Retinal Emboli More Likely in Adults Over Age 70

HOT TOPIC

According to a soon-to-be-published article in the American Journal of Ophthalmology, retinal emboli are 10 times more likely to occur in adults older than 70 years of age than in those between 40 and 49 years of age.

In addition to this, new risk factors, including a patient’s BMI and socioeconomic status, have been identified as significant. This study of 5,764 patients with retinal emboli also sought to determine if there were any links between the emboli and other risk factors, including sex, race, education, income, diabetes, cardiovascular issues, smoking, and alcohol use.

The study found incidental retinal emboli in 0.7% of patients, although the survey-weighted prevalence of retinal emboli increased with age, from 0.1% in the 40 to 49 age group to 1.4% in the ≥ 70 age group. Notably, the prevalence did not differ between sex or race; however, current smokers, those with a low household income, hypertension, and underweight BMI were all associated factors. (Read more here.)

OUTSIDE THE LANE

Visually Impaired and Need to Use the Subway? There’s an App for That!

Researchers at New York University’s Tandon School of Engineering and NYU Grossman School of Medicine have developed a new trip-planning app called the Commute Booster that has shown encouraging results in improving navigation of New York City subway stations for people who are blind and have low vision.

The app routes public transportation users through the “middle mile” (the part of a journey inside subway stations or other similar transit hubs) in addition to the first and last miles that bring travelers to and from those hubs. “The ‘middle mile’ often involves negotiating a complex network of underground corridors, ticket booths, and subway platforms. It can be treacherous for people who cannot rely on sight,” said John-Ross Rizzo, MD, who led the research team that includes advisors from New York City’s Metropolitan Transit Authority. Subway signs are typically graphic or text-based, which creates challenges for the visually impaired to recognize from distances and reduces their ability to be autonomous in unfamiliar environments.

Commute Booster automatically determines what signs a traveler will encounter along the way to a specific subway platform. Then, it uses a smartphone’s camera to recognize and interpret signs posted inside transit hubs, ignoring irrelevant ones and prompting users to follow relevant ones only. In a recent study, researchers tested Commute Booster’s interpretation of signage from three New York City subway stations that a traveler would encounter on a specific journey. The app proved 97% accurate in identifying signs relevant to reaching the intended destination. Testing inside those three subway stations also revealed that Commute Booster could “read” signs from distances and at angles that reflect the expected physical positioning of travelers.

According to the researchers, Commute Booster relies on two technological components; one is general transit feed specification, a standardized way for public transportation agencies to share their transit data with various developers and third-party applications. The second component is optical character recognition, which allows camera phones to translate images of text into actual editable text.

My Two Cents

How great is this? It’s so encouraging to see that as technology continues to advance at a rapid pace, those with various impairments (including visual) are not being left behind. This already impressive technology should continue to improve and allow those who are visually challenged to live a more independent life.

CAN YOU RELATE

Burnout. It’s real. According to one survey, more than 60% of physicians often experience feelings of burnout. Another study reports that burnout among US doctors is becoming more common and now affects more than half of practicing physicians. (Read more here.)

I have experienced burnout. For the first time in my 10 years of practicing optometry, it hit me. We embrace new technology at Williamson Eye Center, and strive to offer our patients the same technology that we would choose for ourselves.

New technology is incredible and affords a substantial upgrade in our ability to offer our patients the most clear and comfortable vision found anywhere, but the process can be extremely mentally challenging. There are times when patients expect superhuman vision that cannot be achieved with modern medicine. This can result in them having unrealistic expectations, which leaves us to deal with that disappointment.

With one of our pieces of technology, we can achieve absolutely astonishing results—from our perspective. Knowing what we know about ocular anatomy and expected BCVA, we couldn’t be happier, but just because we’re ecstatic with outcomes doesn’t mean our patients are. This particular device requires multiple visits with me, the OD, as I work with patients to achieve their best vision possible. However, these visits have turned into therapy sessions, where I have had to discuss the realistic expectations that were set from day 1 over and over again. It wears you down.

In the coming weeks, I’ll discuss how I was able to heal from my burnout and offer some strategies that may help some of you who are going through a similar situation.