Intraocular Pressure Measurement after Photorefractive Keratectomy: Does Contact Area Matter?

Refractive laser surgery induces substantial changes in corneal structure, causing inaccurate intraocular pressure (IOP) readings. Pascal dynamic contour tonometry (PDCT) and I care rebound tonometer (RBT) are two novel devices that do not depend on applanationto measure IOP. Purpose of this prospective study was to compare PDCT and rebound tonometry versus Gold man tonometry (GAT) in a group of patients who underwent photorefractive keratectomy (PRK). 

Central corneal thickness and IOP were measured in 54 eyes before and after PRK. All IOP measurements were taken by the same examiner, using PDCT, RBT and GAT in a randomised, masked fashion. After excimer laser surgery, PDCT measurements were higher than GAT (p<0.0001) and RBT (p=0.0012). Multiple linear regression analysis indicated that size of contact area was significant (b=-0.504; p<0.0001) while corneal thickness was not (b=0.003; p=0.169). 

Saints and Ophthalmology: A Pattern for Emulation, a Model of Healing, and Physicians in Action

From the earliest times, medical practitioners have sought divine help and support to aid them as they go about their busy rounds. In Christian Europe of the High Middle Ages, saints played a central role in the everyday life of the ailing. Alongside healing attempts which involved magic, folk or scientifically-based medicine, the invocation of specific patron saints for the curing of ailments was a widespread practice. 

The miracles of vision performed by saints over the past two millennia are listed and interpreted by various reviewers along faith healing, spontaneous recovery, or physicians acting as saints. The individuals honored as patron saints of medicine were practicing physicians who served their patients and their communities well. It is their role as saints to represent the spiritual element in the healing process as well as personifying the charitable idealism of the good physician, and therefore are models for humanitarian physicians, with the ultimate model of healing being Jesus Christ.

The Disease Course of Bilateral Endogenous Fungal Endophthalmitis

To report the dynamic disease course of a case of bilateral endogenous fungal endophthalmitis, which was successfully treated? Case Report: A 54 year old Chinese man with a history ofextracorporeal shock wave lithotripsy (ESWL) and ureteroscopy was referred to our center. After 1 week, his best corrected Snellen visual acuity (BCVA) values were 20/100 and 20/25; the interface between the posterior vitreous face and the retinal surface appeared to be rough in the right eye, and a similar, larger, low-rounded circumscribed apophysis could be observed in the left eye.

During the 2nd week, his BCVA values decreased to 20/400 and 20/32. He was diagnosed with bilateral endogenous Candida albicans endophthalmitis after a vitreous biopsy and then underwent binocular pars plana vitrectomy (PPV) with silicone oil injection in both eyes. Post operatively, his BCVA values were 20/63 and 20/32, and fundoscopy and optical coherence tomography (OCT) showed a regular and smooth interface and retina surface after the removal of the silicone oil at 3 months. 

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.

Download PDF

Further Research needed to explore the link between Posterior keratoconus and Ocular coloboma

Posterior keratoconus is a rare corneal disorder that results in non-inflammatory thinning of the cornea, leading to cone-like protuberance in the posterior cornea. Ocular coloboma is malformation due to faulty closure of the embryonic fissure, where the entire ocular structure may affect iris, ciliary body, choroid, optic nerve or all of the above. Posterior keratoconus may lead to vision loss over a period of time. A rare case of both Posterior keratoconus along with Ocular coloboma was presented here. The study predict genetic linkage as one of the reasons and suggest further studies to explore the link between Posterior keratoconus and the Ocular coloboma.

Download PDF Here