The Effects of Intense Pulsed Light on Tear Osmolarity in Dry Eye Disease

In this prospective study we show the influence of Intense Pulsed Light Therapy (IPL) on tear osmolarity, an increasingly important metric of dry eye disease. Previous studies have measured the effectiveness IPL has had on other metrics including tear break up time (TBUT), lipid layer grade (LLG), tear evaporation rate (TER), tear meniscus height (TMH), and subjective responses from patients.

Single center prospective study included 16 patients and 32 eyes. Patient ages ranged from 18 to 90 years old with 75% of participants being female. All patients had an at least one eye with a tear osmolarity of 308 mOsm/L or greater, or had an inter-eye difference in tear osmolarity of 11 mOsm/L or greater. Tear osmolarity was measured bilaterally before a single IPL treatment followed by one drop of topical NSAID. Bilateral tear osmolarity was then measured again one month later.

Chronicity and Recurrence as Prognostic Factors in Central Serous Chorioretinopathy after Half-Dose Photodynamic Therapy

Central serous chorioretinopathy (CSC) is a chorioretinal disorder characterized by serous detachment of the neurosensory retina. The patho physiology remains poorly understood, butchoroidal vascular hyper permeability, and subsequent retinal pigment epithelium(RPE) dysfunction, due to a mechanical hydrostatic stress, seem to be primarily involved in its pathophysiology. 

CSC can present itself in an acute or chronic stage. Although acute CSC resolves spontaneously in most cases, leaving no or minor visual complaints, the persistence of sub- macular fluid or history of recurrence are common. Chronic forms of CSC can evolve with severe and permanent visual loss, which is often associated with recurrent or persistent forms of disease.

Scleral Lenses and Irregular Corneas: Patient versus Practitioner Goals

For more than 25 years, my clinical care for the most part has involved providing vision care for individuals with Keratoconus and other types of irregular cornea. What I have come to appreciate is that what the patient seeks to achieve is often very different from what we as eye care providers are looking to accomplish.

First and foremost, individuals who have learned that they suffer from some sort of corneal irregularity that has begun to interfere with their vision, are simply seeking to address that very issue, their vision. Their other concern is that they are not “going to go blind” from the condition. They don’t think about how the selection and application of a vision care correction might adversely affect their future ocular health.

Analysis on Visual Imaging Quality Affected by Human Eye’s Higher Order Aberration Measurement

In the 1990s, human eye’s wave front aberration measurement technology achieved rapid development. Williams DR etc. proposed two indirect wave front aberration measurement methods, namely, interferometry and double optical path methods. 

The former obtains human eye’s Modulation Transfer Function (MTF) by making use of interference that produces interference fringes with different aerial modulation degrees while the latter obtains MTF via irradiating ideal spherical wave into eye pupil, receiving wave-front information carrying aberration reflected from human eye via CCD (Charge Coupled Device), and analyzing its image.

Strabismus Amblyopia in Young Cameroonian at their First Visit at Yaounde Hospital Centre-Essos

The management of strabismus in Cameroon is not well developed and the average age of first consultation is beyond the age amblyopia reversal. It is with the aim of improving strabismus management that we undertook this prospective and descriptive study which spanned 11 months. The objective was to describe amblyopia in patients with comitant strabismus at their first visit. Data collected included the age at the first visit, past history, refractive error, and the characteristics of strabismus, amblyopia and strabismus-associated factors. Forty patients were included amongst whom there were 21 females and 19 males.

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Central Retinal Artery Occlusion with Patent Cilioretinal Artery

A 35 year old female presented with sudden painless decrease of vision in her right eye. Visual acuity in her right eye was 6/12 on distant Snellen’s acuity chart. A relative afferent pupillary defect was noted. Fundus examination in right eye showed optic disc swelling, retinal opacification and retinal edema with a perfused area of retina at posterior pole suggestive of central retinal artery occlusion with patent cilioretinal artery.

A detailed medical history revealed that she had taken a dose of depot progesterone three months back for contraception. Complete haemogram, coagulation profile and lipid profile was normal. Carotid Doppler showed presence of a thrombus in right internal carotid artery for which she is under care of cardiologist. Central retinal artery occlusion with a patent cilioretinal artery presents with constriction of visual fields but central vision is preserved.

Beyond HbA1c: Environmental Risk Factors for Diabetic Retinopathy

Diabetic retinopathy affects 4.2 million people in the United States and is the leading cause of blindness in Working-aged people.

As the prevalence of diabetes continues to rise, cost-effective interventions to decrease blindness from diabetic retinopathy will be paramount. While HbA1c and duration of disease are known risk factors, they account for only 11% of the risk of developing micro vascular complications from the disease. The assessment of environmental risk factors for diabetic eye disease allows for the determination of modifiable population-level challenges that may be addressed to facilitate the end of blindness from diabetes.

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Advantages and limitations of Contact Lens Revolution in Eye Care

Plethora of innovations in the fired of eye care in general and contact lens in particular has revolutionized the way the patients opt for contact lenses. 

Starting from gas permeable lenses, overnight wear of Orthokeratology lenses, and a wide range of soft lenses are offering comfort and quality vision. However, patients cannot simply go away with each innovations blindly without consider the limitations like scratches, tear, lipid accumulation and attraction of tear protein etc. Patients consider appropriate and comfortable options that would not affect the overall health of the eye in this regard.

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How much Change in Refractive Error will Cause a Patient to Seek Ophthalmic Care?

Incredibly, a quantifiable answer for this question could not be readily discovered in the ophthalmic corpus. Although it’s likely that most providers and academic instructors could provide estimates based on clinical experience, a literature review could supply no definite answer for this basic clinical question. 

Even Duke-Elder (System of Ophthalmology) and Borish (Clinical Refraction) are silent on the topic. While it has been qualitatively noted that “substantial change in refractive error…can cause the patient to become aware of a change in vision” and that +0.25 D or +0.50 D of induced reduced refractive error can elicit subjective visual symptoms, the amount of defocus necessary to cause patients to seek ophthalmic care has not been reported to date. The purpose of this brief report is to review observational data in order to provide an initial, quantitative answer to a basic ophthalmic question.

Screening and Diagnosis of Hydroxychloroquine Toxicity: Advances and Controversies

Hydroxychloroquine (HCQ) is a widely-used medication. Although classically associated with the treatment of malaria and systemic lupus erythematosus (SLE), the potential spectrum of HCQ utility is actually quite expansive, and may come to include more common diseases and disorders. 

Although generally considered a safe medication in the medical community, the adverse effect profile of HCQ is distinguished by irreversible retinal toxicity, with a reported prevalence between 0.5% and 7.5%. Primary prevention is a key for these patients, because the retinal damage is considered largely irreversible. However, the means of primary prevention, i.e. screening, has been at the center of controversy in the ophthalmology community for several years.

Pathogenesis of Orderly Loss of Nerve Fibers in Glaucoma

Chronic Glaucoma, commonly known as glaucoma, is a misunderstood disease since given a separate entity in the 1850s. 

Currently, there are many conflicting views of glaucoma but on one issue we have complete agreement: the million or so densely packed nerve fibers in the optic nerve head are being destroyed in an orderly tandem fashion from peripheral to central, never randomly–a pathogenomonic feature. The orderly destruction of NFs is perhaps the only lead we have in solving the mystery of glaucoma, but rarely discussed. If the NFs were not destroyed in a predictable orderly sequence, the role of perimetry in glaucoma would be meaningless.

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