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OVS Announces

Optometry and Vision Science: December 2012 - Volume 89 - Issue 12 - p
doi: 10.1097/OPX.0b013e31827b62e5
OVS ANNOUNCES
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• For Extended Wear Contact Lenses: Change in the Morning is Better than at Night

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Although continuous wear is a convenientmode of lens wear, it is associated with an increased risk of complications. In a series of proof-of-principle studies, researchers set out to test if replacing lenses daily either in the morning or evening during a 30-day continuous wear schedule would impact on the rate of ocular adverse events. It did! Morning lens replacement during continuous wear reduced mechanical and overall ocular adverse events. Replacing lenses at night had no beneficial effects. (p. 1674)

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Editor’s Choice open access

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• Eye Sensitivity and Reported Symptoms in Soft Contact Lens Wearers

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By self-assessment, 2154 contact lens wearers were separated into either ”sensitive eyes“ (12.5%) or ”nonsensitive eyes“ groups with similar sex, age, and refraction characteristics. Perhaps not surprisingly, the prevalence of dryness (43 vs 19%, p < 0.0001), irritation (25 vs 11%, p < 0.0001), redness (20 vs 6%, p < 0.0001), and stinging (6 vs 1%, p < 0.0001) was higher in sensitive eyes patients. Changing lens materials seemed to reduce these reported signs and symptoms. (p. 1682)

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• Effect of Cycloplegia and Biometer Choice on Biometry Measures for Intraocular Lenses

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Although cycloplegia had no effect on the measured axial length or corneal curvature measures, there was a small increase in anterior chamber length and measured iris width. There were no clinically significant differences in the measures by the Lenstar and IOLMaster biometers and only small, clinically insignificant, differences in the calculated intraocular lens power by the four different methods used. (p. 1691)

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• Comparing Methods of Intraocular Lens Calculation in Cataract Surgery

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For a group of 320 eyes, our authors made intraocular lens power calculations for patients receiving sutureless cataract surgery. They report that the Zeiss IOLMaster yielded more accurate refractive outcomes than those of conventional automated keratometry and contact acoustic biometry. Apparently, the variables of age, diabetes, severity of cataract, axial length, and corneal curvature were unrelated to the predictability of postoperative refraction. (p. 1697)

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• Novel Intraocular Lens Designs For Increasing Depth of Focus

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The authors evaluate the performance of two new designs of intraocular lens (IOL) with extended depths of focus. They conclude, using the visual Strehl ratio computed in the spatial frequency domain, that the new extended-depth-of-focus IOLs are a promising solution warranting further clinical study. (p. 1702)

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• Strengthening the Case for Noncontact Pachymetry

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With the development of Fourier domain technology, the optical coherence tomographer for corneal pachymetry is growing in popularity. The authors demonstrate that central corneal thickness measures, using the recently released Topcon 3D OCT-2000 tomographer, have high within-rater repeatability and agreement with standard ultrasound pachymetry. However, they caution clinicians that Fourier domain optical coherence tomography significantly underestimates central corneal thickness compared with that obtained by ultrasound pachymetry. (p. 1708)

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• Diabetic Retinopathy With High-Diastolic Pressure Patients is Associated With Increased Retinal Thickness

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In type 2 diabetes patients with mild or moderate nonproliferative diabetic retinopathy and poor blood glucose control, a higher diastolic blood pressure is associated with greater retinal thickness. But this relationship is absent in diabetes patients with no retinopathy or nondiabetic patients. Our authors believe that clinicians and clinical studies should be aware of the retinal thickness relationship for patients with diabetic retinopathy. (p. 1715)

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•Corneal Ulcer Moxifloxacin Resistance: Antibiotic or Mutation?

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In comparisons of hundreds of corneal ulcers during two consecutive annual surveys, our authors found that whereas resistance to gatifloxacin and tobramycin was significantly higher in samples tested in 2007 as compared with those in 2006, moxifloxacin resistance remained unchanged. The authors suggest that the static resistance pattern to moxifloxacin may indicate that such resistance in moxifloxacin is intrinsic in the antibiotic rather than new resistance stemming from mutations. (p. 1721)

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•Transient Myopia After Near Work More Pronounced in Myopic Children

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The authors describe the baseline results of the Beijing Myopia Progression Study (BMPS), a 3-year cohort study of almost 400 schoolchildren aged between 7 and 17 years living in the inner cityofBeijing.At thisbaseline session, the initial nearwork-induced transient myopia (NITM) and its decay were assessed objectively immediately after binocularly viewing and performing a sustained near task (5minutes; 5 diopters). InitialNITM and decay time were significantly larger/longer in the myopic versus the other hyperopic and emmetropic refractive groups. A goal of the 3-year study is to investigate the possible relationship between NITM and permanent myopia. (p. 1725)

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•Refractive Error Studies Need Cycloplegic Refraction

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Our authors show that for children (aged 6 to 9 years), the most plus sphere measured using cycloplegia was significantly different to that measured using extended optical fogging as an accommodation control method for both retinoscopy and autorefraction. Their findings argue for the use of cycloplegic refraction rather than extended optical fogging as a means of controlling accommodation for refractive error studies in children. (p. 1734)

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• Civilian Traumatic Brain Injury and Convergence Insufficiency

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Although convergence insufficiency (CI) is commonly reported in patients with traumatic brain injury (TBI), the prevalence of CI not associated with other vision or vestibular problems seen in TBI (saccade or pursuit dysfunction; third, fourth, or sixth cranial nerve palsy; visual field deficit; visual spatial inattention/neglect; nystagmus) is not known. A retrospective analysis of 557 medical records from civilian patients with TBI found that 9% of this population had a diagnosis of CI without other visual or vestibular dysfunctions. (p. 1740)

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•Good News and Bad News for Low-Vision Students in Nepal

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Almost 800 blind and vision-impaired students, studying in 67 integrated schools for the blind across Nepal, were examined using the WHO/PBL Eye Examination Record for Children with Blindness and Low Vision. Optical aids provided useful distance and near vision to 20%and 40%of the low-vision children for distance and near vision, respectively. Children with low vision actually represented 80% of the population enrolled in these schools for the blind. In fact, about one-third of the braille learners could get good vision for print reading. Disappointingly, only one-third of those given optical devices were using them a year later. The authors call for developing a national plan for students with low vision in Nepal. (p. 1752)

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• Telescope-Perceived Depth of Field Compression With Magnification and Restricted Field of View

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The magnification produced by a low-vision telescope has been shown to compress perceived depth. Looking through a telescope also entails monocular viewing and visual field restriction, which together compress perceived depth. Whereas magnification compresses perceived depth, monocular viewing, and severely restricted field of view (10 degrees), each also produces substantial compression. However, a moderately restricted (40 degrees) field does not increase the compression found with unrestricted monocular viewing. (p. 1757)

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• Stereoscopic Thresholds and Depth Judgments are Not Necessarily Linked

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Normal observers viewed line stereo targets under conditions that elevated their stereothreshold four to five times. Perceived stereoscopic depth judgments were reduced for some but not all of these same conditions. The data suggest that observers with impaired stereopsis may or may not exhibit an associated reduction of perceived stereoscopic depth. (p. 1768)

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• Clinical Reasoning of Optometrists

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Our authors’ study suggests that expert optometrists, compared with optometrists newly admitted to the profession aremore patient centered, construct a mental representation of their patient’s clinical situation more quickly, plan examinationsmore thoroughly, are able to reflect during cognitively demanding tasks, and draw up their care management plan throughout the encounter. Their results support the growing body of evidence in other health professions that learners can benefit from explicit guidance regarding both analytical and nonanalytical clinical reasoning strategies. (p. 1774)

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• Reliability of Retinal Nerve Fiber Layer Thickness Readings From the Stratus

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Optical coherence tomography is affected by the positioning of the scanning circle used during image acquisition. Our authors provide a method and computer program that estimate how much misalignment occurs between scans, thus providing a useful measure of reliability for comparison with subsequent measures. The scan is potentially useful when comparing retinal nerve fiber layer thickness measures for patients from different scans and different visits. The software is available from the authors of the article. (p. e-109)

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• The Importance of Accurate Pupillary Examination

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There seems to be somewhat of a recurrent theme regarding the importance of accurate pupillary examination in recent clinical reports. In this case, there is a presentation of light-near dissociation with other neurological signs of upgaze paralysis, eyelid retraction, and convergence retraction nystagmus. In the current environment of delegation of so many studies to techs, the doctor may first see the patient dilated, whichmay mask neurological issues. (p. e-112)

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• Mimicking Ocular Myasthenia Gravis

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Although rare, this case presentation points to the necessity of pursuing every potential association in neuro-ophthalmic disorders. A triad of neurological signs characterizes the Miller Fisher syndrome: bilateral external ophthalmoplegia, ataxia, and areflexia. Most of these patients report an antecedent upper respiratory tract or gastrointestinal illness. Serological testing assists the diagnosis. (p. e-118)

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• Ocular Neuromyotonia Caused by Thyroid-Related Orbitopathy

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Another rare case regarding neuro-ophthalmic issues. The ocular neuromyotonia syndrome causing intermittent diplopia is caused by an abnormal delay in extraocular muscle relaxation. In this particular case, there is an associated bilateral miosis during themuscle spasm secondary to thyroid-related orbitopathy. It is important to recognize ocular neuromyotonia syndrome because the condition is treatable. (p. e-124)

© 2012 American Academy of Optometry