{"title":"Retinal Pharmacotherapeutics","authors":"J. Reynolds","doi":"10.3368/aoj.66.1.135","DOIUrl":"https://doi.org/10.3368/aoj.66.1.135","url":null,"abstract":"This is one book of the ongoing Developments in Ophthalmology series. This particular volume has five editors and many contributing chapter authors, as is typical. These authors represent a very diverse international group. The book is divided into six groups, four of which contain many chapters. The groups include \"Basic Sciences in the Retina,\" \"Animal Models and Routes for Retinal Drug Delivery,\" \"Retinal Disease Amenable to Pharmacotherapy,\" and \"Drugs and Mechanisms in Retinal Diseases.\" As we know, the practice of retina has undergone a sea change in the last 10 years. The entire field has shifted dramatically toward pharmacologic treatment. Hence, the utility of a book such as this. The reader would expect a very detailed presentation on anti-VEGF agents, and all the options are here. Also covered, as one would expect, are steroids, immuno-suppressives, and antibiotics. But it is the less expected aspects of this book that make it so useful and attractive. The book opens with a basic science section. Anatomy, biochemistry, physiology, pathology, inflammation, angiogenesis, and genetics. These seven chapters give the reader a sound basis for understanding the clinical material that follows. While","PeriodicalId":76599,"journal":{"name":"The American orthoptic journal","volume":"66 1","pages":"135 - 135"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69587303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"High AC/A Ratio Esotropia: Do we Really Need to be Using Bifocals?","authors":"S. Olitsky","doi":"10.3368/aoj.66.1.5","DOIUrl":"https://doi.org/10.3368/aoj.66.1.5","url":null,"abstract":"Introduction and Purpose Most strabismus specialists use bifocals for patients with convergence excess esotropia whose distance deviation is small. While this is a popular treatment modality, there is actually no good data to indicate that this should be considered a standard of care. Patients and Methods In patients for whom the distance deviation is small enough to allow for the development of binocular vision, my preference is to simply observe these patients. Most will improve with time. For those who do not, or who decompensate, surgery may be indicated. Results A careful review of the literature shows a lack of evidence to suggest that bifocals provide an effective treatment for this problem. Some data and theoretical concern may raise a concern over their use. Time and observation may be all that is necessary. There may be a role for surgical correction in these patients as well. Conclusion While there are theoretical advantages to the use of bifocals in patients with convergence excess esotropia, current data does not support the actual need for active treatment of these patients.","PeriodicalId":76599,"journal":{"name":"The American orthoptic journal","volume":"219 1","pages":"10 - 5"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3368/aoj.66.1.5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69588141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Planning Strabismus Surgery: How to Avoid Pitfalls and Complications","authors":"M. Aroichane","doi":"10.3368/aoj.66.1.63","DOIUrl":"https://doi.org/10.3368/aoj.66.1.63","url":null,"abstract":"Background and Purpose Good surgical results following strabismus surgery depend on several factors. In this article, detailed steps for planning strabismus surgery will be reviewed for basic horizontal strabismus surgery, vertical, and oblique muscle surgeries. The thought process behind each case will be presented to help in selecting the best surgical approach to optimize postoperative results. Patients and Method The surgical planning for strabismus will be developed with clinical examples from easy cases to more complex ones. Preoperative pictures of the ocular alignment are an integral part of planning surgery and help in documenting the strabismus before and after surgery. Results Three cases of strabismus cases will be reviewed with several key factors for planning surgery, including visual acuity, refractive error, potential for stereovision, and risk of postoperative diplopia. The most important factor is accurate orthoptic measurements. The surgical planning for each patient is detailed along with preoperative pictures. Conclusion Strabismus surgery results can be improved by careful preoperative planning. The surgeon has the ability to discern potential pitfalls that can alter the surgical outcome. Surgical planning allows a dedicated time of reflection before surgery, foreseeing potential problems, and avoiding them during the surgery.","PeriodicalId":76599,"journal":{"name":"The American orthoptic journal","volume":"66 1","pages":"63 - 78"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3368/aoj.66.1.63","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69588757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Color Atlas of Strabismus Surgery, 4th Edition","authors":"Andrew L. Reynolds","doi":"10.3368/aoj.66.1.136","DOIUrl":"https://doi.org/10.3368/aoj.66.1.136","url":null,"abstract":"The Color Atlas ofStrabismus Surgery, by Kenneth W. Wright and Yi Nig J. Strube, is now in its fourth edition, with the first edition being published 25 years ago. In the preface, the authors state they believe this printing to be the longest running surgical atlas in ophthalmology, and after reading, one can see why. The book is concise yet wide ranging, with ample finely drawn illustrations and actual patient and surgical photos. The book is broken into two main parts, the first third dealing with the diagnosis and management of both routine and complex strabismus. The goal of this text is not to be comprehensive, and thus this section takes an outline approach. It would serve residents and non-pediatric ophthalmologists well as a quick reference in clinic. Inlays within the text also provide clinical examples of patient presentations and questions/answers on management. Although brief, virtually all forms of strabismus are mentioned in this section, including syndromic and traumatic varieties, as well as cranial nerve palsies. The heart, and most useful portion, of the atlas is the surgical technique section, which covers the final two-thirds of the book. Here, richly illustrated diagrams sit side by side by actual surgical photos. Having both a schematic and a meticulously dissected surgical image is invaluable, and indeed is the true strength of this book. Step by step guides are present for nearly all strabismus surgeries, including horizontal recession and resection, as well as","PeriodicalId":76599,"journal":{"name":"The American orthoptic journal","volume":"66 1","pages":"136 - 136"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3368/aoj.66.1.136","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69587647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Binocular Vision in Chronic Fatigue Syndrome","authors":"D. Godts, G. Moorkens, D. Mathysen","doi":"10.3368/aoj.66.1.92","DOIUrl":"https://doi.org/10.3368/aoj.66.1.92","url":null,"abstract":"Introduction and Purpose To compare binocular vision measurements between Chronic Fatigue Syndrome (CFS) patients and healthy controls. Methods Forty-one CFS patients referred by the Reference Centre for Chronic Fatigue Syndrome of the Antwerp University Hospital and forty-one healthy volunteers, matched for age and gender, underwent a complete orthoptic examination. Data of visual acuity, eye position, fusion amplitude, stereopsis, ocular motility, convergence, and accommodation were compared between both groups. Results Patients with CFS showed highly significant smaller fusion amplitudes (P < 0.001), reduced convergence capacity (P < 0.001), and a smaller accommodation range (P < 0.001) compared to the control group. Conclusion In patients with CFS binocular vision, convergence and accommodation should be routinely examined. CFS patients will benefit from reading glasses either with or without prism correction in an earlier stage compared to their healthy peers. Convergence exercises may be beneficial for CFS patients, despite the fact that they might be very tiring. Further research will be necessary to draw conclusions about the efficacy of treatment, especially regarding convergence exercises. To our knowledge, this is the first prospective study evaluating binocular vision in CFS patients.","PeriodicalId":76599,"journal":{"name":"The American orthoptic journal","volume":"66 1","pages":"92 - 97"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3368/aoj.66.1.92","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69588493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Intermittent Exotropia: Characteristics and Overview","authors":"L. Liebermann","doi":"10.3368/aoj.66.1.11","DOIUrl":"https://doi.org/10.3368/aoj.66.1.11","url":null,"abstract":"Intermittent exotropia, an intermittent divergent misalignment, is a common form of childhood strabismus in many populations of the world. Assessing the severity of this condition is challenging due to the variable nature of this disease. Parameters used to measure severity of intermittent exotropia include control, angle, and stereoacuity. The assessment of symptoms and quality of life can also be helpful.","PeriodicalId":76599,"journal":{"name":"The American orthoptic journal","volume":"66 1","pages":"11 - 15"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3368/aoj.66.1.11","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69587208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Accuracy and Efficiency of Orthoptists in Comprehensive Pediatric Eye Examinations","authors":"J. Scheetz, K. Koklanis, M. Long, M. Morris","doi":"10.3368/aoj.66.1.98","DOIUrl":"https://doi.org/10.3368/aoj.66.1.98","url":null,"abstract":"Introduction and Purpose To investigate the level of agreement between orthoptists and medical practitioners in the comprehensive eye examination of children seen in an orthoptist-led triage clinic. Patients and Methods Patient records over a 6-month period were retrospectively reviewed. Those with a presenting complaint related to vision or ocular motility were triaged into the orthoptist-led clinic and included in the study. Patients who did not meet the triage protocol and those who were not assessed by a medical practitioner at a subsequent appointment were excluded from analysis. The clinical findings from the orthoptist and medical practitioner were collected and compared. Results In total, sixty-three patients were reviewed during the 6-month period and met the inclusion criteria. After the initial comprehensive eye examination with an orthoptist, thirty-two were discharged from hospital and thirty-one were asked to return for a review appointment with a medical practitioner. Agreement between the orthoptists and medical practitioners for the diagnosis of strabismus and/or amblyopia was 84.6% (κ = 0.649, P < 0.001). There was strong agreement between orthoptists and medical practitioners for refractive error of the right eye [τ (19) = 0.352, P = 0.729] and left eye [τ (19) = 1.785, P = 0.090]. Fundus examination comparisons between the orthoptists and medical practitioners showed very high agreement (95.7%). Conclusions Orthoptists have the skills necessary to provide comprehensive care of children referred for ocular motility and/or vision related disorders. There was close agreement between orthoptists and medical practitioners when performing comprehensive eye examinations.","PeriodicalId":76599,"journal":{"name":"The American orthoptic journal","volume":"66 1","pages":"106 - 98"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3368/aoj.66.1.98","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69588626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cell-Based Therapy for Retinal Degenerative Disease","authors":"J. Reynolds","doi":"10.3368/AOJ.65.1.128","DOIUrl":"https://doi.org/10.3368/AOJ.65.1.128","url":null,"abstract":"This text is an excellent foundation in an extremely rapidly evolving field: cell therapy for degenerative disease. Medicine has been flirting with regenerative medicine for nearly 50 years. There have been some very limited successes and some dramatic failures. However, it appears that we are on the threshold of true breakthroughs. Regenerative medicine is being pursued on several fronts. Gene therapy focuses on identifying the abnormal gene and working to replace or repair the gene itself, which hopefully will then operate more normally. Cell therapy, on the other hand, seeks to replace damaged or degenerating cells with replacement cells-i.e., cell transplantation. Such replacement therapy has concentrated on stem cells, including embryonic stem cells (as might","PeriodicalId":76599,"journal":{"name":"The American orthoptic journal","volume":"65 1","pages":"128 - 128"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3368/AOJ.65.1.128","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69584658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pediatric Ophthalmology Practice Efficiency: Utilization of Orthoptists as Partners in the Pediatric Eye Care Team","authors":"Aaron M. Miller","doi":"10.3368/aoj.65.1.9","DOIUrl":"https://doi.org/10.3368/aoj.65.1.9","url":null,"abstract":"Background and Purpose The profession of orthoptics has been present for over 100 years and was created as a partnership with pediatric ophthalmology in an effort to provide better strabismus care to children. Orthoptists are known to improve practice efficiency, but to date, no quantitative data has been presented in the literature to support this claim. Proper utilization of an orthoptist is critical to improving practice efficiency and revenue. Methods Over a 6-month period, the financial impact to a pediatric ophthalmology practice by the addition of a second certified orthoptist (CO.) was analyzed. Both indirect and direct income and expenses were considered. Results Despite their increased salary compared to an ophthalmic assistant, the utilization of an orthoptist provides considerable return on investment. The addition of a certified orthoptist increased practice revenue by over $70,000. Conclusion The addition of a certified orthoptist in a physician's practice significantly increases practice revenue generated. When considering models of healthcare within ophthalmology, the use of an orthoptist as a physician extender has been shown to improve practice efficiency in a cost-effective manner.","PeriodicalId":76599,"journal":{"name":"The American orthoptic journal","volume":"65 1","pages":"13 - 9"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3368/aoj.65.1.9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69586572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparing Visual Acuity Measured by Lea Symbols and Patti Pics","authors":"Eric L. Singman, N. Matta, Jing Tian, D. Silbert","doi":"10.3368/aoj.65.1.94","DOIUrl":"https://doi.org/10.3368/aoj.65.1.94","url":null,"abstract":"Introduction There is little data validating most illiterate eye charts. Lea Symbols®, however, have been well validated in numerous studies. In this study, we compare the assessment of visual acuity employing both the Lea Symbol hanging wall Early Treatment Diabetic Retinopathy Study (ETDRS)-style chart and a similar Patti Pics® ETDRS-style chart in order to determine whether the two charts provide clinically similar data. Methods We tested the vision of the right eyes of fifty-two consecutive patients. Patients were cooperative children or adults between the ages of 3 and 88 years (mean 58 years). We alternated the order of the chart used first. Patients were also categorized by age and by visual acuity. Results The visual acuities measured by the two charts were equal for 83% of the measurements (forty-three eyes). In 8% of eyes (four eyes), the visual acuity measured with the Lea Symbols was one line better than that measured by the Patti Pics; in 9% of eyes (five eyes), the acuity from the Patti Pics chart measured one line better than the Lea Symbols. There was no difference in measurements for either adults or children or among patients with different visual acuities. Conclusion We believe this study will serve to provide useful information when choosing an eye chart to assess visual acuity in a clinic setting. Patti Pics performed similarly to Lea Symbols in adults and children tested in a multi-specialty ophthalmology practice. We suspect that it would also perform similarly in the primary care and school settings.","PeriodicalId":76599,"journal":{"name":"The American orthoptic journal","volume":"65 1","pages":"94 - 98"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3368/aoj.65.1.94","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69586685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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