Measuring Contact Lens Discomfort
Abstract
The measurement of contact lens discomfort is complex; the sensation experienced is inherently variable, and existing measurement scales may not be optimal. This manuscript aims to review and describe instruments commonly used to measure contact lens discomfort. Appropriately designed questionnaires undergo a rigorous process of item development and validation. Interval scales (e.g. numerical rating scale and visual analogue scale) are frequently used to measure temporal characteristics of contact lens discomfort and remain useful in assessing qualities such as duration, onset and chronicity. The...
Source: Current Ophthalmology Reports - April 12, 2015 Category: Opthalmology Source Type: research
Recent Developments in Understanding the Role of Aqueous Humor Outflow in Normal and Primary Open Angle Glaucoma
This article reviews recent research associated with normal and POAG AH outflow. Novel findings elucidating biochemical and pathological changes in the ocular tissues affected in POAG are presented. Stem cell research, identification of lymphatic markers, and increased use of mouse models give researchers exciting new tools to understand AH outflow, changes associated with POAG, and identify underlying causes of the disease. (Source: Current Ophthalmology Reports)
Source: Current Ophthalmology Reports - April 8, 2015 Category: Opthalmology Source Type: research
Continuous Monitoring of Intraocular Pressure: An Overview of New Techniques
Abstract
Elevated intraocular pressure (IOP) is the main risk factor for glaucoma and is currently the only treatable risk factor. IOP is dynamic with regular circadian variations and random short-term and long-term fluctuations. Current glaucoma management is mostly based on single IOP measurements during office visits which may not accurately represent a patient’s 24-h pressure profile. Most of glaucoma patients have their highest IOP outside clinic hours, usually during the nocturnal period. Currently, the only available approach for 24-h IOP monitoring is by using repeated tonometry which is inconve...
Source: Current Ophthalmology Reports - April 3, 2015 Category: Opthalmology Source Type: research
Lamina Cribrosa in Glaucoma: Diagnosis and Monitoring
Abstract
The lamina cribrosa is the putative site of retinal ganglion cell axonal injury in glaucoma. Although histological studies have provided evidence of structural changes to the lamina cribrosa, even in early stages of glaucoma, until recently, the ability to evaluate the lamina cribrosa in vivo has been limited. Recent advances in optical coherence tomography, including enhanced depth and swept-source imaging, have changed this, providing a means to image the lamina cribrosa. Imaging has identified general and localized configurational changes in the lamina of glaucomatous eyes, including posterior...
Source: Current Ophthalmology Reports - April 3, 2015 Category: Opthalmology Source Type: research
Contact Lens Discomfort and Dropout. What is it? Epidemiology
This article analyzes literatures of past 5 years’ on studies of CLD. It reviews the epidemiology and mechanism of CLD, analyzes different characteristics of CLD resulting from CL material, contact lens care system, and wearers. It sketches the relationship between CLD and ocular surface microenvironment, pointing out that CLD is an incompatible status between CL and the ocular surface microenvironment. Literature analysis also reveals that while high-quality optical effect of rigid lens came at the price of unwelcome initial discomfort, soft lens wearing continuously changes the balance of ocular surface microenvironme...
Source: Current Ophthalmology Reports - April 3, 2015 Category: Opthalmology Source Type: research
Vitrectomy for Diabetic Macular Edema
Abstract
Diabetic macular edema (DME) can often be a difficult disease to manage with a subset of patients not improving with existing treatments. As indicated in early studies, patients with hyaloid-retinal traction may benefit the most from vitrectomy for DME. However, some patients without evidence of hyaloid traction may also improve after vitrectomy. It is difficult to predict which patients will improve with surgery. In addition, as treatment options have evolved, the appropriate timing of vitrectomy for DME remains controversial. An improvement in imaging modalities and enhanced understanding of th...
Source: Current Ophthalmology Reports - March 31, 2015 Category: Opthalmology Source Type: research
Optic Disc Hemorrhages in Glaucoma
Abstract
Optic disc hemorrhages are a significant clinical sign seen in patients with glaucoma and often herald glaucomatous progression. Longitudinal and population-based studies have shown that disc hemorrhages are most commonly seen in glaucoma, particularly normal tension glaucoma patients. The exact pathophysiology of an optic disc hemorrhage is not completely understood, but both mechanical rupture and vascular dysregulation theories have been proposed. Recent studies using spectral domain optic coherence tomography and visual field progression analysis have highlighted that structural and functiona...
Source: Current Ophthalmology Reports - March 31, 2015 Category: Opthalmology Source Type: research
Diagnosis and Monitoring of Primary Angle Closure
Abstract
While primary open angle glaucoma is the most prevalent subtype of glaucoma, primary angle closure glaucoma has a higher risk of causing blindness, especially in East and South Asia. Primary angle closure includes a spectrum ranging from angle closure without trabecular or optic nerve damage to angle closure with glaucomatous optic neuropathy. Iridotrabecular contact is the hallmark in all stages and can be detected by gonioscopy. Since most patients with angle closure are asymptomatic, early detection, and timely treatment is important to prevent progression. (Source: Current Ophthalmology Reports)
Source: Current Ophthalmology Reports - March 31, 2015 Category: Opthalmology Source Type: research
Evolving Perspectives on Congenital Glaucoma
Abstract
Congenital glaucoma differs from adult glaucoma in that it represents a panocular disorder defined by structural, functional, and physiologic parameters. In order to achieve excellent visual outcomes, the management of congenital glaucoma involves concurrently controlling intraocular pressure and treating amblyopia, while minimizing any influence of a compromised visual axis. Thus far, difficulty in assessing visual function in pre-verbal children has resulted in a paucity of long-term visual outcome data. However, based on commonly recognized obstacles to structural/physiologic stability and fun...
Source: Current Ophthalmology Reports - March 28, 2015 Category: Opthalmology Source Type: research
Nutritional Supplements for Age-Related Macular Degeneration
Abstract
The Age-Related Eye Disease Study (AREDS) and The Age-Related Eye Disease Study 2, are the only large-scale, long-term, randomized controlled trials to demonstrate a role of nutritional supplements in reducing risk of progression to advanced forms of age-related macular degeneration (AMD). This review summarizes the study design, main results, and implications of these trials in the clinical care of nonexudative AMD patients. In addition, it discusses other recent prospective studies focusing on efficacy of nutritional supplementation for prevention or slowing progression of AMD as well as...
Source: Current Ophthalmology Reports - February 11, 2015 Category: Opthalmology Source Type: research
Brachytherapy in Neovascular AMD
Abstract
Neovascular age-related macular degeneration (AMD) has a complex pathophysiology, and although anti-VEGF therapy has been one of the most significant and successful advances, it is not effective for all patients with neovascular AMD. The potential role of radiation in the management of neovascular AMD has been suggested for several years. While previous work focused on the role of radiation alone, recent trials have evaluated the role of ionizing radiation as a synergistic treatment with anti-VEGF drugs, with endpoints being to reduce choroidal neovascular lesions faster, preserve visual acuity, ...
Source: Current Ophthalmology Reports - February 10, 2015 Category: Opthalmology Source Type: research
PresbyLASIK Techniques and Outcomes
We present a brief review of results from papers and posters on presbyLASIK published in the recent 5–6 years. Two newer techniques for ablation patterns currently being investigated, isovision and prebyond, are also briefly discussed. (Source: Current Ophthalmology Reports)
Source: Current Ophthalmology Reports - February 7, 2015 Category: Opthalmology Source Type: research
Presbyopic PiXL Cross-Linking
We describe principles and initial clinical findings regarding a novel application of topographically customized collagen cross-linking (CXL) aiming to achieve a modest, nevertheless predictable hyperopic and presbyopic refractive changes. CXL is implemented in a specific, annular section mid-peripherally, employing differential response and biomechanical change, inducing central corneal steepening and asphericity changes. Efficacy, safety, and predictability of this procedure are also presented. This non-laser, minimally invasive technique may be applied either with epithelial removal, offering a more stable result or wit...
Source: Current Ophthalmology Reports - February 4, 2015 Category: Opthalmology Source Type: research
Stem Cell Therapy for the Treatment of Dry Age-Related Macular Degeneration
Abstract
Age-related macular degeneration (AMD) is a progressive disease of photoreceptors and retinal pigment epithelium (RPE). Geographic atrophy (GA) is initiated by dysfunction and loss of RPE cells followed by photoreceptor loss. Thus, replacing lost and sick RPE with healthy cells may restore vision in GA. Human embryonic stem cells (hESC) and induced pluripotent stem cells (iPSC) are two main sources for this replacement. There are currently two major approaches to RPE stem cell integration with the human retina. The first employs bolus injections of RPE cell suspension under the retina and the sec...
Source: Current Ophthalmology Reports - January 17, 2015 Category: Opthalmology Source Type: research
Retinal Pigment Epithelium Tear
Abstract
Retinal pigment epithelium (RPE) tear is a potentially vision-threatening complication of retinal pigment epithelial detachment associated with neovascular age-related macular degeneration. RPE tear has been reported to occur spontaneously and after treatment with anti-vascular endothelial growth factor agents. The current study summarizes the presentation, diagnosis, management, and outcomes of RPE tears. (Source: Current Ophthalmology Reports)
Source: Current Ophthalmology Reports - December 6, 2014 Category: Opthalmology Source Type: research
