Fixing a Hole: How to Heal Persistent Epithelial Defects

Corneal metabolism and wound healing are crucial to properly maintaining the cornea’s integrity and functionality. When an insult occurs to the corneal surface, creating an epithelial defect, the complex re-epithelialization process involves limbal stem cells, cell differentiation, proliferation, migration and remodeling of the extracellular matrix. Researchers believe growth factors involved in the process include epidermal, keratinocyte, hepatocyte and basic fibroblast growth factors. In normal, healthy corneas, supportive therapy can help the body resolve an epithelial defect rapidly. However, healing may be delayed or halted altogether in compromised conditions, leaving the underlying stroma exposed and vulnerable to further trauma, infiltrates, infection, scarring or perforation. A persistent epithelial defect, defined as a defect that has not resolved after two weeks of standard treatment, is a significant long-term management problem for ODs.

An OD’s Guide to Corneal Transplant Options

The term corneal transplant is no longer synonymous with full-thickness penetrating keratoplasty (PKP). It is now divided into subcategories with different tissue layers. This family of procedures includes traditional PKP, deep anterior lamellar keratoplasty, Descemet’s stripping endothelial keratoplasty, Descemet’s membrane endothelial keratoplasty and pre-Descemet’s endothelial keratoplasty.

This article reviews these options, what patients need to know and the optometrist’s role in comanagement.

Slaying the Giant Cell Arteritis

Giant cell arteritis is a rare, but urgent and potentially life-threatening, presentation that can have ocular consequences. This course details how to tell which patients are likely to have it based on their history and symptoms as well as how to test for it using both imaging and lab work, and reviews the optometrist’s role in treating and comanaging these patients. 

How Drug Abuse Affects the Eye

It’s no secret that Americans are in the midst of a substance abuse crisis. As primary care physicians, optometrists can play a role in recognizing damage or dysfunction to either ocular structures or the components of the visual pathway these drugs cause and counseling patients in these circumstances. This article reviews commonly used legal and illicit substances, and how each are associated with the formation, or exaggeration, of disease or damage.