Sunday, July 31, 2011

Look Into My Eyes

I used to play a game with my grandson where I put my forehead against his and said, “Look into my eyes!” For some reason he always thought that was funny. It might have been my goofy tone of voice, or else he could see something in my eyes no one else could.

Recently I found out just how deeply an optometrist can look into my eyes. While I was on vacation, I saw some flashes of light in my left peripheral vision and a few quick Internet searches later discovered that it could mean a detached retina. Knowing that doing something soon was the key, I tried to find someone to look at my eye on a weekend in a tiny town in Maine. Well, that just didn’t happen so I made an appointment as soon as I got home.

After dilating my eyes, the optometrist used a powerful scope to examine them. His verdict was that my retinas were in fine shape, and I didn’t have any eye disease. That was the best kind of news for me to hear. After all, my vision is horrible and I didn’t need anything to make it worse.

Now it seems that eyes may be a way to detect Alzheimer’s. Anyone who has been through the diagnostic process, especially with younger-onset dementia, knows just how painstakingly slow, and expensive, getting a diagnosis can be. It is no wonder that some people skip the testing and just assume they have Alzheimer’s.

Researchers have found a couple of different biomarkers in eyes that would indicate Alzheimer’s disease or the risk of getting Alzheimer’s disease. A new study from Australia discovered that blood vessels in the eyes of people with Alzheimer’s were a different width than those who did not have the disease.

Several years ago, researchers at Boston University found amyloid (the substance in Alzheimer’s plaques) in the eyes of people with Alzheimer’s. Some of the original researchers have been working several years on a laser scanner for early detection of Down’s and Alzheimer’s.

It takes years for research to be put into common use and the eye test for Alzheimer’s is no exception. So it doesn’t look like easy detection will happen soon.

You may be wondering why researchers would be trying to detect Alzheimer’s early when there isn’t a cure available and all current medication does is delay the symptoms, not the disease. One of the most compelling arguments for early diagnosis is to make sure you have Alzheimer’s and not a treatable condition.

It took us nearly two years to get a diagnosis for Jim. At first, we thought his symptoms might be from depression. When treating the depression didn’t help, he was checked for vitamin deficiencies, diabetes, AIDS, and other conditions that we probably didn’t even know they were ruling out.

After psychological testing, we learned that Jim had dementia—and the most likely cause was Alzheimer’s. This brought about a new series of tests. One scan indicated damage from a stroke, but a more sensitive scan showed general brain atrophy rather than stroke damage. A few specialists later, the Alzheimer’s type of dementia diagnosis seemed most likely.

So how would earlier detection have helped? If Jim had been able to take the Alzheimer’s drugs, they would have been more effective during the early stages of the disease. More important to us, we didn’t ignore a treatable condition with the assumption that he had Alzheimer’s.

I had good insurance, or we could not have afforded to explore all the possible reasons for Jim’s problems. Not everyone is fortunate enough to have insurance to pay for the endless testing to rule out reversible conditions.

If an eye exam could be used as a screening tool, it would be an inexpensive way to monitor your health. Looking into your eyes could mean you would know if your symptoms are from Alzheimer’s, or whether you need to keep searching for a different, and possibly treatable, cause.

Copyright © July 2011 L. S. Fisher
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