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OVS ANNOUNCES

OVS ANNOUNCES

Optometry and Vision Science: April 2014 - Volume 91 - Issue 4 -
doi: 10.1097/OPX.0000000000000239
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IN THIS ISSUE:

Cutting Edge Optometric Research

See one of the videos online at http://links
See one of the videos online at http://links:
See one of the videos online at http://links.lww.com/OPX/A162.

Clinician-scientists bridge the gap between basic research and patient care. This article summarizes current basic “bench” eye research by four outstanding optometric clinician-scientists in the field of cornea and the ocular surface disease. Their work, along with clinical commentaries by the clinical editor of Optometry and Vision Science, illustrates how basic research can translate into advancing clinical eye care practices. (p. S3).

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Editor’s Choice open access

“Buttonholing” an Intraocular Lens

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The authors describe a relatively novel two-step surgical approach to dealing with implantation of an intraocular lens (IOL) in cases with lens subluxation caused by nonprogressive zonular dialysis. Initially, phacoemulsification is accompanied by creation of a 4-mm posterior capsular opening. The second stage, 6 weeks later, includes anterior vitrectomy and insertion of a foldable three-piece IOL with haptics in the capsule and optics posterior to the capsule. The authors refer to this as “buttonholing” the IOL and suggest that it be considered in similar cases of nonprogressive zonular dialysis. (p. S17)

Absence of Iris Heterochromia Unique in Tapioca Melanoma

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The authors present a rare case of tapioca melanoma of the iris. Although iris heterochromia is a common sign often associated with this rare form of melanoma, no indication was seen in this case. The authors show that tapioca melanoma of the iris must be included among the differential diagnoses when examining patients with amelanotic iris lesions, even when iris heterochromia is not clearly evident. (p. S20)

Rare but Important to Not Miss

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Anterior chamber reactions are usually caused by primary inflammation, systemic inflammatory disease, trauma, or surgery. Although uncommon, they can be an indication of neoplasia. The authors’ case demonstrates the importance of identifying features of an anterior chamber reaction that may be atypical and potentially indicative of a neoplastic process. They accompany the detailed case report with a literature review of intraocular manifestations of mantle cell lymphoma. (p. S25)

Hard Scleral Lens Post-LASIK Ectasia Fitting Challenges

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The authors describe their careful, and sequential, fitting and adjustment of a hard scleral lens “prosthetic replacement of ocular surface ecosystem” (PROSE) device for post-LASIK corneal ectasia. Corneal irregularities and scleral toricity provide challenges, and the authors highlight a successful approach of dealing with these challenges. (p. S30)

Hard Scleral Lens for Bilateral Keratoglobus with Terrien’s Marginal Degeneration

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This case presents a rare patient with multiple corneal issues who was successfully fit with a gas-permeable scleral lens. It demonstrates that multiple follow-up visits may be required to determine the appropriate corneal vault clearance and haptic selection, which are critical to achieving successful wearing times. (p. S34)

Visualizing Edematous Corneas with OCT

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Using clinical cases, our authors demonstrate how anterior segment spectral-domain OCT (optical coherence tomography) provides valuable detailed images of the corneal layers altered in edematous keratitis. The vibrant images visualize different types of edema as well as keratic precipitates. Ongoing corneal thickness measures can also document treatment-induced edema resolution. (p. S40)

Successfully Treating Spasm of the Near Reflex

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Acute-onset comitant esotropia associated with spasm of accommodation in children and adults is a rare clinical condition. When it occurs with pupillary miosis and restricted ocular motility, it is referred to as “spasm of near reflex” (SNR) and may require neurological investigation. Our authors report a clinical case in an otherwise healthy young male who was successfully managed with cycloplegic medications and vision therapy for a 1-year period. The authors caution that SNR may need this course of treatment for this length of time. (p. S46)

Branch Retinal Vein Occlusion Associated with Cystic Fibrosis

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Branch retinal vein occlusion (BRVO), a common sight-threatening vascular disease, is generally seen in patients older than 65 years. Here, the authors report it in a 35-year-old with cystic fibrosis (CF). The authors hypothesize that based on patient blood test results, the BRVO occurred secondary to raised fibrinogen levels, a common feature in CF caused by chronic pulmonary infection and inflammation. (p. S52)

An Unexpected Retinal Tear

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The epithelium of anterior segment structures is derived from the ectoderm, so disorders of “ectrodactyly ectodermal dysplasia” are not surprising and in an acute form can present with bilateral, red, irritated eyes. However, our authors found the additional unexpected finding of an asymptomatic retinal tear in a patient with this inherited condition. The authors are aware of only two other reports with associated retinal findings in ectoderm dysplasia, and they question whether neural ectoderm could also be involved in this inherited disease. (p. S55)

Another Possibility for Bilateral Vision Loss in Children

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An underdeveloped foveal pit, absence of foveal pigmentation and/or foveal avascular zone, and persistence of inner retinal layers at the fovea are characteristic of foveal hypoplasia (FH). It is usually seen in association with other pathologies (e.g., aniridia, albinism, microphthalmos, achromatopsia). But, here, the authors report a presumptively rare case of an isolated FH in a 16 year-old (they believe that it is the first reported case in Turkey). They believe that isolated FH should be considered in the differential diagnosis of bilateral visual impairment, especially in cases where the foveal reflex seems absent. (p. S61)

Cystoid Macular Edema in Cancer-Associated Retinopathy

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Although rare, it is important that clinicians be aware of the clinical presentation of cancer-associated retinopathy (CAR) and treat it, despite the poor prognosis. The authors report on a case of a 67-year-old patient with small-cell lung cancer who was ultimately diagnosed with CAR. He eventually developed mild cystoid macular edema in both eyes related to his CAR. The patient is being treated with triamcinolone injections and maintenance doses of diclofenac to maintain stable visual acuity. (p. S66)

Torpedo Maculopathy in Another Form

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Torpedo maculopathy, a relatively rare, congenital, hypopigmented lesion with a horizontally oval shape (hence “torpedo”), is usually flat. Here, based on the authors’ discovery of two cases of excavated torpedo lesions, it is proposed that torpedo maculopathy be redefined to include this form, rather than to have such forms “misclassified” as macular colobomas. (p. S71)

© 2014 American Academy of Optometry