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  • Review of Optometry

September/October 2017

Features

Featured Articles

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A Closer Look at Corneal Inlays 9/15/2017

This article focuses on corneal inlays in the marketplace and how they are making a difference in the lives of presbyopic patients.
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Combining Optics and Comfort: Piggyback and Hybrid Lenses 9/15/2017

Although scleral lenses are the new trend, some patients might do better with piggybacking and hybrid contact lenses to improve vision and comfort and maintain long-term corneal health.
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Expand Your Horizons: Think GPs for Presbyopes 9/15/2017

This article reviews multifocal GP lens designs, including new hybrid and scleral multifocal options, and how to best incorporate them in everyday optometric practice.
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Sclerals & GPs: How to Build a Better Lens Fitting Experience 9/15/2017

Scleral and gas permeable contact lenses have opened up a new realm of possibilities to provide patients with improved vision correction and relief for dryness, so it’s no surprise practitioner interest is booming. 
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Starting Up with GPs: Use Your Resources 9/15/2017

Here is a closer look at what’s out there to help practitioners add GP lenses to their repertoires. 


Departments

The GP Experts

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Overcoming GP Lens Obstacles 9/15/2017

Research shows GP lenses can provide superior vision quality compared with soft lenses. Let’s address a few reservations practitioners may have.

The Big Picture

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Crocodile Rock 9/15/2017

An 81-year-old male presented with a 60-year history of aphakia OU secondary to idiopathic crystalline lens dislocations. He was referred over concerns about corneal edema and whether he should discontinue wear of his gas permeable contact lenses. Click below for a closer look at this case. 

Practice Progress

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Three GP Lenses to Grow Your Practice 9/15/2017

When we started out in practice, gas permeable (GP) lenses were a mainstay. Practitioners readily fit everyday patients for them, and both practitioners and patients saw them as normal. However, over the last 10 years, opinions surrounding GP lenses have shifted. For example, many patients and practitioners began to overlook the benefits of GP lenses as a result of the increased availability of soft lenses.

One of the benefits of soft lenses, generally, is near immediate comfort for most patients. GP lenses, meanwhile, have historically been known for exceptional performance in vision. Recently, however, interest in GP lenses has picked back up in the marketplace. Here is an overview of three GP lenses and how they can help dramatically grow your practice in patient loyalty and satisfaction.

Pharma Science & Practice

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Know Your Systemic Drugs 9/15/2017

We are very familiar with the potential of certain oral medications to cause ocular sequelae such as hydroxychloroquine, prednisone, topiramate, tamoxifen and amiodarone. But could lesser-known medications cause ocular side effects? How would you know? Click below for more.

News

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News 9/15/2017

In a recent study, researchers at the University of Illinois at Chicago identified the chief molecule responsible for herpes simplex virus-1 (HSV-1) infection-related corneal inflammation. According to the findings, heparanase, a corneal enzyme that degrades heparan sulfate, becomes significantly upregulated during an HSV-1 infection. As a result, the enzyme triggers inflammation, lasting even after the infection has cleared.

My Perspective

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Report Your Adverse Events to the FDA 9/15/2017

When was the last time you reported a corneal ulcer from lens wear or a severe keratopathy secondary to inadvertent hydrogen peroxide instillation prior to neutralization to the Food and Drug Administration (FDA)? The answer is likely never. Fortunately, sight-threatening experiences in contact lens wearers are relatively rare. But when they do occur, there is little tolerance by the affected patient. This is especially true for family members when the patient is under the age of 18.

For a better assessment of risk, the FDA strongly encourages voluntary reporting by healthcare providers, patients, caregivers and consumers on any significant adverse event or problem with medical products.

Guest Editorial

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FDA Efforts: Patient Perspective on LASIK 9/15/2017

Within the last three decades, the ophthalmic field has made great strides in refractive surgery. Laser in situ keratomileusis (LASIK), for example, accounted for approximately 600,000 surgeries in 2015, with most patients reporting satisfaction following the procedure.

While this surgical intervention generally improves vision, we at the US Food and Drug Administration (FDA) have received reports of some patients experiencing debilitating ocular and visual symptoms—such as dryness and glare—that significantly interfered with their daily functioning following LASIK. In response, the FDA formed a collaborative effort with the National Eye Institute to develop a questionnaire to better measure patient symptoms following LASIK. The LASIK Quality of Life Collaboration Project enlisted the clinical expertise of the Navy Medical Center San Diego and five civilian clinical sites across the United States to evaluate the tool.

Fitting Challenges

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Fitting CLs Post Trabeculectomy 9/15/2017

The number of patients diagnosed with glaucoma is expected to exceed 70 million by 2020. When pharmacological or laser treatments fail to control intraocular pressure, surgical options such as trabeculectomy can be effective. But what happens when these patients need contact lenses? To prevent fibrosis, the conjunctiva above the bleb is usually treated with mitomycin C or 5-FU, both of which can make the conjunctiva thin and more susceptible to infection. Additionally, if soft or rigid lenses induce mechanical trauma to the bleb, they can lead to blebitis or endophthalmitis.

To respect the integrity of the bleb, contact lens practitioners have three options: a soft low modulus lens that vaults the entire bleb, a notched scleral lens or a small, well centered rigid gas permeable lens fit with minimal excursion.

Corneal Consult

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Watch Out for HSV Endotheliitis 9/15/2017

Herpes simplex virus (HSV) can affect the anterior cornea in a wide variety of patterns. Dendritic disease sets up the cornea for the many manifestations of inflammatory herpes stromal keratitis (HSK). However, once dendritic disease has occurred, the posterior cornea may just as easily become involved. The posterior cornea is a big target and its involvement presents so differently from its anterior cornea counterpart that if you only consider HSV keratitis as dendritic keratitis, you may miss the diagnosis of HSV endotheliitis. Here is a closer look at HSV endotheliitis, a clinical entity that may seem completely distinct from dendritic HSV or HSK but often follows similar rules.
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