Do You See What I See (or Don t)? Office-based Ophthalmology for the Primary Care Provider
|
|
- Norman Boyd
- 5 years ago
- Views:
Transcription
1 Do You See What I See (or Don t)? Office-based Ophthalmology for the Primary Care Provider Steve Roberts, MDCM, FRCSC, D. ABO 2017 PEIP Conference DoubleTree Hotel, West Edmonton Oct. 22, 2017
2 Faculty/Presenter Disclosure Presenter: Steve Roberts Relationships that may introduce potential bias and/or conflict of interest: Grants/Research Support: N/A Speakers Bureau/Honoraria: Steve Roberts has received a speaker fee and expense support from the Alberta College of Family Physicians. Consulting Fees: N/A Other: N/A
3 Disclosure of Commercial Support This program is presented by the Alberta College of Family Physicians (ACFP) without any commercial or in-kind support. The ACFP provides a speaker fee and expense support for presenting at the Practical Evidence for Informed Practice.
4 How I Arrive at a Diagnosis the best answers to questions asked in this specialty typically require lots of gear!
5
6
7 Hallway Consult Oh good! Dr. Roberts! This happened 2 days ago, I was out with my kids in a field, when.???????????????????????????????????????????????????????????????
8 So it is going to be impossible to independently manage many eye complaints armed with, at best: Be Realistic
9 But Hopeful But you don t have to feel powerless or that the eye is somehow an impenetrable puzzle
10 Outline Helpful Reminders and Tips Dry Eye Disease Allergic Conjunctivitis Cataract Retinal Detachment
11 Basic facts prior to consultation Visual acuity (the vital sign of the eye) Nature of symptom Duration of symptom (blind eye for 1 day or 10 years) Relevant antecedents (eg: recent surgery, trauma, previous similar episode) Previous ocular conditions or surgeries Does the patient wear glasses or contact lenses (and if so, did they bring them to the office or ER for their exam!) Do not fax an urgent referral please call the office, or page the specialist
12 General Tips Visual Acuity Please ascertain this prior to consultation. She can see my fingers is not very descriptive or accurate. It is likely that she can see even more precisely, and this should be communicated. Nurses and clinical staff can do this for you. Patient should be wearing glasses for distance (if checking at distance), or glasses for near if checking vision on a near chart (paper or smart phone, EHB app). Cover left eye, test the right. Cover right eye, test the left. Record.
13 It s, um, in the iris
14 I ll just sew that up.
15 There is a proper way
16 Poor (No?) Repair Can Be Bad
17 Sudden loss of vision Use Red Reflex
18 Dry Eye Disease Endemic problem, affecting % of the population 1 Incidence in Canada may be as high as 25% 2 Particularly worse when the environment does not help at all, such as in Alberta Was dismissed for many years, but its importance is becoming better recognized, and therefore, better studied
19 3 Major Categories Aqueous Tear Deficiency Evaporative Dry Eye Disease Some relative combination of the two
20 Aqueous Tear Deficiency That which is due to SJS, or non-sjs entities Sjögren syndrome ATD + dry mouth
21 Evaporative Dry Eye Disease 3 categories 1. Oil deficient 2. Lid related (exposure) 3. Surface changes of conjunctiva
22
23 Lid-Related Reduced blink rate primary or secondary to neurological disease (Parkinsons, Alzheimer s) Tumors/previous surgery (sling repair of congenital ptosis)/trauma Ectropion Nocturnal lagophthalmos TAO (proptosis/lid retraction)
24 3 Major Categories
25 Symptoms Burning Itching Foreign body sensation Stinging Dryness Photophobia Ocular fatigue Redness Crusting Loss of clarity with concentration/sustained visual focus
26 Testing
27 Testing
28 Therapy for Dry Eye Disease Replacement Many different formulations and admixtures, with various effects benefits and side-effects Lubricating drops Gel-drops Mineral oil-based drops Ophthalmic ointments Preservative-Free Recent Cochrane Review reaffirms that they all in general relieve dry eye disease, but no extrapolations can be made with regards to comparative efficacy of OTC brands 4
29 Restasis 0.05% cyclosporine A Only medicine to assist with helping patient increase tear production, although this was not seen in patients with tear duct plugs or in those using anti-inflammatory drops Clearly improves objective markers of dry eye disease, but is less effective in controlling symptoms 5
30 Hot Compresses Rx
31 Omega 3 FFA Supplementation Improves the quality of the oil secreted Patients objectively and subjectively improved with regular supplementation 6,7
32 Blepharitis Management Daily lid care Tetracycline/doxycycline, for 3 months at a time for rosacea patients with eye symptom flare-up is helpful Short-term (10-14 days) topical steroids (fluorometholone, loteprednol, prednisolone)
33 Blepharitis Management
34 Blepharitis Managment
35 Blinking Exercises Written exercise instruction handouts Smartphone apps PC Programs
36 Environmental
37 Environmental
38 Allergic Conjunctivitis Without Corneal Involvement <24 hours = Acute Allergic Conjunctivitis One season = Seasonal Allergic Conjunctivitis All seasons = Perennial Allergic Conjunctivitis With Corneal Involvement Vernal keratoconjunctivitis (VKC) Atopic keratoconjunctivitis (AKC)
39 Alergic Conjunctivitis - Symptoms Itchiness (with eye rubbing Hx) Swollen lids Swollen conjunctiva Hyperemic conjunctiva Bilateral presentation Ropey or watery discharge
40 Allergic Conjunctivitis
41 Giant Papillary Conjunctivitis
42 VKC
43 AKC
44 Ideal Treatment Prevent/avoid/reduce exposure to offending allergen
45 Real Treatment 8 OTC antihistamine/vasoconstrictor like tetrahydrozoline, oxymetazoline, etc, eg: Visine, Cleareyes H1 receptor antagonist (bepotastine/bepreve) Mast-cell stabilizers (olopatadine/pataday, also a H1 receptor antagonist) Lower dose/potency steroids (Prednisolone %/ Pred Mild, loteprednol 0.2 %/Alrex) NSAIDS ketorolac/acular and ketotifen/zaditor Cold compresses, artificial tears to dilute allergy Allergy specialist referral immunotherapy, sublingual immunotherapy (SLIT)
46 Advice Cochrane review from 2015 indicates that for seasonal/perennial allergic conjunctivitis, ALL reported topical antihistamines and mast cell stabilizers improved symptoms vs. placebo, while being safe and well tolerated 9 Examples Opticrom, Pataday, Bepreve
47 Cataract Media opacity of the human lens Can be completely insignificant Can be life-altering
48 Mature Cataract
49 Medical Treatment? No medical treatment for cataracts A twin study from the UK analysing 1000 female twins, indicated that diets rich in vitamin C were associated with a 20 percent risk reduction for cataract. After 10 years, researchers found that women who reported consuming more vitamin C-rich foods had a 33 percent risk reduction of cataract progression 10
50 Supportive Treatment Changes and progression of cataract can be rapid (trauma, penetrating injury, etc.) or slow (nuclear sclerosis getting slowly worse with age) This incurs refractive change, and patients require frequent updates to their glasses or contact lenses until vision becomes too poor or there is too much light scatter affecting patient s ability to see
51 Nuclear Sclerosis
52 Phacoemulsification
53 Complications one of the most commonly performed, safest medical procedures in existence blurred vision is non-specific and is most likely due to a continued need for glasses for optimal vision postoperatively IFIS intraoperative floppy iris syndrome is a problem during surgery in patients on tamsulosin, as well as those on quetiapine and risperidone to a lesser extent Study from 2009, from Canada, demonstrated men on tamsulosin had 2.3 times the risk of severe postoperative complications from cataract surgery, including retinal detachment and endophthalmitis 11
54 IFIS
55 Recommendation In patients who are anticipating cataract surgery or are on a cataract surgery waiting list, it is advised to hold off on prescribing an alpha blocker until after the surgery 12,13
56 Retinal Detachment Painless loss of vision, which usually starts with a dense visual field loss or darkness, beginning on one side/top/bottom of the visual field, gradually extending centrally
57 Symptoms
58 Vitreous Detachment Flashes may be present, but there is usually a new or prominent large floater, +/- many new little ones (often signifying RBCs) Characterized by a separation of the posterior aspect of the vitreous, and that of the underlying retina % of the time a clean break occurs So the other times are what happens when the vitreous gel pulls too strongly on the retina, causing a retinal hole or tear
59 Retinal Photocoagulation for Tear
60 Retinal Detachment
61 Retinal Detachment
62 RD - Urgency If dark curtain and central vision is good Urgent case If Hx of dark curtain and the central vision is poor 7 days to repair 14
63 References 1. Gayton, JL. Etiology, prevalence, and treatment of dry eye disease. Clinical Ophthalmology. 2009; 3: Doughty MJ, Fonn D, Richeter D, et al. A patient questionnaire approach to estimating the prevalence of dry eye symptoms in patients presenting to optometric practices across Canada. Optom Vis Sci. 1997;74: Viso E, Rodriguez-Ares MT, Abelenda D, Oubina B, Gude F. Prevalence of asymptomatic and symptomatic meibomian gland dysfunction in the general population of Spain. Invest Ophthalmol Vis Sci 2012;53: Pucker AD, Ng SM, Nichols JJ. Over the counter (OTC) artificial tear drops for dry eye syndrome. Cochrane Database of Systematic Reviews 2016, DOI: / CD pub2.
64 References 5. Ames P, Galor A. Cyclosporine ophthalmic emulsions for the treatment of dry eye: a review of the clinical evidence. Clin Investig. 2015; 5(3): Macsai M. The Role of Omega-3 Dietary Supplementation in Blepharitis and Meibomian Gland Dysfunction. Trans Am Ophthalmol Soc Dec; 106: Epitropoulos AT, Donnenfeld ED, Shah ZA, et al. Effect of Oral Reesterified Omega-3 Nutritional Supplementation on Dry Eyes. Cornea Sep;35(9): Au A, Grigorian AP, Adamopoulou C. (2014, December 17). Allergic Conjunctivitis. Retrieved from: on Oct. 12, Castillo M, Scott NW, Mustafa MZ, et al. Topical antihistamines and mast cell stabilisers for treating seasonal and perennial allergic conjunctivitis. Cochrane Database of Systematic Reviews 2015, DOI: / CD pub2.
65 References 10. Yonova-Doing E, et al. Genetic and Dietary Factors Influencing the Progression of Nuclear Cataract. Ophthalmology Jun;123(6): Bell CM, Hatch WV, Fischer HD, et al. Association between tamsulosin and serious ophthalmic adverse events in older men following cataract surgery. JAMA. 2009;301: Gani J, Perlis N, Radomski SB. Urologic medications and ophthalmologic side effects: a review. Can Urol Assoc J Feb; 6(1): Zaman F, Bach C, Junaid I, et al. The Floppy Iris Syndrome What Urologists and Ophthalmologists Need to Know. Curr Urol May; 6(1): Ross WH. Visual recovery after macula-off retinal detachment. Eye. (2002) 16,
Dr Rachael Neiderer. Ophthalmologist Auckland. 8:35-8:50 Managing Allergic Conjunctivitis & Why Sodium Chromoglycate is Out
Dr Rachael Neiderer Ophthalmologist Auckland 8:35-8:50 Managing Allergic Conjunctivitis & Why Sodium Chromoglycate is Out Allergic conjunctivitis Rachael Niederer Greenlane Clinical Centre, Auckland Case
More informationPeople with eye allergies typically have symptoms that include: Eye Anatomy: What Do Eye Allergies Actually Effect?
Eye Allergies Eye Allergies People with eye allergies typically have symptoms that include: Itchy watery eyes Eyelid problems Dark circles around eyes Dry eyes Reactions to Contacts Let us help allow you
More informationOCULAR SURFACE DISEASE SYNDROMES WAYNE ISAEFF, MD LOMA LINDA UNIVERSITY DEPARTMENT OF OPHTHALMOLOGY
OCULAR SURFACE DISEASE SYNDROMES WAYNE ISAEFF, MD LOMA LINDA UNIVERSITY DEPARTMENT OF OPHTHALMOLOGY SURFACE DISEASE DRY EYE DYSFUNCTIONAL TEARS SYND ALLERGIC DISORDERS MEIBOMIAN GLAND PROBLEMS OCULAR IMMUNE
More informationDRY EYE INFORMATION AND TREATMENTS
DRY EYE INFORMATION AND TREATMENTS If you cannot come to your appointment, please call us at least 24 hours before at 450.419.6345. Failure to notify us will result in a $50 fee being charged. Institut
More informationDry eye syndrome. Lacrimal gland. Tear duct into nose. 1 of 6
Dry eye syndrome The aim of this information sheet is to answer any questions you may have about dry eye syndrome. If you have any further questions or concerns, please ask a doctor or nurse caring for
More informationProvided as a service by CiplaMed
Allergy Reaction of the body tissues to an allergen which leads to production of antibodies finally culminating in an antigen-antibody antibody reaction. Normal Individual Entry of allergen Allergen-Antibody
More informationPhone Triage for Optometric Staff ???????? CHEMICAL BURN CHEMICAL BURN
Phone Triage for Optometric Staff There are very few ocular emergencies that you will have to deal with in practice, but it is imperative that you be able to Michelle Welch, O.D. NSU Oklahoma College of
More informationPAINFUL PAINLESS Contact lens user BOV
Common Causes Allergies Infections Ocular Cornea, uveitis, endophthalmitis Orbital Orbital cellulitis Inflammation Uveitis Scleritis / episcleritis Glaucomas Trauma Foreign bodies Chemical injuries History
More informationOCULAR ALLERGY IN CHILDREN. Presenter: Dr C.L.A Ogundo Consultant Ophthalmologist KPA conference April 2017
OCULAR ALLERGY IN CHILDREN Presenter: Dr C.L.A Ogundo Consultant Ophthalmologist KPA conference April 2017 Introduction Hypersensitivity disorder Conjunctival surface is accessible to allergens and is
More informationOcular Allergy. Phil Lieberman, MD
Ocular Allergy Phil Lieberman, MD Disclosure Consultant/Advisory Board: Genentech, Meda, Mylan, Teva Speaker: Genentech, Meda, Merck, Mylan, Teva Learning Objectives Upon completion of this session, participants
More informationOcular Allergies: Scratching the Surface. -20%-50% of the population has allergies -83% of allergy sufferers experience ocular symptoms
How Many People Are Affected? Ocular Allergies: Scratching the Surface Mile Brujic, OD -20%-50% of the population has allergies -83% of allergy sufferers experience ocular symptoms Disclosure: I have no
More informationEffect of Topical Cyclosporine 0.05% in Allergic Conjunctivitis
Effect of Topical Cyclosporine 0.05% in Allergic Conjunctivitis Delhi J Ophthalmol 2015; 25 (3): 171-175 DOI: http://dx.doi.org/10.7869/djo.101 * Sonali Bhalla, SK Sachan **, AM Jain ** * Bhalla Medical
More informationOPHTHALMOLOGY DEPARTMENT Primary care referral guidelines
OPHTHALMOLOGY DEPARTMENT Primary care referral guidelines Contents REFERRAL CATEGIES... 2 Emergency... 2 Urgent... 2 Semi urgent/routine... 2 Not accepted... 2 OPHTHALMOLOGY CONDITIONS NOT ACCEPTED...
More informationBruce H. Koffler, M.D. Lindsay Koffler Cassidy, COT, OSC
Bruce H. Koffler, M.D. Lindsay Koffler Cassidy, COT, OSC Ocular surface disease patients can be very time consuming. You must have a streamlined system and work as a team in order to effectively run a
More informationAgePage. Aging And Your Eyes. Steps To Protect Your Eyesight
National Institute on Aging AgePage Aging And Your Eyes Are you holding the newspaper farther away from your eyes than you used to? Join the crowd age can bring changes that affect your eyesight. Some
More informationCondition: Allergic Eye Disease (Type 1 Hypersensitivity reactions)
Condition: Allergic Eye Disease (Type 1 Hypersensitivity reactions) Description: Seasonal allergic conjunctivitis is caused by seasonal allergens, especially grass pollen, whereas perennial conjunctivitis
More informationTest Bank for Medical Surgical Nursing An Integrated Approach 3rd Edition by White
Test Bank for Medical Surgical Nursing An Integrated Approach 3rd Edition by White Link full download : http://testbankair.com/download/test-bank-for-medical-surgical-nursing-anintegrated-approach-3rd-edition-by-white/
More informationOPHTHALMOLOGY REFERRAL GUIDE FOR GPS
OPHTHALMOLOGY REFERRAL GUIDE FOR GPS A guidebook to support general practitioners in the management and referral of a range of common eye problems. Contents 3 Introduction 4 Ophthalmic Workup 6 Acute Visual
More informationOverview & pathophysiology of Dry Eye and the use of cyclosporine eye drops in dry eye...
Overview & pathophysiology of Dry Eye and the use of cyclosporine eye drops in dry eye... This Allergan sponsored session was held on July 24, 2005, Hotel Satya Ashoka, Jabalpur. The session was followed
More informationCataract. What is a Cataract?
Cataract What is a Cataract? We all have a lens in our eye. This is positioned just behind the iris, which is the coloured ring in the eye that gives your eye its colour. The lens function is to focus
More informationExamining Children s Eyes
Paediatric Ophthalmology What to refer & when? Aims Tips for assessing a child s eyes in general practice Common paediatric ophthalmology symptoms and signs What needs to be referred and when? MISS FARIHA
More information1. Department of Ophthalmology, Pacific Medical College and Hospital, Udaipur, Rajasthan, India
International Journal of Medical Science and Education An official Publication of Association for Scientific and Medical Education (ASME) www.ijmse.com Original Research Article pissn- 2348 4438 eissn-2349-3208
More informationFrequently Asked Questions about General Ophthalmology:
1. Normal Eye Structure The eye is a slightly asymmetrical globe, about an inch in diameter. The parts of the eye include: Cornea (a clear dome over the iris), Iris (the pigmented part); Pupil (the black
More information12/3/2011. Disclosure. Allergic Eye Disease: Diagnostic Pearls and Treatment Options. Symptoms. Allergy Eye Disease
Disclosure Allergic Eye Disease: Diagnostic Pearls and Treatment Options I have no financial relationships to disclose. Ophthalmology Update 2011 Matilda Chan MD, PhD Department of Ophthalmology, UCSF
More informationAcute Eyes for ED. Enis Kocak. The Alfred Ophthalmology
Acute Eyes for ED Enis Kocak The Alfred Ophthalmology The problem with eyes Things to cover Ocular anatomy Basic assessment Common presentations Eye first aid and procedures Ophthalmic emergencies What
More informationOphthalmology Times Case Study Yasmin Mali, MD. Case Study
Ophthalmology Times Case Study Yasmin Mali, MD Case Study A 57 year old female with presented with ocular irritation and discomfort in both eyes for several months. Patient was previously started on a
More informationConjunctivitis - Allergic, Seasonal & Perennial (1 of 6) Patient presents w/ symptoms suggestive of allergic conjunctivitis
, Seasonal & Perennial ( of 6) A B Patient presents w/ symptoms suggestive of allergic conjunctivitis Non-pharmacological therapy 2 DIAGNOSIS Does the clinical presentation confirm seasonal or perennial
More informationKPA PFIZER EDUCATION GRANT
KPA PFIZER EDUCATION GRANT What every Paediatrician needs to know in Paediatric Ophthalmology Dr. Njambi Ombaba Paediatricians knowledge in ophthalmology Outline Visual development in a child Amblyopia
More informationDry Eyes The mucin layer
Dry Eyes Your doctor thinks you may have dry eyes. The tear film is a complex mixture of water and chemicals that moisturize and protect the eye. The tear film also acts as a focusing surface for the eye.
More informationCataract Surgery Patient Information
Cataract Surgery Patient Information www.ihg.org.uk Independent Health Group Patient Referral Centre T: 0330 3801362 E: ihg.referralsandenquiries@nhs.net Independent Health Group Limited is registered
More informationAllergic Conjunctivitis
Allergic Conjunctivitis ASCIA EDUCATION RESOURCES (AER) PATIENT INFORMATION Allergic conjunctivitis usually causes mild to moderate symptoms, including redness, which respond to non medicated treatment.
More informationMacular Hole. Helpline
Macular Hole The retina is a light-sensitive layer of tissue lining the back of the eye. The macula is a small area at the centre of the retina responsible for all of our central vision, most of our colour
More informationPage 1 RED EYES. conjunctivitis keratitis episcleritis / scleritis. Frank Larkin Moorfields Eye Hospital. acute glaucoma anterior uveitis
The RED EYE and ALLERGIC EYE DISEASE DIAGNOSIS & MANAGEMENT Frank Larkin Moorfields Eye Hospital RED EYES conjunctivitis keratitis episcleritis / scleritis acute glaucoma anterior uveitis post-op. / trauma
More informationOphthalmology. Ophthalmology Services
Ophthalmology Ophthalmology Services The Ophthalmology service offers the latest and most comprehensive eye care for patients. With a dedicated team of eye surgeons and consultants, we treat vision problems
More informationDr.Sushil Kumar Tripathi
Rabamipide:360 Benefits in Dry eye syndrome Dr.Sushil Kumar Tripathi Prevalence of Dry Eye Syndrome: vone in four patients attending ophthalmic clinics report symptoms of dry eye. vprevalence of dry eye
More informationDry eye syndrome is more likely to affect people who are over the age of 60, and the condition is more common among women than men.
DRY EYE Introduction Dry eye syndrome, also known as keratoconjunctivitis sicca, is a condition where your eyes do not make enough tears, or your tears evaporate too quickly. This can lead to your eyes
More informationOphthalmic Immunomodulators Prior Authorization with Quantity Limit Program Summary
Ophthalmic Immunomodulators Prior Authorization with Quantity Limit Program Summary FDA APPROVED INDICATIONS DOSAGE 1,4 Agent Indication Dosage and Administration Restasis (cyclosporine ophthalmic emulsion)
More informationBlepharitis. Information for patients Ophthalmology (Emergency Eye Centre) Large Print
Blepharitis Information for patients Ophthalmology (Emergency Eye Centre) Large Print page 2 of 12 Blepharitis is a condition where the rims of the eyelids become inflamed (red and swollen), which can
More informationOphthalmic Antihistamine Step Therapy Program Summary
Ophthalmic Antihistamine Step Therapy Program Summary FDA APPROVED INDICATIONS AND DOSAGE 1-8 Drug FDA Indication(s) Administration and Dosing Bepreve Treatment of itching associated Instill one drop into
More informationOPHTHALMOLOGIC PEARLS FOR THE NON- OPHTHALMOLOGIST. David G. Gross D.O. Deen-Gross Eye Centers Merrillville-Hobart Deengrosseye.
OPHTHALMOLOGIC PEARLS FOR THE NON- OPHTHALMOLOGIST David G. Gross D.O. Deen-Gross Eye Centers Merrillville-Hobart Deengrosseye.com A FEW OF THE AREAS WE WILL DISCUSS Red Eye Glaucoma Neuro ophthalmic tid
More informationNORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC. OPTOMETRIC MEDICINE CLINICAL GUIDELINES: TABLE OF CONTENTS
NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC. OPTOMETRIC MEDICINE CLINICAL GUIDELINES: 2012-2013 TABLE OF CONTENTS CONDITION PAGE(S) Complete Eye and Vision Examination 2 Vision Screening Procedure
More informationGrow Your Practice With a Focus on Ocular Allergy
By Scot Morris, O.D., F.A.A.O. Grow Your Practice With a Focus on Ocular Allergy Build your allergy patient base by making accurate diagnoses, offering the best treatments and increasing revenues with
More informationCataract. What is a Cataract?
Cataract What is a Cataract? We all have a lens in our eye. This is positioned just behind the iris, which is the coloured ring in the eye that gives your eye its colour. The lens s function is to focus
More informationOPTIHEAL NEW VISION NEW LIFE. Toll-free line :
Central Region TTDI (HQ) +603-7722 3177 SHAH ALAM +603-5510 2535 KLANG +603-3323 7742 SUNWAY +603-5621 3388 SRI PETALING +603-9057 7300 SEREMBAN +606-761 0900 Northern Region PENANG +604-282 3522 IPOH
More informationDry Eye Syndrome Prescribing Guidelines
Dry Eye Syndrome Prescribing Guidelines Dry Eye Syndrome is a group of disorders of the ocular surface related to tear film abnormality, associated with ocular discomfort, visual symptoms and objective
More informationThe Emergent Eye in the Acute Setting
The Emergent Eye in the Acute Setting Todd P. Margolis MD, PhD Professor of Ophthalmology & Director of the F.I. Proctor Foundation UCSF Physical Exam-- Visual Acuity Essential Corrected visual acuity
More informationChildren's Eye Assessment
Children's Eye Assessment Dr Antony Bedggood, Children s Specialist Centre Paediatric Ophthalmologist, Cataract & Strabismus Surgeon Why kids need early referral Children s eye problems are often subtle:
More informationCataract Surgery: Information for patients. Back of eye. Vitreous. Retina. Lens
Patient information Cataract Surgery: Information for patients Front of eye Cornea Pupil Iris Back of eye Vitreous Retina Lens The anatomy of the eye is illustrated above. Your cataract is a clouding of
More informationNew Ways to Ease Allergy Symptoms
New Ways to Ease Allergy Symptoms New pharmacologic and immunotherapeutic agents may offer options for allergy sufferers. Michelle Stephenson, Contributing Editor 3/8/2012 Allergy season is quickly approaching,
More informationDry Eye. A Closer Look
Dry Eye. A Closer Look What is dry eye? Normally, the eye constantly bathes itself in tears. By producing tears at a slow and steady rate, the eye stays moist and comfortable. Sometimes people do not produce
More informationCORNEAL CONDITIONS CORNEAL TRANSPLANTATION
GENERAL INFORMATION CORNEAL CONDITIONS CORNEAL TRANSPLANTATION WHAT ARE CORNEAL CONDITIONS? The cornea is the clear outer layer of the eye. Shaped like a dome, it helps to protect the eye from foreign
More informationSetting Your Sight Back on Life.
8089 Callaghan @ IH10 210-342-1228 Patient Registration (Please Print)!!!!!!!!!!! Date: Name: DOB: Address:!! Street!!!!!! City!! State!! Zip Home Phone: Work Phone: Cellular: Occupation: Employer: Social
More information9/23/2014. Emily Thomas, O.D. MOA Paraoptometric Education October 5, 2014
Emily Thomas, O.D. MOA Paraoptometric Education October 5, 2014 Anterior toward the front of the body Posterior toward the rear of the body Unilateral only one eye involved Bilateral both eyes involved
More informationSUPPLEMENTARY INFORMATION
SUPPLEMENTARY INFORMATION Contents METHODS... 2 Inclusion and exclusion criteria... 2 Supplementary table S1... 2 Assessment of abnormal ocular signs and symptoms... 3 Supplementary table S2... 3 Ocular
More informationItchy eyes a little irritation or a big pain
Itchy eyes a little irritation or a big pain Mrs Melanie Hingorani Consultant Ophthalmologist Moorfields Eye Hospital Declaration of any conflicts of interest None Allergic Eye Disease Group of disorders
More informationWhat is Age-Related Macular Degeneration?
Intravitreal Injections Eylea / Lucentis Patient Information What is Age-Related Macular Degeneration? Age-related macular degeneration (AMD) is an eye condition found in older people, which may lead to
More informationA Patient s Guide to Diabetic Retinopathy
Diabetic Retinopathy A Patient s Guide to Diabetic Retinopathy 840 Walnut Street, Philadelphia PA 19107 www.willseye.org Diabetic Retinopathy 1. Definition Diabetic retinopathy is a complication of diabetes
More informationCASE PRESENTATION. DR.Sravani 1 st yr PG Dept of Ophthalmology
CASE PRESENTATION DR.Sravani 1 st yr PG Dept of Ophthalmology Name : X X X X X Age : 50yrs Sex : male Occupation : Farmer Residence : Mothkur CHIEF COMPLAINTS : - Diminision of vision in Right Eye since
More informationRetinal Detachment PATIENT EDUCATION
Retinal Detachment PATIENT EDUCATION What is Retinal Detachment (RD)? Retina is the light-sensitive layer at the back of the eye that converts light images into nerve impulses that are relayed to the brain
More informationInformation for patients
Information for patients Intravitreal Anti-VEGF Treatment (vascular endothelial growth factor) This leaflet gives you information that will help you decide whether to have intravitreal treatment. It also
More informationREFERRAL GUIDELINES: OPHTHALMOLOGY
Outpatient Referral Guidelines Page 1 1 REFERRAL GUIDELINES: OPHTHALMOLOGY Date of birth Demographic Contact details (including mobile phone) Clinical Reason for referral Duration of symptoms Essential
More informationMeibomian Gland Dysfunction: What Does It Mean James P. McCulley, MD, FACS, FRCOph(UK)
Meibomian Gland Dysfunction: What Does It Mean James P. McCulley, MD, FACS, FRCOph(UK) David Bruton, Jr. Professor of Ophthalmology Chairman, Department of Ophthalmology The University of Texas Southwestern
More informationInformation for patients considering cataract surgery Castleton Day Surgery Unit, Yeatman Hospital, Sherborne
Information for patients considering cataract surgery Castleton Day Surgery Unit, Yeatman Hospital, Sherborne 01935 384 309 yeovilhospital.nhs.uk This leaflet gives you information that will help you decide
More informationDry Eye Prescribing Guidelines
Dry Eye Prescribing Guidelines Amendment History VERSION DATE AMENDMENT HISTORY V1.0 2011 Comments V1.1 2013 Updated V1.1 2017 Draft Updated Thealoz Duo replaces carmellose Optive in severe dry eye on
More informationIntravitreal Injection
for patients Eye Clinic Ipswich Hospital Tel: 01473 703230 Intravitreal Injection What is an intravitreal injection? An intravitreal injection is the injection of a drug into the vitreous body (the jelly
More informationRED EYE, RED EYE What do YOU See???
RED EYE, RED EYE What do YOU See??? The role of the front office and optometric assistant in the detection and treatment of RED EYES Front office staff and assistants are THE first ones to begin the RED
More informationCENTRAL MERSEY LOCAL OPTICAL COMMITTEE
CENTRAL MERSEY LOCAL OPTICAL COMMITTEE OPTOMETRIC REFERRAL GUIDELINES The ocular conditions listed in this document are intended to reflect those that might be encountered in optometric practice and this
More informationCase no.4. Subjective. Subjective (2) Caucasian female, 62 Y.O., consulting for a XXX opinion on her condition.
Case no.4 Contact lenses: cause Subjective Caucasian female, 62 Y.O., consulting for a XXX opinion on her condition. Works as a lab technician for a veterenary surgeon No exposure to chemicals Had been
More informationWORLD GLAUCOMA WEEK What is Glaucoma? Can I develop glaucoma if I have increased eye pressure?
WORLD GLAUCOMA WEEK What is Glaucoma? Glaucoma is a group of diseases that damage the optic nerve and can result in gradual vision loss and blindness. However, with early detection and treatment, you can
More informationDISTANCE LEARNING COURSE. Scope of the Eye Care Practice , BSM Consulting All rights reserved.
DISTANCE LEARNING COURSE Scope of the Eye Care Practice 2008 2012, BSM Consulting All rights reserved. Table of Contents OVERVIEW... 1 THREE O'S IN EYE CARE... 1 ROUTINE VS. MEDICAL EXAMS... 2 CONTACT
More informationFlashers and Floaters
Flashers and Floaters Introduction Sometimes people see small, moving spots or specks in their field of vision. These sensations are called floaters. About 7 out of 10 people experience floaters at some
More informationGHPI0100_06_10 Contact: Ophthalmology Review due: June What is a Cataract?
GHPI0100_06_10 Contact: Ophthalmology Review due: June 2013 What is a Cataract? Further information If you or a relative have access to the internet, you can use the following websites for further information:
More informationTENTATIVE DIAGNOSES Based on the information provided so far, what are the potential diagnoses?
Kallendorf-Case Study #4 PEDIATRIC CASE STUDY SCENARIO Mary Jennings has brought her son Joe to your office. Joe is a 6-year old Jordanian male. He presents with the complaint of an itchy red eye. Mary
More informationOOGZIEKTEN VOOR DE HUISARTS F. GOES, JR.
OOGZIEKTEN VOOR DE HUISARTS F. GOES, JR. HET RODE OOG F. GOES, JR. Condition Signs Symptoms Causes Conjunctivitis Viral Normal vision, normal pupil size Mild to no pain, diffuse Adenovirus (most common),
More informationInvestor Presentation December The vision to see past tomorrow
Investor Presentation December 2011 The vision to see past tomorrow Safe Harbor Statement Certain statements contained herein are forward-looking statements (as such term is defined in the Private Securities
More informationDry-eye syndrome affects millions of
CME EDUCATION EyeWorld Supplement July 2006 Making a Case for a Dry-Eye Treatment A CME Supplement from an EyeWorld Educational Symposium held at ASCRS ASOA 2006 in San Francisco I like tears as a first
More informationTITLE: Olopatadine for the Treatment of Allergic Conjunctivitis: A Review of the Clinical Efficacy, Safety, and Cost-Effectiveness
TITLE: Olopatadine for the Treatment of Allergic Conjunctivitis: A Review of the Clinical Efficacy, Safety, and Cost-Effectiveness DATE: 17 March 2016 CONTEXT AND POLICY ISSUES Allergic conjunctivitis,
More informationIn all cases, a doctor will explain the procedure to you and answer any questions you may have.
Vitrectomy surgery Information for patients This leaflet answers common questions about having vitrectomy surgery. If you would like further information, or have any particular worries, please do not hesitate
More informationCATARACT & LENS SURGERY CATARACT SURGERY
GENERAL INFORMATION CATARACT & LENS SURGERY CATARACT SURGERY WHAT IS A CATARACT? A cataract is not a growth, but rather a clouding of the normally transparent and flexible lens of the eye. This condition
More informationRetina of Auburn & Metro-Columbus
INFORMED CONSENT FOR VITRECTOMY SURGERY What is a vitrectomy? Vitrectomy is the surgical removal of the vitreous gel from the middle of the eye. This procedure may be done for several reasons. To remove
More informationPREAMBLE TO MSC PAYMENT SCHEDULE: OPTOMETRY SERVICES
PREAMBLE TO MSC PAYMENT SCHEDULE: OPTOMETRY SERVICES A. GENERAL PROVISIONS 1. Eye Examination Benefits Optometric benefits are services defined in Section 23 of the Medical and Health Care Services Regulations,
More informationUnderstanding the Role of Meibomian Gland Dysfunction in Dry Eyes
Understanding the Role of Meibomian Gland Dysfunction in Dry Eyes The International Dry Eye Workshop separated dry eyes into two main categories in 2007. Aqueous Deficient Dry Eyes as defined by an inability
More informationOphthalmic-1s: Antihistamine and Dual Acting Antihistamine/Mast Cell Stabilizers DHA Formulary Management Branch
May 2017 Antihistamine and Dual Acting Antihistamine/Mast Cell Stabilizers Executive Summary Page 1 of 5 Ophthalmic-1s: Antihistamine and Dual Acting Antihistamine/Mast Cell Stabilizers DHA Formulary Management
More informationBreaking the Cycle. Yijie (Brittany) Lin, MD, MBA, Reena Garg, MD New York Eye and Ear Infirmary of Mount Sinai
Lin, Garg Ophthalmology Times 1 Breaking the Cycle Yijie (Brittany) Lin, MD, MBA, Reena Garg, MD New York Eye and Ear Infirmary of Mount Sinai Abstract A 32 year-old female with a history of LASIK surgery
More informationMedical and/or Vision Insurance plans do not cover the Specialty Dry Eye Testing or LipiFlow services.
ADVANCED BENEFICIARY NOTICE (ABN) Patient s Name: Date of Birth: The purpose of this form is to help you make an informed choice about your visit today. Before you make a decision about your options, you
More informationDNB Question Paper. December
DNB Question Paper December PAPER - I 1. Discuss clinical features, pathogenesis and management of normal tension glaucoma. (3+3+4) 2. Describe clinical manifestations, pathology, differential diagnosis
More informationTHE RED EYE When to treat, when to refer. Dr Beatrice Khater American University of Beirut November 2010
THE RED EYE When to treat, when to refer Dr Beatrice Khater American University of Beirut November 2010 OBJECTIVES Identify most common causes of Red Eye Know the adequate management of these conditions
More informationFinancial Disclosures
March 19, 2015 Financial Disclosures Consultant: Alcon Allergan Bausch & Lomb Modernizing Medicine Ophthalmologyweb.co m Investor: Novabay Ophthotech Ocular Surface Disease Ocular surface disease is often
More informationNo Conflict of Interest to Report Charles Stockwell, O.D
OH MY!!! DRY EYE!!! No Conflict of Interest to Report Charles Stockwell, O.D Charles.stockwell@ttuhsc.edu The Problem 1 Filamentary Keratitis Keratoconjunctivitis sicca, or dry eye syndrome, is the most
More informationPatient Information Cataract Surgery
Patient Information Cataract Surgery Introduction This leaflet has been written to help you understand more about surgery for a cataract. It explains what the operation involves, the benefits and risks
More informationBy Darlene Jones, Nurse. May 2017
By Darlene Jones, Nurse May 2017 Disclosure of potential conflict of interest Darlene Jones, Nurse I have no conflict of interest Course objectives Become familiar with the different pathologies in ophthalmology
More informationThe Eye: Homeostatic Imbalance. Ms. Nobis s 3rd hour Anatomy & Physiology
The Eye: Homeostatic Imbalance Ms. Nobis s 3rd hour Anatomy & Physiology Your assignment... 1. 2. 3. Find the slide with your name in the notes section at the bottom (they are alphabetical by last name).
More informationBrampton Hurontario Street Brampton, ON L6Y 0P6
Diabetic Retinopathy What is Diabetic Retinopathy Diabetic retinopathy is one of the leading causes of blindness world-wide. Diabetes damages blood vessels in many organs of the body including the eyes.
More informationOcular allergy pathogenesis and diagnosis
Ocular allergy pathogenesis and diagnosis Luís Delgado, MD PhD departament of Immunology and Immunoallergology Unit Hospital de S. Joao. Porto (Portugal) Marzo 2006 www.alergomurcia.com Good morning, Mr.
More informationGlaucoma What You Should Know
Glaucoma What You Should Know U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute The National Eye Institute (NEI) conducts and supports research that leads
More informationDry Eye Syndrome (DES)
Dry Eye Syndrome (DES) (1) What is Dry eye syndrome (DES)? (2) What causes dry eye syndrome? (3) What are the features of dry eye syndrome? (ii) Irritation and dry eyes This occurs because without adequate
More informationMEIBOMIAN GLAND DYSFUNCTION & DRY EYE: WHAT DO THE EXPERTS SAY?
MEIBOMIAN GLAND DYSFUNCTION & DRY EYE: WHAT DO THE EXPERTS SAY? Alan G. Kabat, OD, FAAO (901) 252-3691 Memphis, Tennessee alan.kabat@alankabat.com Course description: This course reviews the latest thoughts,
More informationNasolacrimal Duct Blockage
The eyelids play a key role in protecting the eyes. They help spread moisture (tears) over the surface of the eyes when they close (for example, while blinking); thus, they help prevent the eyes from becoming
More informationOptimizing the Ocular Surface. Presentation Title. Charlene M. Grice, Carolina Eyecare Physicians, LLC
Optimizing the Ocular Surface Presentation Title Presenter Charlene M. Grice, Name MD Carolina Eyecare Physicians, LLC Financial Disclosures I have no financial disclosures. I will discuss off label use
More information