keratitis mimicking superior limbic keratoconjunctivitis and herpes simplex virus.

Purpose: keratitis is a rare type of infectious keratitis and may mimic other corneal diseases and lead to delay in diagnosis. This case illustrates how often escapes accurate diagnosis due to its insidious onset, variable clinical manifestations, and unusual characteristics on cultures.

Observation: The patient presented with an epithelial defect and superior pannus and scarring, which was misdiagnosed as superior limbic keratoconjunctivitis (SLK) and herpes simplex virus (HSV) keratitis.

Observational Clinical Studies of Human Lens Transparency Using the Vision Index Pen.

Purpose: Preventing or delaying the onset of presbyopia and cataract formation remains a challenge. The goal of this study was to establish the utility of the Vision Index Pen (VIP), designed to measure in vivo dynamic light scattering (DLS) from the crystalline lens, in the detection of early cataract or loss of accommodation and to show reproducibility through trials at two independent sites. The gradual loss of transparency of the lens was characterized by the lens crystallin aggregation index (LCX) derived from measured DLS data.

Intracameral ketorolac and phenylephrine effect on intraoperative pupil diameter and postoperative pain in cataract surgery.

Purpose: To evaluate the study drug OMS302 (Omidria [phenylephrine and ketorolac injection 1.0%/0.3%]) compared with a balanced salt solution (vehicle), ketorolac, and phenylephrine on pupil diameter during cataract surgery and early postoperative ocular pain.

Topical NSAIDs effect on corneal sensitivity.

Purpose: Topical nonsteroidal antiinflammatory drugs (NSAIDs) are administered topically for a variety of ophthalmologic conditions. Brand diclofenac and brand ketorolac were previously shown to have topical anesthetic effects in addition to analgesic effects. Using the same method, we measured similar anesthetic effects of the 4 currently available topical NSAIDs--generic diclofenac, generic ketorolac, brand bromfenac, and brand nepafenac.

The effect of decreasing the dosage of cyclosporine A 0.05% on dry eye disease after 1 year of twice-daily therapy.

Purpose: To evaluate the effect of decreasing topical cyclosporine 0.05% (tCSA) (Restasis; Allergan, Irvine, CA) from twice-daily dosing to once-daily dosing in patients who have already completed 12 months of twice-daily therapy for dry eye disease.

Design: Prospective, randomized, single-masked, parallel group comparison.

Correlating patient-reported response to hydroxypropyl cellulose ophthalmic insert (LACRISERT®) therapy with clinical outcomes: tools for predicting response.

Background/aims: To determine whether patient-reported improvement in symptoms of dry eye syndrome, activities of daily living, and other quality-of-life measures after treatment with hydroxypropyl cellulose ophthalmic inserts correlates significantly with physician assessment of clinical outcomes.

Methods: Patient registry of those treated for 1 month with inserts as monotherapy or in combination with existing treatments for moderate-to-severe dry eye syndrome. A total of 520 participants were enrolled.

Cyclosporine 0.05% to improve visual outcomes after multifocal intraocular lens implantation.

Purpose: To evaluate the efficacy of cyclosporine 0.05% in alleviating dry-eye signs and improving visual quality after multifocal intraocular lens (IOL) implantation.

Setting: Private practice and university medical center, New York, New York, USA.

Hydroxypropyl cellulose ophthalmic inserts (lacrisert) reduce the signs and symptoms of dry eye syndrome and improve patient quality of life.

Purpose: A multicenter, 2-visit, open-label, 4-week study was conducted to determine the acceptability of hydroxypropyl cellulose ophthalmic inserts in adult patients with a history of dry eye syndrome (DES).

Methods: At visit 1, patients (N = 520) were evaluated, screened by slit-lamp biomicroscopy, and completed the Ocular Surface Disease Index (OSDI), a validated measure of quality of life. Patients were trained in the proper placement and use of hydroxypropyl cellulose ophthalmic inserts and were contacted by telephone on day 3 of the study.

Evaluation of topical cyclosporine for the treatment of dry eye disease.

Objective: To evaluate the use of topical cyclosporine, 0.05% (Restasis; Allergan Inc, Irvine, California), for the treatment of mild, moderate, and severe dry eye disease unresponsive to artificial tears therapy.

Methods: This was a prospective clinical study.

A randomized, masked comparison of topical ketorolac 0.4% plus steroid vs steroid alone in low-risk cataract surgery patients.

Purpose: To evaluate whether adding perioperative topical ketorolac tromethamine 0.4% improves cataract surgery outcomes relative to topical steroids alone in patients without known risk factors for cystoid macular edema (CME).

Design: Prospective, randomized, investigator-masked, multicenter clinical trial.

Methicillin-resistant Staphylococcus aureus infectious keratitis following refractive surgery.

Purpose: To elucidate risk factors, clinical course, visual outcomes, and treatment of culture-proven methicillin-resistant Staphylococcus aureus (MRSA) infectious keratitis following refractive surgery.

Design: Interventional case series.

Methods: Multicenter chart review of 13 cases of MRSA keratitis following refractive surgery and literature review.

Preoperative ketorolac tromethamine 0.4% in phacoemulsification outcomes: pharmacokinetic-response curve.

Purpose: To assess the clinical benefit, relative efficacy, and pharmacokinetic-response curve of preoperative and postoperative ketorolac tromethamine 0.4% (Acular LS) to improve outcomes during and after cataract surgery.

Setting: Private clinical practice.

A comparison of gatifloxacin to ciprofloxacin in the prophylaxis of Streptococcus pneumoniae in rabbits in a LASIK model.

Purpose: To investigate the efficacy of the fourth-generation fluoroquinolone, gatifloxacin 0.3%, compared to ciprofloxacin 0.3%, in preventing Streptococcus pneumoniae keratitis in a rabbit laser in situ keratomileusis (LASIK) model.

Infectious keratitis after photorefractive keratectomy.

Purpose: To elucidate risk factors, microbial culture results, and visual outcomes for infectious keratitis after photorefractive keratectomy (PRK).

Design: Multicenter, retrospective chart review, case report, and literature review.

Methods: The records of 12 patients with infectious keratitis after PRK were reviewed.

Confocal microscopy in Meretoja syndrome.

Purpose: To study the correlation between severity of clinical systemic symptoms and the degree of stromal haze and visibility of epithelial and stromal nerves on scanning slit confocal microscopy examination in Meretoja syndrome.

Methods: Three patients with Meretoja syndrome were examined by slit-lamp microscopy and scanning slit confocal microscopy.

Results: Increased symptoms and abnormal slit-lamp findings correlated positively with confocal microscopic stromal haze intensity and inversely with visibility of epithelial and stromal nerves on confocal examination.

In vivo dynamic light scattering characterization of a human lens: cataract index.

Purpose: To characterize the cataractous state of the living lens by a single parameter, derived from in vivo dynamic light scattering measurements.

Methods: Dynamic light scattering, in conjunction, with a fiber optic transmitter/receiver, was used for measuring the intensity autocorrelation of the light scattered in the backward direction from the living human lens. The fiber optic transreceiver provided a rapid means for active positioning and collection of the back scattered light from any point inside the lens.

EyeScrub: simplifying the management of blepharitis.

1. The cause of blepharitis is still a mystery, and, consequently, a cure for this condition does not exist. Patients suffering from blepharitis must be made to understand this and that it is a manageable condition.

Indications and techniques of penetrating keratoplasties, 1985-1988.

Indications and surgical techniques for penetrating keratoplasties (PKs) were evaluated to determine present trends and suggest future directions for PK. Analyses were based on 3,941 PK cases, with questionnaires completed at the time of surgery by 638 surgeons receiving tissue through Tissue Banks International, Inc. between July 1, 1985, and December 31, 1988.

Conjunctival impression cytology in patients with glaucoma using long-term topical medication.

Increasing evidence indicates that long-term use of topically administered medications can induce changes in the conjunctiva and ocular surface. We used the technique of conjunctival impression cytology to evaluate the conjunctival changes that develop with long-term use of topically administered antiglaucoma medications. Patients with glaucoma who were on a stable regimen of one, two, or three topically administered medications were recruited for study; glaucoma suspects who were not using topically administered medications served as controls.

Conjunctival impression cytology: feasibility of a field trial to detect subclinical vitamin A deficiency.

Two hundred and thirty-six Guatemalan children aged 2-14 y were examined for subclinical vitamin A deficiency by use of conjunctival impression cytology (CIC). The feasibility of the technique and quality of a modified touch procedure were assessed. Neither lid speculum nor physical restraint in the form of a papoose board was used.

Conjunctival impression cytology (CIC) to detect subclinical vitamin A deficiency: comparison of CIC with biochemical assessments.

By use of sensitivity and specificity analysis, conjunctival impression cytology (CIC) was compared with fasting serum vitamin A levels and relative dose response (RDR) of Guatemalan children. One impression was taken from the temporal bulbar aspect of each eye, fasting serum vitamin A levels were then drawn, 480 RE of oil-based retinyl palmitate was given, and a 5-h postdosing vitamin A level was drawn (RDR procedure). For a 20% RDR cutoff, the sensitivity of CIC was 23% with a specificity of 80% and a positive predictive value of 9% (n = 213 children).

Ophthalmology consultations at a large teaching hospital.

We reviewed 100 consecutive ophthalmology consultations performed on inpatients at a large teaching hospital to help identify areas that may require greater emphasis in the medical school and housestaff curriculum. Nonophthalmologists rarely record visual acuities or perform dilated fundus examinations. If visual acuity determination were more consistently made a part of routine physical examinations, it is possible that more pathology would be detected and non-productive consultations could be minimized.