TRAVATAN-Z AS COMFORTABLE AS XALATAN

Journal of Clinical Ophthalmology - Dove Medical Press
This paper states that there is no clinically significant difference in comfort between the two drops. It does not mention redness however.

AWSOME ARTICLE ON RED EYE DIAGNOSIS FOR PCP's

Red eye can often be difficult to diagnose, especially for PCP's or other non-ophthalmic providers who don't have a slit lamp or much expertise. This article is an excellent one to copy and bring to our PCP's to help them understand when and when not to refer.

ULCERATIVE COLITIS ASSOCIATED WITH LACRIMAL GLAND INFLAMMATION

Ulcerative colitis should be included in the differential diagnosis of lacrimal gland pseudotumor.

VITAMIN A DROPS MORE EFFECTIVE THAN ARTIFICIAL TEARS FOR DRY EYE

Both vitamin A eye drops and topical cyclosporine A 0.05% treatments led to significant improvement in blurred vision, tear film BUT, Schirmer I score results, and impression cytologic findings in patients with dry eye syndrome (P < .05) compared to the control group treated with preservative-free artificial tears alone.

LIQUID NITROGEN CRYOTHERAPY FOR SUPERIOR LIMBIC KERATOCONJUNCTIVITIS

Liquid nitrogen cryotherapy appears to be an effective alternative treatment for SLK as all subjects studied achieved long-term cures.

LIPID LOWERING MAY DECREASE NEED FOR PDR IN DIABETICS

A body of evidence supports a role for lipid-modifying therapy in reducing the diabetic retinopathy endpoints. Results from the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study show beneficial effects of fenofibrate in reducing the requirement for laser therapy, and particularly in preventing disease progression in patients with pre-existing diabetic retinopathy.

ANTI-CHOLINERGIC INTOXICATION

European Journal of Ophthalmology:

Anti-cholinergic intoxication cuases symptoms of "blurry vision, lightning flashes, disorientation, loss of balance, agitation, and anxiety. It causes ophthalmic signs of bilateral pupillary dilatation and paresis of accommodation."

Accidental ingestion of Atropa belladonna berries may cause patients to first consult an ophthalmologist. It is important to recognize the anticholinergic syndrome caused by such intoxication in order to make a proper diagnosis, avoid unnecessary testing, and provide expedient appropriate treatment when required."

VASOCONSTRICTORS CAUSE CHRONIC INFLAMMATION

European Journal of Ophthalmology:

"Chronic abuse of decongestant eyedrops can produce a clinical picture resembling an ocular pemphigoid. Histology suggests that late onset immunoreaction and chronic vasoconstriction cause chronic inflammation and neovascularization, respectively."

CONJUNCTIVOCHALASIS MAY HAVE INFLAMMATORY COMPONENT

SpringerLink - Journal Article:

"conjunctivochalasis maybe related to cell apoptosis and inflammation."

CHARACTERISTICS OF OPHTALMOPLEGIC MIGRAINE

(DOI 10.1007/s10194-008-0089-8)


Ophthalmoplegic migraine (OM) as recurrent attacks of headache with migrainous characteristics, associated with paresis of one or more ocular cranial nerves (commonly the third cranial nerve), and in the absence of any demonstrable intracranial lesion . It is diagnosed when at least two attacks with migraine-like headaches are accompanied with, or followed within 4 days of onset by, paresis of one or more of the third, fourth or sixth cranial nerves. Parasellar, orbital fissure and posterior fossa lesions should be ruled out by appropriate investigations.

The headache often lasts for a week or more and there is a latent period of up to 4 days from the onset of headache to the onset of ophthalmoplegia. The condition may be a recurrent demyelinating neuropathy. In general, patients demonstrated a: (1) prolonged time for symptom resolution to occur (median time 3 weeks); (2) tendency for recurrent episodes to have more severe and persistent nerve involvement; (3) evidence of permanent neurological sequelae with recurrent episodes (30% of patients); (4) rapid improvement and shortened duration with corticosteroid therapy and; (5) transient, reversible MRI contrast enhancement of the affected cranial nerve (86% of patients).

ANGIOID STREAKS

Journal of Therapeutics and Clinical Risk Management - Dove Press:

"Angioid streaks are visible irregular crack-like dehiscences in Bruch’s membrane that are associated with atrophic degeneration of the overlying retinal pigmented epithelium. Angioid streaks may be associated with pseudoxanthoma elasticum, Paget’s disease, sickle-cell anemia, acromegaly, Ehlers–Danlos syndrome, and diabetes mellitus, but also appear in patients without any systemic disease.

"Patients with angioid streaks are generally asymptomatic, unless the lesions extend towards the foveola or develop complications such as traumatic Bruch’s membrane rupture or macular choroidal neovascularization (CNV). The visual prognosis in patients with CNV secondary to angioid streaks if untreated, is poor and most treatment modalities, until recently, have failed to limit the devastating impact of CNV in central vision. However, it is likely that treatment with antivascular endothelial growth factor, especially in treatment-naive eyes to yield favorable results in the future and this has to be investigated in future studies."

You can download the PDF of this nice review of Angioid Streaks:
4036 TCRM_4682_Georgalas_120908.pdf

OPTIVE GIVES GOOD RESULTS FOR DRY EYE TREATMENT

Journal of Clinical Ophthalmology - Dove Medical Press

TBUT was measured in 4,338 patients before switching to or initiating therapy with Optive and at final visit (2 to 4 weeks after treatment initiation). Baseline measurement of mean TBUT was 7.7 ± 3.9 seconds. This value increased to 10.0 ± 4.7 seconds at final visit. Most patients (85.4%) reported improvement in local comfort. The majority (75.1%) of patients felt an improvement in symptoms after changing their treatment.

POSSIBLE NON-STEROIDAL TREATMENT FOR UVEITIS

Journal of Clinical Ophthalmology - Dove Medical Press:

"Currently available uveitis therapies are burdened with toxicities and/or lack definitive evidence of efficacy. Voclosporin, a rationally designed novel calcineurin inhibitor, exhibits a favorable safety profile and a wide therapeutic window. If LUMINATE is successful, voclosporin will become the first Food and Drug Administration-approved corticosteroid-sparing agent for this condition."

MORE EVIDENCE ALPHAGAN MAY BE NEUROPROTECTANT

Journal of Clinical Ophthalmology - Dove Medical Press

This article concludes:

"Beyond brimonidine’s pressure lowering capacity, laboratory and early clinical evidence supports its neuroprotective potential. We await validation of this in human clinical trials."

RUBBING CONTACT LENSES BETTER THAN NOT RUBBING

IngentaConnect Soft contact lens cleaning: rub or no-rub?

Not rubbing the soft lens when cleaning is ineffective in removing loosely-bound deposits. A longer rinse, as recommended by the manufacturers, does not remove significantly more deposits than a shorter rinse with the MPS. This work supports the view that contact lens wearers should be encouraged to rub their lenses when cleaning

INSUFFICIENT EVIDENCE FOR MOST BEHAVIORAL VISION THERAPY

IngentaConnect A critical evaluation of the evidence supporting the practice of ...

According to this study:

"Although there are areas where the available evidence is consistent with claims made by behavioural optometrists (most notably in relation to the treatment of convergence insufficiency, the use of yoked prisms in neurological patients, and in vision rehabilitation after brain disease/injury), a large majority of behavioural management approaches are not evidence-based, and thus cannot be advocated."

BOTULINUM TOXIN GOOD LONG-TERM TREATMENT FOR STRABISMUS

Long-term management of strabismus with multiple repeated injections of botulinum toxin

The treatment of strabismus with botulinum toxin on a long-term basis is practicable and valuable in patients with poor binocular potential, complicated strabismus, or multiple previous strabismus operations. A trend toward fewer injections with time was observed, and no significant adverse effects were observed with long-term treatment.

MACULAR TRANSLOCATION SURGERY NOT A GOOD OPTION FOR WET AMD

Macular translocation for neovascular age-related macular degeneration

There is insufficient evidence from randomised controlled trials on the effectiveness of macular translocation, which is also not free of important risks. Furthermore, this technique is difficult to perform. Thus, macular translocation might not be considered for most patients with wet AMD given the treatment options already available.