Srinivas K Rao, Surendra Basti, Amy Lin, Geetha K Iyer, G Seethalakshmi, Dennis S C Lam
{"title":"The itching, burning eye: diagnostic algorithm and management options.","authors":"Srinivas K Rao, Surendra Basti, Amy Lin, Geetha K Iyer, G Seethalakshmi, Dennis S C Lam","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The healthy ocular surface is a complex, composite unit that is essential for patient comfort and visual function. A number of components need to work in an integrated manner to ensure that this is achieved, and a variety of causes can result in the final common symptom complex that can be termed the itching, burning eye. Many of these causes may be due to relatively common and simple issues related to lid disease, allergies, tear dysfunction, excessive computer use, exposure to polluted environment, and convergence problems. However, a smaller group may have potentially more serious pathology due to causes such as underlying immune dysfunction, or tumors; rarely, intraocular conditions and some neurological causes may present with ocular redness and grittiness. Failure or delay in the diagnosis of these latter entities can result in significant morbidity to the eye. This article will clarify issues related to the functioning of the ocular surface, provide a diagnostic algorithm for managing these patients, and discuss the current knowledge in the management of these conditions once they are diagnosed. It is targeted at the practicing ophthalmologist and should help him or her to manage this problem effectively.</p>","PeriodicalId":87396,"journal":{"name":"Comprehensive ophthalmology update","volume":"7 4","pages":"157-67; discussion 169-70"},"PeriodicalIF":0.0,"publicationDate":"2006-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26280314","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}
Jade S Schiffman, Barbara Scherokman, Rosa A Tang, E Ulysses Dorotheo, Pilar Prieto, Joseph Varon
{"title":"Evaluation and treatment of papilledema in pregnancy.","authors":"Jade S Schiffman, Barbara Scherokman, Rosa A Tang, E Ulysses Dorotheo, Pilar Prieto, Joseph Varon","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Papilledema is defined as optic disk edema that is secondary to increased intracranial pressure. During pregnancy, papilledema poses additional diagnostic and therapeutic challenges. As in the nonpregnant patient, the primary goal is to urgently determine the cause of the papilledema followed by implementing appropriate management for life-threatening conditions in a timely fashion while safeguarding the fetus. Papilledema may occur also in conditions that are not life threatening; in either case, papilledema may cause visual failure. We describe the two most common causes of papilledema during pregnancy, idiopathic intracranial hypertension and cerebral venous thrombosis. In the former, there is no threat to life, while in the latter, depending on the extent of the cerebral venous thrombosis, life-threatening medical issues may dominate the picture. In these conditions, attention to the prevention of visual failure is of major importance; however, treatment options may need to be modified to safeguard the developing fetus. In this article, we review the current diagnostic and treatment options for patients with papilledema, emphasizing special considerations for the pregnant patient, including a chart to help the clinician differentiate between the different conditions causing papilledema. A flow chart suggests an approach as to how to monitor vision function and steps to take to prevent visual loss in these conditions causing papilledema. Drugs that may be considered in the management of papilledema are reviewed, and the FDA information regarding their safety for the fetus is provided.</p>","PeriodicalId":87396,"journal":{"name":"Comprehensive ophthalmology update","volume":"7 4","pages":"187-202"},"PeriodicalIF":0.0,"publicationDate":"2006-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26280228","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":"Vitreous floaters.","authors":"E D Roufail, Philip Polkinghorne","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Floaters are a common presenting ophthalmic symptom that may accompany sight-threatening disorders. In most cases, they are often secondary to benign, degenerative changes in the vitreous. In this review, we briefly examine the anatomy of the vitreous and describe how degenerative vitreous change contributes to the development of floaters. The causality of floaters in the presence and absence of a posterior vitreous detachment is reviewed, as is the clinical significance of these symptoms and signs in relation to their predictive value for determining the presence of sight-threatening retinal tears and/or detachment. Finally, a brief review of management options for debilitating floaters is presented.</p>","PeriodicalId":87396,"journal":{"name":"Comprehensive ophthalmology update","volume":"7 4","pages":"171-7"},"PeriodicalIF":0.0,"publicationDate":"2006-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26280316","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":"Proliferative vitreoretinopathy: developments in pathogenesis and treatment.","authors":"Riaz H Y Asaria, David G Charteris","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Proliferative vitreoretinopathy is an abnormal wound-healing response following retinal detachment and occurs in 5% to 10% of cases. It is now possible to treat this once-blinding condition. However, proliferative vitreoretinopathy still remains the most common cause of failure to reattach the retina. Recent work has helped to unravel the causes of proliferative vitreoretinopathy, and new adjuvant treatments are being evaluated to improve the success rate of retinal reattachment surgery, both anatomically and functionally. At present, preventative treatment has only been found to work in high-risk cases. It is hoped that improvement in targeted immunosupression will eventually reduce the incidence of proliferative vitreoretinopathy. At the current time, the management of proliferative vitreoretinopathy still remains a surgical skill.</p>","PeriodicalId":87396,"journal":{"name":"Comprehensive ophthalmology update","volume":"7 4","pages":"179-85"},"PeriodicalIF":0.0,"publicationDate":"2006-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26280225","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}
Anastasios G P Konstas, Sevasti Tsironi, Robert Ritch
{"title":"Current concepts in the pathogenesis and management of exfoliation syndrome and exfoliative glaucoma.","authors":"Anastasios G P Konstas, Sevasti Tsironi, Robert Ritch","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Exfoliative glaucoma is a common, sight-threatening disease that develops as a consequence of exfoliation syndrome. There are important differences in the clinical appearance, course, and prognosis of exfoliative glaucoma versus primary open-angle glaucoma. At the clinical, biochemical, and cellular levels, exfoliative glaucoma is a distinct entity, with an intriguing mechanism of development and numerous systemic manifestations that require further elucidation. The subtlety of clinical signs results in the diagnosis of exfoliative glaucoma often being overlooked and resulting in less-than-ideal management. We provide an overview of recent studies investigating the medical, laser, and surgical therapy of exfoliative glaucoma, with a focus on innovative approaches that may slow the progression of, or even prevent, the development of exfoliation syndrome and exfoliative glaucoma.</p>","PeriodicalId":87396,"journal":{"name":"Comprehensive ophthalmology update","volume":"7 3","pages":"131-41"},"PeriodicalIF":0.0,"publicationDate":"2006-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26174739","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":"Avoiding and managing the dislocated crystalline lens.","authors":"Paul J Dickinson, Craig M Greven","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A major complication of cataract surgery is the posterior dislocation of crystalline lens material, which may lead to poor visual outcomes. Knowledge of preoperative high-risk situations, causes of lens dislocation, and intraoperative warning signs should lead to reduced complications. This update reviews techniques to avoid the dislocated lens, and management options if this complication does occur.</p>","PeriodicalId":87396,"journal":{"name":"Comprehensive ophthalmology update","volume":"7 3","pages":"113-27"},"PeriodicalIF":0.0,"publicationDate":"2006-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26174742","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":"Comments on: Current concepts in the pathogenesis and management of exfoliation syndrome and exfoliative glaucoma.","authors":"Anne M V Brooks","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":87396,"journal":{"name":"Comprehensive ophthalmology update","volume":"7 3","pages":"143-4"},"PeriodicalIF":0.0,"publicationDate":"2006-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26174741","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":"Comments on: Emmetropization in accommodative esotropia: an update and review.","authors":"Merrill Stass-Isern, Scott Olitsky","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":87396,"journal":{"name":"Comprehensive ophthalmology update","volume":"7 3","pages":"151-2"},"PeriodicalIF":0.0,"publicationDate":"2006-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26174744","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":"Emmetropization in accommodative esotropia: an update and review.","authors":"R Scott Lowery, Amy Hutchinson, Scott R Lambert","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Many children with accommodative esotropia are able to successfully discontinue spectacle wear, while others require spectacle correction into adulthood. Parents often ask about the likelihood of glasses being required on a long-term basis and whether use of spectacles will cause dependency. Most infants are hyperopic and gradually become emmetropic. The extent to which accommodation and spectacle use affect this process is still debated. However, certain characteristics, such as degree of hyperopia, can help predict long-term spectacle requirement.</p>","PeriodicalId":87396,"journal":{"name":"Comprehensive ophthalmology update","volume":"7 3","pages":"145-9"},"PeriodicalIF":0.0,"publicationDate":"2006-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26174743","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":"Comments on: Avoiding and managing the dislocated crystalline lens.","authors":"Bhavna P Sheth","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":87396,"journal":{"name":"Comprehensive ophthalmology update","volume":"7 3","pages":"129-30"},"PeriodicalIF":0.0,"publicationDate":"2006-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26174738","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}