Author: Healio ophthalmology

The dysfunctional tear syndrome opus: Review and interpretation

My friend Mark Milner and I have spent countless hours together on various stages in venues across the country talking about dry eye disease. A couple of years ago, he mentioned that he was working on a comprehensive DED diagnostic and treatment protocol that would be published “pretty soon.” I am not Jewish, but I am now fully aware of what my Jewish brothers and sisters mean when they say “next year in Jerusalem.” We have been waiting for the arrival of the CEDARS/ASPENS opus on the evaluation and treatment (Read more...)

PUBLICATION EXCLUSIVE: When will eye drops stop rolling down our faces?

For as long as I have been performing cataract surgery, there are three real reasons for the use of mainstay topical therapy after cataract surgery: to eliminate pain and inflammation, to prevent cystoid macular edema and to prevent any type of infection.Although mainstay topical eye drop therapy has become more advanced from once-daily dosing to unique delivery systems that rely less on patient shaking (emulsions, gels, DuraSite from InSite Vision) to more potency with modification of quinolones (besifloxacin based on in vitro ARMOR surveillance data), there still remains many problems (Read more...)

Speaker: Use skin grafts from flaps in complicated eyelid reconstruction

PHILADELPHIA – Reconstructive surgeons can use a skin graft of excess tissue during flap construction in complicated eyelid surgeries, according to a speaker at the Wills Eye Conference.“In general, we prefer flaps over grafts because local skin has a better color and texture match. In addition, there’s less contraction in healing compared to grafts, and flaps come with their own blood supply,” Renelle Pointdujour-Lim, MD, said.

Topical timolol-dorzolamide combined with anti-VEGF could better treat macular edema

PHILADELPHIA – An ongoing study suggests that topical timolol-dorzolamide can reduce central subfield thickness in patients with persistent macular edema when combined with anti-VEGF treatment, a speaker said at the Wills Eye Conference.“The purpose of this study was to evaluate the effect of topical timolol-dorzolamide on anatomical and functional outcomes in eyes with macular edema, retinal vein occlusion, who have persistent fluid despite fixed intravitreal treatments with the same drug,” David S. Ehmann, MD, said.

Fewer malignant conjunctival tumors seen in children

PHILADELPHIA – Conjunctival tumors in children statistically are more often benign than those in adults and can be differentiated by using a set of markers, a speaker said at the Wills Eye Conference.While a recent analysis of 5,000 conjunctival tumors found 50% to be benign and 50% to be premalignant or malignant, the study did not take age into consideration, Carol L. Shields, MD, said. Therefore, a new analysis conducted with 806 cases of conjunctival tumors occurring in children was completed, which showed that only 3% of their tumors were (Read more...)

PUBLICATION EXCLUSIVE: Middle-age man experiences unilateral sudden-onset vision loss

A 44-year-old man with no significant medical or ocular history was referred by an outside optometrist to Ophthalmic Consultants of Boston for sudden-onset painless decreased vision of the right eye that began 4 days before presentation. At that time, the patient was also experiencing fevers, fatigue, 3 weeks of painless sores on the roof of his mouth, and spots on his palms and soles. His primary care physician obtained blood work, including CBC, ESR, BMP, HIV, Lyme, rheumatoid factor, RPR, ANCA and ANA, which were all negative except for an (Read more...)

Aerie reports fourth quarter net loss of $29.3 million

Aerie Pharmaceuticals reported a GAAP net loss of $29.3 million, or $0.87 per share, in the fourth quarter of 2016 compared with a GAAP net loss of $20.4 million, or $0.76 per share, in 2015’s final quarter, according to a company press release.Quarterly research and development expenses were $14.1 million while general administrative expenses totaled $14.7 million, compared with $12.3 million and $7.7 million, respectively, in the fourth quarter a year ago.

Retina abnormalities associated with increased risk for PAD, CLI

Small abnormalities in the retina were associated with a significant increase in risk for development of peripheral artery disease and critical limb ischemia, according to research presented at the American Heart Association’s Epidemiology and Prevention/Lifestyle and Cardiometabolic Health Scientific Sessions.Chao Yang, MSc, from Johns Hopkins Bloomberg School of Public Health, and colleagues analyzed participants (n = 9,390) from the ARIC cohort study who had retinal photographs taken and no history of PAD.

PUBLICATION EXCLUSIVE: A few books, a mentor and a clear sense of purpose can help forge a practice’s path to success

Most ophthalmologists focus on the sciences during their 4 to 5 years of college education and then are immersed in a very challenging medical school environment for 4 more years, with minimal to no formal training in business or practice management. This is repeated during their 1 year of internship and 3 years of residency. Those who perform a fellowship in a well-managed private practice environment have the opportunity to learn some business and practice management skills, but enhancing clinical and surgical skills remains the top priority.Fortunately, most young ophthalmologists (Read more...)

Reported disclosures lacking among patient-advocacy groups

Researchers at the University of Pennsylvania’s Perelman School of Medicine found that many patient-advocacy organizations do not adequately disclose funding or other connections with drug of medical device makers, according to recent findings.“What we’re seeing is that institutional conflicts of interest are the norm among larger patient-advocacy organizations, and that disclosures and management of these conflicts [are] limited,” Harald Schmidt, PhD, assistant professor of medical ethics and health policy at the University of Pennsylvania’s Perlman School of Medicine, said in the release.

ACP, AMA: Proposed ACA replacement ‘unacceptable,’ ‘critically flawed’

In the midst of the House Republicans recent announcement of their proposed ACA replacement plan, known as the American Health Care Act, the ACP and AMA, among many other health care organizations, have released statements in opposition of the plan, noting that it will negatively impact access, quality and cost of care for patients. “This bill will result in many millions of Americans losing coverage; benefits and consumer protections …,” Nitin S. Damle, MD, MS, MACP, president of ACP, said in a press release. “In sum, it will rollback and (Read more...)

InnFocus MicroShunt with MMC reduces IOP in 4-year series

CORONADO, Calif. — In patients with primary open-angle glaucoma, the InnFocus MicroShunt reduced IOP by 55% from baseline to 11.2 mm Hg, according to a study presented here.The tube’s dimensions and surface effects result in a predictable transscleral gradient, according to Paul F. Palmberg, MD, PhD, who presented the study at the American Glaucoma Society meeting.

Complications common but transient in PTVT study

CORONADO, Calif. — Surgical complications were common in the Primary Tube Versus Trabeculectomy Study, but most were transient and self-limited, Ike K. Ahmed, MD, reported at the American Glaucoma Society meeting.In the PTVT study, patients underwent placement of a 350 mm2 Baerveldt glaucoma implant in the superotemporal quadrant with complete restriction of flow or underwent a superior trabeculectomy with a standard dose of mitomycin C.

PUBLICATION EXCLUSIVE: Business education gives a boost to clinical practice

Investing in a Master of Business Administration degree or some other type of business education can significantly improve an ophthalmologist’s clinical practice and provide enterprising opportunities.Jai G. Parekh, MD, MBA, FAAO, managing partner at Brar-Parekh Eye Associates in Woodland Park and Edison, New Jersey, said earning an MBA is analogous to having undergone refractive surgery. “I see through a different lens now as everything is more ‘macro’ to me, after having practiced for so many years in a ‘micro’ fashion,” he said.