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.
Measuring the oxygen level of the retinal tissues may allow detection of retinal changes in patients with diabetes before structural changes in the capillaries occur, said Amani Fawzi, MD, Doheny Eye Institute, University of Southern California, Los Angeles.
The best results of surgery for the correction of congenital esotropia are achieved in children aged less than 12 months, according to Malcolm Ing, MD, chairman of the Division of Ophthalmology, University of Hawaii, Honolulu.
Adaptive optics scanning laser ophthalmoscope (SLO) imaging allows visualization of the minute details of the retina that were not visible previously and that can help explain visual disturbances, said Srinivas Sadda, MD, Doheny Eye Institute, University of Southern California, Los Angeles.
Patients who have masquerade syndromes-underlying disorders that present with signs and symptoms that appear to indicate idiopathic uveitis-are among the most challenging cases to ophthalmologists, said Scott Whitcup, MD.
Oral corticosteroid therapy is essential for ocular sarcoidosis. A sub-Tenon's triamcinolone infusion, however, is useful for older patients to avoid the side effects of corticosteroids. Managing ocular sarcoidosis often requires vitrectomy for fibrotic lesions and photocoagulation for ischemic retinopathy and macroaneurysms, said Nobuyuki Ohguro, MD, Osaka University Medical School, Osaka, Japan.
As new techniques in cataract surgery present so, too, do new complications and challenges in the management of such cases, said Gregg Kokame, MD, MMM, medical director of The Retina Center at Pali Momi, and clinical professor, Division of Ophthalmology, University of Hawaii School of Medicine, Honolulu.
There is much to be learned about nocturnal-and, more importantly, sleeping-IOP if ophthalmologists are going to optimize glaucoma therapies, said Yaniv Barkana, MD, Department of Ophthalmology, Assaf Harofeh Medical Center, Israel.
A new artificial iris implant (Dr. Schmidt Intraocularlinsen GmbH) provides patients with full or partial iris defects with good surgical results, such that it is difficult to differentiate the normal eye from the one that sustained trauma and underwent implantation of the artificial device.
The incidence of the development of cataracts is low after implantation of an implantable collamer lens (ICL), 1.96% over 5 years of follow-up. The common risk factors for cataract development in association with an ICL are patients aged more than 40 years, high myopia, surgeon learning curve, shallow anterior chamber depth, and male gender.
A technique for removing lens fragments that have fallen into the vitreous, developed by ophthalmologists in India, is a simple and effective surgical procedure, suggest results of a recent case series. The FAVIT technique was developed in 1999, and the recent series included cases performed with both a 900-μm phaco probe and a new modification, a 700-μm probe.
