million fewer people are blind today compared with projections made when the initiative was launched in 1999.

Friday 7 October 2011

MDS Outing - Botanic Gardens

After our successful maiden outdoor event last year at the Hort Park, we are heading out to the sun again! This year, we are visiting the Botanic Gardens, on a guided "Edible and Medicinal Tour" led by the park's official staff. The tour will explain how edible and medicinal plants can contribute to our daily lifestyle. 

 

Participants will be exposed to some of the edible and medicinal plants in Singapore Botanic Gardens. The mission of this tour is to increase awareness of food as medicine as well as a source of nutrients & to increase awareness of the rich biodiversity of our tropical plants.
 
Lunch will be served after the tour, so please sign up now so that we can cater for you. You can take the Circle Line MRT to the new Botanic Gardens station.  


Please be punctual because the tour will start on time. This is our last event of the year, so please join us!

Date: Nov 5, 2011 (Sat)
Time: 9.45am - 11.30am
Venue: Botany Centre, Green Pavilion  (near Tanglin Gate, by Holland Road)

Attire: Light clothes in anticipation of hot weather, please bring a hat or an umbrella for shade if necessary.

Click here for a map of Botanic Gardens.

Call Anne at 6238-7387, or e-mail alleyes@singnet.com.sg to reserve your places now! This event is free for all MDS members.

Friday 30 September 2011

Getting the message

The annual AMD Awareness Week was held from 24 – 30 September 2011.  Dr Amy Khor, Minister of State for Health, was Guest of Honour at the launch last Saturday morning.

MDS Singapore was one of the joint sponsors of the event, and as our contribution to the AMD Awareness exhibition, we had a computer with an extra-large screen monitor to introduce visitors to the online MDS sites – our website, blog and facebook page.   Some “got the message”, as we have been enjoying a larger volume of visitors since then!



MDS, together with the AMD Awareness Week organising committee, put together a very interesting afternoon session, with speakers covering several topics. These included “The Role of Vitamin Supplements in AMD”, “Coping with Vision Loss”,  “Advances in Management of AMD” and a “Healthy Cooking Demonstration”.  For some interesting and creative healthy recipes, check out the hospital website.


Narinder Sharma, CEO of AMD Alliance International, based in London, gave an interesting introduction to the organisation, as well as to the topic of coping with vision loss from a patient’s perspective. MDS is a member of the AMD Alliance International.  Those of you who would like further information on the Alliance and its activities, please visit their website.

Thursday 22 September 2011

China's bogus "stem cell therapies"


Hong Kong (Reuters) - Chinese hotel manager Hong Chun had trouble using chopsticks after a minor stroke and sought treatment at a large Shanghai hospital where doctors injected what they said were donor stem cells into his spinal cord and buttocks, according to his father and cousin.

Leaving hospital the next day, Hong, 27, fell so ill he had to be taken off the train and rushed to another hospital. But doctors were unable to save him and he was declared brain dead before dying a month later.

Desperate for help, patients with incurable diseases are admitting themselves into hospitals in China for "stem cell therapies" but experts say such treatments are backed by little or no scientific evidence and are at best experimental.

Some of these cases involve large general hospitals where patients pay thousands, even tens of thousands, of dollars for treatments that are advertised online. Patients have come away with little or no improvement and a number have died, according to patients, doctors and relatives of patients who spoke to Reuters.

Hong paid 30,000 yuan ($4,800) to the Chinese army's 455 PLA Hospital in Shanghai for the treatment last year, according to hospital receipts seen by Reuters.

His father, Hong Gensho, travelled to Shanghai to seek an explanation. But hospital administrators told him his son didn't die in their hospital, paid him 80,000 yuan and told him not to pursue the matter.

"I am miserable, it's like my son was worth only 80,000 yuan. It's not about money. Our human rights, our place in this society, are not respected. I am devastated. If he hadn't sought treatment, he would not have died," said the elder Hong, 61.

"I can't get my son back, but people must know about these stem cell therapies and no one must be deceived."


LACK OF SCIENTIFIC EVIDENCE
Experts have raised the alarm on patients turning up at clinics and hospitals in China, Mexico, India, Turkey, Russia and elsewhere for stem cell therapies that have not undergone clinical trials and which are not recognized as standard treatment.

Patients often pay fees of $20,000 and more for such therapies after exhausting conventional treatments.

"Stem cell tourism is regarded as ethically problematic because patients receive unproven therapies from untrustworthy sources," Dr David Resnik at the U.S. National Institute of Environmental Health Sciences and Zubin Master at the University of Alberta in Canada wrote in a paper published in the journal European Molecular Biology Organization.

Echoing the same concerns, Dr George Daley at the Harvard Stem Cell Institute and Harvard Medical School said he was swamped by enquiries from patients asking about therapies in China and Brazil for diseases from Alzheimer's to spinal cord injuries.


"What I'm talking about are the less legitimate treatments that have not even undergone clinical trials but are directly marketed therapies... We really have no idea how to use stem cells for these treatments," Daley told Reuters.

When contacted by Reuters, a director at the PLA 455 Hospital, who declined to be identified, said: "There are always good and bad outcomes. No therapy can guarantee success to everyone... Besides, you don't have a better alternative.

"As for patients dying, all deaths must be investigated. What caused the death? If our treatment caused the death, the patient (relatives) can seek redress. If it is a death caused by old age and sickness, then there is nothing I can say."

China's Ministry of Health did not respond to questions from Reuters on stem cell therapies being offered in the country.


VICTIMS ARE THOSE FACING DEATH
Suffering from late-stage liver cirrhosis caused by a lifelong hepatitis B virus infection, Fan Hongkun was led to believe her body would spontaneously grow a healthy liver once stem cells were transplanted.

"We saw the therapy advertised online and talked to the doctor over the phone. He said stem cells were like seeds, after being planted on a liver, they grow, divide and spread and finally form a healthy liver," said Fan's son, Zhou Junjie.

Fan, 63, was so convinced, she admitted herself into Beijing Military General Hospital, whose website still carries information on the stem cell therapies it offers.

"My mother said the PLA (Chinese army) doesn't lie. That's why she trusted them," said Zhou.

Doctors there took her off the drug lamivudine for four weeks to "prepare her for the stem cell therapy". But she fell into a coma before doctors could treat her.

Sold under the brand Epivir by GlaxoSmithKline Plc, lamivudine minimizes liver damage by blocking the hepatitis B virus from replicating. 

Fan's family learnt later from other doctors that she suffered a sudden surge of the virus after she stopped her medication, which pushed her into a coma and killed her.

According to documents seen by Reuters, her family sued the hospital, but the case was dismissed by a Chinese court.

When contacted, a doctor at the hospital, who declined to be identified, said the entire procedure to transplant stem cells into a patient's liver takes only a day.

"We extract the patient's bone marrow cells and isolate the stem cells, which are then inserted into the liver," said the doctor. "...We extract bone marrow cells in the morning and in the afternoon we inject them (stem cells) into the liver. Yes, all it takes is a day. Very fast."

Advertisements for these treatments remain on the hospital's website. In Ireland, many patients have returned from treatments abroad with no improvement, but they are less willing to talk.

"Virtually none will go on record to state they have been conned. This is mainly because many patients have serious immediate health concerns and they need to focus on that," Stephen Sullivan, chief scientific officer of the Irish Stem Cell Foundation, told Reuters.

"Patients are also reluctant to come forward as they are embarrassed at spending lots of money against professional medical advice. Some patients will even claim improvement when there is no measurable improvement."


POTENTIALLY POWERFUL
Researchers believe regenerative medicine will be a powerful form of therapy in the future. Stem cells are immature, master cells in the body that can grow into any kind of human cell or tissue. Scientists are exploring how to use them to treat a variety of diseases and disorders, including cancer, diabetes and injuries.

But for now, they stress that only one type of stem cell therapy has been proven to work. "Only bone marrow transplants for diseases such as leukemia, lymphoma are backed by solid evidence and are well-established clinical procedures. The others are not up to that level," said David Siu, clinical associate professor at the cardiology division of Hong Kong's Queen Mary Hospital.

"There is evidence that certain stem cells can grow into new tissue but do they provide a therapeutic effect? We don't have the evidence yet. Some are in clinical research."

For the conditions highlighted in this article - disability from strokes and liver cirrhosis - experts say there are no proven stem cell treatments.

In their paper, Resnik and Master said while most countries had rules governing research on people and medical malpractice, they did not apply directly to stem cell therapy. When doctors encounter strict regimes, they can simply move to other countries with more permissive legal environments.

Experimental stem cell therapies, however, may be legitimately offered to patients, but these must be carried out within the framework of clinical trials that are approved by regulatory boards that ensure ethical standards are met.

"When experimental stem cell therapy is used on patients, it is not performed on an ad-hoc basis but within the framework of a proper clinical trial prepared beforehand," Siu said. "It has to follow a rigorous methodology: what are the risks, what can and cannot be done? If the results are negative, what are the rescue and safety measures?"

Sullivan urged patients to be on the lookout for scams. Suspicious signs include being asked for large sums of money up front, being told there are no risks, and being offered no post-therapy care.

Patients should be told how they will be treated, what stem cells are used and where they come from. They should not accept any therapy based on hearsay, or without the treatment being validated at least in part by peer review, he said.

Resnik and Master urged stem cell scientists, who have control over stem cell lines, to help stop these scams by not releasing such materials to doctors or clinics if they cannot produce proof of conducting a genuine clinical trial.

"This would ensure that the stem cells and other materials are going to be used in the course of responsible biomedical research, a legally sanctioned clinical trial or in responsible medical innovation," they said.

Monday 12 September 2011

Avastin injections cause blindness

The New York Times
Aug 30, 2011
By Andrew Pollack

At least 16 people in two states have gotten severe eye infections, and some have been blinded, from injections of the drug Avastin, according to health authorities and to lawyers representing the patients.





The cancer drug Avastin has been used by some doctors to treat macular degeneration, an off-label application. The incidents, in Florida and Tennessee, demonstrate the risks associated with the money-saving practice of injecting Avastin into the eye to treat the wet form of age-related macular degeneration, a common cause of severe vision loss in the elderly. 

Click here to read the rest of this article.

Saturday 3 September 2011

AMD Awareness Week 2011

The annual Age-related Macular Degeneration Awareness Week is here again and MDS is happy to play our part in this nation-wide drive.

Date: Sept 24, 2011 (Sat)

Time: 1 - 3pm
Venue: Learning Centre, Khoo Teck Puat Hospital

The event is open to the public.

Here's the programme:

1 - 1.15pm.
Speaker: Mr Narinder Sharma, CEO of AMD Alliance International. 
Topic: Support system for patients with macular degeneration: Role of AMDAI

1.15 - 1.30pm
Speaker: Dr Ajeet Wagle, Consultant, OVS, KTPH
Topic: Advances in Management of AMD

1.35 - 1.45pm
Speaker: To be confirmed
Topic: My experience with AMD treatment - a patient's story

1.45 - 2pm
Speaker: Ms Zoe Soo, pharmacist, KTPH
Topic: Role of vitamin supplements in macular degeneration

2 - 2.15pm
Speaker: Dr Yang Wei Wen, psychologist, KTPH
Topic: Coping with vision loss

21.15 - 3pm
Speaker: Ms Gladys Wong, Nutrition and Dietetics, KTPH
Topic: Healthy Cooking Demonstration

Thursday 1 September 2011

Severe drop in quality of life

Macular degeneration patients suffer a severe drop in quality of life, not unlike those with cancer and kidney dialysis, said Dr Au Eong Kah Guan on Saturday in a talk with our members. Those with moderate age-related macular degeneration, for example, suffers a dip of 40 per cent in quality of life and it is similar to those who need regular kidney dialysis. 


Dr Au Eong, who is the advisor of Macular Degeneration Society (MDS), added that those with severe AMD suffer a drop of 63 per cent in quality of life, a rate on par to prostate cancer sufferers. Such heavy impact on the mental well-being of macular degeneration patients is the reason why it is important to have support groups like the MDS. 

Furthermore, it is critical for awareness to be drummed up so that patients can make better-informed choices which would help them tell of impending attacks, he observed in a talk titled Latest Trends in Management of Macular Degeneration at the Alexandra Hospital. 

Dr Au Eong shared that nutritional supplements can slow progress of AMD by up to 25 per cent, citing Omega-3 fatty acid as useful to those with macular degeneration. He added that authorities in Singapore could soon be carrying pictures of AMD sufferers on cigarette packs here, as smoking is a known threat to macular degeneration. 

He also spoke of the clinical trials comparing the effectiveness of Lucentis versus Avastin, stressing again that early diagnosis is often the key to reduce risk of vision loss. 

MDS held its annual general meeting after the talk, with its annual statement of account presented. MDS President Sharon Siddique gave a presentation of the society's events in the last year and secretary Peh Shing Huei and treasurer Kym Ong spoke about the online platforms of MDS. In particular, members were briefed on the society's venture into Facebook in the past year.




Monday 22 August 2011

The iPad's Secret Abilities

businessweek.com
July 6, 2011
By Rachael King

Jonathan Avila uses his iPad in ways most people might not realize are possible: The device reads e-mail to him while he’s traveling to work, tells him which way to walk when he is lost, and even lets him know if there’s a sidewalk on the other side of the street. Avila needs these features because he’s visually impaired.



"Work bought it as a testing device, but I’ve claimed it as my own since it makes me more efficient," says Avila, chief accessibility officer for SSB Bart Group, a firm that helps companies implement technology for people with disabilities.

Apple has added features that make the iPhone and iPad easily accessible, not only to visually impaired people but also to those with hearing loss and other challenges. The iPhone 4 and the iPad 2, for example, come with VoiceOver, a screen reader for those who can’t read print, as well as FaceTime, video-calling software for people who communicate using sign language. Apple has said that iOS 5—due later this year—will contain improvements to VoiceOver and LED flash and custom vibration settings to let users see and feel when someone is calling.

More such devices as the iPad and iPhone will make their way into the workplace to assist people with physical challenges in the next five years. Disability and aging go hand-in-hand: As baby boomers work past age 65, companies will increasingly face this issue. The incidence of disability in the workplace is 19.4 percent at age 45 and rises to about 50 percent by age 70, according to Jennifer Woodside, chief executive officer of the Disability Training Alliance. Those disabilities can include vision and hearing loss, issues with mobility and dexterity, and learning and cognitive challenges—as well as communications problems.

A Boom in Assistive Technologies
The global market for assistive technologies, including those used in the home, is projected to reach $40.9 billion in 2016, up from $30.5 billion this year, according to a report from BCC Research that’s scheduled to be released this month. In addition to Apple, Microsoft, IBM, Google, and Hewlett-Packard make workplace technologies that are accessible to people with a range of abilities.

"Boomers will demand products, services, and workplaces that adapt to their needs and desires," says Rich Donovan, chief investment officer at WingSail Capital. Crossover technology such as the iPad, which works well both for people with disabilities and the broader consumer market, are the "holy grail" of business and disability efforts and will drive growth in disability-related capital spending, he says. Donovan, who has cerebral palsy, just received his first iPad as a Father’s Day gift. "I love it, it’s simple to use and it’s the ideal accessible technology," he says.

Companies such as Apple are motivated, at least in part, to create products that work for people with disabilities because the population is aging, says Dorrie Rush, marketing director of accessible technology at Lighthouse International, a nonprofit organization dedicated to fighting vision loss.

At the age of 33, Rush was diagnosed with early-onset macular degeneration. Twenty years later, her visual acuity is low, although she retains some peripheral vision. "I used to be on the bus and I would see people reading the newspaper and I’d be so jealous," Rush says. Then she bought an iPhone and downloaded the New York Times app. Her phone now reads the news to her on the bus each morning.

Rapid Technological Improvement
In the past two years, particularly since the release of the iPhone 3GS that came equipped with VoiceOver, Rush says she has noticed a vast improvement in the technology available to visually impaired users. "Previously, I was using and being offered a lot of technology that was obscenely expensive and at best, mediocre," she says.

For people who need to read office memos or other printed materials, Freedom Scientific sells a scanning and reading appliance for $1,800. Alternatively, there’s a free app called SayText that uses the camera from the iPhone 4 to take a photo of a document, prompting the app to read the text aloud. The same app can be used to take photos of business cards, after which the contact info is automatically scanned and uploaded into the phone’s contact directory. Similarly, ZoomReader, an app from Ai Squared that sells for about $20, reads the text in images from the iPhone 4 camera.

Identifying money can be a challenge for visually impaired or blind people because a $1 bill comes in the same size and color as a $100 bill. Reizen sells a portable money reader on Amazon.com for $99.95. In March the LookTel Money Reader app was released for the iPhone, selling for just $1.99. In April the U.S. Bureau of Engraving and Printing released EyeNote, a free money reader.

Workers who find it difficult to speak because they have cerebral palsy or have suffered a stroke once needed to spend thousands of dollars on speech-generating devices. Instead of shelling out $3,000, they can now buy an iPad for $500 and an app called Proloquo2Go from AssistiveWare that sells for about $190, says SSB Bart’s Avila. 


IT Departments Lag in Adapting
As prices decrease, many people with disabilities are discovering the benefits of various apps on Apple iPhones and iPads. Yet information-technology departments have been slow to allow these devices into the workplace. Donovan at WingSail Capital says one of his visually impaired clients brought her iPad to work and was told that the company didn’t support it yet. "There’s this dichotomy between what is accepted as assistive technology and what is actually working," he says.

"There’s a perception that the iPhone or iPad is going to be used for games," says SSB Bart Group’s Avila. Yet people who need these devices realize how much more independent they are with them. "The people I work with at the Veteran’s Administration are trying to push to get iPhones into the hands of blind veterans," Avila says.

Rush says that her office at the Lighthouse is PC-based. There are plenty of Windows-based apps for visually impaired people, but they tend to be relatively expensive. Rush says she couldn’t do her job without ZoomText screen magnifier and reader, which costs up to $995. JAWS, another popular screen reader, costs $1,075 for a single professional license.

The iPad isn’t going to suit everyone, Avila says. He finds it a good way to take notes in meetings; previously he would have needed to buy an expensive device. The iPad also lets him easily read e-mail messages and zoom in on items he needs to see more clearly. The best part might be that he’s using "the normal app that everyone else is using," he says. He’s not using a special browser and he can use AOL Instant Messenger, just like anyone else. "That," says Avila, "is a huge difference."

King
is a writer for Bloomberg Businessweek in San Francisco.

Sunday 21 August 2011

Photos at AGM

The speaker for our Double Bill on 27th Aug, Dr Au Eong Kah Guan, is writing a book on AMD. He would like to take photos of our members at the MDS annual general meeting this coming Saturday for his book and has engaged a photographer for this purpose. So, come in your BEST for your photo-taking! See you!

Monday 18 July 2011

MDS Mid-year Double Bill

By Sharon Siddique
MDS President

Dear MDS members,
 

We will be having a mid-year double bill in August. The afternoon’s programme will begin with a talk and question and answer session by our MDS advisor, Dr Au Eong Kah Guan. This will be followed by our AGM, which will include a review of MDS activities since our previous AGM, held on 10 July 2010. Members are encouraged to attend to share your views on past activities and suggestions for MDS activities in 2011/2012.

Talk: “Latest Trends in the Management of Macular Degeneration” 


Speaker: Dr Au Eong Kah Guan


Date: Saturday 27 August 2011


Time: 2pm – 2.45pm


Venue: Seminar Room, Alexandra Hospital, Alexandra Road




Tea Break: 2.45pm – 3.15pm



=====================

Agenda of the 4th AGM of MDS


Welcome by MDS President, Sharon Siddique


Annual Report 2010/2011


Financial Report 2010/2011


Overview of MDS online: website, blog and Facebook


Discussion of future activities 2011/2012

Please indicate your attendance by either telephoning Anne (62387387), or sending an email to alleyes@singnet.com.sg.
 

We hope to see you on the 27th of August!



Monday 11 July 2011

Bionic spectacles on the way

The Daily Mail
July 5, 2011
By Fiona Macrae

Bionic spectacles could soon be on sale to help hundreds of thousands of blind people ‘see’. Oxford University researchers are developing ‘smart spectacles’ that use tiny cameras and a pocket computer to alert wearers to objects and people ahead.



They will make it easier for the blind to navigate shopping centres and busy train stations, and could even allow them to ‘read’ bus numbers and the computerised displays on cash machines. The lightweight, inexpensive glasses, which could be ready for general sale as early as 2014 if tests are successful, would be suitable for most of the 300,000 Britons who are registered blind.

Elderly people with age-related macular degeneration are likely to be the biggest beneficiaries. Previous attempts to create such a device have resulted in large dark glasses with clunky cameras and bulky computers. But advances in technology mean it should be possible to create bionic spectacles that look almost indistinguishable from standard glasses.

Importantly, a price tag of less than £1,000 should make them affordable, the Royal Society’s Summer Science Exhibition heard. Dr Stephen Hicks, a clinical neuroscience researcher who is being funded by the Department of Health, said: ‘It is satisfying to think that we will be able to produce this at a cost that is going make it available to the people who will benefit the most.’

Dr Hicks has completed the basic research and is now working on prototype spectacles.

He envisages transparent glasses with lenses studded with small light-emitting diodes and cameras the size of a pinhead at the outside top corners of the frame. The cameras will take in the information the eyes should see and send it down a cable to a mobile phone-sized computer in the wearer’s pocket. The computer will process the information and simplify it into a pattern of dots. The LEDs in the lenses then light up in that pattern, giving the wearer vital information about what lies ahead.

A flickering light could mean there is a person ahead, while a solid block might signify an object such as a flight of stairs. While such information may seem unimpressive to the sighted, it could allow those who have lost much of their vision to regain sufficient independence to go shopping alone or take public transport.

Adding in an earpiece could allow more complex information to be transmitted. For instance, the cameras could capture bus numbers or information on railway departure boards to be analysed by the computer. Once processed, the information would be passed on to the wearer via a voice in their ear.

In time, the same principle could be used to help blind people to ‘see’ the screens on cash machines outside banks or ticket dispensers at train stations. The bionic spectacles rely on the wearer being able to perceive light, so will not be suitable for those who are totally blind. But most of those registered blind, including many sufferers of age-related macular degeneration, still have some vision.

Dr Hicks plans to do small-scale laboratory tests on the blind this year, before enrolling 120 people in a two-year trial that will explore the use of the spectacles in shopping centres and at home.

Friday 1 July 2011

US advisers back Eylea

June 17, 2011
By Anna Yukhananov

COLLEGE PARK, Maryland (Reuters) - A new eye medicine from Regeneron Pharmaceuticals Inc and Bayer AG is safe and effective for treating a common cause of vision loss, a panel of U.S. experts said on Friday. The Food and Drug Administration advisory panel voted unanimously to recommend Eylea as a treatment for the most serious form of macular degeneration that affects at least 1.5 million Americans.

The advisers also said the injected drug could be given once every two months, giving it an edge over the typical monthly dosing of its chief competitor, Lucentis, from Roche Holding AG.

"The data is very compelling for equivalence (with Lucentis)," said Dr. Lynn Gordon, a panel member and associate professor at the University of California in Los Angeles.

The FDA usually follows the advice of its advisory panels and is expected to rule on Eylea by August 20. Regeneron shares, halted much of Friday pending the advisory panel decision, lost 4.8 percent on Nasdaq to close at $54.02. Jason Kantor of RBC Capital Markets said Regeneron's share price had reflected an expected favorable opinion, so the decline was likely a case of "selling on the news."

Kantor predicted the drug would fare well, but said the main reason to own Regeneron is its array of antibodies being developed for other diseases in partnership with French drugmaker Sanofi SA. Age-related macular degeneration (AMD) is the leading cause of blindness in the elderly, with the wet form the most serious. Some 11 million Americans have signs of AMD. Piper Jaffray analyst Edward Tenthoff sees Regeneron taking 25 percent of the U.S. market by 2016, with annual sales of $1.2 billion.

CHEAPER CANCER DRUG

Eylea and Lucentis could face competition from Roche's cancer drug Avastin, a much less expensive medicine that is often used by doctors to treat macular degeneration even though it has not been approved by the FDA for that purpose. The amount of Avastin needed for an eye injection costs only around $50, against a U.S. price of $1,950 for Lucentis and probably a similar price for Eylea. All three drugs work in a similar way. An April study showed Avastin was as effective as Lucentis, though it had more side effects.

Eylea's advantage over both rivals may be its two-month dosing. In clinical trials, Regeneron showed that Eylea injected into the eye every two months was as effective as monthly doses of Lucentis. The committee said monthly monitoring of patients receiving Eylea was not necessary.

"I think many of my patients are looking for something they can take less often, and that's the exciting possibility of Eylea," said Dr. Jeffrey Heier, a clinical instructor of ophthalmology at Harvard Medical School who spoke on behalf of Regeneron.

Regeneron has full marketing rights to the drug in the United States and would share overseas profits equally with Germany's Bayer if Eylea wins regulatory approval in other countries. "It's a particularly proud day for us because few companies can go from the discovery of the molecule and take it to this point," said Regeneron Chief Executive Officer Leonard Schleifer.

"We started out as good scientists and hopefully we can become good manufacturers too."

Sunday 26 June 2011

MDS Mid-Year Double Bill

MDS will be having a mid-year double bill in August, holding a talk as well as our Annual General Meeting (AGM).

Our advisor Dr Au Eong Kah Guan will share with members on the "Latest Trends in Management of Macular Degeneration" and take questions after his presentation.

What new therapies are available to treat macular degeneration? Are these new therapies effective? Are they safe? What is the current clinical practice in the management of macular degeneration? Come learn about these and other issues on the latest in the management of macular degeneration.

Date: Aug 27, 2011 (Sat)
Time: 2 - 4pm
Venue: Seminar Room, Alexandra Hospital

We will hold our AGM after the talk, at 3pm. So be there! Call Anne at 6238-7387, or e-mail alleyes@singnet.com.sg to reserve your places now! This event is free for all MDS members.

Friday 17 June 2011

Eylea - new drug for MD

Jun 15, 2011
By Anna Yukhananov

WASHINGTON (Reuters) - A proposed eye medicine from Regeneron Pharmaceuticals and Bayer AG was found by U.S. drug reviewers to be an effective way of treating vision loss from macular degeneration, raising expectations it will be recommended for approval.


The drug, which be marketed under the trade name Eylea, is as effective as the similar Lucentis treatment from Roche Holding, Food and Drug Administration staff said in documents released on Wednesday. But Lucentis has monthly dosing, while Eylea would only have to be taken once every two months, making it more convenient for patients. Analysts forecast Regeneron could reap at least $1 billion in annual Eylea sales.

Both drugs may face competition from Roche's cancer drug Avastin, a much less expensive medicine that is often used by doctors to treat macular degeneration even though it has not been approved by the FDA for that purpose.

Analysts said the FDA did not raise any major issues with Eylea and expect an advisory panel to recommend approval on Friday. Shares of Regeneron closed up 5.1 percent to $57.82 on the Nasdaq, after earlier reaching a high of $61.05.

"This removes both risk and uncertainty," said Edward Tenthoff, senior research analyst at Piper Jaffray. "The FDA documents were very benign, which increases the likelihood of approval.

The drug, known as VEGF Trap-Eye, uses a mechanism similar to the one employed by Lucentis to preserve vision in patients with the wet form of age-related macular degeneration (AMD) -- the leading cause of blindness in the elderly.

Some 13 million Americans have signs of AMD and more than 1 million Americans have the wet form, the most severe type. Both drugs block vascular endothelial growth factor (VEGF), a protein involved in the creation of blood vessels. The condition progressively worsens as blood vessels leak fluid and blood under the retina, creating scar tissue.

In clinical trials, VEGF Trap-Eye injected every two months was as safe and effective in maintaining vision as Lucentis injections given monthly. The FDA will ask the advisory panel to review appropriate dosing and labeling at its meeting.

The FDA also asked the panel to look at higher intraocular pressure after frequent injections of VEGF inhibitors. This is a low-frequency side effect seen in all similar medications, including Lucentis.

Analysts said Eylea's less-frequent dosing should give it a boost over Lucentis and take market share from the rival in the United States and worldwide.

Roche shares closed down 1.6 percent on the Swiss stock exchange. Piper Jaffray's Tenthoff sees Regeneron taking 25 percent of the U.S. market by 2016, with sales of $1.2 billion.

Roche's Avastin is not licensed for use in the eye, but it works in a way similar to Lucentis, and the tiny amount needed for an eye injection costs only around $50, against a U.S. price of $1,950 for Lucentis and probably a similar price for Eylea.

Many doctors, particularly in the United States, already use Avastin "off label" to treat wet age-related macular degeneration. And analysts said more may start to prescribe it after an April study showed Avastin was as effective as Lucentis, though it had more side effects.

"The feedback we've gotten from clinicians is that many of the listed side effects were not plausibly related to Avastin's mechanism of action. So they were largely viewed as noise," said Stifel Nicolaus analyst Maged Shenouda.

"We expect Avastin to grow dramatically based on these (study) results, and for Lucentis to feel significant pressure."

What to say to someone who's sick

Six Things You Should Never Say to a Friend (or Relative or Colleague) Who’s Sick. And Four Things You Can Always Say. 

Read this lovely New York Times article for some great tips on what to say to someone who's sick. Click here.

Monday 30 May 2011

The right lenses and frames

By Kym Ong
MDS Treasurer

Great weather, a delicious orange chiffon cake, a great speaker and a very engaging audience …. This sums up our talk on refractive errors, UV protection and glasses.



When I was younger, my world of eyesight revolved around myopia and astigmatism. When my parents aged, I learnt of Hyperopia (long-sightedness). Even then, these were terms I never understood in depth. From last Saturday’s session, my vocabulary increased by another word Presbyopia and Fifianna also went through a thorough and clear explanation of what all these meant.

In short (very short), by definition:
Myopia
  • Short-sightedness which occurs through i) Axial Myiopia (the length of the eyeball is longer than “normal”) OR ii) Refractive Myopia (refractive power of the eye is higher than “normal”)
  • Light rays entering the eye are focused in front of the retina.
  • Myopia increases risks of retinal detachment, cataract, glaucoma and age-related or myopic macular degeneration.
Hyperopia
  • Long-sightedness which occurs because the length of the eyeball is shorter than normal and the refractive power of the eye is lower than “normal”.
  • Light rays entering the eye are focused behind the retina.
  • Hyperopia can cause eye strain, headaches and intermittent blur vision.

Astigmatism
  • Occurs due to an irregular curvature of the surface of the cornea.
  • Usually occurs with myopia or hyperopia.
  • Light rays entering the eye are focused on 2 points, rather than 1.
Presbyopia (Old-Sightedness)
  • Occurs when the crystalline lens loses its flexibility
  • Usually begins around the age of 40
  • May occur in addition to other refractive errors such as myopia, hyperopia or astigmatism
  • Visual disturbance due to presbyopia
  • Blurry near vision when reading, sewing, computer work or other near tasks
Prescriptive Glasses - Choosing the right type
Lens Selection
There is a wide variety to choose from for lenses. There are single vision lens, bifocal lens and progressive addition lens. There are also different types of lens materials like glass (with different features like multicoating, UV coating, hard coating etc), plastic and polycarbonate. Again, comfort is key.



Frame Selection
There is a wide variety of metals, plastics and other types of frame (wood/bone/buffalo hone etc) available in the shops. Comfort is key. Frame shapes and colours can help bring out your features. Here’s a tip from Fifianna with regards to frame shapes.














Ultraviolet Light Protection
As most of us are aware, we need to protect our eyes from UV-A and UV-B. Especially in Singapore where the rays are strong because we sit on the equator. Like applying sunblock when we go to the beach, we need constant protection for our eyes. If you are not convinced, here’s a list of eye problems that could arise and hopefully, this will prod you into better eye habits.

  • Photokeratitis - damage to the outer layers of the cornea due to exposure to intense light
  • Pterygium - triangular thickening of the conjunctiva that may grow onto the cornea and interfere with vision
  • Pinguecula - benign yellowish thickening of the normal conjunctival tissue
  • Cataract - loss of transparency of crystalline lens
  • Age-related macular degeneration (AMD) - research suggests that UV-A rays may play a role in degeneration of macula
  • Climatic Droplet Keratopathy - accummulation of translucent materials in the superficial corneal stroma