This is My Patient s Condition: Can Scleral Lenses Help? Alan Kwok, OD, FAAO, FSLS Karen G. Carrasquillo, OD, PhD, FAAO, FSLS
|
|
- Donald Davis
- 5 years ago
- Views:
Transcription
1 This is My Patient s Condition: Can Scleral Lenses Help? Alan Kwok, OD, FAAO, FSLS Karen G. Carrasquillo, OD, PhD, FAAO, FSLS Please silence all mobile devices and remove items from chairs so others can sit. Unauthorized recording of this session is prohibited.
2 Disclosure Statement: Salaried employees of BostonSight No proprietary interest in BostonSight PROSE treatment or BostonSight Scleral
3 Broad Indications Irregular Corneas Ocular Surface Disease 3 Innovation Education
4
5 Disease Etiology Concomitant Diseases Patient s emotional state Think BIG picture It s NOT just about the piece of plastic!
6 LONGSTANDING PENETRATING KERATOPLASTY
7 Penetrating keratoplasty - Older grafts are more vulnerable to hypoxia and suction with scleral lens wear
8 Endothelial cell counts decrease Typical endothelial counts range from cells/mm 2 Cell counts decrease with: - Age of patient - Age of graft 8
9 Signs and symptoms of graft edema Complications of older grafts - Microcystic Epithelial Edema - Hazy Vision - Sattler s veil: rainbows around light sources from corneal edema Microcystic Edema (our view in) Sattler s Veil (pt s view out) 9 Lamber, Klyce, The Origins of Sattler s Veil Am J Ophthalmol 1981 Jan 91 (1): 51-6
10 Failing Grafts and Scleral lenses Etiology - Hypoxia Epithelial edema resulting from oxygen deprivation - Suction with Sclerals Suction increases with wearing time Both poor epithelial cell junctions and low endothelial reserve may be contributory to edema 10
11 Fitting Strategies Decrease Hypoxic Stress Studies by Meng Lin, OD, PhD show that Dk/t of material have more an effect of corneal metabolism (hypoxia) and saw no effects on corneal metabolism (hypoxia) with different amounts of lens clearance. - High Dk material Ex. XO 2 with Dk Thin center thickness Design Strategies to Decrease Suction 11 - Large diameters - Fenestrations - Channels
12 Case 52 year old female s/p PKP (OD 1998, OS 1991) secondary to keratoconus Presented to clinic having been fit with scleral lenses in the past for vision OU - Intolerant; required frequent removal and re-insertion throughout the day secondary to discomfort Trial BostonSight PROSE devices - Appreciated comfort and VA (20/20 OD, 20/20 OS) Proceeded to start treatment During treatment reported hazy vision and rainbows around lights - Corroborated by objective observation of epithelial edema 12
13 Strategies: Large and Loose PROSE Device #1: - Vault: 4.9, BC: 8.2, Power: -0.50, Diameter: Wearing times of 2 hours before haze, rainbows and epithelial edema PROSE Device #2: - Vault: 5.1, BC: 8.2, Power: -0.50, Diameter: No haze, rainbows or edema after 9 hours of wear 13
14 Strategies: Large and Loose 14
15 Fitting Strategies Fenestrations in Optic Zone Goal to decrease hypoxia and suction Some keys to fitting: - Apical touch - Bubble management Size Placement 15
16 Fitting Strategies 16
17 Strategies: Decrease Suction Channels - Radial grooves in device to disrupt the seal of the device on the globe - Encourages fluid ventilation 17
18 Strategies: Decrease Suction Channels - Radial grooves in device to disrupt the seal of the device on the globe - Encourages fluid ventilation 18
19 FUCHS DYSTROPHY
20 Fuchs Endothelial cells die off Onset ~30-40 yo, manifests ~50 yo Women > Men Family Hx increases risk 2 Stages Blur decreases over time Blur remains all day 20
21 Case 54 yo female Hx Fuchs OU, s/p PK OD (2003) Failed RGPs OD H/O SCL wear (torics) last 10 yrs BCVA 20/100 PH 20/40 OD; 20/50- PH 20/40 OS Referred goal: improve BCVA 21
22
23
24 Improves to 20/20
25 Glaucoma Patients Dry eye and Glaucoma Glaucoma meds can aggravate ocular surface - BAK is main culprit Alphagan-P Travatan-Z - Preservative free options Zioptan Lumigan Cosopt PF Ocudose 25
26 Glaucoma Patients MIGS - Minimally Invasive Glaucoma Surgery 26 Image courtesy of R. Caywood OD, S. Omidghaemi OD, Review of Optometry July 2018
27 Glaucoma Patients - Case 61 year old male Pellucid Marginal degeneration POAG H/o dermatitis on eye lids Ocular Meds: - Simbrinza - Travatan - Vyzulta 27
28 Glaucoma Patients - Case MIGS OU 5/2018 Discontinuation of drops (Simbrinza, Travatan, Vyzulta) Prolensa QD OS Reports improvement in vision Reduction in dermatitis 28
29 Advanced Glaucoma patients 1. Tube shunts associated with glaucoma drainage devices a. Insertion at limbus b. Ahmed valve higher profile elitemotorperformance.co.uk 29
30 Advanced Glaucoma patients 1. Tube shunts associated with glaucoma drainage devices a. Previous scleral lens use may dictate tube entry b. Recommend Pars Plana entry as opposed to anterior chamber entry to avoid erosion of tube c. Additional benefit of not compromising corneal endothelium stage.abbottmedicaloptics.com 30
31 Fitting over Tube Case 1 75 year old Asian male Neurotrophic keratopathy H/O longstanding diabetes s/p CE, aphakia OU (40 years ago) Advanced POAG s/p Ahmed valve OU (2-3 years ago) 31
32 Fitting over Tube Case 1 Recent history of corneal surface breakdown - 2 neurotrophic ulcers in the past 6 weeks Entering corrected acuities: - OD 20/125 - OS 20/150 32
33 Fitting over Tube Case 1 33
34 Fitting over Tube Case 1 34
35 Fitting over Tube Case 1 35
36 Fitting over Tube Case 1 36
37 Fitting over Tube Case 1 37
38 Fitting over Tube Case 1 Initially limited wearing time to 2-3 hours Monitored before and after with fluorescein and lissamine staining Wearing times up to 12 hr/day IOP s stable: 11 mmhg OD, 11 mmhg OS 38
39 Fitting over Tube Case 1 39
40 Fitting over Tube Case 1 40
41 Fitting over tube Case 2 65 year old female Exposure keratitis h/o lagophthalmos from blepharoplasty OU for congenital ptosis Pseudoexfoliation glaucoma h/o CME OU h/o persistent epithelial defect OS s/p Ahmed tube shunt infero-temporal OS Entering corrected acuities 20/40 OD, 20/80 OS 41
42 Fitting over tube Case year old female Exposure keratitis OU Fit into PROSE device with goal of supporting surface, heal PED, improve vision 7.9 BC / D / 20.0 mm OS Moderate awareness, 20/25- OS Erosion over tube prompted discontinuation of device wear per glaucoma specialist s instruction
43 Fitting over tube Case year old female Exposure keratitis OU Fit into PROSE device with goal of supporting surface, heal PED, improve vision 7.9 BC / D / 20.0 mm OS Moderate awareness, 20/25- OS Erosion over tube prompted discontinuation of device wear per glaucoma specialist s instruction
44 Fitting over tube Case 2 Refit into flatter lens with deeper channel No impingement at edge No conjunctival staining 44
45 Fitting over tube Case 3 67 year old WM h/o Stevens-Johnson Syndrome PROSE devices since 2008 Ahmed tube with supero-temporal tube 2017 Thickened conj confluent with symblepharon 45
46 Fitting over tube Case 3 Fit with smaller diameter with notch Trace staining upon removal 46
47 Fitting over bleb Case 1 84 year old Caucasian female Keratoconus, Dry Eye Syndrome, POAG OU h/o corneal gas permeable lens intolerance OS Corneal GP lens OD, PROSE device OS 47
48 Fitting over bleb Case 1 Fit with PROSE device 2008 BCVA 20/30 OS Combined cataract and filtering bleb surgery OS
49 Fitting over bleb Case 1 Fit with PROSE device 2008 BCVA 20/30 OS Combined cataract and filtering bleb surgery OS 2009 Continued to wear device OS Large diameter 23.0 mm 49
50 Fitting over bleb Case 1 Corrected VA: 20/30 IOPs before surgery: mmhg IOPs after surgery: 8-11 mmhg VFs: stable with no progression of defects after bleb surgery 50
51 Fitting over bleb Case 2 72 year old make with PKP h/o Fuch s Dystrophy Glaucoma with superior bleb OD Initially fit with scleral - Impingement on bleb - Fit deemed unacceptable by glaucoma surgeon 51
52 Fitting over bleb Case 2 Refit into PROSE Small diameter with notch - Unstable with intrusion of bubbles - NaFl Staining at edge of bleb on removal 52
53 Fitting over bleb Case 2 Refit into PROSE Large diameter to vault over PD Conjunctival congestion with PD wear 53
54 Fitting over bleb No easy answers for complex patients who have multiple issues Each needs to be evaluated on it s on merit and 54
55 PATIENT S EMOTIONAL/PSYCHOLOGICAL STATE
56 Pediatric patients Carrasquillo, KG. (2017) Pediatric Scleral Lenses in Pediatrics. Contemporary Scleral Lenses: Theory and Application, Ed : Barnett, M. and Johns, L Trauma Anxiety Pain 56
57 Case 4yo Hispanic female (lives in Uruguay) Hx SJS (Phenobarbital - Seizures) OS>OD Hx AMT 1 yr prior OS Distichiasis, Keratinization, Entropion, Haze, Neovascularization, Keratitis 57
58
59 Trial Only able to apply in right eye Used 16mm lens BCVA 20/80 +2, NVA J5 ~8 (LEA Cards) Seen for 2 weeks in clinic A/R After ~14 A/R sessions with parents - Able to apply unreliably - Unable to remove (patient wouldn t cooperate too anxious) 59
60 Allow ample time on your schedule Establish rapport/trust Even then, patients may not be ready Try again in 6 months/1 yr 60
61 Please remember to complete your session evaluations on the Academy.18 meeting app Tweet about this session using the official meeting hashtag #Academy18
Scleral Lenses: How do you know what is best
Scleral Lenses: How do you know what is best Alan Kwok, OD, FAAO, FSLS Tar Vaz, OD, FAAO Please silence all mobile devices and remove items from chairs so others can sit. Unauthorized recording of this
More informationScleral Lenses and Anterior Segment Disorders
Scleral Lenses and Anterior Segment Disorders Learning to see the BIG picture Karen G. Carrasquillo, OD, PhD, FAAO, FSLS Please silence all mobile devices and remove items from chairs so others can sit.
More informationFitting Keratoconus and Other Complicated Corneas
Fitting Keratoconus and Other Complicated Corneas Christine W Sindt OD FAAO Professor, Clinical Ophthalmology Director, Contact Lens Service University of Iowa Disclosure Consultant: ALCON Vision Care
More informationDoctors of Optometry Course Notes
Doctors of Optometry Course Notes OD22 1 CE Contact Lens Management of the Irregular Cornea Monday, February 19, 2018 9:05 am 10:00 am Plaza A 2 nd Fl Presenter: Dr. Maria Walker Dr. Maria K. Walker earned
More informationThe Management of Infant Aphakia
The Management of Infant Aphakia Christina Twardowski O.D., FAAO Please silence all mobile devices and remove items from chairs so others can sit. Unauthorized recording of this session is prohibited.
More informationScleral Lens Essentials
Scleral Lens Essentials Disclosures: Alcon Bausch + Lomb Contamac CooperVision Johnson & Johnson SpecialEyes Valley Contax Matthew J. Lampa, OD, FAAO lampa@pacificu.edu Scleral Lenses Which Lens Modality???
More informationSCLERAL LENS ASSESSMENT AND FITTING
SCLERAL LENS ASSESSMENT AND FITTING Dr. Anita Gulmiri OD, FAAO Assistant Professor of Clinical Optometry New England College of Optometry This presentation has been created for Orbis International trainees
More informationMedical Affairs Policy
Medical Affairs Policy Service: Corneal Treatments and Specialized Contact Lenses (Corneal remodeling, Corneal transplant, Corneal collagen crosslinking, Intrastromal Rings- INTACS, Keratoconus treatments,
More informationContact Lenses for Infants: Indication, Evaluation, and Technique
Contact Lenses for Infants: Indication, Evaluation, and Technique Maureen Plaumann, OD, FAAO The Ohio State University Elaine Chen, OD, FAAO, FSLS Southern California College of Optometry Marshall B. Ketchum
More informationRevitalization of the Anterior Segment: Corneal Transplantation and Secondary Lens Repair
Revitalization of the Anterior Segment: Corneal Transplantation and Secondary Lens Repair CATHERINE REPPA, MD CORNEA SPECIALIST, ASSISTANT PROFESSOR TTUHSC DEPARTMENT OF OPHTHALMOLOGY AND VISUAL SCIENCES
More informationContact Lenses for Infants: Indication, Evaluation, and Technique
Contact Lenses for Infants: Indication, Evaluation, and Technique Elaine Chen, OD, FAAO, FSLS Southern California College of Optometry Marshall B. Ketchum University Maureen Plaumann, OD, FAAO The Ohio
More informationJason R. Miller, OD, MBA, FAAO. Innovations in Specialty, Irregular Corneas & KCN with Contact Lenses
Jason R. Miller, OD, MBA, FAAO Innovations in Specialty, Irregular Corneas & KCN with Contact Lenses Developing Optometric Subspecialties CL market overview and trends Specialty Lenses Irregular Corneas
More informationEssential Scleral Lens Knowledge
Essential Scleral Lens Knowledge Precilens consultant Bausch and Lomb research Contact Lens Residents Forum Director for Alden Optical Brooke Messer, OD, FAAO, FSLS Cornea and Contact Lens Institute of
More informationCodes for Medically Necessary Contact Lenses
Codes for Medically Necessary Contact Lenses CPT Codes for Medically Necessary Prescribing Preamble for the 9231X Codes The prescription of contact lenses includes specification of optical and physical
More informationCollaboration in the care of glaucoma patients and glaucoma suspects. Barry Emara MD FRCS(C) Nico Ristorante November 29, 2012
Collaboration in the care of glaucoma patients and glaucoma suspects Barry Emara MD FRCS(C) Nico Ristorante November 29, 2012 Goals of Collaboration Patient-centred and evidence based approach Timely access
More informationScleral contact lenses and their therapeutic use Part 1
CET Scleral contact lenses and their therapeutic use Part 1 How should a scleral lens be defined? A scleral contact lens (ScCL) has its bearing surface on the sclera and is fitted with no or minimal corneal
More informationScleral Contact Lenses for Technicians
Course Outline Scleral Contact Lenses for Technicians Aaron McNulty, OD, FAAO Louisville Eye Center Louisville, KY Why use scleral lenses? Introduction to scleral lenses Handling and cleaning sclerals
More informationBaldwin.AFOS.Denver.2014.HO 1
Disclosures: Alden Optical Honoraria, Consultant Essilor Honoraria, Consultant Scleral Lens Education Society Past President No financial interests OBJECTIVES Brief introduction to scleral lens fit principles
More informationFinancial Disclosures. Corneal Problems for the Cataract Surgeon. Four Common Problems. Dry Eye syndrome. Rose-Bengal 3/27/16
Corneal Problems for the Cataract Surgeon Financial Disclosures Consultant: AMO/VISX Consultant: Angiotech/Sharppoint Michael J Taravella, MD Director: Cornea and Refractive Surgery University of Colorado
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 informationSCLERAL CONTACT LENSES EPSILON SCLERAL
SCLERAL CONTACT LENSES EPSILON SCLERAL - Outstands due to multi aspheric variable eccentricity design - Fitted in two steps due to it s novel philosophy and diagnostic set - Reassures limbal stem cells
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 informationGas Permeable Scleral Contact Lens. Description
Subject: Gas Permeable Scleral Contact Lens Page: 1 of 6 Last Review Status/Date: December 2013 Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 3 Gas Permeable
More informationStrategies for Anterior Segment Disease Management Mile Brujic, OD, FAAO 1409 Kensington Blvd Bowling Green, OH
Strategies for Anterior Segment Disease Management Mile Brujic, OD, FAAO 1409 Kensington Blvd Bowling Green, OH 43402 brujic@prodigy.net 419-261-9161 Summary As optometry s scope of practice continues
More informationFITTING GUIDE & TIPS FOR ACHIEVING SUCCESS
AT M hybrid contact lens for astigmatism FITTING GUIDE & TIPS FOR ACHIEVING SUCCESS AT M hybrid contact lens for astigmatism Contents Overview 2 Patient Candidates 2 Key Features of SynergEyes A 3 SynergEyes
More informationSCLERAL CONTACT LENSES 1. EPSILON SCLERAL
SCLERAL CONTACT LENSES 1. EPSILON SCLERAL - Out stands due to multi aspheric variable eccentricity design - Fitted in two steps due to it s novel philosophy and diagnostic set - Reassures limbal stem cells
More informationScleral Lens Basics 09/08/2015. Scleral Lens Learning Objectives. Contact Lenses for Irregular Corneas. Corneal
Scleral Lens Basics Alex D. Nixon, OD, MS East/West Eye Conference October 2, 2015 Scleral Lens Learning Objectives Fitting indications Benefits vs corneal GP lenses Insertion and removal (self and patient)
More informationFleck. Pre-Descemet Dystrophies (generally good vision and comfort) Primary Pre-Descemet Dystrophy
Fleck Etiology: bilateral, sometimes asymmetric, autosomal dominant opacities located in all levels of stroma as early as 1 st decade Slit lamp: well demarcated, small round gray-white doughnut-like, wreath-like
More informationSynergEyes PS Practitioner Training
SynergEyes PS Practitioner Training Post-Surgical Market For 30 years, visual scientists from around the world have struggled with the challenge of surgically correcting human refractive error. While great
More informationDry Eye Assessment and Management Study ELIGIBILITY OCULAR EVALUATION FORM
Page 1 of 13 BEFORE COMPLETING THE OCULAR EXAMINATION, YOU MUST BE ABLE TO ANSWER YES TO THE FOLLOWING QUESTIONS: Have you done MMP9? (SVonly) The Following are done at Baseline: Have you done Tear Osmolarity?
More informationSCLERAL CONTACT LENSES Fitting, Troubleshooting, and Future Advancements
DISCLOSURES SCLERAL CONTACT Fitting, Troubleshooting, and Future Advancements Consultant Bausch + Lomb Allergan Scleral Lens Education Society Fellowship Chair Pam Satjawatcharaphong, OD, FAAO, FSLS Assistant
More information2/1/2017 CONTACT LENS OPTIONS AND FITTING STRATEGIES FOR THE MANAGEMENT OF THE IRREGULAR CORNEA. CL Options: Soft Lenses
CONTACT LENS OPTIONS AND FITTING STRATEGIES FOR THE MANAGEMENT OF THE IRREGULAR CORNEA DAVID I. GEFFEN, OD, FAAO David I Geffen, OD, FAAO Consultant/Advisor/Speaker Accufocus Alcon AMO Annidis Bausch +
More informationGENERAL INFORMATION CORNEAL TRANSPLANTATION
GENERAL INFORMATION CORNEAL TRANSPLANTATION WHAT IS CORNEAL TRANSPLANTATION? A corneal transplant is an operation where a damaged or diseased cornea is replaced with donated, healthy tissue. Also called
More informationClinical Use of Therapeutic Bandage Contact Lenses Bruce Baldwin, OD, PhD, FAAO, FSLS
Clinical Use of Therapeutic Bandage Contact Lenses Bruce Baldwin, OD, PhD, FAAO, FSLS Please silence all mobile devices and remove items from chairs so others can sit. Unauthorized recording of this session
More informationToday s Checklist. What am I even looking at? Corneal procedures. Intacs. Post LASIK
SURGERY WAS THE EASY PART Managing Post-Surgical Corneas with Specialty Contact Lenses Brooke Messer, O.D. Cornea and Contact Lens Institute of Minnesota Today s Checklist What might walk in my door? Challenges
More informationMorning Report. copyright The University of Colorado. Ashley Laing 09/01/10 Preceptor- Dr. Pantcheva
Morning Report Ashley Laing 09/01/10 Preceptor- Dr. Pantcheva Case Presentation CC: Right eye pain and headache HPI: 52 yo Caucasian male Presents to ED with OD pain/redness, decreased vision, headache
More informationHow Strongly Do You Feel That This Patient Has Glaucoma? % % % % %
My Favorite Cases Anthony B. Litwak, OD, FAAO VA Medical Center Baltimore, Maryland Dr. Litwak is a speaker and on advisory boards for Alcon and Zeiss Meditek CASE CR 35 yohf Neg PMH +FOH mother and grandmother
More informationICD TORIC 16.5 CASE REPORT
ICD TORIC 16.5 CASE REPORT OVAL KERATOCONUS Nagham Shama Bakri- B.Optom Ortal Palatchi Sabag B.Sc - Soflex 1 ICD TORIC 16.5 For Oval Keratoconus 23 Y/O patient Female In general good health, does not take
More informationObjectives. Tubes, Ties and Videotape: Financial Disclosure. Five Year TVT Results IOP Similar
Tubes, Ties and Videotape: Surgical Video of Glaucoma Implants and Financial Disclosure I have no financial interests or relationships to disclose. Herbert P. Fechter MD, PE Eye Physicians and Surgeons
More informationCornea and Contact Lens Institute of Minnesota. Specialty Contact Lenses and Vision Management
Cornea and Contact Lens Institute of Minnesota Specialty Contact Lenses and Vision Management We focus on specialty contact lenses. is a leading national resource for specialized contact lenses and eye
More informationMy Favourite Cases Anthony B. Litwak, OD, FAAO VA Medical Center Baltimore, MD
My Favourite Cases Anthony B. Litwak, OD, FAAO VA Medical Center Baltimore, MD Dr. Litwak is a speaker and on advisory boards for Alcon and Zeiss Meditek CASE CR! 35 YOHF! Neg PMH! +FOH mother and grandmother
More informationScleral Lens Education for the Para- Professionsal. Hello 2/7/2018. The rise, fall and rise again of the scleral lens and lab
Disclosures Scleral Lens Education for the Para- Professionsal Valley Contax Allergan Biotissue MiboMedical Physician Recommended Neutraceuticals James Deom OD, MPH, FAAO, FSLS Scleral Lens Institute Hazleton
More informationOvernight wear, Scleral contact lenses, Stevens Johnson disease, Therapeutic
Scleral contact lenses for overnight wear in the M.J. TAPPIN, K.W. PULLUM, R.J. BUCKLEY management of ocular surface disorders M.J. Tappin KW. Pullum R.J. Buckley Moorfields Eye Hospital London EC 1V 2PD,
More informationManaging the Patient with POAG
Managing the Patient with POAG Vision Institute Annual Fall Conference Mitchell W. Dul, OD, MS, FAAO mdul@sunyopt.edu Richard J. Madonna, MA, OD, FAAO rmadonna@sunyopt.edu Ocular Hypertension (OHT) Most
More informationWest Los Angeles VA Health Care Center
West Los Angeles VA Health Care Center A review of the demographics of a group of general optometry patients seen recently (2015) at the main eye clinic in bldg. 304 yielded the following: Age range: 33-75
More informationFUCH S DYSTROPHY & CATARACT SURGERY TREATMENT ALGORITHM
FUCH S DYSTROPHY & CATARACT SURGERY TREATMENT ALGORITHM ΙΟΑΝΝΙS Α. MALLIAS, MD, PHD Director of the Dept. of Ophthalmology, Mediterraneo Hospital, Glyfada, Athens, Greece Clinical Fellow in Cornea and
More informationCorneal Transplants. Corneal transplants. What causes cornea problems? Full thickness corneal transplant
2014 2015 Corneal transplants The cornea is the clear, front window of the eye. It helps focus light into the eye so that you can see. The cornea is made of layers of cells. These layers work together
More informationPearls for the Refractive Technician Fadiah Alkhawaldeh, IMBA, COT, ROUB
Pearls for the Refractive Technician Fadiah Alkhawaldeh, IMBA, COT, ROUB Cleveland Clinic Cole Eye Institute OOS, Columbus, OH February, 2014 alkhawf@ccf.org NO FINANCIAL DISCLOSURES A Puzzle of an Eye
More informationTherapeutical bandage contact lenses for corneal protection
Therapeutical bandage contact lenses for corneal protection M i c h a e l B a e r t s c h i M.S.Optom Optom., M.Med.Educ Educ.,., F.A.A.O. Contact for text manuscript demands michael.baertschi baertschi@bluewin.ch
More informationDeep Anterior Lamellar Keratoplasty - Techniques
Deep Anterior Lamellar Keratoplasty - Techniques SHERAZ DAYA MD FACP FACS FRCS(Ed) FRCOphth Financial Disclosure Company Code 1. Abbott Medical Optics Inc. S 2. Bausch + Lomb C,L 3. Carl Zeiss Meditec
More informationUday Devgan MD Private Practice, Devgan Eye Surgery, Los Angeles
Irregular Astigmatism & honing your K incision Uday Devgan MD Private Practice, Devgan Eye Surgery, Los Angeles Uday Devgan MD Current Disclosures: Aaren Scientific: consultant Accutome Inc: royalties
More informationCHARTING THE NEW COURSE FOR MIGS
CHARTING THE NEW COURSE FOR MIGS SEE WHAT S ON THE HORIZON CyPass Micro-Stent the next wave in micro-invasive glaucoma surgery. MICRO-INVASIVE GLAUCOMA SURGERY (MIGS) OFFERS A REVOLUTIONARY APPROACH TO
More informationInternational Journal of Health Sciences and Research ISSN:
International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571 Original Research Article Clinical Applications and Therapeutic Outcomes of Scleral Contact Lenses- A Archana Preethi
More informationIN THE SCLERAL LENS WORLD: IT SEEMS THAT SMALLER IS BETTER
IN THE SCLERAL LENS WORLD: IT SEEMS THAT SMALLER IS BETTER LANGIS MICHAUD OD M.SC. FAAO (DIPL) FBCLA FEAOO PROFESSOR U DE MONTREAL DISCLOSURE DR MICHAUD SPEAKER S HONORARIUM FROM ALL MAJOR CONTACT LENS
More informationNEW OPPORTUNITIES OF USING THERAPEUTICAL CONTACT LENSES IN OCULAR SURGERY
NEW OPPORTUNITIES OF USING THERAPEUTICAL CONTACT LENSES IN OCULAR SURGERY Authors: Prof univ. dr. Adriana Stănilă, Dr. Elena Mihai, Dr. Adrian Teodoru, Dr. IonuŃ Costache The Clinical Department of Op
More information(877) Progress Drive Front Royal, VA A Revolution in Scleral Lens Fitting
www.visionary-optics.com/smap3d (877) 533-1509 1325 Progress Drive Front Royal, VA 22630 A Revolution in Scleral Lens Fitting The future of custom scleral contact lens fitting is here! I have had extraordinary
More informationMEDICAL POLICY SUBJECT: GAS PERMEABLE SCLERAL CONTACT LENS (E.G., BOSTON OCULAR SURFACE PROSTHESIS)
MEDICAL POLICY SUBJECT: GAS PERMEABLE SCLERAL CONTACT PAGE: 1 OF: 5 If a product excludes coverage for a service, it is not covered, and medical policy criteria do not apply. If a commercial product, including
More informationSubject Index. Atopic keratoconjunctivitis (AKC) management 16 overview 15
Subject Index Acanthamoeba keratitis, see Infective keratitis Acute allergic conjunctivitis AKC, see Atopic keratoconjunctivitis Allergy acute allergic conjunctivitis 15 atopic keratoconjunctivitis 15
More informationFinancial Disclosure. Prostaglandin Analogs (PGs) The Glaucoma Grab Bag: Practical Guidelines for Effective Glaucoma Therapy
The Glaucoma Grab Bag: Practical Guidelines for Effective Glaucoma Therapy Danica J. Marrelli, OD, FAAO University of Houston College of Optometry Financial Disclosure I have received I have received speaking
More informationHistory. Examination. Diagnosis/Course
History A 51 year-old female with a history of chronic dry eyes and photosensitivity was referred for evaluation. She reported a five year history of symptoms of frequent irritation and photophobia in
More informationCourse # Cutting Edge Cornea
Course # 061 Cutting Edge Cornea 44 year old female with sudden onset right eye pain. Has happened 3 times previouslyevery time first thing in the morning Cutting Edge Cornea Terri Kim, M.D. Chairman,
More informationWhen It s Time For A New Cornea
When It s Time For A New Cornea Marsha M. Malooley, O.D. FAAO and Tiffany M. Andrzejewski, O.D. FAAO Chicago Cornea Consultants 806 Central Avenue, Suite 300 Highland Park, IL 60035 (847)432-6010 marsham@chicagocornea.com
More informationIntrastromal corneal ring
Intrastromal corneal ring Kyriakidou Nantia M.D. Diathlasis Day Care Unit Scienti1ic Workshop of Diathlasis Day Care Unit 18-19 November, 2016 The Met Hotel Thessaloniki, Greece DAY CARE UNIT DIATHLASIS,
More informationAdvanced Examination of the Retina: Scleral Indentation & Retinal 3-Mirror
Advanced Examination of the Retina: Scleral Indentation & Retinal 3-Mirror Meredith Whiteside, OD, FAAO Nimesh Patel, OD, FAAO John Shan, OD, FAAO Please silence all mobile devices. Unauthorized recording
More informationSubmitted: September 27, Accepted: December 13, Published: January 19, 2018.
Case Study CLINICAL FINDINGS AND MANAGEMENT OF PELLUCID MARGINAL DEGENERATION USING SCLERAL LENSES OVER INTACS AND CORNEAL COLLAGEN CROSS-LINKING WITH RIBOFLAVIN By Brad T. Cunningham, OD, FSLS About the
More informationA 5 Step Program. A 5 Step Program. A 5 step program. A 5 step Program 2/7/2018. A 5 Step Program Lens Settling Evidence.
Lens Vault Settling evidence Lens Settling Evidence Lens Settling Evidence Optom Vis Sci. 2014 Dec;91(12):1462- A comparison of the short-term settling of three scleral lens designs. Kauffman MJ1, Gilmartin
More informationWhat are some common conditions that affect the cornea?
What are some common conditions that affect the cornea? Injuries After minor injuries or scratches, the cornea usually heals on its own. Deeper injuries can cause corneal scarring, resulting in a haze
More informationScleral Lenses ALEX D GIBBERMAN, O.D. HARPERS POINT EYE ASSOCIATES
Scleral Lenses ALEX D GIBBERMAN, O.D. HARPERS POINT EYE ASSOCIATES Overview/goals today Basic concepts Fitting technique/criteria Insertion, removal, flat vs steep, evaluation, lens care, Troubleshooting
More informationKeratoconus is a noninflammatory, ectatic corneal disorder. Scleral Lenses in the Management of Keratoconus ARTICLE
ARTICLE Scleral Lenses in the Management of Keratoconus Muriel M. Schornack, O.D., and Sanjay V. Patel, M.D. Purpose: To describe the use of Jupiter scleral (Medlens Innovations, Front Royal, VA; and Essilor
More informationWGA. The Global Glaucoma Network
The Global Glaucoma Network Fort Lauderdale April 30, 2005 Indications for Surgery 1. The decision for surgery should consider the risk/benefit ratio. Note: Although a lower IOP is generally considered
More informationCorneal Graft or Transplant Patient information leaflet
Corneal Graft or Transplant Patient information leaflet Corneal Graft or Transplant/MQ/ST/08.2012/v1.2 review 08.2015 Page 1 Corneal Graft or Transplant The Cornea is the clear window at the front of the
More informationOptometric Postoperative Cataract Surgery Management
Financial Disclosures Optometric Postoperative Cataract Surgery Management David Dinh, OD Oak Cliff Eye Clinic Dallas Eye Consultants March 10, 2015 Comanagement Joint cooperation between two or more specialists
More informationOPTOMETRY. Corneal conjunctivalisation in long-standing contact lens wearers
C L I N I C A L A N D E X P E R I M E N T A L OPTOMETRY Corneal conjunctivalisation in long-standing contact lens wearers Clin Exp Optom 2007; 90: 1: 26 30 Raul Martin OD IOBA Eye Institute, School of
More informationCorneal Transplants. Corneal transplants. What causes cornea problems? Full thickness corneal transplant
Corneal transplants The cornea is the clear, front window of the eye. It helps focus light into the eye so that you can see. The cornea is made of layers of cells. These layers work together to protect
More informationLearn Connect Succeed. JCAHPO Regional Meetings 2017
Learn Connect Succeed JCAHPO Regional Meetings 2017 Cataract Surgery in 2017 DARBY D. MILLER, MD MPH CORNEA, CATARACT AND REFRACTIVE SURGERY ASSISTANT PROFESSOR OF OPHTHALMOLOGY MAYO CLINIC FLORIDA Natural
More informationClinical Study of Lens Induced Glaucoma
Clinical Study of Lens Induced Glaucoma Dr. M. Parni Kumar 1, Dr. G. Manjula 2 1 M.S, HOD, Professor of Ophthalmology 2 M.S, D.O, Associate Professor of Ophthalmology, Guntur Medical College, Guntur Abstract:
More informationPlate/Valve Specifications: Thickness: 0.9mm Width: 13.00mm Length: 16.00mm Surface Area: mm 2
Distribué en France par FCI S.A.S. France Chirurgie Instrumentation SAS 20/22 rue Louis Armand 75015 PARIS Tél. 01.53.98.98.98 / Fax. 01.53.98.98.99 fci@fci.fr / www.fci.fr CATALOGUE DE VENTE Features:
More informationHumanity s Vision Is Our Focus. The Ahmed Glaucoma Valve
Humanity s Vision Is Our Focus The Ahmed Glaucoma Valve Dr. A. Mateen Ahmed President - New World Medical New World Medical is a high tech medical device company whose goal is to help humanity lead a better
More informationTechnicians & Nurses Program
ASCRS ASOA Symposium & Congress Technicians & Nurses Program May 6-10, 2016 New Orleans I have none Sunday, May 8, 2016, 10:30-11:30am Amy Jost, BS, COMT, CCRC Cincinnati Eye Institute Identify the tech
More informationIs this glaucoma? Leo Semes, OD Michael Chaglasian, OD Danica Marrelli, OD. Optometry s Meeting 2015 Seattle, WA
Is this glaucoma? Leo Semes, OD Michael Chaglasian, OD Danica Marrelli, OD Optometry s Meeting 2015 Seattle, WA Case 1. 54 WM Engineer is referred to UAB Eye Care as a glaucoma suspect. Mild myopic refractive
More informationSome of the ophthalmic surgeries
Some of the ophthalmic surgeries Some of the ophthalmic surgeries performed at the DMV Center. This document presents some types of the surgeries performed by the ophthalmology service at the DMV veterinary
More informationNeuro-Ophthalmic Masqueraders
Neuro-Ophthalmic Masqueraders Leonid Skorin, Jr., OD, DO, MS, FAAO, FAOCO Mayo Clinic Health System in Albert Lea Denise Goodwin, OD, FAAO Pacific University College of Optometry Please silence all mobile
More informationPROSE Treatment Information for Patients and Doctors
PROSE Treatment Information for Patients and Doctors prior to getting my PROSE devices, life was hard. Everything that I loved to do was slipping away...that all changed the day I got PROSE. PROSE patient
More informationAging & Ophthalmology
Aging & Ophthalmology Pr Jean-Marie Rakic Dr Denis Malaise January 2018 Major ocular diseases 1. Cataract 2. Age-related macular degeneration 3. Ischemic optic neuropathy 4. Horton arteritis 5. Glaucoma
More informationMark Dunbar: Disclosure
Important Things to Understand About OCT Mark T. Dunbar, O.D., F.A.A.O. Bascom Palmer Eye Institute University of Miami, School of Medicine Mark Dunbar: Disclosure Optometry Advisory Board for: Allergan
More informationDoctors of Optometry Course Notes
Doctors of Optometry Course Notes OD25 2 CE Scleral Lenses Basic Fitting to Advanced Problem-Solving Monday, February 19, 2018 3:45 pm 5:45 pm Georgia A/B 2 nd Fl Presenter: Dr. Maria Walker Dr. Maria
More informationINVELTYS (loteprednol etabonate ophthalmic suspension) 1%, for topical ophthalmic use Initial U.S. Approval: 1998
HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use INVELTYS safely and effectively. See full prescribing information for INVELTYS. INVELTYS (loteprednol
More informationNEW YORK UNIVERSITY SCHOOL OF MEDICINE DEPARTMENT OF OPHTHALMOLOGY EDUCATIONAL OBJECTIVES AND GOALS
NEW YORK UNIVERSITY SCHOOL OF MEDICINE DEPARTMENT OF OPHTHALMOLOGY EDUCATIONAL OBJECTIVES AND GOALS Revision Date: 6/30/06 Distribution Date: 7/6/06 The Department of Ophthalmology at the NYU Medical Center
More informationINTRA-CORNEAL LAMELLAR KERATOPLASTY*
Brit. J. Ophthal. (1960) 44, 629. INTRA-CORNEAL LAMELLAR KERATOPLASTY* BY TADEUSZ KRWAWICZ Ophthalmological Clinic, Medical Academy, Lublin, Poland THE operative technique of lamellar keratoplasty is still
More informationGLAUCOMA SURGERY: FROM THEN TIL NOW (COPE Course ID: GL)
MIGS: How did we get here? GLAUCOMA SURGERY: FROM THEN TIL NOW (COPE Course ID: 55570-GL) John Gelvin, O.D., F.A.A.O. MOYES EYE CENTER Kansas City, Missouri jgelvin@moyeseye.com 1. Tube vs Trabeculectomy?
More informationMeet Libby. Corneal Dysgenesis, Degeneration, and Dystrophies Definitions. Dr. Victor Malinovsky
Meet Libby Corneal Dysgenesis, Degeneration, and Dystrophies 2006 Dr. Victor Malinovsky Definitions Dysgenesis: (congenital anomalies) A development disorder that results in a congenital malformation of
More informationMechanics of the Ahmed Glaucoma Valve
Dr. A. Mateen Ahmed President & CEO - New World Medical, Inc. New World Medical, Inc. (NWMI) is a high tech medical device company whose goal is to help humanity lead a better life through improved technology
More informationTHERAPEUTIC CONTACT LENSES
THERAPEUTIC CONTACT LENSES Prof. Univ. Dr. Adriana Stanila Victor Papilian Faculty of Medicine Emergency Academic Hospital Sibiu Ocular Surface Research Center ROMANIA INTRODUCTION therapeuein greac =
More informationCLASS-y Laser Treats Glaucoma
Article # 404 Comments About the Author Released: Author: Category: March 12th, 2014 Issue #0314 Ehud Assia Feature S S S S S CLASS-y Laser Treats Glaucoma Transforming complex, invasive and risky glaucoma
More informationDr Jo-Anne Pon. Dr Sean Every. 8:30-9:25 WS #70: Eye Essentials for GPs 9:35-10:30 WS #80: Eye Essentials for GPs (Repeated)
Dr Sean Every Ophthalmologist Southern Eye Specialists Christchurch Dr Jo-Anne Pon Ophthalmologist Southern Eye Specialists, Christchurch Hospital, Christchurch 8:30-9:25 WS #70: Eye Essentials for GPs
More informationNovel therapies for the treatment of persistent corneal epithelial defects
Novel therapies for the treatment of persistent corneal epithelial defects Disclosures I have no financial interests in any of the techniques or products discussed. Bennie H. Jeng, M.D. Associate Professor
More informationPATIENT INFORMATION ON CORNEAL GRAFT
PATIENT INFORMATION ON CORNEAL GRAFT (TRANSPLANT) SURGERY M ANANDAN What is the cornea? The clear window of the eye approximately 0.5mm thick and 12mm across. It lies in front of the fluid filled anterior
More informationDifferential diagnosis of the red eye. Carol Slight Nurse Practitioner Ophthalmology
Differential diagnosis of the red eye Carol Slight Nurse Practitioner Ophthalmology The red eye Conjunctivitis HSV Keratitis Acute angle closure glaucoma Anterior Uveitis Red eye Scleritis Subconjunctival
More informationGPS Guide to Advanced Scleral Lens Fitting
GPS Guide to Advanced Scleral Lens Fitting Clark Y. Chang, OD, MSA, MSc, FAAO Melissa Barnett, OD, FAAO, FSLS The Cornea and Laser Eye Institute - Center for Keratoconus University of California, Davis
More informationSCLERAL CONTACT LENS FITTING AND TROUBLESHOOTING. Lacey Haines, BSc, OD PhD Candidate November 14, 2014
SCLERAL CONTACT LENS FITTING AND TROUBLESHOOTING Lacey Haines, BSc, OD PhD Candidate November 14, 2014 FINANCIAL DISCLOSURES I have no financial interest in the content of this talk I would like to thank
More information