Abell, R. G., et al. (2014) Femtosecond laser-assisted cataract surgery versus standard phacoemulsification cataract surgery: Outcomes and safety in more than 4000 cases at a single center J Cataract Refract Surg.
Ang M 2014 Cochrane Updated Intervention Review Manual small incision cataract surgery (MSICS) with posterior chamber intraocular lens versus extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens for age-related cataractNovember 18 2014 (full text link)
Bialer, O. Y., et al. (2014) Accuracy of scheimpflug holladay equivalent keratometry readings after corneal refractive surgery in the absence of clinical history Ophthalmic Res 52(4): 217-223. (full text link)
Christen, W. G., et al. (2014) Age-Related Cataract in Men in the Selenium and Vitamin E Cancer Prevention Trial Eye Endpoints Study: A Randomized Clinical Trial JAMA Ophthalmol. 2014 Sep 18. doi: 10.1001/jamaophthalmol.2014.3478. [Epub ahead of print]
Du, X., et al. (2014) Preliminary study of the association between corneal histocytological changes and surgically induced astigmatism after phacoemulsification BMC Ophthalmol 14: 134. (link to full text)
Findl, O., et al. (2014) Capsular bag performance of a hydrophobic acrylic 1-piece intraocular lens J Cataract Refract Surg. (on-line 7 November)
Papaconstantinou, D., et al. (2014) Clinical trial evaluating Viscoat and Visthesia ophthalmic viscosurgical devices in corneal endothelial loss after cataract extraction and intraocular lens implantation Cutan Ocul Toxicol 33(3): 173-180.
Yu, W. K., et al. (2014) Cataract surgery is associated with a reduced risk of dementia: a nationwide population-based cohort study . Eur J Neurol. 2014 Sep 8. doi: 10.1111/ene.12561. [Epub ahead of print]
Zhu, X., et al. (2014) Effect of pupil size on higher-order aberrations in high-myopic pseudophakic eyes with posterior staphyloma Eye (Lond) (full text link)
Agarwal, S., et al. (2014) Clinico-biochemical Correlation of the Effect of Subconjunctival Bevacizumab for Corneal Neovascularization Cornea 33(10): 1016-1021 1010.1097/ICO.0000000000000198.
Barequet, I. S., et al. (2014) Healing Rate of Corneal Erosions: Comparison of the Effect of Chloramphenicol Eye Drops and Ointment and High-Concentration Hyaluronic Acid in an Animal Model Cornea 33(10): 1080-1082 1010.1097/ICO.0000000000000215.
Cabrerizo, J., et al. (2014) Changes in Color Vision and Contrast Sensitivity After Descemet Membrane Endothelial Keratoplasty for Fuchs Endothelial Dystrophy Cornea 33(10): 1010-1015 1010.1097/ICO.0000000000000216.
Dunn, S. P., et al. (2014) Corneal Graft Rejection 10 Years After Penetrating Keratoplasty in the Cornea Donor Study Cornea 33(10): 1003-1009 1010.1097/ICO.0000000000000212.
Essen K Akpek (2014) New Cochrane Intervention Protocol Artificial corneas versus donor corneas for repeat corneal transplants November 5, 2014 (full text link)
Fenzl, C. R., et al. (2014) Accuracy of corneal trephination depth using the Moria single-use adjustable depth vacuum trephine system Clin Ophthalmol 8: 2391-2396 (full text link)
Finis, D., et al. (2014) Six-Month Effects of a Thermodynamic Treatment for MGD and Implications of Meibomian Gland Atrophy Cornea 33(12): 1265-1270.
Güell, J. L., et al. (2014) Epithelial Ingrowth After LASIK: Visual and Refractive Results After Cleaning the Interface and Suturing the Lenticule Cornea 33(10): 1046-1050 1010.1097/ICO.0000000000000214.
Herretes S (2014) Cochrane Updated Intervention Review Topical Corticosteroids as adjunctive therapy for bacterial keratitis October 16,2014 (full text link)
Hussain, M., et al. (2014) Long-term Use of Autologous Serum 50% Eye Drops for the Treatment of Dry Eye Disease Cornea, October 8 (epub ahead of print)
Kanellopoulos, A. J., et al. (2014) Comparison of prophylactic higher fluence corneal cross-linking to control, in myopic LASIK, one year results Clin Ophthalmol 8: 2373-2381 (full text link)
Kumar Kodavoor, S., et al. (2014) One-year clinical study on efficacy of corneal cross-linking in Indian children with progressive keratoconus Cornea 33(9): 919-922.
Kymionis, G. D., et al. (2014) Long-term Follow-up of Corneal Collagen Cross-linking for Keratoconus—The Cretan Study Cornea 33(10): 1071-1079 1010.1097/ICO.0000000000000248.
Monnereau, C., et al. (2014) Multicenter study of descemet membrane endothelial keratoplasty: first case series of 18 surgeons JAMA Ophthalmol 132(10): 1192-1198. (hard copy available in eye library)
Takkar, B., et al. (2014) Lens Status as the Single Most Important Factor in Endothelium Protection After Vitreous Surgery: A Prospective Study Cornea 33(10): 1061-1065 1010.1097/ICO.0000000000000218.
Torricelli, A. A. M., et al. (2014) Screening of Refractive Surgery Candidates for LASIK and PRK Cornea 33(10): 1051-1055 1010.1097/ICO.0000000000000171.
Utsunomiya, T., et al. (2014) Wound Healing Process After Corneal Stromal Thinning Observed With Anterior Segment Optical Coherence Tomography Cornea 33(10): 1056-1060 1010.1097/ICO.0000000000000223.
Wang, D., et al. (2014) Differences in the corneal biomechanical changes after SMILE and LASIK Patients with myopia of greater than -6.00 dioptres (D) who underwent femtosecond laser-assisted LASIK, experienced a more significant decrease in corneal hysteresis, corneal resistance factor, and p1 and p2 areas than patients who underwent small incision lenticule extraction (SMILE). J Refract Surg 30(10): 702-707.
Diabetic Retinopathy/Macular Edema
Bio Space (2014) FDA Grants Priority Review for Genetech Lucentis in Diabetic Retinopathy The FDA has accepted for filing a supplemental Biologics License Application and granted priority review of ranibizumab for the treatment of diabetic retinopathy. There has been no regulatory submission for this indication in the EU.
Broe, R., et al. (2014) Retinal Vessel Calibers Predict Long-term Microvascular Complications in Type 1 Diabetes: The Danish Cohort of Pediatric Diabetes 1987 (DCPD1987) Diabetes 63(11): 3906-3914.
Byrne, M. M., et al. (2014) Cost of a community-based diabetic retinopathy screening program Diabetes Care 37(11): e236-237. (link to pdf)
Cuenca, N., et al. (2014) Cellular responses following retinal injuries and therapeutic approaches for neurodegenerative diseases Prog Retin Eye Res 43c: 17-75.
De Benedetto, U., et al. (2014) Macular dysfunction is common in both type 1 and type 2 diabetic patients without macular edema Retina 34(11): 2171-2177 (full text link)
Deschler, E. K., et al. (2014) Side-effects and complications of laser treatment in diabetic retinal disease Semin Ophthalmol 29(5-6): 290-300.
Goudie, C., et al. (2014) Ophthalmic digital image transfer: benefits to triage, patient care and resource Ophthalmic Physiol Opt 34(6): 628-635 (link to pdf)
Haddad, N. M., et al. (2014) Cataract surgery and its complications in diabetic patients Semin Ophthalmol 29(5-6): 329-337.
Parodi, M. B., et al. (2014) INTRAVITREAL RANIBIZUMAB FOR NAIVE EXTRAFOVEAL CHOROIDAL NEOVASCULARIZATION SECONDARY TO AGE-RELATED MACULAR DEGENERATION Retina 34(11): 2167-2170(link to pdf)
Pedersen L. (2014) Improvement of mild retinopathy in type 2 diabetic patients correlates with narrowing of retinal arterioles. A prospective observational study. Graefes Arch Clin Exp Ophthalmol. 2014 Oct;252(10):1561-7 (full text link)
Reis, A., et al. (2014) Neuroretinal dysfunction with intact blood-retinal barrier and absent vasculopathy in type 1 diabetes Diabetes 63(11): 3926-3937.
Ronnback, C., et al. (2014) Retinal vessel diameters decrease with macular ganglion cell layer thickness in autosomal dominant optic atrophy and in healthy subjects Acta Ophthalmol 92(7): 670-674.
Schwartz, S., et al. (2014) Nonmydriatic fundus camera for diabetic retinopathy screening in a safety net hospital: effectiveness, prevalence, and risk factors Eur J Ophthalmol:
Shikari, H., et al. (2014) Complications of intravitreal injections in patients with diabetes Semin Ophthalmol 29(5-6): 276-289.
Virgili G (2014) Cochrane Updated Intervention Review Anti-vascular endothelial growth factor for diabetic macular oedema October 24, 2014 (full text link)
Zhang, L., et al. (2014) Effects of antioxidant gene therapy on the development of diabetic retinopathy and the metabolic memory phenomenon Graefes Arch Clin Exp Ophthalmol (full text link)
Asaoka, R., et al. (2014) Identifying 'preperimetric' glaucoma in standard automated perimetry visual fields Invest Ophthalmol Vis Sci. (link to full text, manuscript only)
Carson, D., et al. (2014) Optical bench performance of AcrySof((R)) IQ ReSTOR((R)), AT LISA((R)) tri, and FineVision((R)) intraocular lenses Clin Ophthalmol 8: 2105-2113. (full text link)
Chen, H. F., et al. (2014) Neovascular glaucoma after central retinal vein occlusion in pre-existing glaucoma BMC Ophthalmol 14(1): 119. (full text link)
Chaudhry, T. A., et al. (2014) Patients' visual experience during phacoemulsification cataract surgery and associated fear BMC Res Notes 7: 663. (full text link)
Gregori, N. Z., et al. (2014) Ocular decompression with cotton swabs lowers intraocular pressure elevation after intravitreal injection J Glaucoma 23(8): 508-512.
Hirooka, K., et al. (2014) Use of the structure-function relationship in detecting glaucoma progression in early glaucoma BMC Ophthalmol 14: 118 (full text link)
Kim, J. R., et al. (2014) Efficacy, predictability, and safety of small incision lenticule extraction: 6-months prospective cohort study BMC Ophthalmol 14: 117.(full text link)
Meyer, L. M., et al. (2014) Two-year outcome of repeat trabeculectomy with mitomycin C in primary open-angle and PEX glaucoma Eur J Ophthalmol: (on-line Dec 2014)
Michelessi M (2014) New Cochrane Intervention Protocol Combination medical treatment for primary open angle glaucoma and ocular hypertension: a network meta analysis November 4, 2014 (full text link)
Rao, A., et al. (2014) Comparing focal and global responses on multifocal electroretinogram with retinal nerve fibre layer thickness by spectral domain optical coherence tomography in glaucoma Br J Ophthalmol. (full text link)
Riva, I., et al. (2014) Long-term 24-hour Intraocular Pressure Control With Travoprost Monotherapy in Patients With Primary Open-angle Glaucoma J Glaucoma 23(8): 535-540.
Ophthalmology Times Europe (2014) First clinical trial patient receives STARflo Report by Ron Rajecki November 7 2014
Brodie, S. E. (2014) Tips and tricks for successful electroretinography in children Curr Opin Ophthalmol 25(5): 366-373.
Cahill, J. A. and J. Ross (2014) Eye on Children: Acute Work-up for Pediatric Horner's Syndrome. Case Presentation and Review of the Literature J Emerg Med14 Sep 30. pii: S0736-4679(14)00803-8
Cavuoto, K. M., et al. (2014) General anesthesia in the pediatric population Curr Opin Ophthalmol 25(5): 411-416.
Demirel, N., et al. (2014) Remifentanil Analgesia during Laser Treatment for Retinopathy of Prematurity: A Practical Approach in Neonatal Intensive Care Unit Am J Perinatol 31(11): 983-986.
Guler, E., et al. (2014) Influences of Topical Cyclopentolate on Anterior Chamber Parameters With a Dual-Scheimpflug Analyzer in Healthy Children J Pediatr Ophthalmol Strabismus: 1-5.
Gupta, A. K., et al. (2014) Endoscopic optic nerve fenestration amongst pediatric idiopathic intracranial hypertension: A new surgical option Int J Pediatr Otorhinolaryngol 78(10): 1686-1691.
Kaufman, D. A., et al. (2014) Time outside targeted oxygen saturation range and retinopathy of prematurity Early Hum Dev 90 Suppl 2: S35-40.
Kolomeyer, A. M., et al. (2014) Feasibility of retinal screening in a pediatric population with type 1 diabetes mellitus Ophthalmologists may use nonmydriatic retinal imaging to supplement the standard clinical exam to screen diabetic children aged as young as 2 years, according to newly published research. J Pediatr Ophthalmol Strabismus 51(5): 299-306.(hard copy available in eye library)
Kozak, I., et al. (2014) OUTCOMES OF TREATMENT OF PEDIATRIC CHOROIDAL NEOVASCULARIZATION WITH INTRAVITREAL ANTIANGIOGENIC AGENTS: The Results of the KKESH International Collaborative Retina Study Group Retina 34(10): 2044-2052. (full text link)
Kozeis, N., et al. (2014) Comparative Study of Refractive Errors, Strabismus, Microsaccades, and Visual Perception Between Preterm and Full-Term Children With Infantile Cerebral Palsy J Child Neurol.
Lambley, R. G., et al. (2014 Structural and functional outcomes of anaesthetic cornea in children Br J Ophthalmol (full text link)
Liang, P., et al. (2014) Single-dose sufentanil or fentanyl reduces agitation after sevoflurane anesthesia in children undergoing ophthalmology surgery Pak J Med Sci 30(5): 1059-1063. (full text link)
Ma, X., et al. (2014) Effect of providing free glasses on children's educational outcomes in China: cluster randomized controlled trial Bmj 349: g5740 (full text link)
Neffendorf, J. E., et al. (2014) Efficacy and safety of phenylephrine 2.5% with cyclopentolate 0.5% for retinopathy of prematurity screening in 1246 eye examinations Eur J Ophthalmol: (on-line November 14)
Potz-Biedermann, C., et al. (2014) Ophthalmic Rosacea: Case Report in a Child and Treatment Recommendations Pediatr Dermatol. 2014 Oct 16. [Epub ahead of print]
Quinn, G. E., et al. (2014) Validity of a telemedicine system for the evaluation of acute-phase retinopathy of prematurity JAMA Ophthalmol 132(10): 1178-1184. (available to read in eye library)
Ramzan, M., et al. (2014) Isolated bilateral uveitis in child with hypereosinophilic syndrome J Pediatr Hematol Oncol 36(7): e465-467.
Sanita K (2014) New Cochrane Intervention Protocol Strabismus Surgery before versus after completion of amblyopia therapy in children October 15 2014 (full text link)
Schwering, M. S., et al. (2014) Treatment of Cancer in a Child With Ocular Xeroderma Pigmentosa (XP) in Malawi J Pediatr Hematol Oncol 36(8): e540-542.
Tailor V (2014) New Cochrane Intervention Protocol Binocular versus standard occlusion or blurring treatment for unilateral amblyopia in children aged three to eight years November 11, 2014 (full text link)
Thomas R (2014) New Cochrane Intervention Protocol Assistive technology for children and young people with low vision October 20, 2014 (full text link)
Wadia, S., et al. (2014) Ketamine and intraocular pressure in children Ann Emerg Med 64(4): 385-388.e381.
Woo R. et al (2014) Aggressive Retinopathy of Prematurity: a pilot study of quantitative analysis of vascular features Graefes arc.of clin exp ophthal 2014 November (full text link)
Zhang, W., et al. (2014) A comprehensive clinical study about patching after strabismus surgery Eur J Ophthalmol 24(6): 819-82 (full text link)
Broe, R., et al. (2014) Retinal vascular fractals predict long-term microvascular complications in type 1 diabetes mellitus: the Danish Cohort of Pediatric Diabetes 1987 (DCPD1987) Diabetologia 57(10): 2215-2221 (full text link)
Cheung, N. and D. Wong (2014) Graefe's archive for clinical and experimental ophthalmology-instant glue for retinal detachment surgery? Graefes Arch Clin Exp Ophthalmol (full text link)
Durlu, Y. K., et al. (2014) Novel Recessive Cone-Rod Dystrophy Caused by POC1B Mutation JAMA Ophthalmol 132(10): 1185-1191.(hard copy available to read in eye library)
Evans J (2014) New Cochrane Intervention Review Laser photocoagulation for proliferative diabetic retinopathy November 24 2014 (full text link)
Fang L (2014) The effect of flamer syndrome on retinal venous pressure BMC Ophthalmology 2014, 14:121 (full text link)
Jobling, A. I., et al. (2014) Nanosecond laser therapy reverses pathologic and molecular changes in age-related macular degeneration without retinal damage Faseb j. (on-line 12 November)
Hahn P (2014) Successful treatment of neovascular age-related macular degeneration following single bevacizumab failure using aflibercept in a vitrectomized eye Clinical Ophthalmology, 2014:8 2129-31(link to pdf at end of abstract)
Iannaccone, A. and M. A. Zarbin (2014) A new era in medical therapy for retinal degenerative disease? Lancet. (full text link via Science Direct))
Lee, J. A., et al. (2014) Treatment outcome of osteosarcoma after bilateral retinoblastoma: a retrospective study of eight cases Br J Ophthalmol 98(10): 1355-1359. (full text link)
Lim, J. I., et al. (2014) One year results of a phase 1 study of the safety and tolerability of combination therapy using sustained release intravitreal triamcinolone acetonide and ranibizumab for subfoveal neovascular AMD Br J Ophthalmol (full text link)
Lotery, A. and C. MacEwen (2014) What is stopping the NHS from using bevacizumab for macular degeneration and other retinal disorders? Bmj 349: g6887. (full text link)
Kim, Y. J., et al. (2014) Retinal detachment surgery in eyes with iris-fixated phakic intraocular lenses: Short-term clinical results J Cataract Refract Surg.
Kmietowicz, Z. (2014) Cheaper alternative for macular degeneration is as safe as licensed drug, review finds Bmj 349: g5618 (link to full text)
Melles, R. B. and M. F. Marmor (2014) The Risk of Toxic Retinopathy in Patients on Long-term Hydroxychloroquine Therapy JAMA Ophthalmol.(hard copy available in eye library)
Mehta, M. C. and P. T. Finger (2014) Angled transscleral intravitreal injection: a crossover study Eur J Ophthalmol: 2014 10 (epub ahead of print)
Moja, L., et al. (2014) Systemic safety of bevacizumab versus ranibizumab for neovascular age-related macular degeneration Cochrane Database Syst Rev 9: Cd011230. (full text link)
Novack, R. L., et al. (2014) Safety of Intravitreal Ocriplasmin for Focal Vitreomacular Adhesion in Patients with Exudative Age-Related Macular Degeneration Ophthalmology (full text link)
Rajjoub, R. D., et al. (2014) Reproducibility of Retinal Nerve Fiber Layer Thickness Measures Using Eye Tracking in Children With Nonglaucomatous Optic Neuropathy Am J Ophthalmol. (full text link)
Rupal Morjaria, Vaneeta Sood, Kaveh Manavi,Alastair K Denniston, Helen Palmer (2014)
1Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham National Health Service Foundation Trust, Birmingham, United Kingdom; 2Nuffield Department of Ophthalmology, Oxford University Hospitals National Health Service Trust, Oxford, United Kingdom; 3Centre for Translational Inflammation Research, University of Birmingham, Birmingham, United Kingdom
Lowering the limit: reducing the CD4 T-cell threshold for ophthalmic screening in patients with HIV in an ethnically diverse UK population (access to free full text at end of article)
Reuters Health (2014) Will Dunham HIV drugs show promise in treating common eye disease (title links to Medscape write up; if you are not already registered you can either register, or read article below)
WASHINGTON (Reuters) - A class of drugs used for three decades by people infected with the virus that causes AIDS may be effective in treating a leading cause of blindness among the elderly.
HIV drugs called nucleoside reverse transcriptase inhibitors (NRTIs), including AZT and three others, blocked age-related macular degeneration in mice and worked well in experiments involving human retinal cells in the laboratory, researchers said on Thursday.
In HIV-infected people, NRTIs block an enzyme the virus uses to create more copies of itself. The new research shows the drugs also block the activity of a biological pathway responsible for activating inflammatory processes in the body.
It is that previously unrecognized quality that makes NRTIs promising for treating macular degeneration as well as graft-versus-host disease, a rarer ailment that can occur after a stem cell or bone marrow transplant, the researchers said.
University of Kentucky ophthalmologist Dr. Jayakrishna Ambati, who led the study published in the journal Science, said macular generation affects an estimated 50 million people worldwide.
"With the aging of the population, it is projected to affect 200 million people by the year 2020. It is therefore critical that we develop new and improved treatments for this disease, which is growing like an epidemic," Ambati said.
Macular degeneration causes cells to die in the macula, a part of the eye located near the center of the retina that permits vision in fine detail.
The chronic disease has two forms: "dry" and "wet." Several treatments exist for "wet" macular degeneration but only about a third of patients get significant vision improvement. There are no approved treatments for the "dry" form, which is much more common but less severe.
The "wet" type occurs when abnormal blood vessels grow under the macula and leak blood and fluid. The "dry" form occurs when cells in the macula break down.
In the new study, the NRTIs blocked a powerful collection of proteins that can kill cells in the retina, preserving vision in mice.
Researchers are planning for clinical trials in the coming months and it could be known in as soon as two to three years whether the drugs are effective in treating macular degeneration in people, Ambati said.
Because these inexpensive drugs are already approved by the U.S. Food and Drug Administration and have a good safety record, they could be "repurposed" rapidly to treat other illnesses, he added.
Nika, M., et al. (2014) Regular Examinations for Toxic Maculopathy in Long-term Chloroquine or Hydroxychloroquine Users JAMA Ophthalmol 132(10): 1199-1208. (hard copy available in eye library)
Salman S(2014) New Cochrane Intervention Protocol Aflibercept for neovascular age-related macular degeneration October 23 2014 (full text link)
Sandberg, M. A., et al. (2014) The relationship of central foveal thickness to urinary iodine concentration in retinitis pigmentosa with or without cystoid macular edema JAMA Ophthalmol 132(10): 1209-1214.(hard copy available in eye library)
Simcock, P., et al. (2014) A safety audit of the first 10 000 intravitreal ranibizumab injections performed by nurse practitioners Eye (Lond) 28(10): 1161-1164
Press Release 19th November 2014
NHS Royal College of Ophthalmologists is calling on the regulators find a way to license bevacizumab or NICE to find a way to consider off-label use, for the treatment of AMD and thus save the NHS millions of pounds a year and relieve some of the capacity issues.
Babu, K., et al. (2014) Clinical profile of isolated viral anterior uveitis in a South Indian patient population Ocul Immunol Inflamm 22(5): 356-359.
Eadie, B., et al. (2014) Risk for Uveitis With Oral Moxifloxacin: A Comparative Safety Study JAMA Ophthalmol.
Goldberg, N. R., et al. (2014) Success with single-agent immunosuppression for multifocal choroidopathies Am J Ophthalmol 158(6): 1310-1317 (full text link)
Langner-Wegscheider, B. J. and M. D. de Smet (2014) Surgical Management of Severe Complications Arising from Uveitis in Juvenile Idiopathic Arthritis Ophthalmologica (full text link)
Haasnoot, A. J., et al. (2014) Erythrocyte sedimentation rate as baseline predictor for the development of uveitis in children with juvenile idiopathic arthritis Am J Ophthalmol. (full text link)
Moore, D. B., et al. (2014) Retinal Nerve Fiber Layer Thickness Measurements: Uveitis, A Major Confounding Factor Ophthalmology (full text link)
Lim, S. J., et al. (2014) Prevalence of Toxoplasma gondii and Toxocara canis among Patients with Uveitis Ocul Immunol Inflamm 22(5): 360-366.
Sen, H. N., et al. (2014) Periocular corticosteroid injections in uveitis: effects and complications Ophthalmology 121(11): 2275-2286. (full text link)
Slemp, S. N., et al. (2014) Giant cell arteritis presenting with uveitis Ocul Immunol Inflamm 22(5): 391-393.
Vastert, S. J., et al. (2014) Pathophysiology of JIA-associated Uveitis Ocul Immunol Inflamm 22(5): 414-423.
Benitez del Castillo et al. (2014) Evaluation of the efficacy, safety, and acceptability of an eyelid warming device for the treatment of meibomian gland dysfunction (link at end of abstract to download free full text)
Chan, W., et al. (2014) Assisted Local Anesthesia for Powered Endoscopic Dacryocystorhinostomy Orbit: 1-5. (full text link)
Medscape Conference News (2014) Megan Brooks Blinking Exercises may help ease evaporative eye disease (title links to Medscape write up; if you are not already registered you can either register, or read article below)
In patients with evaporative dry eye, blinking exercises can help decrease partial blinking and improve meibomian gland function and symptoms, according to a new study.
Detecting and quantifying partial blinking and blink training might be important in the overall treatment and management of evaporative dry eye, the investigators report.
David Murakami, MPH, OD, from TearScience Inc. in Morrisville, North Carolina, and Korb Associates in Boston, presented the results at the American Academy of Optometry 2014 Annual Meeting in Denver.
Partial blinking is closely involved in evaporative dry eye, he explained in an interview with Medscape Medical News.
"We are a focused society; we stare at computers, smartphones, and video games, and we are trained not to blink. If you aren't blinking fully, you don't express the oil from the glands," he said.
We have hundreds of patients with evaporative dry eye who are on a blinking program," Dr Murakami reported.
Blink and Brain Training
Dr Murakami presented results on 10 patients diagnosed with partial blinking, symptomatic evaporative dry eye, and reduced gland function. Their mean age was 53 years.
All patients completed a dry eye questionnaire, and habitual blinking behavior was recorded for 20 seconds and analyzed with the LipiView (TearScience Inc.), an ophthalmic imaging device used to measure the tear film lipid layer. In addition, the number of functional lower lid meibomian glands was determined with the Meibomian Gland Evaluator (TearScience Inc.).
Each patient was trained in and performed individualized blinking exercises for at least 8 weeks.
"I tell patients to really pause and deliberately close their eyes," Dr Murakami said. "We are training the lids to be stronger, but we are also retraining the brain to do a full blink." A blinking reminder computer program helped remind the patients to do the exercises.
Patients were assessed before and after the intervention.
The percentage of partial blinks improved significantly with the intervention (70.9% vs 23.5%; P = .001). In addition, symptoms decreased (10.1 vs 6.7; P = .02) and the average number of functional glands increased (4.1 vs 5.9; P = .02).
"Blinking exercises have been a well known antidote for dry eye symptoms due to non or partial blinking for many years," Barry Farkas, OD, an optometrist in private practice in New York City, who was not involved in the study.
"We have employed such assistance for over 35 years. In the old days of mostly rigid contact lenses, those exercises were even more necessary for tear and oxygen flow and exchange," he told Medscape Medical News.
Compliance an Issue
"In today's world, where contact lens materials are all breathable, complete blinking still remains more than helpful in spreading both moisture and nutrients to the entire corneal surface," Dr Farkas explained. "Even for those not wearing lenses, failure to blink completely and regularly can push a marginally unstable tear layer toward a too-short contact time with the cornea and lead to corneal surface breakdown." "The issue with blinking exercises has always been, and remains, finding individuals motivated enough to learn the technique and continue with the process. There are those who might find the treatment not enough of a cure and too much of a nuisance," he said. Dr Murakami said he agrees that compliance is "always going to be an issue." However, education is important. Patients who demonstrate more severe partial blinking and who tend to be very symptomatic are likely to be compliant because they understand the problem, he pointed out. Blinking is "important", said Mina Massaro-Giordano, MD, from the Penn Dry Eye and Ocular Surface Center and the Scheie Eye Institute at the University of Pennsylvania in Philadelphia. She said she has been paying more attention to it. "I was kind of surprised to see the amount of partial blinks my patients have. I do give blinking exercises to some of my patients," she told Medscape Medical News. "What's interesting about this study," Dr Massaro-Giordano said, "is that it shows you can improve the muscles involved in blinking. It's just like any muscle; if you work it, it improves." But she said it is also important consider the eyelids. "Older patients may have lax lids or extropion, so even if they are blinking hard, it may be ineffective because that lower lid is just loose from age, prior surgery, or prior damage," she explained. "You also have to look at the meibum. If you have meibum that is completely socked in and the concretions are really dense and it's very viscous, then you can blink all you want — it's not coming out."
This study was funded by TearScience Inc. Dr Murakami and his coauthors are employees of the company. Dr Farkas and Dr Massaro-Giordano have disclosed no relevant financial relationships. American Academy of Optometry 2014 Annual Meeting: Poster F-039. Presented November 14, 2014
Inoe M (2014) Short-term efficacy of intravitreal aflibercept in treatment-naive patients with polypoidal choroidal vasculopathy Retina. 2014 Nov;34(11):2178-84 (full text link)
Kim, J. R., et al. (2014) Efficacy, predictability, and safety of small incision lenticule extraction: 6-months prospective cohort study BMC Ophthalmol 14: 117. (full text link)
Lee, H., et al. (2014) Effects of Topical Loteprednol Etabonate on Tear Cytokines and Clinical Outcomes in Moderate and Severe Meibomian Gland Dysfunction: Randomized Clinical Trial Am J Ophthalmol. (full text link available Science Direct)
MacLean, K. and H. B. Hindman (2014) UR Well Eye Care: a model for medical student ophthalmology education and service in the community Clin Ophthalmol 8: 2397-2401. (full text link
Melki, S., et al. (2014) An implantable intraocular pressure transducer: initial safety outcomes JAMA Ophthalmol 132(10): 1221-1225.
This may be a useful article for your Nurses/Healthcare Assistants –
Peate Ian (2014) Glaucoma-early diagnosis could prevent vision loss British Journal of Healthcare Assistants 2014 October 8:10 pgs 482-88 (full text link) Athens log in required
Taylor HR, (2014) Trachoma
Summary Trachoma is the most common infectious cause of blindness. Repeated episodes of infection with Chlamydia trachomatis in childhood lead to severe conjunctival inflammation, scarring, and potentially blinding inturned eyelashes (trichiasis or entropion) in later life. Trachoma occurs in resource-poor areas with inadequate hygiene, where children with unclean faces share infected ocular secretions. Much has been learnt about the epidemiology and pathophysiology of trachoma. Integrated control programmes are implementing the SAFE Strategy: surgery for trichiasis, mass distribution of antibiotics, promotion of facial cleanliness, and environmental improvement. This strategy has successfully eliminated trachoma in several countries and global efforts are underway to eliminate blinding trachoma worldwide by 2020.
Lancet Volume 384, Issue 9960, 13–19 December 2014, Pages 2142–2152
Yen, H. W., et al. (2014) Non-traumatic Ocular and Periocular Hemorrhages in a Hypertensive Patient under Continuous Ambulatory Peritoneal Dialysis and Warfarin Therapy Intern Med 53(20): 2337-2339. (full text link)
In the News
Friedman, NJ (2014) Link to Hot Topics and Key Research Findings from AAO 2014
Scientists look into regenerating Retinal Cells (11:20am, 3 October 2014)
Scientists have discovered stem cells in the human eye which can be transformed into light-sensitive cells and potentially reverse blindness.
Links to the Science:
Chen X, Thomson H, Cooke J, et al. Adult Limbal Neurosphere Cells: A Potential Autologous Cell Resource for Retinal Cell Generation.
Sticky nanoparticles could “revolutionise” eye drops (12:49pm, 8 October 2014)
Nanoparticles which ‘stick’ to the cornea could improve the effectiveness of eye drops and may in future provide a route to treatments for age-related macular degeneration (AMD), according to new research from the University of Reading.
NHS Choices October 2014
Links to the Science Nivison-Smith L (2014) Sildenafil alters retinal function in mouse carriers of Retinitis Pigmentosa Experimental Eye Research 2014, 128:11, 43-56 (link to full text) Log in required
Ophthalmology Times (9 October 2014)
NHS Networks 29 September 2014
Ophthalmology Times (3 October 2014)
Aflibercept boosts BVCA in DME Ophthalmology Times (31 October)
Combination Glaucoma Drop Moves Toward Approval Ophthalmology Times 30 October 2014
Study examines link between MS and Uveitis Ophthalmology Times, 29 October 2014
UK Charities drive retinal dystrophy consortium Ophthalmology Times 24 October 2014
An independent evaluation has concluded that the UK Vision Strategy’s commissioning for effectiveness and efficiency (CEE) project is helping to improve local provision of eye care services.
NHS Networks 7 November 2014
Reuters NICE Medicines Awareness 7 November 2014
ANSM has written to Roche for information on off-label uses of bevacizumab, which it is reviewing as cheaper alternative to ranibizumab for AMD. The data provided, combined with ANSM's own research, will be examined early next year and recommendations expected first half of 2015.
The College of Optometrists has launched its updated guidance. The guidance for professional practice (previously the Code of Ethics and Guidance for Professional Conduct) has been revised and updated with new sections on research, audit and also social media.
Devon Local Optical Committee has produced a leaflet to raise public awareness of the importance of eye health and regular eye tests
NHS Choices December 2014
The following sources have been searched for evidence. Please contact the editor for further information
A new indication for aflibercept in the treatment of diabetic macular oedema.
The following sources have been searched for the latest evidence Please contact the editor for further information.
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