Genetic risk, in this case, is quantified by a “polygenic score,” and can be used by doctors to decide whether the patient needs preventative measures.

Researchers Comb Through Millions of Genetic Variants to Find Disease Risk

<div class="related"></div>

 Your disease risk is hiding in your DNA, and doctors may soon be able to find it.


<a href="https://www.nature.com/articles/s41588-018-0183-z">
 A study
 </a>
 published today in
 
 Nature Genetics
 
 shows that it is possible to predict whether a person is at a high risk of developing a disease based on millions of changes across their genome. This genetic risk, quantified by a “polygenic score,” can be used by doctors to decide whether the patient needs preventative measures.


 “It’s good to find people at high risk, but it’s even better to be able to do something about that risk,” said Sekar Kathiresan, director of the Center for Genomic Medicine at Massachusetts General Hospital, director of the Cardiovascular Disease Initiative at the Broad Institute, and professor of medicine at Harvard Medical School.


 Kathiresan, the study’s senior author, speaks from experience. He is a practicing cardiologist and sees patients with a high familial risk for heart attacks. That’s where he first got the idea to look for heart attack risk in the genes.


 Traditionally, doctors have thought of high blood pressure and high cholesterol as two of the main risk factors for heart attacks. The role of genetics has been limited to a mutation in a receptor involved in regulating cholesterol levels in the blood. But a prior study found that, among people who suffered heart attacks in their 30s and 40s, only around 2% had a mutation in the gene encoding the receptor that had been at the center of heart attack research for decades. This made Kathiresan wonder: What about the other 98%?


 The answer, he realized, might lie not just in one gene, but dispersed across the entire genome: millions of changes to the genome that each contribute a tiny piece of the overall risk for the disease.


 His team of researchers used the results from previous genome-wide association studies, which identify specific genetic changes linked to diseases. They designed polygenic scores that add up whether a person has each of the genetic changes, weighted by how much that specific change incrementally increases a person’s disease risk. They designed scores for five common diseases: coronary artery disease, atrial fibrillation, type 2 diabetes, inflammatory bowel disease, and breast cancer.


 To figure out whether the scores were actually meaningful, the researchers took them for a test drive. They calculated people’s polygenic score for each disease and compared it to whether they actually had the disease in question. Ideally, people with a high polygenic score should be more likely to have the disease. And that’s exactly what they found.


 For coronary artery disease, for example, the people with the top 8% of polygenic scores were over three times more likely to have the disease. They saw similar trends in the other diseases. People with the top 6.1%, 3.5%, 3.2%, and 1.5% of scores were over three times more likely to have atrial fibrillation, type 2 diabetes, inflammatory bowel disease, and breast cancer, respectively.

<div class="ad"></div>

 This isn’t the first time that researchers have tried to assemble an estimate of disease risk from scattered genetic changes, but previous attempts never quite identified enough risk to be useful in the clinic—you wouldn’t be too worried to find that your risk of developing a disease was 1.1 times higher than your neighbor, right? But increasing your risk 3-fold is more alarming.


 “In my opinion, this is very exciting work,” said Ali Torkamani, director of Genome Informatics at the Scripps Research Translational Institute and associate professor of integrative structural and computational Biology at Scripps Research, who was not involved in the study. “The importance here is that there is little debate about the clinical utility of monogenic mutations, but a great deal of controversy around the clinical utility of polygenic risk. The findings add another strong piece of evidence that polygenic risk should be considered for use in clinical practice.”


 Polygenic scores are even effective in people who may not have the traditional symptoms, but are still at high risk of developing a disease. And most importantly, polygenic risk is modifiable, Kathiresan said, and making lifestyle changes can cut the risk the half. If a patient has a high polygenic score for coronary artery disease, her doctor can prescribe statins preemptively. Or, if she has a high polygenic score for breast cancer, she can get a preventative mammogram.


 The method isn’t perfect yet. A high polygenic score isn’t a guarantee that you will develop a disease, or a mandate to seek out preventative treatment.


 “We have to think through the clinical implication for each disease and think about value of intervening knowing the risk,” Kathiresan said.


 Its largest blind spot is a crucial one: people who aren’t white. This bias can be traced back to the initial source of the data. Since the mutations that go into the calculation come from genome-wide association studies done on white subjects, it’s not surprising that they work as better predictors in white patients. The same team of researchers is working on follow-up studies to design polygenic scores that are better predictors in people of east Asian, south Asian, African, and Hispanic ancestry.


 Kathiresan’s vision for polygenic scores is one where they’re just one more common piece of medical information. Since the risk is determined at birth, he sees people getting genetic testing in early adulthood to generate a “report card” of their risk of various common diseases.


 “In the future, people will know their polygenic risk for heart attack like they know their cholesterol now,” he said.


 Calculating the polygenic scores requires knowing whether an individual has specific mutations. But that’s easier than it sounds. You can get this information from direct-to-consumer genetic testing services like 23andMe or Ancestry. The researchers are currently working on making their score calculator available to people who already have these genetic testing results on hand.


 But they’re also in talks with companies to develop lab tests that can make these genetic tests available to everyone as part of the standard arsenal of diagnostic information available to health care providers. So, what might a doctor’s appointment of the future look like? The usual patient interview, lab tests, imaging—and now, polygenic scores.


 “Polygenic risk scores are not currently used in the traditional clinical workflow,” Torkamani said. “They should be considered anytime a preventative medical decision is being made.”

<div class="newsletter"></div>

 Photo credit:
 <a>
</a>
 Kinghorn Centre for Clinical Genomics / Flickr (CC BY-ND 2.0)

A new study shows it&#x27;s possible to predict whether a person is at a high risk of developing a disease based on millions of changes across their genome.

Epidiolex is the first cannabis-based drug ever approved by the FDA.

The FDA Just Approved Its First-Ever Cannabis-Based Drug

For thousands of years, cannabis has been used to treat everything from pain to indigestion.Now, it is finally making its pharmaceutical debut, potentially opening the door for further marijuana-based treatments.On Monday, the Food and Drug Administration announced the approval of Epidiolex, a cannabidiol (CBD) solution, to treat seizures in two rare forms of epilepsy: Lennox-Gastaut syndrome and Dravet syndrome. CBD is a member of the cannabinoid family, a group of chemicals produced by marijuana and other cannabis plants. Epidiolex is the first cannabis-based drug ever approved by the FDA.
<figure class="richtext-image full-width">
<img alt="" class="richtext-image full-width" src="https://www.pbs.org/wgbh/nova/media/images/cannabis_2048x1152.width-990_Yx284Az.jpg"/>
<figcaption>Epidiolex is the first cannabis-based drug ever approved by the FDA.
 
 </figcaption>
</figure>
The FDA approval was nearly guaranteed after a panel unanimously approved the drug earlier this year, and it comes after a six-year effort propelled by patients and families, with the support of their doctors. The first American patient tried the drug independently, and went from having days with over 100 seizures to a handful of seizures per day. His success allowed more patients to get access, followed by a randomized clinical trial.“The power of this story is the power of the patient community,” said Elizabeth Thiele, director of pediatric epilepsy at Massachusetts General Hospital.Unlike its fellow cannabinoid tetrahydrocannabinol (better known as THC), CBD won’t get you high. The active ingredient in strawberry-flavored Epidiolex is 99% pure CBD, extracted from cannabis grown by GW Pharmaceuticals in the United Kingdom. No one is entirely sure how the drug works, but it is thought to influence signalling between neurons. It’s a similar approach taken by other, more traditional anti-seizure medications, but through a different mechanism, said Orrin Devinsky, director of NYU Langone’s Comprehensive Epilepsy Center and leader of the clinical trial.Epidiolex is anticipated to be available in the fall of 2018, but it isn’t quite ready for prime time yet. For one thing, despite the FDA approval, it’s still illegal. CBD is still a Schedule I drug, which the Drug Enforcement Agency defines as “drugs with no currently accepted medical use and a high potential for abuse.” That’s likely to change in the next 90 days, though. Researchers still have to investigate its accompanying side effects—most notably, liver damage from toxic byproducts, especially in combination with other drugs given to epileptic patients, such as clobazam.For many patients and their families, who had been using CBD on their own for years, the trial was just a formality.“[A study] that says this works for epilepsy? We say, no kidding. We’ve been doing this for six years, and that’s what we see, too,” said Heather Jackson, co-founder and CEO of Realm of Care, a research and education non-profit that focuses on helping families navigate the landscape of cannabinoid treatments. Jackson speaks from experience. Her son Zaki used to have frequent seizures but then they tried CBD; three months later, his condition was in remission.From her office in Massachusetts, Thiele noticed that the patient demand for CBD spread across the country via social media when medical marijuana was legalized in Colorado and California. “Never in my career had I experienced so many patients coming in asking for the same treatment option,” Thiele said.The lack of pharmaceutical options has driven most patients to hemp-based CBD oils like “Charlotte’s Web” (named for a young patient who was one of its earliest success stories), dispensaries in states with legal medical marijuana, or even home-grown cannabis. The main difference between these products and Epidiolex is that the former are usually whole-plant extracts—which retain thousands of cannabis chemicals with unknown effects—while the latter is a purified extract.Cannabis is a “fickle plant,” Thiele said, so she is concerned about treating children with an unregulated product because she doesn’t know exactly how much she’s giving them. Jackson and Realm of Caring have identified certain manufacturers whose products are more consistent—she even monitors the CBD content in her own son’s medication.Despite the new drug’s approval, Jackson isn’t sure it will entice many parents who already use CBD to seek out a prescription. “The parents that I know, if what they’re doing is working, they won’t switch a thing,” Jackson said. “They’re not rocking the boat.” But she acknowledges that the pharmaceutical is a good option to have.Like other anti-epileptic drugs, Epidiolex is expected to be covered by insurance for its approved disorders. Lennox-Gastaut syndrome represents 1-4% of childhood epilepsies, and Dravet syndrome represents less than 1% of all epilepsies total. That leaves a large number of more children with epilepsy whose seizures aren’t under control, said Angel Hernandez, division chief for neurosciences at Helen DeVos Children’s Hospital in Grand Rapids, Michigan and chair of the National Epilepsy Foundation’s professional advisory board. Take Jackson’s son, for example: His condition is Doose syndrome, a different rare form of epilepsy.The drug’s approval makes it available for off-label use, which is when a doctor prescribes a drug to treat a condition for which it isn’t specifically approved. In fact, this is a fairly common practice for epilepsy, Hernandez said, because most anti-epileptic drugs are approved for very narrow diagnoses. But insurance may not cover the cost of off-label use, which the Associated Press estimates will be $25,000 per year. That’s a not insignificant increase for patients currently using whole-plant extracts; for example, Jackson pays $1,800 per year for her son’s treatment.Hernandez expects off-label use to be prevalent. “Our goal as physicians is for the FDA and eventually the DEA to be flexible enough for us to use this medication in other severe forms of epilepsy as well, typically off label,” she said. “There are so many patients with other forms of epilepsy who could benefit.”Because GW Pharmaceuticals developed Epidiolex under the FDA’s Orphan Drug Program, they have an exclusive right to CBD-based therapies for Dravet and Lennox-Gastaut for the next seven years.And while the current approved use is relatively narrow, the re-scheduling of the drug opens up the possibility of research into the medicinal properties of CBD to treat other conditions, like other epilepsy types and chronic pain.“People have been using cannabis to treat epilepsy for thousands of years,” Thiele said. “This is the first time an organization like the FDA has said, ‘yes, this should be available.’”
Photo credit: Public Domain

What’s the significance of studies on the genetics of education?

How Genetic Differences Could Make Schools Better

<div class="related"></div>
Editor’s Note: This article was <a href="http://app.nationalproduction.wgbh.org/e/es.aspx?s=2531&amp;e=1066699&amp;elqTrackId=87bceb0e8d45455b8e6ff9d7c932edc8&amp;elq=7b579c1b35644326b0438f0ea2db01d4&amp;elqaid=5308&amp;elqat=1">originally published</a> in an edition of NOVA’s email newsletter, NOVA Lens, and has now been repurposed for NOVA Next. Sign up for NOVA Lens <a href="http://www.pbs.org/wgbh/nova/newsletters.html">here</a> (select “NOVA Newsletters”).Educational paths are extremely varied, almost as unique as people themselves. They’re influenced by a complex slew of factors, and a recent study has introduced one more variable into the mix: genetics.Last week, the Social Science Genetic Association Consortium published <a href="https://www.nature.com/articles/s41588-018-0147-3.epdf?referrer_access_token=z7lXzhurAF_Tq-hewhjxItRgN0jAjWel9jnR3ZoTv0Nqad92v-7y1ilkmPqR7KMJgq_vv2M-jr2gmZ9CcUCxjKaLpN9-yY9v4iDlGgVeSLr5ogKvfcTUJbNZx0yDurIQhJFRlQfUM4ioAQoTiRCItaE_CPHGgFy3bMcv4KjAJ08graB4GBRZWdd7zJvSlJOCtM6H7igLQNcTpdwZBcQt07XwPYE15giKxVj6wKWb5k75Ld3pG8s1PRqLiUm76oSUgieOTH_pJhJ8sf46fbaAeg%3D%3D&amp;tracking_referrer=www.theatlantic.com">a study</a> identifying <a href="https://www.theatlantic.com/science/archive/2018/07/staying-in-school-genetics/565832/">tiny differences between people’s DNA</a> that are related to educational attainment, or number of years of completed schooling. Now, education researchers have to reconcile these new genetic findings with an already-complicated equation of educational success.Any two individuals have millions of differences between their genetic codes, known as genetic variants, and genome-wide association studies have been used by biologists to relate DNA-level differences with other traits, like height or risk of developing a disease. This study looked at genomes from over 1.1 million people (all of European ancestry, to control the amount of diversity between people’s genomes). That makes it one of the largest data sets ever analyzed this way, and the authors were able to find over 1,200 individual genetic variants that appear to be associated with educational attainment.These variants are tiny changes, like changing single letters in an instruction manual, and together they explained 11% of the variation across the whole group. That means that on average, a little over one-tenth of the differences among the study subjects’ educational attainment seems to be related to genetics. For context, studies of height have only been able to explain around 25% of the variation using genetics.
<div class="ad"></div>
Daniel Benjamin, associate professor of economics at the University of Southern California and co-leader of this study, knows the public is wary of research mixing genetics with social science—and the concern isn’t unwarranted.“It’s extremely important for those of us working at [this] intersection to always be cognizant of the terrible history of mixing genetics and social science,” he said, referencing eugenics as one example.For him, it’s important to remember that genes are not your destiny. There are a lot of things that the study isn’t saying. It certainly doesn’t claim to find the genetic key to a PhD, or a combination of genes that will guarantee academic success. The authors aren’t even commenting on intelligence or capacity for learning. Instead they are making the limited claim that there are genetic variants that appear to be correlated with longer or shorter educational trajectories.Educational attainment is a tricky trait to understand, Benjamin said. “It’s really far removed from what genes actually do,” he added. For example, the study found that many of the affected genes are predominantly expressed in the central nervous system, and are involved in brain development and signaling between neurons. On the surface, that sounds logical, and almost re-affirming—if there were a key to staying in school, it’s not surprising that it would be in the brain. But exactly how does it work? That remains to be seen in future studies.In the education community, the response has been mixed. These genetic methods are relatively new to the field, and even researchers who think the study was well-done admit that the results aren’t yet actionable.“[This study has] absolutely nothing to say about education in practice or in theory,” said Todd Rose, director of the Mind, Brain, &amp; Education Program at the Harvard Graduate School of Education. In an FAQ published online, the study authors themselves acknowledge that it would be premature to make any changes to educational policy based on these results.One major worry is that studies like this will be used to justify treating students unfairly based on their genes. For example, people might want to design a test to separate students based on whether they have the genetic variants. But a test like this would not be a good test, and would get it wrong most of the time, said Dan Belsky, assistant professor of population health sciences at the Duke University School of Medicine and the Social Science Research Institute.Rose agrees. He studies individualization in education, and says that thinking of these variants as the cause of academic success will do more harm than good. “Whenever we try to classify people, or predict, or find the cause, it’s used to discriminate and underestimate what people are capable of doing,” he said.
<div class="newsletter"></div>
Instead, many education researchers agree that the most interesting results of the study are bigger than the subjects themselves.“There’s as much to be learned about the nature of our educational system as about the nature of the individual in this data,” said Mary Helen Immordino-Yang, professor of education, psychology, and neuroscience at the University of Southern California. Specifically, if certain genetic variants are associated with better educational outcomes, then there might be something about the structure of our educational system that’s favoring people with these variants.For example, if the variants were involved in language comprehension, that could tell educators that current teaching methods aren’t working for students who process language differently. That means they should be designing new interventions to accommodate that variation, Belsky said.“We know there’s no direct link between DNA and education,” Belsky said, recommending that researchers “use the DNA to find the process, not the person.”Belsky isn’t wasting any time in doing this work. Even before the educational attainment study was officially published, he did a follow-up study analyzing its data in the context of socioeconomic or family environment. He found that even between people raised in the same environment, genes seemed to play a role in differentiating not only their educational outcomes, but social mobility later in life, as well.Environment was also a key part of the original association. While that study claims that the variants explain 11% of educational attainment (a significant chunk, especially for a genetic study), it still leaves a lot of room for environmental influence. And that’s important, Rose said, because it gives us the power to design educational environments that are responsive to the variation the study found, and that educators have known about for a long time.To Immordino-Yang, who studies how people’s experience of their environments impacts learning, this study reinforces the importance of her ongoing work.“The responsibility of society is not to triage people based on genetics; it’s to provide the best possible quality of experience for everyone so they can show their true potential,” said Immordino-Yang. “It’s not different than anything we’ve known before these studies came along.”

Understanding how students differ could change the educational process, but not in obvious ways.

Study Finds Billions of Dollars in Home Value Lost to Rising Sea Levels

<div class="related"></div>
Houston. Charleston. Most of Florida. The South seems to bear the brunt of flooding and hurricane damage.But the Northeast isn’t staying entirely above water, and neither is its housing market. New data released by First Street Foundation, a technology non-profit, shows that with rising sea levels and increased flooding, home values in the coastal tri-state area—encompassing Connecticut, New York, and New Jersey—have decreased by $6.5 billion since 2005.“So much attention is paid to Florida and the southeastern states around this issue,” said Steven McAlpine, head of data science at First Street Foundation. “We wanted to quantify the impact it’s having here, and to draw attention to the fact that this is a national issue.”The project began with <a href="https://link.springer.com/article/10.1007/s11113-018-9473-5">a case study</a> of Miami-Dade County, published in June, that found over $465 million dollars in property value had been lost between 2005 and 2016. The new data, released to <a href="https://floodiq.com/">their Flood iQ site</a> , now joins existing data on five southern coastal states: Florida, Georgia, South Carolina, North Carolina, and Virginia. Across all eight states, a total of $14.1 billion has been lost in home value between 2005 and 2017.To see this decrease in home values, you just have to look at the prices at which homes are sold. “It’s [a trend] that you could probably observe if you were looking at Zillow,” said Jesse Keenan, lecturer in architecture at Harvard Graduate School of Design who was not involved in the study.The team at First Street Foundation based their model of home values on almost 10 million real estate transactions. After seeing how much of the price variability could be explained by other factors (like the size of the house, amenities, and general market trends), they incorporated flooding and sea level data from the National Oceanic and Atmospheric Administration (NOAA). NOAA has been tracking sea level rise, finding an increase of about one-eighth of an inch per year.Rather than looking at the neighborhood as a whole, flooding was measured on the basis of individual properties. They offer predictions for future flood risk and home value change up to 2033—which shows that some properties with no history of flooding are at risk, and homeowners stand to lose millions of dollars.Previous studies have forecasted changes in home values in the future, but by using historical records and taking such a fine-grained approach, the team was able to show for the first time that housing markets have already started showing the effects of rising sea levels.“This is the very beginning indicator that sea level rise and flooding is having an economic impact, and that the market is responding to it,” said Matthew Eby, executive director of First Street Foundation.And the decline in home values doesn’t just come from houses getting flooded. In addition to house lots, they also looked at the elevation of each road and its exposure to nearby bodies of water. Nearby flooding of roads can impact house prices because it affects commutes and mobility, said Jeremy Porter, professor of sociology at the City University of New York, lecturer in environmental health sciences at Columbia University Mailman School of Public Health, and academic data consultant at First Street Foundation.
<div class="ad"></div>
The Northeast data has been consistent with previous data from the South, a surprise for the team. Over half of the top 20 affected cities and zip codes are in the Northeast. “The exposure of the New Jersey shore is incredible,” McAlpine said. “It takes you back a little bit when you look at Ocean City and see how many homes are regularly dealing with flooding.”For their initial study of Miami-Dade County, the team actually travelled there, armed with a GPS, boots, and rulers to measure the flooding themselves and to see if their model was accurate.But that trip offered more than just a chance to validate their data—they could see the actual impact that flooding has had on people.“A lot of people were interested in talking to us about how this has become the new norm,” said Jeremy Porter, professor of sociology at the City University of New York, lecturer in environmental health sciences at Columbia University Mailman School of Public Health, and academic data consultant at First Street Foundation. “There’s always water in the streets. They deal with water all the time. People said they had trouble selling their home, or that they didn’t know it flooded like that when they bought their home.”People in the tri-state area share these experiences. Clint Andrews, professor of urban planning, director of the Rutgers Center for Green Building, and associate dean for faculty at Rutgers University’s Bloustein School of Planning and Public Policy, studies how homeowners think about flood risk information. He focuses on neighboring county of Monmouth, New Jersey, which Hurricane Sandy swept through in 2012, and his fieldwork backs up what the First Street Foundation data says. If people know that flooding has happened in an area, they’re not willing to pay as much for houses. Flood risk also increases the cost of flood insurance, an added expense for homeowners.Perception is key, Keenan said, because a lot of home buyers gauge risk based on reputation rather than evidence. Andrews thinks that may even be a potential blind spot of First Street Foundation’s model. If a house in a neighborhood that has a reputation for flooding, or has been designated as high risk by a government agency, home buyers may drive prices down even without proof.But perceptions can vary based on the buyer. People buying a second home or investing in a property are more cautious because they have more experience with real estate and know what to check. To Andrews, it seems like these are the buyers that are bringing home prices down, because once they know a house’s flood risk, they are less willing to pay the asking price.On the other hand, he has noticed that people who are purchasing a house to live in as their primary residence tend to be less aware of the flood risks. “They don’t go around buying houses often,” he said. “They are more typically drawn by the constant allure of the seashore and are not thinking very probabilistically to apply a future flood risk discount.”These buyers also don’t have access to a lot of reliable sources of information on flood risk. In focus groups, Andrews hears people wonder whether the sea level rise is going to affect them within the term of their current mortgage, a hundred years later.This information gap compound existing segregation in the real estate market. Keenan studies the concept of “climate gentrification:” As the climate-related calamities become more frequent, certain homes—areas at a higher elevation, weather-proofed neighborhoods—will become more desirable because they are adapted to changing climates. But this may be to the detriment of their coastal counterparts.“Those folks are going to slowly see their property value dwindle away to nothing, and then they’ll walk away,” Andrews said. “That doesn’t feel like an elegant or nice solution.”First Street Foundation has seen this exact phenomenon occur in their data: For example, in Suffolk County on Long Island, wealthier residents have moved away from the coast, leaving behind a lower income population with lower home values.This inequity is part of the issue that First Street Foundation is trying to address. They plan on taking a closer look at how home values are impacted in neighborhoods that have adapted to the rising sea levels with new drainage systems or sea walls.“The bigger issue is the people who don’t necessarily have the means to move or to elevate their homes,” McAlpine said. “Lower income towns with less adaptation capabilities are generally the ones that are going to have to deal with this issue more regularly because it’s harder for them to fix it.”By putting the data online through Flood iQ, it’s accessible to everyone, not just more-experienced home buyers. Since its initial launch, there have been over 170,000 unique users, and numbers have grown as they’ve added the home value feature and increased the number of states, Eby said. The team plans on extending their analysis to cover the entire east coast, including other major coastal metropolitan areas, like Boston, that have seen their own effects of rising sea levels.
<div class="newsletter"></div>

New data shows that with rising sea levels and increased flooding, home values in the coastal tri-state area—encompassing Connecticut, New York, and New Jersey—have decreased by $6.5 billion since 2005.

Lasik Surgery Patients Suffer Serious Side Effects

Every year, over 700,000 people discard their glasses and undergo Lasik surgery to regain nearly-perfect eyesight. But as the procedure reaches a two-decade milestone, stories of debilitating side effects are coming to light.


 Unlike glasses and contacts, which work outside the eye, Lasik works from within. Our eyes work like tiny cameras. The cornea—a prism-like dome in the front of your eye—and an internal lens focus light on the back surface of the eye, creating a high-definition image. But if you’re near- or farsighted, your eye isn’t able to focus the light precisely. Glasses and contacts pre-focus the light before it even enters your eye.


 But with Lasik, the common name for Laser-Assisted
 
 In Situ
 
 Keratomileusis, surgeons re-sculpt the cornea itself to change the angle at which it focuses the light. They cut a thin flap on the surface and fold it back to allow access to a laser that re-shapes the cornea.


 It may seem logical that such an invasive procedure would have side effects. Here’s Roni Caryn Rabin, reporting for the New York Times on a clinical trial carried out last year by the Food and Drug Administration:

<blockquote>

 Three months after surgery, however, glare, halos and double vision were common, affecting 50 to 60 percent of all patients, with up to 5 percent characterizing them as “very” or “extremely” bothersome.

</blockquote>

 Even after six months, some 41 percent of patients reported visual aberrations, with nearly 2 percent—or one in 50—saying the symptoms presented “a lot of difficulty” or “so much difficulty that I can no longer do some of my usual activities.”


 Doctors carefully screen candidates to ensure that they understand the risks and meet the proper criteria. It’s considered an elective surgery—no one is required to get Lasik. But as more patients go under the laser, more horror stories are emerging, including chronic physical and mental pain, and even suicide. Here’s Rabin again:

<blockquote>

 Katie Enders, 35, a kindergarten teacher in Cleveland, said her 2006 Lasik surgery left her feeling she had “paper cuts in her eyes.” She saw over a dozen doctors and tried several pain medications, finally getting relief from a pain pump implanted in her abdomen that carries a constant infusion of anesthetic up her spine.

</blockquote>
<div class="related"></div>

 Although only a minority of patients experience adverse outcomes, they are banding together to increase awareness of the dark underbelly of the seemingly-glamorous procedure. It’ll take more research to understand why exactly Lasik causes so many issues for some patients, and to figure out whether there really is a perfect fix for blurry eyesight.


 Photo credit:
 <a href="https://www.flickr.com/photos/mylifeisheather/4512424869/">
 Heather Schleiffer / Flickr (CC BY-ND 2.0)
 </a>

Aparna Nathan

Articles

Researchers Comb Through Millions of Genetic Variants to Find Disease Risk

The FDA Just Approved Its First-Ever Cannabis-Based Drug

How Genetic Differences Could Make Schools Better

Study Finds Billions of Dollars in Home Value Lost to Rising Sea Levels

Lasik Surgery Patients Suffer Serious Side Effects

Support Provided By