The SCHEIE Visual Field Grading System

No method of grading visual field (VF) defects has been widely accepted throughout the glaucoma community. The SCHEIE (Systematic Classification of Humphrey visual fields-Easy Interpretation and Evaluation) grading system for glaucomatous visual fields was created to convey qualitative and quantitative information regarding visual field defects in an objective, reproducible, and easily applicable manner for research purposes.

Download PDF

Comparison of Combined Bevacizumab plus Dexamethasone Vs. Ranibizumab Monotherapy as First-Line Therapy in Patients with Treatment Naive Neovascular Age-Related Macular Degeneration in Real-Life Clinical Practice: A Retrospective Case-Series Analysis

Age related macular degeneration (AMD) is a major cause of legal blindness in elderly individuals in the western world. It affects the macula, initially with characteristic retinal pigment epithelium (RPE) changes (mottling, hyper/hypopigmentation) and drusen deposition (dry AMD). Of note is the presence of a series of inflammatory factors between the RPE and Bruch's membrane. The progression of AMD leads either to late stage geographic atrophy of the macular RPE, or to neovascularization (neovascular AMD), due to vascular endothelial growth factor (VEGF) production.

Neovascular AMD is the most vision-threatening form of the disease. Visual impairment in neovascular AMD is caused by the formation of a choroidal neovascular membrane (CNV) beneath the macula with consequent subretinal leakage, hemorrhage and intraretinal fluid accumulation. Inflammatory factors and VEGF are the main contributing mediators involved in the progression of AMD, participating in a vicious cycle involving hypoxia, oxidative stress, inflammation, edema and neoangiogenesis.

Download PDF

Periorbital Cellulitis that Developed after Alternative Medication of Hirudo Medicinalis Application

We aimed to present a case of periorbital (preseptal) cellulitis that developed after Hirudo medicinalis alternative medicine application for glaucoma treatment which can be rarely seen in routine ophthalmology practice. A 36 year old woman with a glaucoma was admitted to our outpatient clinic because of redness, pain and swelling around the right eye for three days and gave a history of leech application 1 week ago, that recommended by her relatives as a remedy for glaucoma.

Orbital cellulitis was excluded and cure was achieved with oral ciprofloxacin and flurbiprofen treatment. Patients with chronic diseases such as glaucoma, they are abandoning the treatment over time, will seek solutions from alternative medicine. These inappropriate treatments without scientific evidence can cause various complications. Physicians should maintain proper communication with the patients inform them about their chronic diseases (e.g. glaucoma) to make them the part of the solution and treatments.

Calotropis procera produces Inflammatory Effects omn Cornea, Poses threat to the eyes

Calotropis procera is a flowering plant native to North Africa, South Asia and Indonesia. The flowers produce bitter and sticky toxic milk. It possesses both inflammatory and anti-inflammatory pharmacological properties. Topic application of latex from C. procera I affects eye with diffuse corneal edema. It resulted in reduced endothelial cell count and severe ocular injuries and a loss of endothelial cells over a period of time. Public education, early recognition of such injuries, and timely intervention may prevent permanent ocular damage.

Download PDF

Corneal Toxicity after Self-Application of Calotropis procera (Ushaar) Latex: Case Report and Analysis of the Active Components

Calotropis procera (ushaar) produces a copious amount of latex, which has both inflammatory and antiinflammatory pharmacological properties. Local application produces an intense inflammatory response and causes significant ocular morbidity. 

We report corneal toxicity following self-application of latex from C. procera in a 74-yearold man. He reported painless decreased vision in the affected eye with diffuse corneal edema, and specular microscopy revealed a reduced endothelial cell count. After he was treated with topical corticosteroids, his visual acuity improved from HM to 20/80. The composition of the active compounds in the latex was analyzed. When topically administered, the latex may cause severe ocular injuries and a loss of endothelial cells over a period of time. Public education, early recognition of such injuries, and timely intervention may prevent permanent ocular damage