US OPHTHALMIC REVIEW – VOLUME 10 ISSUE 1 – SPRING 2017

Welcome to the Spring 2017 edition of US Ophthalmic Review. It is a bustling time in ophthalmology now, with a growing number of innovative techniques and technologies, particularly in the fields of cataract surgery, glaucoma, and retina. This issue takes a deeper dive into such innovations. We open with an expert opinion on the subject […]

The role of secondary intraocular lens (IOL) implantation has evolved. Following advances in cataract surgery, surgical aphakia is becoming uncommon, and secondary IOL implantation is now most commonly performed as part of an IOL exchange procedure. A number of techniques and IOLs are available for secondary IOL implantation, and debate persists regarding which methods are […]

Keratitis can be the result of bacterial, fungal, viral or even amoebic infection of the cornea. Infectious keratitis requires urgent medical attention to prevent vision loss. Advances in diagnosis and treatment have improved outcomes but antibiotic resistance, as well as fungal, acanthamoebal, and viral keratitis remain problematic. In an expert interview, Dr Bennie H Jeng […]

Glaucoma is a frequent occurrence in pediatric corneal disease, and its management requires special considerations. This expert interview with Gerald W Zaidman will consider the definition, incidence, diagnosis and treatment of pediatric glaucoma, with the exception of congenital glaucoma, which is not a disease of the cornea. Q: How do we define pediatric glaucoma? The […]

Pseudoexfoliation syndrome (PEX) is a common condition that may represent a serious challenge during cataract surgery.1 Prevalence in the US is up to 14% and is related to aging and low climatic temperature.2 Also known as ‘Viking disease’, PEX is more common in Northern Europeans: in Sweden, an 87-year-old individual has a 61% chance of […]

The treatment of glaucoma usually begins with the use of topical antiglaucoma medications or laser trabeculoplasty, with surgery reserved for cases refractory to, or at high-risk of failing medical management.1 Trabeculectomy with antimetabolite has traditionally been considered the preferred first-line filtration procedure.1 However, failure rates of approximately 50% at 5 years have been reported, as […]

Diabetic retinopathy (DR) is one of the leading causes of adult vision loss in the developed world.1,2 Epidemiological and demographic factors, including the rising rates of diabetes related to obesity and an aging population, are driving the incidence of diabetic eye disease inexorably higher. Over the past 35 years, the number of Americans diagnosed with […]

Ophthalmic medical practices in the United States are under unprecedented pressure to care for a rapidly growing population of patients, even as Medicare reimbursement levels continue to decline and payers are implementing payment programs based on cost and quality metrics. The Centers for Medicare and Medicaid Services (CMS) has continued to enact significant cuts to […]

Due in part to continuous improvement in the safety, speed, and refractive outcomes of cataract surgery, the number of cataract procedures has increased steadily over the past 30 years, and the percentage of patients undergoing the procedure at a younger age is also increasing. These trends were documented in a frequently cited population-based study of […]

Antibiotic-resistant bacteria cause infections worldwide, with potentially serious health consequences,1 although the majority of such infections involve resistance to systemically administered antibiotics used in the treatment of systemic infections. The first case of methicillin resistance in Staphylococcus aureus (MRSA) was reported in 1961, and was an uncommon finding until the 1990s when community-acquired MRSA became […]

Glaucoma is a degenerative disease that, if left untreated, will eventually cause irreversible damage to the optic disc, and loss of vision. This progressive optic neuropathy is estimated to affect 3 million people in the US.1 Current treatment options are limited to lowering intraocular pressure (IOP), with medical therapy in the form of topical drops […]

Gonioscopy is a requisite investigation for all patients with glaucoma. It is a procedure for evaluation of the anterior chamber angle (ACA), utilizing special instruments known as gonio-lenses or -prisms. Alexios Trantas (1867–1961) was the first to use the term “gonioscopy” in 1907 ( Figure 1 ). The term was derived from the Greek word […]

Supplementary Information 1 Supplementary Information 2 Supplementary Information 3 Vascular exposure to hyperglycemia over extended periods, destroys the retinal endothelial cell tight junctions and leads to the development of macular edema with consequent visual loss.1 Indeed, diabetic macular edema (DME) is the most common cause of visual impairment in diabetic patients.2 At the same time, […]

Diabetic retinopathy is the leading cause of blindness worldwide among patients aged 20–74.1 Among eyes with diabetic retinopathy, diabetic macular edema (DME) accounts for a significant proportion of vision loss and associated morbidity,2,3 and the reported incidence is quite high, occuring in 26.1% of type 1 diabetics according to The Wisconsin Epidemiologic Study of Diabetic […]

Retinopathy of prematurity (ROP) is a vasoproliferative disease of preterm infants that continues to be a major cause of preventable blindness worldwide despite concerted efforts to reduce its frequency.1 In developed countries, advances in perinatal care, a reduction in mortality rates of preterm infants, and increased surveillance for ROP has had unintended consequences and has […]

Ocular trauma is an important worldwide cause of preventable morbidity and accounts for half a million cases of monocular blindness worldwide.1–5 Paucity of epidemiological data regarding ocular trauma in the developing world is a major factor in implementing effective health policy measures. The only national estimate regarding the Indian subcontinent is from a survey conducted […]