INTERESTING EYE NEWS & CLINICAL PEARLS

Conjunctival epithelium improvement after systemic pilocarpine in patients with Sjogren's syndrome -- Aragona et al. 90 (2): 166 -- British Journal of Ophthalmology This study concludes: "Oral pilocarpine induced an increase in goblet cells number and an amelioration of conjunctival epithelium not dependent on tear secretion." Yea, but how 'bout those side effects! I can't imagine using oral pilocarpine in anyone but the more desperate dry eye patients.

Journal of Glaucoma - Abstract: Volume 15(2) April 2006 p 120-123 Relationship Between Central Corneal Thickness and Localized Retinal Nerve Fiber Layer Defect in Normal-tension Glaucoma. According to this study: "CCT is a significant factor in predicting the extent of localized RNFL defect at the initial examination of NTG patients." In some ways this study spurs more questions rather than answers. Again, thin corneas are higher risk for glaucoma, but I can't imaine that this study suggests the correlation is anything more than missed diagnoses due to clinician assumptions of "normal" intraocular pressure. For me, anyone with moderate to extensive cupping deserves a pachymetry and if the corneas are thin, further evaluation is warranted.

Journal of Glaucoma - Abstract: Volume 15(2) April 2006 p 124-130 Selective Laser Trabeculoplasty as Initial and Adjunctive Treatment for Open-Angle Glaucoma. This study indicates that: "Selective laser trabeculoplasty was found to be equally efficacious as latanoprost in reducing intraocular pressure in newly diagnosed open-angle glaucoma and ocular hypertension over 12 months, independent of angle pigmentation. These findings support the consideration of selective laser trabeculoplasty as a first-line treatment for newly diagnosed open-angle glaucoma or ocular hypertension."

Clinical Management of fungal keratitis | AOA News This article discusses management of the fusarium keratitis. Additional resources and constant updates are found at the AOA website .

CDC issues snapshot of cases | AOA News This article provides a summary of the demographics of the recent "outbreak" of fusarium keratitis.

Fungal Keratitis Management: A Clinical Perspective | AOA News This is an article by Dr. Art Epstein about the recent fungal (fusarium) keratitis "epidemic" and how to manage it. He suggests we become suspicious of a corneal ulcer being fungal in origin when it has a fluffy, white or grey appearance, or satellite lesions, or if it does not respond to typical antibiotic therapy. He suggests scraping the lesion and plating it on Sabouraud agar (yea, I don't have that in my office either).

ScienceDirect - Ophthalmology : Prophylactic Treatment of Age-Related Macular Degeneration Report Number 1: 810-Nanometer Laser to Eyes with Drusen. Unilaterally Eligible Patients This abstract discusses the prophylactic treatment of drusen with diode laser in the attempt to prevent choroidal neovascularization. It concludes: "Prophylactic diode laser treatment to an eye with multiple large drusen in a patient whose fellow eye has already suffered a neovascular event places the treated eye at higher risk of developing choroidal neovascularization. We advise against using prophylactic subthreshold diode laser treatment in these eyes."