Today's Spotlight

Extended Wear: Still an Option?

Extended contact lens wear has long been thought to be the most desirable modality for our patients because it offers great convenience, uninterrupted good vision and suits those with an active lifestyle. Despite these benefits, extended wear is not prescribed with any frequency in the United States—at least not since the late 1980s, when researchers found a much higher incidence of ulcerative keratitis with this modality compared with daily wear.

While a few extended wear contact lens options remain on the market, many uncertainties hinder their use, including concerns that not enough oxygen passes through the lens to support a healthy cornea or that a toxic tear film exists beneath a contact lens that needs to be flushed by removing the lens. In addition, a practitioner’s history of contact lens patients with microbial keratitis or inflammation may lead them to prescribe a more limited wearing time. This article takes a look at extended wear today, how advances have improved the modality and what questions remain. 

Today's Spotlight

Graft-vs.-host Disease: How, Why and What Next

Graft-vs.-host disease (GVHD)—an abnormal immune response to healthy host tissue following stem cell transplantation for the treatment of hematologic diseases—can be a complex condition for eye care practitioners to manage. It can lead to a host of ocular complications, the most significant of which is dry eye—seen in 40% to 76% of patients with GVHD. In particular, ocular GVHD can cause permanent severe aqueous-deficient dry eye, as well as other dry eye etiologies, which can be visually debilitating. It is critical that practitioners correctly identify dry eye caused by GVHD and treat accordingly.
Today's Spotlight

Contact Lens-associated Red Eye: Causes and Corrections

Red eyes are relatively common in practice but not always straightforward, and adding a contact lens to the ocular surface only complicates things. To avoid potentially vision-threatening scenarios, practitioners need to come up with a timely, appropriate diagnosis and treatment plan. This article discusses how to streamline these processes for contact lens-related red eyes to achieve the best possible outcome.

Today's Spotlight

Go Deep on Corneal Abrasions

In daily practice, we tend to focus more on clinical signs and symptoms than pathophysiology, especially in corneal abrasion cases—the patient is in pain, infection risk is high and time is tight. The way we treat these patients prioritizes pain relief over a more holistic approach to the cornea’s status and risk profile. But gaining a greater awareness of how such conditions progress can help inform our treatment choices. This month we do so by looking more deeply at the mechanisms of corneal trauma and wound repair.
Today's Spotlight

Glaucoma Therapy: Don’t Forget the Ocular Surface

An estimated 2.2 million Americans have glaucoma and 20 million have dry eye disease (DED)—odds are, practitioners are bound to see patients diagnosed with both. Research suggests the comorbidity of DED in patients treated topically for ocular hypertension and glaucoma could be as high as 20% to 59%. But few step back to consider the association between these two chronic and progressive diseases.

Often, it’s nearly impossible to decipher which disease came first and how much of the DED is iatrogenic—caused inadvertently by a medical treatment or procedure. With each additional medication involved in the treatment of glaucoma, the risk of an adverse event or possible exacerbation of dry eye multiplies. Here’s a look at the ocular surface in patients being treated for glaucoma—and how you can help protect it.

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Look Inside The Current Issue

November 15, 2017

Features

A Red Eye: Scleritis or Episcleritis?

Differentiating between the two is crucial to ensure you initiate the right treatment.

Glaucoma Therapy: Don’t Forget the Ocular Surface

Following the mantra “do no harm” can be a challenge when prescribing topical glaucoma medications. These tips can help minimize damage.

Graft-vs.-host Disease: How, Why and What Next

Dry eye is rampant in this population, and other complications abound.

The Conjunctiva in Crisis: Ocular Irritation Unmasked

When conjunctival calamities strike, here’s how to identify the cause and come up with a plan.

The Origins and Management of Contact Lens Discomfort

Understanding how this irritating nuisance develops is the first step toward fighting its deleterious effects.

When Dry Eye Compromises Corneal Integrity

Your patients’ blurry vision, keratitis and infections could be caused by ocular surface disease.

Departments

A Second Helping

Idiopathic intracranial hypertension sometimes returns. When it does, here’s what to do.

Could Eyelids Be the Key to DED?

A new theory finds the two linked by a familiar foe: bacterial biofilm.

Go Deep on Corneal Abrasions

Understanding the physiology of rupture and repair will improve your management decisions.

It’s All About the Benjamins

Let’s discuss the most important word in all of medicine—and it’s not “patient,” unfortunately.

Jaundice and the Eyes

Optometrists may be the first to notice icterus, a harbinger of systemic concerns.

News Review

OD Regulations | Eye Dominance | Drug Patents | Diabetic Retinopathy

Next Time, Order Well Done

A young man returned from an overseas trip with more than just memories.

Product Review

Pharmaceuticals | Diagnostic Technology | Patient-use Devices | Scleral Lenses

Red Alert

A routine conjunctivitis case could portend serious systemic illness.

Red Eyes Mean Optometry

Patients still head to their primary care provider for this when they should be giving their OD a call. What we find could be far more troubling.

Steer Clear of the Coding Rut

Every patient’s office visit is different and, often, so is the coding.

Stemming the Tide

Cycloablation lowers IOP at its source: the ciliary body. Once considered a last resort, it may be warranted earlier.

Sugar Rush

November is Diabetic Eye Disease Awareness Month. So put away that leftover Halloween candy already!

The Role of Toric Peripheries

They provide one last refinement to the fit, improving comfort and vision.

E-Newsletters

Practice Pearls

Expert clinician Paul Karpecki, OD, provides practical insights and management strategies for a wide array of ocular conditions.

RCCL e-News

A quick read of the best pearls from the current issue of Review of Cornea & Contact Lenses, with links to full articles.

Optometric Retina Society E-Newsletter

Keep up to date on the latest research and clinical findings in retinal disease care with this quarterly publication from the ORS.

Optometric Physician E-Journal

A weekly e-journal edited by Art Epstein, OD, featuring incisive commentary, timely research summaries and late-breaking news.

Additional Publications

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Review of Cornea & Contact Lenses

November/December 2017

Women in Optometry

Women in Optometry - November 2017