Refractive Errors a Closer Look
Total Page:16
File Type:pdf, Size:1020Kb
Load more
Recommended publications
-
History of Refractive Surgery
History of Refractive Surgery Refractive surgery corrects common vision problems by reshaping the cornea, the eye’s outermost layer, to bend light rays to focus on the retina, reducing an individual’s dependence on eye glasses or contact lenses.1 LASIK, or laser-assisted in situ keratomileusis, is the most commonly performed refractive surgery to treat myopia, hyperopia and astigmatism.1 The first refractive surgeries were said to be the removal of cataracts – the clouding of the lens in the eye – in ancient Greece.2 1850s The first lensectomy is performed to remove the lens 1996 Clinical trials for LASIK begin and are approved by the of the eye to correct myopia.2 Food & Drug Administration (FDA).3 Late 19th 2 Abott Medical Optics receives FDA approval for the first Century The first surgery to correct astigmatism takes place. 2001 femtosecond laser, the IntraLase® FS Laser.3 The laser is used to create a circular, hinged flap in the cornea, which allows the surgeon access to the tissue affecting the eye’s 1978 Radial Keratotomy is introduced by Svyatoslov Fyodorov shape.1 in the U.S. The procedure involves making a number of incisions in the cornea to change its shape and 2002 The STAR S4 IR® Laser is introduced. The X generation is correct refractive errors, such as myopia, hyperopia used in LASIK procedures today.4 and astigmatism.2,3 1970s Samuel Blum, Rangaswamy Srinivasan and James J. Wynne 2003 The FDA approves the use of wavefront technology,3 invent the excimer laser at the IBM Thomas J. Watson which creates a 3-D map of the eye to measure 1980s Research Center in Yorktown, New York. -
Binocular Vision Disorders Prescribing Guidelines
Prescribing for Preverbal Children Valerie M. Kattouf O.D. FAAO, FCOVD Illinois College of Optometry Associate Professor Prescribing for Preverbal Children Issues to consider: Age Visual Function Refractive Error Norms Amblyogenic Risk Factors Birth History Family History Developmental History Emmetropization A process presumed to be operative in producing a greater frequency of occurrence of emmetropia than would be expected in terms of chance distribution, as may be explained by postulating that a mechanism coordinates the formation and the development of the various components of the human eye which contribute to the total refractive power Emmetropization Passive process = nature and genetics 60% chance of myopia if 2 parents myopic (Ciuffrieda) Active process = mediated by blur and visual system compensates for blur Refractive Error Norms Highest rate of emmetropization – 1st 12-17 months Hyperopia Average refractive error in infants = +2 D > 1.50 diopters hyperopia at 5 years old – often remain hyperopic Refractive Error Norms Myopia 25% of infants are myopic Myopic Newborns (Scharf) @ 7 years 54% still myopic @ 7 years 46% emmetropic @ 7 years no hyperopia Refractive Error Norms Astigmatism Against the rule astigmatism more prevalent switches to with-the-rule with development At 3 1/2 years old astigmatism is at adult levels INFANT REFRACTION NORMS AGE SPHERE CYL 0-1mo -0.90+/-3.17 -2.02+/-1.43 2-3mo -0.47+/-2.28 -2.02+/-1.17 4-6mo -0.00+/-1.31 -2.20+/-1.15 6-9mo +0.50+/-0.99 -2.20+/-1.15 9-12mo +0.60+/-1.30 -1.64+/-0.62 -
Refractive Error Changes in Cortical, Nuclear and Posterior Subcapsular Cataracts
1524 Refractive error changes in cortical, nuclear and posterior subcapsular cataracts. D.B. Elliott & K. Pesudovs . Department of Optometry, University of Bradford, Bradford, United Kingdom.. Purpose • To determine the effect of the three main morphological types of age-related cataract on refractive error. Background • The increase in myopia in some patients with age-related nuclear cataract is well known (Brown & Hill, 1987). This change accounts for the “second sight of the elderly” in which the myopic shift provides normal reading ability without the need for spectacles. Distance vision, however, worsens. • Planter (1981) suggested that cortical opacity can induce hyperopic shifts. However, this claim has not been repeated since and no firm evidence is available. • Review papers suggest that cortical opacity can induce astigmatic changes (Brown, 1993). However, these reports were based on clinical impression with no supporting data. • . The prevalence of uncorrected refractive error in the elderly population is high (Wormald et al., 1992). It is likely that a reasonable proportion of these patients have refractive error changes induced by cataract. • It has been suggested that a delay in operating on age-related cataract of 10 years could reduce the number of patients requiring cataract surgery (Kupfer, 1985). The possible role of correcting cataract-induced refractive error to delay the need for surgery should be explored. Subjects • 98 elderly subjects (mean age 67 ± 8 years) were recruited. • 77 subjects had one type of morphological cataract: 34 subjects had cortical cataract, 21 had nuclear cataract and 21 had posterior subcapsular cataract (PSC). • 22 subjects had normal, healthy eyes. • Ocular screening excluded amblyopia, strabismus, eye disease or surgery. -
Ocular Surface Changes Associated with Ophthalmic Surgery
Journal of Clinical Medicine Review Ocular Surface Changes Associated with Ophthalmic Surgery Lina Mikalauskiene 1, Andrzej Grzybowski 2,3 and Reda Zemaitiene 1,* 1 Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, 44037 Kaunas, Lithuania; [email protected] 2 Department of Ophthalmology, University of Warmia and Mazury, 10719 Olsztyn, Poland; [email protected] 3 Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, 61553 Poznan, Poland * Correspondence: [email protected] Abstract: Dry eye disease causes ocular discomfort and visual disturbances. Older adults are at a higher risk of developing dry eye disease as well as needing for ophthalmic surgery. Anterior segment surgery may induce or worsen existing dry eye symptoms usually for a short-term period. Despite good visual outcomes, ocular surface dysfunction can significantly affect quality of life and, therefore, lower a patient’s satisfaction with ophthalmic surgery. Preoperative dry eye disease, factors during surgery and postoperative treatment may all contribute to ocular surface dysfunction and its severity. We reviewed relevant articles from 2010 through to 2021 using keywords “cataract surgery”, ”phacoemulsification”, ”refractive surgery”, ”trabeculectomy”, ”vitrectomy” in combina- tion with ”ocular surface dysfunction”, “dry eye disease”, and analyzed studies on dry eye disease pathophysiology and the impact of anterior segment surgery on the ocular surface. Keywords: dry eye disease; ocular surface dysfunction; cataract surgery; phacoemulsification; refractive surgery; trabeculectomy; vitrectomy Citation: Mikalauskiene, L.; Grzybowski, A.; Zemaitiene, R. Ocular Surface Changes Associated with Ophthalmic Surgery. J. Clin. 1. Introduction Med. 2021, 10, 1642. https://doi.org/ 10.3390/jcm10081642 Dry eye disease (DED) is a common condition, which usually causes discomfort, but it can also be an origin of ocular pain and visual disturbances. -
Refractive Surgery Faqs. Refractive Surgery the OD's Role in Refractive
9/18/2013 Refractive Surgery Refractive Surgery FAQs. Help your doctor with refractive surgery patient education Corneal Intraocular Bill Tullo, OD, FAAO, LASIK Phakic IOL Verisys Diplomate Surface Ablation Vice-President of Visian PRK Clinical Services LASEK CLE – Clear Lens Extraction TLC Laser Eye Centers Epi-LASIK Cataract Surgery AK - Femto Toric IOL Multifocal IOL ICRS - Intacs Accommodative IOL Femtosecond Assisted Inlays Kamra The OD’s role in Refractive Surgery Refractive Error Determine the patient’s interest Myopia Make the patient aware of your ability to co-manage surgery Astigmatism Discuss advancements in the field Hyperopia Outline expectations Presbyopia/monovision Presbyopia Enhancements Risks Make a recommendation Manage post-op care and expectations Myopia Myopic Astigmatism FDA Approval Common Use FDA Approval Common Use LASIK: 1D – 14D LASIK: 1D – 8D LASIK: -0.25D – -6D LASIK: -0.25D – -3.50D PRK: 1D – 13D PRK: 1D – 6D PRK: -0.25D – -6D PRK: -0.25D – -3.50D Intacs: 1D- 3D Intacs: 1D- 3D Intacs NONE Intacs: NONE P-IOL: 3D- 20D P-IOL: 8D- 20D P-IOL: NONE P-IOL: NONE CLE/CAT: any CLE/CAT: any CLE/CAT: -0.75D - -3D CLE/CAT: -0.75D - -3D 1 9/18/2013 Hyperopia Hyperopic Astigmatism FDA Approval Common Use FDA Approval Common Use LASIK: 0.25D – 6D LASIK: 0.25D – 4D LASIK: 0.25D – 6D LASIK: 0.25D – 4D PRK: 0.25D – 6D PRK: 0.25D – 4D PRK: 0.25D – 6D PRK: 0.25D – 4D Intacs: NONE Intacs: NONE Intacs: NONE Intacs: NONE P-IOL: NONE P-IOL: NONE P-IOL: NONE P-IOL: -
Fact Sheet: Refractive Errors
Fact Sheet: Refractive Errors More than 11 million Americans have common vision problems that can be corrected with the use of prescriptive eyewear such as glasses or contact lenses.1 These conditions are known as refractive errors and they occur when the eye doesn’t correctly bend, or ―refract,‖ light as it enters the eye. Common refractive errors include the following: o Nearsightedness (also called myopia)—A condition where objects up close appear clearly, while objects far away appear blurry. With nearsightedness, light comes to focus in front of the retina instead of on the retina. o Farsightedness (also called hyperopia)—A common type of refractive error where distant objects may be seen more clearly than objects that are near. However, people experience farsightedness differently. Some people may not notice any problems with their vision, especially when they are young. For people with significant farsightedness, vision can be blurry for objects at any distance, near or far. o Astigmatism—A condition in which the eye does not focus light evenly onto the retina, the light-sensitive tissue at the back of the eye. This can cause images to appear blurry and stretched out. o Presbyopia—An age-related condition in which the ability to focus up close becomes more difficult. As the eye ages, the lens can no longer change shape enough to allow the eye to focus close objects clearly. Refractive errors are one of the most common—and correctable—causes of visual impairment in the United States. According to a recent study led by the National Eye Institute (NEI), approximately half of all American adults don’t have the 20/20 vision physicians consider optimal due to refractive errors.2 Women experience refractive error more frequently than men: Twenty-six percent more women aged 12 and older have uncorrected visual impairment due to refractive error compared with men aged 12 and older. -
Hyperopia Hyperopia
Hyperopia Hyperopia hyperopia hyperopia • Farsightedness, or hyperopia, • Farsightedness occurs if your eyeball is too as it is medically termed, is a short or the cornea has too little curvature, so vision condition in which distant objects are usually light entering your eye is not focused correctly. seen clearly, but close ones do • Its effect varies greatly, depending on the not come into proper focus. magnitude of hyperopia, the age of the individual, • Approximately 25% of the the status of the accommodative and general population is hyperopic (a person having hyperopia). convergence system, and the demands placed on the visual system. By Judith Lee and Gretchyn Bailey; reviewed by Dr. Vance Thompson; Flash illustration by Stephen Bagi 1. Cornea is too flap. hyperopia • In theory, hyperopia is the inability to focus and see the close objects clearly, but in practice many young hyperopics can compensate the weakness of their focusing ability by excessive use of the accommodation functions of their eyes. Hyperopia is a refractive error in • But older hyperopics are not as lucky as them. By which parallel rays of light aging, accommodation range diminishes and for 2. Axial is too short. entering the eye reach a focal older hyperopics seeing close objects becomes point behind the plane of the retina, while accommodation an impossible mission. is maintained in a state of relaxation. 1 Amplitude of Accommodation hyperopia Maximum Amplitude= 25-0.4(age) • An emmetropic eye for reading and other near Probable Amplitude= 18.5-.3(age) work, at distance of 16 in (40cm), the required amount of acc. -
Laser Vision Correction Surgery
Patient Information Laser Vision Correction 1 Contents What is Laser Vision Correction? 3 What are the benefits? 3 Who is suitable for laser vision correction? 4 What are the alternatives? 5 Vision correction surgery alternatives 5 Alternative laser procedures 5 Continuing in glasses or contact lenses 5 How is Laser Vision Correction performed? 6 LASIK 6 Surface laser treatments 6 SMILE 6 What are the risks? 7 Loss of vision 7 Additional surgery 7 Risks of contact lens wear 7 What are the side effects? 8 Vision 8 Eye comfort 8 Eye Appearance 8 Will laser vision correction affect my future eye health care? 8 How can I reduce the risk of problems? 9 How much does laser vision correction cost? 9 2 What is Laser Vision Correction? Modern surgical lasers are able to alter the curvature and focusing power of the front surface of the eye (the cornea) very accurately to correct short sight (myopia), long sight (hyperopia), and astigmatism. Three types of procedure are commonly used in If you are suitable for laser vision correction, your the UK: LASIK, surface laser treatments (PRK, surgeon will discuss which type of procedure is the LASEK, TransPRK) and SMILE. Risks and benefits are best option for you. similar, and all these procedures normally produce very good results in the right patients. Differences between these laser vision correction procedures are explained below. What are the benefits? For most patients, vision after laser correction is similar to vision in contact lenses before surgery, without the potential discomfort and limitations on activity. Glasses may still be required for some activities after Short sight and astigmatism normally stabilize in treatment, particularly for reading in older patients. -
Myopia: More Than a Refractive Error − Lasik and Retinal Dystrophies
MYOPIA: MORE THAN A REFRACTIVE ERROR − LASIK AND RETINAL DYSTROPHIES WALRAEDT S.1*, LEROY B.P.1,2*, KESTELYN P.H.1, DE LAEY J.J.1 SUMMARY SAMENVATTING Three patients who had undergone laser in situ Drie patiënten die een correctie van myopie hadden keratomileusis (LASIK) correction for myopia were ondergaan met laser in situ keratomileusis (LASIK) first seen because of suboptimal visual acuity (VA) werden onderzocht omwille van postoperatieve sub- and night blindness and/or photophobia. After a com- optimale visus en nachtblindheid en/of fotofobie. Na prehensive examination including psychophysical uitgebreid onderzoek met inbegrip van psychofysi- and electrophysiological tests, two of the three pa- sche en electrofysiologische testen werd een dia- tients were shown to suffer from a progressive cone- gnose van progressieve kegeltjes-staafjesdystrofie ge- rod dystrophy. The third patient had retinitis pig- steld bij twee patiënten. De derde patiënt leed aan mentosa. These cases illustrate the need for in depth retinitis pigmentosa. Deze gevallen illustreren de preoperative evaluation in myopic patients about to noodzaak van een doorgedreven preoperatief onder- undergo LASIK when signs or problems of night blind- zoek bij myope patiënten die LASIK zullen onder- ness and/or photophobia are present. gaan met klachten van nachtblindheid en fotofobie. KEY WORDS RÉSUMÉ Retinal dystrophy, cone-rod dystrophy, Trois patients sont présentés ayant été examinés pour retinitis pigmentosa, photophobia, night une acuité visuelle sous-optimale et une héméralo- blindness, laser in situ keratomileusis, pie et/ou photophobie, après correction d’une myo- preoperative evaluation pie suivant la technique du laser in situ keratomi- leusis (LASIK). Sur base d’une évaluation élaborée, MOTS-CLÉS y inclus des tests psychophysiques et éléctrophysio- logiques, un diagnostic de dystrophie des cônes et Dystrophie rétinienne, dystrophie de type bâtonnets a été établi chez deux patients. -
Management Modalities for Keratoconus an Overview of Noninterventional and Interventional Treatments
REFRACTIVE SURGERY FEATURE STORY EXCLUSIVE ONLINE CONTENT AVAILABLE Management Modalities for Keratoconus An overview of noninterventional and interventional treatments. BY MAZEN M. SINJAB, MD, PHD anagement of keratoconus has advanced TAKE-HOME MESSAGE during the past few years, and surgeons can • When evaluating patients with keratoconus, ask now choose among numerous traditional and them to stop using RGP contact lenses at least 2 modern treatments. Traditional modalities weeks before evaluation to achieve correct Msuch as spectacle correction, contact lenses, penetrating measurement of the corneal shape. keratoplasty (PKP), and conductive keratoplasty (CK) • Interventional management modalities include CK, are still effective; however, demand for the last two has PKP, DALK, ICRSs, CXL, phakic IOLs, or some decreased with the advent of modern alternatives, specifi- combination of these treatments. cally intrastromal corneal ring segments (ICRSs) and cor- • Making the right management decision depends neal collagen crosslinking (CXL). Caution should be used on the patient’s corneal transparency and stress when considering these newer treatment modalities, and lines, age, progression, contact lens tolerance, surgeons should be aware of their indications, contraindi- refractive error, UCVA and BCVA, K-max, corneal cations, conditions, and complications before proceeding thickness, and sex. with treatment. Keratoconus treatments can be divided into two cate- Some patients achieve good vision correction and comfort gories, interventional and noninterventional. In this article, with this strategy. particular attention is given to ICRSs and CXL, as they are Advances in lens designs and materials have increased the the most popular emerging interventional management proportion of keratoconus patients who can be fitted with modalities for keratoconus. -
Managing a Patient with Post-Radial Keratotomy and Sjogren's Syndrome with Scleral Contact Lenses
Managing a patient with Post-Radial Keratotomy and Sjogren's Syndrome with Scleral Contact Lenses Case Report 1 Candidate #123 Abstract: Surgeons used radial keratotomy (RK) in the past as an attempt to flatten the corneal shape and reduce refractive myopia in a patient. In the present day, many post-RK patients suffer from poor, fluctuating vision due to an irregular corneal shape induced from this procedure. Rigid gas permeable lenses, such as scleral lenses, are an excellent solution to improve and stabilize vision. Scleral lenses help recreate an optimal refractive surface to enhance vision for the patient. Patients with specific dry eye symptoms can receive a therapeutic benefit from scleral lens use as the lens acts as a protective barrier for corneal hydration. This is a case report on a patient suffering from both ocular and systemic conditions resulting in decreased vision and discomfort from severe dry eye. She has been successfully fit with scleral lenses to improve signs and symptoms. Key Words: Radial keratotomy (RK), dry eye, Sjogren's syndrome, scleral lens 2300 East Campbell Avenue, Unit 316 Phoenix, AZ 85016 [email protected] (480) 815-4135 1 Introduction: Patients may present to their eye care provider with multiple conditions impacting 2 both their ocular and systemic health. Ocular comorbidities frequently lead to visual impairment 3 and decreased quality of life. To suitably manage these coinciding ailments, it is essential to 4 obtain an early and proper diagnosis. [1] In some instances, similar approaches can help alleviate 5 patient symptoms in managing these comorbidities. 6 7 The goal of refractive surgery is to eliminate the dependency on glasses and contact lenses. -
Scleral Lenses to Manage Dry Eye Symptoms
Contact us today Scleral Lens for Management of to learn how scleral lenses Dry Eye Symptoms can make a difference in your life. Affix your practice address label here. Scleral lens vaulting the cornea, maintaining a cushion of tears. Blanchard Contact Lenses supplies the specialty GP lens industry with leading lens designs of the highest quality. Our mission is to consistently design and develop innovative specialty GP lenses utilizing cutting edge manufacturing methods, while maintaining unique partnerships with eye care professionals to improve all aspects of the contact lens wearer experience. Scleral Lenses for the Management of Dry Eye Symptoms Chronic Dry Eye Disorders Dry eye can occur or be caused by How msd™ and Onefit™ Scleral Lenses Work According to a consumer survey1, many conditions. Some are: 48% of adults report dry eye msd™ and Onefit™ scleral lenses are • Age related symptoms. Of those, 42% have made of materials that let oXygen pass • Gender (occurs more with women) trouble reading print as a result of dry through the lens promoting long term eye. Nineteen percent report using • Medications and/or medical conditions cornel health and comfort. The lens over the counter drops to help with • Environmental conditions design provides a thin cushion of fluid the condition, but two thirds of those • Post Refractive Surgery (LASIK and that stays between the lens and eye who use drops find that they are not msd™ Mini-Scleral Lens RK), post-surgery, or post-injury providing immediate relief of dry eye comfortably fit to eye. effective. symptoms and long term wearing Patients with dry eye symptoms may comfort.