Dry Eye Diagnostics for Beginners

It is possible to start simply and expand offerings later.

Kenneth Beckman, MD, FACS

Cataract and Refractive Surgery Today

Dry eye disease (DED) is one of the conditions eye care professionals encounter most often. Although millions of patients have been diagnosed with DED, far more remain undiagnosed. With many new treatments and diagnostic tools available, it can be difficult for a clinician to know where and how to start when launching a dry eye clinic. This article provides some guidance. WHY DIAGNOSE DED? Not so many years ago, clinicians generally viewed DED as a nuisance experienced by a minority of patients, and treatment options were limited. Managing the condition involved significant chair time, and patients often remained dissatisfied. Thanks to a growing body of research, attitudes about DED as well as options for its diagnosis and treatment have changed. The Prospective Health Assessment in Cataract Surgery Patients’ Ocular Surface (PHACO) study evaluated individuals scheduled for cataract surgery. The study found that, although only approximately 20% of the patients had been previously diagnosed with DED, 77% of the 136 enrolled patients had corneal staining, and 50% had central corneal staining.

The Benefits of a “Boring” Day

Paul Walton, MD; Blake Williamson, MD, MPH; and Gary Wörtz, MD

Eyetube

Paul Walton, MD, joins Blake Williamson, MD, MPH, and Gary Wörtz, MD, to share concepts to help cataract and refractive surgeons avoid horror stories in the OR. He says the goal should always be to have a “boring” day, emphasizing the importance of communication and understanding with patients. The surgeons also detail their approaches to anesthesia and how to best comfort patients before, during, or after surgery.

Managing Large Macular Holes: ILM Flap vs Peel

The literature continues to identify scenarios in which one technique is more effective than the other.

Kaitlyn Richards, BS, and Ankoor R. Shah, MD

Retina Today

Patients with a full-thickness macular hole (FTMH) have an anatomical defect in the fovea that leads to a significant reduction in central visual acuity and, subsequently, reduced quality of life. While many FTMHs can be idiopathic, they can also be secondary to vitreoretinal traction, high myopia, proliferative diabetic retinopathy, and inflammation.1 The conventional treatment for a FTMH has been pars plana vitrectomy, internal limiting membrane (ILM) peel, and total gas-fluid exchange with long-lasting gas tamponade. This technique is effective in terms of both closure rate and visual acuity improvement, with a 90% success rate for the closure of an acute FTMH noted in numerous studies.2,3 However, alternative treatments for chronic, large, or recalcitrant FTMHs have been developed due to lower closure rates of these subsets of FTMHs with traditional methods.