Today's Spotlight

Lymphocytes on the Loose

We all know the classic presentation of uveitis: cells and flare, pain, photophobia and reduced vision. But because a multitude of events can trigger such a response, we sometimes lose sight of how these processes occur and what they signify about our patient. The patient’s systemic and ocular health rely on you, the optometrist, to carefully and strategically undertake a systemic review and work-up of anterior uveitis (AU) patients, to investigate and potentially uncover, an infectious, autoimmune or inflammatory underlying etiology.

We now know that a properly executed work-up, combined with more recent and advanced diagnostic techniques, yields an underlying systemic diagnosis in 70% of cases. The need is clear for a careful ocular evaluation and review of histopathological and immunological mechanisms to further narrow down the systemic work-up.
Today's Spotlight

Looking to the Future of Glaucoma Treatment

As far as we know, intraocular pressure (IOP) is the only modifiable risk factor with respect to altering glaucoma’s characteristic death of retinal ganglion cells. IOP quantifies the balance between aqueous humor secretion by the ciliary body epithelia and its drainage through the conventional, pressure-sensitive pathway and unconventional, pressure-insensitive or “uveoscleral” pathways. IOP will increase along with any resistance to aqueous outflow. This can result from age-related cellular dysfunction in the conventional outflow pathway or a normal outflow system unable to handle overproduction. Since altering other mechanisms in the pathophysiology of the disease is not possible without profound risk to the patient, lowing IOP is the only means of arresting disease progression. In the United States, the current guidelines for the initial intervention of newly discovered cases of primary open-angle glaucoma recommend a first-line approach with topical ocular hypotensives. To that end, three new agents that are under investigation aim to decrease IOP without upsetting the physiology. If successful, these medications could help keep the primary outflow pathway functioning.
Today's Spotlight

Hitting a Nerve

Neurostimulation has been an invaluable addition to the medical field since the 1950s with the invention of the first implantable pacemaker.

Today, it’s used in implantable defibrillators and cochlear implants and for treating chronic pain, refractory epilepsy, Parkinson’s disease and essential tremor, obsessive- compulsive disorder, obesity, depression and migraine prophylactically. As a means of applying stimulation to regions of the nervous system to alter neurophysiological signals affecting tissues and organs, it has the potential to affect almost any part of the body—and that includes the eyes.
Today's Spotlight

Glaucoma Surgery: Are You Ready to Refer?

While optometrists can serve the needs of most patients with glaucoma, many will eventually require a referral to a glaucoma specialist. The most frequent reasons for a consultation are for surgical care, diagnostic dilemmas and complex or unusual cases. The timing of surgical consults, however, can be tricky, as the need may arise early or late in the course of open-angle glaucoma, depending on the case. In addition, optometrists should be prepared for patients susceptible to angle closure. Here, we discuss the available surgical options for glaucoma, when optometrists should consider a referral and post-op care.
Today's Spotlight

Every Picture Tells a Story

It’s debatable whether all acute isolated oculomotor cranial neuropathies, in patients older than 50 with or without vascular factors, should undergo neuroimaging. Here, we review cranial nerve three, four and six palsies and provide reasons for neuroimaging all isolated cranial mononeuropathies.
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Look Inside The Current Issue

July 15, 2017

Features

10-2 Visual Field Testing: A Tool for All Glaucoma Stages

This diagnostic tool is a must for detecting paracentral and visual field defects close to fixation in glaucoma, even the early-moderate stage.

Be a Hero to Your HSVK Patients

It is important for ODs to have a thorough understanding of this sight-threatening disease.

Caring for Patients With Brain Injury

More often than not, TBI affects a patient’s vision, and ODs must be prepared to evaluate and manage this population.

Glaucoma Surgery: Are You Ready to Refer?

Surgery is inevitable for many patients with glaucoma. These tips can help you refer when the time is right—and comanage after the fact.

Looking to the Future of Glaucoma Treatment

A trio of new therapies is poised to change how ODs fight the disease.

Mastering MIGS: Today and Tomorrow

These procedures have changed the glaucoma treatment landscape—and more are on the way. Here’s a primer for ODs.

2017 Office Design Contest

Your new high-tech and eye-catching office could be a winner. Enter today!

Departments

5 Steps to Better Glaucoma Care

Optometry has to take the lead with glaucoma, especially with recent advancements.

Decoding MIGS Coding

Clinicians must know how to code for these novel additions when comanaging glaucoma surgical patients.

Every Picture Tells a Story

Studies suggest imaging is fruitful in cases of isolated palsies, regardless of whether neurological symptoms are present.

Hitting a Nerve

Here’s what you need to know about the newest technology approved for dry eye disease therapy.

Lymphocytes on the Loose

Most anterior uveitis arises from systemic causes. Make the connection and you’ll be better equipped to quickly and accurately distinguish etiologies.

News Review

AMD | Cognitive Decline | Contact Lenses | Pediatrics

Not Just Another Headache

Migraine is the most common disabling brain disorder. Are you ready to help these patients?

Prescribe with Laser Focus

Know how to pair drugs with associated procedures.

The More Things Change…

Glaucoma care has flourished in recent decades, but still can’t crack its toughest challenge.

What a Pain!

The profession fights to expand and maintain its privileges at every turn—they’re vital to providing care. Don’t take your DEA license for granted.

Who’s the Boss?

Spoiler alert: it isn’t you. So tread carefully.

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.

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Review of Cornea & Contact Lenses

May/June 2017

Women in Optometry

Women in Optometry - June 2017