The Eyes Have It! Update on Common Conditions Affecting the Eye
Total Page：16
File Type：pdf, Size：1020Kb
Load more
Recommended publications
-
Simbrinza BID Adjunctive to PGA Additive Effect of Twice Daily
Alcon - Business Use Only Effective Date: 30-Mar-2017 Document: TDOC-0050474 Version: 3.0; Most-Recent; Effective; CURRENT Status: Effective Page 1 of 66 a Novartis company Short Title Simbrinza BID Adjunctive to PGA Long Title Additive Effect of Twice Daily Brinzolamide 1% /Brimonidine 0.2% Fixed Dose Combination as an Adjunctive Therapy to a Prostaglandin Analogue TDOC-0050474 Version 1.0 replaces TDOC-0018786 Version 1.0 (11-Mar-2015) Protocol Number: GLH694-P001 / NCT02419508 Study Phase: 4 Sponsor Name and Alcon Research, Ltd. Address: 6201 South Freeway Fort Worth, Texas 76134-2099 Investigational Product: SIMBRINZA™ Brinzolamide 1%/Brimonidine 0.2% tartrate ophthalmic suspension US IND# / EudraCT 2015-000736-15 Indication Studied: Ocular Hypertension Open Angle Glaucoma Printed By : Print Date: Alcon - Business Use Only Effective Date: 30-Mar-2017 Document: TDOC-0050474 Version: 3.0; Most-Recent; Effective; CURRENT Status: Effective Page 2 of 66 Investigator Agreement: I have read the clinical study described herein, recognize its confidentiality, and agree to conduct the described trial in compliance with Good Clinical Practices (GCP), the ethical principles contained within the Declaration of Helsinki, this protocol, and all applicable regulatory requirements. Additionally, I will comply with all procedures for data recording and reporting, will permit monitoring, auditing, and inspection of my research center, and will retain all records until notified by the Sponsor. Principal Investigator: Signature Date Name: Address: Printed By : Print Date: Alcon - Business Use Only Effective Date: 30-Mar-2017 Document: TDOC-0050474 Version: 3.0; Most-Recent; Effective; CURRENT Status: Effective Page 3 of 66 1 SYNOPSIS Sponsor: Alcon Research, Ltd. -
RFT List.Xlsx
RFT/Posters Last updated: May 7, 2019 RFT/Posters Session 2 Abstract Title Outcomes of Voretigene Neparvovec-rzyl for Leber Congenital Aaron Nagiel Amaurosis in Eleven Patients: The CHLA Experience AAV2/4-RS1 gene therapy in the retinoschisin knockout mouse Brittni Scruggs model of X-linked retinoschisis Fluorescence Lifetime Imaging Ophthalmoscopy (FLIO) in X-linked Alexandria Vitale retinoschisis RFT/Posters Session 3 Rajvardhan Azad Modified Staging System for FEVR Optical Coherence Tomography Measurements of Retinal and Nikisha Kothari Choroidal Thickness In Preterm Infants The Clinical course and progression of incontinentia pigmenti Charles Calvo retinopathy in treated and untreated patients RFT/Posters Session 7 Omar Moinuddin Patient Outcomes in Coats'-like Retinitis Pigmentosa Andrew Tsai Coats like response in Retinitis Pigmentosa Surgical Management of Advanced Coats' Disease - From Lauren Wright Beginning to End Effect of anti-VEGF therapy on persistent vascular leakage and Irina de la Huerta neovascularization in familial exudative vitreoretinopathy Rapid fire presentation A ROP Expert Confidence in Determining Plus Disease in Borderline Agnieshka Baumritter Images Mike Gaynon Prethreshold ROP - VEGF Inhibition Without VEGF Inhibitors Pre-treatment vs. Post-Treatment Optical Coherence Tomographic Robert Gunzenhauser Angiography in children with strabismic and anisometropic amblyopia. Progression from Pre-Plus Disease to Plus Disease in the G-ROP Alomi Parikh Study Practice patterns changes in the treatment of retinopathy -
HHS Public Access Author Manuscript
HHS Public Access Author manuscript Author Manuscript Author ManuscriptOphthalmology Author Manuscript. Author Author Manuscript manuscript; available in PMC 2016 December 01. Published in final edited form as: Ophthalmology. 2015 December ; 122(12): 2373–2379. doi:10.1016/j.ophtha.2015.06.013. Ability of bottle cap color to facilitate accurate glaucoma patient- physician communication regarding medication identity Pujan Dave, BA1, Guadalupe Villarreal Jr., MD1, David S. Friedman, MD, PhD1, Malik Y. Kahook, MD2, and Pradeep Y. Ramulu, MD, PhD1 1Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland 2Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado Abstract Objective—To determine the accuracy of patient-physician communication regarding topical ophthalmic medication use based on bottle cap color, particularly amongst individuals who may have acquired color vision deficiency from glaucoma. Design—Cross-sectional, clinical study. Participants—Patients ≥ 18 years old with primary open-angle, primary angle-closure, pseudoexfoliation, or pigment dispersion glaucoma, bilateral visual acuity of 20/400 or better, and no concurrent conditions that may affect color vision. Methods—One hundred patients provided color descriptions of 11 distinct medication bottle caps. Patient-produced color descriptors were then presented to three physicians. Each physician matched each color descriptor to the medication they thought the descriptor was describing. Main Outcome Measures—Frequency of patient-physician agreement, occurring when all three physicians accurately matched the patient-produced color descriptor to the correct medication. Multivariate regression models evaluated whether patient-physician agreement decreased with degree of better-eye visual field (VF) damage, color descriptor heterogeneity, and/or color vision deficiency, as determined by Hardy-Rand-Rittler (HRR) score and the Lanthony D15 testing index (D15 CCI). -
MRSA Ophthalmic Infection, Part 2: Focus on Orbital Cellulitis
Clinical Update COMPREHENSIVE MRSA Ophthalmic Infection, Part 2: Focus on Orbital Cellulitis by gabrielle weiner, contributing writer interviewing preston h. blomquist, md, vikram d. durairaj, md, and david g. hwang, md rbital cellulitis is a poten- Acute MRSA Cellulitis tially sight- and life-threat- ening disease that tops the 1A 1B ophthalmology worry list. Add methicillin-resistant OStaphylococcus aureus (MRSA) to the mix of potential causative bacteria, and the level of concern rises even higher. MRSA has become a relatively prevalent cause of ophthalmic infec- tions; for example, one study showed that 89 percent of preseptal cellulitis S. aureus isolates are MRSA.1 And (1A) This 19-month-old boy presented with left periorbital edema and erythema preseptal cellulitis can rapidly develop five days after having been diagnosed in an ER with conjunctivitis and treated into the more worrisome condition of with oral and topical antibiotics. (1B) Axial CT image of the orbits with contrast orbital cellulitis if not treated promptly shows lacrimal gland abscess and globe displacement. and effectively. Moreover, the community-associ- and Hospital System in Dallas, 86 per- When to Suspect ated form of MRSA (CA-MRSA) now cent of those with preseptal cellulitis MRSA Orbital Cellulitis accounts for a larger proportion of and/or lid abscesses had CA-MRSA. Patients with orbital cellulitis com- ophthalmic cases than health care– These studies also found that preseptal monly complain of pain when moving associated MRSA (HA-MRSA). Thus, cellulitis was the most common oph- the eye, decreased vision, and limited many patients do not have the risk fac- thalmic MRSA presentation from 2000 eye movement. -
Adult Patients Common Eye Infections
Common Eye Dermatitis: HZV and HSV Infections: Adult • Redness of periocular skin can be allergic Patients (if associated with prominent itching) or bacterial (if associated with open sores/wounds) Julie D. Meier, MD Assistant Professor of Ophthalmology • Both HZV and HSV can have devastating ocular sequelae if not treated promptly OSU Eye and Ear Institute General Categories of Herpes Zoster Eye Infections Ophthalmicus • Symptoms: Skin rash and pain, may be • Dermatitis of Lids (HZV, HSV) preceded by headache, fever, eye pain or • Cellulitis of Lids (pre- vs post-septal) blurred vision • Blepharitis • Signs: Vesicular skin rash involving CN V • Conjunctivitis distribution; Involvement of tip of nose can predict higher rate of ocular involvement • Keratitis 1 Herpes Zoster Herpes Simplex Virus Ophthalmicus • Symptoms: • Work-up 9 Duration of rash; Immunocompromised? 9 Red eye, pain, light sensitivity, skin rash 9 Complete ocular exam, including slit 9 Fever, flu-like symptoms lamp, IOP, and dilated exam • Signs: • Can have conjunctival or corneal involvement, elevated IOP, anterior 9 Skin rash: Clear vesicles on chamber inflammation, scleritis, or erythematous base that progress to even involvement of retina and optic crusting nerve. Herpes Zoster Herpes Simplex Virus Ophthalmicus • Work-up: • Treatment: 9 Previous episodes? 9 If present within 3 days of rash’s 9 Previous nasal, oral or genital sores? appearance: oral Acyclovir/ Valacyclovir 9 Recurrences can be triggered by fever, stress, trauma, UV exposure 9 Bacitracin ointment to skin lesions 9 External exam: More suggestive of HSV 9 Warm compresses if lesions centered around eye and no involvement of forehead/scalp 9 TOPICAL ANTIVIRALS (e.g. -
Rhopressa™ Netarsudil Ophthalmic Solution 0.02%
Rhopressa™ Netarsudil ophthalmic solution 0.02% CDER Dermatologic and Ophthalmic Drugs Advisory Committee October 13, 2017 Aerie Pharmaceuticals, Inc. 1 Introduction Marvin Garrett Vice President, Regulatory Affairs and Quality Assurance Aerie Pharmaceuticals, Inc. 2 Aerie Pharmaceuticals • 2005: Aerie founded as a spin-out from Duke University: – Dr. Eric Toone – Dr. Casey Kopczynski – Dr. David Epstein – Dr. Epstein’s goal from the beginning: Develop a therapy that targeted the diseased tissue in glaucoma, the trabecular outflow pathway • 2006: Aerie discovered its first Rho kinase inhibitor • 2009: Aerie invented netarsudil • 2012: Netarsudil 1st clinical study • 2017: NDA filed 3 Netarsudil: A New Drug Class for Lowering IOP We are requesting a recommendation for approval of netarsudil ophthalmic solution 0.02% for reduction of intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension given one drop QD 4 Agenda Unmet Medical Needs Richard A. Lewis, MD Chief Medical Officer Aerie Pharmaceuticals, Inc. Past President, American Glaucoma Society Program Design and Efficacy Casey Kopczynski, PhD Chief Scientific Officer Aerie Pharmaceuticals, Inc. Safety Theresa Heah, MD, MBA VP Clinical Research and Medical Affairs Aerie Pharmaceuticals, Inc. Benefits and Risks Janet Serle, MD Professor of Ophthalmology Glaucoma Fellowship Director Icahn School of Medicine at Mount Sinai 5 List of Expert Responders • Cynthia Mattox, MD – Associate Professor of Ophthalmology, Tufts University School of Medicine – Current President, American Glaucoma Society • Mark Reasor, PhD – Professor of Physiology & Pharmacology, Robert C. Byrd Health Sciences Center, West Virginia University • Bennie H. Jeng, MD – Professor and Chair, Department of Ophthalmology & Visual Sciences, University of Maryland School of Medicine • Dale Usner, PhD – Biostatistics Consultant to Aerie Pharmaceuticals, Inc. -
Association Between Topical Beta-Blockers and Risks
BMJ Open: first published as 10.1136/bmjopen-2019-034361 on 22 July 2020. Downloaded from PEER REVIEW HISTORY BMJ Open publishes all reviews undertaken for accepted manuscripts. Reviewers are asked to complete a checklist review form (http://bmjopen.bmj.com/site/about/resources/checklist.pdf) and are provided with free text boxes to elaborate on their assessment. These free text comments are reproduced below. ARTICLE DETAILS TITLE (PROVISIONAL) Association between Topical Beta-Blockers and Risks of Cardiovascular and Respiratory Disease in Glaucoma Patients: a retrospective cohort study AUTHORS Chen, Hsin-Yi; Huang, Wei-Cheng; Lin, Cheng-Li; Kao, Chia-Hung VERSION 1 – REVIEW REVIEWER Marques-Neves, Carlos Ophthalmology University Clinic Faculdade de Medicina da Universidade de Lisboa REVIEW RETURNED 27-Oct-2019 GENERAL COMMENTS Some variables are difficult to control nevertheless, the point is achieved. REVIEWER Reza Razeghinejad Wills Eye Hospital, Philadelphia, PA REVIEW RETURNED 12-Nov-2019 http://bmjopen.bmj.com/ GENERAL COMMENTS A retrospective study on association between Topical Beta- Blockers and Risks of Cardiovascular, stroke, and Respiratory Diseases in Glaucoma Patients reporting higher rate of respiratory issues and stroke in those on beta-blockers. The reported correlations are valid under one condition, being on beta-blocker when the event (stroke, respiratory issues,…..) occurred. The major issue is not including the severity of the systemic diseases and also the severity of glaucoma. on September 25, 2021 by guest. Protected copyright. Although the frequency of DM, HTN, asthma,… were similar between both group, there is no data on the severity of these diseases, for example if the HbA1c of those taking beta blockers is higher it could be the cause of higher rate of stroke not the beta- blockers. -
Glaucoma Medications
9/5/2020 Glaucoma Pharmacology: Old, New and What to Do? Joseph Sowka, OD Greg Caldwell, OD Rho-Kinase White 1 2 GLAUCOMA EPIDEMIOLOGY AND AQUEOUS HUMOR DYNAMICS TREATMENT IOP – A Complex Homeostasis Current Medical Treatments for OAG Aqueous formation in ciliary body – passive diffusion, ultrafiltration and active secretion Cornea Aqueous Production Aqueous Outflow Conventional Outflow – Trabecular Meshwork → Schlemm’s Canal → Conventional Unconventional Episcleral Venous System Trabecular Meshwork Prostaglandin Non-Conventional Outflow – Schlemm’s -blocker Cholinergic agonist analog Uveoscleral Canal Episcleral CAI NO-donating PGA NO-donating Veins 2-agonist RhoKinase inhibitor PGA 2-agonist Uveoscleral Outflow Updated 1/7/18 Ciliary Processes 3 4 PROSTAGLANDINS: PROSTAGLANDINS OCULAR ADVERSE EFFECTS ▪ Prostaglandins are not indicated ideal in secondary inflammatory glaucoma or any ▪ Hyperemia clinical entity that has anterior segment ▪ Increased iris coloration inflammation as a component ▪ Periorbitopathy: skin darkening, Sulcus ▪ Prostaglandins are important in that they deepening flatten the diurnal IOP curve as well as giving - Hyperemia is reversible with medication cessation. Iris color lingering IOP reduction even as much as 60 changes appear to be irreversible. Periorbitopathy may be reversible if the medication is stopped soon enough, but may hours after dosing. Thus, they are more indeed be permanent. forgiving of patients that miss dosages. ▪ Hypertrichosis ▪ Punctate keratopathy, dry eye ▪ Uveitis, CME, and dendritic -
Common Eye Condition Management
Common eye condition management Introduction by Moorfields’ medical director Thank you for taking the time to read this concise advice booklet about common eye conditions. It has been produced by clinicians and other staff CONTENTS at Moorfields to help you to make informed clinical decisions about your Introduction by Moorfields’ patients’ eye conditions locally, and medical director ......................... 3 avoid them having to attend hospital unnecessarily. Schematic diagram of the human eye ........................ 4 For each of the most common conditions you might see in your practice, we have listed signs and symptoms, General information Equipment and drugs to keep the equipment you will need to examine the patient, and at hand in the surgery ............ 4 the procedure to follow in undertaking that examination. General good practice advice ..................................... 5 Towards the end of the booklet, we have included a Eye examination .................... 5 table divided into four levels of urgency for onward referral – immediate, within 24 hours, within one week Care pathways for common and routine – with a list of relevant circumstances and eye conditions: conditions for each. Conjuntivitis ........................... 6 Dry eyes ............................... 7 We have also provided a table of the several locations Blepharitis ............................. 8 in which Moorfields provides care in and around Chalazion (meibomian cyst) ...10 London, and the sub-specialty services we offer in Stye .......................................11 each place. Corneal abrasion ....................12 Corneal foreign body ..............13 Subtarsal foreign body ..........14 I hope you find this guide helpful, and welcome your Subconjunctival views on how we might improve future editions. Please haemorrhage .........................15 contact our GP liaison manager on 020 7253 3411, Episcleritis .............................16 ext 3101 or by email to [email protected] with your comments. -
STYES and CHALAZION
TRE ATM ENT TRE ATM ENT FOR STYES FOR CHALAZION While most styes will drain on their The primary treatment for chalazion is own, the application of a hot or warm application of warm compresses for 10 compress are the most effective to 20 minutes at least 4 times a day. means of accelerating This may soften the hardened oils STYES drainage. The blocking the duct and promote drain- warmth and damp- age and healing. ness encourages the stye to drain. Just like any infection try not to touch it with your fingers. A Chalazion may be treated with compress can be made by putting hot any one or a combination of (not boiling) water on a wash cloth, or antibiotic or steroid drops pre- by using room temperature water and scribed by your healthcare a plastic heat pack. Warm compress- provider. es should be applied for 10—20 and minutes, four (4) times a day. There are occasions when sur- There is also a specialized topical gical drainage is required. ointment for styes, that may be pre- scribed. “Do not use eye makeup Styes may also cause a bruised feel- or wear contact lenses ing around the eye which is treated by application of a warm cloth to the eye. until the stye or chalazion CHALAZION With treatment, styes typically resolve have healed.” within one week. Lancing of a stye is not recommended. Revised: August 2011 WHAT ARE THEY? Signs and Symptoms Signs & Symptoms O f S t ye s of Chalazions The first signs of a stye are: A stye is an infection of the The symptoms of chalazions differ from tenderness, sebaceous glands at the base of the styes as they are usually painless. -
Acquired Colour Vision Defects in Glaucoma—Their Detection and Clinical Significance
1396 Br J Ophthalmol 1999;83:1396–1402 Br J Ophthalmol: first published as 10.1136/bjo.83.12.1396 on 1 December 1999. Downloaded from PERSPECTIVE Acquired colour vision defects in glaucoma—their detection and clinical significance Mireia Pacheco-Cutillas, Arash Sahraie, David F Edgar Colour vision defects associated with ocular disease have The aims of this paper are: been reported since the 17th century. Köllner1 in 1912 + to provide a review of the modern literature on acquired wrote an acute description of the progressive nature of col- colour vision in POAG our vision loss secondary to ocular disease, dividing defects + to diVerentiate the characteristics of congenital and into “blue-yellow” and “progressive red-green blindness”.2 acquired defects, in order to understand the type of This classification has become known as Köllner’s rule, colour vision defect associated with glaucomatous although it is often imprecisely stated as “patients with damage retinal disease develop blue-yellow discrimination loss, + to compare classic clinical and modern methodologies whereas optic nerve disease causes red-green discrimina- (including modern computerised techniques) for tion loss”. Exceptions to Köllner’s rule34 include some assessing visual function mediated through chromatic optic nerve diseases, notably glaucoma, which are prima- mechanisms rily associated with blue-yellow defects, and also some reti- + to assess the eVects of acquired colour vision defects on nal disorders such as central cone degeneration which may quality of life in patients with POAG. result in red-green defects. Indeed, in some cases, there might be a non-specific chromatic loss. Comparing congenital and acquired colour vision Colour vision defects in glaucoma have been described defects since 18835 and although many early investigations Congenital colour vision deficiencies result from inherited indicated that red-green defects accompanied glaucoma- cone photopigment abnormalities. -
Eye Infections
CLINICAL Approach Taking a Look at Common Eye Infections John T. Huang, MD, FRCSC and Peter T. Huang, MD, FRCSC he acutely red eye is often seen first by the primary-care physician. The exact Tcause may be difficult to determine and may cause some concern that a serious ocular condition has been missed. Thorough history and clinical examination will help delineate the final diagnosis. When there are doubts, prompt referral to an oph- thalmologist can prevent serious consequences. Often, the most likely diagnosis of an acutely red eye is acute conjunctivitis. In the first day, an acute bacterial infection may be hard to differentiate from viral, chlamydial and noninfectious conjunctivitis and from episcleritis or scleritis. Below is a review of the most commonly seen forms of eye infections and treat- ments. Failure to improve after three to five days should lead to a re-evaluation of the patient and appropriate referral where necessary. CHRONIC BLEPHARITIS Clinical: Gritty burning sensation, mattering, lid margin swelling and/or scaly, flaky debris, mild hyperemia of conjunctiva; may have acne rosacea or hyperkeratotic dermatitis (Figure 1). Anterior: Staphylococcus aureus (follicles, accessory glands); posterior (meibomian glands). Treatment: • Lid scrubs (baby shampoo, lid-care towellettes, warm compresses). Figure 1. Chronic blepharitis. There may be localized sensitivity to the shampoo or the components of the solution in the towellettes (e.g., benzyl alcohol). • Hygiene is important for the treatment and management of chronic blepharitis. Topical antibiotic-corticosteroid combinations (e.g., tobramycin drops, tobramycin/dexamethasone or sulfacetamide sodium-prednisolone acetate). Usage of these medications is effective in providing symptomatic relief, as the inflammatory component of the problem is more effectively dealt with.