INTERESTING EYE NEWS & CLINICAL PEARLS

Arch Ophthalmol -- Abstract: Optimal Optical Coherence Tomography-Based Measures in the Diagnosis of Clinically Significant Macular Edema: Retinal Volume vs Foveal Thickness, May 2007, Campbell et al. 125 (5): 619 : "Optical coherence tomography–based retinal volume and central foveal thickness variables display comparable abilities to discriminate between those with and without CSME. Both measures may have clinical applications as quantitative diagnostic tests for CSME. "

Ophthalmic Plastic and Reconstructive Surgery - Abstract: Volume 23(3) May/June 2007 p 173-178 Assessing Patients With Epiphora Who Are Patent to Syringing: Clinical Predictors of Response to Dacryocystorhinostomy. These findings show that a negative single-drop Jones I test is predictive of symptomatic improvement after dacryocystorhinostomy surgery in patients with epiphora who are clinically patent to syringing. Lacrimal syringing and the Fluorescein Dye Disappearance Test, on their own, were not predictive of surgical outcome. Jones testing was of significant value in patients, but only when the traditional single-drop test was used. So in situations where the patient is patent to syringing, DCR may still be of value if the single drop Jones I test is negative.

Arch Ophthalmol -- Abstract: Association Between Vitamin D and Age-Related Macular Degeneration in the Third National Health and Nutrition Examination Survey, 1988 Through 1994, May 2007, Parekh et al. 125 (5): 661 This study provides evidence that vitamin D may protect against AMD. Additional studies are needed to confirm these findings.

Eye & Contact Lens: Science and Clinical Practice - Abstract: Volume 33(3) May 2007 p 144-147 Extended-Wear Silicone Hydrogel Soft Contact Lenses in the Management of Moderate to Severe Dry Eye Signs and Symptoms Secondary to Graft-Versus-Host D Conclusions. The Focus NIGHT & DAY contact lens can improve subjective dry eye symptoms and visual acuity in patients with refractory dry eye disease secondary to GVHD. However, objective tests such as TBUT, Schirmers, and Fluorescein staining were not mproved.

Optometry and Vision Science - Abstract: Volume 84(5) May 2007 p 429-434 The Effect of Octylglucoside and Sodium Cholate in Staphylococcus epidermidis and Pseudomonas aeruginosa Adhesion to Soft Contact Lenses. Octylglucoside is a surfactant that inhibits pseudomonas adhesion to silicone hydrogel and conventional contact lenses. Perhaps it could be formulated as an eyedrop for extended wear users to decrease their risk of corneal ulcers.

27 year old uninsured man presents today after getting punched last night in his left eye. He blew his nose this morning and the lower lid immediately swelled up. Conjunctiva, cornea, anterior chamber and posterior pole examination was unremarkable. There was no diplopia on upgaze. Diagnosis? CT of orbits and brain were ordered without contrast and follow-up with our oculoplastics scheduled. Keflex 250mg qid was given and he was instructed to not blow his nose.

A 66 year old woman presented to an optometrist in May of 2006 with the complaint of blurred left vision. Her visual acuity was 20/30 in the right eye and 20/70 in the left. He found no pathology and recommended glasses, with only minimal improvement in visual acuity in the left eye. He explained the decreased visual acuity in the left eye as amblyopia, with no history of long-term visual acuity loss in that eye and no explanation as to why. She was not satisfied with the answers the optometrist gave her. She saw another optometrist at Cosco who agreed with her that something wasn't right, and he referred her to a retinal specialist. She presented to the retinal specialist on June 9th, 2006. He mentioned that she was less light sensitive in the left eye than the right and he noted very minimal optic nerve pallor in the left eye. He diagnosed possible optic neuropathy and ordered a VF 30-2, color vision, and an MRI with contrast. The visual field confirmed a significant junctional s...