Multifocal spectacles in childhood myopia: Are treatment effects maintained? A systematic review and meta-analysis.
We evaluate the impact of duration on the treatment effect of multifocal spectacle lenses used to inhibit myopia progression in children. A systematic literature search identified randomized controlled trials where multifocal lenses were prescribed as the intervention, with single vision lenses as the control. Nine randomized control trials involving 1701 children aged eight to 13 years, were included in the meta-analysis. Treatment effects, i.e. differences in spherical equivalent refraction between intervention and non-intervention groups, were analyzed over both six- and 12-month intervals. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - October 14, 2019 Category: Opthalmology Authors: Dinesh Kaphle, David A. Atchison, Katrina L. Schmid Tags: Major review Source Type: research

How many aqueous humor outflow pathways are there?
The aqueous humor (AH) outflow pathways definition is still matter of intense debate. To date, the differentiation between conventional (trabecular meshwork) and unconventional (uveoscleral) pathways is widely accepted, distinguishing the different impact of the intraocular pressure (IOP) on the AH outflow rate. While the conventional route is recognized to host the main sites for IOP regulation, the unconventional pathway, with its great potential for AH resorption, seems to act as a sort of relief valve, especially when the trabecular resistance rises. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - October 14, 2019 Category: Opthalmology Authors: Ciro Costagliola, Roberto dell ’Omo, Luca Agnifili, Silvia Bartollino, Antonio M. Fea, Maurizio G. Uva, Lucio Zeppa, Leonardo Mastropasqua Tags: Major review Source Type: research

A literature review on Fuchs uveitis syndrome: an update
Fuchs uveitis syndrome (FUS) is a chronic, typically unilateral, ocular condition characterized by an asymptomatic mild inflammatory syndrome that can result in cataract and secondary glaucoma. Diagnosis is largely clinical because the etiology remains obscure. FUS is most likely the result of different insults or pathogenic mechanisms, including infections, autoimmune diseases, hereditary and sympathetic dysfunction. According to the infectious theory, the infection of herpes simplex virus, ocular toxoplasmosis, cytomegalovirus, rubella virus, and other viruses have been implicated in the pathogenesis of the disease. (Sou...
Source: Survey of Ophthalmology - October 14, 2019 Category: Opthalmology Authors: Yang Sun, Yinghong Ji Tags: Major review Source Type: research

Utility of Regional Epithelial Thickness Measurements in Corneal Evaluations
The measurement of regional corneal epithelial thickness and characterization of its behavior in response to changes to corneal architecture are increasingly drawing interest in clinical practice. The epithelium has tremendous capacity for remodeling and does so in response to underlying stromal pathology or changes in anterior corneal curvature. Various remodeling patterns have been identified that help distinguish between various ectatic and non-ectatic corneal conditions. Epithelial mapping has also facilitated more precise, individualized corneal surface disorder treatments. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - September 24, 2019 Category: Opthalmology Authors: Eric S. Hwang, Julie M. Schallhorn, J. Bradley Randleman Tags: Major review Source Type: research

Intraductal Sebaceous Papilloma of a Meibomian Gland: A New Entity Possibly Associated with the MSH6 Subtype of the Muir-Torre Syndrome
Over several months a 63 year old man developed a painless, multinodular, non-erythematous swelling of the deep tissues of his left upper eyelid. An excisional biopsy with histopathologic evaluation disclosed a unique sebaceous papilloma within a cyst lined by non-keratinizing squamous epithelium that focally displayed a variably thick, superficial, eosinophilic cuticular layer. Immunohistochemical staining demonstrated that the tumor and its epithelial cystic lining had a profile consistent with Meibomian gland duct epithelium. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - September 23, 2019 Category: Opthalmology Authors: Frederick A. Jakobiec, Paula Cortes Barrantes, Daniel R. Lefebvre, Tatyana Milman Tags: Major review Source Type: research

Smartphone use in ophthalmology: what is their place in clinical practice?
Smartphones are an increasingly common and rapidly developing tool in clinical practice. Numerous applications or ‘apps’ are available for use on smartphones that aim to help clinicians perform a variety of tasks at the point of care. A large number of ophthalmology-related medical apps that can perform a variety of clinically relevant functions are now available in virtual stores such as the Google Play™ Store or the Apple App Store®. On the ophthalmic front, these include measures of visual acuity, tools to assist in the assessment and treatment of conditions such as amblyopia and glaucoma, as well ...
Source: Survey of Ophthalmology - September 18, 2019 Category: Opthalmology Authors: Daniel T. Hogarty, Joseph P. Hogarty, Alex W. Hewitt Tags: Major review Source Type: research

Management of Meibomian Gland Dysfunction: A Review
Meibomian gland dysfunction (MGD) is the leading cause of evaporative dry eye disease and is one of the most common conditions encountered by eye care providers. MGD is characterized by obstruction of the meibomian gland terminal ducts and/or changes in their glandular secretion, resulting in changes in tear film stability, inflammation, and symptoms of irritation. There is no gold standard treatment for MGD, but rather a diversity of options. Conservative measures include warm compresses and lid hygiene, but there is growing interest and need for medical treatments and procedures. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - September 5, 2019 Category: Opthalmology Authors: Saama Sabeti, Ahmad Kheirkhah, Jia Yin, Reza Dana Tags: Major review Source Type: research

Advancing ophthalmology medical student education: international insights and strategies for enhanced teaching
Enhancing medical student education in ophthalmology can lead to improved eye health care delivery and patient outcomes across all primary care and specialty disciplines., There has been a resurgence in interest in delivering high quality ophthalmic medical student education. This educational revival is both timely and topical. A general consensus has emerged that ,rather than focusing solely on increasing teaching time, strategies are needed to focus on how to optimize the limited time allotted to ophthalmology. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - August 28, 2019 Category: Opthalmology Authors: Tony Succar, John Grigg, Hilary A. Beaver, Andrew G. Lee Tags: Core Competencies in Ophthalmology Source Type: research

Current concepts of cerebrospinal fluid dynamics and the translaminar cribrosa pressure gradient: a paradigm of optic disc disease
Modern advances in measuring and studying cerebrospinal fluid (CSF) dynamics have furthered our understan ding of intracranial pressure (ICP) and its pathophysiological effects on the eye. In particular, the CSF pressure and composition within the optic nerve subarachnoid space (SAS) are key factors in diseases of the optic disc. ICP and intraocular pressure (IOP) establish a pressure gradient across the lamina cribrosa (LC). Alterations in this translaminar cribrosa pressure difference (TLPD) induce structural deformations in the LC manifested clinically by the appearance of optic disc edema (ODE) or optic disc cupping. (...
Source: Survey of Ophthalmology - August 23, 2019 Category: Opthalmology Authors: Katy C. Liu, David Fleischman, Andrew G. Lee, Hanspeter E. Killer, John J. Chen, M. Tariq Bhatti Tags: Major review Source Type: research

Authors' response
We read with great interest, the article by Chronopoulos and Schutz entitled Central retinal artery occlusions –A new, provisional treatment approach.4 We also acknowledge the comments by Grzybowski and Kanclerz5 regarding the lack of evidence basis for the recommendation for a paracentesis in the setting of a recent retinal artery occlusion (RAO). We believe that further clarification is in order regardin g the management of RAO. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - August 19, 2019 Category: Opthalmology Authors: Timothy W. Olsen, Flora Lum, John J. Chen, Jose S. Pulido Tags: Letter Source Type: research

RE: “Central retinal artery occlusions – A new, provisional treatment approach”1
We read with great interest, the article by Chronopoulos and Schutz entitled Central retinal artery occlusions – A new, provisional treatment approach.4 We also acknowledge the comments by Grzybowski and Kanclerz5 regarding the lack of evidence-basis for the recommendation for a paracentesis in the setting of a recent retinal artery occlusion (RAO). We believe that further clarification is in order regardi ng the management of RAO. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - August 19, 2019 Category: Opthalmology Authors: Timothy W. Olsen, Flora Lum, John J. Chen, Jose S. Pulido Tags: Letter Source Type: research

A review of aqueous outflow resistance and its relevance to microinvasive glaucoma surgery
Primary open-angle glaucoma is the leading cause of irreversible blindness worldwide, and intraocular pressure reduction remains the only proven treatment strategy. Elevated intraocular pressure occurs as the result of impaired aqueous humor outflow. Both a passive model and a dynamic model have been used to explain trabecular outflow resistance. The passive model posits that the trabecular meshwork acts as a static filter that exerts stable and passive resistance to outflow. In contrast, the dynamic model involves a “biomechanical pump.” In recent years, the range of surgical management options for glaucoma ha...
Source: Survey of Ophthalmology - August 16, 2019 Category: Opthalmology Authors: Nicholas H. Andrew, Sarmad Akkach, Robert J. Casson Tags: Major review Source Type: research

Sclerotherapy for low-flow vascular malformations of the orbital and periocular regions: Systematic review and meta-analysis
We present the results of a systematic review and meta-analysis examining the safety and efficacy of percutaneous sclerotherapy for the treatment of vascular malformations of the orbit. We searched PubMed, MEDLINE, and EMBASE from 2000 to 2018 for studies evaluating the safety and efficacy of percutaneous sclerotherapy for orbital and periorbital vascular malformations. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - August 16, 2019 Category: Opthalmology Authors: Lucio De Maria, Paolo De Sanctis, Megha Tollefson, Samir Mardini, James A. Garrity, Pearse P. Morris, Emily Bendel, Waleed Brinjikji Tags: Therapeutic review Source Type: research

Optic Neuritis In the Era of Biomarkers
The Optic Neuritis Treatment Trial (ONTT), a landmark study completed in 1991, stratified the risk of multiple sclerosis (MS) in patients with optic neuritis. Since that time, unique biomarkers for optic neuritis have been found. The antibody against aquaporin-4, (AQP4)-immunoglobulin G (IgG), discovered in 2004, was found to be both the pathologic cause and a reliable biomarker for neuromyelitis optica spectrum disorders (NMOSD). This finding enabled an expanded definition of the phenotype of NMOSD and improved treatment of the disease. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - August 16, 2019 Category: Opthalmology Authors: John J. Chen, Sean J. Pittock, Eoin P. Flanagan, Vanda A. Lennon, M.Tariq Bhatti Tags: Major review Source Type: research

A Review of Aqueous Outflow Resistance and its Relevance to Micro-invasive Glaucoma Surgery
Primary open-angle glaucoma is the leading cause of irreversible blindness worldwide, and intraocular pressure (IOP) reduction remains the only proven treatment strategy. Elevated IOP occurs as the result of impaired aqueous humor outflow. Both a passive model and a dynamic model have been used to explain trabecular outflow resistance. The passive model posits that the trabecular meshwork acts as a static filter that exerts stable and passive resistance to outflow. In contrast, the dynamic model involves a ‘biomechanical pump.’ In recent years, the range of surgical management options for glaucoma has dramatica...
Source: Survey of Ophthalmology - August 16, 2019 Category: Opthalmology Authors: Nicholas H. Andrew, Sarmad Akkach, Robert J. Casson Tags: Major review Source Type: research

Sclerotherapy for Low-Flow Vascular Malformations of the Orbital and Periocular Region: Systematic Review and Meta-Analysis
We present the results of a systematic review and meta-analysis examining the safety and efficacy of percutaneous sclerotherapy for the treatment of vascular malformations of the orbit.We searched PubMed, MEDLINE, and EMBASE from 2000 to 2018 for studies evaluating the safety and efficacy of percutaneous sclerotherapy for orbital and periorbital vascular malformations. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - August 16, 2019 Category: Opthalmology Authors: Lucio De Maria, Paolo De Sanctis, Megha Tollefson, Samir Mardini, James A. Garrity, Pearse P. Morris, Emily Bendel, Waleed Brinjikji Tags: Major review Source Type: research

Authors ’ Reply
We appreciate the thoughtful comments Dr. Olsen and colleagues on our article “Central retinal artery occlusion – a new, provisional treatment approach”1. We agree that CRAO is a stroke and we emphasize this in our article because we believe it is still not well understood, nor its significance, by many ophthalmologists, emergency physicians, neurologists and generalist s. We also agree that there is no strong evidence based therapy for CRAO; however, despite the recommendation of no ophthalmic treatment by the Preferred Practice Pattern (PPP) covering CRAO5, ophthalmologists worldwide continue to perform...
Source: Survey of Ophthalmology - August 14, 2019 Category: Opthalmology Authors: Argyrios Chronopoulos, James S. Schutz Tags: Letter Source Type: research

Table of Contents
(Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - August 2, 2019 Category: Opthalmology Source Type: research

NSAID-induced corneal melt: Clinical importance, pathogenesis, and risk mitigation
Corneal melt, an ophthalmological condition in which corneal epithelium is lost accompanied by thinning of the corneal stroma, can lead to corneal perforation and cause loss of vision. Corneal melt is the most serious side effect of topical nonsteroidal anti-inflammatory drugs (NSAIDs), one of the topical treatments of ocular inflammation. NSAID-induced corneal melt (NICM), initially doubted, is real, having been reported by multiple groups. NICM is induced by all but one of the approved ocular NSAIDs and occurs usually in patients whose cornea is compromised by ocular surgery, diabetes, or autoimmune diseases. (Source: Su...
Source: Survey of Ophthalmology - July 12, 2019 Category: Opthalmology Authors: Basil Rigas, Wei Huang, Robert Honkanen Tags: Major review Source Type: research

Phototherapeutic Keratectomy
Phototherapeutic keratectomy (PTK) is an excimer laser based surgical procedure widely performed by corneal surgeons for treating anterior corneal stromal pathologies. PTK helps by ablating the corneal stroma, thereby improving corneal clarity and smoothening the surface. Transient discomfort and induced hyperopia from corneal flattening are the immediate post-operative concerns. The long term course is often marked by the recurrence of original corneal pathology and corneal haze formation. PTK, however, allows for repeat stromal ablation for managing recurrences, as the corneal thickness permits, without affecting the out...
Source: Survey of Ophthalmology - July 12, 2019 Category: Opthalmology Authors: Ritu Nagpal, Prafulla K. Maharana, Prakhyat Roop, Somasheila Murthy, Christopher J. Rapuano, Jeewan S. Titiyal, Rasik B. Vajpayee, Namrata Sharma Tags: Diagnostic and surgical techniques Source Type: research

NSAID-induced corneal melt: Clinical importance, pathogenesis and risk mitigation
Corneal melt, an ophthalmological condition in which corneal epithelium is lost accompanied by thinning of the corneal stroma, can lead to corneal perforation and cause loss of vision. Corneal melt is the most serious side effect of topical nonsteroidal anti-inflammatory drugs (NSAIDs), one of the topical treatments of ocular inflammation. NSAID-induced corneal melt (NICM), initially doubted, is real, having been reported by multiple groups. NICM is induced by all but one of the approved ocular NSAIDs and occurs usually in patients whose cornea is compromised by ocular surgery, diabetes, or autoimmune diseases. (Source: Su...
Source: Survey of Ophthalmology - July 12, 2019 Category: Opthalmology Authors: Basil Rigas, Wei Huang, Robert Honkanen Tags: Major review Source Type: research

Authors' response: Povidone-Iodine for the Treatment of Microbial Keratitis
Thank you for your interest in our article. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - July 5, 2019 Category: Opthalmology Authors: Lawson Ung, Paulo J.M. Bispo, Swapna S. Shanbhag, Michael S. Gilmore, James Chodosh Tags: Letter Source Type: research

Authors' Response: Povidone-Iodine for the Treatment of Microbial Keratitisthis
Thank you for your interest in our article. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - July 5, 2019 Category: Opthalmology Authors: Lawson Ung, Paulo JM. Bispo, Swapna S. Shanbhag, Michael S. Gilmore, James Chodosh Tags: Letter Source Type: research

Diagnostic criteria for limbal stem cell deficiency before surgical intervention —A systematic literature review and analysis
An accurate diagnosis of limbal stem cell deficiency (LSCD) is the premise of an appropriate treatment; however, there is no consensus about the diagnostic criteria for LSCD. We performed a systematic literature search of the peer-reviewed articles on PubMed, Medline, and Ovid to investigate how LSCD was diagnosed before surgical intervention. The methods used to diagnose LSCD included clinical presentation, impression cytology, and in  vivo confocal microscopy. Among 131 eligible studies (4054 eyes), 26 studies (459 eyes, 11.3%) did not mention the diagnostic criteria. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - July 2, 2019 Category: Opthalmology Authors: Qihua Le, Tulika Chauhan, Sophie X. Deng Tags: Major review Source Type: research

Diagnosis of orbital mass lesions: clinical, radiological, and pathological recommendations
The orbit can harbor mass lesions of various cellular origins. The symptoms vary considerably according to the nature, location, and extent of the disease and include common signs of proptosis, globe displacement, eyelid swelling, and restricted eye motility. Although radiological imaging tools are improving, with each imaging pattern having its own differential diagnosis, orbital mass lesions often pose a diagnostic challenge. To provide an accurate, specific, and sufficiently comprehensive diagnosis, to optimize clinical management and estimate prognosis, pathological examination of a tissue biopsy is essential. (Source:...
Source: Survey of Ophthalmology - July 2, 2019 Category: Opthalmology Authors: Ilse Mombaerts, Ingvild Ramberg, Sarah E. Coupland, Steffen Heegaard Tags: Major review Source Type: research

Phacoemulsification in review: Optimization of cataract removal in an in  vitro setting
Phacoemulsification, initially used in the late 1960s, continues to be the standard of care for cataract removal. An animal model was developed so that, in a controlled research setting, all the various machines, handpieces, tips, and settings could be investigated. As a general rule, the higher power, vacuum, and aspiration settings lead to optimally efficient phacoemulsification. In addition, both new phacoemulsification platforms and newly developed devices have been shown to improve efficiency. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - July 2, 2019 Category: Opthalmology Authors: Tyler Boulter, Ashlie Bernhisel, Christina Mamalis, Brian Zaugg, William R. Barlow, Randall J. Olson, Jeff H. Pettey Tags: Core competencies in ophthalmology Source Type: research

Diagnostic criteria for limbal stem cell deficiency prior to surgical intervention - A systematic literature review and analysis
An accurate diagnosis of limbal stem cell deficiency (LSCD) is the premise of an appropriate treatment. However, there is no consensus about the diagnostic criteria for LSCD. We performed a systematic literature search of the peer-reviewed articles on PubMed, Medline, and Ovid to investigate how LSCD was diagnosed prior to surgical intervention. The methods used to diagnose LSCD were collected including clinical presentation, impression cytology (IC) and in vivo confocal microscopy (IVCM). Among 131 eligible studies (4054 eyes), 26 studies (459 eyes, 11.3%) did not mention the diagnostic criteria. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - July 2, 2019 Category: Opthalmology Authors: Qihua Le, Tulika Chauhan, Sophie X. Deng Tags: Major review Source Type: research

Diagnosis of Orbital Mass Lesions Clinical, Radiological and Pathological Recommendations
The orbit can harbor mass lesions of various cellular origins. The symptoms vary considerably according to the nature, location, and extent of the disease and include common signs of proptosis, globe displacement, eyelid swelling, and restricted eye motility. Although radiological imaging tools are improving, with each imaging pattern having its own possible differential diagnosis, orbital mass lesions often pose a diagnostic challenge. To provide an accurate, specific, and sufficiently comprehensive diagnosis, in order to optimize clinical management and estimate prognosis, pathological examination of a tissue biopsy is e...
Source: Survey of Ophthalmology - July 2, 2019 Category: Opthalmology Authors: Ilse Mombaerts, Ingvild Ramberg, Sarah E. Coupland, Steffen Heegaard Tags: Major review Source Type: research

Phacoemulsification in review: Optimization of cataract removal in an in vitro setting
Phacoemulsification, initially used in the late 1960s, continues to be the standard of care for cataract removal. An animal model was developed so that, in a controlled research setting, all of the various machines, handpieces, tips and settings could be investigated. As a general rule, the higher power, vacuum and aspiration settings lead to optimally efficient phacoemulsification. In addition, both new phacoemulsification platforms and newly developed devices have been shown to improve efficiency. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - July 2, 2019 Category: Opthalmology Authors: Tyler Boulter, Ashlie Bernhiesel, Christina Mamalis, Brian Zaugg, William R. Barlow, Randall J. Olson, Jeff H. Pettey Tags: Major review Source Type: research

Povidone-iodine can be used in the treatment of microbial keratitis
We have read the article by Ung et al. on the problems related with diagnosis and treatment of microbial keratitis (MK), in which authors elegantly presented difficulties with antibiotic use and the increasing importance of antibiotic resistance.5 We would like to supplement their interesting review with a few comments on the use povidone-iodine (PVI), which is an interesting option in the treatment of ocular surface infections. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - July 2, 2019 Category: Opthalmology Authors: Andrzej Grzybowski, Piotr Kanclerz Tags: Letter Source Type: research

Gun-Related Eye Injuries: A Primer
Gun-related eye injuries are relatively common in the context of gunshot wounds to the head and neck. Many of the fundamental principles of gunshot wound management apply to the care of these patients, but the complex anatomy and functional relationships of the periocular region do pose special challenges. We provide a focused primer for physicians seeking a more in depth understanding of gun related eye injuries and present three representative cases outlining the spectrum of pathology, provide a focused review of the relevant ballistics concepts, and discuss the management of injuries to the periocular soft tissues, orbi...
Source: Survey of Ophthalmology - June 20, 2019 Category: Opthalmology Authors: Benjamin P. Erickson, Paula W. Feng, Marcus J. Ko, Yasha S. Modi, Thomas E. Johnson Tags: Major review Source Type: research

Heritability of glaucoma and glaucoma-related endophenotypes: Systematic review and meta-analysis
We have systematically extracted all available heritability (h2) estimates of glaucoma and related endophenotypes from the literature, and summarize the evidence by meta-analysis.Glaucoma endophenotypes were classified into 10 clusters: intraocular pressure (IOP), anterior chamber size (ACS), central corneal thickness (CCT), cup-to-disc ratio (CDR), disc size (DS), cup size (CS), corneal hysteresis (CH), retinal nerve fiber layer thickness (RNFLT), cup shape (CSH), and peripapillary atrophy (PPA). (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - June 20, 2019 Category: Opthalmology Authors: Nigus Gebremedhin Asefa, Anna Neustaeter, Nomdo M. Jansonius, Harold Snieder Tags: Genetics in Ophthalmology Source Type: research

Critical Review: Typical and Atypical Optic Neuritis
Typical optic neuritis is an idiopathic demyelinating condition that is often associated with multiple sclerosis. This has been well characterized and has an excellent prognosis. Atypical optic neuritis can result from an inflammatory, infectious, or autoimmune disorder. Differentiating the two types of optic neuritis is paramount and may be challenging early on in the clinical course. This review describes the recent literature describing the pathophysiology, clinical presentation, neuroimaging, and management of these disorders. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - June 20, 2019 Category: Opthalmology Authors: Anne Abel, Collin McClelland, Michael S. Lee Tags: Major review Source Type: research

Table of Contents
(Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - June 18, 2019 Category: Opthalmology Source Type: research

A Child With Unilateral Disk Elevation
A healthy 7-year-old girl underwent a routine eye examination and was referred for unilateral, left optic nerve swelling. Best-corrected visual acuity in the affected eye was 20/20 with full Ishihara color plates and no relative afferent pupillary defect. Initial extensive workup was normal for any cause of unilateral disk swelling. When the patient returned a few years later with decreased vision, her optic nerve had developed a thickened, grey-white preretinal tissue with surrounding retinal contraction and a surrounding charcoal grey lesion. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - May 28, 2019 Category: Opthalmology Authors: Danny A. Mammo, Polly A. Quiram, Michael S. Lee, R. Michael Siatkowski Tags: Clinical challenges Source Type: research

Pediatric Intraocular Pressure Measurements: Tonometers, Central Corneal Thickness, and Anesthesia
Measuring intraocular pressure (IOP) is the cornerstone of a comprehensive glaucoma exam. In babies or small children, however, IOP measurements are problematic, cannot often be done at the slit lamp, and are sometimes require general anesthesia. Therefore, it is essential for an ophthalmologist who examines a pediatric patient to be aware of the different tonometers used in children, as well as the effects of central corneal thickness (CCT) and anesthesia on IOP measurements. Goldmann applanation tonometry is the gold standard for IOP assessment. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - May 24, 2019 Category: Opthalmology Authors: Mahmoud Fayed, Teresa C. Chen Tags: Major review Source Type: research

The Sign of the Cross
A 46-year-old man developed acute, painful, transient, right sided, monocular visual loss lasting four hours. This was followed by headache and left sided transient hemiparesis. The association of ipsilateral transient vision loss with transient contralateral hemiparesis implicates involvement of the ipsilateral internal carotid artery (i.e., a crossed symptom). (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - May 23, 2019 Category: Opthalmology Authors: Aryan Pashaei-Marandi, Ashwini Kini, Bayan Al Othman, Andrew G. Lee, Julie Falardeau Tags: Clinical challenges Source Type: research

High-intensity focused ultrasound procedure: The rise of a new noninvasive glaucoma procedure and its possible future applications
Glaucoma, one of the leading causes of blindness, is usually first managed medically, with incisional surgery as a second step. Noninvasive glaucoma procedures attempt to fill the gap between medical and surgical treatments and may work synergistically with them. High-intensity focused ultrasound induces a selective and controlled thermal ablation of the distal part of the ciliary body, and this effect is independent from the degree of tissue pigmentation with limited damage to adjacent structures. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - May 21, 2019 Category: Opthalmology Authors: Chiara Posarelli, Giuseppe Covello, Anna Bendinelli, Paolo Fogagnolo, Marco Nardi, Michele Figus Tags: Diagnostic and surgical techniques Source Type: research

High-Intensity Focused Ultrasound (HIFU) procedure: the rise of a new non-invasive glaucoma procedure and its possible future applications
Glaucoma, one of the leading causes of blindness, is usually first managed medically with incisional surgery as a second step. Noninvasive glaucoma procedures attempt to fill the gap between medical and surgical treatments and may work synergistically with them. High-intensity focused ultrasound induces a selective and controlled thermic ablation of the distal part of the ciliary body, and this effect is independent from the degree of tissue pigmentation with limited damage to adjacent structures. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - May 21, 2019 Category: Opthalmology Authors: Chiara Posarelli, Giuseppe Covello, Anna Bendinelli, Paolo Fogagnolo, Marco Nardi, Michele Figus Tags: Diagnostic and surgical techniques Source Type: research

Surgical Management of Diabetic Tractional Retinal Detachments
Tractional retinal detachment (TRD) is an end-stage form of diabetic retinopathy that occurs when contractile forces in the vitreous and neovascular tissue lead to the detachment of the neurosensory retina. We review the literature related to the management of this disease. Preoperative planning includes appropriate patient selection, diagnostic and prognostic imaging, and medical optimization with reduction of systemic risk factors. Use of anti-vascular endothelial growth factor for preoperative treatment has had significant benefits for TRD repair in improving surgical efficiency and outcomes. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - May 9, 2019 Category: Opthalmology Authors: Siva SR. Iyer, Kathleen A. Regan, Jordan M. Burnham, Ching J. Chen Tags: Major review Source Type: research

Choroidal and retinal thickness in systemic autoimmune and inflammatory diseases: a review
In order to identify the risk of relapse and subclinical inflammatory stages of systemic autoimmune diseases, new tools are needed. In the recent years, choroidal and retinal thickness measured with ocular coherence tomography (OCT) have been proposed as an inflammatory marker for different systemic diseases, especially for conditions with a vascular component.Our aim in this article was to review the literature regarding the role of choroidal and retinal thickness as a potential inflammatory marker in systemic autoimmune and inflammatory diseases measured by OCT. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - April 26, 2019 Category: Opthalmology Authors: Martina Steiner, Maria del Mar Esteban Ortega, Santiago Mu ñoz- Fernández Source Type: research

Ocular Hypotony: A Comprehensive Review
Ocular hypotony is an infrequent, yet potentially vision-threatening, entity. The list of differential causes is extensive, involving any condition that may compromise aqueous humor dynamics or the integrity of the globe and sometimes following medical treatments or procedures. Depending on the cause and the clinical impact, treatment options aim to correct the underlying pathology and to re-establish anatomical integrity, as well as visual function. We review the pathophysiology, clinical presentation, different causes, and associated therapeutic options of ocular hypotony. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - April 25, 2019 Category: Opthalmology Authors: Qianqian Wang, Avrey Thau, Alex V. Levin, Daniel Lee Source Type: research

A lot of nerve
A 71-year-old woman with a history of acute lymphoblastic leukemia presented with unilateral optic disc edema. Laboratory evaluations for infectious, inflammatory and neoplastic etiologies were negative. Magnetic resonance imaging of the orbits with and without contrast demonstrated enhancement and thickening of the right optic nerve with mild stranding of the intraconal fat. She underwent three large volume lumbar punctures which were negative for malignancy. An optic nerve biopsy was ultimately performed, demonstrating malignant cells on immunohistochemical staining. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - April 25, 2019 Category: Opthalmology Authors: Faith A. Birnbaum, Landon C. Meekins, Archana Srinivasan, Ann P. Murchison Tags: Short Reviews Source Type: research

It is not your eyes
A 55-year-old woman reported blurred vision while walking, numbness and tingling, contact allodynia, and gait imbalance. Visual acuity was 20/20 in both eyes, but there was a loss of 4 lines with horizontal dynamic visual acuity testing. Ocular motility examination demonstrated spontaneous downbeat nystagmus that increased in lateral gaze with a torsional component and impaired smooth pursuits. Head impulse test was positive, and electromyography demonstrated a sensory neuropathy/neuronopathy. Vestibular testing confirmed both central ocular motor pathway and bilateral peripheral vestibular system involvement. (Source: Sur...
Source: Survey of Ophthalmology - April 19, 2019 Category: Opthalmology Authors: Devon A. Cohen, M. Tariq Bhatti, John J. Chen, Michelle L. Mauermann, Daniel R. Gold Tags: Clinical challenges Source Type: research

It ’s Not Your Eyes
A 55-year-old woman reported blurred vision while walking, numbness and tingling, contact allodynia, and gait imbalance. Visual acuity was 20/20 in both eyes, but there was a loss of 4 lines with horizontal dynamic visual acuity testing. Ocular motility examination demonstrated spontaneous downbeat nystagmus that increased in lateral gaze with a torsional component and impaired smooth pursuits. Head impulse test was positive, and electromyography demonstrated a sensory neuropathy/neuronopathy. Vestibular testing confirmed both central ocular motor pathway and bilateral peripheral vestibular system involvement. (Source: Sur...
Source: Survey of Ophthalmology - April 19, 2019 Category: Opthalmology Authors: Devon A. Cohen, M. Tariq Bhatti, John J. Chen, Michelle L. Mauermann, Daniel R. Gold Tags: Clinical challenges Source Type: research

Neurothekeoma of the eye, conjunctiva, and periorbital adnexa: A report of two cases and brief review
Neurothekeomas (NTKs) are benign soft tissue tumors most commonly occurring in the head, neck, and upper extremities of young adults, with a female preponderance. Herein, we report 2 cases of ocular NTK presenting as an orbital mass or chalazion. Both cases underwent excision of the mass with histopathologic diagnosis of cellular NTK. Tumor cells for both cases were immunopositive for smooth muscle actin, microphthalmia-associated transcription factor, and cluster of differentiation 10. S100, human melanoma black 45, and melanoma antigen recognized by t-cell (Melan A) were negative. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - April 9, 2019 Category: Opthalmology Authors: Thonnie Rose O. See, Gustav St ålhammar, Hans E. Grossniklaus Tags: Clinical pathologic review Source Type: research

Referral to community care from school-based eye care programs in the United States
Approximately 25% of school-aged children in the United States have vision abnormalities, most commonly refractive error that can be corrected with spectacles. Limited follow-up adherence after failed school-based vision screening led to an increase in school-based eye care programs that provide screening, eye examinations, and spectacle prescription at the school. These programs address the access barrier and often provide the first point of contact between children and eye care. Nevertheless, several lower prevalence conditions, such as amblyopia, strabismus, and glaucoma, cannot be adequately treated in the school setti...
Source: Survey of Ophthalmology - April 9, 2019 Category: Opthalmology Authors: Ahmed F. Shakarchi, Megan E. Collins Source Type: research

Beware of the Sneeze
We report a patient with SMARCB1 (INI-1)-deficient sinonasal carcinoma who had permanent vision loss after valsalva-induced acute hemorrhage and resultant orbital compartment syndrome. (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - April 9, 2019 Category: Opthalmology Authors: Patrick Yang, Chris Toomey, Jonathan Lin, Don O. Kikkawa, Bobby S. Korn, Andrew Harrison Source Type: research

Neurothekeoma of the eye, conjunctiva and periorbital adnexa. Report of two cases and brief review
Neurothekeomas (NTK) are benign soft tissue tumors most commonly occurring in the head, neck and upper extremities of young adults, with a female preponderance. Herein we report 2 cases of ocular NTK presenting as an orbital mass or chalazion. Both cases underwent excision of the mass with histopathologic diagnosis of cellular NTK. Tumor cells for both cases were immunopositive for smooth muscle actin (SMA), microphthalmia-associated transcription factor (MITF) and cluster of differentiation 10 (CD10). (Source: Survey of Ophthalmology)
Source: Survey of Ophthalmology - April 9, 2019 Category: Opthalmology Authors: Thonnie Rose O. See, Gustav St ålhammar, Hans E. Grossniklaus Source Type: research

Seeing is not believing
Alexia without agraphia is an interesting and distinctive visual disconnection syndrome that results from damage to the dominant left occipital lobe and splenium of the corpus callosum. Although the patient can see individual letters (from the intact right occipital cortex), the damage to the corpus callosum results in disconnection of the transmission of information from the intact right occipital lobe to the intact left angular gyrus. This disconnection produces the symptom of alexia without agraphia. In the acute setting, posterior cerebral artery infarct is the most common cause. Prompt recognition of this unique strok...
Source: Survey of Ophthalmology - April 3, 2019 Category: Opthalmology Authors: Zane Foster, Ashwini Kini, Bayan Al Othman, Andrew G. Lee, Michael Vaphiades Tags: Clinical challenges Source Type: research