Night Blindness: Causes and Treatment of Decreased Night Vision

night blindness

Decreased night vision is a common concern for adults over 50. Although some middle-aged adults may realize that their night vision is not as clear as it once was, others may try to deny there is a problem. Decreased night vision among older adults is especially concerning because it may affect their ability to drive after dark.

Causes of Night Vision Problems

Difficulty seeing in dim light is known as night blindness. Night blindness isn’t actually a disorder – it’s a symptom of other underlying problems. One common cause of night blindness is untreated nearsightedness or myopia. Night blindness can also have a variety of other causes, including vitamin A or zinc deficiency and exposure to the sun.

Night vision problems can be caused by chronic diseases, such as diabetes. People with diabetes often experience nerve damage, which can affect the retina and lead to night blindness. Problems specific to the eye can also cause night vision problems. For example, the first sign of cataracts is often declining night vision. Glaucoma is increased pressure in the eye and may also cause this problem. Complications of LASIK surgery can cause problems with night vision.

Diagnosis and Treatment of Night Vision Problems
Those who suffer with night vision problems should make an appointment to see an ophthalmologist. The doctor will dilate the patient’s eyes and examine them using a bright light to examine the inner parts of the eye. Other tests may also be performed. Any serious cause of night blindness can be detected through this type of exam.

Treatment for night vision problems depends upon the cause. Cataracts can be treated with surgery, and vitamin A and zinc deficiencies can easily be corrected with diet or supplements. If night blindness is caused by diabetes, tight blood sugar control may lead to improvement. For patients who have night vision problems caused by untreated myopia, corrective lenses may correct the problem.

Aging and Night Vision Problems

Night vision problems are especially common among older adults for a variety of reasons. For many older adults, vision changes happen so gradually that they go unnoticed. According to All About Vision, pupils of older people don’t allow as much light to enter the eye. The cornea and lens can become less clear. Older adults have a reduced ability to discern small differences in brightness, which can make it more difficult to see objects in dark or dim light.

More serious eye problems that are related to the aging process can cause decreased night vision. Examples include diabetic retinopathy, age-related macular degeneration, glaucoma and cataracts.

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Nosebleed Causes, Prevention and Treatment

It is very common, especially in children, to suffer from an occasional bloody nose. Nosebleeds are usually easy to treat and are not a cause for concern. However, frequent recurring nosebleeds may indicate a serious condition that requires medical attention.

nosebleed

Causes of Nosebleeds

Nosebleeds may be triggered by numerous factors; here are some of the most common:
  • Dry air: The mucosal lining of the nose is very thin, and when the air is dry, such as in the winter when indoor rooms are heated or in the summer in dry climates, the nasal mucosa can become dry and cracked.
  • Trauma: Trauma to the nose from the outside as by a blow, or from the inside by picking the nose or vigorous nose-blowing can break small vessels.
  • Decongestants: Decongestants, corticosteroids, and other allergy or cold medications can dry out nasal passages.
  • Allergies and infections: Allergies and acute or chronic sinus infections can cause inflammation of the nasal passages, which can lead to irritation. Frequently blowing the nose due to congestion can further irritate membranes.
  • Blood-thinning drugs: Certain types of blood-thinning drugs such as aspirin, heparin and warfarin (Coumarin) inhibit blood coagulation and may produce or worsen nosebleeds.

Frequent nosebleeds may be a sign of a serious medical condition. Leukemia, tumors or polyps in the nose or sinus cavity, high blood pressure, and bleeding disorders including hemophilia, von Willebrand disease, and Osler-Weber-Rendu syndrome are some conditions that can produce recurring nosebleeds. If nosebleeds occur more than once a week, or if the bleeding is heavy and continues for more than a few minutes, see a medical professional.

How to Prevent and Treat Nosebleeds

Nosebleeds can be divided into two general types: anterior (front) and posterior (back). The vast majority (over 90%) of nosebleeds are anterior, with the blood coming from the nasal septum, the wall dividing the two nasal passages. Anterior nosebleeds are usually easy to stop with simple first aid. Posterior nosebleeds, which occur more often in older adults between the ages of 50 and 80, can be a more serious condition because the bleeding is from an artery at the back of the nose, and they are more likely to require medical attention.
To help prevent nosebleeds from occurring, keep air inside the house from becoming too dry by using a humidifier or placing a pot of water on low heat on the stove top, radiator or wood stove and allowing it to evaporate.

Gently apply a small amount of ointment such as petroleum jelly or a water-based moisturizer to the inside of the nose with a cotton swab to keep nasal passages from drying out. Saline nasal sprays can also be used to moisten the mucous membranes.

When a nosebleed occurs, do the following:
  • Sit up straight or lean forward slightly to prevent the blood from running back into the throat. If swallowed, blood can cause nausea and vomiting.
  • Gently pinch the nose between the thumb and forefinger and hold it for at least ten minutes, or until the bleeding stops.
  • Spit out any blood that has entered the mouth.
  • Try not to irritate the nose for at least 24 hours.

For those who suffer from occasional nosebleeds due to nasal dryness, taking steps to humidify the air and moisturize the inside of the nose should help to alleviate the problem. If recurring nosebleeds persist with no apparent cause, see a medical professional.

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Over-Sanitization and Its Impact on Health & the Environment

When the H1N1 pandemic struck, health authorities encouraged the use of hand sanitizers and disinfectant spray in an attempt to stem the outbreak. But while there is nothing wrong with the use of sanitizing products per se, too many people might have taken the way advice too far.

over-sanitization

Prevalence of Triclosan and Triclocarban in the Environment

Triclosan and triclocarban are two chemicals commonly used in many household cleaning products and in disinfectants – otherwise known as antimicrobials. In sufficient amounts, these two chemicals are known to cause among other things skin irritation, allergy susceptibility, bacterial and endocrine disruption.

These chemicals do not break down easily once it is washed down the drain. Traces of triclosan have been found in many of the waterways in the United States and even downstream from water treatment plants. This resilience to treatment is cause for great concern because once exposed to sunlight and water, triclosan could change into a toxin called dioxin.

High concentrations of dioxin can cause skin lesions and even alter liver functions. Long term effects of dioxin exposure could cause problems with the immune, nervous, endocrine and reproductive systems in the body. It is no accident that the majority of disinfectants have a warning label disclaiming the toxicity not mentioned in the commercials.

Don't Overuse Hand Sterilizers

Hand sanitizers that use an ethanol or alcohol base, are an effective means of reducing bacteria count on hands. However, only those with ethanol or alcohol concentrations of at least 62% are of any significant use. The effectiveness of sanitizers with anything less are comparable to washing with just plain water.

Alcohol and ethanol chemically denature proteins. Denaturing occurs when a protein is subject to outside chemical or temperature stresses. Frying an egg on a pan is an example of heat-based denaturing. Exactly like how lime juice "cooks" a piece of salmon, alcohol and ethanol literally cooks bacteria off by denaturing the protein found in all bacteria.

Great care must be taken when choosing hand sanitizers. While most commercial hand sanitizers incorporate moisturizers, some do not. Originally used by medical personnel to sterilize their hands between patients, hand sanitizers without a moisturizing component can cause excessive dryness and, in extreme cases, dermititis, or commonly known as rashes.

Over-Sanitization on Children

The risk is even greater for young children. According to a guide by the Department of Health and Senior Services in the State of Missouri:
All sanitizers are classified as a pesticide. If the wrong product is used, or is mixed too strong, it could be toxic to children. Young children absorb chemicals into their bodies easier than older children and adults. Because of their small body size, a small amount of any chemical has a much greater affect on them than adults.

Understandably, home makers want to ensure that their households are clean and free from bacteria. But it seems that the cure could be more dangerous than the problem.

Furthermore, in the effort to achieve new heights of clinical sterility, children are developing weaker and weaker immune systems. Because their bodies are not given the chance to come into contact with as many types of bacteria, their immune systems become under-developed and weak. Weak immune systems translate into more illnesses later in life when they leave their sterile environment.

Back to the Basics of Cleanliness

But no one is suggesting a spit and polish approach to house cleaning either. Not that it is inherently bad to use sanitizing products but moderation is key here. Soap and warm water is still an effective means of removing a vast majority of bacteria harmful to health. There is no need to perforate every inch of the house with disinfectant to stay healthy.

And while hand sanitizers are a convenient means of cleaning hands in the absence of soap and water, they are not a substitute. Hand sanitizers were originally intended to eliminate the chance of cross-contamination in hospitals where the patients either have weak or no immune defences. Instead of using obsessively using hand sanitizers, simply practice the recommended steps of safe hygiene like sneezing into elbows (instead of the hand) or staying home when sick.

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Participatory Medicine

participatory medicine

Participatory medicine is the emerging paradigm of health care. Dr. Zerhouni, Director of the National Institutes of Health, stated in an interview that the relationship between patient and doctor is changing rapidly. Previously, the patient assumed a passive role, receiving direction from an all-knowing doctor. The doctor is now expected to provide more explanation and communication with the patient and the patient is expected to become more literate and take a more active role in his or her own health.

Internet Use Resulted in the Emergence of the e-patient

The availability of the Internet allowed patients to access medical information that was previously unavailable. The medical establishment previously took the view that the lay person was generally unable to understand complex medical problems, so medical libraries and other sources of information were "off-limits." The Internet leveled the playing field, and the results were astounding. When individuals faced medical problems (their own or that of friends or relatives) and found the medical establishment inadequate to supply answers, they found an immense resource of information on the Internet.

Dr. Tom Ferguson was a prime mover in e-patient empowerment, and established the e-patient Scholars Working Group. His ideas were incorporated in a White Paper called "e-patients-how they can help us heal health care." According to Dr. Ferguson, the term e-patients describe individuals who are equipped, enabled, empowered, and engaged in their health care decisions.

Online Research: How Patients Find Answers not Available in Doctors' Offices

The Internet provides networks of support groups of people who have similar interests in particular medical conditions. The interaction among members results in an understanding of the disease that can be difficult for a person researching alone. A survey of members of online support communities found that online groups ranked higher than physicians for:
  • convenience
  • cost-effectiveness
  • emotional support/compassion/empathy
  • help with issues of death and dying
  • medical referrals
  • practical coping tips
  • In-depth information

The Internet is a particularly valuable resource to learn about state-of-the-art treatments at top treatment centers as well as to learn about treatment options. People with limited access to professional care may find that the Internet is the only resource to become informed about a medical condition.

Can the Medical Community Learn from Patient Research?

The explosion of medical knowledge can make it difficult for even specialists to keep up in their field. This is particularly true if the disease is rarely encountered. Physicians are so busy that they can really benefit from the input from their patient "junior partners."

The e-patients White Paper related the story of Norman Scherzer. His wife contracted a rare form of cancer that was initially misdiagnosed. Through online research he found a specialist that made the correct diagnosis as well as a clinical trial on an experimental drug. His wife was eventually cured. Scherzer established an online group with an impressive array of lay people and specialists who keep up-to-date with the disease. This model can be used for other diseases as well.

The sexual effects of Viagra were originally discovered by patients when they reported on the dramatic side effects of the drug originally designed for angina patients.

A New Journal to Study Participatory Medicine

The Journal of Participatory Medicine was established to create a forum where healthcare professionals, caregivers, and patients all could have a voice to contribute and these voices would be heard. As a result of this participation, a common language could be developed that would describe ideas that resonate among everyone. This communication could result in fresh perspectives brought to the table resulting in clearer understandings and new directions to take in delivering health care. The journal is committed to discover the best practices of participatory medicine and to test their effectiveness in improving health care and reducing costs.

How Can Participatory Medicine be Advanced?

Education is essential to teach people to take care of their own health, to research treatment methods, and to evaluate a doctor's performance. People need to be persuaded to take part in their own health by studies, narratives and reflections.

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Ocular Albinism

ocular albinism

The lack of pigment that defines albinism affects not only outward appearance, but ocular development, as well. Oculocutaneous albinism affects pigment in the skin, hair and eyes. Ocular albinism exclusively affects the development of the eye. In these patients, skin and hair pigmentation appears normal. People with both forms of albinism experience congenital visual problems associated with lack of pigment in the eye.

Albinism is a genetic condition. Because of this, and because of the complexity of the eye, treatment options for vision problems associated with albinism are limited. However, there are existing treatments that can improve patients’ vision, and recent research in gene therapy may give new hope to sufferers.

Vision Problems Associated with Albinism

According to Richard and Laura Windsor of the Low Vision Centers of Indiana (2004), the defining characteristic of ocular albinism is poor development in the center of the retina. This area, called the foveal pit, controls fine vision in a normal eye. Without the ability to focus properly, people with albinism may experience:
  • low visual acuity
  • nystagmus (eye shaking)
  • oscillopsia (disturbed vision in which fixed objects appear to move)
  • strabismus (crossed eyes or eyes that otherwise do not move together)
  • photophobia (sensitivity to light)
  • unusual head or eye movements compensating for variations in vision

There is no surgery or treatment that can correct the developmental defect in the retina of the eye. However, there are some treatments for the specific symptoms associated with albinism. Additionally, vision aids and other treatments that work for the general population can improve the visual acuity of albinism sufferers, as well.

Treatments for Ocular Albinism

While ocular albinism can result in varying levels of visual disability, sufferers can generally adapt well. The disorder is not degenerative, so vision problems that develop later can usually be attributed to the types of vision disorders, such as myopia and hyperopia, that are common in the general population. Treatments for the general population can be used for ocular albinism sufferers, as well. These include:
  • eyeglasses and bifocals
  • prescription sunglasses
  • contact lenses
  • magnifiers
  • surgical laser reshaping (LASIK)
  • lens implant
  • lens replacement

None of these, however, correct any of the congenital defects of ocular albinism. Surgery on the muscles that control eye movements can be used to correct strabismus and improve binocular vision. A similar surgery may be used to minimize nystagmus.

Hand-held telescopes, and bioptic telescope eyeglasses can help with the distance vision issues common in ocular albinism. While some of these devices can be bulky and make the wearer self-conscious, the BITA system is comparatively unobtrusive telescopic eyewear. Another company makes auto-focusing telescoping eyewear.

Research into Albinism

Albinism is a rare disorder that, according to the National Association of Albinism and Hypopigmentation (NOAH) affects approximately one in 17,000 people. Because ocular albinism is rare, non-degenerative, and its sufferers usually adapt well, there is very little research being done into therapies specifically for this condition. However, researchers are working on mapping the specific faulty genes that cause albinism.

Additionally, gene therapy has already been used to improve the vision of patients with congenital blindness. In 2008, researchers at the Children’s Hospital in Philadelphia successfully used gene therapy to improve the vision of three blind patients. While those patients suffered from a different vision disorder, the successful use of gene therapy as a treatment for that retinal disorder indicates that it may one day be used for ocular albinism sufferers, as well.

While there is no treatment specifically for ocular albinism, vision aids, surgery and the adaptability of those affected can minimize the impact of the vision disorder on patients with albinism. The successful use of gene therapy in treating a similar ocular disorder gives hope that a cure is on the horizon for the visual problems associated with albinism.

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Lyme Disease – Know the Signs and Symptoms

lyme disease

Lyme disease is an illness caused by bacteria from the species called Borrelia. This bacterium can live in the stomachs of deer and mice. When a tick feeds from an infected animal, they can become carriers of this bacterium. These ticks can spread the disease to a person by biting the skin thus allowing the bacterium to enter the human body. The disease cannot be spread from person to person. (Journals.uchicago.edu “Clinical Infectious Diseases,” accessed October 6, 2016).

Symptoms of Lyme Disease

Early symptoms of Lyme disease develop within days to weeks of the initial contact. The early symptoms include headaches, fever, weakness and fatigue. The area on the skin where the bacterium enter becomes inflamed with a red, circular, non-raised rash that eventually looks like a bull’s eye target. Not all patients develop this rash and the rash, swelling and redness can resolve on its own in about a month.

Other early symptoms may include muscle and joint stiffness and swollen glands or swollen lymph nodes. According to the Centers for Disease Control, “Lyme Disease”, most cases of the disease can be eliminated if treated early with antibiotics.

If the early symptoms are not treated, the disease can worsen and lead to more serious symptoms affecting other body systems. In a few weeks to months after the initial tick bite, the infection spreads throughout the body. The joints and the nervous system can become affected.

When the disease reaches the joints and nervous system, a person can experience numbness and tingling in muscles and pain and inflammation in the knees and other large joints. Other symptoms may include a stiff neck, light-headedness, confusion, nausea and vomiting and meningitis. Lyme disease can cause anxiety and extreme depression.

As symptoms progress, the patient can have blurred vision, drooping eyelids, sensitivity to light, dysfunctional movement and loss of muscle function. They can develop facial paralysis, also called Bell’s palsy, can experience hallucinations, can have speech impairment, can have decrease in consciousness and become unconscious.

The development of chronic arthritis, usually only in one or a few joints, is a common symptom of this disease. Other late symptoms of Lyme disease can be inflammation of the heart muscle causing palpitations and abnormal heart rhythm. If a patient is not treated effectively, Lyme disease can cause heart failure and death. (Mayoclinic.com “Lyme Disease,” accessed October 6, 2016).

Prevention of Lyme Disease
There are several defense measures that help prevent Lyme disease. One of these measures is to avoid any skin exposure while in areas where ticks live and thrive. These areas include wooded areas and areas with tall grass.

Another preventive measure is to spray exposed skin and clothing with insect repellent prior to engaging in outdoor activities. Other measures include wearing long-sleeves and long pants, and wearing boots while outdoors. Some ticks are very hard to see. Wearing light-colored clothes can help detect exposure.

Pets should be examined routinely for existence of ticks. If pets who acquire ticks play in or around an area where humans play in or around, these play areas should be treated with safe but effective products that eliminate ticks. Ticks should also be removed safely and effectively from pets.

Once back indoors, clothes should be removed immediately. Skin and clothes should be examined thoroughly. The hair and scalp should also be examined closely for ticks. It is also important to properly remove ticks.

If it is necessary to remove a tick from the skin, the area should be cleaned with soap and water immediately after removal. If a person feels like they are symptomatic of Lyme disease, it is important to get diagnosed early by a physician. Early treatment of Lyme disease is the most effective way to prevent it from becoming serious. (Cdc.gov “Lyme Disease Treatment and Prognosis,” accessed October 6, 2016).

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