Review of Optometry articles from October 2002

Review of Optometry archives from October 2002

The U.S. Census Bureau. (In the News).
October 15, 2002... The U.S. Census Bureau reports that the number of Americans without health insurance rose by 1.4 million last year. About 41.2 million people, or 14.6% of U.S. residents, lacked health coverage for all of 2001. On a brighter note, the...

CIBA Vision. (In the News).
October 15, 2002... CIBA Vision CEO Glen Bradley plans to retire in early 2003. His replacement has already been appointed: Joseph Mallof, who was president of the Asia Pacific division of S.C. Johnson & Son.

Diabetic retinopathy. (In the News).
October 15, 2002... A new treatment for diabetic retinopathy, pyridoxamine, has been found to protect retinas in diabetic rats. Reporting their findings in the September issue of the journal Diabetes, researchers in Northern Ireland found that the drug apparently...

Vistakon. (In the News).
October 15, 2002... George W. Mertz, O.D., optometric researcher and director of academic affairs for Vistakon, has died. He was a charter member of the International Society for Contact Lens Research and was currently serving as president of the American...

Is a cosmetic lens just a cosmetic? "No thanks, doctor. I'll buy my contacts at the makeup counter". (News Review).
October 15, 2002... A proposal that would put piano colored contact lenses in the same category as mascara, lipstick and blush is on the table, but may not be for long. The FDA has been holding briefings about whether to transfer oversight of plano tinted...

Study: senior drivers crash less after cataract surgery. (News Review).
October 15, 2002... A recent study shows that adult drivers with cataracts .who undergo intraocular lens implantation have half the crash rate of those who do not have any such treatment. (1) Cataracts can severely impair a senior's ability to drive. One...

CIBA Vision and CooperVision settle suit. (News Review).
October 15, 2002... CIBA Vision has settled its lawsuit against CooperVision. CIBA brought suit against CooperVision last year for patent infringement on its color contact lens technology. As part of the agreement, CIBA will license color contact lens patents to...

A new theory on dry eye: cornea and lacrimal gland function as a unit. (News Review).
October 15, 2002... For years, eye researchers have supposed that some sort of harm to the lacrimal gland--by disease, aging or loss of hormones--caused dry eye. More recently, scientists have observed that damage to the cornea also seems to affect tear...

National panel: refractive surgery fees and patients are slipping, but O.D.s still Satisfied. (News Review).
October 15, 2002... Optometrists appear to be slightly happier this year about the fees they get for comanaging refractive surgery. About 95% of doctors (compared with 93% last year) say they are at least satisfied with refractive surgery comanagement fees. (The...

Contacts and no Rx? Ew, that's yucky! (Editor's Page).
October 15, 2002... Good thing the FDA is backing off the move to reclassify piano cosmetic contact lenses as cosmetic devices. But don't think this is the last you'll hear of this. Plano contact lenses that do nothing but change a person's eye color are a...

How do you know if a logo's a 'no-go'? A little bunny wearing glasses just screams 'eye-care professional,' doesn't it? (Chairside).
October 15, 2002... Get out your pencils and crayons. It's time to find that little bit of creativity you have not yet destroyed in the quest for the perfect slit lamp. It's time to design a logo! We all need something to identify our practices on our signs,...

The real scientists behind what we do: Optometry needs more clinician scientists like Donald Korb and Irvin Borish. (Another Perspective).
October 15, 2002... As a council member of the AOA Contact Lens and Cornea Section, I've been fortunate to help select the recipient for our Donald Korb Award. The council presents this honor at its awards ceremony at the AOA Congress each year. Don Korb,...

Which Windows works well? with several versions available, here's how to decide what's right for you. (Technology Review).
October 15, 2002... Believe it or not, nine versions of Microsoft's popular Windows operating system are currently available. When shopping for a new computer or upgrading an older one, how do you decide which version is right for you? Which is the most secure,...

What today's new O.D.s want from you: here's what it will take to lure them into private practice. (Practice Management).
October 15, 2002... Doug Reynolds has a lot to think about this next year. Mr. Reynolds, a fourth-year student at Nova Southeastern University College of Optometry in Fort Lauderdale, Fla., would like to work as an associate for a year or two in a private practice...

The science behind antibiotic resistance: have you had a patient with a recurrent infection, but were too busy with treatment to learn about out how resistance occurs? Here's your answer. (Ophthalmic Drugs).
October 15, 2002... Marci is a typically energetic 17-year-old, and a -10.00D soft contact lens wearer. Today, she showed up as an emergency walk-in with red, irritated eyes. And you've just informed her that the simple conjunctival infection you diagnosed and...

Consumers on LASIK: Down, but not out; adults who wear vision correction say they depend on your opinion the most when it comes to selecting refractive options. (Special Report: 8th Annual Refractive Surgery Report).
October 15, 2002... Although the market for refractive surgery has declined, it may be a temporary dip, a recent consumer survey shows. Indeed, consumers are interested in refractive procedures. The best news for O.D.s: Most respondents say the advice of "my eye...

Which do you recommend. (Point/Counterpoint: 8th Annual Refractive Surgery Report).
October 15, 2002... Ortho-K: Patient may one day need to reverse the effects. (Editor's note: We asked these doctors whether they would recommend LASIK or orthokeratology for a motivated 37-year-old male who wants to eliminate or reduce his dependency on...

LASIK or Ortho-K? LASIK: patient is in the 'slam dunk' range.
October 15, 2002... One of the biggest advantages we have as optometrists is that we have so many options available for our patients. So now we must fit the best procedure to the individual patient. Whether I would recommend LASIK or orthokeratology for this...

The refractive evolution: Is 20/8 possible? someday, your patients may opt for one of these techniques to improve their vision. (Optometric Study Center: 8th Annual Refractive Surgery Report).
October 15, 2002... Perhaps the most exciting thing about refractive surgery to date is the knowledge we have gained about the visual system. One thing we've learned: 20/20 acuity is not the be-all and end-all of good vision. Indeed, a scientific revolution,...

What landmark research tells us about glaucoma management.
October 15, 2002... Several recent landmark glaucoma studies offer new and/or refined guidelines, which may change the way you manage glaucoma. These landmark studies include the Advanced Glaucoma Intervention Study (AGIS), Normal Tension Glaucoma Study (NTGS),...

Obesity and headaches suggest diagnosis: this teenage boy was an atypical pseudotumor cerebri patient. (Case Report).
October 15, 2002... A 16-year-old white male presented complaining that the vision in his left eye was fading in and out. The episodes occurred daily for about a week, with each episode lasting about seven seconds. He also reported constant occipital headaches...

Eyelid disease: the ins and outs; clinical research is telling us much about what methods are most effective. (Research Review).
October 15, 2002... We frequently encounter eye lid diseases in optometric practice. However, we should not think of these disorders as routine. Blepharitis and meibomitis have been shown to be the leading contributors to bacterial keratitis. (1) A recurrent...

Is teenager having a typical migraine? Is aura followed by numbness normal, and should you comanage this patient? (Comanagement Q&A).
October 15, 2002... Q A neighbor was concerned that her 14-year-old daughter "just lost her vision in the left eye. Upon further questioning, it became apparent that she had a stereotypical migraine aura followed by the headache. However, her left hand went numb...

DLK after LASIK enhancement: does the treatment vary following enhancement vs. the initial procedure? (Cornea & Contact Lens Q&A).
October 15, 2002... Q I've recently seen two patients with diffuse lamellar keratitis (DLK) following LASIK enhancement. What is the mechanism behind this condition? A The mechanism that causes DLK--also known as the "sands of the Sahara"--is unknown,...

OCT finds cause of acuity loss: results yielded treatment options to preserve patient's remaining vision. (Retina Quiz).
October 15, 2002... A 65-year-old Hispanic female presented with reduced acuity O.D. and longstanding amblyopia O.S. She was worried that her vision problems O.D. were related to her 15-year history of non-insulin dependent diabetes mellitus. She said that she had...

How to treat Graves' disease; Part II: drugs and radiation can help control the effects of hyperthyroidism. (Therapeutic Forum).
October 15, 2002... As we discussed last month, there are major ocular manifestations of Graves' disease. These include diplopia due to extraocular muscle enlargement, proptosis due to orbital congestion and optic neuropathy due to optic nerve compression from...

Briot Axcell-erates edging. (Equipment).
October 15, 2002... Briot's Axcell CL edging system now features Digiform software that lets you make precisely targeted lens shape modifications, such as to the boxing value, the circumference or only one zone of the lens. Also, Briot's new PROS (Pattern...

Get the LED out. (Low Vision).
October 15, 2002... Eschenbach's new LED product tray assortment (#1835) has three hand-held magnifiers and three stand magnifiers ranging in power from 7.60D to 28D. The company says these products feature illumination bulbs with nearly unlimited life and...

Get Progressive. (Contact Lenses and Lens Care).
October 15, 2002... CIBA Vision's training program now offers workshops for U.S. and Canadian eye care professionals who are interested in fitting Focus Progressives and Focus Dailies Progressives multifocal contact lenses. The workshops discuss setting...

Comforting news from Alcon. (Contact Lenses and Lens Care).
October 15, 2002... Alcon Laboratories' Opti-Free Express multi-purpose disinfecting solution has earned two new labeling claims from the U.S. Food and Drug Administration. First, Alcon will add the words "lasting comfort" to its labeling. Second, users will be...

Waving a new Flag. (Diagnostic Aids).
October 15, 2002... Gulden Ophthalmics' newly designed Optokinetic Flag helps identify disorders, including functional vs. organic blindness, complete homonymous hemianopia, congenital nystagmus, dorsal mid-brain syndrome, and abduction and adduction defects. It...

PRIO Corporation. (What's New on the Web).
October 15, 2002... Find answers to your questions about computer vision syndrome online at PRIO Corporation's updated Web site. Learn how to develop a computer vision care specialty practice, read up on the latest CVS clinical studies and participate in online...

HIPAA. (What's New on the Web).
October 15, 2002... Get input about interpreting HIPAA (Health Insurance Portability and Accountability Act) from medical and legal experts online. This site, from Easy Compliance Solutions, also offers a compliance kit with a staff training video, step-by-step CD...

The National Rosacea Society. (What's New on the Web).
October 15, 2002... The National Rosacea Society's newly expanded Web site offers comprehensive educational information for you and your patients. Features include photographs, answers to frequently asked questions, printable brochures, a diary checklist for your...

Youthful tips for boomers. (Merchandising).
October 15, 2002... Give your baby boomer patients helpful anti-aging, eyewear selection tips and information about presbyopia through Essilor of America's free Varilux booklet, Boomer Image 2002. The booklet features tips from image consultant and USA Today...

Get the goods on ClearVision. (Merchandising).
October 15, 2002... The ClearVision 2002 catalog features more than 300 frames- collections from Kenneth Cole New York, REACTION Kenneth Cole, IZOD Eyes, Jessica McClintock, OP, Fisher-Price, Save the Children and ClearVision house brands. The 96-page catalog also...

Marc Ecko Scopes counter fixture. (Merchandising).
October 15, 2002... Viva International has introduced a turntable counter-top display for Marc Ecko Scopes with 16 spaces for eyewear. The fixture features a lock and key, eight spaces for eyewear on both sides and a bottom area that holds cases or extra glasses...

There's fundus among us. (Merchandising).
October 15, 2002... Nidek's new NM-200D portable mega pixel digital handheld non-mydriatic fundus camera uses invisible infrared light for alignment and viewing. It captures color digital images with a much lower flash intensity than conventional cameras, giving...

Eight is enough. (Frames).
October 15, 2002... Luxottica Group introduces eight new ophthalmic frames featuring four metals, two plastics and two drill mounts. The four metal frames include the unisex oval LUX 1315; the LUX 1316 for men; the full-rim LUX 2234 and the semi-rim frame LUX...

Marchon's Made in the Shades. (Sunwear).
October 15, 2002... Marchon Eyewear and Made in the Shades Optical introduce a bridge-mounted clip-on that attaches directly to the frame at the nose bridge. The clip-on has no top bar or mounting hooks on the upper portion of the frame to create a seamless look....

Double dose of Titmus. (Safety Eyewear).
October 15, 2002... Titmus Optical unveils two new prescription protective eyewear collections. The Premiere Collection, designed for men, features the rectangular-shaped PC265, with universal bridge, thin temple, eyewire profile and 3BBL standard hinges. It comes...

LASIK patient has foreign-body feeling. (Diagnostic Quiz).
October 15, 2002... History A 35-year-old white male presented for his one-day postoperative evaluation following LASIK. Best-corrected visual acuity before surgery was 20/20+ O.U. with correction of -4.25 -1.25 x 180 O.D. and -4.50 -1.50 x 175 O.S. The...

This month on the Web.
October 15, 2002... Now that beach season is over, it's time to think about hitting the slopes. Visit Review of Optometry Online for information about Review of Optometry's SnowVision 2003 meeting, January 18-23, 2003. You can also read about other upcoming...

From the authors.
October 15, 2002... To Our Colleagues: After a brief hiatus, we are back to present the fifth edition of "The Handbook of Ocular Disease Management." We are grateful to again have this opportunity to reach our optometric colleagues. We are also indebted to...

Molluscum contagiosum. (Eyelids & Eyelashes).
October 15, 2002... Signs and symptoms: Molluscum contagiosum are raised lesions found around the ocular adnexa. The lesions are round, whitishpink, shiny, dome-shaped nodules, 2-3mm in diameter, with an umbilicated center and filled with a cheese-like material....

Canaliculitis. (Eyelids & Eyelashes).
October 15, 2002... Signs and symptoms: Canaliculitis is a relatively rare disorder that predominantly affects individuals over age 50. Complaints center on a chronic, recalcitrant unilateral red eye, and often epiphora. The discharge may range from a simple...

Verruca and papilloma. (Eyelids & Eyelashes).
October 15, 2002... Signs and symptoms: The term papilloma refers to a benign epithelial lesion of either the skin or mucosa. Papillomas affecting the eye primarily appear on the skin of the eyelid, but occasionally they may develop on the palpebral and bulbar...

Pediculosis and Pthiriasis. (Eyelids & Eyelashes).
October 15, 2002... Signs and symptoms: Pediculosis refers to eyelid infestation by Pediculus human-us corporis (body) or capitus (head). Pthiriasis refers to eyelid infestation by Pthirus pubis (pubic louse, sometimes referred to as crab louse). Eyelid...

Conjunctival neoplasms. (Conjunctiva & Sclera).
October 15, 2002... Signs and symptoms: The primary conjunctival neoplasms seen in optometric practice include squamous cell carcinoma and, to a much lesser extent, malignant melanoma. With both these conditions, the typical patient tends to be older (50-plus) and...

Allergic conjunctivitis. (Conjunctiva & Sclera).
October 15, 2002... Signs and Symptoms: The human allergic response has various objective signs and physical symptoms. Ocular allergic conditions vary from the subtle signs of itchy, watery eyes with mild hyperemia to extensive inflammatory interactions between...

Ocular Allergies: OTC or Rx? (Conjunctiva & Sclera).
October 15, 2002... Even though there a dozen FDA-approved prescription topical medications to treat allergic conjunctivitis, the American public still purchases more than 40 million bottles of over-the-counter (OTC) ophthalmic preparations each year. More...

Vernal Keratoconjunctivitis (VKC). (Conjunctiva & Sclera).
October 15, 2002... Signs and symptoms: VKC is a chronic, bilateral inflammation of the superior and limbal palpebral conjunctiva. The warmer the climate, the greater its prevalence. Onset typically occurs between ages 3 and 25 years. Males typically are affected...

Acute bacterial conjunctivitis. (Conjunctiva & Sclera).
October 15, 2002... Signs and symptoms: The patient will present with injection of the bulbar conjunctival and episcleral vessels, and perhaps also the palpebral conjunctiva. Infection may begin in one eye and subsequently spread to the fellow eye. There may be...

Ocular allergies: oral or topical therapy? (Conjunctiva & Sclera).
October 15, 2002... Since the introduction of Livostin (levocabastine, Novartis Ophthalmics) in 1994, the eye-care market has seen an explosion of topical medications for the treatment of allergic conjunctivitis. With no less than 12 prescription topical agents...

Terrien's marginal degeneration. (Cornea).
October 15, 2002... Signs and symptoms: Terrien's marginal degeneration produces superior nasal peripheral corneal thinning, leaving the epithelium intact. The condition is often bilateral and may occur at any age, although it typically occurs in middle-aged...

Acanthamoeba keratitis. (Cornea).
October 15, 2002... Signs and Symptoms: Acanthamoeba keratitis can occur in patients of any age, sex or race, but mostly manifests in young, healthy adults. The list of risk factors is long: corneal foreign body, contact with non-sterile water, bullous...

Fungal keratitis. (Cornea).
October 15, 2002... Signs and Symptoms: Fungal keratitis shows no predilection for age, gender or race, although those with compromised immunity are especially prone. Risk factors include ocular trauma--particularly if organic vegetative matter is...

The fluoroquinolone advantage. (Cornea).
October 15, 2002... The fluorinated quinolones--Ciloxan (ciprofloxacin, Alcon Laboratories), Ocuflox (ofloxacin, Allergan), Quixin (levofloxacin, Santen) and Chilbroxin (norfloxacin, Merck)--have revolutionized the standard of care for cases of infection or...

Filamentary keratitis. (Cornea).
October 15, 2002... Signs and Symptoms: Patients presenting with filamentary keratitis generally report ocular discomfort ranging from mild foreign-body sensation to severe pain. Variable tearing and photophobia are likewise present. The condition may be...

Antibiotics, steroids and combination medications. (Cornea).
October 15, 2002... The anterior eye's limited response to a broad variety of insults sometimes makes it difficult to differentiate viral, bacterial or allergic causes. Using combination medicines such as Tobradex (tobramycin and dexamethasone, Alcon) or Maxitrol...

Bacterial keratitis. (Cornea).
October 15, 2002... Signs and Symptoms: The patient with bacterial keratitis will generally present with a unilateral, acutely painful, photophobic, intensely injected eye. Visual acuity is usually reduced, and profuse tearing is common. There will be a focal...

Understanding corneal topography. (Cornea).
October 15, 2002... Within the past 10 years, corneal topography has grown from an elaborate and costly device used only for clinical research in large institutions to a critical in-office tool that many optometrists now use daily. Along with advances in...

Crystalline lens subluxation. (Uvea & Glaucoma).
October 15, 2002... Signs and Symptoms: While crystalline lens subluxation can occur in any patient, these three profiles are most prone: significant blunt trauma to the eye or head; systemic conditions such as Marfan's syndrome, homocystinuria, hyperlysinuria,...

New insights into treating ocular hypertension. (Uvea & Glaucoma).
October 15, 2002... In the past, when a patient's intraocular pressure (IOP) was elevated with normal visual fields and optic nerves, you faced a dilemma. On one hand, you could initiate lop reduction therapy, knowing full well that the patient might never develop...

Ciliary-block glaucoma. (Uvea & Glaucoma).
October 15, 2002... Signs and Symptoms: Patients with ciliary-block glaucoma are typically hyperopic with small or nanophthalmic eyes. The condition usually develops after ocular surgery--typically glaucoma surgery, and most commonly filtration surgery, but also...

Treating POAG: how low should IOP go? (Uvea & Glaucoma).
October 15, 2002... Choosing a target intraocular pressure has always been an inexact science. The greater and more consistent the reduction in IOP, the greater the reduction of subsequent nerve damage. The target pressure is different for each patient and there...

Primary open-angle glaucoma (POAG). (Uvea & Glaucoma).
October 15, 2002... Signs and Symptoms: Although early and moderate POAG patients are virtually asymptomatic, there are definitive signs: progressive enlargement of the optic cup at the expense of the neuroretinal rim (either diffusely or focally) and repeatable...

Pigment dispersion syndrome and pigmentary glaucoma. (Uvea & Glaucoma).
October 15, 2002... Signs and Symptoms: Pigment dispersion syndrome (PDS) is generally an asymptomatic disorder discovered during routine ophthalmic evaluation. Pigmentary glaucoma (PG), a sequelae of PDS, may likewise be asymptomatic; or patients may complain of...

Pseudoexfoliation syndrome and pseudoexfoliative glaucoma. (Uvea & Glaucoma).
October 15, 2002... Signs and Symptoms: A patient with pseudoexfoliation syndrome remains asymptomatic until an advanced glaucoma develops. The condition is most common in those in their 50s to 70s; glaucoma develops later in this age range. Pseudoexfoliation...

Anterior uveitis. (Uvea & Glaucoma).
October 15, 2002... Signs and Symptoms: The typical presentation of anterior uveitis involves pain, photophobia and hyperlacrimation. Patients report a deep, dull aching of the involved eye and surrounding orbit. Associated sensitivity to lights may be severe....

Understanding nerve fiber layer analysis. (Uvea & Glaucoma).
October 15, 2002... When researchers discovered that a great amount of retinal ganglion cells are lost prior to the development of visual field defects, they studied the retinal nerve fiber layer, initially with an ophthalmoscope. However, just as automated...

Cystoid macular edema. (Vitreous & Retina).
October 15, 2002... Signs and symptoms: Patients with cystoid macular edema (CME) frequently have a history of cataract surgery or some other invasive ocular surgery. About 3% of patients undergoing cataract extraction will have visual reduction due to CME within...

Asteroid hyalosis. (Vitreous & Retina).
October 15, 2002... Signs and symptoms: Asteroid hyalosis is a primarily unilateral disorder that typically occurs in patients over 60 and in men twice as often as women. Usually asymptomatic, in severe cases asteroid hyalosis can mildly affect visually acuity....

Pathological myopia and posterior staphyloma. (Vitreous & Retina).
October 15, 2002... Signs and symptoms: Physiological myopia is the most common eye disorder worldwide. A Degenerative myopia has an incidence of 2% in the United States, and is the seventh leading cause of blindness. The malady seems to have a predilection...

Toxocariasis (Ocular Larva Migrans). (Vitreous & Retina).
October 15, 2002... Signs and symptoms: Toxocariasis is caused by a parasitic nematode. It may develop at any age, although the initial infection typically occurs in childhood. Some 10,000 infections occur in each year, and 700 of these people develop ocular...

Retinal vein occlusion. (Vitreous & Retina).
October 15, 2002... Signs and Symptoms: The patient presenting with retinal vein occlusion will usually be elderly, often with systemic diseases such as diabetes and hypertension. He or she may be asymptomatic, but often will complain of a sudden painless...

A primer on therapeutic ophthalmic lasers. (Vitreous & Retina).
October 15, 2002... With the advancement of refractive surgery, we've all learned a good deal about the excimer laser. However, therapeutic lasers--namely the argon and krypton lasers and the neodymium and holmium YAG lasers--have not received much attention of...

Duane's retraction syndrome. (Optic Nerve & Brain).
October 15, 2002... Signs and symptoms: Duane's retraction syndrome (DRS) is a congenital disorder of ocular motility characterized by limited abduction, adduction or both. It is unilateral in 80% of cases.' The hallmark clinical signs are the classic...

Toxic/Nutritional optic neuropathy. (Optic Nerve & Brain).
October 15, 2002... Signs and symptoms: Toxic/nutritional optic neuropathy often presents as a painless, progressive, bilateral, symmetrical visual disturbance with variable optic nerve pallor. Pallor in the temporal quadrant is most common with this condition....

Aberrant regeneration of Cranial Nerve III. (Optic Nerve & Brain).
October 15, 2002... Signs and symptoms: If patients have had a previous CN Ill palsy, they are likely to undergo secondary aberrant regeneration. In the absence of previous CN III palsy, this is termed primary aberrant regeneration. Patients will have...

Intracranial mass lesions. (Optic Nerve & Brain).
October 15, 2002... Signs and symptoms: The symptom most often associated with intracranial mass lesions is headache, although it has little localizing value. The typical headache from mass lesion has a boring pain, and may awaken the patient during sleep....

Carotid-cavernous sinus fistula. (Optic Nerve & Brain).
October 15, 2002... Signs and Symptoms: Two distinct types of patients develop carotid-cavernous sinus fistula (CCSF). The first is the patient who suffers significant head trauma, often from an traffic accident. This patient bridges age, race and sex profiles....

Systemic lupus erythematosus. (Oculosystemic Disease).
October 15, 2002... Signs and Symptoms: Systemic lupus erythematosus (SLE) commonly presents in young and middle-aged women, who comprise up to 90% of all SLE sufferers. (1-7) SLE is three times more common in blacks than in other races, and Asians display an...

Neurofibromatosis. (Oculosystemic Disease).
October 15, 2002... Signs and Symptoms: Neurofibromatosis (NF-1) describes a variety of related syndromes characterized by neuroectodermal tumors arising within multiple organs. The term Von Recklinghausen's Neurofibromatosis recognizes Friedrich Daniel Von...