Contemporary management of refractory pediatric glaucoma
Purpose of review
The management of pediatric glaucoma poses a unique challenge in terms of maintaining lifelong vision and combating an aggressive scarring response from surgery. Contemporary literature regarding the surgical management of children with pediatric glaucoma who fail, or are at a high risk of failure, from conventional surgery is limited. The aim of this review is to highlight recent developments in relation to the current opinion regarding the management of children with refractory pediatric glaucoma.
Recent findings
Some studies have reported impressive success rates with circumferential trabeculotomy...
Source: Current Opinion in Ophthalmology - February 8, 2020 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research
Glaucoma in pregnancy: an update
Purpose of review
Glaucoma management during pregnancy is a complex challenge, which requires balancing the clinical disease of the mother with the potential risks of therapy to the developing child. Because systematic studies are lacking in the pregnant population, this review aims to collect the array of available data from observational studies and case reports to provide the reader with guidance and context for the safety of glaucoma interventions during pregnancy.
Recent findings
Surgical glaucoma is a rapidly expanding field with many new technologies and procedures. We review the surgical options for the gravid...
Source: Current Opinion in Ophthalmology - February 8, 2020 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research
Management of the glaucoma patient progressing at low normal intraocular pressure
Purpose of review
Patients with glaucoma with disease progression despite low or normal intraocular pressure (IOP) present special challenges to the treating clinician. Treatment goals may depend on whether patients have apparent low IOP with concurrent treatment or have low IOP at baseline without treatment. We review the diagnostic and therapeutic approaches to these patients.
Recent findings
Apparent progression at low IOP should start with confirmation of IOP, made easier by devices enabling patient home self-tonometry. Suspected visual field progression should be confirmed by repeat testing prior to advancement o...
Source: Current Opinion in Ophthalmology - February 8, 2020 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research
Primary angle closure glaucoma genomic associations and disease mechanism
Purpose of review
The genetic basis of primary angle closure (PAC) glaucoma is slowly being elucidated. In recent years, genome-wide association studies have identified eight new susceptibility loci for PAC. Our purpose in this review is to summarize our current knowledge of genetics in angle closure, to take a closer look at the eight novel loci and what we have learned about their function, and consider what they might teach us about angle closure disease.
Recent findings
Multiple novel loci associated with PAC glaucoma have been identified in large genome-wide association studies. Moreover, primary open angle glauc...
Source: Current Opinion in Ophthalmology - February 8, 2020 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research
Glaucoma screening: where are we and where do we need to go?
Purpose of review
Current recommendations for glaucoma screening are decidedly neutral. No studies have yet documented improved long-term outcomes for individuals who undergo glaucoma screening versus those who do not. Given the long duration that would be required to detect a benefit, future studies that may answer this question definitively are unlikely. Nevertheless, advances in artificial intelligence and telemedicine will lead to more effective screening at lower cost. With these new technologies, additional research is needed to determine the costs and benefits of screening for glaucoma.
Recent findings
Using op...
Source: Current Opinion in Ophthalmology - February 8, 2020 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research
Toward a new definition of glaucomatous optic neuropathy for clinical research
Purpose of review
A process is ongoing to produce a definition of glaucomatous optic neuropathy (GON) using quantitative, objective data from structural and functional tests. At present, a common practice is to define GON by subjective features said to be ‘characteristic’ as judged by those experienced in glaucoma care.
Recent findings
An objective definition would standardize the comparison of clinical research results across studies, without precluding simultaneous use of idiosyncratic definitions in the same reports. To achieve this goal, expert opinion was solicited to reach optimal agreement on one or more co...
Source: Current Opinion in Ophthalmology - February 8, 2020 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research
Vision 2020: where are we?
Purpose of review
To describe the VISION 2020: The Right to Sight, global initiative for the elimination of avoidable blindness, the contribution of glaucoma to the magnitude of global blindness and priorities going forward.
Recent findings
Although the target of the World Health Organization's Global Action Plan (2014–2019) has not been met in terms of 25% reduction in avoidable blindness, there is evidence that the contribution of glaucoma to blindness and vision impairment is reducing. Yet this focus on a threshold of visual acuity by which to measure prevalence underestimates the true burden of glaucoma. Recent ...
Source: Current Opinion in Ophthalmology - February 8, 2020 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research
Editorial introduction
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - February 8, 2020 Category: Opthalmology Tags: EDITORIAL INTRODUCTION Source Type: research
Update: The Miller Fisher variants of Guillain-Barré syndrome: Erratum
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - November 29, 2019 Category: Opthalmology Tags: ERRATUM Source Type: research
Manual small incision cataract surgery
Purpose of review
To review various techniques of manual small incision cataract surgery (MSICS), updates on training residents and fellows, and cost-effectiveness of the surgery.
Recent findings
Recent population studies estimate that there are 53 million people blind worldwide from cataracts, up from previous figures. This is in part because of population growth and increased life expectancy worldwide. MSICS continues to play a significant role in addressing cataract burden and there is an increasing need to train surgeons in the technique. In response to this need, several modules and rubrics have been developed to...
Source: Current Opinion in Ophthalmology - November 29, 2019 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research
Drop-free approaches for cataract surgery
Purpose of review
Routine prophylaxis for adverse events following cataract surgery is evolving. Prior reliance on topical eyedrop instillation by patients is giving way to surgeon directed injections at the time of cataract surgery. The benefit of this new approach is assured delivery of drugs in standardized doses which should optimize the healing process and reduce the incidence of untoward events with higher confidence.
Recent findings
Adoption rates of intracameral antibiotic injection amongst European and American cataract surgeons is increasing. Techniques to inject periocular corticosteroid for routine inflamm...
Source: Current Opinion in Ophthalmology - November 29, 2019 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research
The quest for homeopathic and nonsurgical cataract treatment
This article reviews the current understanding of cataract development and discusses several homeopathic remedies purported to treat age-related cataract. Additionally, we will present an overview of evidence regarding the development of pharmacologic cataract reversal therapies.
Recent findings
Some homeopathic therapies have been shown to prevent cataract development in experimental models. More studies are required to elucidate the potential medicinal and toxic properties of the various alternative therapies. However, in recent years, scientists have begun to investigate substances that address cataract by reversing ...
Source: Current Opinion in Ophthalmology - November 29, 2019 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research
Scleral fixation of intraocular lenses
Purpose of review
To review current, effective and more popular techniques for scleral fixation of intraocular lens (IOLs) and IOL–capsular bag complex.
Recent findings
Scleral fixation of IOLs became popular, originally with sutured scleral fixated IOLs and later the Scharioth technique of intrascleral haptic fixation. This was further developed as the Glued IOL technique which enjoys widespread adoption all over the world. Recently the Yamane technique has also become popular and is being widely adopted as well.
Summary
Scleral fixated IOLs have evolved in the last 2 decades with technical modifications, extend...
Source: Current Opinion in Ophthalmology - November 29, 2019 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research
Iris reconstruction suturing techniques
This article will review current suturing techniques for iris reconstruction, as well as the benefits and drawbacks to various suturing methods. Alternative reconstructive methods are also discussed.
Recent findings
One of the earliest iris suturing methods described was the McCannel technique. This technique allows direct suturing of the iris using three incisions. The Siepser slipknot is another method used in closed chamber iris suturing techniques. This knot, and its recent modifications, utilizes a sliding knot, which is created outside the eye and slid into place atop the iris defect. The cerclage iris suture, in ...
Source: Current Opinion in Ophthalmology - November 29, 2019 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research
Methods for achieving adequate pupil size in cataract surgery
Purpose of review
Cataract surgery is the most common surgical procedure performed worldwide. Small pupils have been an eternal challenge for cataract surgeons; insufficient pupil dilation is associated with increased complication rates, including capsule rupture, vitreous loss, iris trauma or postoperative inflammation. The aim of the current review is to present the methods for pupil dilation and the risk factors for a small pupil in a cataract patient.
Recent findings
Risk factors for intraoperative small pupil include diabetes, intraoperative floppy iris syndrome, pseudoexfoliation syndrome, receiving glaucoma med...
Source: Current Opinion in Ophthalmology - November 29, 2019 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research
