Category: Health

  Get Your Sardines On!

This chart graphically details the %DV that a serving of Sardines provides for each of the nutrients of which it is a good, very good, or excellent source according to our Food Rating System. Additional information about the amount of these nutrients provided by Sardines can be found in the Food Rating System Chart. A link that takes you to the In-Depth Nutritional Profile for Sardines, featuring information over 80 nutrients, can be found under the Food Rating System Chart.

Promote Heart Health

Sardines are rich in numerous nutrients that have been found to support cardiovascular health. They are one of the most concentrated sources of the omega-3 fatty acids EPA and DHA, which have been found to lower triglycerides and cholesterol levels; one serving (3.25 ounce can) of sardines actually contains over 50% of the daily value for these important nutrients. Sardines are an excellent source of vitamin B12, second only to calf’s liver as the World’s Healthiest Food most concentrated in this nutrient. Vitamin B12 promotes cardiovascular well-being since it is intricately tied to keeping levels of homocysteine in balance; homocysteine can damage artery walls, with elevated levels being a risk factor for atherosclerosis.

Promote Bone Health

Sardines are not only a rich source of bone-building calcium, but they are also incredibly concentrated in vitamin D, a nutrient not so readily available in the diet and one that is most often associated with fortified dairy products. Vitamin D plays an essential role in bone health since it helps to increase the absorption of calcium. Sardines are also a very good source of phosphorus, a mineral that is important to strengthening the bone matrix. Additionally, as high levels of homocysteine are related to osteoporosis, sardines’ vitamin B12 rounds out their repertoire of nutrients that support bone health.

Promote Optimal Health

For many years, researchers have known that vitamin D, in the form of calcitriol, participates in the regulation of cell activity. Because cell cycles play such a key role in the development of cancer, optimal vitamin D intake may turn out to play an important role in the prevention of various types of cancer. Selenium, of which sardines are also a very good soruce, is a mineral with powerful antioxidant activity, whose dietary intake has been associated with reduced risk of cancer.

Packed with Protein

Sardines are rich in protein, which provides us with amino acids. Our bodies use amino acids to create new proteins, which serve as the basis for most of the body’s cells and structures. Proteins form the basis of muscles and connective tissues, antibodies that keep our immune system strong, and transport proteins that deliver oxygen and nutrients throughout our bodies.

Description

Sardines are named after Sardinia, the Italian island where large schools of these fish were once found. While sardines are delightful enjoyed fresh, they are most commonly found canned, since they are so perishable. With growing concern over the health of the seas, people are turning to sardines since they are at the bottom of the aquatic food chain, feeding solely on plankton, and therefore do not concentrate heavy metals, such as mercury, and contaminants as do some other fish.

While there are six different types of species of sardines belong to the Clupeidae family, more than 20 varieties of fish are sold as sardines throughout the world. What these fish share in common is that they are small, saltwater, oily-rich, silvery fish that are soft-boned. In the United States, sardines actually refers to a small herring, and adult sardines are known as pilchards, a name that is commonly used in other parts of the world. Sardines are abundant in the seas of the Atlantic, Pacific and Mediterranean with Spain, Portugal, France, and Norway being the leading producers of canned sardines.

History

Sardines date back to time immemorial, but it was the emperor Napoleon Bonaparte who helped to popularize these little fish by initiating the canning of sardines, the first fish ever to be canned, in order to feed the citizens of the land over which he presided. Extremely popular in the United States in the 20th century, sardines are now making a comeback as people realize that they are an incredibly rich source of omega-3 fatty acids and vitamin D and that, because they are small fish at the bottom of the food chain, they are not as likely to contain concentrated amounts of contaminants such as mercury and PCBs.

How to Select and Store

Canned sardines packed in olive oil are preferable to those in soybean oil. Those concerned about their intake of fat may want to choose sardines packed in water. Look at the expiration date on the package to ensure that they are still fresh.

If you are purchasing fresh sardines, look for ones that smell fresh, are firm to the touch, and have bright eyes and shiny skin.

Pacific sardines are featured on the Super Green List of the Monterey Bay Aquarium’s Seafood Watch. The Super Green List is considered “the Best of the Best” in seafood; to receive this designation a fish or shellfish needed to be among their “Best Choices” for sustainability, provide at least 250 mg of omega-3s in an 8-ounce serving, and contain low levels of mercury (less than 216 ppb) and PCBs (less than 11 ppb).

Canned sardines can be stored in the kitchen cupboard, ideally one that is cool and not exposed to excessive heat. They have a long storage life; check the package for the expiration date so you know when you should use it by. Turn the can every now and then to ensure that all parts of the sardines are exposed to the oil or liquid in which they are packed; this will help keep them well-moistened. Unused portions of opened sardine cans should be refrigerated.

Fresh sardines are very perishable and normal refrigerator temperatures of 36-40F (2-4C) do not inhibit the enzymatic activity that causes them to spoil; they are best when stored at 28-32F (-2-0C). To store the fresh sardines, remove them from the store packaging, rinse them and place them in a plastic storage bag as soon as you bring them home from the market. Place in a large bowl and cover with ice cubes or ice packs to reduce the temperature of the fish. Remember to drain off the melted water and replenish the ice as necessary. Although fresh sardines will keep for a few days using this method, we recommend using the sardines as soon as possible, within a day or two. Don’t forget that fish not only starts to smell but will dry out or become slimy if not stored correctly.

How to Enjoy

Tips for Preparing Sardines:

Canned sardines require minimal preparation. For canned sardines packed in oil, gently rinse them under water to remove excess oil before serving. Fresh sardines need to be gutted and rinsed under cold running water.

A Few Quick Serving Ideas:

Sprinkle sardines with lemon juice and extra virgin olive oil.

Combine sardines with chopped onion, olives, or fennel.

Top sardines with chopped tomatoes and basil, oregano, or rosemary.

Balsamic vinegar gives sardines a nice zing.

Make a sauce with extra virgin olive oil, lemon juice, pressed garlic, Dijon mustard, and salt and pepper. Serve over sardines.

Individual Concerns

Sardines and Purines

Sardine contain naturally occurring substances called purines. Purines are commonly found in plants, animals, and humans. In some individuals who are susceptible to purine-related problems, excessive intake of these substances can cause health problems. Since purines can be broken down to form uric acid, excess accumulation of purines in the body can lead to excess accumulation of uric acid. The health condition called “gout” and the formation of kidney stones from uric acid are two examples of uric acid-related problems that can be related to excessive intake of purine-containing foods. For this reason, individuals with kidney problems or gout may want to limit or avoid intake of purine-containing foods such as sardines.

Allergic Reactions to Sardines

Although allergic reactions can occur to virtually any food, research studies on food allergy consistently report more problems with some foods than with others. It’s important to realize that the frequency of problems varies from country to country and can change significantly along with changes in the food supply or with other manufacturing practices. For example, in several part of the world, including Canada, Japan, and Israel, sesame seed allergy has risen to a level of major concern over the past 10 years.

In the United States, beginning in 2004 with the passage of the Food Allergen Labeling and Consumer Protection Act (FALCPA), food labels have been required to identify the presence of any major food allergens. Since 90% of food allergies in the U.S. have been associated with 8 food types as reported by the U.S. Centers for Disease Control, it is these 8 food types that are considered to be major food allergens in the U.S. and require identification on food labels. The 8 food types classified as major allergens are as follows: (1) wheat, (2) cow’s milk, (3) hen’s eggs, (4) fish, (5) crustacean shellfish (including shrimp, prawns, lobster and crab); (6) tree nuts (including cashews, almonds, walnuts, pecans, pistachios, Brazil nuts, hazelnuts and chestnuts); (7) peanuts; and (8) soy foods.

These foods do not need to be eaten in their pure, isolated form in order to trigger an adverse reaction. For example, yogurt made from cow’s milk is also a common allergenic food, even though the cow’s milk has been processed and fermented in order to make the yogurt. Ice cream made from cow’s milk would be an equally good example.

Food allergy symptoms may sometimes be immediate and specific, and can include skin rash, hives, itching, and eczema; swelling of the lips, tongue, or throat; tingling in the mouth; wheezing or nasal congestion; trouble breathing; and dizziness or lightheadedness. But food allergy symptoms may also be much more general and delayed, and can include fatigue, depression, chronic headache, chronic bowel problems (such as diarrhea or constipation), and insomnia. Because most food allergy symptoms can be caused by a variety of other health problems, it is good practice to seek the help of a healthcare provider when evaluating the role of food allergies in your health.

Nutritional Profile

Sardines are an excellent source of vitamin B12 and tryptophan. They are a very good source of selenium, vitamin D, omega-3 fatty acids, protein, and phosphorus. In addition, they are a good source of calcium and niacin. For an in-depth nutritional profile click here: Sardines

In-Depth Nutritional Profile

In addition to the nutrients highlighted in our ratings chart, an in-depth nutritional profile for Sardines is also available. This profile includes information on a full array of nutrients, including carbohydrates, sugar, soluble and insoluble fiber, sodium, vitamins, minerals, fatty acids, amino acids and more.

Introduction to Food Rating System Chart

In order to better help you identify foods that feature a high concentration of nutrients for the calories they contain, we created a Food Rating System. This system allows us to highlight the foods that are especially rich in particular nutrients. The following chart shows the nutrients for which this food is either an excellent, very good, or good source (below the chart you will find a table that explains these qualifications). If a nutrient is not listed in the chart, it does not necessarily mean that the food doesn’t contain it. It simply means that the nutrient is not provided in a sufficient amount or concentration to meet our rating criteria. (To view this food’s in-depth nutritional profile that includes values for dozens of nutrients – not just the ones rated as excellent, very good, or good – please use the link below the chart.) To read this chart accurately, you’ll need to glance up in the top left corner where you will find the name of the food and the serving size we used to calculate the food’s nutrient composition. This serving size will tell you how much of the food you need to eat to obtain the amount of nutrients found in the chart. Now, returning to the chart itself, you can look next to the nutrient name in order to find the nutrient amount it offers, the percent Daily Value (DV%) that this amount represents, the nutrient density that we calculated for this food and nutrient, and the rating we established in our rating system. For most of our nutrient ratings, we adopted the government standards for food labeling that are found in the U.S. Food and Drug Administration’s “Reference Values for Nutrition Labeling.” Read more background information and details of our rating system.

 

Sardines 3.25 oz can 92.00 grams 191.36 calories Nutrient Amount DV (%) Nutrient Density World’s Healthiest Foods Rating vitamin B12 (cobalamin) 8.22 mcg 137.0 12.9 excellent tryptophan 0.25 g 78.1 7.3 excellent selenium 48.48 mcg 69.3 6.5 very good vitamin D 250.24 IU 62.6 5.9 very good omega 3 fatty acids 1.36 g 56.7 5.3 very good protein 22.65 g 45.3 4.3 very good phosphorus 450.80 mg 45.1 4.2 very good calcium 351.44 mg 35.1 3.3 good vitamin B3 (niacin) 4.83 mg 24.1 2.3 good World’s Healthiest Foods Rating Rule excellent DV>=75% OR Density>=7.6 AND DV>=10% very good DV>=50% OR Density>=3.4 AND DV>=5% good DV>=25% OR Density>=1.5 AND DV>=2.5%

In-Depth Nutritional Profile for Sardines

References

• Ensminger AH, Esminger M. K. J. e. al. Food for Health: A Nutrition Encyclopedia. Clovis, California: Pegus Press; 1986 1986. PMID:15210.
• Wood, Rebecca. The Whole Foods Encyclopedia. New York, NY: Prentice-Hall Press; 1988 1988. PMID:15220.

Question: How many hours of sleep are enough?

from Timothy Morgenthaler, M.D.

The amount of sleep you need depends on various factors — especially your age. Consider these general guidelines for different age groups:

Age group	Recommended amount of sleep
Infants	14 to 15 hours
Toddlers	12 to 14 hours
School-age children	10 to 11 hours
Adults	7 to 9 hours

In addition to age, other factors may affect how many hours of sleep you need. For example:

• Pregnancy. Changes in a woman’s body during pregnancy can increase the need for sleep.
• Aging. Older adults need about the same amount of sleep as younger adults. As you get older, however, your sleeping patterns may change. Older adults tend to sleep more lightly and awaken more frequently during the night than do younger adults. This may create a need for or tendency toward daytime napping.
• Previous sleep deprivation. If you’re sleep deprived, the amount of sleep you need increases.
• Sleep quality. If your sleep is frequently interrupted or cut short, you’re not getting quality sleep — and the quality of your sleep is just as important as the quantity.

Although some people claim to feel rested on just a few hours of sleep a night, research shows that people who sleep so little over many nights don’t perform as well on complex mental tasks as do people who get closer to seven hours of sleep a night. Additionally, studies among adults show that getting much more or less than seven hours of sleep a night is associated with a higher mortality rate.

If you experience frequent daytime sleepiness, even after increasing the amount of quality sleep you get, consult your doctor. He or she may be able to identify any underlying causes — and help you get a better night’s sleep.

Lyle Denniston Reporter; Posted Thu, November 10th, 2011 12:10 am

 Twenty months after President Obama signed into law the massive new federal health care bill, and with politics still reeling over the controversy that the law has stirred up, the Supreme Court’s presumably calmer reaction to the law is set to begin Thursday, and then play out over the next seven months.   Not many constitutional disputes of the dimension of this one reach the Court and get decided that quickly, but everyone seems to be in a hurry to get a judicial answer on the validity of the Affordable Care Act — the most important piece of social legislation in decades.  In one scenario, the entire law could fall; in another, all of it could survive.  But there could be something in between.

The nine Justices (and it seems clear that all nine will join in the review) are scheduled to take only a preliminary step this morning: deciding whether to hear some or all of the five separate appeals that are ready for their initial examination.  As if the Justices or the Nation needed a reminder that the political world is still debating the law, the voters in Ohio — by majorities in every county — on Tuesday approved by a margin of 66 to 34 percent a new state constitutional amendment seeking to defy the main provision of the new federal law.  That provision mandates that nearly every American must obtain health insurance by 2014, or pay a penalty with their tax returns in 2015.  That amendment, ”Issue 3,” declares that no one in the state could be compelled to do that — a declaration that may have political, but probably no legal, significance.

The law’s individual mandate provision was designed to draw enough people into the health insurance market to assure that insurance companies can afford to provide nearly universal coverage without significantly raising premiums and without turning away people who have preexisting health conditions that require medical treatment.   It has been estimted that the overall scheme could result in health care coverage for perhaps 95 percent of the Nation’s people.  It inaugurated a sweeping regulation of the health insurance market, which makes up 17 percent of the nation’s economy.

The insurance-purchase mandate, and the penalty attached to it, are at the very center of the cases now awaiting the Justices’ response.   If those are ruled to be beyond Congress’s legislative authority, much — and possibly all — of the massive new law will collapse, too.   And the validity of those provisions is what has produced the sharpest division between the federal appeals courts that have ruled on them so far.   That very division is probably the strongest point encouraging the Justices to accept review, and move toward a final ruling before their summer recess begins late next June.

President Obama’s signing of the bill shortly before noon on March 23 of last year, using 22 separate pens, marked the fulfillment of an ambitious — but long frustrated — effort to make basic changes in the way health care is provided to Americans.   The President, in making the measure law, said he was doing so partly in tribute to “all the leaders who took up this cause through the generations — from Teddy Roosevelt to Franklin Roosevelt, from Harry Truman, to Lyndon Johnson, from Bill and Hillary Clinton, to one of the deans who’s been fighting this so long, John Dingell [a Democratic Representative from Michigan).  To [the late] Ted Kennedy…”   The President took note of “all of the overheated rhetoric” over the bill, but added that, when he signed it, that controversy would have to “confront the reality of reform.”

But, even at that moment, it was apparent that, until the courts had their say on constitutionality, that “reality” would be in at least temporary suspension for the most important parts of the new law.   In fact, while the President was making the last pen stroke on his signature, legal aides for the state of Virginia were on their way to a federal courthouse in Richmond, Va., poised to file the first constitutional challenge to the insurance mandate, claiming that it ran counter to a Virginia state law similar to the measure just adopted by the voters in Ohio.  That case was filed 34 minutes after the President finished signing the measure.

Nearly 30 more lawsuits would follow, and federal judges at both the trial and appeals level would move the cases along with dispatch.   Keeping up that hectic pace, the lawyers on all sides quickly moved the cases as they were decided on to the next level, and then on to the Supreme Court in Washington.   That put the five ready petitions on the agenda for the Justices’ Conference this week.   Ironically, the case that Virginia had filed first will not be before the Justices today; it was not ready in time, but is due to be considered at the Conference set for November 22.   It could wind up on an inactive status as some or all of the others proceed.

Although no definite timetable has been set yet for the Court’s review of the new law (if some petitions are, in fact, granted review), it appears that the Court would hold an extended hearing either in late Februry or in March.   Whether the Justices will announce their response following this morning’s Conference, or wait until next Monday, with the regular release of other orders, is not clear.  There is, though, no assurance that the Court will definitely take action after this initial look, but lawyers involved have been doing everything that they could to try to assure prompt action.

What is very likely, however, is that if the Court does take on the controversy, any final ruling — whatever its scope and content — will come in the closing weeks of the current Term.  That would mean its release in late June in the midst of the political campaigning for the Presidency and Congress, pointing toward the general election next November.   The Justices would not choose that timing deliberately; it is just the way the judicial calendar would work if the Court proceeds to a final ruling this Term.

Whatever the Court does, the health care issue is sure to be a debating point in the election campaign.  Indeed, it has already been a political flashpoint among the Republicans seeking the presidential nomination of their party.   If the Court were to uphold the law, the political discussion may well focus on whether the next Congress should repeal at least the major parts of the law.  If the Court were to strike it down, the political conversation then would probably focus on how to salvage some of the law’s major provisions.

There is also a larger theme in current American politics in which the new health care law figures — the debate over national governmental power centered in Washington.  The law’s critics cite it as the primary example of a bloated form of federal authority.  Its defenders retort that it is a long-awaited, necessary way for government to help protect Americans who need a social safety net.

Although there has been some talk, in political circles, that Justices Clarence Thomas and Elena Kagan might not take part in a ruling for reasons that their political challengers believe are convincing, there has been no indication that either of them would choose to disqualify themselves, and that is a choice that only they can make.  (Thomas has drawn some criticism over the role of his wife, Virginia Lamp Thomas, as a political advocate aligned with opponents of the health care law, and Kagan has drawn some challenges on the theory that she may have had something to do with the law while she was in the Obama Administration, a role that she has denied having.  She had served as U.S. Solicitor General.)

If the Court opts to take on all of the issues that have been laid before it, this — in summary — is what will be at stake:

* The insurance-purchase mandate, due to take effect in 2014, and widely regarded by challengers as the most controversial single provision.

* A financial penalty, set as a percentage of household income, for those who do not have insurance by 2014.   The penalty is to be paid with one’s federal tax return.

* If those two provisions fail, what parts of the law would fall with them, or might the entire law go down.   (The government has said that, without the mandate and penalty, the assurance of coverage for those with preexisting medical conditions, and a curb on higher insurance premiums, could not survive.)

* Tax penalties on larger employers (including state and local governments as employers) if they do not provide adequate health insurance coverage for their full-time employees.

* Expansion of the federal-state Medicaid program, providing subsidized health care for the poor and the disabled, so that individuals with incomes below 133 percent of the poverty level are covered.  Through the year 2016, the federal government is to pay 100 percent of the added cost, but that will decline over the period running to 2020 and beyond, with states having to make up the rest (but only to a maximum of 10 percent).

These are the cases that are ready for the Justices, in the order in which they were filed: Thomas More Law Center, et al., v. Obama, et al. (11-117); National Federation of Independent Business, et al., v. Sebelius, et al. (11-393); Department of Health & Human Services, et al., v. Florida, et al. (11-398); Florida, et al., v. Department of Health & Human Services, et al. (11-400). and Liberty University, et al., v. Geithner, et al. (11-438).

The state of Virginia’s case is Virginia, et al., v. Sebelius, et al. (11-420).

When the Court announces its order, it will indicate which if any of the cases it plans to hear.  In addition, it may spell out which issues it has chosen to decide if it does not grant all the petitions without limit, and it may specify how much time it will provide for oral argument.   It may not set an actual argument date in such an opening order.

Recommended Citation: Lyle Denniston, Health care: Now, it’s the Court’s turn, SCOTUSblog (Nov. 10, 2011, 12:10 AM), http://www.scotusblog.com/2011/11/health-care-now-the-courts-turn/

The nation’s largest retailer and employer now wants to become its largest primary-care provider as well. Last month Walmart sent out a request for information seeking partners to help it “dramatically … lower the cost of healthcare … by becoming the largest provider of primary healthcare services in the nation.” The document, obtained by NPR and Kaiser Health News, says the company would offer a range of services, from basic prevention to the management of chronic conditions such as HIV and depression. Analysts say the retailer is likely attempting to boost store traffic. Partners will be selected in January.

They might want to put their own house in order, as in offer it to their own employees first.

Time to think of the Thanksgiving meal already!  Check out these tips to avoid regretting your eating choices on that day!  CBS article follows:

Thanksgiving dinner is frequently the meal that sends people into a downward spiral of bad eating habits for the holidays.

It’s not easy to make good decisions at the table when you’re surrounded by so many once-a-year, favorite dishes – and that can start you on a course to pack on pounds over these next few weeks.

But your calorie consumption doesn’t have to be so high that you stuff yourself like a turkey!

Beating Thanksgiving Sticker Shock
Hidden Holiday Food Allergy Dangers

On “The Early Show on Saturday Morning, dietitian and personal chef Diane Henderiks offered some great tips to help keep your holiday feasting under control and keep you from going overboard on Turkey Day:

I’m not the food police. I completely understand that Thanksgiving is a holiday and it’s a special occasion. People don’t go around eating like this every day of the year, nor should they.

But the truth is that you can easily pack in 3,500 calories in a Thanksgiving dinner, and that equates to one pound. So you can gain a pound in just one meal. Can that pound be worked off? Yes, but nobody wants to do that much work for one dinner.

So what can people do in order to not overeat this Thanksgiving and still enjoy their meal?

I’ve got a lot of great tips to fully enjoy Thanksgiving dinner and the holiday feeding frenzy without feeling guilty or gaining weight.

The first thing that people have to decide is whether they really want to be mindful. If you’re not committed to eating well at Thanksgiving dinner, then you’re just not going to. It’s that simple. People need to be in a motivated mindset. You’ve got to be in the right “frame of mind” to successfully not succumb to temptation during the holidays. Now is the time to either begin or continue being aware of good food choices.

The biggest mistake people make on Thanksgiving Day is that they try to not eat anything beforehand, thinking it will balance out the huge meal that they’re planning on eating for dinner. This is wrong. Don’t go to the table famished! Have a wholesome breakfast and lunch, and eat a light snack an hour before dinner. You are more likely to overeat and make unhealthy choices if you are famished. That snack could consist of some fruit, like an apple or a banana, some unsalted nuts, unsweetened yogurt, a big salad with a light vinaigrette, or even some celery and peanut butter.

My next tip is to lighten up on the liquids. Drink lots of water, and replace sugary beverages with seltzers infused with fresh juices, herbs and spices, iced herbal teas. Cut down on alcohol: Booze can pack some serious calories. If you choose to have a cocktail, drink one glass of non-alcoholic, unsweetened beverage for each alcoholic beverage consumed. Choose wine, spritzers, light beer or spirits mixed with no calorie beverages, as opposed to eggnog, cream drinks etc. Another problem is that what most people think is one serving of wine is actually three, and that can really increase your calorie intake.

Another thing to keep in mind is that deprivation leads to indulgence. Don’t skip your favorite stuffing or side. Taste everything you desire, but watch the portions of high fat and high sugar items.

I like to think of the meal in terms of a dinner plate diagram. When you look at your plate, half of it should be filled with sauce-free, steamed, roasted or baked non-starchy veggies. Then you should have one cup of cooked starches, which is about the size of a tennis ball. Then, your protein should be about 3-6 ounces of lean protein, which is about the size of a deck of cards, or your BlackBerry! How the times have changed!

The last important thing is to be mindful of your stomach and when you get full. I like to call it the satisfaction signal. Listen to your stomach. Eat slowly and stop when you feel satisfied. It takes about 20 minutes for your brain to signal your stomach that you’ve had enough. Pay attention to what it feels like to be satisfied and not full.  

The retina is a layer of tissue at the back of the eye that collects light relayed through the lens. Special photoreceptor cells in the retina convert light into nerve impulses, which are transmitted to the brain. At the retina’s center is an especially critical area called the macula, which enables you to see anything directly in front of you, like words on a page, a person’s face, the road ahead or the image on a screen.

When blood flow through the retina is blocked or when the retina pulls away from the wall of the eye, getting the problem properly diagnosed can be an emergency. Modern treatments can do wonders if they are begun before the damage is irreversible. But a delay in getting to a retinal specialist can diminish the ability of even the best therapy to preserve or restore normal vision.

As with all living tissue, the retina is highly dependent on a constant supply of oxygen-carrying blood. Should anything disrupt that, vision is at risk. Two retinal mishaps, retinal-vein occlusion and retinal detachment, can occur at any age, but both are more common among older people.

Recognizing a Blockage

In July, David Bronson of Stone Ridge, N.Y., an avid reader at age 82, realized that the vision in his left eye was a little cloudy. He thought a developing cataract was the cause, but when he saw an ophthalmologist two weeks later, he learned that the problem was more serious: a partial blockage in the central vein that drains blood from the retina.

The blockage caused pressure to build in the capillaries that take blood to the retina, which then leaked into the center of the eye, clouding Mr. Bronson’s vision. The blockage and its consequences are analogous to a clogged sink drain; if water keeps running into the sink, it will eventually spill over the top.

Retinal-vein occlusion is a common cause of vision loss in older people, second only to diabetic retinopathy as a blood vessel disorder of the retina, according to a report last year in The New England Journal of Medicine.

Unlike Mr. Bronson’s experience, retinal-vein occlusion most often involves a branch vein, which is less serious and in half of cases resolves on its own within six months. If treatment is needed, most, though not all, patients respond well to laser therapy, the journal authors reported.

Central retinal-vein occlusion can cause swelling of the macula and loss of central vision. So Mr. Bronson is being treated with monthly injections into his eye of Lucentis, a drug recently licensed for this condition. Injections of steroids into the eye are also often effective.

The article authors, Dr. Tien Y. Wong of the National University of Singapore and Dr. Ingrid U. Scott of Penn State Hershey Eye Center, noted that retinal-vein occlusion occurs in one or two people in 100 older than 40, most often because of a clot and atherosclerosis, a hardening of retinal arteries that puts pressure on a retinal vein.

High blood pressure, Mr. Bronson’s only other health problem, is the leading risk factor for this disorder, but retinal-vein occlusion is also associated with diabetes, elevated blood lipids, smoking, kidney disease and glaucoma.

Typically, patients develop sudden painless vision loss in one eye. The extent of vision loss depends on how much of the retina is affected and whether the macula is involved. Most of the time, the diagnosis can be made based on a clinical exam, although a test called fluorescein angiography is often performed to assess the severity.

Detachment

Retinal detachment, which occurs in about 18 out of 100,000 people a year, is much less common than retinal-vein occlusion but more likely to cause permanent vision loss if not promptly treated. The longer the retina remains detached, the less likely vision can be restored, so it is vital to recognize the symptoms and seek an ophthalmologist’s care without delay.

Retinal detachment is painless but nearly always causes symptoms, often before the detachment starts: a sudden appearance of many “floaters” — spots, hairs or strings — in your vision; sudden brief flashes of light even when your eyes are closed; or a shadow over part of your visual field.

Donald Distasio of Syracuse was 61 when, he said, “I started seeing floaters and blurriness in the inner corner of my right eye.” His optometrist correctly suspected a retinal detachment and immediately sent Mr. Distasio to a retinal surgeon, who explained that the vitreous gel in the center of his eye had pulled on the retina, causing it to tear.

Retinal holes or tears can also result from thinning of the retina with advancing age or from other eye diseases. Once the retina tears, vitreous fluid can leak behind it and push it away from the wall of the eye, preventing images from reaching photoreceptor cells and, ultimately, the brain. The result is a vision blackout of the affected part of the retina.

In addition to age, risk factors for retinal detachment include extreme nearsightedness, a family history of the problem, a prior detachment in one eye, cataract surgery and a severe eye injury, as can occur in an auto accident or from a paint ball, a BB gun or a bungee cord, said Dr. Donald J. D’Amico, chief of ophthalmology at Weill Cornell Medical College and NewYork-Presbyterian Hospital.

In an interview, he outlined the usual treatments. The simplest, called pneumatic retinopexy, can be done in the doctor’s office under local anesthesia. A gas bubble is injected into the vitreous cavity. As the gas expands, it presses the retina against the wall of the eye and closes the break. The patient must remain face down for most of several days to weeks to keep the bubble in the right place. The retinal break is often permanently sealed with a freezing probe or laser.

Another common treatment is scleral buckling, done in a hospital under anesthesia but usually on an outpatient basis. A permanent silicone band is sewn to the outside wall of the eyeball, creating an indentation that presses the retina back in place.

A third technique, vitrectomy, is also done in a hospital. The vitreous gel that is pulling on the retina is removed and replaced with gas or liquids that reattach the retina. The procedure is sometimes combined with scleral buckling.

After treatment, it can take many months for vision to improve. The treatment itself may also cause a cataract, requiring further surgery.

via nytimes.com