News

The American Academy of Ophthalmology (AAO) has named August Cataract Awareness Month to remind those at risk for cataracts to see their ophthalmologist to determine whether they have a cataract and if it should be removed.

The first in vivo tests of a wireless, soft contact lens sensor demonstrate that the device's measurements correspond with those taken via Goldmann tonometry. The contact lens sensor, which is designed to detect the tiny changes in corneo-scleral curvature induced by IOP changes, could be used potentially to monitor a patient's IOP changes over 24 hours.

The long-running Ocular Hypertension Treatment Study has produced many important clinical findings. Among them is the conclusion that African-American and white patients have similar responses to treatment with topical beta-blockers and prostaglandin analogs. The study also found that optic disk hemorrhages are a risk factor for progression from ocular hypertension to primary open-angle glaucoma.

A retrospective chart review of 200 charts from three centers found that physicians do not adhere consistently to the American Academy of Ophthalmology's Preferred Practice Patterns for glaucoma management. As the world's leading cause of irreversible blindness, the stakes are high to ensure that the patterns are being followed to maximize positive outcomes for patients with glaucoma.

In vitro studies using retinal neurosensory and pigment epithelial cell lines in culture are aiming to define the relative safety profiles of combination corticosteroids and anti-vascular endothelial growth factor (VEGF) agents being considered for intravitreal treatment of retinal diseases.

It is possible to remodel filtering blebs, but much like a home remodeling project, a bleb remodeling should only be undertaken with a plan, a careful review of options, and the realization that it may become more involved than initially expected.

Combination therapy to treat age-related macular degeneration seems to be a promising avenue of research. The gain in visual acuity can be sustained with fewer intravitreal injections. This approach might also reduce the overall cost of treatment.

The systemic complications associated with anti-vascular endothelial growth (VEGF) factor therapy for colon cancer are well documented. Those associated with intravitreal injection of anti-VEGF agents to treat neovascular age-related macular degeneration (AMD) seem to occur infrequently. Monitoring of these events has been limited thus far, however. Good methods need to be developed for post-marketing surveillance of anti-VEGF agents used to treat patients with AMD.

The 2-year results of the PrONTO Study indicated that intravitreal injections of ranibizumab (Lucentis, Genentech) produces rapid improvements in visual acuity (VA) and optical coherence tomography (OCT) outcomes in patients treated for neovascular age-related macular degeneration. The changes on OCT are visible before the changes in VA and allow ophthalmologists to determine each patient's need for additional dosing of ranibizumab.

A hydroxypropyl cellulose ophthalmic insert (Lacrisert, Aton Pharma), a once-daily, preservative-free insert that helps to retain moisture, stabilize the tear film, lubricate the eye, and increase tear break-up time, may be beneficial in the treatment of patients with dry eye due to lid function abnormalities, closure problems, or thyroid disease.

Out of seven anti-allergy medications examined in a laboratory study epinastine is a potent antihistamine but has minimal anticholingeric activity. Ideally, allergy medication should effectively target the histamine receptors without causing adverse effects such as ocular dryness.

Loteprednol etabonate ophthalmic suspension 0.2% and olopatadine HCl ophthalmic solution 0.1% were compared in a study for the treatment of allergic conjunctivitis. After 14 days of use, the topical corticosteroid demonstrated greater efficacy in improving Ocular Surface Disease Index scores and was preferred by a significantly higher proportion of patients. Both medications were safe and well tolerated, and both led to improved signs and symptoms.

New lubricant eye drops (Soothe XP Emollient Eye Drops, Bausch & Lomb) were specifically formulated to address lipid deficiency in the tear film, which is a critical factor in most patients with dry eye disease.

A new high-performance artificial tear product (Systane Ultra, Alcon Laboratories) was created with an intelligent delivery system designed to maximize comfort upon instillation and provide sustained symptomatic relief and ocular surface protection.

Tear hyperosmolarity is central to the dry eye disease process and the value of measuring tear osmolarity in the diagnosis of dry eye disease is well established. Alan Tomlinson, PhD, DSc, FCOptom, and Michael A. Lemp, MD, discuss the obstacles that physicians have come up against when attempting to diagnose dry eye effectively and accurately in a clinic setting. They also report on the latest research that has yielded some effective and user-friendly instruments, which now make osmolarity testing, and therefore, dry eye diagnosis, much easier.

Cyclosporine A ophthalmic emulsion 0.05% (Restasis, Allergan) is effective in treating moderate to severe dry eye in 70% to 75% of patients with the condition, and adding a specific artificial tear (Systane, Alcon Laboratories) to the treatment regimen may prove beneficial for many other patients.

An antimicrobial eyelid cleanser (SteriLid, Advanced Vision Research) reduces bacterial colonization in dry eye and blepharitis. The cleanser's active ingredient is linalool, a naturally occurring oil effective against a number of organisms.

A product containing carboxymethylcellulose, glycerin, and a preservative (Optive, Allergan), is a valuable option in the management of dry eye disease according to an open-label study evaluating patients who previously used an artificial tear product.

Topical cyclosporine 0.05% (Restasis, Allergan) limited progression or improved dry eye severity levels in most patients, while the use of artificial tears alone led to worsening of disease severity levels in nearly one-third of patients in a 12-month randomized study. The rapid progression of the disease in patients using artificial tears and the improvements in the patients using cyclosporine suggest that medication use could be beneficial for many individuals with level 2 dry eye disease.

A new artificial tear eye drop caused significantly less blurring on instillation than a control drop, and offers another option for the treatment of mild-to-moderate dry eye disease.

By implanting a punctal plug in both the superior and inferior punta-literally, plugging the drains-clinicians can reduce tear turnover rate via these ducts. Reducing nasolacrimal drainage is one way of increasing tear volume on the ocular surface, in the hopes of prolonging the residence time of the tear film, and thus improving the signs and symptoms of dry eye.

The eyes can be affected by over-the-counter (OTC) systemic medications, nutrition habits, and systemic agents-all of which contribute to dry eye. Oral treatment options should be considered in these cases, whereas topical treatment with artificial tears is the best option for external causes.

John Snisarenko, vice president of sales and marketing for Lucentis, outlines in an interview with Ophthalmology Times how Genentech Inc. is working to improve its relationship with the ophthalmic community as well as offer assistance to physicians and patients in accessing ranibizumab.

An unexpected appearance by the ailing Sen. Ted Kennedy (D-MA) helped secure bipartisan passage of a "veto-proof" bill to block a 10.6% pay cut for 600,000 physicians who treat Medicare patients. The bill, identical to a House version passed June 24, extends the 0.5% update through the end of 2008 and provides a 1.1% update to the conversion factor for 2009.

A fourth-generation version of the only accommodating IOL available in the United States has been approved by the FDA. The presbyopia-correcting implant (Crystalens HD, Bausch & Lomb) is built on the platform of the previous accommodating IOL and has a 5-mm optic but with a proprietary modification to improve depth of focus without degrading distance vision or contrast sensitivity.

The FDA has approved a new drug application for the topical ophthalmic corticosteroid difluprednate 0.05% emulsion (Durezol, Sirion Therapeutics) for four-times-daily dosing in the treatment of postoperative ocular inflammation and pain.

A 58-year-old Caucasian woman presented to the Bascom Palmer Eye Institute Emergency Department complaining of sudden loss of vision in the right eye 1 day prior. She denied pain or trauma to the right eye. Medical history was significant for poorly controlled type 2 diabetes mellitus, hypertension, hypercholesterolemia, and obesity.

The American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgery are working with the American College of Physicians and the American Academy of Family Physicians to educate prescribers of tamsulosin (Flomax, Boehringer Ingelheim) about the association between the use of alpha blockers and intraoperative floppy eye syndrome.

Do pressure-independent factors play a role in glaucoma? That would seem to be the case, since the disease progresses in many patients despite IOP reduction. Enter a new line of thinking about the disease, neuroprotection, which was the topic of a symposium held here in conjunction with the World Ophthalmology Congress.

The newer generation of a dual-optic accommodating IOL (Synchrony, Visiogen) is easy to implant, centers well, provides good distance visual acuity, and demonstrates good safety in terms of potential posterior capsule opacification development, according to H. Burkhard Dick, MD.