

No truly perfect approach to completely restoring the eye’s accommodative ability currently exists. 

A variety of today’s presbyopia-correcting

can, however, correct patients’ distance refractive error while at the same time improve both intermediate and near vision. 

Surgeons increasingly can provide more spectacle independence for patients; however, not all patients are candidates for such premium technologies.

Presbyopia: Rethinking approach to better meet patients’ needs

Surgeons have come to understand that specific amounts of higher-order aberrations (HOA), particularly spherical aberration, can increase a patient’s overall depth of focus. 

specially designed to neutralize spherical aberration could improve quality of vision, IOL manufacturers began to develop aspheric implants.

—with negative spherical aberration—to neutralize the inherent spherical aberration of the 

The industry has also introduced aspheric aberration-free implants that are made to preserve the cornea’s preexisting 

Study focuses on HOA measurements in normal keratoconic eyes

are aspheric and aberration-free. Because no aberrations are induced with the enVista platform, surgeons are able to preserve the cornea’s natural positive aspherical aberration of, on average, + 0.24 um to + 0.27 um for a 6-mm pupil size.

These factors are important for patients’ visual function because there is a strong correlation between spherical aberration and depth of focus.

 There are benefits to the eye’s having a specific amount of spherical aberration to enhance the depth of focus.

There is a “sweet spot” of about 0.30 to 0.4 um of aberration. 

Too much aberration, and quality of vision will suffer; patients with significant aberration may see halos or glare around lights, as well as decreased contrast sensitivity.

But with the enVista MX60E monofocal implant, for example, patients targeted for plano can experience good distance vision and depth of focus.

Presbyopia-correcting IOLs: Expanding, improving last frontier


Due to the defocus tolerance with this platform’s monofocal implant, excellent image quality is provided.

A variety of factors such as pupil size, total corneal HOA, and corneal asphericity (Q value) affect individual patients’ range of vision with monofocal 

, so it is important to note no single lens provides a one-size-fits-all solution. 

Ultimately, pseudo-accommodation is relative to the unique features of the patient’s optical system, not just the implant chosen or postsurgical changes.

After an IOL is placed in the capsular bag during cataract surgery, a natural decentration of about 0.3 mm to 0.4 mm occurs. Moreover, the aberration-free attributes make the lens more tolerant to this natural decentration.

An aberration-free implant platform is especially important for eyes that are not perfect.

To be most successful at achieving the target refraction, I always perform optical biometry with IOLMaster (Zeiss), corneal topography, and tomography. 

Striving for perfection: Creating the perfect IOL

Because ocular surface disease can masquerade a patient’s astigmatism, corneal imaging is also crucial. In addition, I perform an examination of the macula with 

To allow patients to achieve the best visual outcomes possible, it is incumbent on 

surgeons to also correct astigmatism at the time of the procedure. 

 patients have more than 0.50 D of astigmatism,

 yet toric implants account for less than 10% of procedures.

Even just 0.50 D of residual astigmatism may have an impact on both patients’ functional and low-contrast acuity.

The enVista toric platform provides 110° of capsular bag contact. The toric implant also features a greater than 300% radial compression force compared with traditional hydrophobic acrylic implants.

In the FDA approval study for the MX60T (n = 108), 94.4% of eyes implanted with the technology had 5° or less rotation from the close of case through 180 days, and no patients required a secondary surgical intervention. 

Accurate data key for planning toric IOL surgery

In a prospective, single surgeon study of the enVista toric (n = 53), 92% of patients had less than 0.50 D of residual astigmatism, and 94% of patients could see well enough to pass a driver’s license vision test without glasses.

Additionally, 83% of patients had uncorrected distance visual acuity of 20/25 or better.

 These results are similar to what I have experienced in my practice.

Another added benefit to the enVista toric technology is its improved material properties that help enhance and speed up its optic recovery.*

Toric implants have a higher chance of rotation if not fully opened during the case; efficiency in terms of case time is also an important factor coupled with placement precision. 

All implants on the enVista platform provide glistening-free optics

 and the technology is available in a range of cylinder powers as low as 1.25 D11 or about 0.77 D at the corneal plane. 

ASCRS 2020: Assessing aberration of monofocal toric IOL with enhanced optic recovery, alignment

This allows for a greater range of patients to have astigmatic correction

 The enVista toric lenses are currently the only IOLs in the United States that can correct less than 1.00 D of corneal astigmatism.

Surgeons must seek to understand each patient’s personality and discover which individual goals are key. 

No matter the technology used, it is necessary to customize the implant choice based on the patient’s needs to achieve optimal 

*Compared to the previous generation of enVista IOLs


Karolinne Maia Rocha, MD, PhD, is associate professor of ophthalmology and director of the Cornea and Refractive Surgery Division at Medical University of South Carolina, Storm Eye Institute in Charleston. She is a consultant to Bausch + Lomb.

1. Holladay JT, Piers PA, Koranyi G, van der Mooren M, Sverker Norrby NE. A new intraocular lens design to reduce spherical aberration of pseudophakic eyes. 

2. Rocha KM, Vabre L, Chateau N, Krueger RR. Expanding depth of focus by modifying higher-order aberrations induced by an adaptive optics visual simulator. 

 2009;35(11):1885-1892. doi:10.1016/j.jcrs.2009.05.059

3. Rocha KM, Gouvea L, Waring IV GO, Haddad J. Static and dynamic factors associated with extended depth of focus in monofocal intraocular lenses. 

Published online April 23, 2020. doi:10.1016/j.ajo.2020.04.014

4. Stephenson, PDG. Achieving astigmatism correction with new spherical aberration neutral monofocal toric IOL with intraoperative wavefront-aberrometry. Paper presented at: 2019 American Society of Cataract and Refractive Surgery Annual Meeting; May 3-7, 2019; San Diego, CA. Accessed June 19, 2020. 

https://ascrs.confex.com/ascrs/19am/meetingapp.cgi/Paper/57144

5. enVista. Package insert. Bausch + Lomb; 2018. Accessed June 19, 2020.

https://www.bausch.com/Portals/77/-/m/BL/Global/dfu/4130300.pdf?ver=2019-04-01-093512-787

6. Hill WE. Prevalence of corneal astigmatism prior to cataract surgery. East Valley Ophthalmology. Accessed June 19, 2020. http://www.doctor-hill.com/physicians/docs/Astigmatism.pdf

7. Villegas EA, Alcón E, Artal P. Minimum amount of astigmatism that should be corrected. 

. 2014;40(1):13-19. doi:10.1016/j.jcrs.2013.09.010

8. Bozukova D, Pagnoulle C, Jérôme C. Biomechanical and optical properties of 2 new hydrophobic platforms for intraocular lenses. 

 2013;39(9):1404-1414. doi:10.1016/j.jcrs.2013.01.050

Articles

No matter the technology used, it is necessary to customize the implant choice based on the patient’s needs to achieve optimal refractive outcomes.

Aspheric, aberration-free IOL leverages technology for performance

As is painfully obvious to even the most casual of observers, the 

public health emergency has been disruptive to all industries. And, the health care industry has been at the epicenter of this disruption.

Nonetheless, not all disruption is negative. One bright spot for many health care practitioners during this public health crisis has been the emergence and normalization of telehealth.

 public health crisis, the Centers for Medicare and Medicaid Services (CMS) took an active role in promoting telehealth.

 

This was a welcome surprise to many as CMS has historically not been quick to embrace novel technologies. 


Pass-through provides vehicle to drive innovation

Nonetheless, beginning in early March 2020, CMS made clear that Medicare will provide broader coverage for telehealth services.

CMS noted that telehealth visits will be reimbursed using the same billing rate as in-person visits.

 

More significantly, though, CMS loosened several of the otherwise onerous requirements historically associated with Medicare’s coverage of telehealth visits.

For example, Medicare beneficiaries receiving telehealth services previously had to be located in certain types of “originating sites” and had to be located in certain, generally rural, geographic regions in order for the telehealth visit to be reimbursable. 

By and large, these restrictions have been significantly relaxed through the duration of the public health emergency.

Moreover, previously Medicare required that coinsurance and deductibles would generally apply to telehealth services. 

However, the Department of Health and Human Services Office of Inspector General (HHS-OIG) has noted that it will provide flexibility for health care providers to either reduce or, in some cases, waive cost sharing for telehealth visits.


Clearing hurdles to large scale telemedicine adoption

In addition to some of the regulatory changes, CMS has also made clear that it will allow practitioners to use more novel communication platforms, such as Zoom, Skype, and others, to ensure telehealth coverage. 

The relaxing of technological requirements has opened a new world of software to be utilized and, correspondingly, has made it easier than ever for beneficiaries to take advantage of telehealth.

While CMS and HHS-OIG have offered much needed regulatory flexibility, the risk of enforcement still looms large. Many physicians have learned by painful experience that the failure to strictly comply with Medicare’s rules can be costly. 

And, therefore, practitioners would be well-served to err on the side of caution and tread carefully in embracing these new technologies. Several practical tips for physicians include the following:

All telehealth visits need to ensure that proper documentation is being captured to justify the billing and medical necessity of the visit. A best practice is to update templates for certain office visits that utilize telehealth.


Pearls for managing COVID-19 pandemic north of the border

These templates should include fields that indicate, for example, the method of communication used, confirmation that an audiovisual connection was maintained throughout the entire office visit, and a generalized assessment and plan that clearly indicate the care provided during the telehealth visit.

The rigor for expansive documentation is needed more than ever in the telehealth setting where prosecutors and regulators have historically cast a skeptical eye.

Practitioners would be well served by ensuring that they have a process in place to make sure that patients are informed of risks associated with telehealth visits and that patients fully attest to their consent of using telehealth. 

While patients will only presumably engage in telehealth visits voluntarily, documenting the acknowledgement of inherent risks associated with data transmission (such as hacking, data privacy concerns, etc) is a best practice.

Practices still need to comply with the Health Information and Portability Accountability Act (HIPAA). Therefore, practitioners must remember that strict adherence to HIPAA is mandatory.


Amid COVID-19 pandemic, telehealth patient satisfaction high, could drive future access


Where the government has previously been harsh on telehealth, the government has focused on perceived reflective ordering habits—such as when all telehealth beneficiaries receive, for example, certain durable medical equipment. 

Therefore, in each instance that a patient receives a service or referral, the practitioner should clearly document the need for such service and, to the extent practicable, the justification for the service should be tailored to the patient’s individual needs.

Health care practitioners should remember that there are certain documentation requirements specific to telehealth.

Health care practitioners would benefit from scheduling consultations or appointments with their electronic health record (HER) vendors to ensure that the EHR platform has the capability to properly record telehealth-specific information. 

Most EHR vendors are very willing to schedule these meetings and consultations.

Finally, practitioners must maintain compliance with not only the relaxed federal regulations, but also their individual state-specific laws.


How one surgeon is integrating recent retina advances in COVID-19 (ASRS 2020)

 will continue to affect the country and the health care industry, it seems apparent that the normalization of telehealth is here to stay. 

And, if 

brings positive disruption, many health care professionals are hoping that telehealth will be utilized, and appropriately reimbursed, in the years to come.

CMS’ commitment to regulatory flexibility and innovation has been admirable. It is a welcome change to see CMS acknowledge these emerging technologies and re-shape practical regulations to meet these new times.


COVID-19: Companies offering new technology to connect physicians with patients

While this flexibility has been promising, the wave of potential enforcement still is ominous for many practitioners who have experienced regulators and prosecutors’ past wrath. 

Therefore, as the old adage goes, an ounce of prevention is worth a pound of cure. Never has this adage been more relevant than when deploying new health care technologies.

This article was originally published in:

 is a partner with the Tampa, Florida office of Bradley Arant Boult Cummings LLP and a former assistant US attorney for the Middle District of Florida. He advises companies and individuals facing government inquiries and investigations. He can be reached at jmehta@bradley.com.

1. COVID-19 Partner Toolkit available at https://www.cms.gov/outreach-education/partner-resources/coronavirus-covid-19-partner-toolkit.

2. Medicare Telemedicine Health Care Provider Fact Sheet available at https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet.

Despite current flexibility, future enforcement could prove to be troublesome


Emerging opportunities — and risks — with telehealth in a pandemic



The Tecnis Toric II (ZCU) lens (Johnson & Johnson Vision) will be very familiar to any surgeon who has implanted other 

 from the Tecnis platform. 

The optic is unchanged and the lens looks identical to the Tecnis Toric I (ZCT). It loads into the injector the same way, unfolds at the same comfortable speed and controlled manner, and centers well.


From a material and optical quality standpoint, it has all the same properties of a Tecnis lens, including aspheric optics, low chromatic aberration, and no glistenings.

In my experience, this lens is not difficult to rotate in either direction, clockwise or counterclockwise, when making small adjustments intraoperatively to achieve the desired axis alignment. 

However, there is a reassuring amount of resistance to movement in the eye. When you stop applying angular force to the lens, it stops moving.

The lens incorporates a relatively simple haptic modification with the potential to have a big impact. We know that rotational misalignment of a toric 

can reduce its effect, leaving the patient with residual astigmatism.

Although the Tecnis Toric I ZCT platform demonstrated robust optical performance even in cases of lens rotation,

 surgeons were keen to identify lens modifications that could further enhance stability.

I was part of a team that tested prototypes with various modifications in overall length, haptic geometry, or haptic polishing. The ZCU lens incorporates a very minor change to the haptic polishing, leaving a “frosted” area on the haptics 

In multicenter clinical studies conducted outside the US, the lens was implanted in 98 eyes.

Lens position was evaluated using 2 masked readers and custom image analysis software to compare the positions of 10 different iris and scleral landmarks 

 in photographs taken at the end of the surgery (through the operative microscope) and at the slit lamp at postoperative follow-up visits.


This digital photographic comparison is the most robust method I have seen for measuring rotational stability. It demonstrated that mean rotation of the lens with the ZCU haptic modification at 1 week was less than 1° (0.71° ± 0.69°) and none of the eyes had rotated more than 5°.

Using the commercially available Tecnis Toric II now, I continue to see very little rotation. The lens simply stays exactly where I leave it at the end of the case. 

Getting it right: There is no magic bullet for IOL calculations



Previously, it was not uncommon to find that irrigating viscoelastic out of the chamber or hydrating the wound would create enough turbulence to make the lens rotate, but this particular lens moves very little with irrigation of the anterior segment.

As a practical matter, there is a very short learning curve—or none at all—for surgeons transitioning to this lens with prior Tecnis experience. If you have tried it, let us know what you think of the stability. 


Dr Vukich is a consultant to Johnson & Johnson Surgical Vision. He is an eye surgeon in Milwaukee, Wisconsin, specializing in cataract surgery.

. Simple method for accurate alignment in toric phakic and aphakic intraocular lens implantation. 

. 2008;34(10):1631-1636. doi:10.1016/j.jcrs.2008.04.041

2. Canovas C, Piers P, Sun M, Alarcon A, Weeber HA, Waring G. Impact of residual astigmatism on optical and visual performance for toric intraocular lenses. 

3. Lee BS, Chang DF. Comparison of the rotational stability of two toric intraocular lenses in 1273 consecutive eyes. 

 2018;125(9):1325-1331. doi:10.1016/j.ophtha.2018.02.012

4. Kasthurirangan S, Feuchter L, Smith P, Nixon D. Software-based evaluation of toric IOL orientation in a multicenter clinical study. 

. 2014;30(12):820-826. doi:10.3928/1081597X-20141117-01

5. Vukich J, Waltz K, Straker B, et al. A randomized controlled, multicenter clinical investigation of rotational stability of IOLs. Paper presented at: AAO Annual Meeting; 2019

Lens offering surgeons a reassuring amount of resistance to movement in the eye


Toric stability: A minor change with a major impact for patients

This article was reviewed by Andrés A. Bustamante, MD



Imaging technology has been advancing at a rapid-fire rate of late, but the advancements have not yet reached the level of sophistication that allows the various instruments to detect corneal pathologies before they become symptomatic and permits their measurement. 

This may be the point at which artificial intelligence (AI) enters the picture to fill the existing diagnostic gaps.

Artificial intelligence in medicine: The good, the bad, and the scary

“Standardized quantitative measurement of different corneal structural alterations, that is, stromal edema, inflammatory infiltration, fibrosis, and scarring are crucial for early detection, objective documentation, grading, and disease progression,” said Andrés A. Bustamante, MD.

AI, he explained, has an unlimited capacity to learn and analyze large volumes of data. It can also autocorrect and continue learning to improve sensitivity and specificity as a tool to diagnose and measure disease progression.

AI has already been called into action in 

, and keratoconus, among other applications. 

In corneal ectasia, he pointed out, only the topographic parameters and the tomographic thickness measurements have been analyzed. 

Bustamante is a 

and external disease clinical and research fellow at Tecnológico de Monterrey, School of Medicine and Health Sciences in Monterrey, Mexico.

AI screening: Allowing physicians to see more clearly from afar 

Bustamante and colleagues conducted a study with the goal of training different AI algorithms to discriminate between healthy and diseased corneas by evaluating spectral-domain 

Their prospective, experimental, comparative pilot study included a control group comprised of 71 images of healthy corneas and an experimental group comprised of 22 SD-

 corneal images of random corneal pathologies that included corneal ectasia, corneal ectasia and cross-linking, active and inactive herpes simplex keratitis, and exposure keratopathy.

Bustamante explained that in image processing and the intersection with machine learning, extraction of features is crucial in pattern recognition. 

Hardware, software offer surgeons a window to cornea diagnosis



This process starts by calculating the state of the measured data from images that were intended to be informative and not redundant, which facilitates machine learning tasks.

When imaging processing was complete, the investigators input the information into the different machine learning algorithms, namely, random forest (supervised learning), support vector machines (supervised learning), convolutional neural network (unsupervised learning), and transfer learning, which is associated with random forest. 

The measure of accuracy was the area under the curve (AUC).

Analysis indicated that all 4 methods—random forest, convolutional neural network, transfer learning-support vector machines, and transfer learning-random forest—achieved high levels of sensitivity, specificity, and accuracy. 

However, transfer learning-random forest showed the highest sensitivity and specificity, 1 and 1, respectively, with 100% accuracy in classifying normal and pathological images. 

Transfer learning-support vector machines had the next highest levels of sensitivity, specificity, and accuracy, at 1%, 0.8571%, and 96.43%, respectively, Bustamante reported.

Estimating the total corneal power key in keratoconus patients

Bustamante explained further that although the transfer learning approach seemed the best method, the convolutional neural network model may be attributed to the limited dataset on which it was trained. 

The convolutional neural network is a strong predictor, but an extensive training dataset must be available and in medicine that is not always possible.

“AI is an emerging technology in medicine that facilitates early detection, diagnostic accuracy, objective evaluation of disease progression, and detailed follow-up of therapeutic results of certain ophthalmic disorders, particularly those most related to images of specific ocular structures,” Bustamente explained. “AI is a powerful took that will increase the diagnostic sensitivity and specificity of ophthalmic pathology. We believe that this technology can help us objectively measure disease progression and even in the preclinical diagnosis of certain pathologies.”


Dr Bustamante has no financial disclosures related to this report.

Emerging technology may be able to fill existing imaging diagnostic gaps

Teaching AI algorithms to identify corneal pathology: The future is now

See more Optic Relief content by Jon Carter

Diagnosing a 'down looker'

This article was reviewed by Eric Donnenfeld, MD



Patients expressed a strong preference for a dropless medication regimen after cataract surgery compared with a conventional regimen of topical medications.

In addition to the convenience of not instilling eye drops multiple times a day for up to 4 weeks postoperatively, there was no significant difference in pain or inflammation when both regimens were compared. 



Dropless regimen after cataract surgery relieves patient treatment burden

In addition, the dropless regimen was less expensive, according to Eric Donnenfeld, MD, John A. Hovanesian, MD, and Chad Hummel, MD.

The dropless regimen comprises dexamethasone ophthalmic insert 0.4 mg (Dextenza, Ocular Therapeutix), ketorolac and phenylephrine (Omidria, Omeros Corp), and intracameral moxifloxacin 500 mcg. In terms of delivery, the only component delivered via punctal plug is dexamethasone ophthalmic insert and the only components delivered at the end of surgery are the dexamethasone ophthalmic insert and moxifloxacin. Ketorolac/phenylephrine is delivered intraoperatively but provides/contributes to both intraoperative and postoperative benefits such as a reduction in intraoperative complications and postoperative complications such as CME, and a decrease in postoperative pain and inflammation.

The conventional regimen included the standard topical regimen of prednisolone acetate 1% administered 4 times daily for 2 weeks and then twice daily for 2 weeks, moxifloxacin 0.5% administered 4 times daily for 10 days, and ketorolac administered 4 times daily for 4 weeks.

The dropless future: SLT as a first-line treatment for glaucoma

The investigators conducted a randomized, self-controlled, prospective clinical study to compare the standard (control) and dropless (experimental) regimens for safety and ocular efficacy for controlling postoperative ocular pain, inflammation, and infection associated with cataract surgery.

A total of 56 patients (25 men, 31 women) were included in the study. Each patient underwent sequential bilateral cataract surgery 2 weeks apart and was randomly treated with the dropless regimen in 1 eye and the standard topical regimen in the fellow eye.

Donnenfeld reported that no significant differences were seen at any postoperative time points in the 2 groups in cell and flare, postoperative pain, best-corrected visual acuity, or macular thickness at 2 weeks, 1 month, and 2 months after cataract surgery.

No cases of endophthalmitis or cystoid macular edema developed in either group.


Topical moxifloxacin: Best choice before cataract surgery?

Two patients in the dropless group required rescue topical prednisolone acetate 1% for inflammation, and 1 patient in the standard drop group had rebound iritis requiring additional prednisolone acetate 1%. 

Six patients in the topical medication study developed significant superficial punctate keratitis (SPK). No endophthalmitis or cystoid macular edema developed in the topical group.

When patients were questioned about which eye regimen they preferred, 96% (

 < .0001) of patients chose the eye randomized to the dropless regimen; 2 of 56 patients preferred the standard topical regimen.

The investigators reached the following conclusions.

Compared with a traditional eyedrop regimen, patients receiving dexamethasone ophthalmic insert/ketorolac and phenylephrine + intracameral moxifloxacin expressed a strong preference for the dropless regimen. 

No significant differences were seen in pain and the summed ocular inflammation score. No endophthalmitis developed in either group.

ASCRS 2020: Assessing effectiveness of intracameral phenylephrine/ketorolac post-cataract surgery

The dropless regimen significantly reduced the out-of-pocket expenses for patients because it contains a preservative-free corticosteroid. Also, there was less SPK and no medication toxicity.

“Dropless intracameral and intracanalicular insert delivery medications following cataract surgery are safe, and preservative-free,” Donnenfeld concluded. “These options are an efficacious alternative to traditional topical medications, increasing compliance, improving the ocular surface, and benefiting social distancing,” Donnenfeld concluded.



Dr. Donnenfeld is founding partner at Ophthalmic Consultants of Long Island and Connecticut, a clinical professor of ophthalmology at New York University in New York, and a Trustee of Dartmouth Medical School in Hanover, New Hampshire. John A. Hovanesian, MD, is a clinical assistant professor at the University of California Los Angeles, Stein Eye Institute. Chad Hummel, MD, is in private practice in Massapequa, New York. All authors reported being consultants to Ocular Therapeutix, which funded the study.

Following cataract surgery, the dropless option is proving to be a preferred method during recovery

Dropless, hands-free regimen key for patients

This article was reviewed by Anthony J. St. Leger, PhD



The eye is blessed with a friendly environment that has a protective effect against infection. 

Investigators have reported that tears from colonized mice provide the ocular surface with improved protection from pathogens such as 

, both of which can cause ocular infection.

This is good news because, according to Anthony J. St. Leger, PhD, an assistant professor in the departments of ophthalmology and immunology at the University of Pittsburgh School of Medicine in Pennsylvania, the eye was thought to be an “immune privileged” site, which implied that the organ was largely ignored by the immune system. 

Ocular surface inflammation: Vicious cycle of ocular surface disruption

Indeed, the eye is armed with various mechanisms that dampenexcessive inflammatory responses.

However, we do know that active immune responses occur routinely in and around the eye.

A great balancing act of inflammation must be struck to preserve visual acuity, as a nonexistent immune response would leave the eye susceptible to infectious insults and an overactive inflammatory response would result in irreversible damage. 

In the case of the cornea, excessive inflammation can lead to corneal scarring and the need for a corneal transplant.

Investigators like St. Leger and others are trying to understand the mechanisms governing the line between infection and inflammatory disease. St. Leger has focused the attention of his lab on the conjunctiva. 

In a murine study of ocular surface disease,

 St. Leger and colleagues demonstrated the power of immune responses against commensal bacteria at the ocular surface. 

ASCRS 2020: OSD improvement in eyes implanted with trabecular meshwork bypass stents

 and showed that the bacterium elicited a specific interleukin-17 response that drove the production and release of protective antimicrobials into the tears. The antimicrobials in turn protected the eye from 

Researchers note that more study of conjunctivitis is needed in patients with COVID-19 

Ophthalmology Times: July 15, 2020

Aspheric, aberration-free IOL leverages technology for performance

Emerging opportunities — and risks — with telehealth in a pandemic

Toric stability: A minor change with a major impact for patients

Teaching AI algorithms to identify corneal pathology: The future is now

Diagnosing a 'down looker'

Dropless, hands-free regimen key for patients

Amid pandemic, friendly bugs can help protect the eye from infection

Gene therapy offers hope for choroideremia

Machine-learning algorithms could help predict course of NPDR

Thyroid eye disease: Not limited to visual impairment

Beating burnout with camaraderie

Themistocles: Everyone's second chance

IOP homeostasis in glaucoma: Looking below the surface

Clearing hurdles to large scale telemedicine adoption

The eyes offer conjunctival clue to COVID-19

Show me the patients: Patient satisfaction, not surgical landmarks or chart indices, mark of success