Tag: Optic nerve

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Diabetic retinopathy Macular Degeneration

Legal Blindness and the IRS

Legally blind vision loss can result from either diabetic retinopathy or macular degeneration.  Complete blindness can result diabetic retinopathy, but not ARMD.  Legally blind, or partially sighted individuals, can still “see,” whereas completely blind patients see nothing.

Diabetic Blindness

Diabetic retinopathy can cause a spectrum of vision loss, from slightly blurry vision to complete blindness.  As we have discussed recently, one difference with diabetes as compared to macular degeneration is that diabetic retinopathy can affect the entire retina due to diabetic retinal detachment.

Proliferative diabetic retinopathy can also cause neovascular glaucoma which can completely destroy the optic nerve.

Both diabetic retinal detachment and neovascular glaucoma can blind completely.

Diabetes can also only affect the macula, thus, diabetic retinopathy can cause both legal and complete blindness.

Blindness from ARMD

In contrast, only the macular area of the retina is involved in macular degeneration.  Hence, central vision may be destroyed, yet the peripheral vision is spared.

Macular degeneration can NOT cause complete blindness.

Legal Blindness

Both eye diseases have the potential for causing legal blindness as both can affect the macula, or rather, both can affect central vision.

Legal blindness is defined as vision 20/200 or worse in both eyes despite use of corrective lenses.  There are also considerations of “blindness” for severely restricted visual fields.  Confirm this with your eye doctor.

Legal Blindness May Qualify for Tax Deduction

With tax day fast approaching, obtaining a qualifying statement from your eye doctor, may allow you a tax deduction. If you file jointly, your spouse may qualify, too.

What Does This Mean? Obviously, as one who deals with partially sighted patients, I attest to a patient’s “blindness” all the time.  A letter from your doctor is all you need to confirm your legal blindness.

I have also included a link to a  “Confirmation of Blindness”  form that can be used by your doc, but I don’t know for a fact if this grid is indeed acceptable by the IRS, but it is provided by the National Federation of the Blind.

NOTE:  There are many reasons a person may become legally blind, not just from retinal disease.  As always, feel free to share any of these articles with friends, family or doctors.

Disclaimer: The information contained in this posting should only be used as a reference. Should you have additional questions contact your tax attorney or local IRS office.

U.S. Treasury Circular 230 Notice: Any tax information contained in this communication (including any attachments) was not intended or written to be used, and cannot be used, for the purpose of (1) avoiding penalties that may be imposed under the Internal Revenue Code or by any other applicable tax authority; or (2) promoting, marketing or recommending to another party any tax-related matter addressed herein.

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My Opinion

A "Toy Story"…………Stories that Blind

Most retina specialists are also surgeons.  We operate on retinal detachments, advanced diabetic retinopathy………….and trauma.  Trauma includes careless accidents involving projectiles………..like toys.  This holiday season, think about eye safety.

Airsoft with Safety Eyeware
Airsoft with Safety Eyeware

Paintball – I hate this one.  A compact canister fired at a high rate of speed.  The fancier the gun, the faster the projectile.  These things even can even travel around corners!  The size of the paintball is a perfect fit between your brow and cheekbone.  Thus, ALL the force is absorbed to the eye.  I think the safety/protection is satisfactory, but the accidents happen “off the field” when the players are not expecting a shot to be fired.

I had a 14 year boy several years ago who developed a retinal detachment, had surgery and still went blind.  The impact of the pellet was so severe, it detached his retina and severed his optic nerve.  The other problem with paintball is that the age group is old enough to know right from wrong and may lie to conceal the truth to avoid punishment.  Had I originally known a paintball was involved, we might have approached him differently.

Pocket Knife – I know many people that carry them for small odd jobs around the house; cutting string, small screw drivers, etc.

Airsoft Rifle and Safety Mask
Airsoft Rifle and Safety Mask

Then there was this “kid,” who tried to see how many times he could throw his knife and get it stuck into a tree.  The knife bounced off the tree and landed in his right eye.  The tip of the knife went right through the center of the cornea.  While his retina never detached, the knife cut his natural lens and ruined his cornea.  He needed a corneal transplant, removal of the damaged lens and a possible implant.  He’ll need life long follow up.  The “kid” was 19.

BB Gun – Believe it or not parents, BB guns are either fired on purpose at a “friend” or go off accidentally.  I have had several cases (the term we substitute for “patients”) where the BB went directly into the eye.  Most times it doesn’t penetrate the eye, but can still cause permanent damage.

Blood can fill the front of the eye and is called a hyphema.   My 12 year old boy developed a cataract and is at lifelong risk for developing glaucoma; all due to the trauma.

The kids don’t think that these low-speed projectiles are dangerous and don’t bother to don safety glasses.  They usually don’t even penetrate the skin, so the feeling is these are “safe.”

I have no opinion about “Air Soft.”

“Nerf Gun” That spongy material that has been around for generations can be blinding.  My worst “toy story” is the kid who shot a Nerf dart at a friend.  The Nerf dart had a suction cup at one end which was designed to stick to flat surfaces (e.g. window, refrigerator door, etc.).  This guy modified the suction cup with a straight pin.  I don’t think he meant it to get stuck right in his buddies eye.  They were 9 years old.

The right eye of our little patient has now undergone at least 5 retinal surgeries.  The cornea may need replacing soon due to the original accident and repeated surgeries.  The visual potential?  Legally blind, at best.

What Does This Mean? I am not advocating changing your shopping list.  I am not advocating anything.  All of these “toy stories” are true and have horrible endings.  All of these patients were young and old enough to know better. They are unfortunate.

We have five kids.  Our only rule – no real guns.  They are the same ages of everyone one of my stories.

We have everyone one of the “toys” listed above except the high-velocity paintball guns.  We encourage them about safety (especially eyes).  We encourage them to have fun with their toys and to use them as they were meant to be used.  We try not to over control.   Accidents will happen.

“Randy”

Randall V. Wong, M.D.
Retina Specialist, Ophthalmologist
Fairfax Virginia

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How I Practice Macular Degeneration

Diabetic Retinopathy: Why Is It Necessary to Dilate Your Eyes?

Every diabetic needs to get their eyes dilated once a year to look for diabetic retinopathy. Getting your eyes examined for glasses doesn’t count. Why?

The goal of examining the retina is to detect diabetic retinopathy. Pupillary dilation is the only proper way of examining the retina.  With the pupil properly dilated, your eye doctor can examine the entire retina easily and carefully.  The retina is the inside lining of the eye.  It is the sole tissue in the eye affected by diabetes.

What are we looking for in the eye exam? Basically, we are looking for swelling in the macula and evidence of neovascularization on the retina or other structures of the eye.

Macular edema, or clinically significant macular edema, can blur vision and may need treatment with either laser or intraocular injections such as Avastin® or steroid.  Neovascularization of any of the structures is a clear sign of proliferative diabetic retinopathy.  Proliferative diabetic retinopathy (PDR) can lead to blindness.  Evidence of PDR must be treated with pan-retinal photocoagulation (PRP), an intense array of laser burns to your peripheral retina.

If your eye exam has neither evidence of macular edema nor signs of proliferative diabetic retinopathy, you are considered stable.  Depending upon the severity of your disease, you may be asked to return in 6-12 months for re-exam.  Next time, we’ll be looking for the same things.

A last note:  As I have said many times before, you can not tell if you have diabetic retinopathy as your vision may be normal.  Make sure to have regular dilated exams!

“Randy”

Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist
www.TotalRetina.com

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Retina

Study Finds Cialis and Viagra Safe for Vision and Eye

A recent study published in the April edition of Archives of Ophthalmology reports that both Cialis ® and Viagra ® are safe for the retina and pose no permanent harm to the vision after a 6 month test.  The drugs, or placebo, were given daily for six months.  Several parameters were measured including vision, eye pressure and retinal function.  No deleterious effects were found.  In the past, erectile dysfunction medications have been implicated to cause permanent damage to the eye, specifically to the optic nerve.  Associations with other eye disease, including the optic nerve, are felt to be coincidental.

Randall V. Wong, M.D.
Retina Specialist/Ophthalmologist
www.TotalRetina.com

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