ANOREXIA CAN DECREASE RETINAL NERVE FIBER LAYER THICKNESS

Anatomical and functional impairment of the retina and optic nerve in patients with anorexia nervosa without vision loss -- Moschos et al. -- British Journal of Ophthalmology

REMURA MOVES TO PHASE 3 CLINICAL TRIALS FOR TREATMENT OF DRY EYE

Highlights of dry eye Phase 2 clinical study revealed - Ophthalmology Times Europe

HIGH LEVELS OF SYSTEMIC CORTICOSTEROIDS AND STRESS ARE RISK FACTORS FOR CSR

Access : Central serous chorioretinopathy: an update on pathogenesis and treatment : Eye

CSR is central serous retinopathy which is leakage of fluid through the RPE that leads to serous retinal detachment. It lasts a few months and resolves spontaneously with limited lasting objective effects. It needs to be considered in the differential diagnosis of vision loss in patient undergoing corticosteroid treatment.

TIMOLOL IS EFFECTIVE THROUGHOUT THE DAY IN GLAUCOMA

Intraocular Pressure on #MDlinx

This study shows that Timolol is effective throughout the 24 hour period and has minimal effect on ocular perfusion pressure. These are important facts when considering Timolol as an adjunct in glaucoma therapy.

NICE REVIEW OF ISCHEMIC OPTIC NEUROPATHY

Review of Ophthalmology

Ischemia is tissue damage caused by elimination of oxygen supply to that tissue.

The optic nerve is the wire that connects the the eye to the brain, transmitting electrical signals.

Optic neuropathy is damage to the optic nerve.

Ischemic optic neuropathy is divided into anterior (visible on an eye exam) and posterior (behind the eye). It is also divided into arteritic and non-arteritic. Arteritic is less common and is related to systemic inflammation in the blood. It can be diagnosed with ESR and c-reactive protein blood tests and/or temporal artery biopsy. Symptoms of arteritis include temporal pain on palpation, headache, and jaw pain on chewing. It happens in the very elderly and must be treated aggressively with systemic steroids.

Non-arteritic is more common and related to heart disease, high blood pressure, sleep apnea, and hypercholesterolemia. It is treated only by treating the underlying conditions.

The article is a nice review for ophthalmologists and other eye care providers.

AOA STUDY SHOWS IT'S OKAY TO FIT 10 TO 12 YEAR OLDS IN CONTACT LENSES

VisionMonday > New AOA Study Says Kids 10 to 12 Are OK Wearing Contact Lenses

Personally, I believe it is safe to fit children in contact lenses if:

1) they are properly fit

2) they give their eyes a few hours of breathing time a day and a day or two a week

3) they have an updated pair of glasses that they like

4) they replace their contact lenses and cases as prescribed

5) they are independent of their parents in terms of insertion, removal, and care of the lenses

My experience is that children are (generally) more responsible in caring for their contact lenses than adults are. Perhaps this is because children tend to trust the doctor's advice.

MACULAR EDEMA POSSIBLY ASSOCIATED WITH HYDROCHLOROTHIAZIDE

Macular edema associated with hydrochlorothiazide therapy -- Iacono et al. -- British Journal of Ophthalmology

The macula is that part of the retina that serves the central vision. When you are looking directly at an object, you are projecting the image of that object on your macula.

Macular edema is swelling of the macula.

Hydrochlorothiazide is a drug used for treating high blood pressure.

This paper discusses the case of a gentleman who developed macular edema after initiation of therapy with hydrochlorothiazide.

SUBMANDIBULAR GLAND TRANSPLANT PROVIDES LONG-TERM RELIEF FROM DRY EYE

Long-Term Follow-up after Submandibular Gland Transplantation in Severe Dry Eyes Secondary to Cicatrizing Conjunctivitis

Cicatrizing conjunctivitis causes severe dry eye symptoms, making frequent use of artificial tears necessary. Submandibular transplantation is a procedure that enables increased secretion of salivary tear film. This study compared long-term results of salivary gland transplantation with those of no transplantation and determined that the procedure provides long-term relief from pain and reduces the need for frequent installation of ocular lubricants.

.1% CYCLOSPORIN MORE EFFECTIVE THAN .05% (RESTASIS)

A comparative clinical trial of the efficacy of two different aqueous solutions of cyclosporine for the treatment of moderate-to-severe dry eye syndrome -- Baiza-Durán et al. -- British Journal of Ophthalmology

Restasis is a twice a day eye drop for dry eye. This study compares cyclosporin .1 to .05% and the conclusion was that the .1% significantly improved the symptoms of the dry eye more than the .05%.

PROLONGED NEAR WORK IMMEDIATELY ELONGATES THE EYE

Axial elongation following prolonged near work in myopes and emmetropes -- Woodman et al. -- British Journal of Ophthalmology

The purpose of this study was to investigate the influence of sustained 30 minutes of near work upon the length of the eye in patients that don't need vision correction and those that are near sighted.

Forty young adult subjects (20 near-sighted and 20 normals) were recruited for the study. Length from the front to the back of the eye was measured with a precision instrument before, immediately after and then again 10 min after using the eyes very close for 30 minutes.

The length of the eye increased immediately following close work but returned to normal size after 10 minutes. The effect was significantly greater in near-sighted patients than in normal patients

SPECTACLES FILTER TO HELP MIGRAINE SUFFERERS

Spectacles filter to help migraine sufferers - Ophthalmology Times Europe

A new product, MigraLens, designed to filter red and blue light and help migraine sufferers is now available in the UK in a range of branded plano eyewear including fit-overs for presciption glasses.

The flicker and glare absorbing filter has been trialled by its developer, Mediview, with members of the Macular Disease Society and now, Migraine Action too. Lee Tomkins, Director of Migraine Action, a UK charity that offers advice and support to migraine sufferers commented: “Our members have found that MigraLens is able to minimise the problems caused by flicker and glare and we are confident that it will become a useful new addition to existing migraine treatments available to light sensitive sufferers.”

Intraocular lens dislocation after whole-body vibration

Intraocular lens dislocation after whole-body vibration

Whole body vibration platforms are becoming increasingly used by athletes and elderly individuals for muscle strength and toning, cellulite reduction, improved bone density, heightened secretion of hormones associated with exercise, and depressed response of hormones associated with stress.

This paper describes cases of patients whose intraocular implants (after cataract surgery) dislocated while exercising on the whole-body vibration platform.

PDT GIVES EARLIER RESOLUTION BUT EQUAL LONG-TERM OUTCOME COMPARED TO LASER THERAPY IN CENTRAL SEROUS RETINOPATHY

Comparative study of patients with central serous chorioretinopathy undergoing focal laser photocoagulation or photodynamic therapy -- Lim et al. -- British Journal of Ophthalmology

This study concludes:

Compared with focal laser, half-dose PDT may facilitate earlier resolution of macular detachment and earlier recovery of central retinal function. However, at 3 months after treatment and thereafter, no difference in anatomical and functional recovery was noted between the two modalities of treatment.

PLUGS HELP IN DRY EYE

Dry Eye Syndromes on #MDlinx

This study shows that plugs, inserted in the lower puncta, are effective at decreasing dry eye symptoms in patients.

ACUTE ANGLE CLOSURE ATTACK THINS RNFL BUT DOES NOT INCREASE OPTIC NERVE CUPPING

Acute Primary Angle Closure Attack Does Not Cause an Increased Cup-to-Disc Ratio

Eye doctors use optic disc cupping and retinal nerve fiber layer changes to analyze progression of glaucoma. Usually increased optic disc cupping and decreased RNFL thickness are changes that occur slowly over time in uncontrolled glaucoma patients. However, some patients have acute attacks of glaucoma where the internal drainage of the eye becomes suddenly stopped up. This causes an acute and significant rise in eye pressure that can cause permanent damage.

This study determined that these acute "angle-closure" attacks does decrease the nerve fiber layer thickness but does not significantly increase optic nerve cupping.