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Baltimore-Treatment of people with ocular hypertension without a diagnosis of glau-coma has been poorly understood, but there is no doubt that the Ocular Hypertension Treatment Study (OHTS) has brought the field a lot farther.

Not long after topical timolol was introduced in 1978, it became one of the most widely prescribed glaucoma medications in the world. Although timolol is considered to be the most significant therapeutic advance in the medical treatment of glaucoma in the 20th century, the 1994 introduction of prostaglandin analogs for glaucoma treatment in Japan marked the end of timolol's domination.

When trauma or pathology necessitate removal of the eye, evisceration can be a successful solution and alternative to enucleation when applied in properly selected patients, said John W. Shore, MD.

Baltimore-Ophthalmologists can be comfortable identifying and managing certain eyelid lesions in their offices if they pay attention to a few basic principles. A working knowledge of common benign and malignant lesions is the key to managing these lesions, according to Shannath L. Merbs, MD, PhD, who spoke at the Current Concepts in Ophthalmology meeting here.

Iowa City, IA-Primary open-angle glaucoma (POAG) is a common ocular affliction, but because it is generally a late-onset disease, it is difficult to study molecularly, according to Wallace L.M. Alward, MD.

Omaha, NE-The Ocular Hypertension Treatment Study (OHTS) clearly demonstrat-ed that topical IOP-lowering medications can delay the onset of primary open-angle glaucoma. In addition, the OHTS study also revealed two very important secondary messages, which may be as important as the primary finding, according to M. Roy Wilson, MD.

Refractive surgery in the next few years will be dominated by the intellectually and, we hope, clinically exciting introduction of wavefront-guided surgery. Both from the viewpoint of improving our current results and for the treatment of the patient suffering adverse optical sequelae after LASIK, wavefront technology offers a novel and promising diagnostic and surgical approach. Indeed, refractive surgery today-borrowing from optics, astronomy, physics, engineering, and biology-represents the ultimate fusion of science, technology, and medicine.

Jacksonville, FL-Mastering the lamellar corneal surgery technique may extend the benefits to both physician and patient well beyond LASIK, according to Arun C. Gulani, MD. In the technically demanding surgery, a partial-thickness cornea is replaced with donor tissue of the same size and thickness.

Do you remember not long ago that a trip overseas meant virtually losing contact with home? Even a simple task such as making a phone call became an adventure- looking for the correct change with foreign coins, placing them in the appropriate slots, and then, of course, figuring out the time back home.

Editors Note: Birdshot chorioretinopathy (BSCR) is an uncommon, but potentially serious, inflammatory disorder that involves both the choroid and retina. No systemic associations have been observed consistently to date. While a strong association with the HLA-A29 class I antigen suggests a genetic predisposition, the vast majority of HLA-A29-positive patients never develop BSCR, and the trigger in that small proportion of HLA-A29-positive patients that does develop the disease is unknown.

Editor's Note: I developed myectomy surgery more than 25 years ago, and this procedure has been confirmed to be the best surgical treatment for blepharospasm. I have performed more than 1,000 myectomy procedures, and while functional results (reduction in spasm) have not changed greatly in the past few years, cosmetic results have improved greatly and negative side effects and healing time have been reduced.

Alexandria, LA-With greater surgical expectations from both patient and physician, it is imperative for the cataract surgeon to spend more time discussing the refractive component prior to surgery, according to R. Bruce Wallace, MD.

This report provides a brief review of macroaneurysms, reviews two recently described applications of investigational tools that may assist in diagnosing a macroaneurysm when it is obscured by hemorrhage, reviews two approaches for the management of subhyaloid hemorrhage arising from a macroaneurysm, and discusses a rationale for the application of photocoagulation when treating selected macroaneurysms.

Kansas City, MO-Making the transition from a standard phacoemulsification technique to a bimanual technique requires cataract surgeons learn to perform phaco through two micro-incisions and to develop their skills using an irrigating chopper.

Orlando-When considering computer office integration, physicians must consider what is essential versus what may be little more than a luxury to a smooth-running office. It may or may not be economically feasible to tie all aspects of a practice into a readily accessible communication network at this point.

Orlando-The accommodative response in pseudophakic patients with an accommodative posterior chamber IOL (Human Optics, Erlangen, Germany) implanted is difficult to interpret when measured by various clinical tests, and the pseudophakic accommodation should be differentiated from pseudoaccommodation, according to Achim Langenbucher, PhD.

Space invaders

Baltimore-Using aggressive lobbying techniques and grassroots organizing, optometrists in certain regions of the country have succeeded in getting legislation passed and introducing bills that would enable them to perform laser and surgical procedures, prescribe any class of medicine including narcotics and IV injections, perform diagnostic tests such as fluorescein angiography, and require eye exams of children before they enter school (See related article, "The perfect storm," Ophthalmology Times, March 1 issue, Page 1).

Cataract removal by means of phacoemulsification has improved over the last 35 years in small, incremental steps. The sequential introductions of capsulorhexis, foldable IOLs, clear corneal incisions, and topical anesthesia have made small improvements in the safety andefficacy of cataract surgery and as a whole have taken us one giant leap forward.Bimanual phacoemulsification is just another one of these small steps that may ultimately enhance our ability to offer the best surgical procedure to our patients.

Baltimore-Researchers are working to improve their understanding of the cascade of events that lead to retinal degeneration and vision loss. This active research could lead eventually to clinical treatments, according to Jennifer Sung, MD, who spoke at the Current Concepts in Ophthalmology Meeting here.

Orlando-Emerging imaging technologies are revolutionizing ophthalmologists' understanding and treatment of a variety of ocular disorders, including angle-closure glaucoma, according Jeffrey M. Liebmann, MD.

Baltimore-Ophthalmologists can now use new guidelines on how best to treat optic neuritis based on the results from the Optic Neuritis Treatment Trial (ONTT), which followed long-term outcomes for 10 years, according to Neil R. Miller, MD, who spoke at the Current Concepts in Ophthalmology Meeting.