Tag Archives: Harvard Health

Eye Health: Why Corneal Transplants Are Rising

At one time, replacement parts for the eyes must have seemed unimaginable. Nowadays, if the inner lens of the eye becomes clouded by a cataract, a routine surgery to swap it out with a new artificial lens restores vision.

But what happens if the outer lens of the eye (the cornea) becomes damaged or diseased? You can have that replaced, too. “It’s not as common as cataract surgery, but many people get corneal diseases after age 50 and may need a corneal transplant,” says Dr. Nandini Venkateswaran, a corneal and cataract surgeon at Harvard-affiliated Massachusetts Eye and Ear.

More than 49,000 corneal transplants occurred in 2021 in the US, according to the Eye Bank Association of America.

What is the cornea?

The cornea is a dome of clear tissue at the front of each eye, covering the iris and pupil, that acts as a windshield that protects the delicate eye apparatus behind it, and focuses light onto the retina, which sends signals that the brain turns into images (your vision).

You need this combo of windshield and camera lens to focus and see clearly. But many things can go wrong within the five layers of tissue that make up the cornea. That can make it hard to see and rob you of the ability to read, drive, work, and get through other activities in your day.

How does damage to the cornea occur?

It may stem from a number of causes:

  • Injuries, such as a fall. “Falls are a big reason for people to come in with acute eye trauma. The cornea can be damaged easily if something pokes it,” Dr. Venkateswaran says.
  • Previous eye surgeries. “Especially for adults who’ve had several eye surgeries — such as cataract and glaucoma surgeries — the inner layers of the cornea can become damaged and weakened with age,” she adds.
  • Illness. Problems like severe corneal infections, or genetic conditions such as Fuchs’ endothelial dystrophy, can cause vision loss.

What are the options for treating corneal damage?

Cornea treatment depends on the type of problem you have and the extent of the damage. “It’s a stepwise approach. Sometimes wearing a specialty contact lens or using medications can decrease swelling or scarring in the cornea,” Dr. Venkateswaran says.

Elevated Pulse Rates: The Causes And Concerns

In otherwise healthy people, a heart rate at rest should be less than 100 beats per minute at rest. Heart rates that are consistently above 100, even when the person is sitting quietly, can sometimes be caused by an abnormal heart rhythm. A high heart rate can also mean the heart muscle is weakened by a virus or some other problem that forces it to beat more often to pump enough blood to the rest of the body.

Usually, though, a fast heartbeat is not due to heart disease, because a wide variety of noncardiac factors can speed the heart rate. These include fever, a low red blood cell count (anemia), an overactive thyroid, or overuse of caffeine or stimulants like some over-the-counter decongestants. The list goes on and includes anxiety and poor physical conditioning.

Mammograms: How They Can Reveal Heart Disease

The routine mammograms women receive to check for breast cancer may also offer clues to their risk for heart disease, new research suggests.

White spots or lines visible on mammograms indicate a buildup of calcium in breast arteries. This breast arterial calcification is different from coronary artery calcification, which is known to be a marker for higher cardiovascular risk. For the study, researchers followed 5,059 postmenopausal women (ages 60 to 79) for six and a half years. They found that those with breast arterial calcification were 51% more likely to develop heart disease or have a stroke than those without calcification. The study was published March 15, 2022, in Circulation: Cardiovascular Imaging.

Dementia Study: A High-Fiber Diet May Lower Risk

Fiber is known for keeping your digestive system healthy and lowering cholesterol levels. Now, study findings suggest it also may protect the brain from dementia.

The study involved approximately 3,700 healthy adults, ages 40 to 64, who completed routine dietary surveys for 16 years. Researchers then monitored the participants for two decades to see which ones developed dementia. The study revealed that people who consumed the most daily fiber had the lowest rates of dementia. The reverse also was true — those who ate the least fiber had the highest rates. Specifically, the low-risk group consumed an average of 20 grams daily, while those with the highest risk averaged only 8 grams. (The USDA recommends that men over age 50 eat 30 grams of fiber daily.)

Health: How To Recover From An Ankle Sprain

Prostate Cancer: Benefits Of Radiation Treatment

Chronic Conditions: How To Prevent Kidney Stones

Cardiac Tests: B-Type Natriuretic Peptide (BNP)

B-type natriuretic peptide (BNP) belongs to a family of protein hormones called natriuretic peptides. These natriuretic peptides have an important role in regulating the circulation. They act on blood vessels, causing them to dilate, or widen. They also work on the kidneys, causing them to excrete more salt and water. In addition, the natriuretic peptides reduce the production of various hormones that narrow blood vessels, boost the heart rate, or affect fluid retention; examples include adrenaline, angiotensin, and aldosterone.

Inflammation: How To Treat Ulcerative Colitis

Since ulcerative colitis (UC), a condition that causes inflammation in the colon and rectum, is never medically cured, certain lifestyle behaviors can help you manage symptoms and better cope with your condition. In addition to managing stress, paying attention to what you eat can have a big impact on your quality of life.

There is no single diet that works best for managing UC. In fact, no studies have shown that any specific diet improves symptoms or that any specific foods cause UC flare-ups. The best approach is to avoid or reduce the foods that aggravate your symptoms.

You should eat a well-balanced, healthy diet rich in fresh fruits and vegetables, such as a Mediterranean style diet. Avoid preservatives and emulsifiers, such as carrageenan, carboxymethylcellulose, and polysorbate-80.

Varicose Veins: Symptoms And Treatment (Harvard)

Can you prevent varicose veins?

Even if you have a family history of varicose veins, they aren’t always inevitable, says Dr. Sherry Scovell, a vascular and endovascular surgeon at Harvard-affiliated Massachusetts General Hospital. Three simple strategies can help to prevent them.

1. Get moving. “Leading an active lifestyle is probably the most important thing that you can do for prevention,” says Dr. Scovell. Exercise, particularly walking, induces calf muscle contractions that keep blood flowing efficiently. “The calf muscles act like a heart for the veins,” she says. People sometimes believe that if they stand more and sit less, they can prevent vein problems. But that’s not true if you’re mostly standing still. “It’s better to move as much as possible,” says Dr. Scovell. Exercise also helps you maintain a healthy weight, which can keep varicose veins at bay.

2. Put your feet up. Give your legs a break by elevating your feet at the end of the day, and even during the middle of the day if you’ve got some spare time. This can relieve pressure on the veins to help keep them healthy.

3. Pull on compression stockings. These garments fit snugly on your legs, squeezing them slightly to help keep blood moving. People sometimes think they’re unfashionable and are reluctant to wear them. But today’s stockings don’t resemble old-fashioned versions, says Dr. Scovell. Compression stockings come in numerous styles, including calf-high tube socks, dress socks, and tall stockings that look like tights. “They make them in so many cool colors and patterns,” says Dr. Scovell. “They can be fashionable and still help your veins at the same time.” You can purchase over-the-counter compression stockings at a drugstore or get medical-grade options through your primary care doctor or a specialist.

COMMENTARY:

Varicose veins entered my vocabulary when I noticed that my feet were different in their coloration; my left foot was darker than my right, and had a bruise-like discoloration at the heel. Some enlargement and irregular “snaking” of my veins was also apparant at that time.

I went to see a vascular surgeon who performed an ultrasound on my veins, and informed  me that my popliteal valve, the one in the vein behind my knee, wasn’t working. This caused a constant column of blood, unchecked by a valve, to enlarge my veins.

I have been wearing compression stockings ever since, to slow down the enlargement of those veins.

My right leg has done better than my left, but still has a few varicose veins.

The compression stockings are hard for me to put on my legs, especially since I have arthritis in my hands. However, by learning a few tricks, this is not an intolerable burden.

First, you have to select your stockings. Jobst was the brand first suggested to me, and I used them for years. Recently, my big toe has been starting to cross over the second toe, a condition called “scissor toe”. The jobst stockings had toes in them, like most stockings, and I thought the compression acting on the toes was partially responsible for the scissor toe. Jobst has no open toe option that I can find. After going through several different brands, I settled on Sigvaris open toe. The label states the number of millimeters compression that is provided. More than 30 mm would be best, but 20-30mm. Is the tightest that my fingers will allow. More commonly I use 15 to 20, because after I swim the skin is wet, and wet skin simply gives too much friction to allow my painful hands to get the stockings on.

In the Harvard article, walking is also suggested, since the calf muscles act like a pumping mechanism on the deep veins to get the blood back to the heart. I learned from the article that the deep veins return 80% of the blood, and the superficial varicose veins only 20%, making them expendable. There are a number of different options for getting rid of the varicose veins, “sclerosing” them, including thermal and chemical treatments.

I walk a lot, going along with another suggestion from the article, although I don’t usually prop my legs up; I’m too busy running around to make propping a viable option.

Preventative treatment, such as I’ve been discussing, certainly beats having edematous legs with ulcers, such as I see in many older people.

—Dr. C.