Clinical Diagnosis

La Jolla, CA—Many optic disc measurements obtained using confocal scanning laser ophthalmoscopy (CSLO) can help predict the development of primary open-angle glaucoma (POAG) in patients with ocular hypertension, according to the recently published results of an ancillary study to the National Eye Institute (NEI)-sponsored Ocular Hypertension Treatment Study (OHTS).

La Jolla, CA—Many optic disc measurements obtained using confocal scanning laser ophthalmoscopy (CSLO) can help predict the development of primary open-angle glaucoma (POAG) in patients with ocular hypertension, according to the recently published results of an ancillary study to the National Eye Institute (NEI)-sponsored Ocular Hypertension Treatment Study (OHTS).

Dossenheim, Germany—The Heidelberg Retina Tomograph (HRT) can help predict the development of glaucoma in eyes that appear otherwise normal, by standard clinical exam, according to one published study.

Siena, Italy—Corneal collagen cross-linking—induced by topical treatment with riboflavin and exposure to ultraviolet A light—appears to be a safe and effective, minimally invasive procedure both to reduce disease pro- gression and improve upon the cornea's optical properties in eyes with early keratoconus, said Aldo Caporossi, MD.

Intraoperative floppy iris syndrome (IFIS) can result in a high complication rate when unanticipated, but with a simple preoperative medication history, cataract surgeons can now predict when this problem may occur, said David F. Chang, MD, in the ?Spotlight on Cataract Surgery 2005? session held during the annual meeting of the American Academy of Ophthalmology.

That cryotherapy was to be useful in ophthalmology was first shown by Frederich Schoeler (1844-1918) in a German paper, in which he described application of cold carbonic acid crystals to the sclera of rabbits and showed that a lesion of the retina could be produced.

Editor's Note: Howard Pomeranz, MD, describes a possible association of sildenafil and non-arteritic anterior ischemic optic neuropathy (NAION). There are several compelling parts of the argument, including temporal relationship of symptoms to drug delivery, a suggestive rechallenge history, a biologically plausible mechanism of effect, and analogy from other cases.

When and how do you use laboratory testing in patients with suspected toxoplasmic retinochoroiditis? What patients require no testing? When and how do you use testing of intraocular fluids? What approach should be taken in routine clinical practice?

San Francisco - Developers of specialized perimetric tests and quantitative optic nerve and retinal nerve fiber layer (RNFL) analyzers have introduced hardware and software modifications to improve those new tools for assessing function and structure in patients with glaucoma. However, their roles in clinical practice still await definition pending further study, said Christopher A. Girkin, MD, MPH, associate professor of ophthalmology and director, glaucoma service, Callahan Eye Foundation Hospital, University of Alabama at Birmingham.

Lisbon, Portugal - The Duet-Kelman phakic lens seems to be safe and efficacious to correct moderate and high degrees of myopia, and patients with high degrees of myopia expressed satisfaction with their increased vision, according to Gonzalo Bernabeu, MD. He reported his experience with the IOL Monday at the European Society of Cataract and Refractive Surgeons meeting.

It was important to educate the nurses, respiratory therapists, and families that more oxygen was not necessarily better.

Fort Lauderdale, FL—WDR36 is a novel causative gene for adult-onset primary open-angle glaucoma (POAG) that is located at the GLC1G locus. Sharareh Monemi, MD, PhD, and Mansoor Sarfarazi, PhD, explained that this discovery should help in the diagnosis and treatment of glaucoma.

Minneapolis, MN—Two "all natural" dietary supplements sold as a possible treatment for cataracts and allergy symptoms are not sterile and could be contaminated with bacteria that can cause serious injury when applied to the eyes—including blindness— warn the FDA and manufacturer.

Women age 45 or older going through menopause are most prone to experience dry eye.

Dorado Beach, Puerto Rico—Newer techniques for managing the small pupil are effective, thus enabling safer phacoemulsification. Stephen Obstbaum, MD, reviewed the techniques that are available and demonstrated their use at the Current Concepts in Ophthalmology meeting.

Washington, DC &#8212 With the recent acquisition of VISX and last month's FDA approval of its ReZoom multifocal refractive lens, Advanced Medical Optics (AMO) appears to be experiencing "some exciting times" in ophthalmology.

Cardiovascular medicine has provided a road map that ophthalmology can follow in risk assessment.

When I was a boy, my father mentioned several times how he might have purchased IBM stock decades earlier, and how much such an investment would have been worth at the time. Often, people tell me how they refrained from purchasing a waterfront home because the price seemed way too steep, only to have the value subsequently shoot up 10-fold. Perhaps we all regret not making certain purchases long ago.

Cardiovascular medicine has provided a road map that ophthalmology can follow in risk assessment.

Fairfax, VA—The FDA is asking cataract surgeons to report any incidents of intraoperative floppy iris syndrome (IFIS) that they have experienced on the agency's MedWatch Web site.

San Francisco—A drug commonly prescribed for older men suffering from prostate enlargement seems to cause a "floppy iris" that increases the risk of complications during cataract surgery.

Coronado Island, CA-The focus of attention in caring for babies with incontinentia pigmenti (IP) should be on the potential for rapid development of irreversible blindness rather than on the clinically obvious skin manifestations, said Morton F. Goldberg, MD, in the Gertrude D. Pyron Award Lecture at the annual meeting of the American Society of Retina Specialists.

Heidelberg Engineering has received FDA clearance for its Rostock Cornea Module, a key component of its confocal laser microscope.

New York-Aqueous misdirection is "a rare, but serious complication of intraocular surgery" that requires immediate attention to prevent lasting damage, Celso Tello, MD, told participants at the Glaucoma 2004 meeting here.

The nomenclature and etiology of "dermoid" tumors and fatty lesions of the orbit and ocular adnexa have created longstanding confusion.

New York -Five potential causes of failure of glaucoma filtration surgery include excessive subconjunctival fibrosis, tight scleral flap sutures, encapsulated bleb, occluded internal ostium, and intraocular obstruction, according to James C. Tsai, MD.

New York-"The time to think about preventing a shallow anterior chamber is the moment you decide to perform a trabeculectomy," said Jody R. Piltz-Seymour, MD, at the Glaucoma 2004 meeting here.

New York-The best time to start treating a bleb-associated infection resulting from trabeculectomy is when its first warning signs appear, reported Paul J. Lama, MD, at the Glaucoma 2004 meeting here.

New York-Hypotony maculopathy-damage to the macula caused by clinically significant low IOP-has several causes, including overfiltering blebs, bleb leak, cyclodialysis cleft, and ciliary body effusion/detachment, reported Celso Tello, MD, at the Glaucoma 2004 meeting here.

New York-How do you determine whether a patient identified as having suspected glaucoma has glaucoma or will develop glaucoma? When should you treat a patient? How aggressive should treatment be?