Reliability of Intraocular Pressure Measurements in a Low-Contact Drive-Through Setting.

Prcis: Drive-through intraocular pressure (IOP) measurement using iCare tonometry is a promising method of low-contact, high-throughput IOP monitoring. However, owing to its vulnerability to variable measurement technique and local air currents, the iCare may overestimate IOPs.

Purpose: During the COVID-19 pandemic, a drive-through IOP measurement protocol using the iCare tonometer was established to facilitate low-contact monitoring of select glaucoma patients.

Reducing Injection-Related Safety Events in Retina Clinics.

Purpose: At the Kellogg Eye Center, we identified a series of injection-related patient safety events that led to a systematic review and redesign of our intravitreal injection protocol. The objective was to reduce injection-related patient safety events to zero.

Methods: A retroactive review, using the Healthcare Failure Mode and Effect Analysis model as a guide, was performed on our process for delivering intravitreal injections to identify potential failure modes and their impact.

Glaucoma in Adults-Screening, Diagnosis, and Management: A Review.

Importance: Glaucoma is the most common cause of irreversible blindness worldwide. Many patients with glaucoma are asymptomatic early in the disease course. Primary care clinicians should know which patients to refer to an eye care professional for a complete eye examination to check for signs of glaucoma and to determine what systemic conditions or medications can increase a patient's risk of glaucoma.

Drive-through Intraocular Pressure Checks During the COVID-19 Pandemic.

Precis: A drive-through clinic was created to obtain intraocular pressure measurements before a virtual visit with their provider, in order to provide care for patients in the Kellogg Glaucoma Clinic while minimizing risk of COVID-19 transmission.

Purpose: The aim of this study was to establish a drive-through clinic model to provide glaucoma care for patients while minimizing the risk of COVID-19 transmission.

Patients And Methods: A drive-through clinic was created by adapting a 1-lane, 1-way driveway adjacent to the Kellogg Eye Center building entrance.

Application of the Sight Outcomes Research Collaborative Ophthalmology Data Repository for Triaging Patients With Glaucoma and Clinic Appointments During Pandemics Such as COVID-19.

Importance: During the coronavirus disease 2019 (COVID-19) pandemic, eye care professionals caring for patients with sight-threatening diseases, such as glaucoma, have had to determine whether some patient appointments could safely get postponed, weighing the risk that the patient's glaucoma could worsen during the interim vs the morbidity risk of acquiring COVID-19 while seeking ophthalmic care. They also need to prioritize appointment rescheduling during the ramp-up phase (when pandemic-associated service reductions are eased).

Objective: To describe a flexible and scalable scoring algorithm for patients with glaucoma that considers glaucoma severity and progression risk vs the presence of high-risk features for morbidity from COVID-19, using information from a large data repository.

Mapping standard ophthalmic outcome sets to metrics currently reported in eight eye hospitals.

Background: To determine alignment of proposed international standard outcomes sets for ophthalmic conditions to metrics currently reported by eye hospitals.

Methods: Mixed methods comparative benchmark study, including eight eye hospitals in Australia, India, Singapore, Sweden, U.K.

Establishing a Regional Glaucoma Physician Collaborative to Improve Quality of Care.

Purpose: Improving adherence to practice guidelines can improve patient safety and quality of care. We sought to establish a regional glaucoma physician collaborative to evaluate and improve adherence to the American Academy of Ophthalmology's Primary Open-angle Glaucoma (POAG) Preferred Practice Pattern (PPP) guidelines.

Design: Prospective interventional study.

Perioperative medications for preventing temporarily increased intraocular pressure after laser trabeculoplasty.

Background: Glaucoma is the international leading cause of irreversible blindness. Intraocular pressure (IOP) is the only currently known modifiable risk factor; it can be reduced by medications, incisional surgery, or laser trabeculoplasty (LTP). LTP reduces IOP by 25% to 30% from baseline, but early acute IOP elevation after LTP is a common adverse effect.

A Two-Year Longitudinal Assessment of Ophthalmologists' Perceptions after Implementing an Electronic Health Record System.

Objectives: To understand the attitudes and perceptions of ophthalmologists toward an electronic health record (EHR) system, before and after its clinical implementation.

Methods: Ophthalmologists at a single large academic ophthalmology department were surveyed longitudinally before and after implementation of a new EHR system. The survey measured ophthalmologists' attitudes toward implementation of a new EHR.

Subsequent Receipt of Interventions for Glaucoma Among a Nationwide Sample of Patients Who Underwent Laser Peripheral Iridotomy.

Purpose: To evaluate use of medical, laser, or incisional surgical interventions for glaucoma after laser peripheral iridotomy (LPI).

Design: Retrospective longitudinal cohort study.

Methods: All enrollees aged ≥21 years in a US managed-care network who underwent bilateral LPIs in 2001-2011 were identified.

Baerveldt 250 mm2 Glaucoma Drainage Devices in Eyes With Preexisting Scleral Buckles.

Purpose: To evaluate eyes with preexisting scleral buckles (SBs) that underwent placement of a 250 mm Baerveldt glaucoma drainage device (GDD).

Patients And Methods: Records of all patients with a preexisting SB who underwent 250 mm Baerveldt GDD placement at the Kellogg Eye Center between January 1, 2005 and September 30, 2012 were reviewed. Outcome measures included visual acuity (VA), intraocular pressure (IOP), and number of glaucoma medications prescribed.

Simultaneous placement of 2 glaucoma drainage devices for uncontrolled glaucoma.

Objective: To report baseline characteristics and surgical outcomes of placement of simultaneous glaucoma drainage devices (GDDs) in eyes with considerably elevated intraocular pressure (IOP) despite maximal medical therapy.

Design: Retrospective case series.

Participants: Twelve eyes of 12 patients underwent simultaneous placement of a Baerveldt 350 GDD and an Ahmed S3 GDD in the same eye.

Development of a quality improvement program in a department of ophthalmology.

Objective: To design and implement a quality improvement (QI) programme in an academic department of ophthalmology.

Design: The six core competencies of the Accreditation Council for Graduate Medical Education serve as the model for this programme in an institutional practice. The authors review departmental rates of postoperative infections, unplanned reoperations, intraoperative complications, specific subspecialty postoperative complications and successes, and patient and staff compliments and complaints.

Systematic review of educational interventions to improve glaucoma medication adherence.

Adherence to prescribed glaucoma medications is often poor, and proper adherence can be challenging for patients. We systematically reviewed the literature and identified eight studies using educational interventions to improve glaucoma medication adherence. Overall, five of the eight studies found that educational interventions lead to a significant improvement in medication adherence, and two additional studies found a trend towards improvement.

Multifocal visual evoked potentials for early glaucoma detection.

Background And Objective: To compare multifocal visual evoked potentials (mfVEP) with other detection methods in early open-angle glaucoma.

Patients And Methods: Ten patients with suspected glaucoma and 5 with early open-angle glaucoma underwent mfVEP, standard automated perimetry (SAP), short-wave automated perimetry, frequency-doubling technology perimetry, and nerve fiber layer optical coherence tomography. Nineteen healthy control subjects underwent mfVEP and SAP for comparison.

Glaucoma associated with Boston type I keratoprosthesis.

Purpose: To evaluate outcomes of the Boston type I keratoprosthesis (KPro) and associated incidence of glaucoma.

Design: Retrospective cohort study.

Participants: All patients who underwent KPro surgery at 1 institution from 2003 to 2009 with at least 3 months of follow-up.

Reliability of simultaneous visual field testing.

Objective: To test for differences in reliability and performance between traditional, isolated perimetry and simultaneous testing with 2 patients in the same room.

Design: Comparative case series.

Participants: A total of 471 eyes of 261 subjects.

Can topical ketorolac 0.5% improve the function of Ahmed® glaucoma drainage devices?

Background And Objective: To determine whether postoperative use of topical ketorolac tromethamine 0.5% affects intraocular pressure (IOP) following Ahmed glaucoma drainage device (New World Medical, Inc., Rancho Cucamonga, CA) implantation.

Bleb morphology characteristics and effect on positional intraocular pressure variation.

Background And Objective: To study bleb morphology and positional intraocular pressure (IOP) change (IOP supine to IOP sitting).

Patients And Methods: In this observational case series, blebs were graded for height, extent, vascularity, microcysts, and "ring of steel." Positional IOP change was analyzed using the paired t test.

The clinical utility of dynamic contour tonometry and ocular pulse amplitude.

Purpose: To determine if ocular pulse amplitude (OPA) as measured by dynamic contour tonometry (DCT) is related to severity of glaucoma, and if intraocular pressure (IOP) as measured by DCT is related to central corneal thickness (CCT).

Methods: Patients were selected from the Duke Eye Center glaucoma clinic. Fifty-five eyes of 32 patients were included; right and left eyes were analyzed separately.

Lisch nodules after trabeculectomy.

The development of Lisch nodules in an eye that had undergone trabeculectomy with mitomycin C is described. Complete ophthalmologic examinations and genetic testing of a 12-year-old boy were performed. Lisch nodules can develop after trabeculectomy without the systemic manifestations of neurofibromatosis type 1.

Central corneal thickness as a risk factor for advanced glaucoma damage.

Objective: To determine if central corneal thickness (CCT) is related to the level of glaucoma severity at the initial examination.

Methods: The initial visit to a glaucoma specialist by consecutive patients with primary open-angle glaucoma from 1997 to 2002 was reviewed retrospectively. Each patient's age, sex, race, family history of glaucoma, number of glaucoma medications, visual acuity, spherical equivalent, intraocular pressure, CCT, visual field data, and vertical and horizontal cup-disc ratios were analyzed.

Radial optic neurotomy as treatment for central retinal vein occlusion.

Purpose: To review our initial experience with radial optic neurotomy as treatment for retinal vein occlusion.

Design: Interventional case series.

Patient Population: five patients (four with central retinal vein occlusion and one with hemiretinal vein occlusion).

Intravitreal tissue plasminogen activator for the treatment of central retinal vein occlusion.

A 58-year-old hypertensive man with a perfused central retinal vein occlusion of 21 days' duration received 50 microg of intravitreal recombinant tissue plasminogen activator in 0.1 cc. Best-corrected visual acuity improved 2 weeks after the injection.