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Drug Mechanisms REVIEW OF OPTOMETRY EARN 2 CE CREDITS: Don’t Be Stumped by These Lumps and Bumps, Page 70 ■ VOL. 154 NO. 4 April 15, 2017 www.reviewofoptometry.com TH ■ 10 ANNUAL APRIL 15, 2017 PHARMACEUTICALS REPORT ■ ANNUAL PHARMACEUTICALS REPORT An Insider’s View of DRUG MECHANISMS ■ CE: DIFFERENTIAL DIAGNOSIS OF EYELID LESIONS CE: DIFFERENTIAL DIAGNOSIS OF EYELID LESIONS You can choose agents with greater precision—and evaluate their performance better—when you know what makes them tick. • How Antibiotics Work—and Why They Sometimes Don’t, Page 30 • Glaucoma Therapy: Finding the Right Combination, Page 46 • Anti-inflammatories: Sort Out Your Many Steroids and NSAIDs, Page 40 • Dry Eye: Master the Science Beneath the Surface, Page 56 • Resist the Itch: Managing Allergic Conjunctivitis, Page 64 001_ro0417_fc.indd 1 4/4/17 2:21 PM . rs ke ee S t S up r po fo rtiv Com e. Nature Lovers. Because I know their eyes are prone to discomfort, I prescribe the 1-DAY ACUVUE® MOIST Family. § 88% of all BLINK STABILIZED® Design contact lenses were fi tted in the fi rst attempt, and 99.5% within 2 trial fittings. ** Based on in vitro data. Clinical studies have not been done directly linking differences in lysozyme profi le with specifi c clinical benefi ts. * UV-blocking percentages are based on an average across the wavelength spectrum. † Helps protect against transmission of harmful UV radiation to the cornea and into the eye. ‡ WARNING: UV-absorbing contact lenses are NOT substitutes for protective UV-absorbing eyewear such as UV-absorbing goggles or sunglasses because they do not completely cover the eye and surrounding area. You should continue to use UV-absorbing eyewear as directed. NOTE:Long- term exposure to UV radiation is one of the risk factors associated with cataracts. Exposure is based on a number of factors such as environmental conditions (altitude, geography, cloud cover) and personal factors (extent and nature of outdoor activities). UV-blocking contact lenses help provide protection against harmful UV radiation. However, clinical studies have not been done to demonstrate that wearing UV-blocking contact lenses reduces the risk of developing cataracts or other eye disorders. Consult your eye care practitioner for more information. 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Optical Design Competitive For illustrative purposes only. lens designs: fi xed optical design 1-DAY ACUVUE® MOIST for ASTIGMATISM POWERED DESIGN • BLINK STABILIZED™ Design harnesses the natural power of a blinking eye, delivering exceptional stability and clear vision for astigmatic patients. • First fi t success—nearly 90% of the time§ BLINK STABILIZED® DESIGN for more information visit acuvueprofessional.com The #1 prescribed daily disposable around the world now satisfies a broader range of patients—available in Sphere, Toric and Multifocal ACUVUE® Brand Contact Lenses are indicated for vision correction. As with any contact lens, eye problems, including corneal ulcers, can develop. Some wearers may experience mild irritation, itching or discomfort. Lenses should not be prescribed if patients have any eye infection, or experience eye discomfort, excessive tearing, vision changes, redness or other eye problems. Consult the package insert for complete information. Complete information is also available by visiting acuvueprofessional.com, or by calling Johnson & Johnson Vision Care, Inc. at 1-800-843-2020. Reference: 1. Suwala M, Glasier MA, Subbaraman LN, et al. Quantity and conformation of lysozyme deposited on conventional and silicone hydrogel contact lens materials using an in vitro model. Eye Contact Lens. 2007;33(3):138-143. ACUVUE®, 1-DAY ACUVUE® MOIST, EYE-INSPIRED™, LACREON®, and INFINITY EDGE™ are trademarks of Johnson & Johnson Vision Care, Inc. © Johnson & Johnson Vision Care, Inc. 2016 10444415E January 2016 RO0417_Vistakon Moist.indd 3 3/23/17 11:07 AM News Review VOL. 154 NO. 4 ■ APRIL 15, 2017 IN THE NEWS Stress and AMD: North Carolina Senator Danny Britt recently introduced a bill requesting $2.1 Recognize the Link million for the creation of a new school of optometry at the University of North New research suggests ODs should be looking at more Carolina at Pembroke. With no other schools of optometry in the state (the than a patient’s visual acuity and ocular anatomy. closest being the University of Alabama at By Rebecca Hepp, Managing Editor Birmingham School of Optometry), Sen. Britt believes the legislative environment ll clinicians know the Photo: Julie Poteet, OD is favorable for such a project, and his importance of moni- district would benefi t from the new Atoring patients with school, according to a press release. age-related macular degen- eration (AMD) for disease Researchers recently discovered progress. What fewer think that using SD-OCT to noninvasively about is keeping an eye on measure the peripapillary retinal patients’ psychological sta- structure may be a better way to tus. One research team at the measure intracranial pressure in children. Ohio State University Col- SD-OCT parameters outperformed lege of Optometry sought to other conventional clinical measures, better understand how stress suggesting it is an effective surrogate levels for patients with AMD for invasive techniques currently could affect their health employed. Detecting elevated intracranial status. But fi rst, they had to AMD patients require education about influences pressure in children helps ensure timely prove the best method for on their ocular status, and that includes stress. intervention and prevent neurocognitive monitoring patient stress in impairment, the study said. this population. from interventions for managing Swanson JW, Aleman TS, Xu W. Evaluation of optical The researchers used the Per- stress,” says Bradley E. Dougherty, coherence tomography to detect elevated intracranial pressure in children. JAMA Ophthalmol. February 23, ceived Stress Scale (PSS) with 137 OD, PhD, assistant professor at 2017. [Epub]. patients with AMD and found it the Ohio State University College New research suggests larger eyes and is a useful method of evaluating of Optometry and study author. better eyesight in air vs. water were key the connection between patient “While it may not be commonly to life’s transition from ocean to land, stress and vision loss associated considered, as it’s not directly and even consciousness, according to with AMD. Using Rasch analy- related to the eye, the identifi ca- a recent study. Eyes tripled in size and sis to discover how well the PSS tion and management of perceived shifted from the sides to the top of the measured perceived stress, the stress should be thought of as head long before fi sh modifi ed their fi ns study authors found nine of the important to the complete care of into limbs, researchers found. The com- 10 questions commonly used for the patient. Stress has a negative bination of the increase in eye size and the PSS performed well with the effect on patients’ overall quality vision through air would have conferred study participants and were able of life.” a one million-fold increase in the amount to differentiate between patients According to the authors, AMD of space within which objects could be seen, according to the researchers. with higher vs. lower levels of patients are known for their perceived stress. increased rates of psychological Maclver MA, Schmitz L, Mugan U, et al. Massive “Understanding a patient’s level symptoms. In addition, previ- increase in visual range preceded the origin of terrestrial vertebrates. PNAS. March 7, 2017. [Epub]. of perceived stress could help ous research shows PSS scores identify those who would benefi t (continued on page 9) 4 REVIEW OF OPTOMETRY APRIL 15, 2017 004_ro0417_news.indd 4 4/3/17 2:48 PM Tonometry Done Right D-KAT Digital Keeler quality. SPECIAL OFFER Intellipuff The standard for hand held mobility. Trade in any Tonometer from SPECIAL July 1, 2016 and OFFER Receive $600 Off the Purchase of a Pulsair Desktop Pulsair Intellipuff Smallest footprint and simple to use! Purchase a Pulsair Desktop from July 1, 2016 and get a $1,300 Instant Rebate! Buy Online! Keeler Instruments, Inc. 456 Parkway • Broomall, PA 19008 Keelerusa.com Tel: (800) 523-5620 • Fax: (610) 353-7814 email: [email protected] Learn more at www.keelerusa.com RO0716_Keeler Tono.indd 1 6/30/16 10:51 AM News Review Old Drug Shows Promise for Retinal Disease he breast cancer drug treated mice also demonstrated tients receiving a similar dose,” says tamoxifen appears to protect higher photoreceptor function, Dr. Ferrucci.3,4 against photoreceptor de- compared with controls, according In this case, it may be useful in T 1,2 generation, according scientists at to the study. certain diseases such as AMD and the National Eye Institute (NEI). “What’s interesting is that RP, says Dr. Ferrucci. “Certainly The drug prevented
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