Hand hygiene and instrument sanitization in ophthalmology clinics
This article reviews the various challenges in infection control in eye clinics and successful measures taken to prevent nosocomial infections.
Recent findings
The Center for Disease Control recommends hand-washing when hands are visibly soiled, and after direct contact with patients, and inanimate objects such as medical equipment. Published studies have identified poor hygiene in clinical settings as a major cause of nosocomial outbreaks, particularly in cases of epidemic keratoconjunctivitis (EKC). Some studies of EKC outbreaks are able to support direct observation of hygiene lapses with molecular analysis that can ...
Source: Current Opinion in Ophthalmology - November 29, 2019 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research
Cataract surgery in corneal transplantation
Purpose of review
Corneal diseases are often associated with lens opacity. The present article reviews the recent advances in the management of cataract and corneal transplant.
Recent findings
Thanks to the development of lamellar transplant techniques and the evolution of cataract surgery, we now have several strategies to address corneal diseases and cataract including ‘lamellar triple procedure’. Numerous precautions have been identified to have a successful surgery with good visual recovery.
Summary
Corneal diseases associated with cataract can be successfully managed using separate or combined surgical pro...
Source: Current Opinion in Ophthalmology - November 29, 2019 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research
Cataract surgery and intraocular pressure in glaucoma
Purpose of review
To review the current literature on the relationship between cataract extraction and intraocular pressure (IOP).
Recent findings
Cataract extraction can be an effective IOP lowering treatment for open and closed angle glaucoma as well as ocular hypertension. In comparative trials studying novel micro-invasive glaucoma surgeries in open angle glaucoma, the control group undergoing cataract extraction alone routinely achieved significant reductions in IOP and medication use postoperatively. Data from the Effectiveness in Angle Closure Glaucoma of Lens Extraction (EAGLE) trials have demonstrated that le...
Source: Current Opinion in Ophthalmology - November 29, 2019 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research
How much astigmatism to treat in cataract surgery
Purpose of review
Astigmatism correction in cataract surgery is a common surgical challenge. Although there are numerous approaches to its treatment during cataract surgery, there remains a lack of consensus on what level of postoperative astigmatism to target. We examine the literature to determine the effect of astigmatism on visual function and provide a recommendation on how much to treat in cataract surgery.
Recent findings
Distance visual acuity decreases as myopic, hyperopic, or mixed astigmatism increases. Near visual acuity decreases with hyperopic astigmatism but improves with myopic astigmatism. The effect ...
Source: Current Opinion in Ophthalmology - November 29, 2019 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research
Management of cataract in the setting of uveitis: a review of the current literature
Purpose of review
This review aims to cover the preoperative planning, intraoperative considerations, and postoperative management that aids in successful outcomes of patients with cataract and uveitis. Disease-specific management and pediatric management will also be addressed.
Recent findings
Dexamethasone implants appear to be a safe and effective addition to standard steroid treatment in decreasing the incidence of postoperative cystoid macular edema (CME). Intravitreal steroids and topical difluprednate have shown utility in CME treatment.
Summary
Cataract surgery in eyes with uveitis is generally safe and eff...
Source: Current Opinion in Ophthalmology - November 29, 2019 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research
Editorial: Surgical advancements and innovations in cataract surgery for the complex patient
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - November 29, 2019 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 - November 29, 2019 Category: Opthalmology Tags: EDITORIAL INTRODUCTIONS Source Type: research
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
