US OPHTHALMIC REVIEW – VOLUME 5 ISSUE 1 – SPRING 2012

Obstructive sleep apnea (OSA) or obstructive sleep apnea syndrome (OSAS) is an under-recognized disorder with important systemic implications. It is characterized by repeated episodes of upper airway obstruction during sleep, combined with daytime sleepiness. OSAS is the most severe form of intermittent upper airway obstruction. Milder forms range from primary snoring and upper airway resistance […]

Ghana lies in the center of the West African coast, bordered on the south by the Gulf of Guinea and the Atlantic Ocean, between Ivory Coast to the west and Togo to the east. Its southernmost point is Cape Three Points, 4° 30’ N of the equator, from where it extends inland to latitude 11° […]

It has been almost 10 years since the first wavefront-guided laser refractive surgery procedure was approved in the US.1 A number of laser systems now include the capability for wavefront-guided procedures. While clinical results have generally been equivalent or superior to conventional refractive surgery, the ability to correct measured higher-order aberrations (HOAs) has not been […]

It has been more than a decade since the femtosecond laser entered the ophthalmic market as an alternative to the mechanical microkeratome for the creation of flaps in laser in situ keratomileusis (LASIK).1 The first device approved in the US was the IntraLase® Femtosecond Laser (Abbott Medical Optics) in 2001. The early successes of this […]

The primary function of the ocular surface is to provide clear vision when the eye is open, as the anterior surface of the cornea contributes to more than two-thirds of the total refractive power of the eye. To achieve this, while maintaining comfort and preventing microbial invasion, the ocular surface must be covered by a […]

In the 1960s, Krasnov1 began to develop what became known as ‘non-penetrating glaucoma surgery’ (NPGS). The ‘sinusotomy’ he described consisted of de-roofing Schlemm’s canal from 10–2 o’clock via an external approach and then covering the canal with conjunctiva. With little post-operative detail in the report, plus the need for an operating microscope, the procedure was […]

Glaucoma is a leading cause of preventable and irreversible blindness.1–5 Glaucoma is a chronic and progressive neurodegenerative disorder causing loss of retinal ganglion cells and their axons.6 Characteristic ‘cupping’ of the optic disc is seen with corresponding loss of visual field. Elevated intraocular pressure (IOP) is a causative risk factor for the development and progression […]

Cataract surgery is the most common surgery performed in the US and the number of cataract procedures is estimated to grow exponentially as the baby-boomer generation ages.1 Enhanced technology has resulted in ever-increasing patient expectations of comfort and rapid visual rehabilitation following surgery. Inflammation following cataract surgery can result in pain and slowed visual recovery, […]

The late 1970s and early 1980s was a time of rapid evolution in cataract surgery. In a period of less than a decade, the standard of care changed from intracapsular cataract extraction (ICCE) with aphakic spectacles to microincision phacoemulsification with foldable posterior chamber lenses. Along the way, interim stops included ICCE with iris-supported lenses, ICCE […]

Over the past decade, advances in technology and refinements in surgical techniques have brought pediatric cataract surgery into the modern age. Automation and the use of intraocular lenses (IOLs) have facilitated better anatomical and functional outcomes. At one point, lensectomy was the standard treatment used in such cases. However, in recent times, small incisions, anterior […]

The ‘standard of care’ is an interesting concept and one that is, to varying degrees, dictated not by scientific data but by the potentials for legal ramifications. The ‘standard of care’ can be equated to the column on the pantheon: once built, it is very difficult to tear down or modify. Ophthalmology as a surgical […]

An estimated 20 % of the US population suffers from allergic conjunctivitis,1 related either to seasonal or perennial allergies, and the general incidence of allergy is believed to be increasing. Given its high prevalence, the signs and symptoms of ocular allergy—itching, tearing, and hyperemia—are present in a substantial subset of the patients seen in any […]

Lutein is a carotenoid whose name is derived from luteus, meaning ‘yellow.’ It is generally found in nature in green leafy vegetables and in varying concentrations in the retinal segment and macula of humans. One may take carotenoids such as lutein into the body by direct oral ingestion of vegetables or, more recently, by dietary […]

Uveal melanoma is the most common primary intraocular tumor in adults and often results not only in vision loss but also in metastatic death.1,2 The goals of ocular treatment of the primary uveal melanoma are: to prevent, or reduce the risk of, metastasis; to prevent further growth of the tumor and destruction of ocular tissues; […]

Choroidal melanoma (CM) is both the most common form of uveal melanoma and the most frequent primary intraocular malignancy. There is a reported yearly incidence of 4–6 per million per year in the US and Europe. Of interest, Queensland, Australia (beneath the ozone hole) has the highest reported incidence (10 per million per year) worldwide.1 […]