C Diagnosis and Management of Dry Eyes Part 1. Dr Colm McAlinden, BSc (Hons), MSc, PhD and Dr Eirini Skiadaresi, MD.

Size: px
Start display at page:

Download "C-30078 Diagnosis and Management of Dry Eyes Part 1. Dr Colm McAlinden, BSc (Hons), MSc, PhD and Dr Eirini Skiadaresi, MD."

Transcription

1 C Diagnosis and Management of Dry Eyes Part 1 Dr Colm McAlinden, BSc (Hons), MSc, PhD and Dr Eirini Skiadaresi, MD January Detailed Answers IMAGE A Image Courtesy of Professor Giuseppe Ravalico 1. What clinical sign is shown in Image A? a. Khodadoust line b. Symblepharon c. Lisch nodules d. Ankyloblepharon The clinical sign shown here is symblepharon, which represents a partial or complete adhesion of the palpebral conjunctiva (lower pink part of the umage) of the eyelid to the bulbar conjunctiva (covering the sclera) of the eyeball. Khodadoust line is a sign of rejection in corneal graft surgery and appears as a faint white line in the cornea. Lisch nodules are yellow-brown pigmented hamartomatous nodular aggregates of dendritic melanocytes affecting the iris, often seen in people aged over 6 years and commonly associated with neurofibromatosis type 1. Ankyloblepharon represents adhesion of the eyelids together at the margin such that the eye cannot be opened. 2. In a patient with the clinical sign shown in Image A who is currently self medicating with artificial tears, is referral to an ophthalmologist indicated? a. Referral is not indicated as this is typically a sign of dry eye and symptoms can continue to be managed with lubricants

2 b. Referral is indicated as this is a sign of a potential sight threatening auto-immune condition c. Referral is indicated only if the patient is over 65 years of age and symptoms persist d. Referral is indicated only if there is anterior chamber inflammation also present Symblepharon can be caused by conjunctival sequelae of trachoma or trauma, whilst there is also association with autoimmune disorders such as cicatricial pemphigoid and, in severe cases, rosacea. As such, patients should be referred to an ophthalmologist for further investigation. 3. If slit lamp examination reveals flattening of the plica and keratinization of the caruncle along with the sign shown in Image A, what is the MOST likely diagnosis? a. Ocular cicatricial pemphigoid b. Systemic lupus erythematosus c. Ocular lymphoma d. Epidermolysis bullosa Cicatricial pemphigoid is a rare chronic autoimmune subepithelial blistering disease characterized by erosive skin lesions of the mucous membranes and skin, including the conjunctiva, which results in scarring. The other conditions listed do not cause scarring although epidermolysis bullosa is associated with blistering of mucous membranes too. IMAGE B Image Courtesy of Dr Edward Boshnick 4. What is the MOST appropriate combination of tests to use in clinical practice to aid diagnosis and monitoring of the condition and procedure shown in Image B? a. Schirmer I and II tests and lactoferrin assay b. Rose bengal staining, Schirmer I test and impression cytology c. Lissamine green staining, Schirmer II test and lysozyme analysis

3 d. Tear break up time with fluorescein, Schirmer I test and tear film osmolarity Assessment of the tear film should always begin with the least invasive tests first. Furthermore, the most relevant clinical tests associated with evaluating dry eye after LASIK refractive surgery relate to assessing tear quality and quantity, which are diagnosed by measuring tear break up time with fluorescein (least invasive) and the Schirmer I test respectively. Tear osmolarity also gives an indication of tear quality but is more invasive than sodium fluorescein testing, as it requires a tear sample to be extracted from the eyes. 5. Which of the following systemic disorders is NOT typically considered a relative or absolute contraindication for the procedure shown in Image B? a. Sjögren syndrome b. Rheumatoid arthritis c. Amyloidosis d. Multiple sclerosis All of the conditions listed are associated with dry eyes except multiple sclerosis, which is a demyelination disorder. Amyloidosis rarely causes dry eyes and dry mouth through protein deposition in the lacrimal gland, affecting tear production, whilst Sjögren syndrome and rheumatoid arthritis cause infiltration and inflammation of the lacrimal gland, also affecting tear production. These conditions have consequences on post-operative risk of dry eye with LASIK, whilst there is also risk associated with healing of the corneal flap too. 6. By what mechanism does the procedure shown in Image B cause dry eyes? a. Intraoperative dilatation of the nasolacrimal duct b. Interference with the greater petrosal nerve c. Severing of corneal nerves during flap creation d. Changing the ph of the tears In certain cases, LASIK can cause dry eyes after penetrating the corneal surface and severing the nerves when creating the flap. This in turn reduces corneal nerve sensitivity, which reduces the eye s ability to detect a need for lubrication, hence resulting in inadequate tear production. IMAGE C Image Courtesy of Professor Giuseppe Ravalico

4 7. A patient who is using N-acetylcysteine 5% eye drops presents with the clinical picture shown in Image C. What is this condition MOST likely to be? a. Corneal ulcer b. Acute anterior uveitis c. Vernal keratoconjunctivitis d. Filamentary keratopathy N-acetylcysteine is an anti-mucolytic medication. The image depicts filaments of mucous on the surface of the cornea, indicating the condition to be filamentary keratopathy. 8. What clinical feature is associated with the condition shown in Image C? a. Foreign body sensation and photophobia b. Ocular hyperaemia and occasional pseudoptosis c. Connective tissue disorders d. All of the above Patients presenting with filamentary keratopathy generally report ocular discomfort ranging from mild foreign-body sensation to severe pain due to dry eyes, variable tearing and photophobia, which in turn can lead to increased redness and drooping lids. Mucous filaments form when the normally soluble mucin component of the tear film becomes corrupted, causing it to precipitate out as particles or strands. Loose, compromised epithelial cells bind with these mucin strands, forming long filaments that adhere to damaged sites on the corneal surface. As the lids open and close with each blink, they tug at the loose end of the filaments, stimulating the painsensitive corneal nerves. Many patients with filamentary keratitis have underlying systemic conditions, particularly connective tissue disorders. Patients with immune deficiencies also are at greater risk. 9. Which one of the following is NOT associated with the condition shown in Image C? a. Keratoconjunctivitis sicca b. High intraocular pressure c. Recent cataract surgery with prolonged patching d. Bullous keratopathy Keratoconjunctivitis sicca can cause filamentary keratopathy as the normally soluble mucin component of the tear film becomes corrupted, causing it to precipitate from the reduced tear film. There is also an association with prolonged patching following cataract surgery, which can exacerbate dry eye, and bullous keratopathy whereby the cornea becomes permanently swollen due to endothelial dysfunction, eventually leading to blistering of the epithelium and disruption of the tear film.

5 IMAGE D 10. A patient presents complaining of a gritty eye and epiphora. What clinical sign is shown in Image D? a. Entropion b. Ectropion c. Distichiasis d. Madarosis The image depicts the lower lid of the eye to be folded outwards, which is known as ectropion. Entropion represents the lids folding in towards the eye whilst distichiasis represents abnormal eyelash growth from the meibomian gland orifices. Madarosis represents loss of the eyelashes. 11. Which of the following is NOT associated with the clinical sign shown in Image D? a. Facial nerve (cranial nerve VII) paralysis b. Ichthyosis c. Fuchs endothelial dystrophy d. Facial burn Ectropion can be caused by facial nerve (Bell s) palsy, which controls the orbicularis oculi muscle around the eye when it is palsied the muscle becomes weak and can no longer close the eye. Ichthyosis is a genetic skin disorder characterised by dry, thickened, scaly or flaky skin. Lamellar Ichthyosis can cause ectropion through fibrosis and shrinkage of the skin covering the eye lids. Facial burn of the skin around the eye can lead to scarring, fibrosis and shrinking of the lower lid, leading to ectropion.

6 12. If the clinical sign shown in Image D is associated with mild fluorescein staining on the inferior cornea and foreign body sensation but no infiltrates, which of the following is the MOST appropriate to recommend for the patient? a. Artificial tears as and when needed and avoid pulling the skin when wiping his tears. Review symptoms until surgery can be performed b. Iopidine eye drops and lid hygiene until surgery can be performed c. Prednisolone eye drops and warm compresses until surgery can be performed d. Chloramphenicol eye drops and weekly review until surgery can be performed Ectropion will most likely require surgical treatment to correct. Until this can be done, artificial tears will be required to manage the patient s symptoms of foreign body sensation and although there is mild fluorescein staining, which should reduce with the use of artificial tears, there are no infiltrates indicating that an infective or inflammatory process is not occurring. As such, chloramphenicol and prednisolone are not indicated. Furthermore, iopidine is a sympathomimetic which will only reduce ocular redness, not the presenting symptoms. References to aid completion of the exam Q1, Q2, & Q3: Hingorani M (1999) The Compromised Eye: Tear Film Abnormalities and Atopic Disease: Module 1 Part 10. Optometry Today. 39(October 8th): Q4, Q5, & Q6: Q7, Q8, & Q9: Q10, Q11, &Q12: Skorin Jr L (2001) Ectropian and its management. Optometry Today. 41(May 18th):

There Are Millions of People at Risk For Dry Eye Who Is Likely to Develop This Irritating Condition?

There Are Millions of People at Risk For Dry Eye Who Is Likely to Develop This Irritating Condition? There Are Millions of People at Risk For Dry Eye Who Is Likely to Develop This Irritating Condition? Dry eye can be a temporary or chronic condition and occurs when the eye does not produce tears properly,

More information

Thyroid Eye Disease. Anatomy: There are 6 muscles that move your eye.

Thyroid Eye Disease. Anatomy: There are 6 muscles that move your eye. Thyroid Eye Disease Your doctor thinks you have thyroid orbitopathy. This is an autoimmune condition where your body's immune system is producing factors that stimulate enlargement of the muscles that

More information

Lacrimal gland. Tear duct into nose

Lacrimal gland. Tear duct into nose Dry eye syndrome The aim of this information sheet is to answer any questions you may have about dry eye syndrome. If you have any further questions or concerns, please ask a doctor or nurse caring for

More information

Eye Manifestations of Lupus And Sjogren s Syndrome

Eye Manifestations of Lupus And Sjogren s Syndrome Eye Manifestations of Lupus And Sjogren s Syndrome Based on a presentation by Dr. N. Kevin Wade at the BC Lupus Society Symposium held October 22, 2005. Background Dr. Wade completed his MD in 1998 at

More information

Institute of Ophthalmology. Thyroid Eye Disease. aka Thyroid Associated Ophthalmopathy

Institute of Ophthalmology. Thyroid Eye Disease. aka Thyroid Associated Ophthalmopathy Institute of Ophthalmology Thyroid Eye Disease aka Thyroid Associated Ophthalmopathy Causes TED/TAO is an eye disease associated with disease of the thyroid gland Most commonly, it occurs with an overactive

More information

Thyroid Eye Disease. A Patient s Guide

Thyroid Eye Disease. A Patient s Guide Sashank Prasad, MD www.brighamandwomens.org/neuro-ophthalmology A Patient s Guide Symptoms Diagnosis Treatment Prognosis What are the symptoms of Thyroid Eye Disease? Patients with Thyroid Eye Disease

More information

Descemet s Stripping Endothelial Keratoplasty (DSEK)

Descemet s Stripping Endothelial Keratoplasty (DSEK) Descemet s Stripping Endothelial Keratoplasty (DSEK) Your doctor has decided that you will benefit from a corneal transplant operation. This handout will explain your options to you. It explains the differences

More information

Consent for LASIK (Laser In Situ Keratomileusis) Retreatment

Consent for LASIK (Laser In Situ Keratomileusis) Retreatment Consent for LASIK (Laser In Situ Keratomileusis) Retreatment Please read the following consent form very carefully. Please initial at the bottom of each page where indicated. Do not sign this form unless

More information

Atopic Keratoconjunctivitis

Atopic Keratoconjunctivitis Atopic Keratoconjunctivitis Austin Strohbehn, M3; Matthew Ward, MD; Anna Kitzmann, MD March 8, 2013 Chief Complaint: Poor vision and severe ocular itching. History of Present Illness: A 52-year-old Caucasian

More information

Guideline for the Management of Acute Peripheral Facial nerve palsy. Bells Palsy in Children

Guideline for the Management of Acute Peripheral Facial nerve palsy. Bells Palsy in Children Guideline for the Management of Acute Peripheral Facial nerve palsy Definition Bells Palsy in Children Bell palsy is an acute, idiopathic unilateral lower motor neurone facial nerve palsy that is not associated

More information

WHAT TO DO IF YOU HAVE DRY EYES...

WHAT TO DO IF YOU HAVE DRY EYES... WHAT TO DO IF YOU HAVE DRY EYES... Frank J. Holly, PhD Dry Eye Institute Yantis, Texas Based on a presentation given in Spanish at the patient session of the VIIIth Triennial Meeting of the International

More information

Care of the Patient with Ocular Surface Disorders

Care of the Patient with Ocular Surface Disorders OPTOMETRIC CLINICAL PRACTICE GUIDELINE OPTOMETRY: THE PRIMARY EYE CARE PROFESSION Doctors of optometry are independent primary health care providers who examine, diagnose, treat, and manage diseases and

More information

Eye Trauma: Incidence

Eye Trauma: Incidence Ocular Emergencies and Trauma Stuart Fourman, MD Director, Glaucoma Center Department of Ophthalmology Stony Brook University Eye Trauma: Incidence 1.3 million eye injuries per year in the United States.

More information

800-475-6473. www.sjogrens.org. www.sjogrens.org

800-475-6473. www.sjogrens.org. www.sjogrens.org S j ö g r e n s F a s t F a c t s l The hallmark symptoms of Sjögren s syndrome are dry eyes and dry mouth. l Sjögren s is one of the most prevalent autoimmune disorders, striking as many as 4,000,000

More information

Managing Post-Operative Complications for LASIK and PRK

Managing Post-Operative Complications for LASIK and PRK Managing Post-Operative Complications for LASIK and PRK LASIK Flap Complications Epithelial defects o Cause Basement membrane dystrophy Recurrent erosion syndrome Dry eyes Trauma PRK as alternative Pre-treat

More information

Kensington Eye Center 4701 Randolph Road, #G-2 Rockville, MD 20852 (301) 881-5701 www.keceyes.com

Kensington Eye Center 4701 Randolph Road, #G-2 Rockville, MD 20852 (301) 881-5701 www.keceyes.com Kensington Eye Center 4701 Randolph Road, #G-2 Rockville, MD 20852 (301) 881-5701 www.keceyes.com Natasha L. Herz, MD INFORMED CONSENT FOR DESCEMET S STRIPPING and AUTOMATED ENDOTHELIAL KERATOPLASTY (DSAEK)

More information

Minor Lid Surgery. Information for patients

Minor Lid Surgery. Information for patients Minor Lid Surgery Information for patients This leaflet has been produced to give you information about the problems you have been having with your eyelid. If you have any questions or require further

More information

LASIK What is LASIK? Am I a good candidate for LASIK? What happens before surgery? How is LASIK done?

LASIK What is LASIK? Am I a good candidate for LASIK? What happens before surgery? How is LASIK done? LASIK What is LASIK? Laser assisted in situ keratomileusis, or LASIK, is an outpatient surgical procedure used to treat myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. With LASIK,

More information

Descemet s Stripping Automated Endothelial Keratoplasty (DSAEK)

Descemet s Stripping Automated Endothelial Keratoplasty (DSAEK) Descemet s Stripping Automated Endothelial Keratoplasty (DSAEK) John D. Goosey, MD Introduction DSAEK is a corneal transplant technique where the unhealthy, diseased, posterior portion of a patient s cornea

More information

Keeping Your Eyes Healthy after Treatment for Childhood Cancer

Keeping Your Eyes Healthy after Treatment for Childhood Cancer Keeping Your Eyes Healthy after Treatment for Childhood Cancer High doses of radiation to the brain, eye, or eye socket (orbit) during treatment for childhood cancer can have a long-lasting affect on the

More information

A normal eye is protected by a layer of natural tears.

A normal eye is protected by a layer of natural tears. A normal eye is protected by a layer of natural tears. If you need to use eye drops several times a day to make your eyes comfortably moist, you should consult your eye doctor. Helps increase tear production

More information

IntraLase and LASIK: Risks and Complications

IntraLase and LASIK: Risks and Complications No surgery is without risks and possible complications and LASIK is no different in that respect. At Trusted LASIK Surgeons, we believe patients can minimize these risks by selecting a highly qualified

More information

The LASIK experience WHO CAN HAVE LASIK? SELECTING A SURGEON

The LASIK experience WHO CAN HAVE LASIK? SELECTING A SURGEON The LASIK experience I WHO CAN HAVE LASIK? To be eligible for LASIK you should be at least 21 years of age, have healthy eyes and be in good general health. Your vision should not have deteriorated significantly

More information

Getting Ready for ICD-10. Dianna Hoskins, OCS Cincinnati Eye Institute

Getting Ready for ICD-10. Dianna Hoskins, OCS Cincinnati Eye Institute Dianna Hoskins, OCS Cincinnati Eye Institute Chart Documentation: Will your documentation stand up to ICD-10? Do you always mark which eye, severity or status of the disease (chronic or acute), site, etiology

More information

Disclosure Statement. I have no financial interest in any of material presented today

Disclosure Statement. I have no financial interest in any of material presented today The eyes have it PEARLS IN EVALUATION, TREATMENT, AND REFERRAL OF PEDIATRIC OCULAR CONDITIONS AND TRAUMA MICHAEL G. HUNT, MD PEDIATRIC EYE SPECIALISTS, LLP Disclosure Statement I have no financial interest

More information

ALTERNATIVES TO LASIK

ALTERNATIVES TO LASIK EYE PHYSICIANS OF NORTH HOUSTON 845 FM 1960 WEST, SUITE 101, Houston, TX 77090 Office: 281 893 1760 Fax: 281 893 4037 INFORMED CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK) INTRODUCTION This information

More information

DRY EYE & Carboxymethyl Cellulose

DRY EYE & Carboxymethyl Cellulose DRY EYE & Carboxymethyl Cellulose DR.SHIKHA DUBEY, DOMS (Nagpur University), Short-term fellow retina, Phaco-fellow. SHANTI EYE CARE CENTRE Dinner session sponsored by Cipla Foresight, held on 19-03-05

More information

REFRACTIVE SURGERY NIGHTMARES Dr.ATHIYA AGARWAL

REFRACTIVE SURGERY NIGHTMARES Dr.ATHIYA AGARWAL REFRACTIVE SURGERY NIGHTMARES Dr.ATHIYA AGARWAL POST LASIK INFECTION Infection occurring after photorefractive keratectomy (PRK) may be 1. Secondary to the defect in the epithelium as well as the use of

More information

Dry Eye: Natural History, Diagnosis and Treatment By Jeffrey P. Gilbard, M.D.

Dry Eye: Natural History, Diagnosis and Treatment By Jeffrey P. Gilbard, M.D. Dry Eye: Natural History, Diagnosis and Treatment By Jeffrey P. Gilbard, M.D. Our understanding of dry eye disorders has improved dramatically over the past several years, enhancing our ability to diagnose

More information

Pre-Operative Laser Surgery Information

Pre-Operative Laser Surgery Information Pre-Operative Laser Surgery Information Contact 1800 10 20 20 Our Facility The Canberra Eye Laser Centre has always been at the forefront of refractive technology employing the most up to date equipment

More information

Thyroid Eye Disease (TED)

Thyroid Eye Disease (TED) Manchester Royal Eye Hospital Thyroid Eye Disease (TED) Information For Patients 2 What is Thyroid Eye Disease (TED)? The thyroid gland is located in the neck and produces a hormone that helps regulate

More information

Nick Strouthidis MBBS MD PhD FRCS FRCOphth FRANZCO CONSULTANT OPHTHALMIC SURGEON

Nick Strouthidis MBBS MD PhD FRCS FRCOphth FRANZCO CONSULTANT OPHTHALMIC SURGEON TUBES/SHUNTS TUBES/SHUNTS Implantation of a glaucoma drainage device (GDD - also known as a tube or aqueous shunt) works by diverting aqueous from the front of the eye via a tube to a drainage plate stitched

More information

The Definition & Classification of Dry Eye Disease

The Definition & Classification of Dry Eye Disease Issue: April 2008 The Definition & Classification of Dry Eye Disease Guidelines from the 2007 International Dry Eye Workshop BY MICHAEL A. LEMP, M. D. AND GARY N. FOULKS, M. D., F.A.C.S. The diagnosis

More information

U.S. Food and Drug Administration

U.S. Food and Drug Administration U.S. Food and Drug Administration Notice: Archived Document The content in this document is provided on the FDA s website for reference purposes only. It was current when produced, but is no longer maintained

More information

Eye Associates Custom LASIK With IntraLASIK Correction Of Nearsightedness, Farsightedness, and Astigmatism Using IntraLase TM Technology

Eye Associates Custom LASIK With IntraLASIK Correction Of Nearsightedness, Farsightedness, and Astigmatism Using IntraLase TM Technology Eye Associates Custom LASIK With IntraLASIK Correction Of Nearsightedness, Farsightedness, and Astigmatism Using IntraLase TM Technology INDICATIONS AND PROCEDURE This information is being provided to

More information

INFORMED CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK)

INFORMED CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK) Lasik Center 2445 Broadway Quincy, IL 62301 217-222-8800 INFORMED CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK) INTRODUCTION This information is being provided to you so that you can make an informed

More information

COPYRIGHTED MATERIAL. What Is Dry Eye Syndrome, and Who Gets It?

COPYRIGHTED MATERIAL. What Is Dry Eye Syndrome, and Who Gets It? C H A P T E R 1 What Is Dry Eye Syndrome, and Who Gets It? Myth Dry eye syndrome is not a serious disease. Fact If dry eye syndrome is not treated properly, it can lead to severe eye problems, including

More information

Educational Goals & Objectives for Ophthalmology Residents at Parkland Memorial Hospital (PMH)

Educational Goals & Objectives for Ophthalmology Residents at Parkland Memorial Hospital (PMH) Educational Goals & Objectives for Ophthalmology Residents at Parkland Memorial Hospital (PMH) Competencies addressed: PC = Patient care MK = Medical knowledge Pr = Professionalism PBLI = Practice-based

More information

Prosthetic Replacement of the Ocular Surface Ecosystem PROSE. Information for Patients and Doctors

Prosthetic Replacement of the Ocular Surface Ecosystem PROSE. Information for Patients and Doctors Prosthetic Replacement of the Ocular Surface Ecosystem PROSE Information for Patients and Doctors Treatment Description PROSE (prosthetic replacement of the ocular surface ecosystem) is a pioneering treatment

More information

1 Always test and record vision wearing distance spectacles test each eye separately A 1mm pinhole will improve acuity in refractive errors

1 Always test and record vision wearing distance spectacles test each eye separately A 1mm pinhole will improve acuity in refractive errors Golden eye rules Examination techniques 1 Always test and record vision wearing distance spectacles test each eye separately A 1mm pinhole will improve acuity in refractive errors Snellen chart (6 metre)

More information

Chronic Runny Eyes in Rabbits by Dana Krempels, Ph.D Department of Biology, University of Miami

Chronic Runny Eyes in Rabbits by Dana Krempels, Ph.D Department of Biology, University of Miami Chronic Runny Eyes in Rabbits by Dana Krempels, Ph.D Department of Biology, University of Miami We hear the complaint all the time. My rabbit constantly has runny eyes. The vet gave us antibiotics, and

More information

Cornea and Refractive Surgery Update

Cornea and Refractive Surgery Update Cornea and Refractive Surgery Update Fall 2015 Optometric Education Dinner Sebastian Lesniak MD Matossian Eye Associates Disclosures: None Bio: Anterior Segment and Cornea Surgery Fellowship Wills Eye

More information

MODERN CLINICAL OPTOMETRY BILLING & CODING THE MEDICAL EYE EXAMINATION. Definitions of Eye Examinations. Federal Government Definition

MODERN CLINICAL OPTOMETRY BILLING & CODING THE MEDICAL EYE EXAMINATION. Definitions of Eye Examinations. Federal Government Definition MODERN CLINICAL OPTOMETRY BILLING & CODING THE MEDICAL EYE EXAMINATION Craig Thomas, O.D. 3900 West Wheatland Road Dallas, Texas 75237 972-780-7199 thpckc@yahoo.com Definitions of Eye Examinations Optometry

More information

Oculoplastic, Orbital and Lacrimal Fellowship Programme.

Oculoplastic, Orbital and Lacrimal Fellowship Programme. Oculoplastic, Orbital and Lacrimal Fellowship Programme. Faculty: Mr Raman Malhotra Mr Konal Saha (Oct 2012-Sept 2013) A. Definition and scope of the subspecialty The goal of fellowship training in oculoplastic

More information

INFORMED CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK) USING INTRALASE TM BLADE-FREE TECHNOLOGY

INFORMED CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK) USING INTRALASE TM BLADE-FREE TECHNOLOGY EYE PHYSICIANS OF NORTH HOUSTON 845 FM 1960 WEST, SUITE 101, Houston, TX 77090 Office: 281 893 1760 Fax: 281 893 4037 INFORMED CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK) USING INTRALASE TM BLADE-FREE

More information

Indolent ulcers in dogs eyes

Indolent ulcers in dogs eyes OPHTHALMOLOGY Indolent ulcers in dogs eyes G. Janssens (1) SUMMARY Corneal ulcers are probably the most common problem of the canine eye seen in general veterinary practice. Most of these ulcers result

More information

Reasons for Eye Problems After Acoustic Neuroma Surgery

Reasons for Eye Problems After Acoustic Neuroma Surgery Recovery from Acoustic Neuroma Surgery Many patients who have an acoustic neuroma removed have eye problems after surgery. Proper eye care after hospital discharge is vitally important for those whose

More information

MANAGEMENT OF CORNEAL DISEASE AND CATARACT

MANAGEMENT OF CORNEAL DISEASE AND CATARACT MANAGEMENT OF CORNEAL DISEASE AND CATARACT Edward J. Holland, MD Director of Cornea Cincinnati Eye Institute Professor of Ophthalmology University of Cincinnati FINANCIAL DISCLOSURES I would like to disclose

More information

SF-DCT INFORMATION FOR PRIMARY SJOGREN S SYNDROME (PSS) CLAIMS OPTION 1. (PSS claims are not eligible for Disease Option 2)

SF-DCT INFORMATION FOR PRIMARY SJOGREN S SYNDROME (PSS) CLAIMS OPTION 1. (PSS claims are not eligible for Disease Option 2) SF-DCT INFORMATION FOR PRIMARY SJOGREN S SYNDROME (PSS) CLAIMS OPTION 1 (PSS claims are not eligible for Disease Option 2) 1 Primary Sjogren s Syndrome (PSS) Sjogren s Syndrome (SHOW-grins) is an autoimmune

More information

Refractive errors are caused by an imperfectly shaped eyeball, cornea or lens, and are of three basic types:

Refractive errors are caused by an imperfectly shaped eyeball, cornea or lens, and are of three basic types: Tips on Lasik Eye Surgery If you re tired of wearing glasses or contact lenses, you may be considering Lasik eye surgery one of the newest procedures to correct vision problems. Before you sign up for

More information

BSM Connection elearning Course

BSM Connection elearning Course BSM Connection elearning Course Scope of the Eye Care Practice 2008, BSM Consulting All Rights Reserved. Table of Contents OVERVIEW...1 THREE O S IN EYE CARE...1 ROUTINE VS. MEDICAL EXAMS...2 CONTACT LENSES/GLASSES...2

More information

Ocular Surface Syndrome after LASIK

Ocular Surface Syndrome after LASIK Alaa Atef Ghaith, MD Professor of Ophthalmology Alexandria University Ocular Surface Syndrome after LASIK Up to 33% of eyes Multifactorial entity which causes distress to the patients and physicians 1

More information

1801 West End Avenue Suite 1150 Nashville, TN 37203, USA Office: 615.321.8881 Fax: 615.321.8874

1801 West End Avenue Suite 1150 Nashville, TN 37203, USA Office: 615.321.8881 Fax: 615.321.8874 1801 West End Avenue Suite 1150 Nashville, TN 37203, USA Office: 615.321.8881 Fax: 615.321.8874 T he purpose of this consent form is to educate you on the bladeless (Intralase) LASIK procedure. It is not

More information

Intended Benefits. Who Is Not Eligible For the Procedure? (Intralase Sub-Bowman s Keratomileusis)

Intended Benefits. Who Is Not Eligible For the Procedure? (Intralase Sub-Bowman s Keratomileusis) PATIENT CONSENT FORM Intralase SBK / WGA SBK (Intralase Sub-Bowman s Keratomileusis) Intralase Sub-Bowman s Keratomileusis (SBK) is a term used to describe a Laser Vision Correction procedure where a laser

More information

PROSE Treatment Information for Patients and Doctors

PROSE Treatment Information for Patients and Doctors PROSE Treatment Information for Patients and Doctors prior to getting my PROSE devices, life was hard. Everything that I loved to do was slipping away...that all changed the day I got PROSE. PROSE patient

More information

Blepharoplasty - Eyelid Surgery

Blepharoplasty - Eyelid Surgery Blepharoplasty - Eyelid Surgery Introduction Eyelid surgery repairs sagging or drooping eyelids. The surgery is also known as blepharoplasty, or an eyelid lift. Sagging or drooping eyelids happen naturally

More information

Allan J Panzer, O.D. Therapeutic Optometrist. www.houstondryeyeclinic.com

Allan J Panzer, O.D. Therapeutic Optometrist. www.houstondryeyeclinic.com Allan J Panzer, O.D. Therapeutic Optometrist www.houstondryeyeclinic.com What conditions are you likely to see in your office? Watery Eyes Symptom: Tearing Common causes: Scratched eye Corneal foreign

More information

Types of Refractive Surgery. Infection and Inflammation in the Refractive Surgery Patient. Inflammation vs Infection. Types of Infection

Types of Refractive Surgery. Infection and Inflammation in the Refractive Surgery Patient. Inflammation vs Infection. Types of Infection Types of Refractive Surgery Infection and Inflammation in the Refractive Surgery Patient Kurt Buzard MD FACS Assistant Clinical Professor University of Nevada Medical School Tulane University Medical School

More information

WAKE FOREST BAPTIST HEALTH EYE CENTER. LASIK Consent Form

WAKE FOREST BAPTIST HEALTH EYE CENTER. LASIK Consent Form 1 WAKE FOREST BAPTIST HEALTH EYE CENTER LASIK Consent Form 1. GENERAL INFORMATION The following information is intended to help you make an informed decision about having Laser In-Situ Keratomileusis (LASIK).

More information

INFORMED CONSENT FOR PHAKIC IMPLANT SURGERY

INFORMED CONSENT FOR PHAKIC IMPLANT SURGERY INFORMED CONSENT FOR PHAKIC IMPLANT SURGERY INTRODUCTION This information is being provided to you so that you can make an informed decision about having eye surgery to reduce or eliminate your nearsightedness.

More information

ICD-10 Workshop. Financial Disclosure. Quick Guide (if you missed Part I) Tool Box. GEM Files. 2014 Corcoran Consulting Group (800) 399-6565

ICD-10 Workshop. Financial Disclosure. Quick Guide (if you missed Part I) Tool Box. GEM Files. 2014 Corcoran Consulting Group (800) 399-6565 Financial Disclosure ICD-10 Workshop Mary Pat Johnson is a Senior Consultant at Corcoran Consulting Group and acknowledges a financial interest in the subject matter of this presentation. Mary Pat Johnson,

More information

Ocular Surface Diseases Course 2016 MIAMI,FLORIDA. Bascom Palmer Eye Institute. Sponsored by the University of Miami Miller School of Medicine

Ocular Surface Diseases Course 2016 MIAMI,FLORIDA. Bascom Palmer Eye Institute. Sponsored by the University of Miami Miller School of Medicine Ocular Surface Diseases Course 2016 Bascom Palmer Eye Institute Sponsored by the University of Miami Miller School of Medicine MIAMI,FLORIDA April 16, 2016 BASCOM PALMER EYE INSTITUTE Ocular Surface Diseases

More information

Principles of Diagnosis MEDICAL DECISION-MAKING IN OPTOMETRIC PRACTICE. Medical Decision-Making. Medical Decision-Making.

Principles of Diagnosis MEDICAL DECISION-MAKING IN OPTOMETRIC PRACTICE. Medical Decision-Making. Medical Decision-Making. MEDICAL DECISION-MAKING IN OPTOMETRIC PRACTICE Craig Thomas, O.D. 3900 West Wheatland Road Dallas, Texas 75237 972-780-7199 thpckc@yahoo.com Principles of Diagnosis The study of the art and science of

More information

Not Just for Dry Eyes Off Label Use of Cyclosporine

Not Just for Dry Eyes Off Label Use of Cyclosporine Not Just for Dry Eyes Off Label Use of Cyclosporine William D. Townsend, O.D., F.A.A.O Advanced Eye Care Canyon, TX Adjunct Professor- UHCO Houston, TX drbilltownsend@gmail.com TOA Convention Austin, TX

More information

Grading staining: Oxford Schema The scheme is used to estimate surface damage in dry eye.

Grading staining: Oxford Schema The scheme is used to estimate surface damage in dry eye. DEWS DRY EYE: DIAGNOSTIC TEST TEMPLATE RAPPORTEUR A.J.Bron 21 st Oct 2004 TEST TO DIAGNOSE VERSION of TEST DESCRIPTION NATURE of STUDY CONDUCT of TESTS Grading staining: Oxford Schema The scheme is used

More information

CONSENT FORM. Procedure: Descemet s Stripping Automated Endothelial Keratoplasty (DSAEK)

CONSENT FORM. Procedure: Descemet s Stripping Automated Endothelial Keratoplasty (DSAEK) CONSENT FORM Procedure: Descemet s Stripping Automated Endothelial Keratoplasty (DSAEK) Surgeon: Jeffrey W. Liu, M.D. Peninsula Laser Eye Medical Group 1174 Castro Street, Ste. 100 Mountain View, CA 94040

More information

Dry Eye Diagnosis and Management Revisited

Dry Eye Diagnosis and Management Revisited Ocular Ocular Surface Surface Disorder Dry Eye Diagnosis and Management Revisited Rohit Shetty DNB Rohit Shetty DNB Narayana Nethralaya, Bangalore, India Dry eye disease is a major healthcare problem due

More information

Wang Vision Institute 1801 West End Avenue Nashville, TN 37203 615/321-8881

Wang Vision Institute 1801 West End Avenue Nashville, TN 37203 615/321-8881 Wang Vision Institute 1801 West End Avenue Nashville, TN 37203 615/321-8881 The purpose of this consent for is to educate you on the Phototherapeutic Keratectomy (PTK) and Photorefractive Keratectomy (PRK)

More information

Program Requirements for Fellowship Education in Cornea, External Diseases & Refractive Surgery*

Program Requirements for Fellowship Education in Cornea, External Diseases & Refractive Surgery* Program Requirements for Fellowship Education in Cornea, External Diseases & Refractive Surgery* I. Introduction A. Definition and Scope of Subspecialty Fellowship training requires more in depth education

More information

Consent for Bilateral Simultaneous Refractive Surgery

Consent for Bilateral Simultaneous Refractive Surgery Consent for Bilateral Simultaneous Refractive Surgery Please sign and return Patient Copy While many patients choose to have both eyes treated at the same surgical setting, there may be risks associated

More information

Risks and Limitations of LASIK Procedure

Risks and Limitations of LASIK Procedure Drs. Fine, Hoffman & Packer, LLC 1550 Oak Street, Suite #5 Eugene, OR 97401 541-687-2110 From Drs. Fine, Hoffman, & Packer Risks and Limitations of LASIK Procedure Infection, serious injury, or even death,

More information

Thymus Cancer. This reference summary will help you better understand what thymus cancer is and what treatment options are available.

Thymus Cancer. This reference summary will help you better understand what thymus cancer is and what treatment options are available. Thymus Cancer Introduction Thymus cancer is a rare cancer. It starts in the small organ that lies in the upper chest under the breastbone. The thymus makes white blood cells that protect the body against

More information

Incomplete blinking: Exposure keratopathy, lid wiper epitheliopathy, dry eye, refractive surgery, and dry contact lenses

Incomplete blinking: Exposure keratopathy, lid wiper epitheliopathy, dry eye, refractive surgery, and dry contact lenses Contact Lens & Anterior Eye 30 (2007) 37 51 www.elsevier.com/locate/clae Incomplete blinking: Exposure keratopathy, lid wiper epitheliopathy, dry eye, refractive surgery, and dry contact lenses Charles

More information

THE EYES IN CHARGE: FOR THE OPHTHALMOLOGIST Roberta A. Pagon, M.D. Division of Medical Genetics, CH-25, Children's Hospital /Medical Center, Box C5371, Seattle, WA 98105-0371 bpagon@u.washington.edu (206)

More information

Pterygium and Pterygium Surgery

Pterygium and Pterygium Surgery Pterygium and Pterygium Surgery Introduction This booklet is to give you information about pterygium and to help you make a decision about surgery, if needed. Some of the words used may seem confusing

More information

Europa Scleral Case Studies. (877) 533-1509 www.visionary-optics.com 1325 Progress Drive Front Royal, VA 22630

Europa Scleral Case Studies. (877) 533-1509 www.visionary-optics.com 1325 Progress Drive Front Royal, VA 22630 Europa Scleral Case Studies (877) 533-1509 www.visionary-optics.com 1325 Progress Drive Front Royal, VA 22630 Visionary Case Study Doctors Matt Kauffman, OD, FAAO Dr. Matt Kauffman, OD, FAAO, graduated

More information

NEW YORK UNIVERSITY SCHOOL OF MEDICINE DEPARTMENT OF OPHTHALMOLOGY SUPERVISION OF RESIDENTS POLICY

NEW YORK UNIVERSITY SCHOOL OF MEDICINE DEPARTMENT OF OPHTHALMOLOGY SUPERVISION OF RESIDENTS POLICY NEW YORK UNIVERSITY SCHOOL OF MEDICINE DEPARTMENT OF OPHTHALMOLOGY SUPERVISION OF RESIDENTS POLICY Applies to: All Ophthalmology Residents, including those in ACGME- and non-acgme-accredited specialty

More information

ARTHRITIS INTRODUCTION

ARTHRITIS INTRODUCTION ARTHRITIS INTRODUCTION Arthritis is the most common disease affecting the joints. There are various forms of arthritis but the two that are the most common are osteoarthritis (OA), and rheumatoid arthritis

More information

Secretary for Quality of Care Anne L. Coleman, MD, PhD

Secretary for Quality of Care Anne L. Coleman, MD, PhD Dry Eye Syndrome Secretary for Quality of Care Anne L. Coleman, MD, PhD Academy Staff Nicholas P. Emptage, MAE Nancy Collins, RN, MPH Doris Mizuiri Jessica Ravetto Flora C. Lum, MD Medical Editor: Design:

More information

Surgical Coding Errors & English 101. Riva Lee Asbell. Fort Lauderdale, FL

Surgical Coding Errors & English 101. Riva Lee Asbell. Fort Lauderdale, FL Surgical Coding Errors & English 101 Riva Lee Asbell Fort Lauderdale, FL INTRODUCTION Many surgical coding mistakes result from misinterpretation of CPT (Current Procedural Terminology) wording. When the

More information

Bladeless LASIK and PRK

Bladeless LASIK and PRK Bladeless LASIK and PRK Bladeless LASIK and PRK The specialists at North Shore-LIJ Laser Vision Correction understand how valuable your sight is to you, which is why we use the safest, most advanced technology

More information

Diagnosing dry eye: It s now a fine art

Diagnosing dry eye: It s now a fine art Article Date: 4/1/2016 Diagnosing dry eye: It s now a fine art Research has led to better, more diverse ways to reach a diagnosis, let alone more knowledge about DED itself. BY MARK B. ABELSON, MD, CM,

More information

THE EYES IN MARFAN SYNDROME

THE EYES IN MARFAN SYNDROME THE EYES IN MARFAN SYNDROME Marfan syndrome and some related disorders can affect the eyes in many ways, causing dislocated lenses and other eye problems that can affect your sight. Except for dislocated

More information

Dry eyes holding you back? Ask your doctor about LipiFlow.

Dry eyes holding you back? Ask your doctor about LipiFlow. Dry eyes holding you back? Ask your doctor about LipiFlow. Think you may have dry eye? Take the quiz below to find out. Do you experience sensitivity to light, blurred vision, a burning sensation, or discomfort

More information

Acknowledgements. Dry Eye Update. Dry Eye. Dry Eye. Dry Eye. 2014 Monterey Symposium

Acknowledgements. Dry Eye Update. Dry Eye. Dry Eye. Dry Eye. 2014 Monterey Symposium 2014 Monterey Symposium Update Jimmy Jackson, OD, FAAO President InSight Lasik Acknowledgements I have received honoraria from Alcon Laboratories, Inc for speaking engagements. I have received research

More information

10/9/2014. Basics of Scleral Lens Fitting: Its as Easy as 1-2-3

10/9/2014. Basics of Scleral Lens Fitting: Its as Easy as 1-2-3 Basics of Scleral Lens Fitting: Its as Easy as 1 2 3 Melissa Barnett, OD, FAAO, FSLS Bruce Baldwin, OD, FAAO, FSLS Michael Lipson, OD, FAAO, FSLS Jason Jedlicka, OD, FAAO, FSLS Mindy Toabe, OD, FAAO, FSLS

More information

INFORMED CONSENT FOR LASER ASSISTED SUBEPITHELIAL KERATOMILEUSIS (LASEK)/PHOTO-REFRACTIVE KERATECTOMY (PRK)

INFORMED CONSENT FOR LASER ASSISTED SUBEPITHELIAL KERATOMILEUSIS (LASEK)/PHOTO-REFRACTIVE KERATECTOMY (PRK) INFORMED CONSENT FOR LASER ASSISTED SUBEPITHELIAL KERATOMILEUSIS (LASEK)/PHOTO-REFRACTIVE KERATECTOMY (PRK) Please read the following consent form very carefully. Please initial each page where indicated.

More information

Dry Eye After Clear Cornea Phacoemulsification

Dry Eye After Clear Cornea Phacoemulsification Original Article Philippine Journal of OPHTHALMOLOGY Dry Eye After Clear Cornea Phacoemulsification Peter Mark G. Chao, MD 1 and Ruben Lim-Bon-Siong, MD 1,2 1 Department of Ophthalmology and Visual Sciences

More information

LASIK. What is LASIK? Eye Words to Know. Who is a good candidate for LASIK?

LASIK. What is LASIK? Eye Words to Know. Who is a good candidate for LASIK? 2014 2015 LASIK What is LASIK? LASIK (laser in situ keratomileusis) is a type of refractive surgery. This kind of surgery uses a laser to treat vision problems caused by refractive errors. You have a refractive

More information

STANILA A.(1), BOTEZAN A.(1), COSTACHE I.(2), STANILA D.M.(1)

STANILA A.(1), BOTEZAN A.(1), COSTACHE I.(2), STANILA D.M.(1) STANILA A.(1), BOTEZAN A.(1), COSTACHE I.(2), STANILA D.M.(1) (1) The Faculty of Medicine "Victor Papilian, SIBIU, ROMANIA ; (2) Ocular Surface Research Center CCSO, SIBIU, ROMANIA The facial nerve is

More information

NURS 821 Alterations in the Musculoskeletal System. Rheumatoid Arthritis. Type III Hypersensitivity Response

NURS 821 Alterations in the Musculoskeletal System. Rheumatoid Arthritis. Type III Hypersensitivity Response NURS 821 Alterations in the Musculoskeletal System Margaret H. Birney PhD, RN Lecture 12 Part 2 Joint Disorders (cont d) Rheumatoid Arthritis Definition: Autoimmune disorder occurring in genetically sensitive

More information

What is LASIK? The eye and vision errors

What is LASIK? The eye and vision errors What is LASIK? The eye and vision errors The cornea is a part of the eye that helps focus light to create an image on the retina. It works in much the same way that the lens of a camera focuses light to

More information

Management of Epithelial Ingrowth after LASIK. Helen K. Wu, MD New England Eye Center Tufts University School of Medicine Boston, MA

Management of Epithelial Ingrowth after LASIK. Helen K. Wu, MD New England Eye Center Tufts University School of Medicine Boston, MA Management of Epithelial Ingrowth after LASIK Helen K. Wu, MD New England Eye Center Tufts University School of Medicine Boston, MA Acknowledgements IOP Ophthalmics Staar Surgical Case Presentation 46

More information

Congratulations! You have just joined the thousands of people who are enjoying the benefits of laser vision correction.

Congratulations! You have just joined the thousands of people who are enjoying the benefits of laser vision correction. Dear Valued Patient, Thank you for choosing Shady Grove Ophthalmology for your laser vision correction procedure. Our excellent staff is committed to offering you the highest quality eye care using state

More information

Corporate Medical Policy Reconstructive Eyelid Surgery and Brow Lift

Corporate Medical Policy Reconstructive Eyelid Surgery and Brow Lift Corporate Medical Policy Reconstructive Eyelid Surgery and Brow Lift File Name: Origination: Last CAP Review: Next CAP Review: Last Review: reconstructive_eyelid_surgery_and_brow_lift 1/2000 9/2015 9/2016

More information

Eye Diseases. 1995-2014, The Patient Education Institute, Inc. www.x-plain.com otf30101 Last reviewed: 05/21/2014 1

Eye Diseases. 1995-2014, The Patient Education Institute, Inc. www.x-plain.com otf30101 Last reviewed: 05/21/2014 1 Eye Diseases Introduction Some eye problems are minor and fleeting. But some lead to a permanent loss of vision. There are many diseases that can affect the eyes. The symptoms of eye diseases vary widely,

More information

Outline and Learning Objectives. Dry Eye Focus on the Lipid Layer. Joe Barr, OD, MS, FAAO, FBCLA. Tear Osmolarity Mucs Lipid Layer

Outline and Learning Objectives. Dry Eye Focus on the Lipid Layer. Joe Barr, OD, MS, FAAO, FBCLA. Tear Osmolarity Mucs Lipid Layer Outline and Learning Objectives Dry Eye Focus on the Lipid Layer Joe Barr, OD, MS, FAAO, FBCLA Tear Structure and Function 2015 Current understanding of structure, function and dry eye variables Tear Osmolarity

More information

Maximizing Your Cataract Surgery Outcomes in Corneal Disease

Maximizing Your Cataract Surgery Outcomes in Corneal Disease Maximizing Your Cataract Surgery Outcomes in Corneal Disease W. Barry Lee, M.D., F.A.C.S. Cornea & Refractive Surgery Eye Consultants of Atlanta Piedmont Hospital Co-Medical Director Georgia Eye Bank Atlanta,

More information

INFORMED CONSENT FOR PHAKIC LENS IMPLANT SURGERY

INFORMED CONSENT FOR PHAKIC LENS IMPLANT SURGERY INTRODUCTION INFORMED CONSENT FOR PHAKIC LENS IMPLANT SURGERY This information is being provided to you so that you can make an informed decision about having eye surgery to reduce or eliminate your nearsightedness.

More information

Comparative Evaluation of Dry Eye Following Cataract Surgery: A Study from North India

Comparative Evaluation of Dry Eye Following Cataract Surgery: A Study from North India IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 13, Issue 6 Ver. III (Jun. 2014), PP 13-18 Comparative Evaluation of Dry Eye Following Cataract Surgery:

More information