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I have been using endoscopic cyclophotocoagulation (ECP) to treat patients with cataract and medically controlled glaucoma for 5 1/2 years and have found it to be a very useful addition to my armamentarium. The procedure is particularly attractive as an adjunct to small-incision cataract surgery. It takes only about 5 to 10 extra minutes to add ECP to phacoemulsification.

Los Angeles-Joseph L. Demer, MD, PhD, a noted authority on extraocular muscle movement, has been named the first holder of the Leonard Apt Endowed Chair in Pediatric Ophthalmology at the Jules Stein Eye Institute at the University of California, Los Angeles (UCLA).

San Francisco-The American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, and American Academy of Pediatrics released a series of recommendations on which to base effective detection and treatment of retinopathy of prematurity (ROP). The groups discuss improvements in the possible treatment of ROP and the importance of carefully timed retinal exams by an ophthalmologist for at-risk premature infants.

Dallas-Essilor of America Inc. now offers Definityprogressive lenses through its network of laboratories and otherselect labs nationwide. Definity lenses feature Dual Add, apatented technology that maximizes available design space of thelens, minimizing peripheral distortion and providing a smoothertransition between all distances.

Sacramento, CA-Obtaining reimbursement and resources forvision screening seems to be a thankless task with little return.However, there are strategies that can be used to give pediatricvision screening a fair share of the available health-care funds,according to James Bradford Ruben, MD.

Clowning around

When Stephen R. Powell, MD, is spreading cheer throughout the community, his patients usually do not recognize him. Why? Dr. Powell moonlights as a unicycle-riding clown.

Portland, OR?Mass vision screening of school-age children was first recommended in 1983. At that time there was not a large population of children of preschool age, a situation that has changed markedly since then because today many more 3- and 4-year-olds are in a preschool setting. However, there is still no standardization in vision screening.

Madison, WI - Uniform testing and reporting criteria are needed toidentify amblyogenic risk factors in children and prevent thedevelopment of amblyopia. Leslie W. France, CO, described theevidence base for the guidelines to detect amblyogenic riskfactors.

Experience from clinical trials and daily clinical practice indicate that loteprednol etabonate 0.2% (Alrex, Bausch & Lomb) is a valuable therapeutic option for both short- and longer-term management of allergic conjunctivitis, according to ophthalmologists who have studied and used this novel anti-inflammatory corticosteroid agent.

Dorado, Puerto Rico?Patients with allergies should be identified and treated before undergoing ophthalmic surgery in order to improve healing for optimal visual outcomes, explained Francis S. Mah, MD, who spoke during the Current Concepts in Ophthalmology meeting in Dorado, Puerto Rico.

Chicago—Screening to detect preclinical vision loss in children is important and should ideally be done in the offices of pediatricians or family practitioners. In addition, it is now time to add objective testing to pediatric practices, according to Robert W. Arnold, MD, who spoke at the annual meeting of the American Academy of Ophthalmology.

In case you have been so busy with your practice and other obligations that you missed it, two medical miracles (my opinion) have recently been reported. Each is only partially relevant to the practice of ophthalmology, but it seems to me that these are worth awareness.

Portland, OR—The novel formulation of timolol maleate 0.5% ophthalmic solution containing potassium sorbate (Istalol, ISTA Pharmaceuticals) is a good option to consider for adjunctive therapy in patients whose IOP is not adequately controlled by a prostaglandin analogue alone, said John R. Samples, MD.

Chicago—Clinicians should use a systematic approach when confronted with the complaint of double vision. Knowing the possible symptoms and signs associated with diplopia can help with the diagnosis, explained Kimberly Cockerham, MD, FACS, at the neuro-ophthalmology subspecialty day meeting during the American Academy of Ophthalmology annual meeting.

Chicago-"When is a lid laceration not just a lid laceration?" When it is occult penetrating orbito-cranial trauma, explained Roger E. Turbin, MD, assistant professor of ophthalmology and associate director of neuro-ophthalmology, University of Medicine and Dentistry of New Jersey-New Jersey Medical School.

Toulouse, France—With lengthening follow-up, the posterior chamber implantable collamer lens (ICL) (STAAR Surgical) continues to be associated with encouraging results in the management of refractive amblyopia in children who have not had a response to conventional therapy with contact lenses or spectacles, said Laurence C. Lesueur, MD.

Houston—Filtering bleb encapsulation after trabeculectomy seems to respond well to tapering topical corticosteroids alone or in conjunction with IOP-lowering agents. Withdrawing steroids appeared beneficial for lowering the IOP compared with continuing the use of steroids to prevent inflammation, according to Sheila Bazzaz, MD.

With cataract and refractive procedures, ocular comfort and inflammation management are highly relevant to the patient's impression of a successful procedure. Add to that an expectation that an increase in visual acuity will follow closely on the heels of surgery, and the standards are set very high.

Intracameral triamcinolone acetonide (Kenalog, Bristol?Myers Squibb) used judiciously offers simple and safe anti-inflammatory treatment in cataract surgery patients, said James P. Gills, MD, at "Spotlight on Cataract Surgery in 2005" during the annual meeting of the American Academy of Ophthalmology.

A number of pathologies can be confused with giant cell arteritis, Anthony Arnold, MD, explained Monday at the American Academy of Ophthalmology annual meeting. Patients with a painful ophthalmoplegia might have an isolated cranial neuropathy, a skull-based or cavernous sinus process such as a tumor, or an inflammatory or infiltrative process, an orbital process, a brainstem process, or a vasculitic process.

Mass vision screening for amblyopia in school-age children should be standardized, and Pamela Hutt Berg, CO, COMT, recommended how that might be accomplished Sunday at the American Academy of Ophthalmology annual meeting.

The patterns of childhood blindness and visual impairment are changing over time, according to Clare Gilbert, MD, MSc. Dr. Gilbert described the shifts in pediatric blindness patterns resulting from the ?nurture? factors Sunday at the American Academy of Ophthalmology annual meeting.