Nova Vision Site

Nova Vision Site Contact information, map and directions, contact form, opening hours, services, ratings, photos, videos and announcements from Nova Vision Site, Hospital, 951 Broken Sound Parkway, Suite 320 Boca Raton, Miami, FL.

NovaVision VRT is intended for the diagnosis and improvement of visual functions in patients with impaired vision that may result from trauma, stroke, inflammation, surgical removal of brain tumor(s) or brain surgery. VRT is designed to strengthen the visual information processing of residual neuronal structures that have survived following acute lesions of the nervous system resulting from trauma, stroke, inflammation, or elective surgery for removal of brain tumors. By repeated activation through the course of the therapy, VRT is designed to improve the neuronal efficacy of such residual cells, i.e., patients use the program to train and improve their impaired visual functions, and thus regain useful vision in the area of the visual field deficit.

ISPOR Europe Panels – Healthcare EconomistMark your calendars and be sure to register: I will be speaking on two panels ...
11/08/2021

ISPOR Europe Panels – Healthcare Economist

Mark your calendars and be sure to register: I will be speaking on two panels at the upcoming ISPOR Europe 2021 virtual conference. These panels include: “Addressing Payment Challenges for Alzheimer’s Disease-Modifying Therapies” on December 1, 16:00-17:00 CET and “Challenges in Quantifying the Value of Digital Therapeutics” on December 2, 11:00-12:00 CET.

Further event details here: https://bit.ly/3q1mV1F

News ISPOR Europe Panels – Healthcare Economist Byadmin November 8, 2021 Mark your calendars and be sure to register: I will be speaking on two panels at the upcoming ISPOR Europe 2021 virtual conference. These panels include: “Addressing Payment Challenges for Alzheimer’s Disease-Modifying Th...

Who won from rising insulin drug prices? – Healthcare EconomistPerhaps surprisingly, the answer is PBMs, not drug manufa...
11/06/2021

Who won from rising insulin drug prices? – Healthcare Economist

Perhaps surprisingly, the answer is PBMs, not drug manufacturers. That is one of the conclusions discussed in a recent commentary by Good and Hernandez (2021). They try to get to the bottom of this question, writing:

Most explanations for increasing drug costs start with drug companies, and indeed they are an easy target. Manufacturers in the US are allowed to set their own price for new products, which are then protected from competition through patent exclusivity…list prices of branded drugs increased at a yearly average of 9.1% from 2007 to 2018…
However, increasing list prices of drugs are partially mediated by ever-increasing discounts. Thus, drug manufacturers point to the net price of drugs (the cost of drugs after all discounts have been applied) rather than the list price as representing a more accurate figure of drug costs…previous analyses indicate that discounts on branded products accounted for 60% the increase in drug costs from 2007 to 2018

More empirical details are provided in a paper by Van Nuys et al. (2021). Using an approach similar to what was used to track flow of funds through the drug distribution system overall (Sood et al. 2017), they find that:

Between 2014 and 2018, mean list prices of 32 insulin products increased by 40.1% (from $19.60 to $27.45), while mean net prices received by manufacturers decreased by 30.8% (from $10.53 to $7.29). Net expenditures per 100 units of insulin increased by 3.2% (from $15.11 to $15.59) while the share of a hypothetical $100 insulin expenditure accruing to manufacturers decreased by 33.0% (from $69.71 to $46.73) and the share accruing to health plans decreased by 24.7% (from $13.82 to $10.40). The share of insulin expenditures retained by pharmacy benefit managers increased by 154.6% (from $5.64 to $14.36), the share retained by pharmacies increased by 228.8% (from $6.21 to $20.42), and the share retained by wholesalers increased by 74.7% (from $4.63 to $8.09).

In short, intermediaries (PBMs, pharmacies) are gaining increasing share of the insulin price relative to drug manufacturers. The graphics below are courtesy of JAMA. Do read the entire paper here.

News Who won from rising insulin drug prices? – Healthcare Economist Byadmin November 5, 2021 Perhaps surprisingly, the answer is PBMs, not drug manufacturers. That is one of the conclusions discussed in a recent commentary by Good and Hernandez (2021). They try to get to the bottom of this questi...

Mitochondria: Essential Powerhouse for Brain & VisionCellular organelles called mitochondria produce energy.Why are mito...
10/28/2021

Mitochondria: Essential Powerhouse for Brain & Vision

Cellular organelles called mitochondria produce energy.

Why are mitochondria essential to your health and well-being?

Mitochondria are the energy batteries of our cells. They are tiny organelles within most cells of the body that provide respiration and energy. Low metabolism develops in the brain as we age and is noticeable in brain regions where mitochondrial structure has changed. 1 The mitochondria attempt to replace themselves whenever they are damaged and destroyed. However, mitochondrial biogenesis can be disrupted. Mitochondrial disease, oxidative stress and free radical damage, drinking alcohol, eating a poor diet, and heavy metals can harm the mitochondria. Research on links between mitochondrial dysfunction and Alzheimer’s Disease are underway. The good news is that lifestyle and natural supplements can support healthy mitochondria functioning.

Mitochondrial Biogenesis

Mitochondrial biogenesis is the process by which cells increase mitochondria to replace damaged or non-functioning organelles. This process plays an essential role in maintaining an adequate functional neuronal mitochondrial mass by compensating for damaged mitochondria that have been eliminated. It is highly regulated and requires coordination and crosstalk between the complete set of DNA in a cell (nuclear genome) and mitochondrial genomes. While mitochondrial biogenesis occurs on a regular basis in healthy cells where mitochondria constantly divide and fuse with each other, it also occurs in response to oxidative stress, increased energy demand, exercise training, and certain diseases.

Mitochondrial Disease

Some conditions are considered mitochondrial diseases. These are chronic and genetic disorders that can be inherited and which occur when mitochondria are altered and consequently can not produce sufficient energy for the body to function efficiently.

Examples are Lebers’, deafness, diabetes, and retinitis pigmentosa.

Other conditions are associated with mitochondria dysfunction.

Examples of eye disease are cataracts, optic nerve atrophy, eye muscle weakness, optic neuropathy, retinal damage, rod-cone dystrophy, and Stargardt’s disease.

Examples of brain disorders are Alzheimer’s, Parkinson’s, and possibly other dementia-related disorders where mitochondria problems appear to be critical factors.

Symptoms of mitochondrial diseases can include:

Poor growth.

Muscle weakness, muscle pain, low muscle tone, exercise intolerance.

Vision and/or hearing problems.

Learning disabilities, delays in development.

Autism spectrum disorder.

Heart, liver or kidney diseases.

Alzheimer’s and Neurodegenerative Diseases

In Alzheimer’s disease 2 brain mitochondria abnormalities

reduce membrane potential, the ability for ion transfer across membranes allowing the cell to act as a battery, and transmit signals to different parts of the cell,

increase permeability, reducing the membrane’s ability to act as gatekeeper, and

produce excess free radicals which damage proteins, lipids, and nucleic acids.

Growing evidence suggests that elevated amyloid beta levels (Aβ) related to Alzheimer’s disease (AD) contribute to these mitochondrial abnormalities and although the mechanism is not clearly established, both amyloid precursor protein (APP) and Aβ are found in mitochondrial membranes and interact with mitochondrial proteins. Overproduction of APP and Aβ may affect dynamics of mitochondrial fusion/fission,3 impair mitochondrial transport, disrupt the electron transfer chain, increase ROS (Reactive Oxygen Species) production,4 and impair mitochondrial function.

These findings build a strong case for mitochondrial dysfunction in AD and effective treatment will likely include targets that address mitochondrial function.

Issues that Negatively Affect Mitochondria

Oxidative Stress and Free Radicals

Oxidative stress develops when production of free radicals in cells exceeds the ability of antioxidants to stabilize them. Oxidative stress is probably at the root of most health conditions, because it has the capacity to damage all cell structures. It is implicated in a wide range of chronic and degenerative diseases.

Much of the free radical damage is done to mitochondria causing mutations or premature cell death. Within cell mitochondria, damage due to oxidative stress results in DNA strand breaks and lowered ability of DNA to replicate. Some forms of cancer are traced to this malfunction.

Inflammation is both a cause and result of oxidative stress. Oxidative stress and inflammation easily induce each other.

Free radical accumulation and restriction of the ability to move electrons via mitochondrial pathway (known as the respiratory chain enzyme complex) causes damage to mitochondria in the brain,5 leading to the onset of neurodegenerative diseases, such as Parkinson’s, Alzheimer’s, and Huntington’s disease.

Too many free radicals react with fatty acids and proteins within cells and impair their function.

Membranes of lipids are highly vulnerable to oxidative stress, and damage to them in the brain may be important in understanding Alzheimer’s disease where accumulation of beta amyloid may be a protective response to oxidative stress.

Alcohol

In the last few years researchers have determined that not only does alcohol negatively impact mitochondria in the liver, but that brain mitochondria are particularly vulnerable.6 Research in both animal and human models have shown that alcohol intake changes mitochondrial structure and function by impairing mitochondrial biogenesis and causing mitochondrial DNA damage.7

Poor Diet

A poor diet with large amounts of refined carbohydrates, fats, sugars, and various additives, flavorings and preservatives contributes to development of free radicals, inflammation, and oxidative stress, which, in turn negatively affect mitochondria function. “Mitochondria are the powerhouse of the cell and mainly responsible for nutrients metabolism, but they are also the main source of oxidative stress and cell death by apoptosis. Unappropriated nutrients may support mitochondria to become the Trojan horse in the cell. “8

Heavy Metals

The accumulation of heavy metals in the body may induce various detrimental intracellular events, including oxidative stress, mitochondrial dysfunction, DNA fragmentation, protein misfolding, cell cleansing/removal, and premature cell death.9

Promote Healthy Mitochondrial Function

Researchers have identified several methods to improve mitochondrial functioning.

Caloric restriction involves consuming 20-40% lower calories than normal, and has been reported to protect against age-related mitochondrial dysfunction10 and to reduce mtDNA damage.11

Exercise, alone or in combination with caloric restriction may also represent an efficient strategy to delay mitochondrial aging and age-related as it improves oxidative capacity, protein quality control, and has been shown in aging men to promote mitochondrial biogenesis.12, 13

Diet. try to avoid all refined carbohydrates, trans fatty acids found in many processed foods, baked goods, margarine, crackers, avoid fried foods, sugary drinks and diet sodas, artificial sweeteners, all sugar particularly high fructose sugar. Eat lots of green, leafy vegetables, colored foods such as berries, carrots and purple cabbage.

The ketogenic diet increases production of specific mitochondrial uncoupling proteins (UCPs)14 and may also protect against various forms of cell death. [iii] 15

Foods. Favor green leafy vegetables, blueberries, mulberries, green and black tea.

Herbs.16 Acetyl-L-Carnitine, L-carnosine, Alpha Lipoic Acid, Ashwagandha, Astaxanthin, Baicalein, CoQ10, Curcumin, D-Ribose, Ginseng, Glutathione, Gotu Kola, Grapeseed Extract, Lutein, Lycopene, Pyrroloquinoline quinone (PQQ), Resveratrol, Vitamin C.

Supplement Recommendations

PPQ. Pyrroloquinoline quinone helps support mitochondria function, the power supply of the cells, and is a powerful antioxidant. This formula is non-GMO

L-Carnosine. Carnosine is a molecule (containing two amino acids) that has antioxidant properties to fight free radicals.

Dr. Grossman’s Vitamin C – (plant-based). Organic Amla supplies vitamin C content of this formulation, along with bioflavonoids that synergistically support vitamin C.

Dr. Grossman’s Advanced Eye and Dr. G’s Whole Food Superfood Multi120 Vcap Combo – 2 months supply

Advanced Eye and Vision Support Formula

Mitochondria Support Package – any one of the products in this package can be ordered individually as well.

Books

Natural Eye Care: Your Guide to Healthy Vision and Healing

Natural Brain Support: Your Guide to Preventing and Treating Alzheimer’s, Dementia, and Other Related Diseases Naturally

Natural Parkinson’s Support: Your Guide to Preventing and Managing Parkinson’s

Footnotes

News Mitochondria: Essential Powerhouse for Brain & Vision Byadmin October 28, 2021 Cellular organelles called mitochondria produce energy. Why are mitochondria essential to your health and well-being? Mitochondria are the energy batteries of our cells. They are tiny organelles within most cells of....

Characteristics of neighborhoods with high and low COVID-19 vaccination rates – Healthcare EconomistWhat do the vaccinat...
10/27/2021

Characteristics of neighborhoods with high and low COVID-19 vaccination rates – Healthcare Economist

What do the vaccination rates look like in the largest U.S. cities? In these cities, how do the characteristics of individuals in neighborhoods with low vs. high vaccination rates differ?

To answer this question, a paper by Sacarny and Daw (2021) use data from 9 large US cities: New York, Los Angeles, Chicago, Houston, Phoenix, Philadelphia, San Antonio, San Diego, and Dallas. Specifically, they gather data on COVID-19 vaccination and death rates for these cites from health authority websites and sociodemographic information from the American Community Survey (ACS).

They find that neighborhood with high vaccination rates have: (i) more Whites and Asians and fewer Blacks and Hispanics, (ii) more people who received a bachelor’s degree or higher, and (iii) higher income levels, (iv) a higher share of individuals aged 65 and above. Unsurprisingly, COVID-19 deaths are lower in the highly vaccinated neighborhoods in these cities.

News Characteristics of neighborhoods with high and low COVID-19 vaccination rates – Healthcare Economist Byadmin October 27, 2021 What do the vaccination rates look like in the largest U.S. cities? In these cities, how do the characteristics of individuals in neighborhoods with low vs. high vacci...

Halloween Contacts – InSight Vision CenterHalloween contact lenses, are a must-have for a spook-tacular Halloween look! ...
10/25/2021

Halloween Contacts – InSight Vision Center

Halloween contact lenses, are a must-have for a spook-tacular Halloween look! While you are spoilt for choice with a plethora of options available in the market, there are a few important things to keep in mind before choosing that perfect pair of Halloween contacts to complete your spooky look.

In order to bust myths around contact lenses and create awareness regarding the types of eye diseases which may result from wearing such lenses without prescription, we have made a concise and easy-to-follow infographic so that you dress up this Halloween with care!

Take a look at this infographic to know how you can treat your eyes with a safe choice when it comes to Halloween contact lenses.

Book an appointment with InSight Vision Center to know more about it.

News Halloween Contacts – InSight Vision Center Byadmin October 25, 2021 Halloween contact lenses, are a must-have for a spook-tacular Halloween look! While you are spoilt for choice with a plethora of options available in the market, there are a few important things to keep in mind before choosin...

What is it? – Healthcare EconomistIf you are on Medicare, how much will you pay for insulin? The answer is in the graph ...
10/23/2021

What is it? – Healthcare Economist

If you are on Medicare, how much will you pay for insulin? The answer is in the graph below (via MedPAC’s Payment Basics)

Seem confusing? Well it is. Medicare Part D beneficiaries have a deductible, then the standard coverage phase with 25% cost sharing, then a coverage gap where beneficiaries pay 25% of cost (manufacturers cover 70% of the cost for branded drugs in this coverage gap), and then a catastrophic phase where beneficiaries pay 5%. Wouldn’t it be easier if there were simple copayments like many commercial plans?

That is what CMS has been trying out in their Part D Senior Savings Model. The model includes fixed copayments for certain enhanced Part D plans. CMS writes:

The voluntary Model tests the impact of offering beneficiaries an increased choice of enhanced alternative Part D plan options that offer lower out-of-pocket costs for insulin. CMS is testing a change to the Manufacturer Coverage Gap Discount Program (the “discount program”) to allow Part D sponsors, through eligible enhanced alternative plans, to offer a Part D benefit design that includes predictable copays in the deductible, initial coverage, and coverage gap phases by offering supplemental benefits that apply after manufacturers provide a discounted price for a broad range of insulins included in the Model.

As described by former CMS administrator Seema Verma in the Health Affairs blog:

MS’s Part D Senior Savings Model is designed to lower prescription drug costs by providing Medicare patients with Part D plans that offer the broad set of insulins that beneficiaries use at a stable, affordable, and predictable cost of no more than $35 for a 30-day supply…beneficiaries who do not qualify for the low-income subsidy (LIS) currently pay 5 percent of the negotiated price when they reach the catastrophic phase, which should be lower than $35 in most cases. Part D sponsors could offer lower copays than $35 and still maintain all formulary flexibilities and choices.

Sharon Jhawar, Chief Pharmacy Officer at the SCAN Health Plan argues that the Senior Savings Model is working, should be made permanent, and should be expanded to both other diabetes medications and medications used to treat other common chronic conditions. Previous research shows that cost is a barrier to medication adherence, and she writes:

Let’s accelerate the timeline for making the Model permanent and use the expected cost-savings ($250 million per year) to advance other health initiatives for Medicare beneficiaries with diabetes…Yet diabetes is only the fifth most common chronic condition among Medicare beneficiaries. People with other chronic conditions, such as heart conditions, neurological conditions, or auto-immune diseases, will encounter the same financial challenges we see in the diabetes medication scenario. With a successful template in place to manage costs, we have a unique opportunity to reduce prescription costs across the board.

For more information, read the CMS Senior Savings Program Fact Sheet and visit their website.

News What is it? – Healthcare Economist Byadmin October 23, 2021 If you are on Medicare, how much will you pay for insulin? The answer is in the graph below (via MedPAC’s Payment Basics) Seem confusing? Well it is. Medicare Part D beneficiaries have a deductible, then the standard coverage phase...

CMMI and its revised strategy – Healthcare EconomistCreated by Section 3021 of the Affordable Care Act (ACA), the Center...
10/22/2021

CMMI and its revised strategy – Healthcare Economist

Created by Section 3021 of the Affordable Care Act (ACA), the Centers for Medicare and Medicaid Innovation (CMMI; aka The CMS Innovation Center) has been tasked with creating new reimbursement strategies to improve quality and decrease costs. Over the past decade, CMMI has tested over 50 new payment models, and in just the last 3 years (2018-2020) CMMI models have reached almost 28 million patients and over half a million health care providers and plans.

Despite these ambitious goals, CMMI reports that “only six out of more than 50 models launched generated statistically significant savings to Medicare and to taxpayers and four of these met the requirements to be expanded in duration and scope.”

In their recently released white paper “Innovation Center Strategy Refresh.” CMMI claims to have learned the following lessons:

Ensure health equity is embedded in every model

Streamline the model portfolio and reduce complexity and overlap to help scale what works.

Tools to support transformation in care delivery can assist providers in assuming financial risk.

Design of models may not consistently ensure broad provider participation.

Complexity of financial benchmarks have undermined model effectiveness.

Models should encourage lasting care delivery transformation.

Some interesting points from the report include:

Medicare FFS beneficiaries will be in an accountable care relationship with providers and will have the opportunity to select who will be responsible for assessing and coordinating their care needs and the cost and quality of their care.

The above seems obvious, but previously, beneficiaries were attributed to physicians typically based on the number of physician visits (often just evaluation and management [E&M] visits). This meant that some patients who would be overseen by a specialist during an acute bout of a disease would be then held responsible for all of a patient’s cost. Further, neither the patient nor the provider would know to which physician the patient would be attributed. While this approach may seem confusing, the benefit was attribution could be done passively; while more active attribution probably makes sense, it is unclear whether patients will actively select providers to manage their care or what will be needed to incentivize patients to do so.

The CMS Innovation Center will address barriers to participation for providers that serve a high proportion of underserved and rural beneficiaries, such as those in Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas (MUAs), and designated provider types such as Federally Qualified Health Centers (FQHCs), rural health clinics (RHCs), and other
safety net providers and create more opportunities for them to join models with supports needed to be successful.

A key question is how CMS will do this. One approach would be to set lower quality or less strict cost evaluations for these types of providers. While doing so would make participation in alternative payment models more attractive, it would also create a two-tiered system with lower quality standards for disadvantaged beneficiaries in HPSA and MUAs who are often treated at FQHCs, HCS and other safety net providers. CMMI have not spelled out explicitly how they plan to accomplish this equity quote. The only concrete action CMMI mentions is collecting data on race, ethnicity and geography to examine health disparities.

Drawing on more diverse beneficiary, caregiver, and patient perspectives will systematically inform development of models that test care delivery changes and innovations that are meaningful and understandable to them….Providers participating in models, particularly total cost of care models, will have access to more payment flexibilities that support accountable care, such as telehealth, remote patient monitoring, and home-based care.

This is clearly a good idea. How to implement more patient-centered care, however, is a challenge. It is good to see that CMS is considering allowing for payment flexibilities around telehealth going forward, but it is not clear why this flexibility would only be extended to providers in total cost of care models; all providers should be able to leverage telehealth to improve patient access and outcomes, not just those in total cost of care models.

CMMI also proposes to lower beneficiary out-of-pocket cost spending, but focuses only on increased use of generic and biosimilars. The Innovation Center also calls for the use of value-based insurance design (VBID). While VBID is sensible, health economic analysis will be needed to determine what treatments qualify as “high-value” and would be subject to low patient cost sharing.

To achieve some of these goals, the CMS Innovation Center aims to go ‘all-in’ on value-based reimbursement and is attempting to expand these payment schemes beyond Medicare. Specifically, they aim to measure their progress as follows:

All Medicare beneficiaries with Parts A and B and most Medicaid beneficiaries will be in a care relationship with accountability for quality and total cost of care by 2030.

Where applicable, all new models will make multi-payer alignment available by 2030.

Below is a table describing how CMS will measure success for different stakeholder groups.

There is much more in the white paper and you can read the full document here.

News CMMI and its revised strategy – Healthcare Economist Byadmin October 22, 2021 Created by Section 3021 of the Affordable Care Act (ACA), the Centers for Medicare and Medicaid Innovation (CMMI; aka The CMS Innovation Center) has been tasked with creating new reimbursement strategies to improve ...

Center for Healthcare Economics and Policy brochure – Healthcare EconomistCheck out FTI Consulting’s Center for Healthca...
10/19/2021

Center for Healthcare Economics and Policy brochure – Healthcare Economist

Check out FTI Consulting’s Center for Healthcare Economics and Policy‘s new services sheet here. The cover page and overview of some of our HEOR services are below.

More details on the full scope of health economics services that we offer can be found here.

News Center for Healthcare Economics and Policy brochure – Healthcare Economist Byadmin October 18, 2021 Check out FTI Consulting’s Center for Healthcare Economics and Policy‘s new services sheet here. The cover page and overview of some of our HEOR services are below. More details on the full...

The impact of public health efforts on US Mortality – Healthcare EconomistResearch by D. Mark Anderson, Kerwin Kofi Char...
10/15/2021

The impact of public health efforts on US Mortality – Healthcare Economist

Research by D. Mark Anderson, Kerwin Kofi Charles & Daniel I. Rees in the NBER report provides some useful graphs looking at how various public health interventions have impacted health outcomes in the U.S over the last century. Specifically, the authors show that public health interventions aimed at improving the health of the municipal water supply had large impacts on both mortality for some groups, illness, and inequality of health outcomes. Regarding the latter point, the authors find that:

…chlorinating the water supply, which was relatively cheap, had no observable effect on the White infant mortality rate (IMR), but led to a 9 percent reduction in the Black IMR and a 10 percent reduction in the Black-White IMR ratio — our measure of the Black-White infant mortality gap. Moreover, we found that adding chlorine to the water supply narrowed the Black-White infant mortality gap, at least in part, through its effect on diarrheal disease.

More details are available here.

News The impact of public health efforts on US Mortality – Healthcare Economist Byadmin October 15, 2021 Research by D. Mark Anderson, Kerwin Kofi Charles & Daniel I. Rees in the NBER report provides some useful graphs looking at how various public health interventions have impacted health outcome...

Poor Night Vision – What Can You Do About Night Blindness?Poor night vision or night blindness can be a life-limiting sy...
10/14/2021

Poor Night Vision – What Can You Do About Night Blindness?

Poor night vision or night blindness can be a life-limiting symptom. Night blindness can be caused by either an inherited or acquired reason. Poor night vision disorders (night blindness, impaired dark adaptation, etc.) include the experience of reduced vision in dimly lit environments, including at night. They include partial or complete impairment in ability of the eyes to adapt from brightness to darkness. It is not a disease in itself, but rather a symptom of an underlying problem, usually located in the retina. It is common for patients who are myopic (nearsighted) to have some difficulties with night vision, but this is due to optical issues rather than to a retinal condition. Symptoms include difficulty driving at night, tripping over objects when walking in the dark, and slow response when light conditions change (such as entering a dark movie theater). Photoreceptor cells in the retina allow you to see in dim lighting. When they malfunction, vision in dark conditions becomes difficult.

The photoreceptors called “rod cells” are mainly responsible for night vision. Rods can detect single photons and transmit that data to rod bipolar cells. This makes dim light information more usable to the brain.

Acquired Causes of Poor Night Vision

Vitamin A Deficiency. Poor night vision affects more people in other areas of the world than the U.S. because of wide-ranging vitamin A deficiencies in undeveloped nations. In America, it is a rare disease that affects less than 200,000 people. Vitamin A is required to make the chemical rhodopsin, crucial to night vision. Dietary deficiency of Vitamin A is uncommon in developed countries. Proper absorption is key. Iron or zinc deficiency, small bowel bypass surgery, and too much alcohol can impair Vitamin A absorption. Inflammatory bowel disease, pancreatic issues, and fibrosis can cause Vitamin A issues. Low fat diets may not have enough vitamin A. Many orange, yellow, and dark leafy green foods are rich in beta carotene, which the body converts to vitamin A. People with thyroid issues may have difficulty in converting beta carotene into Vitamin A as well. Note: Vitamin A deficiencies need early treatment or vision damage can be permanent.

Cataracts. Cloudy spots on the lens obscure vision.

Myopia (nearsightedness). A symptom of uncorrected myopia can result in night blindness.

Medications. If a glaucoma medication side-effect is pupil constriction, night vision can be compromised.

Other diseases and conditions. Cystic fibrosis, cirrhosis of the liver, gastric bypass, celiac disease, obstruction of the bile duct (gallstones), and diabetes can reduce night vision.

Congenital Causes of Poor Night Vision

Genetics. Inherited genetic mutations can cause night blindness.

Retinitis Pigmentosa. Genetic problems result in damage to the retina, impairing night vision, as well as central and peripheral vision. Usher syndrome results in hearing loss and retinitis pigmentosa.

How Night Blindness Is Diagnosed

Contrary to popular belief, night blindness cannot be self-diagnosed. The biggest danger is driving at night. Injuries are likely when walking in insufficient light. Therefore, anyone who is concerned about their night vision should consult an eye doctor.

The eye doctor will run several painless tests to measure pupil adaptation, your ability to see color, and visual acuity. The doctor will also apply dilating drops and examine most of the structures of the eye.

You may need an electroretinogram to measure how your rods and cones react to light. The doctor may order visual field testing if the cause might be glaucoma, another eye disease, or stroke. He or she may also order an OCT (optical coherence tomography) scan which gives a detailed view of the layers of the retina and optic nerve, and provides a baseline to compare in future scans.

You should be having regular eye exams regardless. Ask your eye doctor if you suspect night vision problems.

Prognosis

Poor night vision will not resolve itself. Clean your windshield and glasses in case it is just glare. Consult an eye doctor.

Standard Treatments for Poor Night Vision

The primary treatment for night blindness depends on the cause.

If the cause of night blindness is congenital, regular care from an eye care specialist is crucial. The condition is life-long. Do whatever is necessary prevent injuries at night and in dark basements, caves, etc. The doctor may tell your state Department of Motor Vehicles to add a “daylight driving only” restriction to your driver’s license, for the safety of yourself and others.

Acquired night blindness treatment depends on the cause.

Cataracts (moderate to mature) are typically treated thru surgery by replacing them with an artificial lens. If you need to delay surgery for medical reasons for example, see our cataracts page. Early stage cataracts may still impact night vision (particularly due to glare at night), so there are natural approaches that may help with this.

Myopia can be treated with the right prescription lenses.

Vitamin A deficiency or malabsorption reacts well to a better diet and supplements. Sometimes the doctor can change a problematic medication.

Glaucoma patients may do better on a different medication.

Attempt to better control other conditions or diseases if they are causing night blindness.

In the future, stem cell therapy may provide relief for night blindness.

Poor Night Vision and Nutrients

Rhodopsin. One key to seeing at night is a healthy amount of rhodopsin, which is an eye pigment in the retina responsible for night vision. It is used specifically by the photoreceptor cone cells to perceive light, while the rods, on the other hand, are highly sensitive to darkness. Rhodopsin enables us to quickly adapt our vision from a dark room to a light room. The dark purple color of bilberries comes in part from rhodopsin and bilberry supplements improve poor night vision patients’ rate of adapting to darkness.1

Vitamin A activates rhodopsin and increases photoceptor sensitivity to UV light.2 Though vitamin A deficiency is rare in industrial nations, there are other reasons vitamin A intake may be compromised, including:

Iron deficiency can affect vitamin A uptake.

Small-bowel bypass surgery may reduce vitamin A absorption.

Excess alcohol consumption impairs absorption.

Medications can affect fat absorption (Xenical) or cholesterol (statins).

Low fat diets may be low in vitamin A.

Zinc deficiency is associated with decreased release of vitamin A from the liver.

Other conditions such as fibrosis, pancreatic insufficiency, and inflammatory bowel disease affect how vitamin A is utilized in the body.

Taurine is the most abundant amino acid in the retina. It helps rhodopsin regenerate, a crucial process for night vision. It’s lack causes cone degeneration.3 The amino acid taurine is produced by the body, and it is abundant in high-protein animal foods such as milk, eggs, seafoods, and meat. Ten times more taurine is in the photoreceptors than any other amino acid.

Zinc is also important for night vision. It interacts with taurine and vitamin A to modify photoreceptor plasma membranes, regulate the light-rhodopsin reaction, acts as an antioxidant, and supports the retina and retinal pigment epithelium.4

Also Important

Astaxanthin. The antioxidant astaxanthin is the pink color in certain seafood and certain algae. A champion eye nutrient, astaxanthin protects the cells and support eye circulation, and helps protect the eyes against sunlight and blue light exposure from mobile and other electronic devices.

Lutein and Zeaxanthin. Found abundantly in certain vegetables and egg yolks, lutein and zeaxanthin together are a powerful eye protection combination. Important food sources: dark leafy greens, zucchini, peas, brussels sprouts, pumpkin, lettuce, broccoli, asparagus, lettuce, carrots, and pistachios. Lutein and zeaxanthin help the eyes by filtering out blue light and protecting healthy eye cells. Although there are 600 carotenoids in nature, the retina uses these two the most. Only these two are deposited in high quantities in the retina (macula) of the eye.

Omega-3. Insufficient omega-3 fatty acids are wide-spread. However, these nutrients are important for healthy rod cells. Food sources include certain seafood (salmon, cod liver oil, sardines, herring, mackerel, oysters, anchovies, caviar), walnuts, flaxseeds, chia seeds, and soybeans.

Other night-vision-friendly nutrients include zinc, green tea extract, ginkgo biloba, and vitamin B complex.

Poor Night Vision and Diet

Eat plenty of green, leafy vegetables, any colored fruits and vegetables, limit or avoid all sugar and refined carbohydrates, include healthy oils such as first cold pressed, extra virgin olive oil, coconut oil, butter in limited amounts. Butter and coconut oils are good for cooking as they have a high heat threshold.

Make fresh, organic, ideally home-made juice. Include fruits, vegetables, and some of: ginger, garlic, parsley, turnips, spinach, blueberries, beets, carrots, watercress, and wheatgrass.

Nutritional Support Recommendations

Advanced Eye & Vision Support Formula (whole food) 60 vcaps

Dr. Grossman’s Bilberry/Ginkgo Combination 2oz (60ml)

ReVision Formula (wild-crafted herbal formula) 2 oz

Discounts: Night Vision Protocol 1-Month Supply or Night Vision Protocol 3-Month Supply

News Poor Night Vision – What Can You Do About Night Blindness? Byadmin October 14, 2021 Poor night vision or night blindness can be a life-limiting symptom. Night blindness can be caused by either an inherited or acquired reason. Poor night vision disorders (night blindness, impaired dark adaptat...

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