OVERNIGHT ORTHO-K INDUCES DECREASED MESOPIC CONTRAST SENSITIVITY AND INCREASED HIGHER-ORDER ABERRATIONS

American Journal of Ophthalmology Volume 145, Issue 4, April 2008, Pages 645-655.

According to this paper:

"Mesopic contrast sensitivity after overnight orthokeratology is deteriorated significantly as ocular higher-order aberrations increase, and these changes depend on the amount of myopic correction"

LACRISERT FOR DRY EYE PATIENTS

Lacrisert

According to the company's web page:

"In a study comparing Lacrisert once daily with artificial tears used at least 4 times a day, Lacrisert was more effective at relieving symptoms and was able to help existing tears stay longer on the eye surface. Most patients in clinical studies preferred lacrisert over artificial tears."

REVIEW OF SUPPLEMENTS

Review of Optometry

This article contains a review of some of the benefits of supplements, some pitfalls, interactions with other medications, and other warnings.

PALS HELP SLOW MYOPIC PROGRESSION IN CERTAIN CHILDREN

Review of Optometry:

This review of the COMET study concluded:

"O.D.s should counsel families about risk factors (high accommodative lag/ esophoria at near, low amounts of myopia, two myopic parents) and suggest that PALs may be useful to slow the progression of myopia and prevent the development of high myopia when a child has one or more of these risk factors. For children who do not fall into these categories, PALs do not appear to offer any clinical advantage to slow the progression of myopia vs. SVLs."

In children with these risk factors, myopia progressed between .50 D and .68 D less in three years than the controls when they wore the PALS.

PREGNANCY AND TOPICAL ANTIBIOTICS

EyeWorld Magazine: March 2008

This opinion talks about all topical antibiotics being category C for pregnancy, except for Erythromycin ointment and Azasite, which are category B.

PERFORM GONIOSCOPY WITH LIGHTS OUT

EyeWorld Magazine: March 2008

This report explains the importance of lighting conditions while doing gonioscopy. Oftentimes the light is bright enough so that the pupil constricts and widens the angle, creating the impression that a closed angle is actually open.

OVERNIGHT CORNEAL RESHAPING SAFE

Eye & Contact Lens: Science and Clinical Practice - Abstract: Volume 34(2) March 2008 p 94-99 Long-term Clinical Outcomes for Overnight Corneal Reshaping in Children and Adults.

In this study only 3 of the 296 patients undergoing corneal reshaping therapy had adverse events, but these events did not result in loss of BCVA. It concludes:

"Overnight Corneal Reshaping resulted in comparable safety and efficacy in temporarily reducing myopia for children younger than 12 years as it is for children older than 12 years and adults."

CPAP CAN INCREASE IOP

Continuous Positive Airway Pressure Therapy Is Associated with an Increase in Intraocular Pressure in Obstructive Sleep Apnea -- Kiekens et al. 49 (3): 934 -- Investigative Ophthalmology & Visual Science

According to this study:

"Patients with obstructive sleep apnea demonstrated significant 24-hour IOP fluctuations (3 mmHg more), with the highest values at night. CPAP therapy causes an additional IOP increase, especially at night. Regular screening of visual fields and the optic disc is warranted for all patients with OSA, especially those treated with CPAP.

ATROPINE PENALIZATION BETTER THAN PLUS LENS PENALIZATION IN AMBLYOPIA

American Journal of Ophthalmology Volume 145, Issue 3, March 2008, Pages 562-569

The purpose of this study was:

"To compare the efficacy and sensory outcome of pharmacologic and optical penalization in the treatment of moderate to mild amblyopia."

And the conclusion was:

"Atropine penalization may be considered more effective than optical penalization with positive lenses."

PSEUDOEXFOLIATION SYNDROME LINKED TO HEARING LOSS

Ophthalmology Volume 115, Issue 3, March 2008, Pages 425-429

According to this study:

"Hearing thresholds at frequencies that are important for speech comprehension are significantly worse in individuals with ocular pseudoexfoliation than in matched controls. This finding may support the multiorgan nature of pseudoexfoliation syndrome."

ASPHERIC NO BETTER THAN NON-ASPHERIC CL's

Optometry and Vision Science - Abstract: Volume 85(3) March 2008 p 201-210 Optical and Visual Performance of Aspheric Soft Contact Lenses.:

According to this study:

"At least with respect to the brand of lenses tested, the fitting of aspheric design soft contact lenses does not result in superior visual acuity, aberration control, or subjective appreciation compared with equivalent spherical design soft contact lenses."

STILL CAN GET CORNEAL ULCERS W/ SILICONE HYDROGELS

Eye & Contact Lens: Science and Clinical Practice - Abstract: Volume 34(2) March 2008 p 124-128 Pseudomonas Keratitis Associated With Daily Wear of Silicone Hydrogel Contact Lenses.:

Keep in mind that we may still get corneal ulcers with silicone hydrogel lenses, even on a daily wear schedule. I'm interested to see studies done with Purevision and Night and Day contact lenses, and with 30 day continuous vs. daily wear.

"Increased oxygen permeability associated with silicone hydrogel contact lenses may reduce, but does not eliminate, the risk of pseudomonas keratitis. Studies have yet to quantify the risk of keratitis associated with daily wear of these lens materials. Further study is necessary to identify the risks of complications with daily wear of silicone hydrogel lenses and to determine which factors may contribute to those risks."

METHOTREXATE SAFE & EFFECTIVE IN CHRONIC SCLERITIS

American Journal of Ophthalmology Volume 145, Issue 3, March 2008, Pages 487-492.e2

According to this study:

"Methotrexate seems to be a well-tolerated therapy that can reduce inflammation successfully and can decrease the corticosteroid requirement in the treatment of chronic, noninfectious, and nonnecrotizing scleritis."

POSSIBLE LINK BETWEEN TIMOLOL USE AND MORTALITY

Arch Ophthalmol -- Abstract: Open-angle Glaucoma and Mortality: The Barbados Eye Studies, March 2008, Wu et al. 126 (3): 365:

"In this black population, cardiovascular mortality tended to increase in persons with previously diagnosed/treated OAG and ocular hypertension. The excess mortality associated with timolol maleate treatment of OAG, also found in a white population, warrants further investigation."

PATCHING BEYOND 6 HRS/DAY NO HELP IN AMBLYOPIA

IngentaConnect Objectively monitored patching regimens for treatment of amblyopi...:

This study determined whether amblyopic children with 12 hours/day patching had a faster rate of improved VA than patients on 6 hours/day patching. It concluded:

"6 hours/day and 12 hours/day prescribed occlusion results in similar visual outcome."

VITAMIN B12 & FOLATE DEFICIENCY MAY INCREASE CRVO RISK

Journal of Medical Case Reports Abstract 1752-1947-2-77 Malnutrition and bilateral central retinal vein occlusion in a young woman: a case report:

This report suggests that deficiency in Vitamin B12 and folate can increase risk of CRVO due to elevated homocysteine levels. It concludes:

"Vitamin B12 and folate deficiency can lead to elevated levels of homocysteine. We found a large amount of published data relating central retinal vein occlusion to elevated homocysteine levels, but there was a lack of conclusive evidence for this association Patients should be asked about their dietary history where a thrombotic event is suspected or confirmed."

HOMOCYSTEINE AND DIABETIC MACULAR EDEMA

EJO - European Journal of Ophthalmology:

According to this study:


"Mild to moderate elevation of homocysteine may explain the role of vascular dysregulation and endothelial dysfunction in patients with diabetic retinopathy. Hyperhomocysteinemia may be one of the crucial risk factors for development of macular edema"

IV vs. ORAL TREATMENT FOR ORBITAL CELLULITIS

Eye - Abstract of article: Our experience using primary oral antibiotics in the management of orbital cellulitis in a tertiary referral centre:

According to this study:

"Empirical oral ciprofloxacin and clindamycin combination may be as safe and effective as i.v. therapy in the management of orbital cellulitis."

ZYLET CAUSES LESS IOP RISE THAN TOBRADEX

Cornea - Abstract: Volume 27(1) January 2008 p 50-55 Effects of Loteprednol/Tobramycin Versus Dexamethasone/Tobramycin on Intraocular Pressure in Healthy Volunteers.

Only 1.95% of patients on Zylet had IOP rise equal to or higher than 10mmHg as compared to 7.5% with Tobradex.

RETINAL ARTERIOLAR NARROWING PREDICTS DIABETES

Retinal Arteriolar Narrowing Predicts Incidence of Diabetes: The Australian Diabetes, Obesity and Lifestyle (AusDiab) Study -- Nguyen et al. 57 (3): 536 -- Diabetes:

From this study:

"Narrower retinal arteriolar caliber predicted risk of diabetes. These data provide further evidence that microvascular changes may contribute to the pathogenesis of diabetes."