Optometric Physician



Vol. 24, #3 •   Monday, January 16, 2023


Off the Cuff: Lifelong Learning

I managed to graduate high school and college without ever taking a foreign language class. Where I went to undergrad, you had the option of two semesters of a foreign language or one semester of an Intro to Linguistics. I obviously chose the latter. Learning another language was something I was curious about, and for years wondered if I was even able. Ich lerne Deutsch. For a little over a year, I've been plugging away at learning German using the Duolingo app. I had this particular app on my phone for years. It was recommended as something I might like, but I hadn't ever opened it after downloading it. What started out as just a fun little distraction has become a nightly habit of doing a couple lessons to learn a few new words and phrases, and review ones I've already learned. I'm not very good at German yet, but I'm trying.

When I was a third-year at SCCO, we were in the clinic studying for our last final exam ever. We were discussing how relieved we were going to be not having to constantly study. Dr David Sendrowski overheard us and said something that still resonates with me to this day. (Actually, he said many highly memorable things being the amazing professor that he is.) On this day, he interjected, "You can never stop learning. This is just the beginning." At that moment, it felt as if my entire learning paradigm shifted. Ending were the days of panic studying and cramming to pass the next exam just to purge, rinse and repeat to get to the next one. Opening before me was the process of lifelong learning, of curiosity, and learning for learning's sake. The reality was that finishing professional school wasn't the end of my educational career, but in fact, was just the foundational piece for what was yet to come.

Our continuing education requirements contribute to our base knowledge, essentially serving as an extension of our formal education. Clinical practice supplies the inspiration with new instruments, tests, and medications that necessitate staying current for the ultimate driver of lifelong learning about patient care. Our patients present as puzzles—some are simple and straightforward, others hypercomplex and multidimensional. How well we are able to help our patients solve their puzzles largely depends on how well we've maintained our knowledge base and integrated new information. Though formal exams ended years ago for most of us, it shows how right Dr. Sendrowski was in that we never stop learning. Vielen Dank, Herr Sendrowski.


Shannon L. Steinhäuser, OD, MS, FAAO
Chief Medical Editor


Want to share your perspective?
Write to Dr. Shannon L. Steinhäuser, OD, MS, FAAO at ssteinhauser@gmail.com. The views expressed in this editorial are solely those of the author and do not necessarily represent the opinions of Jobson Medical Information LLC (JMI), or any other entities or individuals.


Obstructive Sleep Apnea Syndrome: Is it a Risk Factor for Ocular Surface Disease and Ocular Comorbidities?

The purpose of this study was to investigate the accompanying ocular findings in patients with obstructive sleep apnea syndrome (OSAS) and evaluate the susceptibility to ophthalmological diseases. In this cross-sectional study, qualifying study subjects were patients who had been diagnosed with severe OSAS (apnea/hypopnea index (AHI > 30/h), n=31), and control subjects (n=30) who had an AHI index of <5 (as normal). General ophthalmological examination, eyelid laxity measurements, corneal topography, visual field, retinal nerve fiber layer parameters and dry eye tests were performed on the patients.

It was observed that the two groups had similar characteristics in terms of gender, age, presence of hypertension, diabetes, and body mass index. According to eyelid laxity measurements, the incidence of loose eyelids was higher in the OSAS patient group. Choroidal thickness was thinner in the study group than in the control group. Schirmer test and tear break-up time were significantly lower in the study group than in the control group. The percentage of meibomian gland loss in meibography and the ocular surface disease index score for symptoms was significantly higher in the study group than in the control group.

In this study, the authors found significant changes in ocular surface parameters, eyelid laxity, choroidal thickness, and visual field indices in OSAS patients. They suggested that dry eye syndrome might be related eyelid laxity and inflammation in OSAS patients. The authors concluded that early diagnosis and follow-up of ocular diseases in OSAS, which affect the quality of life and visual prognosis in advanced ages, are important.

SOURCE: Mavigok E, Ozcan AA, Ulas B. Obstructive sleep apnea syndrome: is it a risk factor for ocular surface disease and ocular comorbidities? Int Ophthalmol. 2022 Dec 29. Epub ahead of print.



Retinal Vascular Changes in Alzheimer's Dementia and Mild Cognitive Impairment: A Pilot Study Using Ultra-Widefield Imaging

Retinal microvascular abnormalities measured on retinal images are a potential source of prognostic biomarkers of vascular changes in the neurodegenerating brain. This study assessed the presence of these abnormalities in Alzheimer's dementia and mild cognitive impairment (MCI) using ultra-widefield (UWF) retinal imaging. UWF images from 103 participants (28 with Alzheimer's dementia, 30 with MCI, and 45 with normal cognition) underwent analysis to quantify measures of retinal vascular branching complexity, width, and tortuosity.

Participants with Alzheimer's dementia displayed increased vessel branching in the midperipheral retina and increased arteriolar thinning. Participants with MCI displayed increased rates of arteriolar and venular thinning and a trend for decreased vessel branching.

The authors observed statistically significant differences in the retinal vasculature in peripheral regions of the retina among the distinct cognitive stages. However, they indicated that larger studies would be required to establish the clinical importance of this study’s findings. They added that UWF imaging may be a promising modality to assess a larger view of the retinal vasculature to uncover retinal changes in Alzheimer's disease.

SOURCE: Pead E, Thompson AC, Grewal DS, et al. Retinal vascular changes in alzheimer's dementia and mild cognitive impairment: a pilot study using ultra-widefield imaging. Transl Vis Sci Technol. 2023;12(1):13.

Comparison of Changes in Blood Pressure in Phacoemulsification Cataract Surgery Performed via Topical and Peribulbar Anesthesia

The purpose of this study was to compare the changes in blood pressure in patients undergoing phacoemulsification cataract surgery under topical and peribulbar anesthesia during preoperative, intraoperative and postoperative period. In this prospective cohort study, 240 patients undergoing phacoemulsification were divided into topical (Group 1) and peribulbar (Group 2) equally. Proparacaine 0.5% drops were used for topical anesthesia, and Inj lignocaine with Inj bupivacaine were used to give peribulbar anesthesia. Preoperative blood pressure was taken 30 min before surgery with automated sphygmomanometer. Intraoperative blood pressure was taken during phacoemulsification, and postoperative blood pressure was taken 1 hour after surgery. Outcomes assessed were systolic, diastolic and mean blood pressure.

Systolic blood pressure in Group 1 was significantly increased in the intraoperative phase, whereas it was significantly decreased in Group 2 in the intraoperative phase. Diastolic and mean blood pressure in Group 1 showed no significant change, whereas in Group 2 showed significant reduction in both in the intraoperative and postoperative phases.

Researchers wrote that the increase in intraoperative systolic blood pressure in topical group could be due to discomfort from microscope light, iris manipulation, irrigation and aspiration during surgery. They added that the decrease in intraoperative systolic and diastolic blood pressure in peribulbar group could be due to systemic absorption of local anesthetic. The mean preoperative systolic blood pressure was also higher in the topical group, which could be due to anxiety or stress under topical anesthesia, they wrote further. The authors suggested that changes in blood pressure during cataract surgery should be observed so that timely intervention can be made to achieve favorable postoperative outcome.

SOURCE: Singh B, Kumar P, Moulick PS, et al. Comparison of changes in blood pressure in phacoemulsification cataract surgery performed via topical and peribulbar anaesthesia: A cohort study. Med J Armed Forces India. 2023;79(1):34-9.



Industry News

Olleyes Earns ISO Certification

Olleyes announced that earned the International Organization for Standardization (ISO) 13485:2016 certification from SGS, demonstrating the company's compliance with medical device quality management system requirements under the Medical Device Single Audit Program (MDSAP). ISO/MDSAP certifications emphasize a key achievement in the international expansion for Olleyes' FDA-cleared VisuALL VRP. The VisuALL VRP offers virtual reality, artificial intelligence, and matrix eye tracking to enable eyecare providers to efficiently test their patient base. Learn more about the company.

FFB Offers COPE Course on Inherited Retinal Disease

The Foundation Fighting Blindness will host an online continuing medical education course on optogenetics for inherited retinal diseases on January 24, at 7 p.m. Eastern time. Learn more.














Journal Reviews Editor:
Katherine M. Mastrota, MS, OD, EMBA, FAAO

Optometric Physician™ (OP) newsletter is owned and published by Dr. Arthur Epstein. It is distributed by the Review Group, a Division of Jobson Medical Information LLC (JMI), 19 Campus Boulevard, Newtown Square, PA 19073.

To change your email address, reply to this email. Write "change of address" in the subject line. Make sure to provide us with your old and new address.

To ensure delivery, please be sure to add Optometricphysician@jobsonmail.com to your address book or safe senders list.

Click here if you do not want to receive future emails from Optometric Physician. HOW TO SUBMIT NEWS E-mail optometricphysician@jobson.com or FAX your news to: 610.492.1039.

Advertising: For information on advertising in this e-mail newsletter, please contact sales managers Michael Hoster, Michele Barrett or Jonathan Dardine.

News: To submit news or contact the editor, send an e-mail, or FAX your news to 610.492.1039