Ocular manifestations of herpes simplex virus
Purpose of review To review ocular manifestations and complications of herpes simplex virus (HSV) and discuss recent advancements in diagnostic and treatment strategy. Recent findings In-vivo confocal microscopy has expanded our understanding of corneal nerve degeneration, corneal dendritic cell activity, and changes in biomechanical properties in HSV keratitis. Although currently available only as a research tool, metagenomic deep sequencing has the potential to improve diagnostic accuracy beyond the well established PCR technology, especially in atypical cases. Development of an HSV vaccine has shown some encouragin...
Source: Current Opinion in Ophthalmology - October 4, 2019 Category: Opthalmology Tags: OCULAR MANIFESTATIONS OF SYSTEMIC DISEASE: Edited by John A. Gonzales Source Type: research

Floppy eyelid syndrome: ocular and systemic associations
Purpose of review To summarize the ocular and systemic associations of floppy eyelid syndrome (FES) as well as provide an up-to-date review on the pathogenesis and treatment strategies. Recent findings Virtually all patients with FES have obstructive sleep apnea (OSA). However, a significantly lower proportion of patients with OSA have FES. Although some studies demonstrate no association between OSA and FES, almost all show at least an association with increased eyelid laxity, which may be a less severe form of FES. FES has also been associated with keratoconus (KCN) and glaucoma. Decreased corneal hysteresis has bee...
Source: Current Opinion in Ophthalmology - October 4, 2019 Category: Opthalmology Tags: OCULAR MANIFESTATIONS OF SYSTEMIC DISEASE: Edited by John A. Gonzales Source Type: research

Endogenous endophthalmitis and other ocular manifestations of injection drug use
Purpose of review The United States has experienced a dramatic rise in opioid and injection drug use over the past 2 decades. A public health emergency was declared in 2017 and subsequently, there have been several new reports on the rise of endogenous endophthalmitis specifically associated with injection drug use. The purpose of this review is to provide a current perspective of the ocular harms posed by injection drug use. Recent findings The opioid epidemic has prompted several new studies from New England, one of the US regions most heavily affected, that examine the trends and characteristics of injection drug u...
Source: Current Opinion in Ophthalmology - October 4, 2019 Category: Opthalmology Tags: OCULAR MANIFESTATIONS OF SYSTEMIC DISEASE: Edited by John A. Gonzales Source Type: research

Ocular manifestations of dengue
Purpose of review There are an increasing number of publications related to dengue ophthalmic manifestations and multimodality imaging related to dengue. This review summarizes the current literature, describe ocular manifestations, current using of ocular imaging/investigations, and management of ocular dengue. Recent findings Ocular manifestations of dengue can be present in many stages of dengue fever including after the resolution of systemic disease. Most cases of ocular dengue will exhibit an improvement in vision spontaneously over time. Multimodal imaging such as optical coherence tomography, optical coherence...
Source: Current Opinion in Ophthalmology - October 4, 2019 Category: Opthalmology Tags: OCULAR MANIFESTATIONS OF SYSTEMIC DISEASE: Edited by John A. Gonzales Source Type: research

Primary vitreoretinal lymphoma: empowering our clinical suspicion
Purpose of review Vitreoretinal lymphoma (VRL) is well known as a masquerade syndrome. However, delays in diagnosis are common particularly because of the small volume of tissue that is used for investigative studies. We outline the current diagnostic tests available to clinicians and provide a glimpse of possible future novel diagnostics. Recent findings The use of spectral domain ocular coherence tomography to identify subretinal lesions has proven to be a reliable ally to clinicians. Nevertheless, the diagnostic gold standard remains cytology, which requires a skilled pathologist. Molecular tests, including MYD88 p...
Source: Current Opinion in Ophthalmology - October 4, 2019 Category: Opthalmology Tags: OCULAR MANIFESTATIONS OF SYSTEMIC DISEASE: Edited by John A. Gonzales Source Type: research

Relationship between sleep position and glaucoma progression
Purpose of review As humans spend a considerable portion of life in the horizontal position, it is vital to better understand the effect of sleep position on glaucoma. Recent findings The mean positional increase from the supine position to the lateral decubitus position (LDP) in recent literature is less than 2 mmHg for each eye in its dependent position and less than 1 mmHg in the nondependent position. The right LDP is most commonly favored sleeping position. Some evidence suggests that the positional increases persist and so could lead to worse glaucomatous progression in the dependent eye. However, multiple s...
Source: Current Opinion in Ophthalmology - October 4, 2019 Category: Opthalmology Tags: OCULAR MANIFESTATIONS OF SYSTEMIC DISEASE: Edited by John A. Gonzales Source Type: research

The neuro-ophthalmology of inherited myopathies
Purpose of review Inherited myopathies, and in particular mitochondrial myopathies, are heterogeneous disorders, and ocular manifestations may be the presenting feature or offer important diagnostic clues. The ophthalmologist may be key to diagnosis, facilitating recognition of associated potentially life-threatening organ manifestations and an integral part of multidisciplinary care. This review, focusing especially on mitochondrial myopathies, provides updates on clinical features, diagnosis and recent therapeutic developments. Recent findings Ptosis and/or ophthalmoplegia is present in over half of patients with mi...
Source: Current Opinion in Ophthalmology - October 4, 2019 Category: Opthalmology Tags: NEURO-OPHTHALMOLOGY: Edited by Dean M. Cestari Source Type: research

Superior oblique myokymia, a review
Purpose or review Superior oblique myokymia is a rare, monocular condition that typically presents in healthy adults. In this article, we review the proposed pathophysiology, describe the typical clinical presentation, and discuss the recommended work up and various treatment options. Recent findings Treatment for this condition ranges from observation and reassurance to various topical and systemic medications. Both strabismus surgery and neurosurgery are reserved for patients who fail medical therapy or are intolerant to medication secondary to side effects. Summary Due to its episodic nature, SOM is often under-...
Source: Current Opinion in Ophthalmology - October 4, 2019 Category: Opthalmology Tags: NEURO-OPHTHALMOLOGY: Edited by Dean M. Cestari Source Type: research

Spontaneous cerebrospinal fluid leak and idiopathic intracranial hypertension
Purpose of review To review the most recent literature on the relationship of spontaneous cerebrospinal fluid (CSF) leak with idiopathic intracranial hypertension (IIH) and considerations in management of these conditions. Recent findings A link has been proposed between spontaneous CSF leak and IIH based on similar demographics, radiologic, and clinical findings in these patients, and on a plausible mechanism of skull base erosion in the setting of high CSF pressure over time. IIH patients with CSF leak may not present with classic IIH signs and symptoms as the leak can alleviate excess pressure; however, they may de...
Source: Current Opinion in Ophthalmology - October 4, 2019 Category: Opthalmology Tags: NEURO-OPHTHALMOLOGY: Edited by Dean M. Cestari Source Type: research

Update: the Miller Fisher variants of Guillain–Barré syndrome
This article will update and review the Miller Fisher variants (MFV) of Guillain–Barré syndrome (GBS) including the clinical presentation, diagnostic testing, and treatment. Recent findings Although the diagnosis of GBS and MFV can be made on clinical grounds, cerebrospinal fluid (CSF) analysis, nerve conduction studies, imaging (e.g. ultrasound and MRI), and serologic testing can help to confirm the diagnosis. Some patients may need immunotherapy with either intravenous immunoglobulin (IVIg) or plasma exchange, and recent studies suggest that complement inhibition combined with IVIg could be of benefit, bu...
Source: Current Opinion in Ophthalmology - October 4, 2019 Category: Opthalmology Tags: NEURO-OPHTHALMOLOGY: Edited by Dean M. Cestari Source Type: research

Infectious ocular motor neuropathies
Purpose of review Describe the range of infectious causes of ocular motor neuropathies, from common presentations to unusual manifestations of diseases less frequently seen in the developed world. Provide information on recent developments in diagnostic testing for pathogens that may cause ocular motor neuropathies. Recent findings Antigen detection in serum or CSF has improved the diagnosis of cryptococcal disease. Cartridge PCR testing for tuberculosis has increased diagnostic accuracy, though tuberculous meningitis remains difficult to diagnose. Rapid, multiplex PCR and unbiased sequencing allow for diagnosis of a ...
Source: Current Opinion in Ophthalmology - October 4, 2019 Category: Opthalmology Tags: NEURO-OPHTHALMOLOGY: Edited by Dean M. Cestari Source Type: research

Visual and oculomotor outcomes in children with prenatal opioid exposure
Purpose of review To summarize the visual and oculomotor outcomes in children with prenatal opioid exposure and review the effects of opioids on the developing central nervous system. Recent findings Animal models and imaging studies in children suggest that prenatal opioid exposure may affect neuronal survival and result in delayed maturation of white matter tracts and decreased volumes in certain brain areas. Visual evoked potential testing in children demonstrates delayed maturation of the afferent visual system in opioid-exposed groups compared with controls, though ‘catch-up’ development is seen with ...
Source: Current Opinion in Ophthalmology - October 4, 2019 Category: Opthalmology Tags: NEURO-OPHTHALMOLOGY: Edited by Dean M. Cestari Source Type: research

Ocular motor manifestations of movement disorders
Purpose of review Impaired eye movements are frequently seen in ophthalmic and neurologic clinical practice, especially in individuals with movement disorders. Identification of the abnormal movement can aid initial diagnosis and improve understanding of the underlying disease pathophysiology. The present article reviews the ocular motor manifestations and recent research on them in common movement disorders. Recent findings Ocular motor manifestations and their pathophysiologic correlates are being defined. In particular, study of eye movements can help clarify the changing clinicopathologic spectrum of atypical park...
Source: Current Opinion in Ophthalmology - October 4, 2019 Category: Opthalmology Tags: NEURO-OPHTHALMOLOGY: Edited by Dean M. Cestari Source Type: research

Neuro-ophthalmic manifestations of the phakomatoses
Purpose of review The phakomatoses are a group of inherited disorders with variable clinical manifestations that are characterized by brain, cutaneous, ocular and other distinct lesions in multiple organs. Correctly recognizing the neuro-ophthalmic signs and symptoms can lead to early diagnosis and treatment. The group is composed of neurofibromatosis (type 1 and 2), tuberous sclerosis complex, von Hippel–Lindau, ataxia–telangiectasia and Sturge–Weber syndromes. However, more than 60 syndromes have been described in the medical literature. This review provides an update on the diagnosis and management o...
Source: Current Opinion in Ophthalmology - October 4, 2019 Category: Opthalmology Tags: NEURO-OPHTHALMOLOGY: Edited by Dean M. Cestari Source Type: research

Immune checkpoint inhibitors: what neuro-ophthalmologists need to know
Purpose of review Immune checkpoint inhibitors are currently an exceedingly powerful tool in the management of hitherto incurable malignancies and their use in clinical practice is expected to increase in the near future. The purpose of this review is to discuss the current medical uses of checkpoint inhibitors with a focus on their neuro-ophthalmic side-effects. Recent findings Immune checkpoint inhibitors have emerged as a promising breakthrough in the treatment of several tumor types. However, these targeted therapies can induce a wide range of immune-related ophthalmic and neuro-ophthalmic toxicities. It is import...
Source: Current Opinion in Ophthalmology - October 4, 2019 Category: Opthalmology Tags: NEURO-OPHTHALMOLOGY: Edited by Dean M. Cestari Source Type: research

Update on pediatric optic neuritis
Purpose of review To summarize recent developments in the classification, investigation and management of pediatric optic neuritis (PON). Recent findings A recent surge in interest surrounding antibodies to myelin oligodendrocyte glycoprotein antibody (MOG-Ab) has instigated a paradigm shift in our assessment of children with PON. This serological marker is associated with a broad spectrum of demyelinating syndromes that are clinically and radiologically distinct from multiple sclerosis (MS) and aquaporin-4 antibody positive neuromyelitis optica spectrum disorder (AQP4+NMOSD). Optic neuritis is the most common present...
Source: Current Opinion in Ophthalmology - October 4, 2019 Category: Opthalmology Tags: NEURO-OPHTHALMOLOGY: Edited by Dean M. Cestari Source Type: research

Clinical and radiologic approach to ‘typical’ versus antibody-related optic neuritis
Purpose of review Optic neuritis is an autoimmune optic neuropathy that has been associated with multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and more recently antimyelin oligodendrocyte glycoprotein (anti-MOG)-positive disorder. At initial presentation, it is often difficult to differentiate these entities given their significant overlap in clinical presentation and MRI findings. This review summarizes the distinguishing clinical and radiological features of MS, NMOSD, and anti-MOG disorders to help clinicians accurately diagnose and manage patients affected by these conditions. Recent findi...
Source: Current Opinion in Ophthalmology - October 4, 2019 Category: Opthalmology Tags: NEURO-OPHTHALMOLOGY: Edited by Dean M. Cestari Source Type: research

Advances in the diagnosis of giant cell arteritis
Purpose of review To summarize recent advances in the diagnosis of giant cell arteritis (GCA). Recent findings Less common manifestations of GCA include corneal edema, proptosis from lacrimal gland ischemia and sensorineuronal hearing loss. Histology studies have suggested that temporal artery biopsies (TAB) with fixed specimen lengths of 15 mm may be adequate to prevent false negative biopsies. In centers with appropriate radiologic expertise, a European rheumatology consensus guideline has proposed Doppler ultrasound as a first-line confirmatory test for GCA in lieu of temporal artery biopsy. Finding extracranial ...
Source: Current Opinion in Ophthalmology - October 4, 2019 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 4, 2019 Category: Opthalmology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Update on the clinical assessment and management of thyroid eye disease
Purpose of review To offer an update on advances and controversies in the assessment, investigation and treatment of thyroid eye disease (TED), a disfiguring orbital autoimmune disease, which can manifest with diplopia and threaten not only sight – but also life. Recent findings Developments in biomarkers and imaging are helping to tailor the management of patients. Emerging therapies target different pathways in the disease and are informed by studies into TED pathogenesis: the last 2 years has, for example, seen the culmination of a two-decade long bench-to-bedside story in which an original focus on the IGF1 ...
Source: Current Opinion in Ophthalmology - August 9, 2019 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Periocular hyaluronic acid fillers: applications, implications, complications
This article reviews current understanding of the principal complications in the periocular area and their management. Recent findings Hyaluronic acid is a ubiquitous, biodegradable, nonspecies-specific molecular substrate with limited potential for immunogenic reactions. However, in the periocular area, such products can migrate and last significantly longer than the expected filler lifespan. Contamination or subsequent immune stimulation can trigger delayed-onset inflammatory reactions. Though minor vascular occlusions are not uncommon, cases of blindness secondary to facial filler injections are thought to be rare. T...
Source: Current Opinion in Ophthalmology - August 9, 2019 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Neurostimulation for tear production
Purpose of review Dry eye disease (DED) is a chronic multifactorial disease that affects millions of people worldwide. Despite ongoing research, treatment for DED remains a challenge. Neurostimulation for tear production is a rapidly evolving field that culminated in the development of the intranasal tear neurostimulator (ITN). In this article, we review the neuroanatomy and pathophysiology of tear production and the evolution of neurostimulation for the treatment of DED. Recent findings The ITN was approved for commercial use in April 2017. This innovation stemmed from the success of lacrimal nerve and anterior ethmo...
Source: Current Opinion in Ophthalmology - August 9, 2019 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Medical and sclerosing agents in the treatment of orbital lymphatic malformations: what's new?
Purpose of review Currently, there is no ideal management for orbital lymphatic malformations. Significant advances have been made since the discovery of new agents in the treatment. The purpose of this manuscript is to review the recent evidence on new sclerotherapy agents and systemic medications. Recent findings Traditional sclerosants are OK-432, sodium tetradecyl sulphate and ethanol. More recent developments are the use of doxycycline, bleomycin, and pingyangmycin. Sirolimus as a systemic medication has revolutionized the medical management of lymphatic malformations. Other oral drugs such as propranolol and sil...
Source: Current Opinion in Ophthalmology - August 9, 2019 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Applications of three-dimensional printing in orbital diseases and disorders
Purpose of review To comprehensively review the applications of advanced three-dimensional printing technology in the management of orbital abnormalities. Recent findings Three-dimensional printing has added value in the preoperative planning and manufacturing of patient-specific implants and surgical guides in the reconstruction of orbital trauma, congenital defects and tumor resection. In view of the costs and time, it is reserved as strategy for large and complex craniofacial cases, in particular those including the bony contour. There is anecdotal evidence of a benefit of three-dimensional printing in the manufact...
Source: Current Opinion in Ophthalmology - August 9, 2019 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Surgical management of congenital nasolacrimal duct obstruction; one procedure for all versus all procedures for one
Purpose of review After failed conservative management, most clinicians treat congenital nasolacrimal duct obstruction (CNLDO) in a conventional stepwise fashion: starting with probing, then repeat probing, next silicone intubation and/or balloon dilatation, and finally dacryocystorhinostomy. This approach is based on the patient's age and previously failed procedures and recruits ‘one procedure for all’ CNLDO. A newly introduced approach is based on the type of obstruction and recruits ‘all procedures for one’ CNLDO. The aim of this review is to examine the best available evidence regarding CNLDO...
Source: Current Opinion in Ophthalmology - August 9, 2019 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Current treatment of optic nerve gliomas
Purpose of review Optic pathway gliomas are low-grade neoplasms that affect the precortical visual pathway of children and adolescents. They can affect the optic nerve, optic chiasm, optic tracts and radiations and can either be sporadic or associated with neurofibromatosis type one. Gliomas isolated to the optic nerve (ONG) represent a subgroup of optic pathway gliomas, and their treatment remains controversial. New developments in ONG treatment have emerged in recent years, and it is necessary for clinicians to have a current understanding of available therapies. Recent findings The current review of the literature ...
Source: Current Opinion in Ophthalmology - August 9, 2019 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Paediatric orbital and periorbital infections
This study is a review of recent literature in the diagnosis and management of preseptal cellulitis, orbital cellulitis and dacryocystitis, including causative organisms, diagnosis and medical or surgical therapy and potential complications. Recent findings Advances in vaccination against Haemophilus influenzae B have resulted in a shift in the most common causative organisms of preseptal and orbital cellulitis. Management of orbital cellulitis has been advanced by adjuvant corticosteroids, and subperiosteal abscess volumes of more than 1250 ml has been shown as predictive for requiring potential surgical intervention...
Source: Current Opinion in Ophthalmology - August 9, 2019 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Editorial: Reclaiming the term ‘preseptal cellulitis’
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - August 9, 2019 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Artificial intelligence for pediatric ophthalmology
This article discusses the unique needs of pediatric patients and how artificial intelligence techniques can address these challenges, surveys recent applications to pediatric ophthalmology, and discusses future directions. Recent findings The most significant advances involve the automated detection of retinopathy of prematurity, yielding results that rival experts. Machine learning has also been applied to the classification of pediatric cataracts, prediction of postoperative complications following cataract surgery, detection of strabismus and refractive error, prediction of future high myopia, and diagnosis of readi...
Source: Current Opinion in Ophthalmology - August 9, 2019 Category: Opthalmology Tags: PEDIATRICS AND STRABISMUS: Edited by Cynthia Alley Source Type: research

Ergonomics in strabismus surgery
This article will summarize current findings pertaining to musculoskeletal disorders in ophthalmology and review their implications for strabismus surgeons. Recent findings Optical motion capture is a promising alternative to older qualitative and quantitative methods for evaluating ergonomic posture. Recent studies support the need for training to reduce work-related musculoskeletal disorders. (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - August 9, 2019 Category: Opthalmology Tags: PEDIATRICS AND STRABISMUS: Edited by Cynthia Alley Source Type: research

Does general anesthesia or intravitreal injection affect neurodevelopment in children undergoing ophthalmic procedures?
Purpose of review To review recent studies on potential neurodevelopmental impacts on the pediatric population through general anesthesia events or intravitreal anti-vascular endothelial growth factor (VEGF) injection. Recent findings Studies on this topic have been extensive with varied reported neurodevelopmental outcomes. Initial investigations in rodents and primates showed negative impact of anesthetics on neurodevelopment. Subsequent retrospective human reviews had mixed results whereas more recent sibling and prospective studies have been published without evidence of clinically significant impact. A similar na...
Source: Current Opinion in Ophthalmology - August 9, 2019 Category: Opthalmology Tags: PEDIATRICS AND STRABISMUS: Edited by Cynthia Alley Source Type: research

β-blockers in the treatment of periocular infantile hemangioma
Purpose of review To evaluate the medical literature on the use of β-blockers, through different routes, for the treatment of periorbital infantile hemangiomas and to summarize the recommendations available on dosage and monitoring. Recent findings β-blockers for the treatment of infantile hemangioma are now considered to be first-line treatment. Growing literature on the role of oral propranolol confirmed its efficacy but also presented its multiple side-effects including hypotension, bradycardia, hypoglycemia, and bronchospasm. No universal guidelines exist concerning pretreatment evaluation, dosage, monit...
Source: Current Opinion in Ophthalmology - August 9, 2019 Category: Opthalmology Tags: PEDIATRICS AND STRABISMUS: Edited by Cynthia Alley Source Type: research

Congenital fibrosis of the extraocular muscles: review of recent literature
Purpose of review Congenital fibrosis of the extraocular muscles (CFEOM) is caused by abnormal development of the innervation of extraocular muscles. We update the recent literature regarding the clinical, anatomic, genetic, and molecular characteristics of CFEOM. Surgical considerations are addressed. Recent findings CFEOM is broken down into three main subtypes, CFEOM1, CFEOM2, and CFEOM3. Several recent reports of individuals, as well as family pedigrees, highlight the phenotypic heterogeneity of CFEOM. Intracranial and intraorbital radiologic findings have enhanced our understanding of the disease pathophysiology....
Source: Current Opinion in Ophthalmology - August 9, 2019 Category: Opthalmology Tags: PEDIATRICS AND STRABISMUS: Edited by Cynthia Alley Source Type: research

Stickler syndrome: exploring prophylaxis for retinal detachment
Purpose of review The literature regarding prophylactic treatment of rhegmatogenous retinal detachment in Stickler syndrome remains controversial. We review major published clinical studies and offer a critical analysis of this subject. Summary Stickler syndrome is a systemic collagenopathy affecting multiple organ systems including the eye, ear, and skeleton. Stickler syndrome is probably the most common cause of genetically determined pediatric rhegmatogenous retinal detachment. Congenital developmental anomalies constitute over half rhegmatogenous detachments (RRD) in patients less than 10 years. The majority are c...
Source: Current Opinion in Ophthalmology - August 9, 2019 Category: Opthalmology Tags: PEDIATRICS AND STRABISMUS: Edited by Cynthia Alley Source Type: research

Ocular manifestations of Sturge–Weber syndrome
Purpose of review Sturge–Weber syndrome (SWS) is a rare, congenital disease which frequently involves the eye. It is important that ophthalmologists recognize this syndrome and are aware of its range of ocular manifestations. The aim of this article is to present our understanding of the pathogenesis and clinical manifestations of this syndrome and provide updated information on the treatment of SWS glaucoma and choroidal hemangioma. Recent findings SWS glaucoma usually fails medical management. Surgical options include angle procedures, filtering procedures, device placement, and combination procedures. Combina...
Source: Current Opinion in Ophthalmology - August 9, 2019 Category: Opthalmology Tags: PEDIATRICS AND STRABISMUS: Edited by Cynthia Alley Source Type: research

Editorial: A new perspective
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - August 9, 2019 Category: Opthalmology Tags: PEDIATRICS AND STRABISMUS: Edited by Cynthia Alley Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - August 9, 2019 Category: Opthalmology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Corneal neurotization
This article aims at reviewing the current surgical advances, along with the current thoughts and evidence available for corneal nerve regeneration. Recent findings Corneal neurotization was first introduced in 2009 by Terzis et al., but recently picked up more interest since 2014. Direct and indirect neurotization are being developed, and different nerves (sural nerve, great auricular nerve) have been explored for interposition between frontal nerve branches and the cornea. New endoscopic techniques are introduced for less invasive approaches. On the corneal front, confocal microscopy and esthesiometry studies have est...
Source: Current Opinion in Ophthalmology - June 7, 2019 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

The future of keratoplasty: cell-based therapy, regenerative medicine, bioengineering keratoplasty, gene therapy
Purpose of review To provide an update on the state of development of novel therapeutic modalities for the treatment of corneal diseases. Recent findings Novel corneal therapeutics may be broadly classified as cell therapy, regenerative medicine, bioengineered corneal grafts and gene therapy. Cell therapy encompasses cultivation of cells, such as corneal endothelial cells (CECs) and keratocytes to replenish the depleted native cell population. Regenerative medicine is mainly applicable to the corneal endothelium, and is dependent on the ability of native, healthy CECs to restore the corneal endothelium following traum...
Source: Current Opinion in Ophthalmology - June 7, 2019 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Descemet's stripping without endothelial keratoplasty
Purpose of review To summarize the recent literature regarding descemetorhexis stripping without endothelial keratoplasty (DWEK), increasingly referred to as Descemet's stripping only (DSO). To report the characteristic clinical, confocal and histologic findings associated with this procedure. Recent findings Reported clearance rates following DSO range from 63 to 100% in recent series, with variation between surgical techniques. Topical Rho-kinase inhibitor has been reported as successfully salvaging failing cases. Its use as an adjuvant to the surgery is gaining widespread adoption with the results of early series n...
Source: Current Opinion in Ophthalmology - June 7, 2019 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Update on Descemet membrane endothelial keratoplasty
Purpose of review To provide an update on new perspectives on Descemet membrane endothelial keratoplasty (DMEK). Recent findings Preloaded DMEK grafts allow optimization of DMEK surgery time and reduce costs of the procedure, which is allowing the procedure to become more easily performed as reflected in the increasing number of cases. The surgical technique in the United States differs from the technique in Europe, but outcomes have been similar. Hemi-DMEK and quarter-DMEK have shown similar outcomes to conventional DMEK with respect to corneal transparency and visual acuity. Three-year follow-up of hemi-DMEK has als...
Source: Current Opinion in Ophthalmology - June 7, 2019 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Ultrathin Descemet stripping automated endothelial keratoplasty
Purpose of review Endothelial keratoplasty has evolved tremendously since its inception. Thick Descemet stripping automated endothelial keratoplasty (DSAEK) grafts have made sway for slimmer ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK). This review discusses the recent literature comparing outcomes of UT-DSAEK, DSAEK, and Descemet membrane endothelial keratoplasty (DMEK). Recent findings DMEK provides quick visual recovery and has remarkably low incidence of graft rejection. However, the learning curve is long compared to DSAEK. UT-DSAEK utilizes donor grafts less than 100-μm thick. Re...
Source: Current Opinion in Ophthalmology - June 7, 2019 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Femtosecond laser-assisted deep anterior lamellar keratoplasty
Purpose of review A survey of the recent literature of deep anterior lamellar keratoplasty using femtosecond laser technology. Recent findings There are several recent reports in the literature assessing technique and outcomes of deep anterior lamellar keratoplasty done with a femtosecond laser trephination. Most of these reports are laboratory studies and small case series with short-term outcomes. The laser technology is expensive and may not produce better results than conventional manual techniques. However, there are several theoretical advantages to femtosecond laser incisions in deep anterior lamellar keratopla...
Source: Current Opinion in Ophthalmology - June 7, 2019 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Update on Bowman layer transplantation
Purpose of review Bowman layer transplantation is a novel technique that may stabilize progressive ectatic corneal changes in eyes with keratoconus, which are too steep or too thin for ultraviolet corneal crosslinking or intracorneal ring segments. In this way, patients can maintain stable vision with contact lenses, and avoid or postpone more invasive corneal transplants, such as penetrating keratoplasty or deep anterior lamellar keratoplasty. This review aims to summarize the currently available literature on Bowman layer transplantation. Recent findings Bowman layer transplantation seems to be a promising, minimall...
Source: Current Opinion in Ophthalmology - June 7, 2019 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Long-term outcomes of permanent keratoprosthesis
Purpose of review To provide an update on recent advances in keratoprosthesis surgery with a focus on long-term outcomes. Recent findings Reports over the past year have focused on long-term outcomes showing good anatomical and functional results. In addition, preoperative diagnosis and surgical modifications that can impact postoperative outcomes are discussed. Outcomes of primary keratoprosthesis as an option for patients with poor prognosis for traditional keratoplasty are also presented in this review. Summary Keratoprosthesis is an option for visual rehabilitation in select patients. Current 5-year outcomes ar...
Source: Current Opinion in Ophthalmology - June 7, 2019 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Small-aperture strategies for the correction of presbyopia
This article reviews what is known to date about various small-aperture optics platforms, including a posterior chamber IOL, add on device, corneal inlay, contact lenses, and pupil-constricting drops. Additionally, the impact of small-aperture technologies on light perception and visual performance, as well as the relative merits of monocular versus binocular small apertures are discussed. Summary Small-aperture optics are a dynamic, physiologic solution to the problem of presbyopia. They are effective throughout the range of accommodation loss and in pseudophakia. Small-aperture optics offer an opportunity to improve v...
Source: Current Opinion in Ophthalmology - June 7, 2019 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Hyperopic small-incision lenticule extraction
Purpose of review Small-incision lenticule extraction (SMILE) has shown great promise in the treatment of myopia; however, the literature is less extensive in its hyperopic counterpart. The purpose of this review is to detail the recent advancements and outcomes of SMILE in the treatment of hyperopic eye disease. Recent findings SMILE has demonstrated similar visual outcomes, regression rates, centration ability, safety profiles, and wound healing as hyperopic laser-assisted in situ keratomileusis (LASIK). Lenticule preservation and implantation show further promise in the correction of higher degrees of hyperopia. S...
Source: Current Opinion in Ophthalmology - June 7, 2019 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research

Effectiveness of intracorneal ring segments for keratoconus
Purpose of review To review the efficacy of intrastromal corneal ring segments (ICRS) for keratoconus and with other interventions such as contacts lens, keratoplasty, and corneal collagen cross-linking. Recent findings Changes in ICRS thickness and size, combination of procedures, and the adaptation of a more sophisticated classification system have broadened our application of ICRS. Recent studies have shown the long-term efficacy of ICRS in visual acuity, keratometry, and astigmatism. Summary Studies have demonstrated the short-term and long-term efficacy of ICRS implantation in patients with keratoconus. (Sourc...
Source: Current Opinion in Ophthalmology - June 7, 2019 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research

Recent updates on myopia control: preventing progression 1 diopter at a time
Purpose of review Myopia refers to a refractive state of the eye that can predispose to visually significant ocular disease. The prevalence of myopia is increasing worldwide. Researchers internationally have been investigating methods to slow down its progression to prevent sight-threatening complications. In this article, we perform a review of the current literature discussing interventions for preventing pediatric myopic progression. Recent findings Various interventions, including lifestyle modification, optical methods, and pharmacologic approaches, have been proposed to help control myopic progression. Increasin...
Source: Current Opinion in Ophthalmology - June 7, 2019 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - June 7, 2019 Category: Opthalmology Tags: EDITORIAL INTRODUCTIONS Source Type: research