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Minimally invasive brow lifting techniques: erratum
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: Erratum Source Type: research

The role of small incision suture-less cataract surgery in the developed world
Purpose of review Manual small incision cataract surgery (MSICS) has recently gone through much refinement and fine tuning. It is often taken as an alternate option for phacoemulsification, especially in developing country. This review will present some insight on its applications especially for developed nations. The role of MSCIS in tackling complex cataracts with stony hard nucleus is fairly established. The role of training residents with MSCIS has certain advantages though debatable. Recent findings MSCIS is much faster and cost-effective surgical technique often possible in suboptimal condition and avoids the ca...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Measuring outcomes in cataract surgery
Purpose of review The article presents a review of recently published studies reporting postcataract surgery outcomes and the use of electronic systems to track them. Recent findings Current publications report several parameters to measure cataract outcomes such as visual acuity, patient-reported visual function, contrast sensitivity, reading speed, residual refractive errors and complications (intraoperative and postoperative). Summary Cataracts currently afflict an estimated 94 million people worldwide, and surgical removal is the only effective therapy known. Tracking outcomes through registry databases has bee...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Role of lens extraction and laser peripheral iridotomy in treatment of glaucoma
Purpose of review Lens extraction in people with coexisting cataract and open angle glaucoma is associated with a reduction in intraocular pressure (IOP). In primary angle-closure glaucoma (PACG), lens extraction and laser peripheral iridotomy (LPI) can be used to open the anterior chamber angle, increase the outflow through the trabecular meshwork and reduce the IOP. The present review will summarize the recent available literature regarding the role of both interventions for the treatment of glaucoma. Recent findings Recent articles have confirmed the effect of cataract surgery as an IOP-lowering procedure in people...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Co-management of cataract and glaucoma in the era of minimally invasive glaucoma surgery
We present a strategy for planning which surgery should be performed based on goals of care. Recent findings New clinical evidence for using the CyPass, Kahook and Xen45 devices has been published recently and is summarized. Summary Cataract and glaucoma frequently exist together. Because the field of glaucoma surgical care is expanding and cataract surgery is becoming progressively safer, it is important to frequently re-evaluate our treatment paradigms. We review and evaluate current studies and treatment options. (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Cataract surgery in ocular surface diseases: clinical challenges and outcomes
This article discusses the challenges and outcomes of cataract surgery in complex cases targeting eyes with ocular surface diseases like Stevens–Johnson syndrome, ocular cicatricial pemphigoid, Mooren's ulcer, vernal keratoconjunctivitis and limbal stem cell deficiency. Recent findings Ocular surface diseases are commonly associated with corneal scarring and vascularization, conjunctival inflammation, symblepharon and forniceal shortening. Any surgical intervention in a hostile ocular surface environment may worsen the disease, which may result in visual deterioration. In recent past, with the use of immunosuppres...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Cataract surgery in eyes with keratoconus: a review of the current literature
Purpose of review There are an increasing number of keratoconic eyes, requiring cataract surgery. We review the preoperative planning, intraoperative options, and postoperative management that aid in successful outcomes. Recent findings Management of keratoconic eyes requiring cataract surgery requires a multifaceted approach. Preoperatively, corneal crosslinking and intrastromal corneal ring segments can be considered in order to provide stable keratometry values for intraocular lens (IOL) calculations. Deciding between toric and monofocal IOLs requires a thorough evaluation. Intraoperatively, the decision of clear c...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Management of cataract in uveitis patients
Purpose of review This review is timely because the outcomes of surgical invention in uveitic eyes with cataract can be optimized with adherence to strict anti-inflammatory principles. Recent findings All eyes should be free of any cell/ flare for a minimum of 3 months preoperatively. Another helpful maneuver is to place dexamethasone in the infusion fluid or triamcinolone intracamerally at the end of surgery. Recent reports about the choice of intraocular lens material or lens design are germane to the best surgical outcome. Integrating these findings will promote better visual outcomes and allow advancement in resea...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Dysphotopsia: a multifaceted optic phenomenon
Purpose of review To summarize the literature on dysphotopsia, focusing on strategies for management and prevention. Recent findings Clinical studies and ray-tracing diagrams have improved our understanding of the risk factors for positive and negative dysphotopsiae. Well known management and prevention strategies such as piggyback IOL, reverse optic capture, Nd:YAG capsulotomy, and IOL exchange are reviewed, as well as newer strategies such as the infertemporal approach to IOL implantation, ‘in-the-bag nasal optic truncation’ and new IOL design implantation, and new IOL design. Summary Positive and neg...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Femtosecond laser-assisted versus phacoemulsification for cataract extraction and intraocular lens implantation: clinical outcomes review
Purpose of review Femtosecond laser-assisted cataract surgery (FLACS) has gained popularity in recent years with the new technology suggesting potential improvements in clinical and safety outcomes over conventional phacoemulsification cataract surgery (PCS). A decade since the advent of FLACS has given time and experience for laser technology to develop in maturity, and better quality evidence to become available. This review evaluates current evidence on the clinical and safety outcomes for FLACS in comparison to PCS. Recent findings FLACS technology continues to improve and with it our confidence in tackling more c...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Prevention of macular edema after cataract surgery
Purpose of review Although cataract surgery can effectively restore visual function in many patients with cataract, PCME remains an important cause of suboptimal visual acuity. The present review provides an overview of the current literature on the prevention and treatment of PCME. Recent findings Optimal prevention of PCME starts preoperatively with a personalized risk assessment. Diabetes mellitus, retinal vein occlusion, epiretinal membrane, macular hole, and uveitis are the most important risk factors for developing cystoid macular edema after cataract surgery. Topical NSAIDs either in addition to, or instead of,...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Recent advances in small pupil cataract surgery
Purpose of review To highlight the existing and emerging cataract surgery trends in patients with insufficient mydriasis. Discuss the latest pharmacological approaches for pre and intraoperative pupil dilatation. Present the variety of newest pupil expansion devices; critically review their advantages and possible limitations to be considered by the surgeon. Recent findings The intracameral use of various mydriatic combinations augmenting the preoperative mydriatic instillations is currently gaining popularity in cataract surgery. Two main options are available: bolus injection of pharmacological agent or its constant...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Intracameral antibiotics during cataract surgery: evidence and barriers
Purpose of review There is continuing debate regarding the safety, efficacy, and necessity of intracameral antibiotics to prevent postoperative endophthalmitis. We summarize the most recent evidence-based publications that either support or caution against this practice. Recent findings Several additional large, international retrospective clinical studies found a significant reduction in endophthalmitis rates with intracameral antibiotic prophylaxis. Many surgeons are looking for alternatives to vancomycin for intracameral prophylaxis because of its association with the rare but sight-threatening complication of hemo...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

The use of povidone–iodine in ophthalmology
Purpose of review Povidone–iodine (PVI) is a disinfectant and antiseptic agent used for preoperative preparation of the skin and mucous membranes, as well as for the treatment of contaminated wounds. Currently regimens for prophylaxis against postsurgical endophthalmitis are being modified, including a total withdrawal of antibiotics in intravitreal injections. The aim of this study was to evaluate the use of PVI in ophthalmology. Recent findings As a result of its broad spectrum of microbicidal activity, PVI is routinely used in ophthalmic surgery. However, various protocols are applied worldwide and within dif...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Wound closure and tissue adhesives in clear corneal incision cataract surgery
Purpose of review Achieving secure wound closure in clear corneal incision cataract surgery remains highly desired for its role in reducing infection risk and leak-related complications, including hypotony, corneal edema, and lens dislocation. Although classic techniques of stromal hydration or wound suturing represent traditional approaches, the introduction of newer and more effective ocular surface adhesives has increased the options that are available. This review aims to provide an update on the peer-reviewed literature regarding wound closure and the currently available and investigational tissue adhesives used to ...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Astigmatism evaluation prior to cataract surgery
Purpose of review To evaluate and summarize literature from the past 18 months reporting advancements and issues in astigmatism assessment prior to cataract surgery. Recent findings New and updated toric calculators and regression formulas offer the opportunity for more accurate lens selection for our patients. Concurrently, improvements in topographic evaluation of corneal keratometry have allowed for a decrease in unplanned residual corneal astigmatism. Measuring posterior corneal astigmatism is especially valuable in eyes with keratoconus when planning to implant toric intraocular lens (IOL) and now allows access t...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Evaluation of the macula prior to cataract surgery
Purpose of review To describe recent evidence regarding methods of evaluation of retinal structure and function prior to cataract surgery. Recent findings Studies in patients with cataract but no clinically detectable retinal disease have shown that routine use of optical coherence tomography (OCT) prior to cataract surgery can detect subtle macular disease, which may alter the course of treatment or lead to modification of consent. The routine use of OCT has been especially useful in patients being considered for advanced-technology intraocular lenses (IOLs) as subtle macular disease can be a contraindication to the ...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Advances in cataract surgery in patients with multiple ocular diagnoses
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: Editorial Introductions Source Type: research

Aflibercept, bevacizumab or ranibizumab for diabetic macular oedema: recent clinically relevant findings from DRCR.net Protocol T
Purpose of review The aim of this study was to provide clinically relevant findings from the DRCR.net Protocol T, a multicentre randomized clinical trial comparing intravitreous aflibercept, repackaged (compounded) bevacizumab and ranibizumab for vision-impairing centre-involved diabetic macular oedema (DME). Recent findings At 1 year, all three antivascular endothelial growth factor (anti-VEGF) drugs, on average, improved visual acuity. There was no difference among drugs in mean change in visual acuity from baseline among eyes with baseline Snellen equivalent visual acuity of 20/32 to 20/40, whereas aflibercept yielded ...
Source: Current Opinion in Ophthalmology - October 12, 2017 Category: Opthalmology Tags: Special Commentary Source Type: research

Tubulointerstitial nephritis and uveitis
Purpose of review Tubulointerstitial nephritis and uveitis (TINU) is an important yet underrecognized ocular inflammatory syndrome. This review summarizes key historical publications that identified and defined the syndrome, and more recent literature that reveal the importance of urinary β2-microglobulin testing and kidney biopsy in the diagnostic evaluation of patients with TINU. Additionally, research studies providing new insights into disease pathogenesis are highlighted. Recent findings In contrast with initial reports of TINU manifesting exclusively as an anterior uveitis in pediatric patients, more recent rep...
Source: Current Opinion in Ophthalmology - October 12, 2017 Category: Opthalmology Tags: OCULAR MANIFESTATIONS OF SYSTEMIC DISEASE: Edited by Russell W. Read Source Type: research

Sickle cell disease and the eye
Purpose of review To review recent literature pertaining to sickle cell retinopathy (SCR) and, in particular, sickle cell maculopathy. Recent findings Several recent studies suggest that macular perfusion abnormalities seen in patients with sickle cell disease of various genotypes may affect both the superficial and deep capillary plexi, with a predilection for the deep capillary plexus. Further, these changes may be associated with areas of macular thinning, as well as with peripheral retinal ischemia, even in individuals without visual symptoms, contrary to what has previously been described in both diabetic retinopathy...
Source: Current Opinion in Ophthalmology - October 12, 2017 Category: Opthalmology Tags: OCULAR MANIFESTATIONS OF SYSTEMIC DISEASE: Edited by Russell W. Read Source Type: research

IgG4-related disease in the eye and ocular adnexa
Purpose of review IgG4-related disease is a multi-organ fibro-inflammatory disease with characteristic histopathology showing lymphoplasmacytic infiltration, increased IgG4+ plasma cells and elevated IgG4/IgG ratios (>40%). The lacrimal gland is the most common ocular site of involvement. Scleritis and intraocular involvement in IgG4-related ophthalmic disease (IgG4-ROD) have recently been reported. The purpose of this review is to describe orbital and intraocular IgG4-ROD with a focus on publications since 2016. Recent findings Case reports of scleritis and uveitis in IgG4-ROD have been described since 2012. Systemic ...
Source: Current Opinion in Ophthalmology - October 12, 2017 Category: Opthalmology Tags: OCULAR MANIFESTATIONS OF SYSTEMIC DISEASE: Edited by Russell W. Read Source Type: research

Ophthalmologic manifestations of systemic vasculitis
Purpose of review To review the systemic vasculitides and associated ocular manifestations with emphasis on publications within the last 12 months. Recent findings There are multiple case reports demonstrating atypical ocular manifestations of systemic vasculitis. Often the eye findings are the initial presentation of the disorder and require a high degree of clinical suspicion to evaluate further as these conditions can compromise vision but some may also be life threatening. Summary The systemic vasculitides are a heterogenous group of rare disorders with inflammation of blood vessels as a common feature. This review w...
Source: Current Opinion in Ophthalmology - October 12, 2017 Category: Opthalmology Tags: OCULAR MANIFESTATIONS OF SYSTEMIC DISEASE: Edited by Russell W. Read Source Type: research

Ophthalmic manifestations of bartonella infection
This article reviews recently published data on epidemiology of CSD, clinical features of ocular involvement, diagnosis and treatment. Recent findings The annual incidence of CSD has been estimated as 4.7 per 100 000 in the United States. It occurs predominantly in the southern states, with a peak in January, and disproportionately affects children. Retinal infiltrates, neuroretinitis and branch retinal artery occlusions have been reported as common manifestations of ocular bartonellosis in recent series. The use of different antigens for serodiagnosis and new real-time PCR assays for molecular diagnosis have been descr...
Source: Current Opinion in Ophthalmology - October 12, 2017 Category: Opthalmology Tags: OCULAR MANIFESTATIONS OF SYSTEMIC DISEASE: Edited by Russell W. Read Source Type: research

An update on ocular complications of Ebola virus disease
Purpose of review This review provides a summary of our current understanding of the ophthalmic manifestations of Ebola virus disease (EVD), pathogenesis, treatment options and directions for future study. The individual, public health and global health implications of eye disease in EVD survivors are discussed. Recent findings The West Africa EVD outbreak was of unprecedented magnitude, leading to the largest survivor cohort since the first documented EVD outbreak in 1976. Because of the magnitude of the recent outbreak, thousands of survivors are at-risk of systemic and ophthalmic sequelae termed the ‘post Ebola v...
Source: Current Opinion in Ophthalmology - October 12, 2017 Category: Opthalmology Tags: OCULAR MANIFESTATIONS OF SYSTEMIC DISEASE: Edited by Russell W. Read Source Type: research

Zika virus and the eye
Purpose of review The aim of this study was to review the ocular findings related to the Zika virus (ZIKV) based on the main studies published to date, describe the patterns of the lesions and risk factors, and identify the public health implications and scientific importance of this emerging disease. Recent findings In most studies, the ZIKV seems related to congenital ocular lesions and most mothers reported mild symptoms during the first pregnancy trimester. Five fundus patterns were seen most often: macular chorioretinal atrophy, chorioretinal atrophy elsewhere, focal pigmentary changes in the macular region, optic ne...
Source: Current Opinion in Ophthalmology - October 12, 2017 Category: Opthalmology Tags: OCULAR MANIFESTATIONS OF SYSTEMIC DISEASE: Edited by Russell W. Read Source Type: research

Ophthalmic and neuro-ophthalmic manifestations of sarcoidosis
Purpose of review Sarcoidosis is a multisystemic inflammatory disease that commonly affects the eye and less often the neuro-ophthalmic pathways. The manifestations can be quite variable but can have characteristic signs and clinical features. This review provides a comprehensive overview of the various ocular and neuro-ophthalmic manifestations of sarcoidosis, emerging diagnostic measures and approach to treatment. Particular focus is given to recent advances in diagnostic approach and available treatment options. Recent findings Laboratory investigations, chest and nuclear medicine imaging remain important techniques fo...
Source: Current Opinion in Ophthalmology - October 12, 2017 Category: Opthalmology Tags: NEURO-OPHTHALMOLOGY: Edited by Dean M. Cestari Source Type: research

Congenital anomalies of the optic disc: insights from optical coherence tomography imaging
Purpose of review Congenital anomalies of the optic nerve are rare but significant causes of visual dysfunction in children and adults. Accurate diagnosis is dependent on a thorough funduscopic examination, but can be enhanced by imaging information garnered from optical coherence tomography (OCT). We review common congenital optic nerve anomalies, including optic disc pit, optic nerve coloboma, morning glory disc anomaly, and hypoplasia of the optic nerve, review their systemic associations, and discuss insights from OCT imaging. Recent findings Optic disc pits are a result of a defect in the lamina cribrosa and abnormal...
Source: Current Opinion in Ophthalmology - October 12, 2017 Category: Opthalmology Tags: NEURO-OPHTHALMOLOGY: Edited by Dean M. Cestari Source Type: research

Ganglion cell layer complex measurements in compressive optic neuropathy
Purpose of review Neuroophthalmologists and neurosurgeons are often asked by their patients what their visual prognosis will be after decompression of an optic chiasm lesion. Previous methods have been studied but have not provided consistent guidance. However, a recent algorithm which allows for retinal ganglion cell analysis from optical coherence tomography (OCT) may be more helpful. Recent findings Recent studies have shown that ganglion cell layer complex (GCC) measurements from OCT strongly correlate with the visual field loss associated with compressive optic neuropathies. For example, GCC measurements show corresp...
Source: Current Opinion in Ophthalmology - October 12, 2017 Category: Opthalmology Tags: NEURO-OPHTHALMOLOGY: Edited by Dean M. Cestari Source Type: research

Neuro-ophthalmic manifestations of cerebrovascular accidents
Purpose of review Ocular functions can be affected in almost any type of cerebrovascular accident (CVA) creating a burden on the patient and family and limiting functionality. The present review summarizes the different ocular outcomes after stroke, divided into three categories: vision, ocular motility, and visual perception. We also discuss interventions that have been proposed to help restore vision and perception after CVA. Recent findings Interventions that might help expand or compensate for visual field loss and visuospatial neglect include explorative saccade training, prisms, visual restoration therapy (VRT), and...
Source: Current Opinion in Ophthalmology - October 12, 2017 Category: Opthalmology Tags: NEURO-OPHTHALMOLOGY: Edited by Dean M. Cestari Source Type: research

Advances in experimental optic nerve regeneration
Purpose of review Recent advances in experimental studies of optic nerve regeneration to better understand the pathophysiology of axon regrowth and provide insights into the future treatment of numerous optic neuropathies. Recent findings The optic nerve is part of the central nervous system and cannot regenerate if injured. There are several steps that regenerating axons of retinal ganglion cells (RGCs) must take following optic nerve injury that include: maximizing the intrinsic growth capacity of RGCs, overcoming the extrinsic growth-inhibitory environment of the optic nerve, and optimizing the reinnervation of regener...
Source: Current Opinion in Ophthalmology - October 12, 2017 Category: Opthalmology Tags: NEURO-OPHTHALMOLOGY: Edited by Dean M. Cestari Source Type: research

The use of optical coherence tomography in neuro-ophthalmology
Purpose of review In the last decade, with the advances of optical coherence tomography (OCT) technology, different imaging protocols and analysis algorithms have been introduced to maximize the potential of this diagnostic tool in the evaluation of different eye diseases. This review aims to provide an update on these additional features, with respect to the management of a diverse range of neuro-ophthalmologic conditions. Recent findings Macular ganglion cell complex (mGCC) analysis has been shown to be superior to peripapillary retinal nerve fiber layer (pRNFL) analysis in certain settings, such as differentiating Lebe...
Source: Current Opinion in Ophthalmology - October 12, 2017 Category: Opthalmology Tags: NEURO-OPHTHALMOLOGY: Edited by Dean M. Cestari Source Type: research

Ethambutol optic neuropathy
Purpose of review We provide a summary of the epidemiology, clinical findings, management and outcomes of ethambutol-induced optic neuropathy (EON). Ethambutol-induced optic neuropathy is a well-known, potentially irreversible, blinding but largely preventable disease. Clinicians should be aware of the importance of patient and physician education as well as timely and appropriate screening. Recent findings Two of the largest epidemiologic studies investigating EON to date showed the prevalence of EON in all patients taking ethambutol to be between 0.7 and 1.29%, a value consistent with previous reports of patients taking...
Source: Current Opinion in Ophthalmology - October 12, 2017 Category: Opthalmology Tags: NEURO-OPHTHALMOLOGY: Edited by Dean M. Cestari Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - October 12, 2017 Category: Opthalmology Tags: Editorial Introductions Source Type: research

Intimate partner violence in ophthalmology: a global call to action
Purpose of review Intimate partner violence (IPV) is a leading cause of death and disability worldwide. Despite increasing public awareness of IPV, little information is available regarding the prevalence, associated injury patterns, and impact of IPV as a mechanism of ocular and orbital trauma. The purpose of this review is to summarize the literature regarding the impact of IPV in ophthalmology and provide team members with guidance on appropriate practices for screening and referral. Recent findings Data from 48 population-based studies estimates that the lifetime prevalence of IPV ranges from 10 to 69% among women int...
Source: Current Opinion in Ophthalmology - September 1, 2017 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Invasive fungal sinusitis: treatment of the orbit
Purpose of review To summarize diagnostic techniques for invasive fungal rhinosinusitis and provide a review of treatment options once disease has spread to the orbit. Recent findings Improved imaging criteria, polymerase chain reaction and other serologic tests show promise in advancing our ability to accurately diagnose invasive fungal disease. Currently, there exists three treatment options for infected orbital tissue: exenteration, conservative debridement and transcutaneous retrobulbar injection of amphotericin B. Exenteration, the most frequently reported intervention, has not been proven to enhance survival. Conser...
Source: Current Opinion in Ophthalmology - September 1, 2017 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Diagnosis of enlarged extraocular muscles: when and how to biopsy
Purpose of review To review current knowledge regarding diagnosis of nonthyroid orbital disorders with extraocular muscle enlargement. Recent findings Recent publications have focused on immunoglobulin G4-related disease as a possible cause of enlarged extraocular muscles, on patterns of strabismus that raise a clinical suspicion of intramuscular lymphoma, and on surgical techniques to access the muscles for tissue biopsy. Summary With enlarged extraocular muscles, features to distinguish between competing diagnostic possibilities are based on imaging in the context of history and clinical signs. Infraorbital nerve enlar...
Source: Current Opinion in Ophthalmology - September 1, 2017 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Update on Graves disease: advances in treatment of mild, moderate and severe thyroid eye disease
Purpose of review To report the most recent therapeutic advances of thyroid eye disease (TED) and offer general recommendations for management of TED. Recent findings Treatment of Graves ophthalmopathy is traditionally based on the use of high doses of corticosteroids and/or radiotherapy (RT) to decrease the activity of the disease, with the subsequent proptosis, strabismus and eyelid deformites treated with different surgical procedures. In recent years, the evidence that oxidative stress plays a relevant role in exacerbating TED severity has encouraged the use of antioxydative agents such as selenium, which has shown a ...
Source: Current Opinion in Ophthalmology - September 1, 2017 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Graft versus host disease: what should the oculoplastic surgeon know?
Purpose of review To provide a concise review of the oculoplastic manifestations of ocular graft versus host disease (GVHD), and to discuss their management. Recent findings Ocular GVHD occurs as a common immune-mediated complication of hematopoietic stem cell transplantation that presents as a Stevens–Johnson-like syndrome in the acute phase or a Sjögren-like syndrome in the chronic phase. Cicatricial conjunctivitis may be underreported in ocular GVHD. The spectrum of oculoplastic manifestations includes GVHD of the skin, cicatricial entropion, nasolacrimal duct obstruction, and lacrimal gland dysfunction. Sur...
Source: Current Opinion in Ophthalmology - September 1, 2017 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Pediatric blepharokeratoconjunctivitis: is there a ‘right’ treatment?
This article highlights the importance of recognizing blepharokeratoconjunctivitis (BKC) in children and reviews the clinical characteristics and current therapeutic modalities. Recent findings The mainstay of BKC treatment remains controlling the meibomian gland inflammation and treating cobormid conditions. BKC can occur in the setting of ocular rosacea and Demodex infestation. Small studies have shown treatment benefits of topical cyclosporine A as well as oral azithromycin in pediatric BKC. Summary BKC is a cause for visual loss in children, and therefore pediatric ophthalmologists should be more vigilant about early...
Source: Current Opinion in Ophthalmology - September 1, 2017 Category: Opthalmology Tags: PEDIATRICS AND STRABISMUS: Edited by J. Mark Engel Source Type: research

PAX6 aniridia syndrome: clinics, genetics, and therapeutics
Purpose of review Aniridia is a rare and panocular disorder affecting most of the ocular structures which may have significant impact on vision. The purpose of this review is to describe the clinical features, genetics, and therapeutic options for this disease and to provide an update of current knowledge and latest research findings. Recent findings Aside from the ocular features, a variety of associated systemic abnormalities, including hormonal, metabolic, gastrointestinal, genitourinary, and neurologic pathologies have been reported in children with aniridia. Although mutations in PAX6 are a major cause of aniridia, g...
Source: Current Opinion in Ophthalmology - September 1, 2017 Category: Opthalmology Tags: OCULAR GENETICS: Edited by Alex V. Levin Source Type: research

Leber hereditary optic neuropathy: bridging the translational gap
Purpose of review Leber hereditary optic neuropathy (LHON) is the most common primary mitochondrial DNA (mtDNA) genetic disorder in the population. We address the clinical evolution of the disease, the secondary etiological factors that could contribute to visual loss, and the challenging task of developing effective treatments. Recent findings LHON is characterized by a preclinical phase that reflects retinal ganglion cell (RGC) dysfunction before rapid visual deterioration ensues. Children can present atypically with slowly progressive visual loss or an insidious/subclinical onset that frequently results in considerable...
Source: Current Opinion in Ophthalmology - September 1, 2017 Category: Opthalmology Tags: OCULAR GENETICS: Edited by Alex V. Levin Source Type: research

Minimally invasive brow lifting techniques
This article will review several minimally invasive techniques that can be used to address the needs of patients with mild-to-moderate brow ptosis. Recent findings:Recent publications describe and analyse efficacy of several variations of browpexy techniques. Summary:Browpexy techniques provide a minimally invasive way to provide stabilization and modest elevation of the lateral brow. They can enhance outcomes of upper eyelid surgery in patients with both functional and cosmetic brow ptosis, who desire to avoid the cost and morbidity of more formal brow lifting techniques. (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Intimate partner violence in ophthalmology: a global call to action
Purpose of review:Intimate partner violence (IPV) is a leading cause of death and disability worldwide. Despite increasing public awareness of IPV, little information is available regarding the prevalence, associated injury patterns, and impact of IPV as a mechanism of ocular and orbital trauma. The purpose of this review is to summarize the literature regarding the impact of IPV in ophthalmology and provide team members with guidance on appropriate practices for screening and referral. Recent findings:Data from 48 population-based studies estimates that the lifetime prevalence of IPV ranges from 10 to 69% among women int...
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Invasive fungal sinusitis: treatment of the orbit
Purpose of review:To summarize diagnostic techniques for invasive fungal rhinosinusitis and provide a review of treatment options once disease has spread to the orbit. Recent findings:Improved imaging criteria, polymerase chain reaction and other serologic tests show promise in advancing our ability to accurately diagnose invasive fungal disease. Currently, there exists three treatment options for infected orbital tissue: exenteration, conservative debridement and transcutaneous retrobulbar injection of amphotericin B. Exenteration, the most frequently reported intervention, has not been proven to enhance survival. Conser...
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Diagnosis of enlarged extraocular muscles: when and how to biopsy
Purpose of review:To review current knowledge regarding diagnosis of nonthyroid orbital disorders with extraocular muscle enlargement. Recent findings:Recent publications have focused on immunoglobulin G4-related disease as a possible cause of enlarged extraocular muscles, on patterns of strabismus that raise a clinical suspicion of intramuscular lymphoma, and on surgical techniques to access the muscles for tissue biopsy. Summary:With enlarged extraocular muscles, features to distinguish between competing diagnostic possibilities are based on imaging in the context of history and clinical signs. Infraorbital nerve enlar...
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Update on Graves disease: advances in treatment of mild, moderate and severe thyroid eye disease
Purpose of review:To report the most recent therapeutic advances of thyroid eye disease (TED) and offer general recommendations for management of TED. Recent findings:Treatment of Graves ophthalmopathy is traditionally based on the use of high doses of corticosteroids and/or radiotherapy (RT) to decrease the activity of the disease, with the subsequent proptosis, strabismus and eyelid deformites treated with different surgical procedures. In recent years, the evidence that oxidative stress plays a relevant role in exacerbating TED severity has encouraged the use of antioxydative agents such as selenium, which has shown a ...
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Graft versus host disease: what should the oculoplastic surgeon know?
Purpose of review:To provide a concise review of the oculoplastic manifestations of ocular graft versus host disease (GVHD), and to discuss their management. Recent findings:Ocular GVHD occurs as a common immune-mediated complication of hematopoietic stem cell transplantation that presents as a Stevens–Johnson-like syndrome in the acute phase or a Sjögren-like syndrome in the chronic phase. Cicatricial conjunctivitis may be underreported in ocular GVHD. The spectrum of oculoplastic manifestations includes GVHD of the skin, cicatricial entropion, nasolacrimal duct obstruction, and lacrimal gland dysfunction. Sur...
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Avoiding the Hughes flap in lower eyelid reconstruction
Purpose of review:To review current surgical practices of lower eyelid reconstruction with a focus on recent studies. Recent findings:Combination techniques and new flap techniques offer efficacy comparable with existing reconstructive approaches, with the advantage of less local trauma. Inappropriate handling of posterior lamellar grafts, such as kerfing, may predispose to graft failures. Modified Hughes procedure is a favorable choice for large lower eyelid reconstruction; however, it requires temporary eye closure. Other surgical options have been developed to achieve a 1-stage procedure without the need of eye closure...
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research