NECROTIZING SCLERITIS A POSSIBLE COMPLICATION OF EYE WHITENING

This case study in the Journal of Ophthalmic Inflammation and Infection has the following abstract, reporting a serious complication of eye whitening procedure:

Background

We report necrotizing scleritis as a serious complication of a cosmetic eye whitening procedure that involves the use of intraoperative and postoperative topical mitomycin C.

Findings: This is a single case report. A 59-year-old Caucasian male with a history of blepharitis status post uncomplicated LASIK refractive surgery reported chronic conjunctival hyperemia for 15 years prior to undergoing a cosmetic eye whitening procedure. He presented to our clinic 12 months after the cosmetic eye whitening procedure with progressive bilateral necrotizing scleritis and scleral calcification.

Conclusions

Chronic conjunctival hyperemia may prompt patients to seek surgical correction with cosmetic eye whitening procedures. However, conjunctival hyperemia secondary to tear deficiency and evaporative dry eye may predispose to poor wound healing. Serious complications including necrotizing scleritis may result from cosmetic eye whitening procedures and the use of topical mitomycin C.

MULTIFOCAL IOLS INTERFERE WITH VF ASSESSMENT

According to this study published in JAMA:

Patients with a diffractive MFIOL have a clinically relevant reduction of the visual sensitivity. The reduction seems to be related to the multifocal design of the IOL rather than to pseudophakia.  The reduction interferes with the assesment of common eye diseases such as glaucoma and comes on top of the decline of visual sensitivity due to normal aging or age-related eye diseases..

MOXIFLOXACIN AS EFFECTIVE AS FORTIFIED ANTIBIOTICS IN CORNEAL ULCERS

This study in Ophthalmology concludes:

Corneal healing using 0.5% moxifloxacin monotherapy is equivalent to that of combination therapy using fortified cefazolin and tobramycin in the treatment of moderate bacterial corneal ulcers.

PREGNANCY MAY EFFECT CORNEAL CURVATURE IN KERATOCONUS

This report in The Journal of Refractive Surgery concludes:

CONCLUSIONS:

These clinical cases indicate that hormonal changes occurring regularly during gestation may have a severe impact on the progression of keratoconus. However, these changes are transient and fully reversible. Therefore, physicians should be reluctant to perform cross-linking during or directly after pregnancy and should wait until the corneal curvature has been stabilized.

SEASONAL CHANGES IN INTRAOCULAR PRESSURE AND VISUAL FIELDS IN GLAUCOMA PATIENTS

Below is the abstract from a study published in January 2013's January edition of Ophthalmology:

Purpose

Longitudinal testing plays a key role in glaucoma management. Variability between visits hampers the ability to monitor progression. It has previously been shown that average intraocular pressure (IOP) exhibits seasonal fluctuations. This study examines whether visual field sensitivity also exhibits seasonal fluctuations and seeks to determine whether such fluctuations are correlated to seasonal IOP effects.

Design

Comparative case series.

Participants

A total of 33 873 visits by 1636 participants enrolled in the Ocular Hypertension Treatment Study. Participants were split into 6 geographic zones according to the prevailing climate in their location.

Testing

At each visit, standard automated perimetry was conducted on each eye, and IOP was measured.

Main Outcome Measures

Mixed effects regression models were formed to look for sinusoidal periodic effects on the change in perimetric mean deviation since the last visit (ΔMD) and on IOP, both overall and within each zone.

Results

When all the data were included, a significant seasonal effect on ΔMD was found with magnitude 0.06 dB, peaking in February (P < 0.001). Five of the 6 geographic zones exhibited significant seasonal effects on ΔMD, peaking between January and April, with magnitudes ranging from 0.04 dB (P = 0.049) to 0.21 dB (P < 0.001). Zones with greater climactic variation showed larger seasonal effects on ΔMD. All 6 zones exhibited a seasonal effect on IOP, peaking in January or February, with magnitudes ranging from 0.14 to 0.39 mmHg (P ≤ 0.02 in all cases). However, there was no evidence of a significant association between the magnitudes or dates of peaks of the 2 seasonal effects.

Conclusions

The mean deviation was significantly higher in winter than in summer. There is no evidence of an association with seasonal IOP fluctuations. The cause of the seasonal effect on visual field sensitivity is unknown. These findings may help shed light on the glaucomatous disease process and aid efforts to reduce test–retest variability.

BROMFENAC BETTER THAN FLUORMETHOLONE OR DEXAMETHOSONE FOR POST-OP MACULAR EDEMA PROPHYLAXIS

This study in Ophthalmologica concluded:

Bromfenac sodium was more effective and safer than fluorometholone and dexamethasone as an anti-inflammatory, decreasing macular thickness and preventing CME in age-related cataract patients after cataract surgery.

UV-A INHIBITS ACANTHOMOEBAL GROWTH

This study reported in Graefe's Archive for Clinical and Experimental Ophthalmology studied the effect of UV-A exposure, with and without riboflavin, on in vitro acanthomeobal growth.  It's results and were conclusion were:

Results
The exposure of ultraviolet light resulted in an inhibited growth of Acanthamoeba compared to the non-exposed solutions, with a statistically significant reduction over time (p = 0.0003). The addition of riboflavin did not amplify the effect, and there were no tendencies for an interaction effect between UVA and riboflavin.

Conclusions
The antiprotozoal effect of the UVA wavelength, utilized in CXL, is solely mediated by ultraviolet light, and riboflavin does not seem to amplify the antimicrobial efficacy.

TOPICAL TACROLIMUS FOR OCULAR INFLAMMATION

This study reported in the American Journal of Ophthalmology tested .02% Tacrolimus ointment 1-3 times per day on patients with various ocular inflammatory disease.   Their results and conclusion were:

Results
In all 3 groups, tacrolimus showed an immunosuppressive effect, especially on scleritis and Mooren ulcer. These effects included suppression of corneoscleral melting and reduction of hyperemia. In chronic cicatrizing conjunctivitis, simultaneous topical tacrolimus while tapering steroid therapy suppressed inflammatory relapse. The elevated IOP in steroid responders recovered to normal range after successful tapering of steroid. No adverse side effects were noted after 1.5 to 31 months of continuous tacrolimus treatment.
Conclusion
The use of topical tacrolimus ointment is effective in controlling refractory inflammatory ocular surface disease, and can reduce the need for steroid use while reducing inflammation recurrence.

Tacrolimus is currently used in the U.S. as an oral medication for the prevention of organ rejection and topically as .03%  or .1% ointment under the name Protopic for the treatment of atopic dermatologic disorders.

INCREASED LENGTH OF DAYLIGHT DECREASES MYOPIC PROGRESSION

This study in Ophthalmology concluded:

Eye elongation and myopia progression seem to decrease in periods with longer days and to increase in periods with shorter days. Children should be encouraged to spend more time outside during daytime to prevent myopia.

LUTEIN MAY IMPROVE VISUAL ACUITY IN EARLY MACULAR DEGENERATION PATIENTS

According to this study in Investigative Ophthalmology and Visual Science:

Lutein supplementation increases macular pigment optical density levels in early-stage AMD patients. Visual acuity measurements suggest the progress of AMD might be slowed in some patients with augmented levels of macular pigment.

SLEEP APNEA AND GLAUCOMA

According to this study in Sleep Medicine, Patients with sleep apnea had a higher prevalence of glaucoma and ocular hypertension. higher intra-ocular pressure, worse visual field indices, and lower retinal nerve fiber layer parameters compared with the control group.

SCLERAL CROSS-LINKING AS A THEORETICAL THERAPY FOR GLAUCOMA

This article in Current Opinion in Pharmacology explains that theoretically, cross-linking, a procedure used to stiffen the cornea in keratoconus patients, can be used to stiffen the lamina cribrosa, thereby strengthening the optic nerve against pressure.