Sample records for ophthalmic inserts lacrisert

  1. Vehicle effects in ophthalmic bioavailability: an evaluation of polymeric inserts containing pilocarpine.

    PubMed

    Saettone, M F; Giannaccini, B; Chetoni, P; Galli, G; Chiellini, E

    1984-04-01

    A series of polymeric ophthalmic inserts containing pilocarpine were formulated with four different types of polyvinyl alcohol, PVA, and two types of hydroxypropylcellulose. Pilocarpine was present as the nitrate, or as the salt with polyacrylic acid, PAA. In-vivo miosis vs time experiments on albino rabbits, showed that all inserts increased significantly the bioavailability of pilocarpine, with respect to a standard solution of pilocarpine nitrate. Two PVA inserts, containing the PAA-salt of pilocarpine, were particularly effective. The preparations were also submitted to in-vitro release tests and to differential scanning calorimetry, to ascertain the release mechanism, and to verify, via the thermal behaviour, possible interactions between drug and polymers. The chemical and physiochemical factors, most likely to influence the ophthalmic bioavailability of pilocarpine from the present preparations, are briefly reviewed.

  2. 21 CFR 886.5420 - Contact lens inserter/remover.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Contact lens inserter/remover. 886.5420 Section... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Therapeutic Devices § 886.5420 Contact lens inserter/remover. (a) Identification. A contact lens inserter/remover is a handheld device intended to insert or remove...

  3. Ex vivo rabbit cornea diffusion studies with a soluble insert of moxifloxacin.

    PubMed

    Sebastián-Morelló, María; Calatayud-Pascual, María Aracely; Rodilla, Vicent; Balaguer-Fernández, Cristina; López-Castellano, Alicia

    2018-02-01

    The objective of this research was to develop and evaluate an ocular insert for the controlled drug delivery of moxifloxacin which could perhaps be used in the treatment of corneal keratitis or even bacterial endophthalmitis. We have evaluated the ex vivo ocular diffusion of moxifloxacin through rabbit cornea, both fresh and preserved under different conditions. Histological studies were also carried out. Subsequently, drug matrix inserts were prepared using bioadhesive polymers. The inserts were evaluated for their physicochemical parameters. Ophthalmic ex vivo permeation of moxifloxacin was carried out with the most promising insert. The formulate insert was thin and provided higher ocular diffusion than commercial formulations. Ocular diffusion studies revealed significant differences between fresh and frozen corneas. Histological examinations also showed differences in the thickness of stroma between fresh and frozen corneas. The ophthalmic insert we have developed allows a larger quantity of moxifloxacin to permeate through the cornea than existing commercial formulations of the drug. Ocular delivery of moxifloxacin with this insert could be a new approach for the treatment of eye diseases.

  4. 21 CFR 886.5420 - Contact lens inserter/remover.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Contact lens inserter/remover. 886.5420 Section 886.5420 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Therapeutic Devices § 886.5420 Contact lens inserter/remover...

  5. 21 CFR 349.50 - Labeling of ophthalmic drug products.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., discard.” (3) For ophthalmic drug products containing mercury compounds used as a preservative. “This product contains (name and quantity of mercury-containing ingredient) as a preservative. Do not use this product if you are sensitive to” (select one of the following: “mercury” or “(insert name of mercury...

  6. 21 CFR 349.50 - Labeling of ophthalmic drug products.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ..., discard.” (3) For ophthalmic drug products containing mercury compounds used as a preservative. “This product contains (name and quantity of mercury-containing ingredient) as a preservative. Do not use this product if you are sensitive to” (select one of the following: “mercury” or “(insert name of mercury...

  7. 21 CFR 349.50 - Labeling of ophthalmic drug products.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ..., discard.” (3) For ophthalmic drug products containing mercury compounds used as a preservative. “This product contains (name and quantity of mercury-containing ingredient) as a preservative. Do not use this product if you are sensitive to” (select one of the following: “mercury” or “(insert name of mercury...

  8. 21 CFR 349.50 - Labeling of ophthalmic drug products.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ..., discard.” (3) For ophthalmic drug products containing mercury compounds used as a preservative. “This product contains (name and quantity of mercury-containing ingredient) as a preservative. Do not use this product if you are sensitive to” (select one of the following: “mercury” or “(insert name of mercury...

  9. 21 CFR 349.50 - Labeling of ophthalmic drug products.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ..., discard.” (3) For ophthalmic drug products containing mercury compounds used as a preservative. “This product contains (name and quantity of mercury-containing ingredient) as a preservative. Do not use this product if you are sensitive to” (select one of the following: “mercury” or “(insert name of mercury...

  10. Ophthalmic drug dosage forms: characterisation and research methods.

    PubMed

    Baranowski, Przemysław; Karolewicz, Bożena; Gajda, Maciej; Pluta, Janusz

    2014-01-01

    This paper describes hitherto developed drug forms for topical ocular administration, that is, eye drops, ointments, in situ gels, inserts, multicompartment drug delivery systems, and ophthalmic drug forms with bioadhesive properties. Heretofore, many studies have demonstrated that new and more complex ophthalmic drug forms exhibit advantage over traditional ones and are able to increase the bioavailability of the active substance by, among others, reducing the susceptibility of drug forms to defense mechanisms of the human eye, extending contact time of drug with the cornea, increasing the penetration through the complex anatomical structure of the eye, and providing controlled release of drugs into the eye tissues, which allows reducing the drug application frequency. The rest of the paper describes recommended in vitro and in vivo studies to be performed for various ophthalmic drugs forms in order to assess whether the form is acceptable from the perspective of desired properties and patient's compliance.

  11. Ophthalmic Drug Dosage Forms: Characterisation and Research Methods

    PubMed Central

    Baranowski, Przemysław; Karolewicz, Bożena; Gajda, Maciej; Pluta, Janusz

    2014-01-01

    This paper describes hitherto developed drug forms for topical ocular administration, that is, eye drops, ointments, in situ gels, inserts, multicompartment drug delivery systems, and ophthalmic drug forms with bioadhesive properties. Heretofore, many studies have demonstrated that new and more complex ophthalmic drug forms exhibit advantage over traditional ones and are able to increase the bioavailability of the active substance by, among others, reducing the susceptibility of drug forms to defense mechanisms of the human eye, extending contact time of drug with the cornea, increasing the penetration through the complex anatomical structure of the eye, and providing controlled release of drugs into the eye tissues, which allows reducing the drug application frequency. The rest of the paper describes recommended in vitro and in vivo studies to be performed for various ophthalmic drugs forms in order to assess whether the form is acceptable from the perspective of desired properties and patient's compliance. PMID:24772038

  12. 78 FR 68714 - Medical Devices; Ophthalmic Devices; Classification of the Scleral Plug

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-15

    ... the device materials must be performed; (iv) Performance data must demonstrate acceptable mechanical properties under simulated clinical use conditions including insertion and removal of the device; (v...

  13. 76 FR 51876 - Medical Devices; Ophthalmic Devices; Classification of the Eyelid Thermal Pulsation System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-19

    ... meibomian gland dysfunction (MGD), also known as evaporative dry eye or lipid deficiency dry eye. The system... evaporative dry eye or lipid deficiency dry eye. The system consists of a component that is inserted around...

  14. Brinzolamide Ophthalmic

    MedlinePlus

    ... see if you should still use the same eye drop bottle.tell your doctor if you wear soft contact lenses. Wait at least 15 minutes after using the medicine to put in soft contact lenses.use caution when driving or operating machinery because vision may be blurred after inserting the drops.

  15. 21 CFR 886.4300 - Intraocular lens guide.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Intraocular lens guide. 886.4300 Section 886.4300...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4300 Intraocular lens guide. (a) Identification. An intraocular lens guide is a device intended to be inserted into the eye during surgery to direct...

  16. 21 CFR 886.4300 - Intraocular lens guide.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4300 Intraocular lens guide. (a) Identification. An intraocular lens guide is a device intended to be inserted into the eye during surgery to direct... lenses, the device is exempt from the premarket notification procedures in subpart E of part 807 of this...

  17. 21 CFR 349.55 - Labeling of ophthalmic astringent drug products.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...” (select one of the following: “eye” or “ophthalmic”) “(insert dosage form, e.g., drops).” (b) Indications... temporary relief of discomfort from minor eye irritations.” (c) Warnings. In addition to the warnings in... products containing any ingredient identified in § 349.10: (1) “If you experience eye pain, changes in...

  18. 21 CFR 349.55 - Labeling of ophthalmic astringent drug products.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...” (select one of the following: “eye” or “ophthalmic”) “(insert dosage form, e.g., drops).” (b) Indications... temporary relief of discomfort from minor eye irritations.” (c) Warnings. In addition to the warnings in... products containing any ingredient identified in § 349.10: (1) “If you experience eye pain, changes in...

  19. 21 CFR 349.70 - Labeling of ophthalmic hypertonicity drug products.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... “hypertonicity” (select one of the following: “eye” or “ophthalmic”) “(insert dosage form, e.g., drops).” (b... supervision of a doctor. If you experience eye pain, changes in vision, continued redness or irritation of the eye, or if the condition worsens or persists, consult a doctor.” (2) “This product may cause temporary...

  20. 21 CFR 349.70 - Labeling of ophthalmic hypertonicity drug products.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... “hypertonicity” (select one of the following: “eye” or “ophthalmic”) “(insert dosage form, e.g., drops).” (b... supervision of a doctor. If you experience eye pain, changes in vision, continued redness or irritation of the eye, or if the condition worsens or persists, consult a doctor.” (2) “This product may cause temporary...

  1. 21 CFR 349.65 - Labeling of ophthalmic emollient drug products.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...” or “emollient (lubricant)” (select one of the following: “eye” or “ophthalmic”) “(insert dosage form... due to dryness of the eye.” (2) “For the temporary relief of discomfort due to minor irritations of the eye or to exposure to wind or sun.” (3) “For use as a protectant against further irritation or to...

  2. 21 CFR 349.65 - Labeling of ophthalmic emollient drug products.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...” or “emollient (lubricant)” (select one of the following: “eye” or “ophthalmic”) “(insert dosage form... due to dryness of the eye.” (2) “For the temporary relief of discomfort due to minor irritations of the eye or to exposure to wind or sun.” (3) “For use as a protectant against further irritation or to...

  3. 21 CFR 349.60 - Labeling of ophthalmic demulcent drug products.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...” or “demulcent (lubricant)” (select one of the following: “eye” or “ophthalmic”) “(insert dosage form... dryness of the eye.” (2) “For the temporary relief of discomfort due to minor irritations of the eye or to... the eye.” (4) “For use as a lubricant to prevent further irritation or to relieve dryness of the eye...

  4. 21 CFR 349.60 - Labeling of ophthalmic demulcent drug products.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...” or “demulcent (lubricant)” (select one of the following: “eye” or “ophthalmic”) “(insert dosage form... dryness of the eye.” (2) “For the temporary relief of discomfort due to minor irritations of the eye or to... the eye.” (4) “For use as a lubricant to prevent further irritation or to relieve dryness of the eye...

  5. Mucoadhesive ocular insert based on thiolated poly(acrylic acid): development and in vivo evaluation in humans.

    PubMed

    Hornof, Margit; Weyenberg, Wim; Ludwig, Annick; Bernkop-Schnürch, Andreas

    2003-05-20

    The aim of the study was to develop a mucoadhesive ocular insert for the controlled delivery of ophthalmic drugs and to evaluate its efficacy in vivo. The inserts tested were based either on unmodified or thiolated poly(acrylic acid). Water uptake and swelling behavior of the inserts as well as the drug release rates of the model drugs fluorescein and two diclofenac salts with different solubility properties were evaluated in vitro. Fluorescein was used as fluorescent tracer to study the drug release from the insert in humans. The mean fluorescein concentration in the cornea/tearfilm compartment as a function of time was determined after application of aqueous eye drops and inserts composed of unmodified and of thiolated poly(acrylic acid). The acceptability of the inserts by the volunteers was also evaluated. Inserts based on thiolated poly(acrylic acid) were not soluble and had good cohesive properties. A controlled release was achieved for the incorporated model drugs. The in vivo study showed that inserts based on thiolated poly(acrylic acid) provide a fluorescein concentration on the eye surface for more than 8 h, whereas the fluorescein concentration rapidly decreased after application of aqueous eye drops or inserts based on unmodified poly(acrylic acid). Moreover, these inserts were well accepted by the volunteers. The present study indicates that ocular inserts based on thiolated poly(acrylic acid) are promising new solid devices for ocular drug delivery.

  6. Dispersion of microemulsion drops in HEMA hydrogel: a potential ophthalmic drug delivery vehicle.

    PubMed

    Gulsen, Derya; Chauhan, Anuj

    2005-03-23

    Approximately 90% of all ophthalmic drug formulations are now applied as eye-drops. While eye-drops are convenient and well accepted by patients, about 95% of the drug contained in the drops is lost due to absorption through the conjunctiva or through the tear drainage. A major fraction of the drug eventually enters the blood stream and may cause side effects. The drug loss and the side effects can be minimized by using disposable soft contact lenses for ophthalmic drug delivery. The essential idea is to encapsulate the ophthalmic drug formulations in nanoparticles, and disperse these drug-laden particles in the lens material. Upon insertion into the eye, the lens will slowly release the drug into the pre lens (the film between the air and the lens) and the post-lens (the film between the cornea and the lens) tear films, and thus provide drug delivery for extended periods of time. This paper focuses on dispersing stabilized microemulsion drops in poly-2-hydroxyethyl methacrylate (p-HEMA) hydrogels. The results of this study show that the p-HEMA gels loaded with a microemulsion that is stabilized with a silica shell are transparent and that these gels release drugs for a period of over 8 days. Contact lenses made of microemulsion-laden gels are expected to deliver drugs at therapeutic levels for a few days. The delivery rates can be tailored by controlling the particle and the drug loading. It may be possible to use this system for both therapeutic drug delivery to eyes and the provision of lubricants to alleviate eye problems prevalent in extended lens wear.

  7. A Framework for Modelling Connective Tissue Changes in VIIP Syndrome

    NASA Technical Reports Server (NTRS)

    Ethier, C. R.; Best, L.; Gleason, R.; Mulugeta, L.; Myers, J. G.; Nelson, E. S.; Samuels, B. C.

    2014-01-01

    Insertion of astronauts into microgravity induces a cascade of physiological adaptations, notably including a cephalad fluid shift. Longer-duration flights carry an increased risk of developing Visual Impairment and Intracranial Pressure (VIIP) syndrome, a spectrum of ophthalmic changes including posterior globe flattening, choroidal folds, distension of the optic nerve sheath, kinking of the optic nerve and potentially permanent degradation of visual function. The slow onset of changes in VIIP, their chronic nature, and the similarity of certain clinical features of VIIP to ophthalmic findings in patients with raised intracranial pressure strongly suggest that: (i) biomechanical factors play a role in VIIP, and (ii) connective tissue remodeling must be accounted for if we wish to understand the pathology of VIIP. Our goal is to elucidate the pathophysiology of VIIP and suggest countermeasures based on biomechanical modeling of ocular tissues, suitably informed by experimental data, and followed by validation and verification. We specifically seek to understand the quasi-homeostatic state that evolves over weeks to months in space, during which ocular tissue remodeling occurs. This effort is informed by three bodies of work: (i) modeling of cephalad fluid shifts; (ii) modeling of ophthalmic tissue biomechanics in glaucoma; and (iii) modeling of connective tissue changes in response to biomechanical loading.

  8. Tear fluid collection in dogs and cats using ophthalmic sponges.

    PubMed

    Sebbag, Lionel; Harrington, Danielle M; Mochel, Jonathan P

    2018-05-01

    To compare the use of two ophthalmic sponges for tear collection in dogs and cats. Ten healthy dogs and 10 healthy cats. A strip (4 × 10 mm) of either cellulose or polyvinyl acetal (PVA) sponge was inserted into the ventral fornix of each eye for either 15, 30, or 60 s. The wetted strip was placed into a 0.2-mL tube that was first punctured at its bottom. Tears were eluted through the drainage hole into a 1.5-mL tube via centrifugation. Tear volume absorbed (VA) and tear volume recovered (VR) were calculated as the difference of the post- and precollection weight of the 0.2-mL tube and 1.5-mL tube, respectively. Recovery ratio (RR) was determined as the ratio between VR and VA. Ophthalmic sponges were well tolerated by all subjects. In dogs and cats, median (95% range) VA, VR, and RR were as follows: 44 μL (11-106 μL) and 16 μL (2-43 μL); 27 μL (1-84 μL) and 6 μL (0-29 μL); 64% (7-91%) and 35% (0-86%), respectively. PVA sponges achieved significantly greater VR in cats and RR in both species. All parameters were significantly greater with a collection time of 60 vs. 30 and 15 s. Body weight was associated with VA and VR in dogs but not cats. Polyvinyl acetal is better than cellulose for tear collection given its superior recovery. Ophthalmic sponges could facilitate routine analysis of tear fluid in dogs and cats, although further studies are needed to evaluate the quality of tears obtained with this method. © 2017 American College of Veterinary Ophthalmologists.

  9. Anesthetic management of pediatric patients with Sturge-Weber syndrome: our experience and a review of the literature.

    PubMed

    Khanna, Puneet; Ray, Bikash Ranjan; Govindrajan, Srinivas Rhagvan; Sinha, Renu; Chandralekha; Talawar, Praveen

    2015-12-01

    Sturge-Weber syndrome (SWS) is a rare sporadic congenital neurocutaneous syndrome which is characterized by vascular malformation involving the brain, face and eye. The anesthetic management is complicated by its localized as well as systemic manifestations, associated anomalies and difficult airway due to the presence of angiomas of the oral cavity and airway. We retrospective analyzed the perioperative anesthetic management of children with SWS undergoing ophthalmic surgery and reviewed the literature. Medical records and anesthetic charts of all the children with SWS who had undergone an ophthalmic procedure under general anesthesia during the past 6 years were reviewed. Information related to the demographic profile, preoperative evaluation, anesthetic techniques, and perioperative complications were collected and analyzed. Forty children with SWS received general anesthesia for an ophthalmic procedure within the 6-year period. The median age of the children was 3 years. 30 (92.5%) children had facial port-wine staining, 10 (25%) had facial hypertrophy, 15 (37.5%) had a history of convulsion and 4 (10%) children had mental retardation. Inhalational induction was performed in 34 (85%) children (sevoflurane 82.8%). A laryngeal mask airway (LMA) and endotracheal tube were used in 32 (80%) and 5 (12.5%) cases, respectively. One patient had difficult mask ventilation and difficult LMA insertion. There was no significant problem in any of the other children. Preoperative evaluation with airway assessment should be performed with the knowledge of local and systemic manifestation of the syndrome. Proconvulsant and anticonvulsant properties of the anesthetics, as well as drug interactions of antiepileptic medications should be considered when planning anesthesia. Avoiding a rise in intracranial and intraocular pressures, vigilant intraoperative monitoring and postoperative care are the key for conducting safe anesthesia in these children. For ophthalmic procedures, LMAs can be used for airway maintenance with minimal complications in children with SWS.

  10. A chandelier-illuminated anterior chamber maintainer for use during descemet stripping automated endothelial keratoplasty in patients with advanced bullous keratopathy.

    PubMed

    Inoue, Tomoyuki; Oshima, Yusuke; Hori, Yuich; Maeda, Naoyuki

    2010-08-01

    A new 25-gauge illuminated anterior chamber maintainer composed of a 25-gauge infusion cannula through which a 29-gauge chandelier fiber probe passes was developed for use during Descemet stripping automated endothelial keratoplasty to treat patients with advanced bullous keratopathy. This device, which is compatible with a xenon or mercury vapor illuminator to generate powerful wide-angle illumination from the cone-shaped chandelier fiber tip, is self-retained at the corneal limbus after insertion of the infusion cannula through a corneal side port. Because of its bifunctionality, that is, bright illumination and adequate irrigation flow, excellent visibility with stable anterior chamber maintenance can be concurrently obtained for Descemet stripping, endothelial graft insertion, and subsequent intraocular manipulations without the need for use of a biologic staining technique or ophthalmic viscosurgical products even in patients with severe corneal haze. This new device facilitates safe and simple intraocular manipulation during Descemet stripping automated endothelial keratoplasty.

  11. 21 CFR 886.4230 - Ophthalmic knife test drum.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic knife test drum. 886.4230 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4230 Ophthalmic knife test drum. (a) Identification. An ophthalmic knife test drum is a device intended to test the keenness of ophthalmic surgical...

  12. Biopharmaceutical evaluation of surface active ophthalmic excipients using in vitro and ex vivo corneal models.

    PubMed

    Juretić, Marina; Cetina-Čižmek, Biserka; Filipović-Grčić, Jelena; Hafner, Anita; Lovrić, Jasmina; Pepić, Ivan

    2018-07-30

    The objective of this study was to systematically investigate the effects of surface active ophthalmic excipients on the corneal permeation of ophthalmic drugs using in vitro (HCE-T cell-based model) and ex vivo (freshly excised porcine cornea) models. The permeation of four ophthalmic drugs (i.e., timolol maleate, chloramphenicol, diclofenac sodium and dexamethasone) across in vitro and ex vivo corneal models was evaluated in the absence and presence of four commonly used surface active ophthalmic excipients (i.e., Polysorbate 80, Tyloxapol, Cremophor® EL and Pluronic® F68). The concentration and self-aggregation-dependent effects of surface active ophthalmic excipients on ophthalmic drug permeability were studied from the concentration region where only dissolved monomer molecules of surface active ophthalmic excipients exist, as well as the concentration region in which aggregates of variable size and dispersion are spontaneously formed. Neither the surface active ophthalmic excipients nor the ophthalmic drugs at all concentrations that were tested significantly affected the barrier properties of both corneal models, as assessed by transepithelial electrical resistance (TEER) monitoring during the permeability experiments. The lowest concentration of all investigated surface active ophthalmic excipients did not significantly affect the ophthalmic drug permeability across both of the corneal models that were used. For three ophthalmic drugs (i.e., chloramphenicol, diclofenac sodium and dexamethasone), depressed in vitro and ex vivo permeability were observed in the concentration range of either Polysorbate 80, Tyloxapol, Cremophor® EL or Pluronic® F68, at which self-aggregation is detected. The effect was the most pronounced for Cremophor® EL (1 and 2%, w/V) and was the least pronounced for Pluronic® F68 (1%, w/V). However, all surface active ophthalmic excipients over the entire concentration range that was tested did not significantly affect the in vitro and ex vivo permeability of timolol maleate, which is the most hydrophilic ophthalmic drug that was investigated. The results of the dynamic light scattering measurements point to the association of ophthalmic drugs with self-aggregates of surface active ophthalmic excipients as the potential mechanism of the observed permeability-depressing effect of surface active ophthalmic excipients. A strong and statistically significant correlation was observed between in vitro and ex vivo permeability of ophthalmic drugs in the presence of surface active ophthalmic excipients, which indicates that the observed permeability-altering effects of surface active ophthalmic excipients were comparable and were mediated by the same mechanism in both corneal models. Copyright © 2018 Elsevier B.V. All rights reserved.

  13. Evaluation of the efficacy and safety of a standardised intracameral combination of mydriatics and anaesthetics for cataract surgery

    PubMed Central

    Labetoulle, Marc; Findl, Oliver; Malecaze, François; Alió, Jorge; Cochener, Béatrice; Lobo, Conceição; Lazreg, Sihem; Hartani, Dahbia; Colin, Joseph; Tassignon, Marie-José; Behndig, Anders

    2016-01-01

    Background/aims To compare the efficacy and safety of intracameral (IC) administration at the beginning of cataract surgery, of Mydrane, a standardised ophthalmic combination of tropicamide 0.02%, phenylephrine 0.31% and lidocaine 1%, to a standard topical regimen. Methods In this international phase III, prospective, randomised study, the selected eye of 555 patients undergoing phacoemulsification with intraocular lens (IOL) implantation received 200 μL of Mydrane (Mydrane group) just after the first incision or a topical regimen of one drop each of tropicamide 0.5% and phenylephrine 10% repeated three times (reference group). The primary efficacy variable was achievement of capsulorhexis without additional mydriatics. The non-inferiority of Mydrane to the topical regimen was tested. The main outcome measures were pupil size, patient perception of ocular discomfort and safety. Results Capsulorhexis without additional mydriatics was performed in 98.9% of patients and 94.7% in the Mydrane and reference groups, respectively. Both groups achieved adequate mydriasis (>7 mm) during capsulorhexis, phacoemulsification and IOL insertion. IOL insertion was classified as ‘routine’ in a statistically greater number of eyes in the Mydrane group compared with the reference group (p=0.047). Patients in the Mydrane group reported statistically greater comfort than the reference group before IOL insertion (p=0.034). Safety data were similar between groups. Conclusions Mydrane is an effective and safe alternative to standard eye drops for initiating and maintaining intraoperative mydriasis and analgesia. Patients who received IC Mydrane were significantly more comfortable before IOL insertion than the reference group. Surgeons found IOL insertion less technically challenging with IC Mydrane. Trial registration number NCT02101359; Results. PMID:26531052

  14. Evaluation of the efficacy and safety of a standardised intracameral combination of mydriatics and anaesthetics for cataract surgery.

    PubMed

    Labetoulle, Marc; Findl, Oliver; Malecaze, François; Alió, Jorge; Cochener, Béatrice; Lobo, Conceição; Lazreg, Sihem; Hartani, Dahbia; Colin, Joseph; Tassignon, Marie-José; Behndig, Anders

    2016-07-01

    To compare the efficacy and safety of intracameral (IC) administration at the beginning of cataract surgery, of Mydrane, a standardised ophthalmic combination of tropicamide 0.02%, phenylephrine 0.31% and lidocaine 1%, to a standard topical regimen. In this international phase III, prospective, randomised study, the selected eye of 555 patients undergoing phacoemulsification with intraocular lens (IOL) implantation received 200 μL of Mydrane (Mydrane group) just after the first incision or a topical regimen of one drop each of tropicamide 0.5% and phenylephrine 10% repeated three times (reference group). The primary efficacy variable was achievement of capsulorhexis without additional mydriatics. The non-inferiority of Mydrane to the topical regimen was tested. The main outcome measures were pupil size, patient perception of ocular discomfort and safety. Capsulorhexis without additional mydriatics was performed in 98.9% of patients and 94.7% in the Mydrane and reference groups, respectively. Both groups achieved adequate mydriasis (>7 mm) during capsulorhexis, phacoemulsification and IOL insertion. IOL insertion was classified as 'routine' in a statistically greater number of eyes in the Mydrane group compared with the reference group (p=0.047). Patients in the Mydrane group reported statistically greater comfort than the reference group before IOL insertion (p=0.034). Safety data were similar between groups. Mydrane is an effective and safe alternative to standard eye drops for initiating and maintaining intraoperative mydriasis and analgesia. Patients who received IC Mydrane were significantly more comfortable before IOL insertion than the reference group. Surgeons found IOL insertion less technically challenging with IC Mydrane. NCT02101359; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. 21 CFR 886.4250 - Ophthalmic electrolysis unit.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Ophthalmic electrolysis unit. 886.4250 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4250 Ophthalmic electrolysis unit. (a) Identification. An ophthalmic electrolysis unit is an AC-powered or battery-powered device intended to destroy...

  16. 21 CFR 886.4250 - Ophthalmic electrolysis unit.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Ophthalmic electrolysis unit. 886.4250 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4250 Ophthalmic electrolysis unit. (a) Identification. An ophthalmic electrolysis unit is an AC-powered or battery-powered device intended to destroy...

  17. 21 CFR 886.4250 - Ophthalmic electrolysis unit.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Ophthalmic electrolysis unit. 886.4250 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4250 Ophthalmic electrolysis unit. (a) Identification. An ophthalmic electrolysis unit is an AC-powered or battery-powered device intended to destroy...

  18. 21 CFR 886.4250 - Ophthalmic electrolysis unit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ophthalmic electrolysis unit. 886.4250 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4250 Ophthalmic electrolysis unit. (a) Identification. An ophthalmic electrolysis unit is an AC-powered or battery-powered device intended to destroy...

  19. 21 CFR 886.4250 - Ophthalmic electrolysis unit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic electrolysis unit. 886.4250 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4250 Ophthalmic electrolysis unit. (a) Identification. An ophthalmic electrolysis unit is an AC-powered or battery-powered device intended to destroy...

  20. 21 CFR 886.5100 - Ophthalmic beta radiation source.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Ophthalmic beta radiation source. 886.5100 Section... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Therapeutic Devices § 886.5100 Ophthalmic beta radiation source. (a) Identification. An ophthalmic beta radiation source is a device intended to apply superficial...

  1. 21 CFR 886.5100 - Ophthalmic beta radiation source.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ophthalmic beta radiation source. 886.5100 Section... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Therapeutic Devices § 886.5100 Ophthalmic beta radiation source. (a) Identification. An ophthalmic beta radiation source is a device intended to apply superficial...

  2. 21 CFR 886.5100 - Ophthalmic beta radiation source.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Ophthalmic beta radiation source. 886.5100 Section... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Therapeutic Devices § 886.5100 Ophthalmic beta radiation source. (a) Identification. An ophthalmic beta radiation source is a device intended to apply superficial...

  3. 21 CFR 886.5100 - Ophthalmic beta radiation source.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Ophthalmic beta radiation source. 886.5100 Section... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Therapeutic Devices § 886.5100 Ophthalmic beta radiation source. (a) Identification. An ophthalmic beta radiation source is a device intended to apply superficial...

  4. 21 CFR 886.5100 - Ophthalmic beta radiation source.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic beta radiation source. 886.5100 Section... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Therapeutic Devices § 886.5100 Ophthalmic beta radiation source. (a) Identification. An ophthalmic beta radiation source is a device intended to apply superficial...

  5. 21 CFR 886.4390 - Ophthalmic laser.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic laser. 886.4390 Section 886.4390 Food... DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4390 Ophthalmic laser. (a) Identification. An ophthalmic laser is an AC-powered device intended to coagulate or cut tissue of the eye, orbit, or surrounding skin...

  6. 21 CFR 886.4390 - Ophthalmic laser.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ophthalmic laser. 886.4390 Section 886.4390 Food... DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4390 Ophthalmic laser. (a) Identification. An ophthalmic laser is an AC-powered device intended to coagulate or cut tissue of the eye, orbit, or surrounding skin...

  7. 21 CFR 886.5800 - Ophthalmic bar reader.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic bar reader. 886.5800 Section 886.5800...) MEDICAL DEVICES OPHTHALMIC DEVICES Therapeutic Devices § 886.5800 Ophthalmic bar reader. (a) Identification. An ophthalmic bar reader is a device that consists of a magnifying lens intended for use by a...

  8. 21 CFR 886.4750 - Ophthalmic eye shield.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ophthalmic eye shield. 886.4750 Section 886.4750...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4750 Ophthalmic eye shield. (a) Identification. An ophthalmic eye shield is a device that consists of a plastic or aluminum eye covering intended to...

  9. 21 CFR 886.4750 - Ophthalmic eye shield.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic eye shield. 886.4750 Section 886.4750...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4750 Ophthalmic eye shield. (a) Identification. An ophthalmic eye shield is a device that consists of a plastic or aluminum eye covering intended to...

  10. 21 CFR 886.1410 - Ophthalmic trial lens clip.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic trial lens clip. 886.1410 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1410 Ophthalmic trial lens clip. (a) Identification. An ophthalmic trial lens clip is a device intended to hold prisms, spheres, cylinders, or...

  11. 21 CFR 886.1420 - Ophthalmic lens gauge.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic lens gauge. 886.1420 Section 886.1420...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1420 Ophthalmic lens gauge. (a) Identification. An ophthalmic lens gauge is a calibrated device intended to manually measure the curvature of a...

  12. 21 CFR 886.1655 - Ophthalmic Fresnel prism.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ophthalmic Fresnel prism. 886.1655 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1655 Ophthalmic Fresnel prism. (a) Identification. An ophthalmic Fresnel prism is a device that is a thin plastic sheet with embossed rulings which...

  13. 21 CFR 886.1655 - Ophthalmic Fresnel prism.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Ophthalmic Fresnel prism. 886.1655 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1655 Ophthalmic Fresnel prism. (a) Identification. An ophthalmic Fresnel prism is a device that is a thin plastic sheet with embossed rulings which...

  14. 21 CFR 886.1655 - Ophthalmic Fresnel prism.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Ophthalmic Fresnel prism. 886.1655 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1655 Ophthalmic Fresnel prism. (a) Identification. An ophthalmic Fresnel prism is a device that is a thin plastic sheet with embossed rulings which...

  15. 21 CFR 886.1655 - Ophthalmic Fresnel prism.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Ophthalmic Fresnel prism. 886.1655 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1655 Ophthalmic Fresnel prism. (a) Identification. An ophthalmic Fresnel prism is a device that is a thin plastic sheet with embossed rulings which...

  16. 21 CFR 886.1655 - Ophthalmic Fresnel prism.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic Fresnel prism. 886.1655 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1655 Ophthalmic Fresnel prism. (a) Identification. An ophthalmic Fresnel prism is a device that is a thin plastic sheet with embossed rulings which...

  17. 21 CFR 886.1670 - Ophthalmic isotope uptake probe.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Ophthalmic isotope uptake probe. 886.1670 Section... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1670 Ophthalmic isotope uptake probe. (a) Identification. An ophthalmic isotope uptake probe is an AC-powered device intended to measure...

  18. 21 CFR 886.1670 - Ophthalmic isotope uptake probe.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Ophthalmic isotope uptake probe. 886.1670 Section... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1670 Ophthalmic isotope uptake probe. (a) Identification. An ophthalmic isotope uptake probe is an AC-powered device intended to measure...

  19. 21 CFR 886.1670 - Ophthalmic isotope uptake probe.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Ophthalmic isotope uptake probe. 886.1670 Section... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1670 Ophthalmic isotope uptake probe. (a) Identification. An ophthalmic isotope uptake probe is an AC-powered device intended to measure...

  20. 21 CFR 886.4790 - Ophthalmic sponge.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic sponge. 886.4790 Section 886.4790 Food... DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4790 Ophthalmic sponge. (a) Identification. An ophthalmic sponge is a device that is an absorbant sponge, pad, or spear made of folded gauze, cotton...

  1. 21 CFR 886.4390 - Ophthalmic laser.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Ophthalmic laser. 886.4390 Section 886.4390 Food... DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4390 Ophthalmic laser. (a) Identification. An ophthalmic laser is an AC-powered device intended to coagulate or cut tissue of the eye, orbit, or surrounding skin...

  2. 21 CFR 886.4390 - Ophthalmic laser.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Ophthalmic laser. 886.4390 Section 886.4390 Food... DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4390 Ophthalmic laser. (a) Identification. An ophthalmic laser is an AC-powered device intended to coagulate or cut tissue of the eye, orbit, or surrounding skin...

  3. 21 CFR 886.4390 - Ophthalmic laser.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Ophthalmic laser. 886.4390 Section 886.4390 Food... DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4390 Ophthalmic laser. (a) Identification. An ophthalmic laser is an AC-powered device intended to coagulate or cut tissue of the eye, orbit, or surrounding skin...

  4. 21 CFR 886.1140 - Ophthalmic chair.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic chair. 886.1140 Section 886.1140 Food... DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1140 Ophthalmic chair. (a) Identification. An ophthalmic chair is an AC-powered or manual device with adjustable positioning in which a patient is to sit...

  5. 21 CFR 886.1405 - Ophthalmic trial lens set.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic trial lens set. 886.1405 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1405 Ophthalmic trial lens set. (a) Identification. An ophthalmic trial lens set is a device that is a set of lenses of various dioptric powers...

  6. 21 CFR 886.5810 - Ophthalmic prism reader.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Ophthalmic prism reader. 886.5810 Section 886.5810...) MEDICAL DEVICES OPHTHALMIC DEVICES Therapeutic Devices § 886.5810 Ophthalmic prism reader. (a) Identification. An ophthalmic prism reader is a device intended for use by a patient who is in a supine position...

  7. 21 CFR 886.5810 - Ophthalmic prism reader.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic prism reader. 886.5810 Section 886.5810...) MEDICAL DEVICES OPHTHALMIC DEVICES Therapeutic Devices § 886.5810 Ophthalmic prism reader. (a) Identification. An ophthalmic prism reader is a device intended for use by a patient who is in a supine position...

  8. 21 CFR 886.5810 - Ophthalmic prism reader.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Ophthalmic prism reader. 886.5810 Section 886.5810...) MEDICAL DEVICES OPHTHALMIC DEVICES Therapeutic Devices § 886.5810 Ophthalmic prism reader. (a) Identification. An ophthalmic prism reader is a device intended for use by a patient who is in a supine position...

  9. 21 CFR 886.5810 - Ophthalmic prism reader.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ophthalmic prism reader. 886.5810 Section 886.5810...) MEDICAL DEVICES OPHTHALMIC DEVICES Therapeutic Devices § 886.5810 Ophthalmic prism reader. (a) Identification. An ophthalmic prism reader is a device intended for use by a patient who is in a supine position...

  10. 21 CFR 886.1760 - Ophthalmic refractometer.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1760 Ophthalmic refractometer. (a) Identification. An ophthalmic refractometer is an automatic AC-powered device that consists of a fixation system... of the eye by measuring light reflexes from the retina. (b) Classification. Class I (general controls...

  11. OIPAV: an integrated software system for ophthalmic image processing, analysis and visualization

    NASA Astrophysics Data System (ADS)

    Zhang, Lichun; Xiang, Dehui; Jin, Chao; Shi, Fei; Yu, Kai; Chen, Xinjian

    2018-03-01

    OIPAV (Ophthalmic Images Processing, Analysis and Visualization) is a cross-platform software which is specially oriented to ophthalmic images. It provides a wide range of functionalities including data I/O, image processing, interaction, ophthalmic diseases detection, data analysis and visualization to help researchers and clinicians deal with various ophthalmic images such as optical coherence tomography (OCT) images and color photo of fundus, etc. It enables users to easily access to different ophthalmic image data manufactured from different imaging devices, facilitate workflows of processing ophthalmic images and improve quantitative evaluations. In this paper, we will present the system design and functional modules of the platform and demonstrate various applications. With a satisfying function scalability and expandability, we believe that the software can be widely applied in ophthalmology field.

  12. 21 CFR 886.3100 - Ophthalmic tantalum clip.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... blood vessels in the eye. (b) Classification. Class II (special controls). The device is exempt from the...) MEDICAL DEVICES OPHTHALMIC DEVICES Prosthetic Devices § 886.3100 Ophthalmic tantalum clip. (a) Identification. An ophthalmic tantalum clip is a malleable metallic device intended to be implanted permanently...

  13. 21 CFR 886.5800 - Ophthalmic bar reader.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Ophthalmic bar reader. 886.5800 Section 886.5800 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Therapeutic Devices § 886.5800 Ophthalmic bar reader. (a...

  14. 21 CFR 886.5810 - Ophthalmic prism reader.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Ophthalmic prism reader. 886.5810 Section 886.5810 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Therapeutic Devices § 886.5810 Ophthalmic prism reader. (a...

  15. The Advanced Human Eye Model (AHEM): a personal binocular eye modeling system inclusive of refraction, diffraction, and scatter.

    PubMed

    Donnelly, William

    2008-11-01

    To present a commercially available software tool for creating eye models to assist the development of ophthalmic optics and instrumentation, simulate ailments or surgery-induced changes, explore vision research questions, and provide assistance to clinicians in planning treatment or analyzing clinical outcomes. A commercially available eye modeling system was developed, the Advanced Human Eye Model (AHEM). Two mainstream optical software engines, ZEMAX (ZEMAX Development Corp) and ASAP (Breault Research Organization), were used to construct a similar software eye model and compared. The method of using the AHEM is described and various eye modeling scenarios are created. These scenarios consist of retinal imaging of targets and sources; optimization capability; spectacles, contact lens, and intraocular lens insertion and correction; Zernike surface deformation on the cornea; cataract simulation and scattering; a gradient index lens; a binocular mode; a retinal implant; system import/export; and ray path exploration. Similarity of the two different optical software engines showed validity to the mechanism of the AHEM. Metrics and graphical data are generated from the various modeling scenarios particular to their input specifications. The AHEM is a user-friendly commercially available software tool from Breault Research Organization, which can assist the design of ophthalmic optics and instrumentation, simulate ailments or refractive surgery-induced changes, answer vision research questions, or assist clinicians in planning treatment or analyzing clinical outcomes.

  16. Retinal venous blood carbon monoxide response to bright light in male pigs: A preliminary study.

    PubMed

    Oren, Dan A; Duda, Magdalena; Kozioł, Katarzyna; Romerowicz-Misielak, Maria; Koziorowska, Anna; Sołek, Przemysław; Nowak, Sławomir; Kulpa, Magdalena; Koziorowski, Marek

    2017-03-01

    The physical mechanism by which light is absorbed in the eye and has antidepressant and energizing effects in Seasonal Affective Disorder and other forms of psychiatric major depression is of scientific interest. This study was designed to explore one specific aspect of a proposed humoral phototransduction mechanism, namely that carbon monoxide (CO) levels increase in retinal venous blood in response to bright light. Eleven mature male pigs approximately six months of age were kept for 7days in darkness and fasted for 12h prior to surgery. Following mild sedation, anesthesia was induced. Silastic catheters were inserted into the dorsal nasal vein through the angular vein of the eye to reach the ophthalmic sinus, from which venous blood outflowing from the eye area was collected. The animals were exposed to 5000lx of fluorescent-generated white light. CO levels in the blood were analyzed by gas chromatography before and after 80min of light exposure. At baseline, mean CO levels in the retinal venous blood were 0.43±0.05(SE)nmol/ml. After bright light, mean CO levels increased to 0.54±0.06nmol/ml (two-tailed t-test p<0.05). This study provides preliminary mammalian evidence that acute bright light exposure raises carbon monoxide levels in ophthalmic venous blood. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Experimental microendoscopic photoablative laser goniotomy as a surgical model for the treatment of dysgenetic glaucoma.

    PubMed

    Jacobi, P C; Dietlein, T S; Krieglstein, G K

    1996-11-01

    The aim of this study was to investigate the feasibility of photoablative Er:YAG laser goniotomy under microendoscopic control in a surgical cloudy corneal model of primary infantile glaucoma. Pectinate ligaments of 12 freshly enucleated cadaver porcine eyes were treated by ab interno single-pulse (5 mJ, 200 microseconds) Er:YAG laser (2.94 microns) photoablation. Through a clear corneal incision near the limbus an ophthalmic microendoscope (18 and 20 gauge) was inserted into the anterior chamber. Internal structures were observed and photoablative laser goniotomy was conducted under video guidance. Following treatment all eyes were prepared for light and scanning electron microscopy. Anterior chamber angle structures and tissue photoablation were clearly visualized on the videoscreen using ophthalmic microendoscopy. Energy settings of 5 mJ per pulse proved to be sufficient for reproducible photoablation of pectinate ligaments, accompanied by the root of the iris falling back and exposing trabecular meshwork. This was confirmed histopathologically. Scatter thermal damage was less than 30 microns. This new therapeutic modality, which combines endoscopic visualization of the internal structures with photoablative laser goniotomy, can be effective in the management of dysgenetic glaucoma in the presence of a cloudy cornea. High reproducibility of contact laser photoablation enabled sufficient control of incision depth and was not accompanied by inadvertent tissue damage to adjacent intraocular structures.

  18. 21 CFR 886.1415 - Ophthalmic trial lens frame.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic trial lens frame. 886.1415 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1415 Ophthalmic trial lens frame. (a) Identification. An opthalmic trial lens frame is a mechanical device intended to hold trial lenses for vision...

  19. 21 CFR 200.50 - Ophthalmic preparations and dispensers.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... intended for ophthalmic use, including preparations for cleansing the eyes, should be sterile. It is... use in the eye. (2) The Food and Drug Administration concludes that all such preparations, if they are... applicable to ophthalmic preparations that are regulated as medical devices. (3) The containers of ophthalmic...

  20. Allergic Contact Dermatitis to Ophthalmic Medications: Relevant Allergens and Alternative Testing Methods.

    PubMed

    Grey, Katherine R; Warshaw, Erin M

    Allergic contact dermatitis is an important cause of periorbital dermatitis. Topical ophthalmic agents are relevant sensitizers. Contact dermatitis to ophthalmic medications can be challenging to diagnose and manage given the numerous possible offending agents, including both active and inactive ingredients. Furthermore, a substantial body of literature reports false-negative patch test results to ophthalmic agents. Subsequently, numerous alternative testing methods have been described. This review outlines the periorbital manifestations, causative agents, and alternative testing methods of allergic contact dermatitis to ophthalmic medications.

  1. Effect of ophthalmic solution components on acrylic intraocular lenses.

    PubMed

    Ayaki, Masahiko; Nishihara, Hitoshi; Yaguchi, Shigeo; Koide, Ryohei

    2007-01-01

    To investigate the effect of ophthalmic solution components on the surface of acrylic intraocular lenses (IOLs). Department of Opthalmology, Showa University School of Medicine. Measurement of the contact angles of ophthalmic solutions on 3 acrylic IOLs was performed. The solutions were diclofenac sodium (Diclod), bromfenac sodium (Bronuck), betamethasone phosphate (Rinderon), dibekacin sulfate (Panimycin), polysorbate 80 (Tween 20), benzalkonium chloride, chlorobutanol, methylparahydroxybenzoate, and propylparahydroxybenzoate. The IOLs were incubated at 35 degrees C for 2 weeks in undiluted ophthalmic solutions and in 1:10 dilutions of ophthalmic solution components. The IOLs were sectioned and observed by scanning electron microscopy. The contact angle of Diclod and Bronuck solutions was the smallest. The contact angle of Rinderon and Panimycin was similar to that of distilled water. Scanning electron microscopy examination of IOLs incubated in ophthalmic solution components showed intralenticular changes. The IOLs immersed in ophthalmic solutions did not show any change, even after extended incubation. The chemical components of ophthalmic solutions, such as surfactants and solvents, permeate acrylic IOLs, suggesting the potential for long-term adverse effects of eyedrops in pseudophakic eyes.

  2. The Risk of Microbial Contamination in Multiple-Dose Preservative-Free Ophthalmic Preparations.

    PubMed

    Saisyo, Atsuyuki; Shimono, Rima; Oie, Shigeharu; Kimura, Kazuhiro; Furukawa, Hiroyuki

    2017-01-01

    Multiple-dose ophthalmic preparations that do not contain preservatives carry high risks of microbial contamination. However, there are various types of hospital preparations, with different physicochemical properties. In the present study, we evaluated the association between physicochemical properties and microbial contamination in ophthalmic preparations. The investigated hospital preparations included ophthalmic preparations of physiological saline, 0.2% fluconazole, 0.5% vancomycin hydrochloride, and 2% cyclosporine. We investigated the microbial dynamics of each ophthalmic preparation and microbial contamination in ophthalmic preparations used by patients. Remarkable growth of Pseudomonas aeruginosa, Burkholderia cepacia, and Serratia marcescens was observed in ophthalmic preparations of physiological saline and 0.2% fluconazole. All tested microorganisms displayed decreased counts after inoculation in 0.5% vancomycin hydrochloride. In 2% cyclosporine, all investigated microorganisms were below the limit of detection after inoculation for 6 h. The microbial contamination rates of ophthalmic preparations used by patients were 16.7% (3/18 samples) for 0.5% vancomycin hydrochloride and 0% (0/30 samples) for 2% cyclosporine. All detected contaminants in 0.5% vancomycin hydrochloride were Candida spp., one of which was present at a level of 1×10 4 colony-forming units/mL. The storage method for in-use ophthalmic preparations should be considered on the basis of their physicochemical properties.

  3. Diquafosol ophthalmic solution 3 %: a review of its use in dry eye.

    PubMed

    Keating, Gillian M

    2015-05-01

    Diquafosol ophthalmic solution 3 % (Diquas(®)) is a P2Y2 receptor agonist that promotes tear fluid and mucin secretion and is currently approved in Japan and South Korea for the treatment of dry eye. In randomized, double-blind, multicentre trials in patients with dry eye, significantly greater improvements in fluorescein and rose bengal staining scores were seen with diquafosol ophthalmic solution 3 % than with placebo, and diquafosol ophthalmic solution 3 % was noninferior to sodium hyaluronate ophthalmic solution 0.1 % in terms of the improvement in the fluorescein staining score and more effective than sodium hyaluronate ophthalmic solution 0.1 % in terms of the improvement in the rose bengal staining score. The efficacy of diquafosol ophthalmic solution 3 % in the treatment of dry eye was maintained in the longer term, with improvements also seen in subjective dry eye symptoms, and was also shown in a real-world setting. Diquafosol ophthalmic solution 3 % also demonstrated efficacy in various specific dry eye disorders, including aqueous-deficient dry eye, short tear film break-up time dry eye, obstructive meibomian gland dysfunction, dry eye following laser in situ keratomileusis surgery and dry eye following cataract surgery, as well as in contact lens wearers and visual display terminal users. Diquafosol ophthalmic solution 3 % was generally well tolerated in patients with dry eye, with eye irritation the most commonly reported adverse event. In conclusion, diquafosol ophthalmic solution 3 % is a useful option for the treatment of dry eye.

  4. Basics of Sterile Compounding: Ophthalmic Preparations, Part 2: Suspensions and Ointments.

    PubMed

    Allen, Loyd V

    2016-01-01

    Ophthalmic preparations are used to treat allergies, bacterial and viral infections, glaucoma, and numerous other eye conditions. When the eye's natural defensive mechanisms are compromised or overcome, an ophthalmic preparation, in a solution, suspension, or ointment form, may be indicated, with solutions being the most common form used to deliver a drug to the eye. This article discusses ophthalmic suspensions and ointments and represents part 2 of a 2-part article, the first of which discussed ophthalmic solutions. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

  5. 16 CFR 315.2 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... contact lens fitting. Ophthalmic goods are contact lenses, eyeglasses, or any component of eyeglasses. Ophthalmic services are the measuring, fitting, and adjusting of ophthalmic goods subsequent to an eye...

  6. 16 CFR 315.2 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... contact lens fitting. Ophthalmic goods are contact lenses, eyeglasses, or any component of eyeglasses. Ophthalmic services are the measuring, fitting, and adjusting of ophthalmic goods subsequent to an eye...

  7. 16 CFR 315.2 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... contact lens fitting. Ophthalmic goods are contact lenses, eyeglasses, or any component of eyeglasses. Ophthalmic services are the measuring, fitting, and adjusting of ophthalmic goods subsequent to an eye...

  8. 16 CFR 315.2 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... contact lens fitting. Ophthalmic goods are contact lenses, eyeglasses, or any component of eyeglasses. Ophthalmic services are the measuring, fitting, and adjusting of ophthalmic goods subsequent to an eye...

  9. 16 CFR 315.2 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... contact lens fitting. Ophthalmic goods are contact lenses, eyeglasses, or any component of eyeglasses. Ophthalmic services are the measuring, fitting, and adjusting of ophthalmic goods subsequent to an eye...

  10. Polymeric hydrogels for novel contact lens-based ophthalmic drug delivery systems: a review.

    PubMed

    Xinming, Li; Yingde, Cui; Lloyd, Andrew W; Mikhalovsky, Sergey V; Sandeman, Susan R; Howel, Carol A; Liewen, Liao

    2008-04-01

    Only about 5% of drugs administrated by eye drops are bioavailable, and currently eye drops account for more than 90% of all ophthalmic formulations. The bioavailability of ophthalmic drugs can be improved by a soft contact lens-based ophthalmic drug delivery system. Several polymeric hydrogels have been investigated for soft contact lens-based ophthalmic drug delivery systems: (i) polymeric hydrogels for conventional contact lens to absorb and release ophthalmic drugs; (ii) polymeric hydrogels for piggyback contact lens combining with a drug plate or drug solution; (iii) surface-modified polymeric hydrogels to immobilize drugs on the surface of contact lenses; (iv) polymeric hydrogels for inclusion of drugs in a colloidal structure dispersed in the lens; (v) ion ligand-containing polymeric hydrogels; (vi) molecularly imprinted polymeric hydrogels which provide the contact lens with a high affinity and selectivity for a given drug. Polymeric hydrogels for these contact lens-based ophthalmic drug delivery systems, their advantages and drawbacks are critically analyzed in this review.

  11. Eye health care in Hungary.

    PubMed

    Németh, J; Molnár, F; Kocur, I

    2002-01-01

    To describe eye health-care services provided by in patient Departments of Ophthalmology in Hungary as of 1998. A standardised questionnaire was sent to all Hungarian in-patient ophthalmic departments. The response rate was 100%, and data from six university departments and 56 hospitals with ophthalmic units are summarised. During the 12-month period, a total of 78,008 ophthalmic operations were performed, by 489 ophthalmologists. They worked in 62 in-patient ophthalmic units having a total of 1952 beds. The cataract rate was 3564 operations per million inhabitants; intraocular lens implantation was performed on 97% of the cases. There were 591 corneal transplants, 1698 operations for retinal detachment and 510 vitrectomies for diabetic eye complications. The level of ophthalmic care in Hungary, judged on the basis of key objective parameters including number of ophthalmic specialists, number of ophthalmic beds, and the rates of surgery, generally conforms to standards prevailing in Western Europe, in spite of financial difficulties and the consequent lack of investment in new equipment and instruments, both major and minor.

  12. Thin Film Coating Technology For Ophthalmic Lenses

    NASA Astrophysics Data System (ADS)

    Guenther, K. H.

    1986-05-01

    Coating of ophthalmic lenses is an application of high-vacuum coating technology which must satisfy not only physical and technical requirements but also customer demands with respect to aesthetics, color fidelity, and exchangeability of coated ophthalmic lenses. Because this application caters specifically to the consumer market, ophthalmic lenses are subject to certain fashion trends which frequently require quick adaptation of the coating technique. The state-of-the-art of ophthalmic lens coating is reviewed in this paper, with particular emphasis on the durability requirements in daily use by untrained consumers as well as on the applicable testing methods.

  13. What Is an Ophthalmologist?

    MedlinePlus

    ... medical tests and minor office surgery. Ophthalmic Registered Nurse These clinicians have undergone special nursing training and ... with hospital or office surgery. Some ophthalmic registered nurses also serve as clinic or hospital administrators. Ophthalmic ...

  14. Evaluation of the effectiveness of ophthalmic assistants as screeners for glaucoma in North India

    PubMed Central

    Sinha, S K; Astbury, N

    2011-01-01

    Aim To assess whether ophthalmic assistants are effective in screening people for glaucoma in India. Methodology The study subjects were examined by both trained ophthalmic assistants and an ophthalmologist in both hospital and community settings. Specific tests for the diagnosis of glaucoma suspects included visual field examination using frequency doubling technology perimetry, intraocular pressure measurement (Tonopen), A-scan central anterior chamber depth measurement and dilated optic disc examination. The findings recorded by the ophthalmic assistants were masked to the ophthalmologist to avoid measurement bias. Results In the hospital setting, there was a substantial level of agreement between the ophthalmic assistants and the ophthalmologist in the diagnosis of glaucoma suspects (89.29%, k=0.7, 95% confidence interval (CI)=0.54–0.86). The diagnostic accuracy of the ophthalmic assistants in detecting glaucoma suspects was high for sensitivity (95.2%, 95% CI=91.4–97.7%) but lower for specificity at 71.4% (95% CI=60.0–78.7%). In the community setting, there was a moderate level of agreement between the ophthalmic assistants and the ophthalmologist in the diagnosis of glaucoma suspects (78.23%, k=0.50, 95% CI=0.37–0.64). The diagnostic accuracy of the ophthalmic assistants in detecting glaucoma suspects was moderate for sensitivity (82.9, 95% CI=69.7–91.5%) but lower for specificity at 76.8% (95% CI=72.7–79.5%). Conclusion Ophthalmic assistants can be used for opportunistic case detection of glaucoma suspects in the community. Structured training of the ophthalmic assistants together with enhanced clinical experience would improve their performance in detecting glaucoma suspects in the community. PMID:21720416

  15. Referral patterns to an ophthalmic outpatient clinic by general practitioners and ophthalmic opticians and the role of these professionals in screening for ocular disease.

    PubMed

    Harrison, R J; Wild, J M; Hobley, A J

    1988-11-05

    Case notes of 1113 consecutive new patients referred to a consultant ophthalmologist at a district general hospital were reviewed to determine the source and efficacy of referrals and the current screening practices of general practitioners and ophthalmic opticians. General practitioners initiated referral in 546 cases (49%) and ophthalmic opticians referral in 439 (39%). Visual loss or visual disturbance was the most important single reason for referral (345 cases; 31%), followed by suspected glaucoma (145 cases; 13%), abnormalities of binocular vision (140; 12.5%), disorders of eyelids or ocular adnexa (127; 11%), and red eye (86; 8%). General practitioners referred many more patients with disorders of the eyelids and adnexa and ophthalmic opticians many more patients with suspected glaucoma. Ophthalmic opticians were far more likely than general practitioners to refer patients with suspected glaucoma correctly. A total of 180 patients (16%) were referred from ocular screening, in 149 cases by ophthalmic opticians and in 10 by general practitioners. Seventy patients had glaucoma or incomplete features of glaucoma, all of them referred by ophthalmic opticians. Of eight diabetic patients referred by ophthalmic opticians, three had asymptomatic disease and in two diabetes was diagnosed as a result of ocular screening. No patient was referred for asymptomatic diabetic retinopathy from screening by general practitioners. Ophthalmic opticians were more likely than general practitioners to diagnose retinopathy requiring photocoagulation. Use of a community based service to screen for glaucoma could save unnecessary consultant outpatient appointments. A similar service could facilitate detection of diabetic retinopathy at a stage when treatment is most effective.

  16. Referral patterns to an ophthalmic outpatient clinic by general practitioners and ophthalmic opticians and the role of these professionals in screening for ocular disease.

    PubMed Central

    Harrison, R. J.; Wild, J. M.; Hobley, A. J.

    1988-01-01

    Case notes of 1113 consecutive new patients referred to a consultant ophthalmologist at a district general hospital were reviewed to determine the source and efficacy of referrals and the current screening practices of general practitioners and ophthalmic opticians. General practitioners initiated referral in 546 cases (49%) and ophthalmic opticians referral in 439 (39%). Visual loss or visual disturbance was the most important single reason for referral (345 cases; 31%), followed by suspected glaucoma (145 cases; 13%), abnormalities of binocular vision (140; 12.5%), disorders of eyelids or ocular adnexa (127; 11%), and red eye (86; 8%). General practitioners referred many more patients with disorders of the eyelids and adnexa and ophthalmic opticians many more patients with suspected glaucoma. Ophthalmic opticians were far more likely than general practitioners to refer patients with suspected glaucoma correctly. A total of 180 patients (16%) were referred from ocular screening, in 149 cases by ophthalmic opticians and in 10 by general practitioners. Seventy patients had glaucoma or incomplete features of glaucoma, all of them referred by ophthalmic opticians. Of eight diabetic patients referred by ophthalmic opticians, three had asymptomatic disease and in two diabetes was diagnosed as a result of ocular screening. No patient was referred for asymptomatic diabetic retinopathy from screening by general practitioners. Ophthalmic opticians were more likely than general practitioners to diagnose retinopathy requiring photocoagulation. Use of a community based service to screen for glaucoma could save unnecessary consultant outpatient appointments. A similar service could facilitate detection of diabetic retinopathy at a stage when treatment is most effective. PMID:3144331

  17. Trends in ophthalmic antimicrobial utilization pattern in Bahrain between 1993 and 2000: a resurgence of chloramphenicol?

    PubMed

    Jassim Al Khaja, K A; Sequeira, R R; Mathur, V S

    2003-01-01

    The occurrence of aplastic anemia following topical administration of ophthalmic chloramphenicol is controversial and debated internationally. We have determined the influence of such debate on the utilization of ophthalmic chloramphenicol in Bahrain, through studying the utilization patterns of ophthalmic antimicrobial preparations by the Ministry of Health, with an emphasis on chloramphenicol, between 1993 and 2000. Cost-implications of these patterns are examined. Information on the annual purchase of ophthalmic antimicrobial drug preparations and their unit price was obtained from the Directorate of Materials Management, Ministry of Health, and analyzed. In 1993, the 3 most commonly purchased ophthalmic antibacterial preparations were oxytetracycline 1% eye ointment (40.1%); sulfacetamide 10% and 20% eye drops (25.3%); and chloramphenicol 0.5% eye drops and 1% eye ointment (10.8%). In 2000, oxytetracycline remained the most frequently purchased preparation (33%), followed by chloramphenicol (21.2%). Between 1993 and 1999, chloramphenicol purchases fluctuated between 10% to 16.4% with a remarkable increase to 21.2%, in 2000. Chloramphenicol accounted for 8.6% and 15.1% of cost of total ophthalmic preparations purchased in 1993 and 2000, respectively. Despite continued concerns of potential risks of ophthalmic chloramphenicol, this preparation is extensively utilized in Bahrain. We are of the opinion that for minor infections, chloramphenicol ophthalmic preparations should be replaced by safer alternatives. Further, we recommend that their use be reserved for ocular infections that are resistant to other antimicrobials, and that ophthalmologists, at the secondary care level, should supervise such treatment.

  18. Digital mobile telephones and interference of ophthalmic equipment.

    PubMed

    Ang, G S; Lian, P; Ng, W S; Whyte, I; Ong, J M

    2007-01-01

    To assess the effect of mobile telephone electromagnetic interference on electronic ophthalmic equipment. Prospective audit with mobile telephones placed at distances of 3 m, 1 m, and 30 cm from, and in contact with, electronic ophthalmic equipment. Any interruption or cessation of the function of the ophthalmic device was assessed with the mobile telephones in standby, and in dialling or receiving modes. Any alterations of displayed digital figures or numbers were also assessed. A total of 23 electronic ophthalmic devices in two hospital ophthalmology outpatient departments were evaluated. All six mobile telephones used, and 22 (95.7%) of the 23 ophthalmic equipment evaluated had the Conformité Européene (CE) mark. No device showed any interruption or cessation of function. There were no alterations of displayed digital figures or numbers. The only effect of any kind was found with four instruments (1 non-CE marked), where there was temporary flickering on the screen, and only occurred when the mobile telephones were dialling or receiving at a distance of 30 cm or less from the instruments. This study shows that among the electronic ophthalmic devices tested, none suffered failure or interruption of function, from mobile telephone interference. Although not comprehensive for all ophthalmic equipment, the results question the need for a complete ban of mobile telephones in ophthalmic departments. It highlights the need for a controlled, objectively measured study of the clinically relevant effects of mobile telephones in the ophthalmology outpatient setting.

  19. A workforce in crisis: a case study to expand allied ophthalmic personnel.

    PubMed

    Astle, William; Simms, Craig; Anderson, Lynn

    2016-08-01

    To examine how the development of allied ophthalmic personnel training programs affects human resource capacity. Using a qualitative case study method conducted at a single Ontario institution, this article describes 6 years of establishing a 2-tiered allied ophthalmic personnel training program. The Kingston Ophthalmic Training Centre participated in the study with 8 leadership and program graduate interviews. To assess regional eye health workforce needs, a case study and iterative process used triangulations of the literature, case study, and qualitative interviews with stakeholders. This research was used to develop a model for establishing allied ophthalmic personnel training programs that would result in expanding human resource capacity. Current human resource capacity development and deployment is inadequate to provide the needed eye care services in Canada. A competency-based curriculum and accreditation model as the platform to develop formal academic training programs is essential. Access to quality eye care and patient services can be met by task-shifting from ophthalmologists to appropriately trained allied ophthalmic personnel. Establishing formal training programs is one important strategy to supplying a well-skilled, trained, and qualified ophthalmic workforce. This initiative meets the criteria required for quality, relevance, equity, and cost-effectiveness to meet the future demands for ophthalmic patient care. Copyright © 2016 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  20. Cyclopentolate Ophthalmic

    MedlinePlus

    ... e.g., use sunglasses). Cyclopentolate may make your eyes sensitive to sunlight.you should know that ophthalmic cyclopentolate contains benzalkonium chloride, which can be absorbed by soft contact lenses. If you wear contact lenses, remove them before instilling ophthalmic cyclopentolate.

  1. Salvage/Adjuvant Brachytherapy After Ophthalmic Artery Chemosurgery for Intraocular Retinoblastoma

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Francis, Jasmine H., E-mail: francij1@mskcc.org; Barker, Christopher A.; Wolden, Suzanne L.

    2013-11-01

    Purpose: To evaluate the efficacy and toxicity of brachytherapy after ophthalmic artery chemosurgery (OAC) for retinoblastoma. Methods and Materials: This was a single-arm, retrospective study of 15 eyes in 15 patients treated with OAC followed by brachytherapy at (blinded institution) between May 1, 2006, and December 31, 2012, with a median 19 months' follow-up from plaque insertion. Outcome measurements included patient and ocular survival, visual function, and retinal toxicity measured by electroretinogram (ERG). Results: Brachytherapy was used as adjuvant treatment in 2 eyes and as salvage therapy in 13 eyes of which 12 had localized vitreous seeding. No patients developedmore » metastasis or died of retinoblastoma. The Kaplan-Meier estimate of ocular survival was 79.4% (95% confidence interval 48.7%-92.8%) at 18 months. Three eyes were enucleated, and an additional 6 eyes developed out-of-target volume recurrences, which were controlled with additional treatments. Patients with an ocular complication had a mean interval between last OAC and plaque of 2.5 months (SD 2.3 months), which was statistically less (P=.045) than patients without ocular complication who had a mean interval between last OAC and plaque of 6.5 months (SD 4.4 months). ERG responses from pre- versus postplaque were unchanged or improved in more than half the eyes. Conclusions: Brachytherapy following OAC is effective, even in the presence of vitreous seeding; the majority of eyes maintained stable or improved retinal function following treatment, as assessed by ERG.« less

  2. Ophthalmic adverse drug reactions to systemic drugs: a systematic review.

    PubMed

    Miguel, Ana; Henriques, Filipe; Azevedo, Luís Filipe; Pereira, Altamiro Costa

    2014-03-01

    To perform a comprehensive and systematic review regarding ophthalmic adverse drug reactions (ADRs) to systemic drugs to: (i) systematically summarize existing evidence, (ii) identify areas, ophthalmic ADRs or drugs that lacked systematization or assessment (namely drugs with original studies characterizing specific ophthalmic ADRs but without causality assessment nor without meta-analysis). Systematic review of several electronic databases (last search 1/7/2012): Medline, SCOPUS, ISI web of knowledge, ISI Conference Proceedings, International Pharmaceutical Abstracts and Google scholar. Search query included: eye, ocular, ophthalmic, ophthalmology, adverse and reaction. Inclusion criteria were: (i) Primary purpose was to assess an ophthalmic ADR to a systemic medication; (ii) Patient evaluation performed by an ophthalmologist; (iii) Studies that specified diagnostic criteria for an ocular ADR. Different types of studies were included and analyzed separately. Two independent reviewers assessed eligibility criteria, extracted data and evaluated risk of bias. From 562 studies found, 32 were included (1 systematic review to sildenafil, 11 narrative reviews, 1 trial, 1 prospective study, 6 transversal studies, 6 spontaneous reports and 6 case series). Drugs frequently involved included amiodarone, sildenafil, hydroxychloroquine and biphosphonates. Frequent ophthalmic ADRs included: keratopathy, dry eye and retinopathy. To increase evidence about ophthalmic ADRs, there is a need for performing specific systematic reviews, applying strictly the World Health Organization's (WHO) definition of ADR and WHO causality assessment of ADRs. Some ophthalmic ADRs may be frequent, but require ophthalmological examination; therefore, ophthalmologists' education and protocols of collaboration between other specialties whenever they prescribe high-risk drugs are suggestions for the future. Copyright © 2014 John Wiley & Sons, Ltd.

  3. International Council of Ophthalmology: Refocusing Ophthalmic Education in the Asia-Pacific Region and Beyond.

    PubMed

    Golnik, Karl; Mayorga, Eduardo; Spivey, Bruce; Ritch, Robert; Gauthier, Tina-Marie

    2012-01-01

    The International Council of Ophthalmology (ICO) is a global organization with a regional focus. Working in partnership with supranational and ICO member societies, the ICO is building a "World Alliance for Sight" to improve access to the highest-quality eye care worldwide. Designed to preserve and restore vision on an international scale, the ICO initiative, "Refocusing Ophthalmic Education," enhances ophthalmic education of residents, subspecialists, medical students, and allied eye care personnel by redefining the most effective ways to teach and in creating beneficial educational opportunities. The "Teaching the Teachers" program helps ophthalmic educators incorporate more effective methods of training and continuing professional development to meet societal needs, achieved in part through regional courses for residency program directors; symposia, and keynote talks presented by ICO's World Ophthalmology Educational Colloquium, Conferences for Ophthalmic Educators, and ophthalmic surgical competency rubrics. Recognizing that standardized curricula are essential for consistent ophthalmic education, the ICO has developed a curricular framework whereby goals, expectations, knowledge base, competencies, and technical training are delineated. The ICO is defining worldwide models of team training and compiling best practice, which will include training-program accreditation to ensure improvement in the education of ophthalmologists. International Council of Ophthalmology Web-based teaching courses, a Webinar Network, and a technology blog further support information and communication technologies for teaching and learning. At the ICO's Center for Ophthalmic Educators (educators.icoph.org), trainers will find valuable teaching resources in multiple languages as well as ways to share ideas and collaborate with peers and other ophthalmic educators.

  4. Evaluation of the cytotoxic effects of ophthalmic solutions containing benzalkonium chloride on corneal epithelium using an organotypic 3-D model

    PubMed Central

    Khoh-Reiter, Su; Jessen, Bart A

    2009-01-01

    Background Benzalkonium chloride (BAC) is a common preservative used in ophthalmic solutions. The aim of this study was to compare the cytotoxic effects of BAC-containing ophthalmic solutions with a BAC-free ophthalmic solution using an organotypic 3-dimensional (3-D) corneal epithelial model and to determine the effects of latanoprost ophthalmic solution and its BAC-containing vehicle on corneal thickness in a monkey model. Methods The cytotoxicity of commercially available BAC-containing ophthalmic formulations of latanoprost (0.02% BAC) and olopatadine (0.01% BAC) was compared to that of BAC-free travoprost and saline in a corneal organotypic 3-D model using incubation times of 10 and 25 minutes. To compare the extent of differentiation of 3-D corneal cultures to monolayer transformed human corneal epithelial (HCE-T) cell cultures, expression levels (mRNA and protein) of the corneal markers epidermal growth factor receptor, transglutaminase 1 and involucrin were quantified. Finally, latanoprost ophthalmic solution or its vehicle was administered at suprapharmacologic doses (two 30 μL drops twice daily in 1 eye for 1 year) in monkey eyes, and corneal pachymetry was performed at baseline and at weeks 4, 13, 26 and 52. Results In the 3-D corneal epithelial culture assays, there were no significant differences in cytotoxicity between the BAC-containing latanoprost and olopatadine ophthalmic solutions and BAC-free travoprost ophthalmic solution at either the 10- or 25-minute time points. The 3-D cultures expressed higher levels of corneal epithelial markers than the HCE-T monolayers, indicating a greater degree of differentiation. There were no significant differences between the corneal thickness of monkey eyes treated with latanoprost ophthalmic solution or its vehicle (both containing 0.02% BAC) and untreated eyes. Conclusion The lack of cytotoxicity demonstrated in 3-D corneal cultures and in monkey studies suggests that the levels of BAC contained in ophthalmic solutions are not likely to cause significant direct toxicity to epithelium of otherwise normal corneas. PMID:19638217

  5. Alternative methods of ophthalmic treatment in Russia.

    PubMed

    Vader, L

    1994-04-01

    Russian ophthalmic nurses and physicians are using alternative methods of treatment to supplement traditional eye care. As acupuncture and iridology become more popular in the United States, ophthalmic nurses need to be more knowledgeable about these treatments and the implications for patients.

  6. The international council of ophthalmology: vision for ophthalmic education in an interdependent world.

    PubMed

    Lee, Andrew G; Golnik, Karl C; Tso, Mark O M; Spivey, Bruce; Miller, Kathleen; Gauthier, Tina-Marie

    2012-10-01

    To describe the emerging strategic global perspective of the International Council of Ophthalmology (ICO) efforts in ophthalmic education. A global perspective describing how the development of sophisticated educational tools in tandem with information technology can revolutionize ophthalmic education worldwide. Review of ICO educational tools, resources, and programs that are available to ophthalmic educators across the globe. With the explosive growth of the Internet, the ability to access medical information in the most isolated of locations is now possible. Through specific ICO initiatives, including the ICO curricula, the "Teaching the Teachers" program, and the launching of the new ICO Center for Ophthalmic Educators, the ICO is providing ophthalmic educators across the globe with access to standardized but customizable educational programs and tools to better train ophthalmologists and allied eye care professionals throughout the world. Access to educational tools and strengthening of global learning will help providers meet the goals of VISION 2020 and beyond in eliminating avoidable blindness. It is the intent of the ICO that its programs for ophthalmic educators, including conferences, courses, curricula, and online resources, result in better-trained ophthalmologists and eye care professionals worldwide. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Netarsudil Ophthalmic

    MedlinePlus

    ... an eye injury or develop an eye or eye lid infection while using netarsudil ophthalmic solution, ask your doctor if you can continue using netarsudil ophthalmic.If you wear contact lenses, remove them before instilling netarsudil. You may put them back in 15 minutes after you instill the drops.

  8. 16 CFR 456.1 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... the use of objective or subjective tests. (c) Ophthalmic goods are eyeglasses, or any component of eyeglasses, and contact lenses. (d) Ophthalmic services are the measuring, fitting, and adjusting of... Practices FEDERAL TRADE COMMISSION TRADE REGULATION RULES OPHTHALMIC PRACTICE RULES (EYEGLASS RULE) § 456.1...

  9. 16 CFR 456.1 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... the use of objective or subjective tests. (c) Ophthalmic goods are eyeglasses, or any component of eyeglasses, and contact lenses. (d) Ophthalmic services are the measuring, fitting, and adjusting of... Practices FEDERAL TRADE COMMISSION TRADE REGULATION RULES OPHTHALMIC PRACTICE RULES (EYEGLASS RULE) § 456.1...

  10. 16 CFR 456.1 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... the use of objective or subjective tests. (c) Ophthalmic goods are eyeglasses, or any component of eyeglasses, and contact lenses. (d) Ophthalmic services are the measuring, fitting, and adjusting of... Practices FEDERAL TRADE COMMISSION TRADE REGULATION RULES OPHTHALMIC PRACTICE RULES (EYEGLASS RULE) § 456.1...

  11. 76 FR 23640 - Small Business Size Standards: Waiver of the Nonmanufacturer Rule

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-27

    ... (Ophthalmic Instruments, Equipment, and Supplies), under the North American Industry Classification System...(a) Business Development (BD) program. DATES: Comments and source information must be submitted May... under PSC 6540 (Ophthalmic Instruments, Equipment, and Supplies), under NAICS code 339115 (Ophthalmic...

  12. Moxifloxacin Ophthalmic

    MedlinePlus

    Moxifloxacin ophthalmic solution is used to treat bacterial conjunctivitis (pink eye; infection of the membrane that covers the outside of the ... Moxifloxacin comes as an ophthalmic solution (liquid) to instill in the eyes. It is usually used three times a day for 7 days. Try to use at ...

  13. 75 FR 36101 - Dermatologic and Ophthalmic Drugs Advisory Committee; Cancellation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-24

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0001] Dermatologic and Ophthalmic Drugs Advisory Committee; Cancellation AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The meeting of the Dermatologic and Ophthalmic Drugs Advisory Committee...

  14. 21 CFR 886.4350 - Manual ophthalmic surgical instrument.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Manual ophthalmic surgical instrument. 886.4350 Section 886.4350 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... suturing needle, lachrymal probe, trabeculotomy probe, cornea-sclera punch, ophthalmic retractor...

  15. Association of Midfacial Fractures with Ophthalmic Injury

    PubMed Central

    Politis, Constantinus; Kluyskens, Alexandra; Dormaar, Titiaan

    2017-01-01

    The aim of this study is to evaluate the incidence of ophthalmic complications following midfacial fractures and investigate its relation to surgical or nonsurgical treatment. This article is a retrospective study, describing the spectrum and incidence of ophthalmic injury in 106 patients presenting with midfacial fractures at the Department of Oral and Maxillofacial Surgery of the University Hospitals Leuven over a period of 16 months (January 2013 to April 2014). The mean age of the patients was 45.6 years with a gender distribution of 68 men and 38 women. The main cause of trauma was road traffic accidents. Forty-one patients suffered an ophthalmic injury following the fracture. Twelve of them had a persistent ophthalmic problem. Ophthalmic examination is necessary during the initial management. The time window for preservation of sight is small and treatment should be started immediately. Development of an emergency trauma scale that includes fractures, symptoms of visual impairment, and patient history is recommended and should stimulate a multidisciplinary approach of complex cases. PMID:28523083

  16. ANAESTHESIA FOR OPHTHALMIC SURGICAL PROCEDURES.

    PubMed

    Onakpoya, O H; Asudo, F D; Adeoye, A O

    2014-03-01

    Ophthalmic surgical procedures are performed under anaesthesia to enhance comfort and cooperation of patient. To review factors influencing the choice of anaesthesia for ophthalmic surgical procedures. Restrospective descriptive study. Eye unit of a tertiary hospital. All patients who had ophthalmic surgeries in the operating theatre from January 2002 to December 2009. Two hundred and ninety ophthalmic surgeries were carried out during the study period. Age range was 1-95 years and mean of 61.0 ± 1.9; most (55%) were elderly while 4.8% were children. One hundred and fourty seven (50.7%) were males, 143(49.3%) females; male:female of 1.03:1. Local anaesthesia was the more commonly (92.1%) employed while general anaesthesia was used in 23(7.9%) patients. General anaesthesia was used more frequently (71.4%) in children compared to other age groups; the mean age and standard error of means for patients who had general anaesthesia (27.2 /5.4 years) is smaller compared to 63.9/0.93 years for patients who had local anaesthesia (p < 0.0001). Regional anaesthesia was the most frequently used for all types of procedures except for eye wall repairs in which general anaesthesia was used for 71.4% of patients (p < 0.0001). General anaesthesia was indicated in seven (41.2%) of emergency ophthalmic surgical procedures as compared to 16 (5.9%) of elective ophthalmic procedures P < 0.0001. General anaesthesia was more commonly employed in children, eye wall repairs and emergency ophthalmic surgical procedures.

  17. 21 CFR 524.390d - Chloramphenicol-prednisolone ophthalmic ointment.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS OPHTHALMIC AND TOPICAL DOSAGE FORM NEW ANIMAL DRUGS § 524.390d Chloramphenicol-prednisolone ophthalmic ointment. (a) Specifications. Each gram...) Limitations. Therapy for cats should not exceed 7 days, prolonged use in cats may produce blood dyscrasia. As...

  18. 21 CFR 524.1484 - Neomycin sulfate ophthalmic and topical dosage forms.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 6 2013-04-01 2013-04-01 false Neomycin sulfate ophthalmic and topical dosage forms. 524.1484 Section 524.1484 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... NEW ANIMAL DRUGS § 524.1484 Neomycin sulfate ophthalmic and topical dosage forms. ...

  19. 21 CFR 524.1044 - Gentamicin sulfate ophthalmic and topical dosage forms.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Gentamicin sulfate ophthalmic and topical dosage forms. 524.1044 Section 524.1044 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... NEW ANIMAL DRUGS § 524.1044 Gentamicin sulfate ophthalmic and topical dosage forms. ...

  20. 21 CFR 524.1484 - Neomycin sulfate ophthalmic and topical dosage forms.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Neomycin sulfate ophthalmic and topical dosage forms. 524.1484 Section 524.1484 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... NEW ANIMAL DRUGS § 524.1484 Neomycin sulfate ophthalmic and topical dosage forms. ...

  1. 21 CFR 524.1044c - Gentamicin sulfate ophthalmic ointment.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 6 2013-04-01 2013-04-01 false Gentamicin sulfate ophthalmic ointment. 524.1044c... § 524.1044c Gentamicin sulfate ophthalmic ointment. (a) Specifications. Each gram of ointment contains gentamicin sulfate equivalent to 3 milligrams of gentamicin. (b) Sponsors. See Nos. 000061 and 043264 in...

  2. 21 CFR 524.1044c - Gentamicin sulfate ophthalmic ointment.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Gentamicin sulfate ophthalmic ointment. 524.1044c... § 524.1044c Gentamicin sulfate ophthalmic ointment. (a) Specifications. Each gram of ointment contains gentamicin sulfate equivalent to 3 milligrams of gentamicin. (b) Sponsors. See Nos. 000061 and 025463 in...

  3. 21 CFR 524.1484 - Neomycin sulfate ophthalmic and topical dosage forms.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 6 2012-04-01 2012-04-01 false Neomycin sulfate ophthalmic and topical dosage forms. 524.1484 Section 524.1484 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... NEW ANIMAL DRUGS § 524.1484 Neomycin sulfate ophthalmic and topical dosage forms. ...

  4. 21 CFR 524.1044c - Gentamicin sulfate ophthalmic ointment.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 6 2012-04-01 2012-04-01 false Gentamicin sulfate ophthalmic ointment. 524.1044c... § 524.1044c Gentamicin sulfate ophthalmic ointment. (a) Specifications. Each gram of ointment contains gentamicin sulfate equivalent to 3 milligrams of gentamicin. (b) Sponsors. See Nos. 000061 and 025463 in...

  5. 21 CFR 524.1044 - Gentamicin sulfate ophthalmic and topical dosage forms.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 6 2011-04-01 2011-04-01 false Gentamicin sulfate ophthalmic and topical dosage forms. 524.1044 Section 524.1044 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... NEW ANIMAL DRUGS § 524.1044 Gentamicin sulfate ophthalmic and topical dosage forms. ...

  6. 21 CFR 524.1044 - Gentamicin sulfate ophthalmic and topical dosage forms.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 6 2013-04-01 2013-04-01 false Gentamicin sulfate ophthalmic and topical dosage forms. 524.1044 Section 524.1044 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... NEW ANIMAL DRUGS § 524.1044 Gentamicin sulfate ophthalmic and topical dosage forms. ...

  7. 21 CFR 524.1044 - Gentamicin sulfate ophthalmic and topical dosage forms.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 6 2012-04-01 2012-04-01 false Gentamicin sulfate ophthalmic and topical dosage forms. 524.1044 Section 524.1044 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... NEW ANIMAL DRUGS § 524.1044 Gentamicin sulfate ophthalmic and topical dosage forms. ...

  8. 21 CFR 524.1484 - Neomycin sulfate ophthalmic and topical dosage forms.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 6 2011-04-01 2011-04-01 false Neomycin sulfate ophthalmic and topical dosage forms. 524.1484 Section 524.1484 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... NEW ANIMAL DRUGS § 524.1484 Neomycin sulfate ophthalmic and topical dosage forms. ...

  9. 21 CFR 524.1044c - Gentamicin sulfate ophthalmic ointment.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 6 2011-04-01 2011-04-01 false Gentamicin sulfate ophthalmic ointment. 524.1044c... § 524.1044c Gentamicin sulfate ophthalmic ointment. (a) Specifications. Each gram of ointment contains gentamicin sulfate equivalent to 3 milligrams of gentamicin. (b) Sponsors. See Nos. 000061 and 025463 in...

  10. 21 CFR 886.1430 - Ophthalmic contact lens radius measuring device.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic contact lens radius measuring device... lens radius measuring device. (a) Identification. An ophthalmic contact lens radius measuring device is... lens. (b) Classification. Class I (general controls). The device is exempt from the premarket...

  11. 21 CFR 524.1662 - Oxytetracycline hydrochloride ophthalmic and topical dosage forms.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Oxytetracycline hydrochloride ophthalmic and topical dosage forms. 524.1662 Section 524.1662 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... DOSAGE FORM NEW ANIMAL DRUGS § 524.1662 Oxytetracycline hydrochloride ophthalmic and topical dosage forms. ...

  12. 21 CFR 524.390a - Chloramphenicol ophthalmic ointment.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 6 2011-04-01 2011-04-01 false Chloramphenicol ophthalmic ointment. 524.390a Section 524.390a Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS OPHTHALMIC AND TOPICAL DOSAGE FORM NEW ANIMAL DRUGS...

  13. 21 CFR 524.390a - Chloramphenicol ophthalmic ointment.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Chloramphenicol ophthalmic ointment. 524.390a Section 524.390a Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS OPHTHALMIC AND TOPICAL DOSAGE FORM NEW ANIMAL DRUGS...

  14. Serum sialic acid levels in patients with sympathetic ophthalmitis.

    PubMed

    Lamba, P A; Pandey, P K; Sarin, G S; Mathur, M D

    1993-12-01

    Serum sialic acid levels were measured in 16 patients with sympathetic ophthalmitis, 36 with neglected traumatic uveitis following penetrating injury and 40 healthy subjects. There was no significant alteration of its level in patients with traumatic uveitis. However, its level was significantly elevated in patients with sympathetic ophthalmitis. It was high even in the early stage of the disease. It decreased significantly at the remission stage. It is proposed that measurement of sialic acid level in serum can be used as a diagnostic aid when the diagnosis of sympathetic ophthalmitis remains doubtful on clinical grounds. The extent of rise in its level may be considered a good parameter of the degree of severity of sympathetic ophthalmitis. It may also act as a useful tool to evaluate the drug efficacy in this disease.

  15. Dose uniformity of loteprednol etabonate ophthalmic gel (0.5%) compared with branded and generic prednisolone acetate ophthalmic suspension (1%).

    PubMed

    Marlowe, Zora T; Davio, Stephen R

    2014-01-01

    Loteprednol etabonate (LE) ophthalmic gel 0.5% (Lotemax®) is a new polycarbophil-based, nonsettling topical ophthalmic formulation. The formulation is a semisolid gel at rest and a shear thinning fluid when expressed through a dropper tip. The present study was undertaken to determine how the nonsettling character of LE ophthalmic gel affects dose uniformity. Prednisolone acetate ophthalmic suspension 1% (Pred Forte®) and a generic prednisolone acetate suspension 1% were used as comparators. Drug concentrations of LE ophthalmic gel, Pred Forte, and a generic prednisolone acetate suspension were determined following simulated dosing - consisting of 2 drops, expressed four times daily for 2 weeks, with bottles that were shaken or not shaken immediately prior to expressing the drops. Drug concentrations were determined using a reverse-phase high-performance liquid chromatography (HPLC) method and reported as a percentage of the declared (labeled) concentration. Comparative kinetics of drug particle sedimentation were also determined for each formulation, using dispersion analysis under gravity. Mean drug concentrations in drops of all three formulations were within a few percentage points of the declared concentration when the bottles were shaken for 5 seconds prior to dispensing. Only LE ophthalmic gel showed consistent and on-target concentrations when the bottles were unshaken prior to dispensing, with a mean (standard deviation [SD]) percent declared concentration of 102% (1.92%) over the 2-week dosing regimen. Drug concentrations for the branded and generic prednisolone acetate suspensions following expression from unshaken bottles were highly variable (overall relative SDs of 16.8% and 20.3%, respectively), with mean concentrations for both falling significantly below the declared concentration for drops expressed at the beginning of the 2-week dosing regimen and significantly above the declared concentration for drops expressed near the end of the dosing regimen. Dispersion analysis at 120× g showed no drug particle sedimentation for LE ophthalmic gel over the 24-hour testing period, whereas the prednisolone acetate suspensions settled in less than 6 hours. LE ophthalmic gel 0.5% provided consistent dose uniformity at the declared concentration whether or not the bottle was shaken prior to dispensing, whereas Pred Forte® and the generic prednisolone acetate required shaking to provide consistent drug concentrations. LE ophthalmic gel may be beneficial to patients because it eliminates the potential impact on the clinical response of both under- and overdosing.

  16. [Optimization of benzalkonium chloride concentration in 0.0015% tafluprost ophthalmic solution from the points of ocular surface safety and preservative efficacy].

    PubMed

    Asada, Hiroyuki; Takaoka-Shichijo, Yuko; Nakamura, Masatsugu; Kimura, Akio

    2010-06-01

    Optimization of benzalkonium chloride (alkyl dimethylbenzylammonium chloride: BAK) concentration as preservative in 0.0015% tafluprost ophthalmic solution (Tapros 0.0015% ophthalmic solution), an anti-glaucoma medicine, was examined from the points of ocular surface safety and preservative efficacy. BAKC(12), which is dodecyl dimethylbenzylammonium chloride, and BAKmix, which is the mixture of dodecyl, tetradecyl and hexadecyl dimethylbenzylammonium chloride were used in this study. The effects of BAKC(12) concentrations and the BAK types, BAKC(12) and BAKmix, in tafluprost ophthalmic solution on ocular surface safety were evaluated using the in vitro SV 40-immobilized human corneal epithelium cell line (HCE-T). Following treatments of Tafluprost ophthalmic solutions with BAKC(12), its concentration dependency was observed on cell viability of HCE-T. The cell viability of HCE-T after treatment of these solutions with 0.001% to 0.003% BAKC(12) for 5 minutes were the same level as that after treatment of the solution without BAK. Tafluprost ophthalmic solution with 0.01% BAKC(12) was safer for the ocular surface than the same solution with 0.01% BAKmix. Preservatives-effectiveness tests of tafluprost ophthalmic solutions with various concentrations of BAKC(12) were performed according to the Japanese Pharmacopoeia (JP), and solutions with more than 0.0005% BAKC(12) conformed to JP criteria. It was concluded that 0.0005% to 0.003% of BAKC(12) in tafluprost ophthalmic solution was optimal, namely, well-balanced from the points of ocular surface safety and preservative efficacy.

  17. 21 CFR 886.4570 - Ophthalmic surgical marker.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ophthalmic surgical marker. 886.4570 Section 886.4570 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...) Identification. An ophthalmic surgical marker is a device intended to mark by use of ink, dye, or indentation the...

  18. 21 CFR 886.4570 - Ophthalmic surgical marker.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic surgical marker. 886.4570 Section 886.4570 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...) Identification. An ophthalmic surgical marker is a device intended to mark by use of ink, dye, or indentation the...

  19. 21 CFR 886.4570 - Ophthalmic surgical marker.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Ophthalmic surgical marker. 886.4570 Section 886.4570 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...) Identification. An ophthalmic surgical marker is a device intended to mark by use of ink, dye, or indentation the...

  20. 21 CFR 886.4570 - Ophthalmic surgical marker.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Ophthalmic surgical marker. 886.4570 Section 886.4570 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...) Identification. An ophthalmic surgical marker is a device intended to mark by use of ink, dye, or indentation the...

  1. 21 CFR 886.4570 - Ophthalmic surgical marker.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Ophthalmic surgical marker. 886.4570 Section 886.4570 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...) Identification. An ophthalmic surgical marker is a device intended to mark by use of ink, dye, or indentation the...

  2. 78 FR 77688 - Ophthalmic Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-24

    ...] Ophthalmic Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting AGENCY: Food and Drug...: Ophthalmic Devices Panel of the Medical Devices Advisory Committee. General Function of the Committee: To... Swink, Center for Devices and Radiological Health, Food and Drug Administration, 10903 New Hampshire Ave...

  3. The ideal imaging AR waveguide

    NASA Astrophysics Data System (ADS)

    Grey, David J.

    2017-06-01

    Imaging waveguides are a key development that are helping to create the Augmented Reality revolution. They have the ability to use a small projector as an input and produce a wide field of view, large eyebox, full colour, see-through image with good contrast and resolution. WaveOptics is at the forefront of this AR technology and has developed and demonstrated an approach which is readily scalable. This paper presents our view of the ideal near-to-eye imaging AR waveguide. This will be a single-layer waveguide which can be manufactured in high volume and low cost, and is suitable for small form factor applications and all-day wear. We discuss the requirements of the waveguide for an excellent user experience. When enhanced (AR) viewing is not required, the waveguide should have at least 90% transmission, no distracting artifacts and should accommodate the user's ophthalmic prescription. When enhanced viewing is required, additionally, the waveguide requires excellent imaging performance, this includes resolution to the limit of human acuity, wide field of view, full colour, high luminance uniformity and contrast. Imaging waveguides are afocal designs and hence cannot provide ophthalmic correction. If the user requires this correction then they must wear either contact lenses, prescription spectacles or inserts. The ideal imaging waveguide would need to cope with all of these situations so we believe it must be capable of providing an eyebox at an eye relief suitable for spectacle wear which covers a significant range of population inter-pupillary distances. We describe the current status of our technology and review existing imaging waveguide technologies against the ideal component.

  4. Communication: an ophthalmic practice issue.

    PubMed

    Whitton, S J

    1995-12-01

    In the 1990's communication becomes an ophthalmic practice issue. The present ophthalmic climate of cost containment, downsizing, budget cuts, and lack of appreciation of contributions, results in a low staff morale. Recognition of the effects of job satisfaction and productivity led one group to seek solutions. A communication task force was formed to identify problems and the appropriate interventions.

  5. 75 FR 35495 - Ophthalmic Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-22

    ...] Ophthalmic Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting AGENCY: Food and Drug...: Ophthalmic Devices Panel of the Medical Devices Advisory Committee. General Function of the Committee: To... Glaukos iStent Trabecular Micro-Bypass Stent, Model GTS-100 L/R, sponsored by Glaukos Corp. The device is...

  6. 21 CFR 524.1484e - Neomycin sulfate and polymyxin B sulfate ophthalmic solution.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 6 2012-04-01 2012-04-01 false Neomycin sulfate and polymyxin B sulfate... DOSAGE FORM NEW ANIMAL DRUGS § 524.1484e Neomycin sulfate and polymyxin B sulfate ophthalmic solution. (a) Specifications. Each milliliter of the ophthalmic preparation contains 5.0 milligrams neomycin sulfate (3.5...

  7. 21 CFR 524.1484e - Neomycin sulfate and polymyxin B sulfate ophthalmic solution.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 6 2013-04-01 2013-04-01 false Neomycin sulfate and polymyxin B sulfate... DOSAGE FORM NEW ANIMAL DRUGS § 524.1484e Neomycin sulfate and polymyxin B sulfate ophthalmic solution. (a) Specifications. Each milliliter of the ophthalmic preparation contains 5.0 milligrams neomycin sulfate (3.5...

  8. 21 CFR 524.1484e - Neomycin sulfate and polymyxin B sulfate ophthalmic solution.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 6 2011-04-01 2011-04-01 false Neomycin sulfate and polymyxin B sulfate... DOSAGE FORM NEW ANIMAL DRUGS § 524.1484e Neomycin sulfate and polymyxin B sulfate ophthalmic solution. (a) Specifications. Each milliliter of the ophthalmic preparation contains 5.0 milligrams neomycin sulfate (3.5...

  9. 21 CFR 524.1484e - Neomycin sulfate and polymyxin B sulfate ophthalmic solution.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Neomycin sulfate and polymyxin B sulfate... DOSAGE FORM NEW ANIMAL DRUGS § 524.1484e Neomycin sulfate and polymyxin B sulfate ophthalmic solution. (a) Specifications. Each milliliter of the ophthalmic preparation contains 5.0 milligrams neomycin sulfate (3.5...

  10. 10 CFR 35.433 - Decay of strontium-90 sources for ophthalmic treatments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Decay of strontium-90 sources for ophthalmic treatments... Brachytherapy § 35.433 Decay of strontium-90 sources for ophthalmic treatments. (a) Only an authorized medical physicist shall calculate the activity of each strontium-90 source that is used to determine the treatment...

  11. 10 CFR 35.433 - Decay of strontium-90 sources for ophthalmic treatments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Decay of strontium-90 sources for ophthalmic treatments... Brachytherapy § 35.433 Decay of strontium-90 sources for ophthalmic treatments. (a) Only an authorized medical physicist shall calculate the activity of each strontium-90 source that is used to determine the treatment...

  12. 10 CFR 35.433 - Decay of strontium-90 sources for ophthalmic treatments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 1 2011-01-01 2011-01-01 false Decay of strontium-90 sources for ophthalmic treatments... Brachytherapy § 35.433 Decay of strontium-90 sources for ophthalmic treatments. (a) Only an authorized medical physicist shall calculate the activity of each strontium-90 source that is used to determine the treatment...

  13. 10 CFR 35.433 - Decay of strontium-90 sources for ophthalmic treatments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Decay of strontium-90 sources for ophthalmic treatments... Brachytherapy § 35.433 Decay of strontium-90 sources for ophthalmic treatments. (a) Only an authorized medical physicist shall calculate the activity of each strontium-90 source that is used to determine the treatment...

  14. 10 CFR 35.433 - Decay of strontium-90 sources for ophthalmic treatments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 1 2012-01-01 2012-01-01 false Decay of strontium-90 sources for ophthalmic treatments... Brachytherapy § 35.433 Decay of strontium-90 sources for ophthalmic treatments. (a) Only an authorized medical physicist shall calculate the activity of each strontium-90 source that is used to determine the treatment...

  15. METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS INFECTIONS OF THE EYE AND ORBIT (AN AMERICAN OPHTHALMOLOGICAL SOCIETY THESIS)

    PubMed Central

    Blomquist, Preston Howard

    2006-01-01

    Purpose To ascertain if methicillin-resistant Staphyloccocus aureus (MRSA) ophthalmic infections are increasing. Methods A retrospective review of all patients with a culture positive for MRSA in the Parkland Health and Hospital System, the urban public healthcare system for Dallas County, Texas, for the years 2000 through 2004 was performed. Patients with ocular, orbital, and ocular adnexal infection were identified, and isolates were categorized as nosocomial or community-acquired (CA). Results A total of 3,640 patients with a culture positive for MRSA were identified, with 1,088 patients (30%) considered to have acquired the isolate via nosocomial transmission and 2,552 patients (70%) considered to have CA-MRSA. Forty-nine patients (1.3%) had ophthalmic MRSA involvement. For both ophthalmic and nonophthalmic cases, the number of CA-MRSA patients increased each year, whereas the numbers of nosocomial patients remained fairly constant. Patients with ophthalmic MRSA tended to be younger than other MRSA patients (P = .023). The most common manifestation of ophthalmic MRSA infection was preseptal cellulitis and/or lid abscess followed by conjunctivitis, but sight-threatening infections, including corneal ulcers, endophthalmitis, orbital cellulitis, and blebitis, also occurred. Empirical antibiotic coverage was initially prescribed in 48 (98%) of ophthalmic cases and did not adequately cover for the MRSA isolate in 24 (50%). Conclusions CA-MRSA is becoming increasingly prevalent, and ophthalmologists will see more ophthalmic MRSA infections. Although ophthalmic CA-MRSA commonly presents as preseptal lid infection and conjunctivitis, sight-threatening infections also occur. Ophthalmologists must identify MRSA patients, adjust empirical treatment regimens where MRSA is endemic, and take steps to control emergence of resistant organisms in both inpatient and outpatient practices. PMID:17471350

  16. Iatrogenic occlusion of the ophthalmic artery after cosmetic facial filler injections: a national survey by the Korean Retina Society.

    PubMed

    Park, Kyu Hyung; Kim, Yong-Kyu; Woo, Se Joon; Kang, Se Woong; Lee, Won Ki; Choi, Kyung Seek; Kwak, Hyung Woo; Yoon, Ill Han; Huh, Kuhl; Kim, Jong Woo

    2014-06-01

    Iatrogenic occlusion of the ophthalmic artery and its branches is a rare but devastating complication of cosmetic facial filler injections. To investigate clinical and angiographic features of iatrogenic occlusion of the ophthalmic artery and its branches caused by cosmetic facial filler injections. Data from 44 patients with occlusion of the ophthalmic artery and its branches after cosmetic facial filler injections were obtained retrospectively from a national survey completed by members of the Korean Retina Society from 27 retinal centers. Clinical features were compared between patients grouped by angiographic findings and injected filler material. Visual prognosis and its relationship to angiographic findings and injected filler material. Ophthalmic artery occlusion was classified into 6 types according to angiographic findings. Twenty-eight patients had diffuse retinal and choroidal artery occlusions (ophthalmic artery occlusion, generalized posterior ciliary artery occlusion, and central retinal artery occlusion). Sixteen patients had localized occlusions (localized posterior ciliary artery occlusion, branch retinal artery occlusion, and posterior ischemic optic neuropathy). Patients with diffuse occlusions showed worse initial and final visual acuity and less visual gain compared with those having localized occlusions. Patients receiving autologous fat injections (n = 22) had diffuse ophthalmic artery occlusions, worse visual prognosis, and a higher incidence of combined brain infarction compared with patients having hyaluronic acid injections (n = 13). Clinical features of iatrogenic occlusion of the ophthalmic artery and its branches following cosmetic facial filler injections were diverse according to the location and extent of obstruction and the injected filler material. Autologous fat injections were associated with a worse visual prognosis and a higher incidence of combined cerebral infarction. Extreme caution and care should be taken during these injections, and physicians should be aware of a diverse spectrum of complications following cosmetic facial filler injections.

  17. Comparison of systemic absorption between ofloxacin ophthalmic in situ gels and ofloxacin conventional ophthalmic solutions administration to rabbit eyes by HPLC-MS/MS.

    PubMed

    Li, Jiawei; Zhao, Hainan; Okeke, Chukwunweike Ikechukwu; Li, Lin; Liu, Zhidong; Yin, Zhongpeng; Zhuang, Pengwei; Sun, Jingtong; Wu, Tao; Wang, Meng; Li, Nan; Pi, Jiaxin; Zhang, Qian; Zhang, Rui; Ma, Li; Pang, Xiaochen; Liu, Zhanbiao; Zhang, Li; Fan, Lili

    2013-06-25

    In recent years, many pharmaceutical scientists have focused on developing the in situ gel-forming systems to overcome the poor bioavailability and therapeutic response exhibited by conventional ophthalmic solutions due to rapid pre-corneal elimination of the drug. The present work was to compare the systemic absorptions of ophthalmic ofloxacin in situ gel with the conventional ofloxacin eye drop after topical instillation to rabbit eyes by HPLC-MS/MS method and also determine the relative contribution of the nasal and the conjunctival mucosae to systemic ofloxacin absorption following topical instillation. The systemic AUC, Cmax, Tmax and Ke for ophthalmic in situ gel and ophthalmic solution after ocular instillation were 202.63±118.85 and 202.25±57.74 ng mL(-1) h, 54.22±28.31 and 48.4±25.97 ng mL(-1), 1.08±0.20 and 1.25±0.88 h, 0.0576±0.0207 and 0.0388±0.0248, respectively. And the values for the ratios of the AUC of anterior chamber of rabbit eye to blood plasma, AUCac/AUCpl, for ofloxacin conventional eye drop and in situ gel were 0.25 and 0.52, respectively. Statistic results showed that there was no significant difference in systemic absorption between the test groups and the reference groups (P>0.05) as both formulations have an AUCsa/AUCpl of 0.35. Therefore, the ophthalmic in situ gel may not decrease the drugs systemic absorption when administered in an equivalent dose as ophthalmic solutions into the rabbit eyes. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. In vitro testing of thiolated poly(aspartic acid) from ophthalmic formulation aspects.

    PubMed

    Budai-Szű Cs, Mária; Horvát, Gabriella; Gyarmati, Benjámin; Szilágyi, Barnabás Áron; Szilágyi, András; Csihi, Tímea; Berkó, Szilvia; Szabó-Révész, Piroska; Mori, Michela; Sandri, Giuseppina; Bonferoni, Maria Cristina; Caramella, Carla; Csányi, Erzsébet

    2016-08-01

    Ocular drug delivery formulations must meet anatomical, biopharmaceutical, patient-driven and regulatory requirements. Mucoadhesive polymers can serve as a better alternative to currently available ophthalmic formulations by providing improved bioavailability. If all requirements are addressed, a polymeric formulation resembling the tear film of the eye might be the best solution. The optimum formulation must not have high osmotic activity, should provide appropriate surface tension, pH and refractive index, must be non-toxic and should be transparent and mucoadhesive. We would like to highlight the importance of in vitro polymer testing from a pharmaceutical aspect. We, therefore, carried out physical-chemical investigations to verify the suitability of certain systems for ophthalmic formulations. In this work, in situ gelling, mucoadhesive thiolated poly(aspartic acid)s were tested from ophthalmic formulation aspects. The results of preformulation measurements indicate that these polymers can be used as potential carriers in ophthalmic drug delivery.

  19. EyeMIAS: a cloud-based ophthalmic image reading and auxiliary diagnosis system

    NASA Astrophysics Data System (ADS)

    Wu, Di; Zhao, Heming; Yu, Kai; Chen, Xinjian

    2018-03-01

    Relying solely on ophthalmic equipment is unable to meet the present health needs. It is urgent to find an efficient way to provide a quick screening and early diagnosis on diabetic retinopathy and other ophthalmic diseases. The purpose of this study is to develop a cloud-base system for medical image especially ophthalmic image to store, view and process and accelerate the screening and diagnosis. In this purpose the system with web application, upload client, storage dependency and algorithm support is implemented. After five alpha tests, the system bore the thousands of large traffic access and generated hundreds of reports with diagnosis.

  20. Ophthalmic community perception of new medication needs.

    PubMed

    Stewart, William C; Stewart, Jeanette A; Nelson, Lindsay A

    2018-01-01

    To survey ophthalmologists (who have participated previously in clinical research) and ophthalmic industry professionals (who have been involved in ocular research and development) to indicate perceived needs for new pharmaceuticals in various ophthalmic subspecialties. A prospective, industry-based survey was sent to ophthalmologists and ophthalmic industry professionals about the perceived needs for new pharmaceutical products. This survey was sent to 559 ophthalmic pharma professionals and ophthalmologists. We received 82 (15%) responses. The results showed that the most commonly perceived need for new pharmaceuticals were dry and wet age-related macular degeneration, glaucoma, diabetic macular edema and dry eye. There was a statistical difference found between response groups ( P <0.0001). Respondents indicated they would express their commitment to a new product they perceived as needed by recommending to colleagues (63%), prescribing (60%), participating as principle investigator in a related clinical trial (52%), advising the company (52%), lecturing on behalf of the product (43%), investing in the product (38%), taking no action (7%) or obtain a position in the company (1%). Ophthalmic pharma professionals and ophthalmologists perceive the greatest need for new medicines in ophthalmology to be in dry and wet age-related macular degeneration, glaucoma, diabetic macular edema and dry eye.

  1. Serum beta-2 microglobulin level in sympathetic ophthalmitis.

    PubMed

    Sen, D K; Sarin, G S; Mathur, M D

    1990-04-01

    Serum beta-2 microglobulin (beta 2-m) levels were measured in 12 patients with sympathetic ophthalmitis, 34 with neglected traumatic uveitis following penetrating injury and 36 healthy subjects by ELISA technique. There was no significant alteration of its level in patients with traumatic uveitis. However, its levels were significantly increased in patients with sympathetic ophthalmitis. They were high even in the early stage of the disease. Serum beta 2-m levels paralleled the severity of disease. It decreased significantly at the remission stage. Four patients came back with relapse of the condition and the level of serum beta 2-m was again found to be elevated in them. It is proposed that estimation of beta 2-m can be used as a diagnostic aid when the diagnosis of sympathetic ophthalmitis remains doubtful on clinical grounds. It is also suggested that a rise in serum beta 2-m in patients with traumatic uveitis following perforating injuries may point to the onset of sympathetic ophthalmitis. The extent of rise in its level may be considered a good parameter of the degree of severity of sympathetic ophthalmitis. It may also act as a useful tool to evaluate the drug efficacy in this disease and predict relapse.

  2. Degree and duration of corneal anesthesia after topical application of 0.4% oxybuprocaine hydrochloride ophthalmic solution in ophthalmically normal dogs.

    PubMed

    Douet, Jean-Yves; Michel, Julien; Regnier, Alain

    2013-10-01

    To assess the anesthetic efficacy and local tolerance of topically applied 0.4% oxybuprocaine ophthalmic solution to in dogs and compare its effects with those of 1% tetracaine solution. 34 ophthalmically normal Beagles. Dogs were assigned to 2 groups, and baseline corneal touch threshold (CTT) was measured bilaterally with a Cochet-Bonnet aesthesiometer. Dogs of group 1 (n = 22) received a single drop of 0.4% oxybuprocaine ophthalmic solution in one eye and saline (0.9% NaCl) solution (control treatment) in the contralateral eye. Dogs of group 2 (n = 12) received a single drop of 0.4% oxybuprocaine ophthalmic solution in one eye and 1% tetracaine ophthalmic solution in the contralateral eye. The CTT of each eye was measured 1 and 5 minutes after topical application and then at 5-minute intervals until 75 minutes after topical application. CTT changes over time differed significantly between oxybuprocaine-treated and control eyes. After instillation of oxybuprocaine, maximal corneal anesthesia (CTT = 0) was achieved within 1 minute, and CTT was significantly decreased from 1 to 45 minutes, compared with the baseline value. No significant difference in onset, depth, and duration of corneal anesthesia was found between oxybuprocaine-treated and tetracaine-treated eyes. Conjunctival hyperemia and chemosis were detected more frequently in tetracaine-treated eyes than in oxybuprocaine-treated eyes. Topical application of oxybuprocaine and tetracaine similarly reduced corneal sensitivity in dogs, but oxybuprocaine was less irritating to the conjunctiva than was tetracaine.

  3. [Medical Studies + Internship + Vocational Training = A Complete Ophthalmic Surgeon? A Theoretical Analysis of the Ophthalmic Surgery Training from the Perspective of Medical and Educational Sciences].

    PubMed

    Köffler, N M; Kastl, G

    2017-02-01

    "Let's have the courage to train young doctors to conduct ophthalmic surgery!" - This is the final plea of this theoretical article, which appeals for greater collaboration between medical and educational sciences in the training of ophthalmic surgeons. It will be discussed whether surgery-based training is adequate, from the point of view of both medical knowledge and learning theory. Standard requirements for the specialist qualification in ophthalmic surgery are presented for Bavaria, Austria and Switzerland; these are then compared and contrasted with the experience-based practice of vocational training. Assuming that vocational training can be understood as providing the context for action-oriented learning, the relevance of procedural knowledge will be discussed for the development of practical surgical skills. A model for expertise in ophthalmic surgery will be outlined. Instructors' didactic skills and expertise will be discussed in relation to the requirements and guidelines for receiving the license to train assistants. In general, the article highlights the relevance of performance in learning surgery, and calls for the provision of sufficient possibilities to learn surgery in the course of assistant doctors' vocational training. This article addresses those who are involved in ophthalmologists' and ophthalmic surgeons' vocational training (e.g. medical instructors, medical associations, assistant doctors) and who welcome thought-provoking impulses from unfamiliar academic disciplines on key questions and concerns in practical vocational training. Georg Thieme Verlag KG Stuttgart · New York.

  4. 10 CFR 35.2433 - Records of decay of strontium-90 sources for ophthalmic treatments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Records of decay of strontium-90 sources for ophthalmic... Records § 35.2433 Records of decay of strontium-90 sources for ophthalmic treatments. (a) A licensee shall maintain a record of the activity of a strontium-90 source required by § 35.433 for the life of the source...

  5. 10 CFR 35.2433 - Records of decay of strontium-90 sources for ophthalmic treatments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Records of decay of strontium-90 sources for ophthalmic... Records § 35.2433 Records of decay of strontium-90 sources for ophthalmic treatments. (a) A licensee shall maintain a record of the activity of a strontium-90 source required by § 35.433 for the life of the source...

  6. 10 CFR 35.2433 - Records of decay of strontium-90 sources for ophthalmic treatments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Records of decay of strontium-90 sources for ophthalmic... Records § 35.2433 Records of decay of strontium-90 sources for ophthalmic treatments. (a) A licensee shall maintain a record of the activity of a strontium-90 source required by § 35.433 for the life of the source...

  7. 10 CFR 35.2433 - Records of decay of strontium-90 sources for ophthalmic treatments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 1 2012-01-01 2012-01-01 false Records of decay of strontium-90 sources for ophthalmic... Records § 35.2433 Records of decay of strontium-90 sources for ophthalmic treatments. (a) A licensee shall maintain a record of the activity of a strontium-90 source required by § 35.433 for the life of the source...

  8. 10 CFR 35.2433 - Records of decay of strontium-90 sources for ophthalmic treatments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 1 2011-01-01 2011-01-01 false Records of decay of strontium-90 sources for ophthalmic... Records § 35.2433 Records of decay of strontium-90 sources for ophthalmic treatments. (a) A licensee shall maintain a record of the activity of a strontium-90 source required by § 35.433 for the life of the source...

  9. Smart ophthalmics: the future in tele-ophthalmology has arrived

    NASA Astrophysics Data System (ADS)

    Fink, Wolfgang; Tarbell, Mark A.; Garcia, Kevin

    2016-05-01

    Smart Ophthalmics© extends ophthalmic healthcare to people who operate/live in austere environments (e.g., military, third world, natural disaster), or are geographically dispersed (e.g., rural populations), where time, cost, and the possibility of travel/transportation make access to even adequate medical care difficult, if at all possible. Operators attach optical devices that act as ophthalmic examination extensions to smartphones and run custom apps to perform examinations of specific areas of the eye. The smartphone apps submit over wireless networks the collected examination data to a smart remote expert system, which provides in-depth medical analyses that are sent back in near real-time to the operators for subsequent triage.

  10. Updates in ophthalmic pathology.

    PubMed

    Mendoza, Pia R; Grossniklaus, Hans E

    2017-05-01

    Ophthalmic pathology has a long history and rich heritage in the field of ophthalmology. This review article highlights updates in ophthalmic pathology that have developed significantly through the years because of the efforts of committed individuals and the confluence of technology such as molecular biology and digital pathology. This is an exciting period in the history of ocular pathology, with cutting-edge techniques paving the way for new developments in diagnostics, therapeutics, and research. Collaborations between ocular oncologists and pathologists allow for improved and comprehensive patient care. Ophthalmic pathology continues to be a relevant specialty that is important in the understanding and clinical management of ocular disease, education of eye care providers, and overall advancement of the field.

  11. Long-term results of treatment with diquafosol ophthalmic solution for aqueous-deficient dry eye.

    PubMed

    Koh, Shizuka; Ikeda, Chikako; Takai, Yoshihiro; Watanabe, Hitoshi; Maeda, Naoyuki; Nishida, Kohji

    2013-09-01

    To evaluate the preliminary long-term efficacy of diquafosol ophthalmic solution for aqueous-deficient dry eye. Fifteen patients with mild-to-moderate aqueous-deficient dry eye were enrolled. After a washout period, the patients were treated with 3 % diquafosol ophthalmic solution for 6 months. We assessed 12 subjective dry eye symptoms, corneal and conjunctival staining with fluorescein, tear film break-up time (BUT), lower tear meniscus height measured with anterior-segment optical coherence tomography, Schirmer's testing, and adverse reactions at baseline and 1, 3, and 6 months after the start of treatment. Treatment with diquafosol ophthalmic solution significantly improved dry eye symptoms, corneal staining, BUT, and tear meniscus height at 1 month and maintained the effectiveness for 6 months. Conjunctival staining significantly improved 3 and 6 months after treatment. No significant adverse reactions developed. Prolonged use of diquafosol ophthalmic solution for 6 months produced significant improvement both subjectively (dry eye symptom score) and objectively (ocular staining score and tear function tests) for aqueous-deficient dry eye.

  12. Recent advances in developing ophthalmic formulations: a patent review.

    PubMed

    Lu, Guang Wei

    2010-01-01

    In an effort to improve the drug solubility, stability and/or ocular bioavailability of ophthalmic formulations,various approaches have been explored in the recent past. Additionally, different formulations have been investigated in order to seek those preservative systems that are more tolerable to the ocular tissue. Over the past ten years, inventions in ophthalmic formulations directed toward front-of-eye instillations have concentrated in the areas of new excipients' applications, novel and combined use of conventional excipients, and developments of novel dosage forms. Among these areas, applications of polymeric excipients, cyclodextrins and stabilized chloride dioxide (SCD) have been the most actively studied fields. In addition, oil-in-water (O/W) emulsions have been becoming more popular as an ophthalmic dosage form due to the potentials in increasing drug solubility, stabilizing active pharmaceutical ingredients (APIs), improving ocular tolerance, and providing palliative effects. Some of these innovations from the past decade have the capability of leading to new commercial products. This patent review has a useful knowledge in the advancement for treating various ophthalmic diseases.

  13. Evaluation and Referral of Diabetic Eye Disease in the Endocrinology and Primary Care Office Settings.

    PubMed

    Silva, Fabiana Q; Adhi, Mehreen; Wai, Karen M; Olansky, Leann; Lansang, M Cecilia; Singh, Rishi P

    2016-10-01

    The purpose of this study was to identify whether endocrinologists and primary care physicians (PCP) adequately screen for ophthalmic symptoms/signs within office visits and provide timely ophthalmology referrals in patients with diabetes. Patients between the ages of 18 years and 80 years with diabetes who underwent an office visit with an endocrinologist or a PCP between January 1, 2014, and December 31, 2014, were identified. Demographics, ophthalmic assessments, and referral information were collected. A total of 1,250 patient records were reviewed. Providers asked about ophthalmic symptoms/signs in 95.5% and 71% of endocrinology and primary care office encounters, respectively (P < .0001). Past and/or future ophthalmology appointments were verified in 86.1% and 49.7% of patients during endocrinology and PCP visits, respectively (P < .0001). Ophthalmic complications from diabetes are not adequately screened, especially within the primary care setting, and further quality improvement measures may improve adherence to recommended screening protocols. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:930-934.]. Copyright 2016, SLACK Incorporated.

  14. Facilitating the quality of care in a specialist Pacific ophthalmic nursing workforce.

    PubMed

    du Toit, R; Hughes, F; Mason, I; Tousignant, B

    2011-03-01

    Sufficient, appropriately trained health personnel need to be retained in the workforce, and their performance maintained, to achieve quality care. Mid-level ophthalmic personnel in Western Pacific Island Countries and Territories (WPICT) are no exception. The study aims to assess influences on the quality of care provided by specialist mid-level ophthalmic personnel in WPICT and devise strategies to train, retain and maintain performance of these personnel. A situational assessment employed a checklist and semi-structured interviews with specialist mid-level ophthalmic personnel, nursing bodies and Ministry of Health representatives from seven WPICT. A selective literature review guided strategies to address the issues identified. Appropriate training allows nurses to fulfill a mid-level role in WPICT as specialist ophthalmic nurses. Resources generally do not restrict practice. Nursing structures have generally failed to support professionalism: scope and conditions of service, clinical supervision, career structures, professional recognition and opportunities for continuing professional development are rudimentary. Ophthalmic nurses were dissatisfied with the lack of specialty recognition, career progression and salary increase. Regional and local strategies tailored to each country have been devised to establish sustainable processes for support. Salary was a major cause of dissatisfaction. It should be addressed along with professional recognition and related processes. Without professional support, specialist and advanced cadres within nursing may cease to exist, nurses' performance may be affected or they may leave. Specialist ophthalmic nursing, recognized, situated within and properly supported by nursing structures can provide a model for specialist clinical care for other specialties and in other countries. © 2010 The Authors. International Nursing Review © 2010 International Council of Nurses.

  15. Ophthalmic presentation of giant cell arteritis in African-Americans

    PubMed Central

    Garrity, S T; Pistilli, M; Vaphiades, M S; Richards, N Q; Subramanian, P S; Rosa, P R; Lam, B L; Osborne, B J; Liu, G T; Duncan, K E; Shin, R K; Volpe, N J; Shindler, K S; Lee, M S; Moster, M L; Tracey, E H; Cuprill-Nilson, S E; Tamhankar, M A

    2017-01-01

    Purpose To determine the differences in the presentation of ophthalmic giant cell arteritis between African-Americans and Caucasians. Methods This was a multicenter retrospective case series comparing African-American patients with ophthalmic GCA to a previously published Caucasian cohort. Neuro-ophthalmic centers across the United States were contacted to provide data on African-American patients with biopsy-proven ophthalmic giant cell arteritis. The differences between African-American and Caucasian patients with respect to multiple variables, including age, sex, systemic and ophthalmic signs and symptoms, ocular ischemic lesions, and laboratory results were studied. Results The Caucasian cohort was slightly older (mean=76.1 years) than the African-American cohort (mean=72.6 years, P=0.03), and there was no difference in sex distribution between the two cohorts. Headache, neck pain, and anemia were more frequent, while jaw claudication was less frequent in African-Americans (P<0.01, <0.001, 0.02, and 0.03 respectively). Acute vision loss was the most common presentation of giant cell arteritis in both groups, though it was less common in African-Americans (78 vs 98% of Caucasians, P<0.001). Eye pain was more common in African-Americans (28 vs 8% of Caucasians, P<0.01). Conclusions The presenting features of ophthalmic giant cell arteritis in African-Americans and Caucasians are not markedly different, although a few significant differences exist, including higher rates of headache, neck pain, anemia, and eye pain, and lower rates of jaw claudication and acute vision loss in African-Americans. Persons presenting with suspicious signs and symptoms should undergo evaluation for giant cell arteritis regardless of race. PMID:27636230

  16. SOCIETAL COSTS ASSOCIATED WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION IN THE UNITED STATES.

    PubMed

    Brown, Melissa M; Brown, Gary C; Lieske, Heidi B; Tran, Irwin; Turpcu, Adam; Colman, Shoshana

    2016-02-01

    The purpose of this study was to use a cross-sectional prevalence-based health care economic survey to ascertain the annual, incremental, societal ophthalmic costs associated with neovascular age-related macular degeneration. Consecutive patients (n = 200) with neovascular age-related macular degeneration were studied. A Control Cohort included patients with good (20/20-20/25) vision, while Study Cohort vision levels included Subcohort 1: 20/30 to 20/50, Subcohort 2: 20/60 to 20/100, Subcohort 3: 20/200 to 20/400, and Subcohort 4: 20/800 to no light perception. An interviewer-administered, standardized, written survey assessed 1) direct ophthalmic medical, 2) direct nonophthalmic medical, 3) direct nonmedical, and 4) indirect medical costs accrued due solely to neovascular age-related macular degeneration. The mean annual societal cost for the Control Cohort was $6,116 and for the Study Cohort averaged $39,910 (P < 0.001). Study Subcohort 1 costs averaged $20,339, while Subcohort 4 costs averaged $82,984. Direct ophthalmic medical costs comprised 17.9% of Study Cohort societal ophthalmic costs, versus 74.1% of Control Cohort societal ophthalmic costs (P < 0.001) and 10.4% of 20/800 to no light perception subcohort costs. Direct nonmedical costs, primarily caregiver, comprised 67.1% of Study Cohort societal ophthalmic costs, versus 21.3% ($1,302/$6,116) of Control Cohort costs (P < 0.001) and 74.1% of 20/800 to no light perception subcohort costs. Total societal ophthalmic costs associated with neovascular age-related macular degeneration dramatically increase as vision in the better-seeing eye decreases.

  17. Lodoxamide Ophthalmic

    MedlinePlus

    Ophthalmic lodoxamide is used to treat redness, burning, itching, and swelling of the eyes that is caused by allergic reactions. Lodoxamide is in a class of medications called mast cell stabilizers. ...

  18. Latanoprostene Bunod Ophthalmic

    MedlinePlus

    Latanoprostene bunod ophthalmic is used to treat glaucoma (condition in which increased pressure in the eye can lead to gradual loss of vision) and ocular hypertension (condition which causes increased pressure ...

  19. An investigation of prescription and over-the-counter supply of ophthalmic chloramphenicol in Wales in the 5 years following reclassification.

    PubMed

    Du, Hank C T; John, Dai N; Walker, Roger

    2014-02-01

    The aims of the study were to (i) quantify the sales of over-the-counter (OTC) ophthalmic chloramphenicol from all community pharmacies in Wales and investigate the impact on primary care prescriptions up to 5 years after reclassification and (ii) investigate the temporal relationship between items supplied OTC and on NHS primary care prescriptions. Primary care prescription data (2004-2010) and OTC sales data (2005-2010) for ophthalmic chloramphenicol were obtained. The quantity sold OTC was calculated from pharmacy wholesale records and sales data from a large pharmacy multiple. Spearman's rank correlation for prescription and OTC supplies of ophthalmic chloramphenicol was calculated for data from January 2008 to December 2010. OTC supply of chloramphenicol eye drops and ointment were both highest in 2007-2008 and represented 68% (57,708/84,304) and 48% (22,875/47,192) of the corresponding prescription volume, respectively. There was a steady year-on-year increase in the combined supply of OTC ophthalmic chloramphenicol and that dispensed on prescription from 144,367 items in 2004-2005 to 210,589 in 2007-2008 before stabilising in 2008-2009 and 2009-2010. A significant positive correlation was observed between prescription items and OTC sales of chloramphenicol eye drops and ointment combined (r=0.7, P<0.001). OTC availability increased the total quantity of ophthalmic chloramphenicol supplied in primary care compared to that seen prior to reclassification. Although growth in the sales of ophthalmic chloramphenicol OTC has stabilised and the supply pattern mirrors primary care prescribers, further work is required to investigate whether use is appropriate and whether the publication of updated practice guidance has changed this. © 2013 The Authors. IJPP © 2013 Royal Pharmaceutical Society.

  20. The incidence of neuro-ophthalmic diseases in Singapore: a prospective study in public hospitals.

    PubMed

    Lim, Su Ann; Wong, Wan Ling; Fu, Esther; Goh, Kong Yong; Seah, Alvin; Tan, Clement; Tow, Sharon; Cullen, James F; Wong, Tien Y

    2009-01-01

    To describe the incidence of neuro-ophthalmic diseases in a multi-ethnic Asian population in Singapore. Prospective study in public hospitals in Singapore. All neuro-ophthalmic cases seen in four public sector hospitals over a 22-month period (September 2002 to June 2004) were identified using a standardized protocol. The 2004 Singapore population was used as a denominator to estimate annual incidence. The prevalence of ischemic risk factors (hypertension, diabetes, and hypercholesterolemia) among cases was compared to population data. A total of 1,356 patients with neuro-ophthalmic diseases were seen during the study period, of which 627 were new incident cases. The overall annual incidence of neuro-ophthalmic diseases was 9.81 per 100,000 (95% confidence interval, 8.80-10.90). The incidence increased with age. After controlling for age, the annual incidence was similar between men (10.75 per 100,000) and women (9.00 per 100,000), but was higher in Chinese (10.33 per 100,000) and Indians (9.34 per 100,000) than in Malays (6.62 per 100,000). The three commonest specific neuro-ophthalmic conditions were abducens nerve palsy (1.27 per 100,000), anterior ischemic optic neuropathy (1.08 per 100,000) and oculomotor nerve palsy (0.91 per 100,000). The incidence of optic neuritis was 0.83 per 100,000. Compared with the Singapore general population, the prevalence of diabetes was significantly higher in people aged 40-59, while the prevalence of hypercholesterolemia was significantly higher in 60-69 year age group. In this study of public hospitals in Singapore, the incidence of neuro-ophthalmic diseases was higher in Chinese and Indians compared to Malays.

  1. Outpatients flow management and ophthalmic electronic medical records system in university hospital using Yahgee Document View.

    PubMed

    Matsuo, Toshihiko; Gochi, Akira; Hirakawa, Tsuyoshi; Ito, Tadashi; Kohno, Yoshihisa

    2010-10-01

    General electronic medical records systems remain insufficient for ophthalmology outpatient clinics from the viewpoint of dealing with many ophthalmic examinations and images in a large number of patients. Filing systems for documents and images by Yahgee Document View (Yahgee, Inc.) were introduced on the platform of general electronic medical records system (Fujitsu, Inc.). Outpatients flow management system and electronic medical records system for ophthalmology were constructed. All images from ophthalmic appliances were transported to Yahgee Image by the MaxFile gateway system (P4 Medic, Inc.). The flow of outpatients going through examinations such as visual acuity testing were monitored by the list "Ophthalmology Outpatients List" by Yahgee Workflow in addition to the list "Patients Reception List" by Fujitsu. Patients' identification number was scanned with bar code readers attached to ophthalmic appliances. Dual monitors were placed in doctors' rooms to show Fujitsu Medical Records on the left-hand monitor and ophthalmic charts of Yahgee Document on the right-hand monitor. The data of manually-inputted visual acuity, automatically-exported autorefractometry and non-contact tonometry on a new template, MaxFile ED, were again automatically transported to designated boxes on ophthalmic charts of Yahgee Document. Images such as fundus photographs, fluorescein angiograms, optical coherence tomographic and ultrasound scans were viewed by Yahgee Image, and were copy-and-pasted to assigned boxes on the ophthalmic charts. Ordering such as appointments, drug prescription, fees and diagnoses input, central laboratory tests, surgical theater and ward room reservations were placed by functions of the Fujitsu electronic medical records system. The combination of the Fujitsu electronic medical records and Yahgee Document View systems enabled the University Hospital to examine the same number of outpatients as prior to the implementation of the computerized filing system.

  2. Effect of rebamipide ophthalmic suspension on the success of lacrimal stent intubation.

    PubMed

    Mimura, Masashi; Ueki, Mari; Oku, Hidehiro; Sato, Bunpei; Ikeda, Tsunehiko

    2016-02-01

    To evaluate the effect of the postoperative administration of rebamipide ophthalmic suspension on the success rate of lacrimal stent intubation (LSI) for the treatment of primary acquired nasolacrimal duct obstruction (PANDO). This comparative interventional cohort study investigated 110 consecutive patients with PANDO who were treated with LSI and followed up for 12 months postoperatively at one institution. LSI was performed by one surgeon, and all patients received identical postoperative care. Among the total 110 patients, 71 underwent LSI with postoperative administration of rebamipide ophthalmic suspension, and 39 underwent LSI without administration of the suspension. Data related to patient age, gender, laterality, and postoperative administration of rebamipide ophthalmic suspension were collected and used as independent variables, and logistic regression analyses were performed to compare the anatomical success rate at 12 months postoperatively between patients with and without postoperative administration of the suspension. The anatomical success rate of LSI in patients with and without postoperative administration of rebamipide ophthalmic suspension was 90.1 and 69.2 %, respectively. A comparison of these success rates showed statistical significance, in that the rate of treatment success was higher in PANDO patients who underwent LSI with postoperative administration of the suspension [odds ratio (OR), 3.37; P < 0.05]. The findings of this study show that postoperative administration of rebamipide ophthalmic suspension increases the rate of anatomical success in patients who undergo LSI for the treatment of PANDO.

  3. 21 CFR 886.1120 - Opthalmic camera.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1120 Opthalmic camera. (a) Identification. An ophthalmic camera is an AC-powered device intended to take photographs of the eye and the surrounding area...

  4. Challenges Encountered Using Ophthalmic Anesthetics in Space Medicine

    NASA Technical Reports Server (NTRS)

    Bayuse, T.; Law, J.; Alexander, D.; Moynihan, S.; LeBlanc, C.; Langford, K.; Magalhaes, L.

    2015-01-01

    On orbit, ophthalmic anesthetics are used for tonometry and off-nominal corneal examinations. Proparacaine has been flown traditionally. However, the manufacturers recently changed its storage requirements from room temperature storage to refrigerated storage to preserve stability and prolong the shelf-life. Since refrigeration on orbit is not readily available and there were stability concerns about flying proparacaine unrefrigerated, tetracaine was selected as an alternative ophthalmic anesthetic in 2013. We will discuss the challenges encountered flying and using these anesthetics on the International Space Station.

  5. Marfan syndrome presenting with headache and coincidental ophthalmic artery aneurysm.

    PubMed

    Vandersteen, Anthony Martin; Kenny, Joanna; Khan, Naheed L; Male, Alison

    2013-03-15

    A 24-year-old Ugandan woman was referred for a neurology opinion after complaining of a year long history of right-sided retro-orbital stabbing pain. Brain imaging revealed a coincidental 3 mm left ophthalmic artery aneurysm. Marfanoid habitus was noted; after further investigations she was diagnosed with mild aortic root dilatation, subtle lens dislocation and Marfan syndrome. Her symptoms were secondary to temporomandibular joint dysfunction, an under-recognised complication of Marfan syndrome. Her ophthalmic artery aneurysm is likely to be a coincidental finding.

  6. Tafluprost Ophthalmic

    MedlinePlus

    ... your doctor.Tafluprost ophthalmic comes in single-use containers. The solution from one container should be used immediately after opening for one or both eyes. Dispose of each single-use container and any remaining solution after one use.Tafluprost ...

  7. [Biological availability of ophthalmic drugs. 1. Increasing drug permeability in the cornea].

    PubMed

    Masteiková, R; Chalupová, Z; Savickiene, N

    2004-03-01

    Most eye diseases are treated by topical administration of ophthalmic preparations. Low ophthalmic bioavailability is due to a number of physiological and physicochemical factors. The main obstacle to the penetration of active ingredients to the eye is the layered character of the cornea. Formulation of ophthalmic preparations enabling easier penetration of this biological barrier thus ranks among the most effective ways of improving bioavailability. Penetrability of the cornea can be increased by the following methods: a) adjustment of the actual acidity in such a way that pH of the preparation makes it possible to produce the optimal portion of non-ionized particles; b) incorporation of absorption enhancers (non-ionic tensides, salts of bile acids, some antimicrobial substances, EDTA, cyclodextrins, etc.) into the composition of the preparation, and c) production of prodrugs or ionic pairs.

  8. Screening of diabetics for retinopathy by ophthalmic opticians.

    PubMed Central

    Burns-Cox, C J; Hart, J C

    1985-01-01

    Diabetes mellitus is a major cause of blindness in England and Wales in those aged between 30 and 64. Photocoagulation can frequently prevent blindness provided the retinopathy is detected at an appropriate stage but unfortunately the benefits are small if the changes are advanced. Early detection of diabetic retinopathy by regular examination is needed. We have shown that ophthalmic opticians have the skill to detect retinal changes at a treatable stage. Out of 844 eye checks, 80 were reported by ophthalmic opticians to justify referral to an ophthalmologist and 20 of these required photocoagulation treatment. Of a sample of 197 patients rechecked by an ophthalmologist reported by ophthalmic opticians not to justify referral, only one needed treatment. With local agreement this system of detecting retinopathy could be easily applied anywhere in the United Kingdom. No extra personnel or facilities are needed. PMID:3921106

  9. Screening of diabetics for retinopathy by ophthalmic opticians.

    PubMed

    Burns-Cox, C J; Hart, J C

    1985-04-06

    Diabetes mellitus is a major cause of blindness in England and Wales in those aged between 30 and 64. Photocoagulation can frequently prevent blindness provided the retinopathy is detected at an appropriate stage but unfortunately the benefits are small if the changes are advanced. Early detection of diabetic retinopathy by regular examination is needed. We have shown that ophthalmic opticians have the skill to detect retinal changes at a treatable stage. Out of 844 eye checks, 80 were reported by ophthalmic opticians to justify referral to an ophthalmologist and 20 of these required photocoagulation treatment. Of a sample of 197 patients rechecked by an ophthalmologist reported by ophthalmic opticians not to justify referral, only one needed treatment. With local agreement this system of detecting retinopathy could be easily applied anywhere in the United Kingdom. No extra personnel or facilities are needed.

  10. Ophthalmic Manifestations of Congenital Zika Syndrome in Colombia and Venezuela.

    PubMed

    Yepez, Juan B; Murati, Felipe A; Pettito, Michele; Peñaranda, Carlos F; de Yepez, Jazmin; Maestre, Gladys; Arevalo, J Fernando

    2017-05-01

    The ocular manifestations and sequelae of Zika virus infection are not well known. Recently, the World Health Organization changed the declaration of Zika as a public health emergency and designated the viral outbreak and related microcephaly clusters as a long-term program of work. This change indicates the urgent need to evaluate and document ophthalmic manifestations in patients for timely management of this disease. In addition, confirmation whether the public health problem in Brazil extends to other regions in South America is needed. To report the ocular manifestations of congenital Zika syndrome with microcephaly in Colombia and Venezuela. This prospective case series included 43 patients from 2 ophthalmic centers in Colombia and Venezuela who underwent evaluation from October 1, 2015, through June 30, 2016, and were clinically diagnosed with congenital Zika syndrome. Twenty patients were Hispanic; 13, African; 8, white; and 2, Native American. Ophthalmic and systemic evaluations and serologic testing were performed on all infants. Patients underwent external ocular examination and dilated ophthalmoscopy. Serologic testing ruled out toxoplasmosis, rubella, cytomegalovirus, syphilis, and human immunodeficiency virus. Ophthalmic manifestations of congenital Zika syndrome. Of the 43 patients included in this series (28 female and 15 male), the mean (SD) age at examination was 2.1 (1.5) months. The mothers of all the children had no ophthalmic findings and did not report ocular symptoms during pregnancy. All patients had bilateral ophthalmic manifestations. Optic nerve findings included hypoplasia with the double-ring sign, pallor, and increased cup-disc ratio in 5 patients (11.6%). Macular abnormalities included mild to severe pigment mottling in 27 patients (63%) and lacunar maculopathy in 3 (6.9%). Chorioretinal scarring was present in 3 patients (7%). Eleven patients (26%) had a combination of lesions in the posterior pole. Five patients (12%) were diagnosed with congenital glaucoma, characterized by the clinical triad of epiphora, photophobia, and blepharospasm; increased intraocular pressure; corneal clouding at birth; and buphthalmos. These data reveal that 12% (95% CI, 5%-24%) of cases of congenital Zika with microcephaly had anterior segment abnormalities and 88% (95% CI, 76%-94%) had important macular and optic nerve abnormalities. The visual sequelae of these ophthalmic manifestations remain unknown. Congenital Zika syndrome in the current study had severe ocular abnormalities, and all patients had bilateral involvement. Ocular findings were focal macular pigment mottling, chorioretinal atrophy with a predilection for the macular area, congenital glaucoma and optical nerve hypoplasia, and optic disc abnormalities. Ophthalmic examination is recommended in patients with congenital Zika syndrome.

  11. The incidence of ocular candidiasis and evaluation of routine opthalmic examination in critically ill patients with candidaemia.

    PubMed

    Gluck, S; Headdon, W G; Tang, Dws; Bastian, I B; Goggin, M J; Deane, A M

    2015-11-01

    Despite a paucity of data regarding both the incidence of ocular candidiasis and the utility of ophthalmic examination in critically ill patients, routine ophthalmic examination is recommended for critically ill patients with candidaemia. The objectives were to estimate the incidence of ocular candidiasis and evaluate whether ophthalmic examination influenced subsequent management of these patients. We conducted a ten-year retrospective observational study. Data were extracted for all ICU patients who were blood culture positive for fungal infection. Risk factors for candidaemia and eye involvement were quantified and details regarding ophthalmic examination were reviewed. Candida species were cultured in 93 patients. Risk factors for ocular candidiasis were present in 57% of patients. Forty-one percent of patients died prior to ophthalmology examination and 2% of patients were discharged before candidaemia was identified. During examination, signs of ocular candidiasis were only present in one (2.9%) patient, who had a risk factor for ocular candidiasis. Based on these findings, the duration of antifungal treatment for this patient was increased. Ocular candidiasis occurs rarely in critically ill patients with candidaemia, but because treatment regimens may be altered when diagnosed, routine ophthalmic examination is still indicated.

  12. Superior ophthalmic vein enlargement and increased muscle index in dysthyroid optic neuropathy.

    PubMed

    Lima, Breno da Rocha; Perry, Julian D

    2013-01-01

    To compare superior ophthalmic vein diameter and extraocular muscle index in patients with thyroid eye disease with or without optic neuropathy. High-resolution CT scan images of 40 orbits of 20 patients with history of thyroid eye disease (with or without optic neuropathy), who underwent orbital decompression surgery from January 2007 to November 2009, were retrospectively reviewed. Superior ophthalmic vein diameter was measured in coronal and axial planes. Extraocular muscle index was calculated according to the method proposed by Barrett et al. The clinical diagnosis of optic neuropathy was based on characteristic signs that included afferent pupillary defect, decreased visual acuity, visual field defects, and dyschromatopsia. Orbits were divided in 2 groups based on presence or absence of optic neuropathy. Superior ophthalmic vein diameter was significantly higher in orbits with concomitant optic neuropathy (mean 2.4 ± 0.4mm, p < 0.0001). Increased muscle index was also related to optic neuropathy (mean 57.9% ± 5.7%, p = 0.0002). Muscle index greater than 50% was present in all patients with dysthyroid optic neuropathy. This study suggests that patients with thyroid eye disease with enlarged superior ophthalmic vein and increased extraocular muscle index are more likely to have concomitant optic neuropathy.

  13. Comparative analysis of image classification methods for automatic diagnosis of ophthalmic images

    NASA Astrophysics Data System (ADS)

    Wang, Liming; Zhang, Kai; Liu, Xiyang; Long, Erping; Jiang, Jiewei; An, Yingying; Zhang, Jia; Liu, Zhenzhen; Lin, Zhuoling; Li, Xiaoyan; Chen, Jingjing; Cao, Qianzhong; Li, Jing; Wu, Xiaohang; Wang, Dongni; Li, Wangting; Lin, Haotian

    2017-01-01

    There are many image classification methods, but it remains unclear which methods are most helpful for analyzing and intelligently identifying ophthalmic images. We select representative slit-lamp images which show the complexity of ocular images as research material to compare image classification algorithms for diagnosing ophthalmic diseases. To facilitate this study, some feature extraction algorithms and classifiers are combined to automatic diagnose pediatric cataract with same dataset and then their performance are compared using multiple criteria. This comparative study reveals the general characteristics of the existing methods for automatic identification of ophthalmic images and provides new insights into the strengths and shortcomings of these methods. The relevant methods (local binary pattern +SVMs, wavelet transformation +SVMs) which achieve an average accuracy of 87% and can be adopted in specific situations to aid doctors in preliminarily disease screening. Furthermore, some methods requiring fewer computational resources and less time could be applied in remote places or mobile devices to assist individuals in understanding the condition of their body. In addition, it would be helpful to accelerate the development of innovative approaches and to apply these methods to assist doctors in diagnosing ophthalmic disease.

  14. 21 CFR 524.1982 - Proparacaine hydrochloride ophthalmic solution.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...) Conditions of use. (1) The drug is indicated for use as a topical ophthalmic anesthetic in animals. It is used as an anesthetic in cauterization of corneal ulcers, removal of foreign bodies and sutures from...

  15. 21 CFR 524.1982 - Proparacaine hydrochloride ophthalmic solution.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) Conditions of use. (1) The drug is indicated for use as a topical ophthalmic anesthetic in animals. It is used as an anesthetic in cauterization of corneal ulcers, removal of foreign bodies and sutures from...

  16. Color Doppler Imaging Analysis of Retrobulbar Blood Flow Velocities in Diabetic Patients Without or With Retinopathy: A Meta-analysis.

    PubMed

    Meng, Nana; Liu, Jing; Zhang, Yue; Ma, Jinlan; Li, Hao; Qu, Yi

    2014-08-01

    To analyze hemodynamic changes in retrobulbar blood vessels using color Doppler imaging in diabetic patients without or with retinopathy. Pertinent publications were retrieved from 3 databases. Changes in peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) of the ophthalmic artery, central retinal artery, and short posterior ciliary artery of diabetic eyes without or with retinopathy and healthy controls were evaluated by color Doppler imaging. Comparisons were conducted in 3 groups: group 1, no retinopathy versus control; group 2, retinopathy versus control; and group 3, no retinopathy versus retinopathy. In group 1, eyes without retinopathy had a significant increase in ophthalmic artery PSV (P = .002), with no heterogeneity (Pheterogeneity = 0.09; inconsistency index [I(2)] = 46%); however, significant reductions in central renal artery PSV and EDV were shown (P = .002; P = .007, respectively), with significant heterogeneity (Pheterogeneity < .00001; I(2) = 85%; Pheterogeneity = .008, I(2) = 68%). A significant increase in ophthalmic artery RI (P = .02) was found in eyes without retinopathy, with heterogeneity (Pheterogeneity = .0009; I(2) = 74%). In group 2, central retinal artery PSV and EDV in eyes with retinopathy decreased significantly (P < 0.00001). Similar results were found for ophthalmic and short posterior ciliary artery EDVs (P= .0003; P< .00001). Ophthalmic artery RI was significantly higher in eyes with retinopathy than controls (P = .0008), with heterogeneity (Pheterogeneity < .00001; I(2) = 84%). In group 3, ophthalmic artery PSV was lower in eyes with retinopathy (P= .04) than eyes without, and central retinal artery PSV and EDV decreased significantly (P = .004; P < .00001) in eyes with retinopathy compared to eyes without. Differences in ophthalmic and central retinal artery RIs were also found in eyes with retinopathy (P = .05; P < .00001). Significant changes in retrobulbar blood flow were found in eyes without and with diabetic retinopathy, especially those with retinopathy. © 2014 by the American Institute of Ultrasound in Medicine.

  17. Simulation of Ophthalmic Alterations at the Arctic, Antarctica and the International Space Station for Long-Duration Spaceflight

    NASA Astrophysics Data System (ADS)

    De Morais Mendonca Teles, Antonio; Gonçalves, Cristiane

    2016-07-01

    Well, we propose a series of long-period medical simulations in scientific bases at the Arctic, at Antarctica and aboard the International Space Station (ISS), involving natural ophthalmic diseases such as radiation, solar and trauma retinopathy, keratoconus, cataract, glaucoma, etc., and ophthalmic alterations by accidental injuries. These natural diseases, without a previous diagnosis, specially those specific retinopathy, appear after 1 month to 1.5 year, in average. Such studies will be valuable for the human deep-space exploration because during long-duration spaceflight, such as staying at the ISS, a Moon base and a manned trip to planet Mars, requires several months within such environments, and during such periods ophthalmic diseases and accidents might eventually occur, which could seriously affect the 'round-the-clock' work schedule of the astronauts and the long-duration spaceflight manned program.

  18. Ophthalmic Start-Up Chief Executive Officers' Perceptions of Development Hurdles.

    PubMed

    Stewart, William C; Nelson, Lindsay A; Kruft, Bonnie; Stewart, Jeanette A

    2018-01-01

    To identify current challenges facing ophthalmic pharmaceutical start-ups in developing new products. Surveys were distributed to the chief executive officer (CEO) or president of ophthalmic start-ups. The survey attracted 24 responses from 78 surveys distributed (31%). The CEOs stated that a lack of financial capital (n = 18, 75%), FDA regulations (n = 6, 25%), and failure to meet clinical endpoints (n = 6, 25%) were their greatest development hurdles. Risk aversion to medicines in early development (n = 18, 75%), mergers and acquisitions reducing corporate choice for licensing agreements (n = 7, 29%), the emergence of large pharmaceutical-based venture capital funding groups (n = 12, 50%), and the failure of many large pharmaceutical companies to develop their own medicines (n = 10, 42%) were noted as recent prominent trends affecting fundraising. The study suggests that development funding, regulatory burden, and meeting clinical endpoints are the greatest development challenges faced by ophthalmic start-up CEOs. © 2017 S. Karger AG, Basel.

  19. Fast scanning probe for ophthalmic echography using an ultrasound motor.

    PubMed

    Carotenuto, Riccardo; Caliano, Giosuè; Caronti, Alessandro; Savoia, Alessandro; Pappalardo, Massimo

    2005-11-01

    High-frequency transducers, up to 35-50 MHz, are widely used in ophthalmic echography to image fine eye structures. Phased-array techniques are not practically applicable at such a high frequency, due to the too small size required for the single transducer element, and mechanical scanning is the only practical alternative. At present, all ophthalmic ultrasound systems use focused single-element, mechanically scanned probes. A good probe positioning and image evaluation feedback requires an image refresh-rate of about 15-30 frames per second, which is achieved in commercial mechanical scanning probes by using electromagnetic motors. In this work, we report the design, construction, and experimental characterization of the first mechanical scanning probe for ophthalmic echography based on a small piezoelectric ultrasound motor. The prototype probe reaches a scanning rate of 15 sectors per second, with very silent operation and little weight. The first high-frequency echographic images obtained with the prototype probe are presented.

  20. Genotype, B-vitamin status, and androgens affect spaceflight-induced ophthalmic changes

    PubMed Central

    Zwart, Sara R.; Gregory, Jesse F.; Zeisel, Steven H.; Gibson, Charles R.; Mader, Thomas H.; Kinchen, Jason M.; Ueland, Per M.; Ploutz-Snyder, Robert; Heer, Martina A.; Smith, Scott M.

    2016-01-01

    Ophthalmic changes have occurred in a subset of astronauts on International Space Station missions. Visual deterioration is considered the greatest human health risk of spaceflight. Affected astronauts exhibit higher concentrations of 1-carbon metabolites (e.g., homocysteine) before flight. We hypothesized that genetic variations in 1-carbon metabolism genes contribute to susceptibility to ophthalmic changes in astronauts. We investigated 5 polymorphisms in the methionine synthase reductase (MTRR), methylenetetrahydrofolate reductase (MTHFR), serine hydroxymethyltransferase (SHMT), and cystathionine β-synthase (CBS) genes and their association with ophthalmic changes after flight in 49 astronauts. The number of G alleles of MTRR 66 and C alleles of SHMT1 1420 both contributed to the odds of visual disturbances. Preflight dehydroepiandrosterone was positively associated with cotton wool spots, and serum testosterone response during flight was associated with refractive change. Block regression showed that B-vitamin status and genetics were significant predictors of many of the ophthalmic outcomes that we observed. In one example, genetics trended toward improving (P = 0.10) and B-vitamin status significantly improved (P < 0.001) the predictive model for refractive change after flight. We document an association between MTRR 66 and SHMT1 1420 polymorphisms and spaceflight-induced vision changes. This line of research could lead to therapeutic options for both space travelers and terrestrial patients.—Zwart, S. R., Gregory, J. F., Zeisel, S. H., Gibson, C. R., Mader, T. H., Kinchen, J. M., Ueland, P. M., Ploutz-Snyder, R., Heer, M. A., Smith, S. M. Genotype, B-vitamin status, and androgens affect spaceflight-induced ophthalmic changes. PMID:26316272

  1. Current Perspectives on Ophthalmic Mycoses

    PubMed Central

    Thomas, Philip A.

    2003-01-01

    Fungi may infect the cornea, orbit and other ocular structures. Species of Fusarium, Aspergillus, Candida, dematiaceous fungi, and Scedosporium predominate. Diagnosis is aided by recognition of typical clinical features and by direct microscopic detection of fungi in scrapes, biopsy specimens, and other samples. Culture confirms the diagnosis. Histopathological, immunohistochemical, or DNA-based tests may also be needed. Pathogenesis involves agent (invasiveness, toxigenicity) and host factors. Specific antifungal therapy is instituted as soon as the diagnosis is made. Amphotericin B by various routes is the mainstay of treatment for life-threatening and severe ophthalmic mycoses. Topical natamycin is usually the first choice for filamentous fungal keratitis, and topical amphotericin B is the first choice for yeast keratitis. Increasingly, the triazoles itraconazole and fluconazole are being evaluated as therapeutic options in ophthalmic mycoses. Medical therapy alone does not usually suffice for invasive fungal orbital infections, scleritis, and keratitis due to Fusarium spp., Lasiodiplodia theobromae, and Pythium insidiosum. Surgical debridement is essential in orbital infections, while various surgical procedures may be required for other infections not responding to medical therapy. Corticosteroids are contraindicated in most ophthalmic mycoses; therefore, other methods are being sought to control inflammatory tissue damage. Fungal infections following ophthalmic surgical procedures, in patients with AIDS, and due to use of various ocular biomaterials are unique subsets of ophthalmic mycoses. Future research needs to focus on the development of rapid, species-specific diagnostic aids, broad-spectrum fungicidal compounds that are active by various routes, and therapeutic modalities which curtail the harmful effects of fungus- and host tissue-derived factors. PMID:14557297

  2. 21 CFR 524.154 - Bacitracin or bacitracin zinc-neomycin sulfate-polymyxin B sulfate ophthalmic ointment.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... organisms. (3) Limitations. Laboratory tests should be conducted including in vitro culturing and... sulfate ophthalmic ointment. (a) Sponsor. To firms identified in § 510.600(c) of this chapter as follows...

  3. 21 CFR 524.154 - Bacitracin or bacitracin zinc-neomycin sulfate-polymyxin B sulfate ophthalmic ointment.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... organisms. (3) Limitations. Laboratory tests should be conducted including in vitro culturing and... sulfate ophthalmic ointment. (a) Sponsor. To firms identified in § 510.600(c) of this chapter as follows...

  4. Liability and ophthalmic drug use.

    PubMed

    Classé, J G

    1992-01-01

    Ophthalmic drug use has been an aspect of optometry for more than two decades. Although utilization of these drugs has produced significant changes in the clinical and legal responsibilities of optometrists, the liability posture of the profession has remained unaltered. Studies of malpractice claims against optometrists and ophthalmologists have demonstrated that ophthalmologists are much more likely to be charged with negligence for adverse drug reactions and that drug-related malpractice claims are not a liability issue for optometrists. Based on the experiences of both professions, this paper describes the adverse effects of common ophthalmic drugs, with emphasis on those drug reactions that have resulted in litigation.

  5. Generalized ray tracing method for the calculation of the peripheral refraction induced by an ophthalmic lens

    NASA Astrophysics Data System (ADS)

    Rojo, Pilar; Royo, Santiago; Caum, Jesus; Ramírez, Jorge; Madariaga, Ines

    2015-02-01

    Peripheral refraction, the refractive error present outside the main direction of gaze, has lately attracted interest due to its alleged relationship with the progression of myopia. The ray tracing procedures involved in its calculation need to follow an approach different from those used in conventional ophthalmic lens design, where refractive errors are compensated only in the main direction of gaze. We present a methodology for the evaluation of the peripheral refractive error in ophthalmic lenses, adapting the conventional generalized ray tracing approach to the requirements of the evaluation of peripheral refraction. The nodal point of the eye and a retinal conjugate surface will be used to evaluate the three-dimensional distribution of refractive error around the fovea. The proposed approach enables us to calculate the three-dimensional peripheral refraction induced by any ophthalmic lens at any direction of gaze and to personalize the lens design to the requirements of the user. The complete evaluation process for a given user prescribed with a -5.76D ophthalmic lens for foveal vision is detailed, and comparative results obtained when the geometry of the lens is modified and when the central refractive error is over- or undercorrected. The methodology is also applied for an emmetropic eye to show its application for refractive errors other than myopia.

  6. Ophthalmic preservatives: focus on polyquaternium-1.

    PubMed

    Rolando, Maurizio; Crider, Julie Y; Kahook, Malik Y

    2011-11-01

    Ophthalmic preservatives, such as polyquaternium-1 (PQ-1), are critical for the inhibition of growth of microbial contaminants in multi-dose bottles of topical medications. These antimicrobial agents must have a high efficacy against pathogenic organisms, while maintaining a favorable tolerability and safety profile. This review focuses on the ophthalmic preservative PQ-1. For comparison purposes, the most commonly used preservative, benzalkonium chloride (BAK), is also discussed. This survey focuses primarily on data collected during the past 10 years. Effective drug delivery requires more than just an active ingredient that achieves its desired biological effect on end-target tissues. In addition, drugs must be stable in the containers that they are stored in, and must possess minimal undesired local and systemic side effects that can cause patients to decrease their adherence. In addressing these concerns, specifically in topical ophthalmic drops, one must take into account the active ingredients, vehicle components and preservatives. Medications with fewer adverse effects may lead to enhanced adherence to therapy; therefore, the induction of such adverse outcomes must be considered by physicians when treating patients with chronic ocular disease. Although BAK will continue to be used in ophthalmic medications, due to its familiarity and compatibility with a broad range of topical ocular formulations, PQ-1 is certainly a viable alternative in the preservative formulary armamentarium.

  7. The international forum of ophthalmic simulation: developing a virtual reality training curriculum for ophthalmology.

    PubMed

    Saleh, George M; Lamparter, Julia; Sullivan, Paul M; O'Sullivan, Fiona; Hussain, Badrul; Athanasiadis, Ioannis; Litwin, Andre S; Gillan, Stewart N

    2013-06-01

    To investigate the effect of a structured, supervised, cataract simulation programme on ophthalmic surgeons in their first year of training, and to evaluate the level of skill transfer. Trainees with minimal intraocular and simulator experience in their first year of ophthalmology undertook a structured, sequential, customised, virtual reality (VR) cataract training programme developed through the International Forum of Ophthalmic Simulation. A set of one-handed, bimanual, static and dynamic tasks were evaluated before and after the course and scores obtained. Statistical significance was evaluated with the Wilcoxon sign-rank test. The median precourse score of 101.50/400 (IQR 58.75-145.75) was significantly improved after completing the training programme ((postcourse score: 302/400, range: 266.25-343), p<0.001). While improvement was evident and found to be statistically significant in all parameters, greatest improvements were found for capsulorhexis and antitremor training ((Capsulorhexis: precourse score=0/100, range 0-4.5; postcourse score=81/100, range 13-87.75; p=0.002), (antitremor training: precourse score=0/100, range 0-0; postcourse score=80/100, range 60.25-91.50; p=0.001)). Structured and supervised VR training can offer a significant level of skills transfer to novice ophthalmic surgeons. VR training at the earliest stage of ophthalmic surgical training may, therefore, be of benefit.

  8. Characterization of novel microsphere chain fiber optic tips for potential use in ophthalmic laser surgery.

    PubMed

    Hutchens, Thomas C; Darafsheh, Arash; Fardad, Amir; Antoszyk, Andrew N; Ying, Howard S; Astratov, Vasily N; Fried, Nathaniel M

    2012-06-01

    Ophthalmic surgery may benefit from use of more precise fiber delivery systems during laser surgery. Some current ophthalmic surgical techniques rely on tedious mechanical dissection of tissue layers. In this study, chains of sapphire microspheres integrated into a hollow waveguide distal tip are used for erbium:YAG laser ablation studies in contact mode with ophthalmic tissues, ex vivo. The laser's short optical penetration depth combined with the small spot diameters achieved with this fiber probe may provide more precise tissue removal. One-, three-, and five-microsphere chain structures were characterized, resulting in FWHM diameters of 67, 32, and 30 μm in air, respectively, with beam profiles comparable to simulations. Single Er:YAG pulses of 0.1 mJ and 75-μs duration produced ablation craters with average diameters of 44, 30, and 17 μm and depths of 26, 10, and 8 μm, for one-, three-, and five-sphere structures, respectively. Microsphere chains produced spatial filtering of the multimode Er:YAG laser beam and fiber, providing spot diameters not otherwise available with conventional fiber systems. Because of the extremely shallow treatment depth, compact focused beam, and contact mode operation, this probe may have potential for use in dissecting epiretinal membranes and other ophthalmic tissues without damaging adjacent retinal tissue.

  9. iPhone 4s and iPhone 5s Imaging of the Eye.

    PubMed

    Jalil, Maaz; Ferenczy, Sandor R; Shields, Carol L

    2017-01-01

    To evaluate the technical feasibility of a consumer-grade cellular iPhone camera as an ocular imaging device compared to existing ophthalmic imaging equipment for documentation purposes. A comparison of iPhone 4s and 5s images was made with external facial images (macrophotography) using Nikon cameras, slit-lamp images (microphotography) using Zeiss photo slit-lamp camera, and fundus images (fundus photography) using RetCam II. In an analysis of six consecutive patients with ophthalmic conditions, both iPhones achieved documentation of external findings (macrophotography) using standard camera modality, tap to focus, and built-in flash. Both iPhones achieved documentation of anterior segment findings (microphotography) during slit-lamp examination through oculars. Both iPhones achieved fundus imaging using standard video modality with continuous iPhone illumination through an ophthalmic lens. Comparison to standard ophthalmic cameras, macrophotography and microphotography were excellent. In comparison to RetCam fundus photography, iPhone fundus photography revealed smaller field and was technically more difficult to obtain, but the quality was nearly similar to RetCam. iPhone versions 4s and 5s can provide excellent ophthalmic macrophotography and microphotography and adequate fundus photography. We believe that iPhone imaging could be most useful in settings where expensive, complicated, and cumbersome imaging equipment is unavailable.

  10. Relationship between the Direction of Ophthalmic Artery Blood Flow and Ocular Microcirculation before and after Carotid Artery Stenting.

    PubMed

    Ishii, Masashi; Hayashi, Morito; Yagi, Fumihiko; Sato, Kenichiro; Tomita, Goji; Iwabuchi, Satoshi

    2016-01-01

    When internal carotid artery stenosis is accompanied by ocular ischemic syndrome, intervention is recommended to prevent irreversible visual loss. In this study, we used laser speckle flowgraphy to measure the ocular microcirculation in the optic nerve head before and after carotid artery stenting (CAS) of 40 advanced internal carotid stenosis lesions from 37 patients. The aim was to investigate the relationship between ocular microcirculation and the direction of ophthalmic artery blood flow obtained by angiography. We found that there was a significant increase in blood flow after CAS ( P = 0.003). Peak systolic velocity as an indicator of the rate of stenosis was also significantly higher in the group with retrograde/undetected flow of the ophthalmic artery than in the group with antegrade flow ( P = 0.002). In all cases where retrograde flow of the ophthalmic artery was observed before stenting, the flow changed to antegrade after stenting. Through the use of laser speckle flowgraphy, this study found that CAS can improve ocular microcirculation. Furthermore, while patients displaying retrograde flow of the ophthalmic artery before stenting have a poor prognosis, CAS corrected the flow to antegrade, suggesting that visual loss can be prevented by improving the ocular microcirculation.

  11. Ophthalmic Manifestations of Congenital Zika Syndrome in Colombia and Venezuela

    PubMed Central

    Yepez, Juan B.; Murati, Felipe A.; Pettito, Michele; Peñaranda, Carlos F.; de Yepez, Jazmin; Maestre, Gladys

    2017-01-01

    Importance The ocular manifestations and sequelae of Zika virus infection are not well known. Recently, the World Health Organization changed the declaration of Zika as a public health emergency and designated the viral outbreak and related microcephaly clusters as a long-term program of work. This change indicates the urgent need to evaluate and document ophthalmic manifestations in patients for timely management of this disease. In addition, confirmation whether the public health problem in Brazil extends to other regions in South America is needed. Objective To report the ocular manifestations of congenital Zika syndrome with microcephaly in Colombia and Venezuela. Design, Setting, and Participants This prospective case series included 43 patients from 2 ophthalmic centers in Colombia and Venezuela who underwent evaluation from October 1, 2015, through June 30, 2016, and were clinically diagnosed with congenital Zika syndrome. Twenty patients were Hispanic; 13, African; 8, white; and 2, Native American. Interventions Ophthalmic and systemic evaluations and serologic testing were performed on all infants. Patients underwent external ocular examination and dilated ophthalmoscopy. Serologic testing ruled out toxoplasmosis, rubella, cytomegalovirus, syphilis, and human immunodeficiency virus. Main Outcomes and Measures Ophthalmic manifestations of congenital Zika syndrome. Results Of the 43 patients included in this series (28 female and 15 male), the mean (SD) age at examination was 2.1 (1.5) months. The mothers of all the children had no ophthalmic findings and did not report ocular symptoms during pregnancy. All patients had bilateral ophthalmic manifestations. Optic nerve findings included hypoplasia with the double-ring sign, pallor, and increased cup-disc ratio in 5 patients (11.6%). Macular abnormalities included mild to severe pigment mottling in 27 patients (63%) and lacunar maculopathy in 3 (6.9%). Chorioretinal scarring was present in 3 patients (7%). Eleven patients (26%) had a combination of lesions in the posterior pole. Five patients (12%) were diagnosed with congenital glaucoma, characterized by the clinical triad of epiphora, photophobia, and blepharospasm; increased intraocular pressure; corneal clouding at birth; and buphthalmos. These data reveal that 12% (95% CI, 5%-24%) of cases of congenital Zika with microcephaly had anterior segment abnormalities and 88% (95% CI, 76%-94%) had important macular and optic nerve abnormalities. The visual sequelae of these ophthalmic manifestations remain unknown. Conclusions and Relevance Congenital Zika syndrome in the current study had severe ocular abnormalities, and all patients had bilateral involvement. Ocular findings were focal macular pigment mottling, chorioretinal atrophy with a predilection for the macular area, congenital glaucoma and optical nerve hypoplasia, and optic disc abnormalities. Ophthalmic examination is recommended in patients with congenital Zika syndrome. PMID:28418539

  12. Three percent diquafosol ophthalmic solution as an additional therapy to existing artificial tears with steroids for dry-eye patients with Sjögren's syndrome.

    PubMed

    Yokoi, N; Sonomura, Y; Kato, H; Komuro, A; Kinoshita, S

    2015-09-01

    To investigate the long-term results of 3% diquafosol ophthalmic solution as an alternative therapy to existing ophthalmic solutions, including topical immunosuppression, for the treatment of dry eye in patients with Sjögren's syndrome. This study involved 14 female dry-eye patients (mean age: 62.4 years) with Sjögren's syndrome who insufficiently responded to their current therapy. In all patients, 3% diquafosol ophthalmic solution was administered six times daily for 12 months in substitution for artificial tears and sodium hyaluronate ophthalmic solution. Their use of corticosteroid eye drops remained unchanged from that prior to the treatment with diquafosol sodium. The subjective symptoms assessed, and ocular signs including tear meniscus radius and the tear film breakup time, and ocular-surface epithelial damage score were examined at 1, 2, 3, 4, 5, 6, 9, and 12 months after initiating treatment. Among the subjective symptoms, significant improvement was obtained in dryness at 2 months post treatment, in eye fatigue at 1, 2, 3, 4, and 12 months post treatment, and in pain at 1, 2, 6, and 12 months post treatment. Difficulty in opening the eye, foreign body sensation, and redness were also significantly ameliorated at various time-points. The tear meniscus radius and the tear film breakup time were significantly improved throughout the observation period, and the corneal epithelial staining scores were significantly decreased at 3 months post treatment. In dry-eye patients with Sjögren's syndrome, treatment with 3% diquafosol ophthalmic solution improved both symptoms and signs, and that effectiveness was maintained for 12 months.

  13. Degree of corneal anesthesia after topical application of 0.4% oxybuprocaine ophthalmic solution in normal equids.

    PubMed

    Little, Erika; Yvorchuk-St Jean, Kathy; Little, William; Sithole, Fortune; St Jean, Guy

    2016-10-01

    Oxybuprocaine hydrochloride ophthalmic solution has been widely used off-label in horses and donkeys, despite lack of data demonstrating efficacy and safety in these species. The objective of this study was to assess anesthetic efficacy of 0.4% oxybuprocaine hydrochloride ophthalmic solution in horses ( n = 5) and donkeys ( n = 24) and compare the effects with 0.5% proparacaine hydrochloride ophthalmic solution. The baseline corneal touch threshold (CTT) was measured with a Cochet-Bonnet esthesiometer. Donkeys ( n = 12) and horses ( n = 5) in group A received sterile ophthalmic solutions 0.4% oxybuprocaine with fluorescein (also termed benoxinate with fluorescein, abbreviated as ben + flu) instilled in one eye and 0.9% sterile sodium chloride solution (NaCl) with fluorescein (Na + flu) in the contralateral eye. Donkeys ( n = 12) and horses ( n = 5) in group B received sterile ophthalmic solutions (ben + flu) in one eye and 0.5% proparacaine with fluorescein (prop + flu) in the contralateral eye. The CTT was measured at 1 and 5 min post-application and at 5-minute intervals until 75 min after treatment. The CTT changes over time differed significantly between oxybuprocaine-treated and control eyes ( P < 0.001). The CTT continued to decrease throughout the duration of the study when compared with baseline values. No statistically significant difference in onset, depth, or duration of corneal anesthesia was found between oxybuprocaine and proparacaine treated eyes during the time of the study. Interestingly, horses were shown to have a significantly more sensitive cornea than donkeys ( P = 0.002). Oxybuprocaine and proparacaine reduced corneal sensitivity in donkeys and horses. No local irritation was observed with 0.4% oxybuprocaine.

  14. Degree of corneal anesthesia after topical application of 0.4% oxybuprocaine ophthalmic solution in normal equids

    PubMed Central

    Little, Erika; Yvorchuk-St. Jean, Kathy; Little, William; Sithole, Fortune; St. Jean, Guy

    2016-01-01

    Oxybuprocaine hydrochloride ophthalmic solution has been widely used off-label in horses and donkeys, despite lack of data demonstrating efficacy and safety in these species. The objective of this study was to assess anesthetic efficacy of 0.4% oxybuprocaine hydrochloride ophthalmic solution in horses (n = 5) and donkeys (n = 24) and compare the effects with 0.5% proparacaine hydrochloride ophthalmic solution. The baseline corneal touch threshold (CTT) was measured with a Cochet-Bonnet esthesiometer. Donkeys (n = 12) and horses (n = 5) in group A received sterile ophthalmic solutions 0.4% oxybuprocaine with fluorescein (also termed benoxinate with fluorescein, abbreviated as ben + flu) instilled in one eye and 0.9% sterile sodium chloride solution (NaCl) with fluorescein (Na + flu) in the contralateral eye. Donkeys (n = 12) and horses (n = 5) in group B received sterile ophthalmic solutions (ben + flu) in one eye and 0.5% proparacaine with fluorescein (prop + flu) in the contralateral eye. The CTT was measured at 1 and 5 min post-application and at 5-minute intervals until 75 min after treatment. The CTT changes over time differed significantly between oxybuprocaine-treated and control eyes (P < 0.001). The CTT continued to decrease throughout the duration of the study when compared with baseline values. No statistically significant difference in onset, depth, or duration of corneal anesthesia was found between oxybuprocaine and proparacaine treated eyes during the time of the study. Interestingly, horses were shown to have a significantly more sensitive cornea than donkeys (P = 0.002). Oxybuprocaine and proparacaine reduced corneal sensitivity in donkeys and horses. No local irritation was observed with 0.4% oxybuprocaine. PMID:27733789

  15. Scientific publications in ophthalmic journals from China and other top-ranking countries: a 12-year review of the literature.

    PubMed

    Huang, Wenbin; Wang, Wei; Zhan, Jiao; Zhou, Minwen; Chen, Shida; Zhang, Xiulan

    2013-06-26

    Eye diseases with increasing mortality are common health problems that affect people of all ages and demographic backgrounds. In this study, we study the publication characteristics in international ophthalmic journals of the US, the UK, Germany, Australia, Japan, and China. Articles published in 53 ophthalmic journals from 2000 to 2011 were retrieved from the PubMed database. We recorded the number of articles published each year, analyzed the publication type, and evaluated the accumulated and average impact factors (IFs), and the distribution of articles in ophthalmic journals in relation to IFs. The characteristics of publication outputs from China and other top-ranking countries were compared. The total number of articles increased significantly during the past 12 years, with an increase of 51.0%. The growth in the annual number of articles from the US, the UK, Australia, and China showed a significantly positive trend. Publications from the US exceeded those from any other country and had the highest IFs, largest number of total citations of articles, and the most articles published in leading ophthalmic journals. During the past 12 years, China contributed 3.5% of the total publications, and the number of Chinese articles showed a more than 6-fold increase (from 99 to 605, R2 =0.947, P<0.001). The numbers of IFs and citations of articles originating in China were mostly lower than for other top-ranking counties. Research on ophthalmic journals has maintained an upward growing trend from 2000 to 2011. Chinese ophthalmology research has developed rapidly, but the gap still exists between China and other top-ranking countries for the advanced level of research.

  16. Preparation of ophthalmic formulations containing cilostazol as an anti-glaucoma agent and improvement in its permeability through the rabbit cornea.

    PubMed

    Okamoto, Norio; Ito, Yoshimasa; Nagai, Noriaki; Murao, Takatoshi; Takiguchi, Yusuke; Kurimoto, Takuji; Mimura, Osamu

    2010-01-01

    To evaluate the pharmacological properties of cilostazol (CLZ), we examined its intraocular pressure (IOP) -lowering effect. CLZ is an inhibitor of Type III phosphodiesterase that increases intracellular cyclic AMP levels by restraining platelet aggregation, and has a potential protective effect against atherosclerosis. We attempted to apply it for use as an anti-glaucoma agent; however, the application of CLZ in the ophthalmic field is limited due to its poor water solubility. We attempted to enhance CLZ solubility using 2-hydroxypropyl-beta-cyclodextrin (HPbetaCD). The solubility of CLZ increased with increasing HPbetaCD concentrations, and 0.05% CLZ was dissolved in 10% HPbetaCD. Moreover, fine particle suspension of 0.5% CLZ in 5% HPbetaCD (soluble CLZ: ca. 0.027%) were prepared using a Microfluidizer, an impact-type emulsifying comminution device. In an in vitro transcorneal penetration experiment through the rabbit cornea, the CLZ penetration rate was dependent on the CLZ content of the solutions and suspensions. When a 0.05% CLZ ophthalmic solution was instilled into a rabbit eye, the absorption rate constant for CLZ into an aqueous humor was 0.0059+/-0.001 min(-1), and the elimination rate constant was 0.048+/-0.024 min(-1). Also CLZ ophthalmic solutions and fine particle suspension were examined to for their ability to reduce enhanced intraocular pressure (IOP) of rabbits in a darkroom. The instillation of 0.05% CLZ ophthalmic solutions and 0.5% CLZ fine particle suspensions into rabbit eyes reduced the enhanced IOP. These results demonstrate that the instillation of CLZ ophthalmic solutions and fine particle suspensions may represent an effective anti-glaucoma formulation.

  17. An ophthalmic solution of a peroxisome proliferator-activated receptor gamma agonist prevents corneal inflammation in a rat alkali burn model

    PubMed Central

    Uchiyama, Masaaki; Masuda, Yukinari; Nagasaka, Shinya; Fukuda, Yuh; Takahashi, Hiroshi

    2013-01-01

    Purpose We clarified the effects of an ophthalmic solution of a peroxisome proliferator-activated receptor gamma (PPARγ) agonist on corneal inflammation and wound healing after alkali burn injury in rats. Methods After alkali exposure, either an ophthalmic solution with 0.1% pioglitazone hydrochloride (the PPARγ group) or vehicle (the vehicle group) was topically applied to the cornea until day 14. Histological, immunohistochemical, and real-time reverse transcription polymerase chain reaction analysis were performed. Results After alkali injury, PPARγ expression increased, with the infiltration of many inflammatory cells. The infiltration of neutrophils and macrophages started from the corneal limbus within 6 h, and developed in the corneal center by day 7, with associated neovascularization. The accumulation of α-smooth muscle actin-positive myofibroblasts and the deposition of type III collagen were noted on day 14. The histological changes were suppressed significantly by treatment with the ophthalmic solution of the PPARγ agonist. In addition, the number of infiltrating M2 macrophages in the cornea was increased by PPARγ agonist treatment. In real-time reverse transcription polymerase chain reaction analysis, the messenger ribonucleic acid expression levels of interleukin-1β (IL-1β), IL-6, IL-8, monocyte chemoattractant protein-1, tumor necrosis factor-α, transforming growth factor beta 1, and vascular endothelial growth factor-A were decreased in the PPARγ group compared to the vehicle group in the early periods of corneal inflammation. Conclusions The ophthalmic solution of the PPARγ agonist inhibited inflammation, decreased the fibrotic reaction, and prevented neovascularization in the cornea from the early phase after alkali burn injury. The ophthalmic solution of the PPARγ agonist may provide a new treatment strategy with useful clinical applications for corneal inflammation and wound healing. PMID:24194635

  18. Rescue Sedation With Intranasal Dexmedetomidine for Pediatric Ophthalmic Examination After Chloral Hydrate Failure: A Randomized, Controlled Trial.

    PubMed

    Gan, Xiaoliang; Lin, Haotian; Chen, Jingjing; Lin, Zhuoling; Lin, Yiquan; Chen, Weirong

    2016-06-01

    It is a challenge to rescue ophthalmology examinations performed in children in the sedation room after initial chloral hydrate failure. Intranasal dexmedetomidine can be used in rescue sedation in children undergoing computed tomography. The present study aimed to assess the efficacy and tolerability of intranasal dexmedetomidine use in children undergoing ophthalmic examination after chloral hydrate failure. Sixty uncooperative pediatric patients with cataract (aged 5-36 months; weight, 7-15 kg) presented for follow-up ophthalmic examination. Patients who experienced chloral hydrate failure were randomized to 1 of 2 groups to receive intranasal dexmedetomidine 1 or 2 μg/kg for rescue sedation. Each group contained 30 patients. The primary outcome was the rate of a successful ophthalmic examination. Secondary outcomes included sedation onset time, recovery time, duration of examination, discharge time, and adverse events, including percentage of heart rate reduction, respiratory depression, vomiting, and postsedative agitation. A successful ophthalmic examination was achieved in 93.3% (28/30) of patients in the 2-μg/kg dose group and in 66.7% (20/30) of patients in the 1-μg/kg dose group (P = 0.021). The onset time, recovery time, and discharge time did not significantly differ between the 2 groups. None of the patients required clinical intervention due to heart rate reduction, and none of the patients in either group experienced vomiting, respiratory depression, or agitation after the administration of dexmedetomidine. In children undergoing ophthalmic examination, intranasal dexmedetomidine can be administered in the sedation room for rescue sedation after chloral hydrate failure, with the 2-μg/kg dose being more efficacious than the 1-μg/kg dose, as measured by success rate. ClinicalTrials.gov identifier: NCT02077712. Copyright © 2016 Elsevier HS Journals, Inc. All rights reserved.

  19. Besifloxacin ophthalmic suspension, 0.6%: a novel topical fluoroquinolone for bacterial conjunctivitis.

    PubMed

    O'Brien, Terrence P

    2012-06-01

    Acute bacterial conjunctivitis, the most common cause of conjunctivitis, is responsible for approximately 1% of all primary-care consultations. Of the topical ophthalmic antibiotics used to treat acute bacterial conjunctivitis, fluoroquinolones are especially useful because they possess a broad antibacterial spectrum, are bactericidal in action, are generally well tolerated, and have been less prone to development of bacterial resistance. Besifloxacin, the latest advanced fluoroquinolone approved for treating bacterial conjunctivitis, is the first fluoroquinolone developed specifically for topical ophthalmic use. It has a C-8 chlorine substituent and is known as a chloro-fluoroquinolone. Besifloxacin possesses relatively balanced dual-targeting activity against bacterial topoisomerase IV and DNA gyrase (topoisomerse II), two essential enzymes involved in bacterial DNA replication, leading to increased potency and decreased likelihood of bacterial resistance developing to besifloxacin. Microbiological data suggest a relatively high potency and rapid bactericidal activity for besifloxacin against common ocular pathogens, including bacteria resistant to other fluoroquinolones, especially resistant staphylococcal species. Randomized, double-masked, controlled clinical studies demonstrated the clinical efficacy of besifloxacin ophthalmic suspension 0.6% administered three-times daily for 5 days to be superior to the vehicle alone and similar to moxifloxacin ophthalmic solution 0.5% for bacterial conjunctivitis. In addition, besifloxacin ophthalmic suspension 0.6% administered two-times daily for 3 days was clinically more effective than the vehicle alone for bacterial conjunctivitis. Besifloxacin has also been shown in preclinical animal studies to be potentially effective for the "off-label" treatment of infections following ocular surgery, prophylaxis of endophthalmitis, and the treatment of bacterial keratitis. Taken together, clinical and preclinical animal studies indicate that besifloxacin is an important new option for the treatment of ocular infections.

  20. Ophthalmic gels: Past, present and future.

    PubMed

    Al-Kinani, Ali A; Zidan, Ghada; Elsaid, Naba; Seyfoddin, Ali; Alani, Adam W G; Alany, Raid G

    2018-02-15

    Aqueous gels formulated using hydrophilic polymers (hydrogels) along with those based on stimuli responsive polymers (in situ gelling or gel forming systems) continue to attract increasing interest for various eye health-related applications. They allow the incorporation of a variety of ophthalmic pharmaceuticals to achieve therapeutic levels of drugs and bioactives at target ocular sites. The integration of sophisticated drug delivery technologies such as nanotechnology-based ones with intelligent and environment responsive systems can extend current treatment duration to provide more clinically relevant time courses (weeks and months instead of hours and days) which will inevitably reduce dose frequency, increase patient compliance and improve clinical outcomes. Novel applications and design of contact lenses and intracanalicular delivery devices along with the move towards integrating gels into various drug delivery devices like intraocular pumps, injections and implants has the potential to reduce comorbidities caused by glaucoma, corneal keratopathy, cataract, diabetic retinopathies and age-related macular degeneration. This review describes ophthalmic gelling systems with emphasis on mechanism of gel formation and application in ophthalmology. It provides a critical appraisal of the techniques and methods used in the characterization of ophthalmic preformed gels and in situ gelling systems along with a thorough insight into the safety and biocompatibility of these systems. Newly developed ophthalmic gels, hydrogels, preformed gels and in situ gelling systems including the latest in the area of stimuli responsive gels, molecularly imprinted gels, nanogels, 3D printed hydrogels; 3D printed devices comprising ophthalmic gels are covered. Finally, new applications of gels in the production of artificial corneas, corneal wound healing and hydrogel contact lenses are described. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Mapping Opthalmic Terms to a Standardized Vocabulary.

    ERIC Educational Resources Information Center

    Patrick, Timothy B.; Reid, John C.; Sievert, MaryEllen; Popescu, Mihail; Gigantelli, James W.; Shelton, Mark E.; Schiffman, Jade S.

    2000-01-01

    Describes work by the American Academy of Ophthalmology (AAO) to expand the standardized vocabulary, Systematized Nomenclature of Medicine (SNOMED), to accommodate a definitive ophthalmic standardized vocabulary. Mapped a practice-based clinical ophthalmic vocabulary to SNOMED and other vocabularies in the Metathesaurus of the Unified Medical…

  2. 76 FR 42157 - Small Business Size Standards: Waiver of the Nonmanufacturer Rule

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-18

    ... (Ophthalmic Instruments, Equipment, and Supplies), under the North American Industry Classification System..., Service-Disabled Veteran- Owned (SDVO) small businesses, Participants in SBA's 8(a) Business Development..., Equipment, and Supplies), under NAICS code 339115 (Ophthalmic Goods Manufacturing). In response, on April 27...

  3. The impact of the European Working Time Regulations on Ophthalmic Specialist Training--a national trainee survey.

    PubMed

    O'Gallagher, M K; Lewis, G; Mercieca, K; Moutray, T

    2013-01-01

    To assess ophthalmic trainees' perspective of the impact of the European Working Time Regulations (EWTR) on their training. All trainees in ophthalmology in the UK were emailed a link to an electronic survey asking about their experiences of the EWTR. 324 trainees (46% of those invited) responded to the survey. 44.4% of trainees reported that their posts were compliant with the EWTR. 40.7% felt that training had been adversely affected. 49.1% thought that ophthalmic trainees should opt out of the EWTR to work more than 48 h per week, with 57 the mean number of hours suggested appropriate. Many ophthalmic trainees in the United Kingdom are working in rotas which are not compliant with the European Working Time Directive. Many trainees feel that implementation of the EWTD has had a negative effect on training and feel it would be acceptable to work a higher number of hours per week. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  4. Modulation of Vasomotive Activity in Rabbit External Ophthalmic Artery by Neuropeptides

    PubMed Central

    Delgado, Esmeralda Sofia Costa; Marques-Neves, Carlos; Rocha, Maria Isabel Sousa; Sales-Luís, José Paulo Pacheco; Silva-Carvalho, Luís Filipe

    2012-01-01

    Purpose. To investigate the vasomotive activity upon the external ophthalmic artery of vasointestinal peptide (VIP) and neuropeptide Y (NPY) using a previously developed model. Methods. Isolated rabbit eyes (n = 12) were perfused in situ with tyrode through the external ophthalmic artery. Effects of intra-arterial injections of NPY 200 μg/ml (Group A; n = 6) and VIP 200 μg/ml (Group B; n = 6) on the recorded pressure were obtained. For statistical analysis, Student's paired t-test and Fast Fourier Transform were used. Results. Spontaneous oscillations were observed before any drug administration in the 12 rabbit models. NPY produced an increase in total vascular resistance and a higher frequency and amplitude of oscillations, while VIP evoked the opposite effects. Conclusions. This study provides evidence of vasomotion in basal conditions in rabbit external ophthalmic artery. Concerning drug effects, NPY increased arterial resistance and enhanced vasomotion while VIP produced opposite effects which demonstrates their profound influence in arterial vasomotion. PMID:22496962

  5. Efficacy of contact lens disinfecting solutions against Staphylococcus aureus and Pseudomonas aeruginosa.

    PubMed

    Manuj, Kapur; Gunderson, Charlise; Troupe, John; Huber, Mary E

    2006-07-01

    To evaluate the disinfection properties of multipurpose contact lens disinfection solutions, based on the International Organization for Standardization (ISO) 14729 guidelines. ReNu with MoistureLoc Multi-Purpose Solution, OPTI-FREE Express with Aldox Multi-Purpose Solution, Betadine 5% sterile ophthalmic preparation solution (povidone iodine), and 0.9% normal saline solution were inoculated with strains of Staphylococcus aureus and Pseudomonas aeruginosa. Surviving bacteria were quantified at specified times. ReNu with MoistureLoc, OPTI-FREE Express, and 5% ophthalmic povidone iodine were effective in achieving a 5-log reduction in bacterial count. Additionally, all three products maintained their effectivity at 72 hours. However, ReNu with MoistureLoc and povidone iodine resulted in the greatest reduction in bacterial colonization. ReNu with MoistureLoc, OPTI-FREE Express, and 5% ophthalmic povidone iodine meet the ISO 14729 guidelines for standalone contact lens solutions. However, ReNu with MoistureLoc and 5% ophthalmic povidone iodine are most efficient in reducing and maintaining low bacterial count for a period of 72 hours.

  6. Readability assessment of online ophthalmic patient information.

    PubMed

    Edmunds, Matthew R; Barry, Robert J; Denniston, Alastair K

    2013-12-01

    Patients increasingly use the Internet to access information related to their disease, but poor health literacy is known to impact negatively on medical outcomes. Multiple agencies have recommended that patient-oriented literature be written at a fourth- to sixth-grade (9-12 years of age) reading level to assist understanding. The readability of online patient-oriented materials related to ophthalmic diagnoses is not yet known. To assess the readability of online literature specifically for a range of ophthalmic conditions. Body text of the top 10 patient-oriented websites for 16 different ophthalmic diagnoses, covering the full range of ophthalmic subspecialties, was analyzed for readability, source (United Kingdom vs non-United Kingdom, not for profit vs commercial), and appropriateness for sight-impaired readers. Four validated readability formulas were used: Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Gunning Fog Index (GFOG). Data were compared with the Mann-Whitney test (for 2 groups) and Kruskal-Wallis test (for more than 2 groups) and correlation was assessed by the Spearman r. None of the 160 webpages had readability scores within published guidelines, with 83% assessed as being of "difficult" readability. Not-for-profit webpages were of significantly greater length than commercial webpages (P = .02) and UK-based webpages had slightly superior readability scores compared with those of non-UK webpages (P = .004 to P < .001, depending on the readability formula used). Of all webpages evaluated, only 34% included facility to adjust text size to assist visually impaired readers. To our knowledge, this is the first study to assess readability of patient-focused webpages specifically for a range of ophthalmic diagnoses. In keeping with previous studies in other medical conditions, we determined that readability scores were inferior to those recommended, irrespective of the measure used. Although readability is only one aspect of how well a patient-oriented webpage may be comprehended, we recommend the use of readability scoring when producing such resources in the future. Minimum readability policies and inclusion of facilities within webpages to maximize viewing potential for visually impaired readers are important to ensure that online ophthalmic patient information is accessible to the broadest audience possible.

  7. The gaseous messenger carbon monoxide is released from the eye into the ophthalmic venous blood depending on the intensity of sunlight.

    PubMed

    Koziorowski, M; Stefańczyk-Krzymowska, S; Tabecka-Lonczyńska, A; Gilun, P; Kamiński, M

    2012-01-01

    Circadian and seasonal rhythms in daylight affect many physiological processes. In the eye, energy of intense visible light not only initiates a well-studied neural reaction in the retina that modulates the secretory function of the hypothalamus and pineal gland, but also activates the heme oxygenase (HO) to produce carbon monoxide (CO). This study was designed to determine whether the concentration of carbon monoxide (CO) in the ophthalmic venous blood changes depending on the phase of the day and differing extremely light intensity seasons: summer and winter. The concentration of CO in the venous blood flowing out from the nasal cavity, where heme oxygenase (HO) is expressed, but no photoreceptors, was used as a control. Sixteen mature males of a wild boar and pig crossbreed were used for this study. Samples of ophthalmic and nasal venous blood and systemic arterial and venous blood were collected repeatedly for two consecutive days during the longest days of the summer and the shortest days of the winter. The concentrations of CO in blood samples was measured using a standard addition method. During the longest days of the summer the concentration of CO in ophthalmic venous blood averaged 3.32 ± 0.71 and 3.43 ± 0.8 nmol/ml in the morning and afternoon, respectively, and was significantly higher than in the night averaging 0.89 ± 0.12 nmol/ml (p<0.001). During the shortest day of the winter CO concentration in ophthalmic venous blood was 1.11 ± 0.10 and 1.13 ± 0.14 nmol/ml during the light and nocturnal phase, respectively, and did not differ between phases, but was lower than in the light phase of the summer (p<0.01). The CO concentration in the control nasal venous blood did not differ between seasons and day phases and was lower than in ophthalmic venous blood during the summer (p<0.01) and winter (p<0.05). The results indicate that the gaseous messenger carbon monoxide is released from the eye into the ophthalmic venous blood depending on the intensity of sunlight.

  8. Treatment of neuro-ophthalmic sarcoidosis.

    PubMed

    Frohman, Larry P

    2015-03-01

    Because of the rarity of neuro-ophthalmic sarcoidosis, there are no therapeutic guidelines based on evidence-based medicine for this disorder. Review of literature combined with personal experience. Corticosteroids are the preferred initial therapy for neuro-ophthalmic sarcoidosis. If patients cannot tolerate the requisite dose of corticosteroid needed to control their disease, or if corticosteroids fail to adequately control the disease process, the choices of a second agent are based on the consideration of rapidity of clinical response and the safety profile. Although methotrexate and mycophenolate mofetil are the medications that are often selected after corticosteroid failure, more rapidly acting agents that have been used are infliximab and intravenous cyclophosphamide.

  9. Transarterial Embolization of a Spontaneous Intraorbital Arteriovenous Fistula With n-BCA Glue.

    PubMed

    Konstas, Angelos A; Rootman, Daniel B; Quiros, Peter A; Ross, Ian B

    Arteriovenous fistulae of the orbit are exceedingly rare. They are high-flow vascular malformations involving a fistula from the ophthalmic artery to one of the draining ophthalmic veins. Presenting symptoms can mimic those of carotid cavernous fistulae or of ophthalmic venous varices, and include diplopia, proptosis, chemosis, decreased visual acuity, and retro-orbital pain. Very few case reports are published on the treatment of this aggressive vascular malformation, and they uniformly describe techniques involving a transvenous access for the embolization of the fistula. To the best of authors' knowledge, they report the first case of transarterial embolization of an intraorbital AVF.

  10. Sustained release ophthalmic formulations of pilocarpine.

    PubMed

    Deshpande, S G; Shirolkar, S

    1989-03-01

    The bioavailability of drugs from conventional ophthalmic formulations is low. To optimize the therapy, sustained release ophthalmic dosage forms are warranted. Hydrogels such as sodium-carboxymethyl cellulose, hydroxypropylmethyl cellulose, Carbopol-940, Carbopol-941 and Lutrol-FC-127 increase the duration of action of various drugs. Gels containing pilocarpine were prepared and evaluated by measuring the intensity and duration of miotic response in albino rabbits. Carbopol-940 gels, being the best of those used, were studied further for the effect of its concentration and of additives (benzalkonium chloride, phenylmercuric nitrate, chlorbutol and disodium edetate), autoclaving at 121 degrees C for 30 min and irradiation with gamma rays (2.5 Mrad), on the end product.

  11. Evidence-based emergency medicine. Update: do ophthalmic nonsteroidal anti-inflammatory drugs reduce the pain associated with simple corneal abrasion without delaying healing?

    PubMed

    Weaver, Christopher S; Terrell, Kevin M

    2003-01-01

    Some studies have suggested that ophthalmic nonsteroidal anti-inflammatory drugs (NSAIDs) decrease the pain associated with corneal abrasions without impairing healing. This evidence-based emergency medicine (EBEM) critical appraisal reviews the literature, including additional studies appearing since the publication of an earlier EBEM review in 1999. The updated search for randomized controlled trials from 1999 to 2002 complemented the previous 1966 to 1999 search. The methodologic quality of the studies was assessed. Qualitative methods were used to summarize the study results. The search identified 3 studies not included in the previously published review of ophthalmic NSAIDs, yielding a total of 5 blinded, randomized, placebo-controlled trials involving NSAIDs for corneal abrasions. The methodologic quality of the new studies was somewhat higher than that of the 2 original studies and was rated as "good" to "strong." The qualitative summary indicates that NSAIDs provide greater pain relief and improvement of other subjective symptoms when compared with placebo. However, whether the reduction of pain, as measured by visual analog pain scales, exceeds the minimal clinically significant difference is equivocal. The use of ophthalmic NSAIDs may decrease the need for sedating analgesics. Ophthalmic NSAIDs appear to be useful for decreasing pain in patients with corneal abrasions who can afford the medication and who must return to work immediately, particularly where potential opioid-induced sedation is intolerable.

  12. NEUROSARCOIDOSIS MASQUERADING AS A CENTRAL NERVOUS SYSTEM TUMOR.

    PubMed

    Elia, Maxwell; Kombo, Ninani; Huang, John

    2017-01-01

    To report a case of neurosarcoidosis with an isolated brain lesion mimicking a low-grade glioma. A 38-year-old woman presented with 2 weeks of blurry vision in the left eye. Ophthalmic examination, visual field testing, fluorescein angiography, laboratory testing, and MRI of the brain were performed. Ophthalmic examination revealed left-sided optic nerve infiltration, and MRI of the brain demonstrated a solitary lesion in the brain. The visual symptoms and ophthalmic examination improved significantly with initiation of high-dose oral prednisone. Because the MRI appearance was concerning for malignancy, a brain biopsy was performed. Pathology demonstrated gliosis consistent with a low-grade central nervous system (CNS) glioma. One year later, after initial loss to ophthalmic follow-up, the right optic nerve became involved, and the patient was again treated successfully for presumed ocular sarcoidosis. At this time, serial neuroimaging demonstrated enlargement of the CNS lesion, prompting rebiopsy. Rebiopsy demonstrated a noncaseating granuloma, confirming the diagnosis of neurosarcoidosis. The patient was treated with 20 mg of methotrexate weekly and a prednisone taper with improvement in visual and neurologic symptoms. The authors present an unusual case of neurosarcoidosis masquerading as a CNS glioma. In cases of solitary CNS granulomas, radiographically differentiating neurosarcoidosis from a glioma can be challenging. In this case, serial ophthalmic examination identifying sequential involvement of both optic nerves helped to identify the underlying cause of the CNS disease as sarcoidosis.

  13. Diquafosol ophthalmic solution for dry eye treatment.

    PubMed

    Nakamura, Masatsugu; Imanaka, Takahiro; Sakamoto, Asuka

    2012-07-01

    There has been rapid progress in our understanding of dry eye pathogenesis, as well as the development of improved diagnostic clinical tests. Various types of dry eye treatment drugs have been developed. This review summarizes the basic and clinical research carried out in the development of diquafosol for ophthalmic use. Diquafosol is a dinucleotide, purinoreceptor P2Y(2) receptor agonist. Basic pharmacological studies have shown that it acts on P2Y(2) receptors at the ocular surface, to promote tear and mucin secretion via elevated intracellular Ca(2+) concentrations. Diquafosol also improves tear and mucin secretion in experimental dry eye models. Based on the results of laboratory experiments, the authors conducted a series of clinical studies in patients with dry eye disease. Diquafosol was effective in the treatment of dry eye disease at an optimal dose of 3% six times a day. In comparison to commercially available 0.1% sodium hyaluronate ophthalmic solution, 3% diquafosol ophthalmic solution showed non-inferiority in improving corneal fluorescein staining scores and superiority in improving keratoconjunctival Rose Bengal staining scores. Diquafosol ophthalmic solution has a novel mechanism of action that is characterized by its stimulatory effects on tear and mucin secretion. This drug has the potential to be effective in patients with tear film instability and short break-up time type of dry eye, which are essential factors in dry eye pathogenesis.

  14. Characterization of novel microsphere chain fiber optic tips for potential use in ophthalmic laser surgery

    PubMed Central

    Hutchens, Thomas C.; Darafsheh, Arash; Fardad, Amir; Antoszyk, Andrew N.; Ying, Howard S.; Astratov, Vasily N.

    2012-01-01

    Abstract. Ophthalmic surgery may benefit from use of more precise fiber delivery systems during laser surgery. Some current ophthalmic surgical techniques rely on tedious mechanical dissection of tissue layers. In this study, chains of sapphire microspheres integrated into a hollow waveguide distal tip are used for erbium:YAG laser ablation studies in contact mode with ophthalmic tissues, ex vivo. The laser’s short optical penetration depth combined with the small spot diameters achieved with this fiber probe may provide more precise tissue removal. One-, three-, and five-microsphere chain structures were characterized, resulting in FWHM diameters of 67, 32, and 30 μm in air, respectively, with beam profiles comparable to simulations. Single Er:YAG pulses of 0.1 mJ and 75-μs duration produced ablation craters with average diameters of 44, 30, and 17 μm and depths of 26, 10, and 8 μm, for one-, three-, and five-sphere structures, respectively. Microsphere chains produced spatial filtering of the multimode Er:YAG laser beam and fiber, providing spot diameters not otherwise available with conventional fiber systems. Because of the extremely shallow treatment depth, compact focused beam, and contact mode operation, this probe may have potential for use in dissecting epiretinal membranes and other ophthalmic tissues without damaging adjacent retinal tissue. PMID:22734790

  15. iPhone 4s and iPhone 5s Imaging of the Eye

    PubMed Central

    Jalil, Maaz; Ferenczy, Sandor R.; Shields, Carol L.

    2017-01-01

    Background/Aims To evaluate the technical feasibility of a consumer-grade cellular iPhone camera as an ocular imaging device compared to existing ophthalmic imaging equipment for documentation purposes. Methods A comparison of iPhone 4s and 5s images was made with external facial images (macrophotography) using Nikon cameras, slit-lamp images (microphotography) using Zeiss photo slit-lamp camera, and fundus images (fundus photography) using RetCam II. Results In an analysis of six consecutive patients with ophthalmic conditions, both iPhones achieved documentation of external findings (macrophotography) using standard camera modality, tap to focus, and built-in flash. Both iPhones achieved documentation of anterior segment findings (microphotography) during slit-lamp examination through oculars. Both iPhones achieved fundus imaging using standard video modality with continuous iPhone illumination through an ophthalmic lens. Comparison to standard ophthalmic cameras, macrophotography and microphotography were excellent. In comparison to RetCam fundus photography, iPhone fundus photography revealed smaller field and was technically more difficult to obtain, but the quality was nearly similar to RetCam. Conclusions iPhone versions 4s and 5s can provide excellent ophthalmic macrophotography and microphotography and adequate fundus photography. We believe that iPhone imaging could be most useful in settings where expensive, complicated, and cumbersome imaging equipment is unavailable. PMID:28275604

  16. 21 CFR 524.155 - Bacitracin zinc-polymyxin B sulfate-neomycin sulfate-hydrocortisone or hydrocortisone acetate...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... sulfate-hydrocortisone or hydrocortisone acetate ophthalmic ointment. 524.155 Section 524.155 Food and... zinc-polymyxin B sulfate-neomycin sulfate-hydrocortisone or hydrocortisone acetate ophthalmic ointment... hydrocortisone. (2) To 043264; each gram of ointment contains 400 units of bacitracin zinc, 10,000 units of...

  17. 21 CFR 524.155 - Bacitracin zinc-polymyxin B sulfate-neomycin sulfate-hydrocortisone or hydrocortisone acetate...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... sulfate-hydrocortisone or hydrocortisone acetate ophthalmic ointment. 524.155 Section 524.155 Food and... zinc-polymyxin B sulfate-neomycin sulfate-hydrocortisone or hydrocortisone acetate ophthalmic ointment... hydrocortisone. (2) To 025463; each gram of ointment contains 400 units of bacitracin zinc, 10,000 units of...

  18. 21 CFR 524.155 - Bacitracin zinc-polymyxin B sulfate-neomycin sulfate-hydrocortisone or hydrocortisone acetate...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... sulfate-hydrocortisone or hydrocortisone acetate ophthalmic ointment. 524.155 Section 524.155 Food and... zinc-polymyxin B sulfate-neomycin sulfate-hydrocortisone or hydrocortisone acetate ophthalmic ointment... hydrocortisone. (2) To 025463; each gram of ointment contains 400 units of bacitracin zinc, 10,000 units of...

  19. 21 CFR 524.155 - Bacitracin zinc-polymyxin B sulfate-neomycin sulfate-hydrocortisone or hydrocortisone acetate...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... sulfate-hydrocortisone or hydrocortisone acetate ophthalmic ointment. 524.155 Section 524.155 Food and... zinc-polymyxin B sulfate-neomycin sulfate-hydrocortisone or hydrocortisone acetate ophthalmic ointment... hydrocortisone. (2) To 025463; each gram of ointment contains 400 units of bacitracin zinc, 10,000 units of...

  20. 21 CFR 524.1200a - Kanamycin ophthalmic ointment.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... prophylactic in traumatic conditions, removal of foreign bodies, and intraocular surgery. Apply a thin film to... 21 Food and Drugs 6 2012-04-01 2012-04-01 false Kanamycin ophthalmic ointment. 524.1200a Section 524.1200a Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

  1. 21 CFR 524.1200a - Kanamycin ophthalmic ointment.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... kanamycin. For prophylaxis in traumatic conditions, removal of foreign bodies, and intraocular surgery. (3... 21 Food and Drugs 6 2014-04-01 2014-04-01 false Kanamycin ophthalmic ointment. 524.1200a Section 524.1200a Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

  2. 21 CFR 524.1200a - Kanamycin ophthalmic ointment.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... prophylactic in traumatic conditions, removal of foreign bodies, and intraocular surgery. Apply a thin film to... 21 Food and Drugs 6 2013-04-01 2013-04-01 false Kanamycin ophthalmic ointment. 524.1200a Section 524.1200a Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

  3. 21 CFR 524.1200b - Kanamycin ophthalmic solution.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... sensitive to kanamycin. For prophylaxis in traumatic conditions, removal of foreign bodies, and intraocular... 21 Food and Drugs 6 2014-04-01 2014-04-01 false Kanamycin ophthalmic solution. 524.1200b Section 524.1200b Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

  4. 76 FR 30176 - Dermatologic and Ophthalmic Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-24

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0002] Dermatologic and Ophthalmic Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration... Food and Drug Administration (FDA). The meeting will be open to the public. Name of Committee...

  5. 10 CFR 35.491 - Training for ophthalmic use of strontium-90.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Training for ophthalmic use of strontium-90. 35.491 Section 35.491 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Manual Brachytherapy... radiotherapy. The training must include— (i) Radiation physics and instrumentation; (ii) Radiation protection...

  6. 10 CFR 35.491 - Training for ophthalmic use of strontium-90.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 1 2011-01-01 2011-01-01 false Training for ophthalmic use of strontium-90. 35.491 Section 35.491 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Manual Brachytherapy... radiotherapy. The training must include— (i) Radiation physics and instrumentation; (ii) Radiation protection...

  7. 10 CFR 35.491 - Training for ophthalmic use of strontium-90.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Training for ophthalmic use of strontium-90. 35.491 Section 35.491 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Manual Brachytherapy... radiotherapy. The training must include— (i) Radiation physics and instrumentation; (ii) Radiation protection...

  8. 10 CFR 35.491 - Training for ophthalmic use of strontium-90.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 1 2012-01-01 2012-01-01 false Training for ophthalmic use of strontium-90. 35.491 Section 35.491 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Manual Brachytherapy... radiotherapy. The training must include— (i) Radiation physics and instrumentation; (ii) Radiation protection...

  9. Initiating an ophthalmic laser program for VA outpatients.

    PubMed

    Newcomb, R D

    1995-08-01

    Administrative and clinical considerations for the establishment of an ophthalmic laser program at a VA Outpatient Clinic are discussed. Outcomes of the first 320 patients treated over a 3-year period of time are presented. The program is evaluated from the perspectives of patient care, safety, maintenance, education, and economics.

  10. New Zealand health reforms: effect on ophthalmic practice.

    PubMed

    Raynel, S; Reynolds, H

    1999-01-01

    Are specialized ophthalmic units with inpatient facilities going to disappear in the New Zealand public health system? We have entered the era of cost containment, business methodologies, bench marking, day case surgery, and technologic advances. The dilemma for nursing is maintenance of a skill base with dwindling clinical practice areas.

  11. 21 CFR 886.1750 - Skiascopic rack.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Skiascopic rack. 886.1750 Section 886.1750 Food... DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1750 Skiascopic rack. (a) Identification. A skiascopic rack is a device that is a rack and a set of attached ophthalmic lenses of various dioptric strengths...

  12. 76 FR 72619 - Ophthalmic and Topical Dosage Form New Animal Drugs; Eprinomectin

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-25

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Part 524 [Docket No. FDA-2011-N-0003] Ophthalmic and Topical Dosage Form New Animal Drugs; Eprinomectin AGENCY: Food and Drug Administration, HHS. ACTION: Final rule; technical amendment. SUMMARY: The Food and Drug...

  13. 21 CFR 524.390b - Chloramphenicol ophthalmic solution.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS OPHTHALMIC AND TOPICAL DOSAGE FORM NEW ANIMAL DRUGS... susceptible to chloramphenicol. Therapy should be continued for 48 hours after the eye appears normal. (3) Limitations. Therapy for cats should not exceed 7 days. As with other antibiotics, prolonged use may result in...

  14. Efficacy of sucrose to reduce pain in premature infants during eye examinations for retinopathy of prematurity.

    PubMed

    Gal, Peter; Kissling, Grace E; Young, William O; Dunaway, Kimberly K; Marsh, Virginia A; Jones, Susan M; Shockley, Dawn H; Weaver, Nicole L; Carlos, Rita Q; Ransom, J Laurence

    2005-06-01

    Eye examinations for retinopathy of prematurity (ROP) are painful to the neonate. The use of topical anesthetic for eye examinations to evaluate ROP is routine in our neonatal intensive care unit (NICU), but does not completely suppress painful responses. Sweet solutions have been shown to reduce procedural pain in newborns. To examine whether the addition of sucrose 24% to topical anesthetic improves procedural pain control during the ROP eye examination. Neonates born at < or = 30 weeks' gestation were included in this placebo-controlled, double-blind, crossover study. Patients were randomly assigned to receive treatment with either proparacaine HCl ophthalmic solution 0.5% plus 2 mL of sucrose 24% or proparacaine HCl ophthalmic solution 0.5% plus 2 mL of sterile water (placebo) prior to an eye examination. In a subsequent eye examination, each patient received the alternate treatment. Oral sucrose and sterile water were prepared in the pharmacy in identical syringes, and physicians, nurses, and pharmacists in the NICU were blinded to the treatment given. Pain was measured using the Premature Infant Pain Profile (PIPP) scoring system, which measures both physical and physiologic measures of pain, and the scores were simultaneously assessed by 2 study nurses. PIPP scores were recorded 1 and 5 minutes before and after the eye examination and during initial placement of the eye speculum. The same ophthalmologist performed all eye examinations. Several different definitions of a pain response were investigated. Twenty-three infants were studied, with 12 receiving sucrose and 11 receiving placebo as the first treatment. For 3 of the 5 definitions of pain response, patients experienced significantly less pain at speculum insertion with sucrose than with placebo. After the ROP examination, pain responses were similar with either sucrose or placebo. Oral sucrose may reduce the immediate pain response in premature infants undergoing eye examination for ROP.

  15. Short-term outcomes of small incision cataract surgery provided by a regional population in the Pacific.

    PubMed

    Bhikoo, Riyaz; Vellara, Hans; Lolokabaira, Salome; Murray, Neil; Sikivou, Biu; McGhee, Charles

    2017-11-01

    This study aims to describe patient demographics, visual and surgical outcomes of a cohort undergoing small incision cataract surgery at a Pacific regional ophthalmic training facility. This is a prospective, longitudinal study conducted at the Pacific Eye Institute, Fiji. One hundred fifty-six patients underwent small incision cataract surgery. Preoperatively, a complete ophthalmic examination, including pachymetry and macular optical coherence tomography performed by two independent investigators. Temporal small incision cataract surgery with intraocular lens insertion was performed by ophthalmologists, and trainee ophthalmologists. Follow-up occurred at day one, four weeks and 3 months. Patient characteristics, visual outcomes including surgically induced astigmatism and complications. Ninety-one per cent (142/156) attended 3-month follow-up with median age 63 years (range 19-82), 52% female (81/156) and 58% (90/156) Fijian ethnicity. In 37% (57/156), the contralateral eye was pseudophakic. Mean preoperative best spectacle-corrected visual acuity was logMAR 1.44 (6/165). At 3 months, 74% (105/142) achieved ≥6/18 unaided vision (94% [133/142] best spectacle-corrected visual acuity). Mean postoperative spherical equivalent was -0.78 (SD 0.95) D and mean surgically induced astigmatism 1.04 (0.57) D. Complications included posterior capsular rupture with vitreous loss (4% [6/156]), optical coherence tomography confirmed macular oedema (8% [12/152] at 4 weeks), significant posterior capsular opacity (23% [31/136]) and >5% increase in preoperative pachymetry (1% [1/142]) at 3 months. Reduction in preoperative best spectacle-corrected visual acuity occurred in 2% (3/142). No cases of endophthalmitis. Small incision cataract surgery provided to a regional population is effective with 94% achieving the World Health Organisation's definition of 'Good Vision' (≥6/18). Refinements in biometric and surgical techniques may allow a greater proportion of patients to achieve good unaided vision. © 2017 Royal Australian and New Zealand College of Ophthalmologists.

  16. New 223-nm excimer laser surgical system for photorefractive keratectomy

    NASA Astrophysics Data System (ADS)

    Bagaev, Sergei N.; Razhev, Alexander M.; Zhupikov, Andrey A.

    1999-02-01

    The using of KrCl (223 nm) excimer laser in ophthalmic devices for Photorefractive Keratectomy (PRK) and phototherapeutic Keratectomy (PTK) is offered. The structure and functions of a new surgical UV ophthalmic laser systems Medilex using ArF (193 nm) or KrCl (223 nm) excimer laser for corneal surgery are presented. The systems Medilex with the new optical delivery system is used for photoablative reprofiling of the cornea to correct refraction errors (myopia, hyperopia and astigmatism) and to treat a corneal pathologies. The use of the 223 nanometer laser is proposed to have advantages over the 193 nanometer laser. The results of application of the ophthalmic excimer laser systems Medilex for treatment of myopia are presented.

  17. Use of ECT in the presence of acute bilateral posterior vitreous detachmanet.

    PubMed

    Taye, Tesema; Dobranici, Letitia; Fisher, Mark; Cullum, Sarah

    2018-04-01

    We describe a case of acute bilateral posterior vitreous detachment (PVD) in a 71-year-old female, which developed during a course of electroconvulsive therapy (ECT) for treatment-resistant depression. The risks and benefits of continuing ECT were assessed and the patient completed the full course of 16 ECT treatments without further ophthalmic complications. As the incidence of PVD increases with age, and ECT is used more frequently in elderly people with depression, we recommend paying attention to ophthalmic symptoms as part of the routine clinical monitoring of ECT side effects. If ophthalmic symptoms occur, the risks and benefits of ECT need to be weighed up including consultation with an ophthalmologist.

  18. 21 CFR 524.960 - Flumethasone, neomycin sulfate, and polymyxin B sulfate ophthalmic solutions.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 6 2013-04-01 2013-04-01 false Flumethasone, neomycin sulfate, and polymyxin B sulfate ophthalmic solutions. 524.960 Section 524.960 Food and Drugs FOOD AND DRUG ADMINISTRATION... TOPICAL DOSAGE FORM NEW ANIMAL DRUGS § 524.960 Flumethasone, neomycin sulfate, and polymyxin B sulfate...

  19. 21 CFR 524.960 - Flumethasone, neomycin sulfate, and polymyxin B sulfate ophthalmic solutions.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 6 2012-04-01 2012-04-01 false Flumethasone, neomycin sulfate, and polymyxin B sulfate ophthalmic solutions. 524.960 Section 524.960 Food and Drugs FOOD AND DRUG ADMINISTRATION... TOPICAL DOSAGE FORM NEW ANIMAL DRUGS § 524.960 Flumethasone, neomycin sulfate, and polymyxin B sulfate...

  20. 21 CFR 524.155 - Bacitracin, neomycin, polymyxin B, and hydrocortisone ophthalmic ointment.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... hydrocortisone ophthalmic ointment. 524.155 Section 524.155 Food and Drugs FOOD AND DRUG ADMINISTRATION... TOPICAL DOSAGE FORM NEW ANIMAL DRUGS § 524.155 Bacitracin, neomycin, polymyxin B, and hydrocortisone... sulfate, and10 mg of hydrocortisone. (b) Sponsors. See Nos. 000061 and 043264 in § 510.600(c) of this...

  1. 21 CFR 524.1200b - Kanamycin ophthalmic aqueous solution.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ..., removal of foreign bodies, and intraocular surgery. Instill a few drops into the affected eye every 3... 21 Food and Drugs 6 2013-04-01 2013-04-01 false Kanamycin ophthalmic aqueous solution. 524.1200b Section 524.1200b Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

  2. 21 CFR 524.1200b - Kanamycin ophthalmic aqueous solution.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ..., removal of foreign bodies, and intraocular surgery. Instill a few drops into the affected eye every 3... 21 Food and Drugs 6 2012-04-01 2012-04-01 false Kanamycin ophthalmic aqueous solution. 524.1200b Section 524.1200b Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

  3. Canine viral infections.

    PubMed

    Willis, A M

    2000-09-01

    The ophthalmic effects of viral infection are varied. With the added possibility for pathologic effects of attenuated vaccine viruses, the diagnosis of viral diseases can be a challenge. In many cases, ocular manifestations can provide added support to a presumptive diagnosis of viral disease, thereby underscoring the benefit of thorough ophthalmic examination of any animal with nonspecific signs of illness.

  4. 76 FR 71349 - Dermatologic and Ophthalmic Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    .... Contact Person: Yvette Waples, Center for Drug Evaluation and Research, Food and Drug Administration... following topics related to the use of ophthalmic drug products (products intended for use in the eye): (1... infection. FDA's Center for Drug Evaluation and Research would like the advisory committee to provide advice...

  5. 76 FR 28045 - Determination That XIBROM (Bromfenac Ophthalmic Solution) 0.09% Was Not Withdrawn From Sale for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-13

    ... marketing for reasons other than safety or effectiveness. ANDAs that refer to XIBROM (bromfenac ophthalmic... Safety or Effectiveness AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and... withdrawn from sale for reasons of safety or effectiveness. This determination will allow FDA to approve...

  6. 75 FR 54492 - Ophthalmic and Topical Dosage Form New Animal Drugs; Gentamicin and Betamethasone Ophthalmic...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-08

    ..., 2010. FOR FURTHER INFORMATION CONTACT: Melanie R. Berson, Center for Veterinary Medicine (HFV-110... to the Commissioner of Food and Drugs and redelegated to the Center for Veterinary Medicine, 21 CFR... for use. For treatment of external bacterial infections of the eye (conjunctiva and cornea). (3...

  7. Wideband Electrically-Pumped 1050 nm MEMS-Tunable VCSEL for Ophthalmic Imaging.

    PubMed

    John, Demis D; Burgner, Christopher B; Potsaid, Benjamin; Robertson, Martin E; Lee, Byung Kun; Choi, Woo Jhon; Cable, Alex E; Fujimoto, James G; Jayaraman, Vijaysekhar

    2015-08-15

    In this paper, we present a 1050 nm electrically-pumped micro-electro-mechanically-tunable vertical-cavity-surface-emitting-laser (MEMS-VCSEL) with a record dynamic tuning bandwidth of 63.8 nm, suitable for swept source optical coherence tomography (SS-OCT) imaging. These devices provide reduced cost & complexity relative to previously demonstrated optically pumped devices by obviating the need for a pump laser and associated hardware. We demonstrate ophthalmic SS-OCT imaging with the electrically-pumped MEMS-VCSEL at a 400 kHz axial scan rate for wide field imaging of the in vivo human retina over a 12 mm × 12 mm field and for OCT angiography of the macula over 6 mm × 6 mm & 3 mm × 3 mm fields to show retinal vasculature and capillary structure near the fovea. These results demonstrate the feasibility of electrically pumped MEMS-VCSELs in ophthalmic instrumentation, the largest clinical application of OCT. In addition, we estimate that the 3 dB coherence length in air is 225 meters ± 51 meters, far greater than required for ophthalmic SS-OCT and suggestive of other distance ranging applications.

  8. Correlation of ophthalmic examination with carrier status in females potentially harboring a severe Norrie disease gene mutation.

    PubMed

    Khan, Arif O; Aldahmesh, Mohammed A; Meyer, Brian

    2008-04-01

    To correlate ophthalmic findings with carrier status for a severe Norrie disease (ND) gene mutation (C95F). Prospective interventional case series. Six potential carriers and 1 obligate carrier from a family harboring the mutation. An ophthalmologist blind to the pedigree performed a full ophthalmic examination for the 7 asymptomatic family members. A peripheral blood sample was collected from each for ND gene sequencing. Ophthalmic examination findings (with attention to the presence or absence of retinal findings) and results of ND gene sequencing. Three carriers were identified by molecular genetics, and all 3 of them had peripheral retinal abnormality. However, 3 of the 4 genetically identified noncarriers also exhibited peripheral retinal abnormality. Two of these noncarriers with retinal findings were the offspring of a confirmed noncarrier. The genetically identified noncarrier with a normal peripheral retinal examination was the daughter of an obligate carrier. The presence of peripheral retinal changes was not useful for carrier prediction in a family harboring ND. There are likely additional loci responsible for phenotypic expression.

  9. Diffusion-Based Design of Multi-Layered Ophthalmic Lenses for Controlled Drug Release

    PubMed Central

    Pimenta, Andreia F. R.; Serro, Ana Paula; Paradiso, Patrizia; Saramago, Benilde

    2016-01-01

    The study of ocular drug delivery systems has been one of the most covered topics in drug delivery research. One potential drug carrier solution is the use of materials that are already commercially available in ophthalmic lenses for the correction of refractive errors. In this study, we present a diffusion-based mathematical model in which the parameters can be adjusted based on experimental results obtained under controlled conditions. The model allows for the design of multi-layered therapeutic ophthalmic lenses for controlled drug delivery. We show that the proper combination of materials with adequate drug diffusion coefficients, thicknesses and interfacial transport characteristics allows for the control of the delivery of drugs from multi-layered ophthalmic lenses, such that drug bursts can be minimized, and the release time can be maximized. As far as we know, this combination of a mathematical modelling approach with experimental validation of non-constant activity source lamellar structures, made of layers of different materials, accounting for the interface resistance to the drug diffusion, is a novel approach to the design of drug loaded multi-layered contact lenses. PMID:27936138

  10. A randomized, double-blind, safety and tolerability study to assess the ophthalmic and renal effects of tafenoquine 200 mg weekly versus placebo for 6 months in healthy volunteers.

    PubMed

    Leary, Kevin J; Riel, Michael A; Roy, Michael J; Cantilena, Louis R; Bi, Daoqin; Brater, D Craig; van de Pol, Corina; Pruett, Khadeeja; Kerr, Caron; Veazey, James M; Beboso, Ronnie; Ohrt, Colin

    2009-08-01

    A randomized, double-blind, placebo-controlled study was conducted to assess the effect of tafenoquine, 200 mg weekly for 6 months on ophthalmic and renal safety. This trial was carried out after observations in previous clinical trials that tafenoquine may be associated with the development of corneal deposits and elevations in serum creatinine. In 120 healthy volunteers who received tafenoquine or placebo in a 2:1 randomization, there was no effect on night vision or other ophthalmic indices measured. Persons taking tafenoquine also showed no difference in mean change in glomerular filtration rate (GFR, mL/s/1.73 m(2)) after 6 months of dosing, with a treatment difference of -0.061 (95% confidence interval, -0.168, 0.045), and non-inferiority margin of -0.247 mL/s/1.73 m(2). Tafenoquine was well tolerated over the course of the study. The results of this study showed no clinically significant effects of tafenoquine on ophthalmic or renal function, and support its continued development as an antimalarial drug.

  11. Visual acuity estimation from simulated images

    NASA Astrophysics Data System (ADS)

    Duncan, William J.

    Simulated images can provide insight into the performance of optical systems, especially those with complicated features. Many modern solutions for presbyopia and cataracts feature sophisticated power geometries or diffractive elements. Some intraocular lenses (IOLs) arrive at multifocality through the use of a diffractive surface and multifocal contact lenses have a radially varying power profile. These type of elements induce simultaneous vision as well as affecting vision much differently than a monofocal ophthalmic appliance. With myriad multifocal ophthalmics available on the market it is difficult to compare or assess performance in ways that effect wearers of such appliances. Here we present software and algorithmic metrics that can be used to qualitatively and quantitatively compare ophthalmic element performance, with specific examples of bifocal intraocular lenses (IOLs) and multifocal contact lenses. We anticipate this study, methods, and results to serve as a starting point for more complex models of vision and visual acuity in a setting where modeling is advantageous. Generating simulated images of real- scene scenarios is useful for patients in assessing vision quality with a certain appliance. Visual acuity estimation can serve as an important tool for manufacturing and design of ophthalmic appliances.

  12. Ophthalmic acid accumulation in an Escherichia coli mutant lacking the conserved pyridoxal 5'-phosphate-binding protein YggS.

    PubMed

    Ito, Tomokazu; Yamauchi, Ayako; Hemmi, Hisashi; Yoshimura, Tohru

    2016-12-01

    Escherichia coli YggS is a highly conserved pyridoxal 5'-phosphate (PLP)-binding protein whose biochemical function is currently unknown. A previous study with a yggS-deficient E. coli strain (ΔyggS) demonstrated that YggS controls l-Ile- and l-Val-metabolism by modulating 2-ketobutyrate (2-KB), l-2-aminobutyrate (l-2-AB), and/or coenzyme A (CoA) availability in a PLP-dependent fashion. In this study, we found that ΔyggS accumulates an unknown metabolite as judged by amino acid analyses. LC/MS and MS/MS analyses of the compound with propyl chloroformate derivatization, and co-chromatography analysis identified this compound as γ-l-glutamyl-l-2-aminobutyryl-glycine (ophthalmic acid), a glutathione (GSH) analogue in which the l-Cys moiety is replaced by l-2-AB. We also determine the metabolic consequence of the yggS mutation. Absence of YggS initially increases l-2-AB availability, and then causes ophthalmic acid accumulation and CoA limitation in the cell. The expression of a γ-glutamylcysteine synthetase and a glutathione synthetase in a ΔyggS background causes high-level accumulation of ophthalmic acid in the cells (∼1.2 nmol/mg cells) in a minimal synthetic medium. This opens the possibility of a first fermentative production of ophthalmic acid. Copyright © 2016 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.

  13. Bacterial Contamination of Multi-dose Eye Drops at Ophthalmology Department, University of Gondar, Northwest Ethiopia.

    PubMed

    Tsegaw, Asegedech; Tsegaw, Asamere; Abula, Tefera; Assefa, Yared

    2017-01-01

    Ophthalmic solutions used for both diagnostic and therapeutic purposes were found to be contaminated with bacteria pathogens and caused serious ocular infections such as keratitis and endophthalmitis. The objective was to assess the magnitude and pattern of bacterial contamination of multi-dose ophthalmic medications and investigate the drug susceptibility pattern of the isolates in the Department of Ophthalmology at Gondar University Teaching Hospital. A total of 100 ophthalmic medications in-use by patients and eye-care workers have been taken and cultured for potential bacterial contamination in the Microbiology Department after 1 week and >1 week of use. The dropper tip and the residual eye medications were examined for contamination. The contaminating bacteria were identified using a standard procedure and drug susceptibility testing to selected antimicrobial agents was done. Eleven ophthalmic medications were contaminated by different bacterial species with a prevalence of 11%. Multi-use and longer duration of use of eye medications were associated with higher rate of contamination. The contamination level ranges from 0% for antibiotics, 20% for local anesthetics, and 40% for povidone iodine. Among bacteria identified, Staphylococcus aureus and coagulase-negative Staphylococcus species were resistant to methicillin while others were sensitive to the antibiotics tested. The prevalence of contamination was low, but methicillin-resistant Staphylococcus was a potential risk. It is recommended that the Department of Ophthalmology should design set of rules about duration of use and safe handling of ophthalmic medications by the staff and patients.

  14. Use of topical anesthetic and non-medical alternatives in welding workers regarding ophthalmic problems.

    PubMed

    Aslan, Lokman; Sucakli, Mustafa Haki; Bozkurt, Selim; Aslankurt, Murat; Aksoy, Adnan; Celik, Mustafa

    2014-06-01

    Welding workers' ophthalmic problems resulting from their professions are frequently observed in ophthalmic emergencies and can cause severe visual impairment. We aimed to investigate the use of topical anesthetic and non-medical alternatives of this population regarding ophthalmic problems in this study. The study included 204 welding workers randomly selected from a population of 1852 people who had at least one-year experience as a welding worker and who were members of a chamber of welding workers. Data were collected at face to face interviews with a questionnaire composed of questions about ophthalmic problems caused by their profession and about how they eliminated these problems. Obtained data were analyzed with SPSS. Of 204 workers, 38.7% preferred non-medical alternatives including application of potatoes (22%), dressing with tea (17%), rinsing with cold water (3.4%) and closing eyes (2%). 30.5% of the participants used topical anesthetics (72% commercial and 28% prepared in pharmacies). There was a significant relation between use of non-medical methods and topical anesthetics, and workers' education, duration of work experience and receiving training from their seniors (p < 0.05). Use of non-medical methods and topical anesthetics by welding workers was found to be associated with low-education levels and insufficient knowledge about ophthalmologic problems due their professions and their treatment. They should be provided with appropriate training for the issue and precautions should be taken to prevent people from buying drugs without a prescription.

  15. Comparison of sedation by intranasal dexmedetomidine and oral chloral hydrate for pediatric ophthalmic examination.

    PubMed

    Cao, Qianzhong; Lin, Yiquan; Xie, Zhubin; Shen, Weihua; Chen, Ying; Gan, Xiaoliang; Liu, Yizhi

    2017-06-01

    Pediatric ophthalmic examinations can be conducted under sedation either by chloral hydrate or by dexmedetomidine. The objective was to compare the success rates and quality of ophthalmic examination of children sedated by intranasal dexmedetomidine vs oral chloral hydrate. One hundred and forty-one children aged from 3 to 36 months (5-15 kg) scheduled to ophthalmic examinations were randomly sedated by either intranasal dexmedetomidine (2 μg·kg -1 , n = 71) or oral chloral hydrate (80 mg·kg -1 , n = 70). The primary endpoint was successful sedation to complete the examinations including slit-lamp photography, tonometry, anterior segment analysis, and refractive error inspection. The secondary endpoints included quality of eye position, intraocular pressure, onset time, duration of examination, recovery time, discharge time, any side effects during examination, and within 48 h after discharge. Sixty-one children were sedated by dexmedetomidine with a success rate of 85.9%, which is significantly higher than that by chloral hydrate (64.3%) [OR 3.39, 95% CI: 1.48-7.76, P = 0.003]. Furthermore, children in the dexmedetomidine group displayed better eye position in anterior segment analysis than in chloral hydrate group median difference. All children displayed stable hemodynamics and none suffered hypoxemia in both groups. Oral chloral hydrate induced higher percentages of vomiting and altered bowel habit after discharge than dexmedetomidine. Intranasal dexmedetomidine provides more successful sedation and better quality of ophthalmic examinations than oral chloral hydrate for small children. © 2017 John Wiley & Sons Ltd.

  16. An Analysis of Medicare Reimbursement to Ophthalmologists: Years 2012 to 2013.

    PubMed

    Han, Everett; Baisiwala, Shivani; Jain, Atul; Bundorf, M Kate; Pershing, Suzann

    2017-10-01

    To analyze trends in utilization and payment of ophthalmic services in the Medicare population for years 2012 and 2013. Retrospective, cross-sectional study. A retrospective cross-sectional observational analysis was performed using publicly available Medicare Physician and Other Supplier aggregate file and the Physician and Other Supplier Public Use File. Variables analyzed included aggregate beneficiary demographics, Medicare payments to ophthalmologists, ophthalmic medical services provided, and the most common Medicare-reimbursed ophthalmic services. In 2013, total Medicare Part B reimbursement for ophthalmology was $5.8 billion, an increase of 3.6% from the previous year. From 2012 to 2013, the total number of ophthalmology services rendered increased by 2.2%, while average dollar amount reimbursed per ophthalmic service decreased by 5.4%. The top 5 highest reimbursed services accounted for 85% of total ophthalmic Medicare payments in 2013, an 11% increase from 2012. During 2013, drug reimbursement represented 32.8% of the total Medicare payments to ophthalmologists. Ranibizumab and aflibercept alone accounted for 95% of the entire $1.9 billion in drug reimbursements ophthalmologists in 2013. Medicare Part B reimbursement for ophthalmologists was primarily driven by use of anti-vascular endothelial growth factor (anti-VEGF) injections from 2012 to 2013. Of the total drug payments to ophthalmologists, biologic anti-VEGF agents ranibizumab and aflibercept accounted for 95% of all drug reimbursement. This is in contrast to other specialties, in which drug reimbursement represented only a small portion of Medicare reimbursement. Published by Elsevier Inc.

  17. Deep lateral wall orbital decompression following strabismus surgery in patients with Type II ophthalmic Graves' disease.

    PubMed

    Ellis, Michael P; Broxterman, Emily C; Hromas, Alan R; Whittaker, Thomas J; Sokol, Jason A

    2018-01-10

    Surgical management of ophthalmic Graves' disease traditionally involves, in order, orbital decompression, followed by strabismus surgery and eyelid surgery. Nunery et al. previously described two distinct sub-types of patients with ophthalmic Graves' disease; Type I patients exhibit no restrictive myopathy (no diplopia) as opposed to Type II patients who do exhibit restrictive myopathy (diplopia) and are far more likely to develop new-onset worsening diplopia following medial wall and floor decompression. Strabismus surgery involving extra-ocular muscle recession has, in turn, been shown to potentially worsen proptosis. Our experience with Type II patients who have already undergone medial wall and floor decompression and strabismus surgery found, when additional decompression is necessary, deep lateral wall decompression (DLWD) appears to have a low rate of post-operative primary-gaze diplopia. A case series of four Type II ophthalmic Graves' disease patients, all of whom had already undergone decompression and strabismus surgery, and went on to develop worsening proptosis or optic nerve compression necessitating further decompression thereafter. In all cases, patients were treated with DLWD. Institutional Review Board approval was granted by the University of Kansas. None of the four patients treated with this approach developed recurrent primary-gaze diplopia or required strabismus surgery following DLWD. While we still prefer to perform medial wall and floor decompression as the initial treatment for ophthalmic Graves' disease, for proptosis following consecutive strabismus surgery, DLWD appears to be effective with a low rate of recurrent primary-gaze diplopia.

  18. A Profile of Neuro-Ophthalmic Practice Around the World.

    PubMed

    Frohman, Larry P

    2018-03-01

    To compare contrast neuro-ophthalmic practice in various countries, an 18-question survey was sent to the international North American Neuro-Ophthalmology Society (NANOS) members in the spring of 2016. At least 1 NANOS member was contacted for each non-US nation in the NANOS membership roster. If there were multiple NANOS members from 1 country, multiple were contacted. If responses were received from more than 1 person from a single country, the first response received was used as the source data. The survey (in English) was emailed to 47 NANOS members from 31 countries. Twenty responses were received representing members from 15 nations. In all 15 nations, at least half of the neuro-ophthalmologists were trained as ophthalmologists. In 60% of nations, at least half of the neuro-ophthalmologists were trained internally, whereas in 33% of countries, at least half were trained in the United States. The number of physicians who practiced a significant amount of neuro-ophthalmology ranged from low (0.08/million, India) to high (3.10/million, Israel). Countries having the highest percentage of neuro-ophthalmologists exclusively practicing neuro-ophthalmology also were those with better patient access to neuro-ophthalmic care. Requirement of approval to see a neuro-ophthalmologist or for imaging studies requested by neuro-ophthalmologists was not typical. In most nations, academic neuro-ophthalmologists were paid a straight salary. In no nation were neuro-ophthalmologists paid more than another ophthalmic subspecialty. Individual national health care system designs and compensation models have had a profound influence on the rewards and challenges that face neuro-ophthalmologists. There seems to have been a connection between recognition of the discipline, financial rewards of neuro-ophthalmic practice, conditions that permit full-time neuro-ophthalmic practice, and patient access to care. A higher percentage of gross national product for health care did not seem to insure an adequate supply of neuro-ophthalmologists.

  19. Ocular and systemic pharmacokinetics of lidocaine hydrochloride ophthalmic gel in rabbits after topical ocular administration.

    PubMed

    Liu, Bing; Ding, Li; Xu, Xiaowen; Lin, Hongda; Sun, Chenglong; You, Linjun

    2015-12-01

    Lidocaine hydrochloride ophthalmic gel is a novel ophthalmic preparation for topical ocular anesthesia. The study is aimed at evaluating the ocular and systemic pharmacokinetics of lidocaine hydrochloride 3.5 % ophthalmic gel in rabbits after ocular topical administration. Thirty-six rabbits were randomly placed in 12 groups (3 rabbits per group). The rabbits were quickly killed according to their groups at 0 (predose), 0.0833, 0.167, 0.333, 0.667, 1, 1.5, 2, 3, 4, 6, and 8 h postdose and then the ocular tissue and plasma samples were collected. All the samples were analyzed by a validated LC-MS/MS method. The test result showed that the maximum concentration (C max) of lidocaine in different ocular tissues and plasma were all achieved within 20 min after drug administration, and the data of C max were (2,987 ± 1814) μg/g, (44.67 ± 12.91) μg/g, (26.26 ± 7.19) μg/g, (11,046 ± 2,734) ng/mL, and (160.3 ± 61.0) ng/mL for tear fluid, cornea, conjunctiva, aqueous humor, and plasma, respectively. The data of the elimination half-life in these tissues were 1.5, 3.2, 3.5, 1.9, and 1.7 h for tear fluid, cornea, conjunctiva, aqueous humor, and plasma, respectively. The intraocular lidocaine levels were significantly higher than that in plasma, and the elimination half-life of lidocaine in cornea, conjunctiva, and aqueous humor was relatively longer than that in tear fluid and plasma. The high intraocular penetration, low systemic exposure, and long duration in the ocular tissues suggested lidocaine hydrochloride 3.5 % ophthalmic gel as an effective local anesthetic for ocular anesthesia during ophthalmic procedures.

  20. Periocular dermatitis: a report of 401 patients.

    PubMed

    Temesvári, E; Pónyai, G; Németh, I; Hidvégi, B; Sas, A; Kárpáti, S

    2009-02-01

    Periocular contact dermatitis may appear as contact conjunctivitis, contact allergic and/or irritative eyelid and periorbital dermatitis, or a combination of these symptoms. The clinical symptoms may be induced by several environmental and therapeutic contact allergens. The aim of the present study was to map the eliciting contact allergens in 401 patients with periocular dermatitis (PD) by patch testing with environmental and ophthalmic contact allergens. Following the methodics of international requirements, 401 patients were tested with contact allergens of the standard environmental series, 133 of 401 patients with the Brial ophthalmic basic and supplementary series as well. Contact hypersensitivity was detected in 34.4% of the patients. Highest prevalence was seen in cases of PD without other symptoms (51.18%), in patients of PD associated with ophthalmic complaints (OC; 30.4%), and PD associated with atopic dermatitis (AD; 27.9%). In the subgroup of PD associated with seborrhoea (S) and rosacea (R), contact hypersensitivity was confirmed in 17.6%. Most frequent sensitisers were nickel sulphate (in 8.9% of the tested 401 patients), fragrance mix I (4.5%), balsam of Peru (4.0%), paraphenylendiamine (PPD) (3.7%), and thiomersal (3.5%). By testing ophthalmic allergens, contact hypersensitivity was observed in nine patients (6.7% of the tested 133 patients). The most common confirmed ophthalmic allergens were cocamidopropyl betaine, idoxuridine, phenylephrine hydrochloride, Na chromoglycinate, and papaine. Patients with symptoms of PD were tested from 1996 to 2006. The occurence of contact hypersensitivity in PD patients was in present study 34.4%. A relatively high occurrence was seen in cases of PD without other symptoms, in PD + OC and in PD + AD patients. The predominance of environmental contact allergens was remarkable: most frequent sensitizers were nickel sulphate, fragrance mix I, balsam of Peru, thiomersal, and PPD. The prevalence of contact hypersensitivity to ophthalmic allergens did not exceed l.5%.

  1. N-Acetylcarnosine and histidyl-hydrazide are potent agents for multitargeted ophthalmic therapy of senile cataracts and diabetic ocular complications.

    PubMed

    Babizhayev, Mark A; Guiotto, Andrea; Kasus-Jacobi, Anne

    2009-01-01

    In human diabetes, the deleterious effects of chronic hyperglycemia are the result of excessive nonenzymatic modification of proteins and phospholipids by glucose and its by-products leading to the formation of irreversible oxidized, aromatic, and fluorescent ligands known as advanced glycation end products. This glycation process has been associated with deleterious health effects. The present invention provides the potent inhibitors of protein glycation and AGEs formation, which are particularly advantageous for eyedrop delivery in the prevention and treatment of diabetes- and age-related pathologies. We proposed a deglycation system involving removal, by transglycation of sugar or aldehyde moieties from the Schiff bases by ophthalmic aldehyde scavenger L-carnosine derived from its ocular bioactivating sustained release prodrug 1% N-acetylcarnosine (NAC) lubricant eyedrops containing a mucoadhesive cellulose compound combined with corneal absorption promoters in drug delivery system. Carnosine analogs bearing the histidyl-hydrazide moiety were synthesized and patented in ophthalmic formulations with NAC bioactivating prodrug to moderate the enzymatic hydrolysis of a dipeptide by carnosinase (inhibited by a nonhydrolyzable substrate analog so that this keeps steadier levels of the drug active principle in the aqueous humor). Leucyl-histidylhydrazide peptidomimetic demonstrated the transglycation activity more pronounced than L-carnosine accounting for the ability of either molecule to reverse pre-existing, glycation-induced, cross-linking, and checking the nonenzymatic glycation cascade in the ophthalmic pathologies. The ophthalmic drug N-acetylcarnosine eye drop formulation with sustained time- release and increased absorption of L-carnosine in the aqueous humor (a prolonged effective dose) showed follow-up treatment efficacy for age-related cataracts for enrolled patients into the randomized double blind placebo controlled crossover clinical trial, and in over 50250 various cohort patients, was demonstrated to have an efficacy, safety and good tolerability for prevention and treatment of visual impairment in the older population data base. The bioactivating antioxidant NAC and histidyl-hydrazide are potent agents with the pleiotropic effects for ophthalmic therapy of senile cataracts and diabetic ocular complications.

  2. Location of the internal carotid artery and ophthalmic artery segments for non-invasive intracranial pressure measurement by multi-depth TCD.

    PubMed

    Hamarat, Yasin; Deimantavicius, Mantas; Kalvaitis, Evaldas; Siaudvytyte, Lina; Januleviciene, Ingrida; Zakelis, Rolandas; Bartusis, Laimonas

    2017-12-01

    The aim of the present study was to locate the ophthalmic artery by using the edge of the internal carotid artery (ICA) as the reference depth to perform a reliable non-invasive intracranial pressure measurement via a multi-depth transcranial Doppler device and to then determine the positions and angles of an ultrasonic transducer (UT) on the closed eyelid in the case of located segments. High tension glaucoma (HTG) patients and healthy volunteers (HVs) undergoing non-invasive intracranial pressure measurement were selected for this prospective study. The depth of the edge of the ICA was identified, followed by a selection of the depths of the IOA and EOA segments. The positions and angles of the UT on the closed eyelid were measured. The mean depth of the identified ICA edge for HTG patients was 64.3 mm and was 63.0 mm for HVs (p = 0.21). The mean depth of the selected IOA segment for HTG patients was 59.2 mm and 59.3 mm for HVs (p = 0.91). The mean depth of the selected EOA segment for HTG patients was 48.5 mm and 49.8 mm for HVs (p = 0.14). The difference in the located depths of the segments between groups was not statistically significant. The results showed a significant difference in the measured UT angles in the case of the identified edge of the ICA and selected ophthalmic artery segments (p = 0.0002). We demonstrated that locating the IOA and EOA segments can be achieved using the edge of the ICA as a reference point. OA: ophthalmic artery; IOA: intracranial segments of the ophthalmic artery; EOA: extracranial segments of the ophthalmic artery; ICA: internal carotid artery; UT: ultrasonic transducer; HTG: high tension glaucoma; SD: standard deviation; ICP: intracranial pressure; TCD: transcranial Doppler.

  3. Outcomes of an inner-city vision outreach program: give kids sight day.

    PubMed

    Dotan, Gad; Truong, Billy; Snitzer, Melanie; McCauley, Colleen; Martinez-Helfman, Sarah; Santa Maria, Kathy; Levin, Alex V

    2015-05-01

    Low-socioeconomic urban children often do not have access to ophthalmic care. To characterize the demographic characteristics and ophthalmic conditions in children attending Give Kids Sight Day (GKSD), an outreach ophthalmic care program held annually in Philadelphia, Pennsylvania, providing vision screening and immediate treatment when needed. Retrospective case-series study of children attending GKSD in 2012 (GKSD 2012) at an ophthalmology center in Philadelphia. Registration forms and records of all children attending GKSD 2012 were reviewed. Demographic characteristics, insurance status, spoken languages, reasons for attending, prior failure of vision screening, and attendance pattern of previous events were analyzed. The ophthalmological findings of these children were examined, including refractive errors, need for optical correction, and diagnoses for which continuous ophthalmic care was necessary. For children who needed ophthalmic follow-up, the rate of return to clinic and barriers for continuous care were analyzed. We studied 924 children (mean age, 9 years; age range, 0-18 years; 51% female; 25% speaking a non-English language) coming from 584 families who attended GKSD 2012, of whom 27% were uninsured and 10% were not aware of their insurance status. Forty-two percent of participants had public insurance, which covered vision care and glasses, but 35% did not know their benefits and did not realize vision care was covered. Forty-nine percent of children attended because they failed community vision screening. Provision of free glasses and failure of previous vision screening were the most common reasons families elected to attend GKSD (64% and 49%, respectively). Eighty-five percent of children attended GKSD 2012 for the first time, whereas 15% attended prior events. Glasses were provided to 61% of attendees. Ten percent of the attendees needed continuous ophthalmic care, most commonly for amblyopia. Ten children needed ocular surgery for cataract, strabismus, nystagmus, ptosis, or nasolacrimal duct obstruction. With the assistance of a social worker, 59% of children requiring continuous treatment returned to the clinic, compared with 2% in prior years before social worker intervention. Programs such as GKSD can bridge the gap between successful vision screening and ophthalmic treatment, a gap that often occurs in low-socioeconomic urban populations. Those with public insurance coverage for vision services may not realize these services are covered. Social worker intervention is useful in overcoming common barriers to follow-up care.

  4. Besifloxacin ophthalmic suspension 0.6% in patients with bacterial conjunctivitis: A multicenter, prospective, randomized, double-masked, vehicle-controlled, 5-day efficacy and safety study.

    PubMed

    Karpecki, Paul; Depaolis, Michael; Hunter, Judy A; White, Eric M; Rigel, Lee; Brunner, Lynne S; Usner, Dale W; Paterno, Michael R; Comstock, Timothy L

    2009-03-01

    Besifloxacin ophthalmic suspension 0.6% is a new topical fluoroquinolone for the treatment of bacterial conjunctivitis. Besifloxacin has potent in vitro activity against a broad spectrum of ocular pathogens, including drug-resistant strains. The primary objective of this study was to compare the clinical and microbiologic efficacy of besifloxacin ophthalmic suspension 0.6% with that of vehicle (the formulation without besifloxacin) in the treatment of bacterial conjunctivitis. This was a multicenter, prospective, randomized, double-masked, vehicle-controlled, parallel-group study in patients with acute bacterial conjunctivitis. Patients received either topical besifloxacin ophthalmic suspension or vehicle administered 3 times daily for 5 days. At study entry and on days 4 and 8 (visits 2 and 3), a clinical assessment of ocular signs and symptoms was performed in both eyes, as well as pinhole visual acuity testing, biomicroscopy, and culture of the infected eye(s). An ophthalmoscopic examination was performed at study entry and on day 8. The primary efficacy outcome measures were clinical resolution and eradication of the baseline bacterial infection on day 8 in culture-confirmed patients. The safety evaluation included adverse events, changes in visual acuity, and biomicroscopy and ophthalmoscopy findings in all patients who received at least 1 dose of active treatment or vehicle. The safety population consisted of 269 patients (mean [SD] age, 34.2 [22.3] years; 60.2% female; 82.5% white) with acute bacterial conjunctivitis. The culture-confirmed intent-to-treat population consisted of 118 patients (60 besifloxacin ophthalmic suspension, 58 vehicle). Significantly more patients receiving besifloxacin ophthalmic suspension than vehicle had clinical resolution of the baseline infection at visit 3 (44/60 [73.3%] vs 25/58 [43.1%], respectively; P < 0.001). Rates of bacterial eradication also were significantly greater with besifloxacin ophthalmic suspension compared with vehicle at visit 3 (53/60 [88.3%] vs35/58 [60.3%]; P < 0.001). The cumulative frequency of adverse events did not differ significantly between the 2 groups (69/137 [50.4%] and 70/132 [53.0%]). The most common ocular adverse events were eye pain (20/190 treated eyes [10.5%] and 13/188 [6.9%]), blurred vision (20/190 [10.5%] and 22/188 [11.7%]), and eye irritation (14/190 [7.4%] and 23/188 [12.2%]); these events were of mild or moderate severity. Changes in visual acuity and treatment-emergent events observed on biomicroscopy and direct ophthalmoscopy also were comparable between treatment groups. Besifloxacin ophthalmic suspension 0.6% given 3 times daily for 5 days was both efficacious and well tolerated compared with vehicle in the treatment of these patients with bacterial conjunctivitis. ClinicalTrials.gov Identifier: NCT00622908.

  5. 21 CFR 524.154 - Bacitracin or bacitracin zinc-neomycin sulfate-polymyxin B sulfate ophthalmic ointment.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 6 2012-04-01 2012-04-01 false Bacitracin or bacitracin zinc-neomycin sulfate-polymyxin B sulfate ophthalmic ointment. 524.154 Section 524.154 Food and Drugs FOOD AND DRUG ADMINISTRATION... TOPICAL DOSAGE FORM NEW ANIMAL DRUGS § 524.154 Bacitracin or bacitracin zinc-neomycin sulfate-polymyxin B...

  6. 21 CFR 524.154 - Bacitracin or bacitracin zinc-neomycin sulfate-polymyxin B sulfate ophthalmic ointment.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 6 2013-04-01 2013-04-01 false Bacitracin or bacitracin zinc-neomycin sulfate-polymyxin B sulfate ophthalmic ointment. 524.154 Section 524.154 Food and Drugs FOOD AND DRUG ADMINISTRATION... TOPICAL DOSAGE FORM NEW ANIMAL DRUGS § 524.154 Bacitracin or bacitracin zinc-neomycin sulfate-polymyxin B...

  7. 78 FR 13350 - Ophthalmic Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-27

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0001] Ophthalmic Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting AGENCY: Food and Drug... of the Food and Drug Administration (FDA). The meeting will be open to the public. Name of Committee...

  8. 78 FR 27971 - Determination That REV-EYES (Dapiprazole Hydrochloride Ophthalmic Solution), 0.5%, Was Not...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-13

    ...] Determination That REV-EYES (Dapiprazole Hydrochloride Ophthalmic Solution), 0.5%, Was Not Withdrawn From Sale.... SUMMARY: The Food and Drug Administration (FDA) has determined that REV-EYES (dapiprazole hydrochloride... CFR 314.161)). FDA may not approve an ANDA that does not refer to a listed drug. REV-EYES (dapiprazole...

  9. Mississippi Curriculum Framework for Ophthalmic Technology (Program CIP: 51.1801--Opticianry/Dispensing Optician). Postsecondary Programs.

    ERIC Educational Resources Information Center

    Mississippi Research and Curriculum Unit for Vocational and Technical Education, State College.

    This document, which is intended for use by community and junior colleges throughout Mississippi, contains curriculum frameworks for the course sequences in the ophthalmic technology program. Presented in the introductory section are a description of the program and suggested course sequence. Section I lists baseline competencies, and section II…

  10. Ophthalmic Surgery in Prion Diseases

    PubMed Central

    Hamaguchi, Tsuyoshi; Noguchi-Shinohara, Moeko; Nakamura, Yosikazu; Sato, Takeshi; Kitamoto, Tetsuyuki; Mizusawa, Hidehiro

    2007-01-01

    Eleven (1.8%) of 597 patients underwent ophthalmic surgery within 1 month before the onset of prion disease or after the onset. All ophthalmologists reused surgical instruments that had been incompletely sterilized to eliminate infectious prion protein. Ophthalmologists should be aware of prion diseases as a possible cause of visual symptoms and use disposable instruments whenever possible. PMID:17370537

  11. 21 CFR 524.1044a - Gentamicin ophthalmic solution.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Gentamicin ophthalmic solution. 524.1044a Section 524.1044a Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... in § 510.600(c) of this chapter. (c) Conditions of use. (1) The drug is used in dogs and cats for the...

  12. 21 CFR 524.1044a - Gentamicin ophthalmic solution.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 6 2011-04-01 2011-04-01 false Gentamicin ophthalmic solution. 524.1044a Section 524.1044a Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... in § 510.600(c) of this chapter. (c) Conditions of use. (1) The drug is used in dogs and cats for the...

  13. A New Anatomic Variation: Coexistence of Both Dandy-Walker Variant and Ophthalmic Artery Originating From Contralateral Internal Carotid Artery.

    PubMed

    Ogul, Hayri; Havan, Nuri; Gedikli, Yusuf; Pirimoglu, Berhan; Kantarci, Mecit

    2016-06-01

    The authors report on 1 patient of variant origin of right ophthalmic artery (OA) from ophthalmic segment of the left internal carotid artery. A 41-year-old man was performed magnetic resonance (MR) imaging and MR angiography. Cerebral MR imaging revealed a Dandy-Walker variant. In MR angiography the authors observed this unusual variant of origin of OA and a complete occlusion of right internal carotid artery. To the authors' knowledge, this is the first patient who has coincidence of both Dandy-Walker variant and origin of OA from contralateral internal carotid artery. Careful observation of MR angiography images with maximum intensity projection is very important for detecting rare vascular variations.

  14. CRISPR-mediated Ophthalmic Genome Surgery.

    PubMed

    Cho, Galaxy Y; Abdulla, Yazeed; Sengillo, Jesse D; Justus, Sally; Schaefer, Kellie A; Bassuk, Alexander G; Tsang, Stephen H; Mahajan, Vinit B

    2017-09-01

    Clustered regularly interspaced short palindromic repeats (CRISPR) is a genome engineering system with great potential for clinical applications due to its versatility and programmability. This review highlights the development and use of CRISPR-mediated ophthalmic genome surgery in recent years. Diverse CRISPR techniques are in development to target a wide array of ophthalmic conditions, including inherited and acquired conditions. Preclinical disease modeling and recent successes in gene editing suggest potential efficacy of CRISPR as a therapeutic for inherited conditions. In particular, the treatment of Leber congenital amaurosis with CRISPR-mediated genome surgery is expected to reach clinical trials in the near future. Treatment options for inherited retinal dystrophies are currently limited. CRISPR-mediated genome surgery methods may be able to address this unmet need in the future.

  15. [Embolization of the feeding artery of a meningioma with dangerous vascular anastomosis between the middle meningeal artery and the ophthalmic artery].

    PubMed

    Meguro, Toshinari; Tomita, Yusuke; Tanabe, Tomoyuki; Muraoka, Kenichiro; Terada, Kinya; Hirotsune, Nobuyuki; Nishino, Shigeki

    2013-11-01

    Preoperative embolization of intracranial meningioma has been applied to reduce intraoperative blood loss and to facilitate microsurgical removal of a tumor. It is well known that one of the reasons of the neurological risk of embolization is due to dangerous anastomosis between the extracranial and the intracranial arteries. One of the most known and dangerous case of anastomosis is between the middle meningeal artery to the ophthalmic artery. A 48-year-old woman underwent preoperative embolization of a large right middle cranial fossa meningioma. The right external carotid angiogram showed that the tumor was fed by the right middle meningeal artery and there was no branch to the right orbital region. The right internal carotid angiogram showed that the right ophthalmic artery originated from the right internal carotid artery and there was no branch to the tumor. The selective angiogram of the anterior branch of the middle meningeal artery disclosed the anastomosis to the right ophthalmic artery. Following embolization of the anterior branch of the middle meningeal artery, the patient underwent embolization of the main feeding branch of the meningioma. She successfully underwent surgical removal of the tumor without any blood transfusion and was discharged without neurological deficit. In addition, to avoid complication in embolization of the feeding artery of a skull base meningioma, clinicians must be aware of the dangerous anastomosis between the middle meningeal artery and the ophthalmic artery, even if conventional external and internal carotid angiograms do not show any anastomosis.

  16. Efficacy of Detergent and Water Versus Bleach for the Disinfection of Direct Contact Ophthalmic Lenses

    PubMed Central

    Abbey, Ashkan M.; Gregori, Ninel Z.; Surapaneni, Krishna; Miller, Darlene

    2014-01-01

    Purpose While manufacturers recommend cleaning ophthalmic lenses with detergent and water and then a specific disinfectant, disinfectants are rarely used in ophthalmic practices. The aim of this pilot study was to evaluate the efficacy of detergent and water versus bleach, a recommended disinfectant, to eliminate common ocular bacteria and viruses from ophthalmic lenses. Methods Three bacterial strains (Staphylococcus epidermidis, Corynebacterium straitum, and methicillin-resistant Staphylococcus aureus (MRSA) and two viral strains (adenovirus and herpes simplex virus (HSV) type-1) were individually inoculated to 20 gonioscopy and laser lenses. Lenses were washed with detergent and water and then disinfected with 10% bleach. All lenses were cultured after inoculation, after detergent and water, and after the bleach. Bacterial cultures in thioglycollate broth were observed for 3 weeks and viral cultures for 2 weeks. The presence of viruses was also detected by multiplex polymerase chain reaction (PCR). Results All 20 lenses inoculated with Staphylococcus epidermidis, Corynebacterium straitum, adenovirus, and HSV-1 showed growth after inoculation, but no growth after detergent/water and after the bleach. All lenses showed positive HSV and adenovirus PCR after inoculation and negative PCR after detergent/water and after bleach. All MRSA contaminated lenses showed growth after inoculation and no growth after detergent and water. However, one lens showed positive growth after bleach. Conclusions Cleaning with detergent and water appeared to effectively eliminate bacteria and viruses from the surface of contaminated ophthalmic lenses. Further studies are warranted to design practical disinfection protocols that minimize lens damage. PMID:24747806

  17. Malassezia spp on the periocular skin of dogs and their association with blepharitis, ocular discharge, and the application of ophthalmic medications.

    PubMed

    Newbold, Georgina M; Outerbridge, Catherine A; Kass, Philip H; Maggs, David J

    2014-06-01

    To determine how frequently Malassezia spp were identified on the periocular skin of dogs and assess the respective associations between the presence of Malassezia spp on the periocular skin and blepharitis, ocular discharge, and the application of ophthalmic medications. Prospective clinical study. 167 eyelids of 84 dogs. Samples obtained from the surface of the eyelid skin by use of adhesive tape were evaluated cytologically for the presence of Malassezia spp. Dogs were grouped on the basis of the presence of blepharitis, nature of ocular discharge, and whether ophthalmic medications were applied, and the proportion of samples with Malassezia spp was compared among the groups. Malassezia spp were detected in 19 samples, of which 15 were obtained from eyes without blepharitis and 14 were obtained from eyes treated with topical ophthalmic medications. The proportion of samples with Malassezia spp was significantly higher for eyes with ocular discharge than for eyes without ocular discharge, especially if that discharge was mucoid or mucopurulent, and for eyes that were treated with aqueous-based medications only or a combination of oil- and aqueous-based medications than for eyes that were not treated. Malassezia organisms were detected on the periocular skin of 3 of 56 (5%) clinically normal dogs. Malassezia organisms were also frequently found on the periocular skin of dogs that had mucoid or mucopurulent ocular discharge or that were administered topical aqueous-based ophthalmic medications, and the periocular skin of these dogs should be cytologically evaluated for Malassezia organisms.

  18. Virtual guidance as a tool to obtain diagnostic ultrasound for spaceflight and remote environments.

    PubMed

    Martin, David S; Caine, Timothy L; Matz, Timothy; Lee, Stuart M C; Stenger, Michael B; Sargsyan, Ashot E; Platts, Steven H

    2012-10-01

    With missions planned to travel greater distances from Earth at ranges that make real-time two-way communication impractical, astronauts will be required to perform autonomous medical diagnostic procedures during future exploration missions. Virtual guidance is a form of just-in-time training developed to allow novice ultrasound operators to acquire diagnostically-adequate images of clinically relevant anatomical structures using a prerecorded audio/visual tutorial viewed in real-time. Individuals without previous experience in ultrasound were recruited to perform carotid artery (N = 10) and ophthalmic (N = 9) ultrasound examinations using virtual guidance as their only training tool. In the carotid group, each untrained operator acquired two-dimensional, pulsed and color Doppler of the carotid artery. In the ophthalmic group, operators acquired representative images of the anterior chamber of the eye, retina, optic nerve, and nerve sheath. Ultrasound image quality was evaluated by independent imaging experts. Of the studies, 8 of the 10 carotid and 17 of 18 of the ophthalmic images (2 images collected per study) were judged to be diagnostically adequate. The quality of all but one of the ophthalmic images ranged from adequate to excellent. Diagnostically-adequate carotid and ophthalmic ultrasound examinations can be obtained by previously untrained operators with assistance from only an audio/video tutorial viewed in real time while scanning. This form of just-in-time training, which can be applied to other examinations, represents an opportunity to acquire important information for NASA flight surgeons and researchers when trained medical personnel are not available or when remote guidance is impractical.

  19. Ophthalmic randomized controlled trials reports: the statement of the hypothesis.

    PubMed

    Lee, Chun Fan; Cheng, Andy Chi On; Fong, Daniel Yee Tak

    2014-01-01

    To evaluate whether the ophthalmic randomized controlled trials (RCTs) were designed properly, their hypotheses stated clearly, and their conclusions drawn correctly. A systematic review of 206 ophthalmic RCTs. The objective statement, methods, and results sections and the conclusions of RCTs published in 4 major general clinical ophthalmology journals from 2009 through 2011 were assessed. The clinical objective and specific hypothesis were the main outcome measures. The clinical objective of the trial was presented in 199 (96.6%) studies and the hypothesis was specified explicitly in 56 (27.2%) studies. One hundred ninety (92.2%) studies tested superiority. Among them, 17 (8.3%) studies comparing 2 or more active treatments concluded equal or similar effectiveness between the 2 arms after obtaining insignificant results. There were 5 noninferiority studies and 4 equivalence studies. How the treatments were compared was not mentioned in 1 of the noninferiority studies. Two of the equivalence studies did not specify the equivalence margin and used tests for detecting difference rather than confirming equivalence. The clinical objective commonly was stated, but the prospectively defined hypothesis tended to be understated in ophthalmic RCTs. Superiority was the most common type of comparison. Conclusions made in some of them with negative results were not consistent with the hypothesis, indicating that noninferiority or equivalence may be a more appropriate design. Flaws were common in the noninferiority and equivalence studies. Future ophthalmic researchers should choose the type of comparison carefully, specify the hypothesis clearly, and draw conclusions that are consistent with the hypothesis. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Characteristics and Ophthalmic Manifestations of the Classic Dengue Fever Epidemic in Singapore (2005-2006).

    PubMed

    Koh, Yan Tong; Sanjay, Srinivasan

    2013-01-01

    The aim of this study was to report the characteristics and ophthalmic manifestations associated with dengue fever (DF) in the 2005-2006 DF epidemic in Singapore. A retrospective case series. Eleven patients (7 males, 4 females) who were 14 to 40 years old (mean age, 27.3 years) with visual complaints occurring 1 to 2 weeks after the onset of DF underwent a complete ophthalmologic examination. The presenting visual acuity (VA) ranged from 6/6 to counting fingers. Five patients had bilateral eye involvement. Ophthalmic findings included retinal hemorrhages (15 eyes), cotton wool spots (15 eyes), retinal pigment epithelium alterations (5 eyes), optic disc swelling (3 eyes), foveolitis (3 eyes), and hyperemia (2 eyes). Impaired color vision was noted in 12 eyes. Visual field defects were noted in 13 eyes; 4 of these eyes were asymptomatic. Fundus fluorescein angiography was done in 9 patients; the findings include choroidal hyperfluorescence (9 eyes), blocked fluorescence (8 eyes), and capillary nonperfusion (1 eye). In 2 eyes, it was normal. Electrophysiology confirmed optic neuropathy in 3 eyes and maculopathy in 1 eye. The follow-up ranged from 12 days to 12 months. The VA at the last follow-up ranged from no light perception to 6/6. Visual field abnormalities were noted in 5 eyes despite a normal VA. Dengue fever is associated with a wide spectrum of ophthalmic manifestations. Rarely, ophthalmic complications in DF can result in permanent visual impairment. Further work can be done to elucidate the relationship between systemic and ocular manifestations of DF.

  1. Design of Novel Ophthalmic Formulation Containing Drug Nanoparticles and Its Usefulness as Anti-glaucoma Drugs.

    PubMed

    Nagai, Noriaki

    2016-01-01

    The ophthalmic application of drugs is the primary route of administration for the therapy of glaucoma; however, in traditional formulations, only small amounts of the administered drug penetrate the cornea to reach the desired intraocular tissue due to corneal barriers. Recently, nanoparticulate drug delivery is expected as a technology to overcome the difficulties in delivering drugs across biological barriers (improvement of bioavailability). In this study, we attempted to establish a new method for preparing solid drug nanoparticles by using a bead mill and various additives, and succeeded in preparing a high quality dispersion containing drug nanoparticles. For a more concrete example, a mean particle size of disulfiram (DSF) treated with bead mill is 183 nm. The corneal penetration and corneal residence time of DSF from the ophthalmic dispersion containing DSF nanoparticles were significantly higher than those from a 2-hydroxypropyl-β-cyclodextrin solution containing DSF (DSF solution). It is known that the administration of DSF has intraocular pressure (IOP)-reducing effects. The IOP-reducing effects of the ophthalmic dispersion containing DSF nanoparticles were significantly greater than those of the DSF solution in rabbits (the IOP was enhanced by placing the rabbits in a dark room for 5 h). In addition, the ophthalmic dispersion containing DSF nanoparticles is better tolerated by corneal epithelial cells than DSF solution. It is possible that dispersions containing DSF nanoparticles provide new possibilities for effectively treating glaucoma, and that ocular drug delivery systems using drug nanoparticles may expand their usage for therapy in the ophthalmologic field.

  2. 4D microscope-integrated OCT improves accuracy of ophthalmic surgical maneuvers

    NASA Astrophysics Data System (ADS)

    Carrasco-Zevallos, Oscar; Keller, Brenton; Viehland, Christian; Shen, Liangbo; Todorich, Bozho; Shieh, Christine; Kuo, Anthony; Toth, Cynthia; Izatt, Joseph A.

    2016-03-01

    Ophthalmic surgeons manipulate micron-scale tissues using stereopsis through an operating microscope and instrument shadowing for depth perception. While ophthalmic microsurgery has benefitted from rapid advances in instrumentation and techniques, the basic principles of the stereo operating microscope have not changed since the 1930's. Optical Coherence Tomography (OCT) has revolutionized ophthalmic imaging and is now the gold standard for preoperative and postoperative evaluation of most retinal and many corneal procedures. We and others have developed initial microscope-integrated OCT (MIOCT) systems for concurrent OCT and operating microscope imaging, but these are limited to 2D real-time imaging and require offline post-processing for 3D rendering and visualization. Our previously presented 4D MIOCT system can record and display the 3D surgical field stereoscopically through the microscope oculars using a dual-channel heads-up display (HUD) at up to 10 micron-scale volumes per second. In this work, we show that 4D MIOCT guidance improves the accuracy of depth-based microsurgical maneuvers (with statistical significance) in mock surgery trials in a wet lab environment. Additionally, 4D MIOCT was successfully performed in 38/45 (84%) posterior and 14/14 (100%) anterior eye human surgeries, and revealed previously unrecognized lesions that were invisible through the operating microscope. These lesions, such as residual and potentially damaging retinal deformation during pathologic membrane peeling, were visualized in real-time by the surgeon. Our integrated system provides an enhanced 4D surgical visualization platform that can improve current ophthalmic surgical practice and may help develop and refine future microsurgical techniques.

  3. Indocyanine Green Videoangiography Transoptic Visualization and Clipping Confirmation of an Optic Splitting Ophthalmic Artery Aneurysm.

    PubMed

    Rustemi, Oriela; Cester, Giacomo; Causin, Francesco; Scienza, Renato; Della Puppa, Alessandro

    2016-06-01

    Ophthalmic artery aneurysms with medial and superior projection in exceptionally rare cases can split the optic nerve. Treatment of these aneurysms is challenging, because the aneurysm dome is hidden from the optic nerve, rendering its visualization and clipping confirmation difficult. In addition, optic nerve function should be preserved during surgical maneuvers. Preoperative detection of this growing feature is usually missing. We illustrate the first case of indocyanine green videoangiography (ICG-VA) application in an optic penetrating ophthalmic artery aneurysm treatment. A 57-year-old woman presented with temporal hemianopsia, slight right visual acuity deficit, and new onset of headache. The cerebral angiography detected a right ophthalmic artery aneurysm medially and superiorly projecting. The A1 tract of the ipsilateral anterior cerebral artery was elevated and curved, being suspicious for an under optic aneurysm growth. Surgery was performed. Initially the aneurysm was not visible. ICG-VA permitted the transoptic aneurysm visualization. After optic canal opening, the aneurysm was clipped and transoptic ICG-VA confirmed the aneurysm occlusion. ICG-VA showed also the slight improvement of the optic nerve pial vascularization. Postoperatively, the visual acuity was 10/10 and the hemianopsia did not worsen. The elevation and curve of the A1 tract in medially and superiorly projecting ophthalmic aneurysms may be an indirect sign of under optic growth, or optic splitting aneurysms. ICG-VA transoptic aneurysm detection and occlusion confirmation reduces the surgical maneuvers on the optic nerve, contributing to function preservation. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Brainstem auditory evoked responses and ophthalmic findings in llamas and alpacas in eastern Canada

    PubMed Central

    Cullen, Cheryl L.; Lamont, Leigh A.

    2006-01-01

    Abstract Seventeen llamas and 23 alpacas of various coat and iris colors were evaluated for: 1) deafness by using brainstem auditory evoked response testing; and 2) for ocular abnormalities via complete ophthalmic examination. No animals were deaf. The most common ocular abnormalities noted were iris-to-iris persistent pupillary membranes and incipient cataracts. PMID:16536233

  5. Vision Changes after Space Flight Are Related to Alterations in Folate-Dependent One-Carbon Metabolism

    NASA Technical Reports Server (NTRS)

    Smith, Scott M.; Gibson, C. Robert; Mader, Thomas H.; Ericson, Karen; Ploutz-Snyder, Robert; Heer, Martina; Zwart, Sara R.

    2011-01-01

    About 20% of astronauts on International Space Station missions have developed measurable ophthalmic changes after flight. This study was conducted to determine whether the folate-dependent 1-carbon pathway is altered in these individuals. Data were modeled to evaluate differences between individuals with ophthalmic changes (n=5) and those without them (n=15). We also correlated mean preflight serum concentrations of the 1-carbon metabolites with changes in measured refraction after flight. Serum homocysteine (HCy), cystathionine, 2-methylcitric acid, and methylmalonic acid concentrations were 25%-45% higher (P<0.001) in astronauts with ophthalmic changes than in those without them. These differences existed before, during, and after flight. Preflight serum HCy and cystathionine, and in-flight serum folate, were significantly (P<0.05) correlated with postflight change in refraction, and preflight serum concentrations of 2-methylcitric acid tended to be associated (P=0.06) with ophthalmic changes. The biochemical differences observed in those with vision issues strongly suggests impairment of the folate-dependent 1-carbon transfer pathway. Impairment of this pathway, by polymorphisms, diet or other means, may interact with components of the microgravity environment to influence these pathophysiologic changes. This study was funded by the NASA Human Research Program.

  6. Fabry disease in children: correlation between ocular manifestations, genotype and systemic clinical severity.

    PubMed

    Allen, L E; Cosgrave, E M; Kersey, J P; Ramaswami, U

    2010-12-01

    Fabry disease is an X linked lysosomal disorder associated with severe multiorgan failure and premature death. This study aims to determine the prevalence of ophthalmic manifestations in children with the condition and investigate the correlation with genotype and systemic disease severity. The records of 26 children from 18 pedigrees with Fabry disease undergoing regular ophthalmic and systemic examination were reviewed. All pedigrees underwent GLA gene sequencing to determine genotype. Correlations between ocular and systemic phenotype and genotype were investigated. Corneal verticillata occurred in 50% of the children in this study (95% CI, 29% to 79%). Children with ophthalmic manifestations were more likely to have loss-of-function GLA mutations (p=0.003). Retinal vascular tortuosity was seen in seven children (27%), all of whom had systemic symptoms suggestive of autonomic neuropathy, such as diarrhoea and syncope. These symptoms seemed less prevalent in children without retinal vascular changes, although this did not reach statistical significance (p=0.134). Ophthalmic manifestations of Fabry disease are common even in young children with loss-of-function GLA gene mutations. Although the limited sample size possibly prevented statistical significance, systemic symptoms of autonomic neuropathy often coexist with retinal vascular changes and may share the same pathogenesis.

  7. Financial return-on-investment of ophthalmic interventions: a new paradigm.

    PubMed

    Brown, Melissa M; Brown, Gary C; Lieske, Heidi B; Lieske, P Alexander

    2014-05-01

    Although the patient value gain (improvement in quality-of-life and/or length-of-life) has been highlighted in Value-based Medicine cost-utility analyses, the financial value gain associated with healthcare interventions has received less emphasis. It is important for professional healthcare providers to realize their interventions often confer a large financial return-on-investment (ROI) to society. The societal costs associated with vitreoretinal and other ophthalmic interventions include: direct ophthalmic medical costs expended (hospital, physician, drug, diagnostic testing and so forth), direct medical costs saved (decreased costs for depression, injury, skilled nursing facility, nursing home and others), direct nonmedical costs saved (decreased costs for caregivers, transportation, residence costs, moving costs, and others), and indirect medical costs saved (improving employment incidence and wages). The financial ROI for direct ophthalmic medical costs expended for ranibizumab therapy for neovascular age-related macular degeneration is 450%, whereas that for cataract surgery is 4500% and for medical open-angle glaucoma therapy is 4000%. Many costs gained add to the Gross Domestic Product and increase the wealth of the nation. Many vitreoretinal and other ophthalmologic interventions confer considerable patient value, but also result in a large financial ROI to society. This financial ROI increases the wealth of the nation.

  8. Histopathological reporting of corneal pathology by a biomedical scientist: the Sheffield Experience.

    PubMed

    Meeney, A; Mudhar, H S

    2013-02-01

    The advanced specialist diploma in ophthalmic pathology was jointly ratified by the Royal College of Pathologists and the Institute of Biomedical Science in 2008. It results in extended roles for suitably qualified Biomedical Scientists (BMSs) in ophthalmic pathology specimen dissection and histological reporting of selected specimens, specifically non-neoplastic corneas. This study aimed to examine the reporting of corneal histology by a BMS training towards this diploma in comparison with a Consultant Ophthalmic Pathologist. This report covers a non-interventional, prospective examination of BMS's diagnostic skills. After 6 months training, 50 consecutive corneal cases were reported by the BMS and the same case reported by the consultant ophthalmic pathologist. The BMS's diagnosis was compared with the final consultant's diagnosis. This exercise was then repeated after 24 months of training. After 6 months, the BMS's diagnoses matched the consultant diagnoses in 44/50 (88%) cases. After 24 months, the BMS's diagnoses matched the consultant diagnoses in 48/50 (96%) of cases. The results indicate that BMS's reporting of corneal histology is a real and safe possibility. Furthermore, it indicated deficiencies in BMS's diagnostic skills to inform further training/knowledge acquisition.

  9. Ophthalmic Drug Delivery Systems for Antibiotherapy—A Review

    PubMed Central

    Dubald, Marion; Bourgeois, Sandrine; Andrieu, Véronique; Fessi, Hatem

    2018-01-01

    The last fifty years, ophthalmic drug delivery research has made much progress, challenging scientists about the advantages and limitations of this drug delivery approach. Topical eye drops are the most commonly used formulation in ocular drug delivery. Despite the good tolerance for patients, this topical administration is only focus on the anterior ocular diseases and had a high precorneal loss of drugs due to the tears production and ocular barriers. Antibiotics are popularly used in solution or in ointment for the ophthalmic route. However, their local bioavailability needs to be improved in order to decrease the frequency of administrations and the side effects and to increase their therapeutic efficiency. For this purpose, sustained release forms for ophthalmic delivery of antibiotics were developed. This review briefly describes the ocular administration with the ocular barriers and the currently topical forms. It focuses on experimental results to bypass the limitations of ocular antibiotic delivery with new ocular technology as colloidal and in situ gelling systems or with the improvement of existing forms as implants and contact lenses. Nanotechnology is presently a promising drug delivery way to provide protection of antibiotics and improve pathway through ocular barriers and deliver drugs to specific target sites. PMID:29342879

  10. Development of Selective Lamellar Keratoplasty within an Asian Corneal Transplant Program: The Singapore Corneal Transplant Study (An American Ophthalmological Society Thesis)

    PubMed Central

    Tan, Donald; Ang, Marcus; Arundhati, Anshu; Khor, Wei-Boon

    2015-01-01

    Purpose: To evaluate outcomes of anterior lamellar keratoplasty (ALK) and endothelial keratoplasty (EK) within the Singapore Corneal Transplant Study (SCTS), with the hypothesis that both ALK and EK are able to provide equivalent or improved clinical outcomes, compared to penetrating keratoplasty (PK), and to determine changing trends globally with other international databases. Methods: Clinical data on all transplants performed was derived from our SCTS database, a prospective national keratoplasty registry, and clinical outcomes (graft survival, endothelial cell loss, complications, visual acuity) were compared between PK, ALK, and EK. Global trends on indications and forms of keratoplasty performed in 2011/2012 were obtained from national keratoplasty or eye banking registries, corneal/ophthalmological societies, national eye banks, and national ophthalmic institutions. Results: Global rates of EK surgery vary widely, from 52% (Sweden) to 0% (South Africa), with higher adoption by industrialized countries. ALK adoption rates similarly vary from 28.7% (China) to 1.0% (Philippines). SCTS data show high adoption rates in Singapore: EK 44% and ALK 28%. Our surgical modifications to big-bubble deep anterior lamellar keratoplasty (DALK) surgery resulted in visual outcomes matching PK, and a low conversion to PK of 2.1%, whereas our evolving approaches to donor insertion in Descemet’s stripping automated endothelial keratoplasty (DSAEK) show significant reduction in 1-year postoperative endothelial cell loss rates from 60% (folding), to 22% to 30% (Sheets Glide), to 15% (EndoGlide inserter). Conclusion: Improvements in various forms of ALK and EK surgery can lead to better visual outcomes, longer graft survival, and reduced complications, as compared to PK. Global trends suggest adoption of these procedures at different rates. PMID:26755854

  11. Visual-Accommodation Trainer/Tester

    NASA Technical Reports Server (NTRS)

    Randle, Robert J., Jr.

    1986-01-01

    Ophthalmic instrument tests and helps develop focusing ability. Movable stage on a fixed base permits adjustment of effective target position as perceived by subject. Various apertures used to perform tests and training procedures. Ophthalmic instrument provides four functions: it measures visual near and far points; provides focus stimulus in vision research; measures visual-accommodation resting position; can be used to train for volitional control of person's focus response.

  12. Enhancing Medical Student Education by Implementing a Competency-Based Ophthalmology Curriculum.

    PubMed

    Succar, Tony; McCluskey, Peter; Grigg, John

    2017-01-01

    To evaluate innovative educational strategies that help optimize ophthalmology teaching in a crowded medical curriculum. The knowledge acquisition and perceptions of medical students undertaking the revised competency-based curriculum were compared with the prior content-based curriculum within the Sydney Medical Program. A mixed-methods research design was employed to include both quantitative and qualitative dimensions in evaluating the revised curriculum with medical students (n = 328) undergoing their ophthalmology rotation. Quantitative evaluation was performed with a 20-item multiple choice pre- and post-test of ophthalmic knowledge. A 12-month follow-up test was readministered to compare the long-term retention rate of graduates. Qualitative evaluation was measured with student satisfaction questionnaires. In the original curriculum there was an improvement of 19.9% from pre- to post-test scores [2.15; 95% confidence interval (CI), 1.35-2.94; P < 0.001] and a greater improvement of 31.6% from pre- to post-test (3.50; 95% CI, 3.03-3.97; P < 0.001) in the revised curriculum. When assessing retained knowledge at 12 months, students from the revised curriculum scored 11.5% higher than students from the original curriculum (1.56; 95% CI, 0.42-2.71; P = 0.008). In addition, qualitative feedback also improved, with the rotation being highly valued. The revised ophthalmic curriculum resulted in an increase in academic performance and a higher degree of student satisfaction. Given the gradual decline of ophthalmic education in the standard medical school curriculum, our results are timely in providing guidance for minimum ophthalmic curriculum exposure and strategies to improve ophthalmic education in medical schools. Copyright© 2017 Asia-Pacific Academy of Ophthalmology.

  13. Efficacy of detergent and water versus bleach for disinfection of direct contact ophthalmic lenses.

    PubMed

    Abbey, Ashkan M; Gregori, Ninel Z; Surapaneni, Krishna; Miller, Darlene

    2014-06-01

    Although manufacturers recommend cleaning ophthalmic lenses with detergent and water and then with a specific disinfectant, disinfectants are rarely used in ophthalmic practices. The aim of this pilot study was to evaluate the efficacy of detergent and water versus that of bleach, a recommended disinfectant, to eliminate common ocular bacteria and viruses from ophthalmic lenses. Three bacterial strains (Staphylococcus epidermidis, Corynebacterium straitum, and methicillin-resistant Staphylococcus aureus and 2 viral strains (adenovirus and herpes simplex virus [HSV] type-1) were individually inoculated onto 20 gonioscopy and laser lenses. The lenses were washed with detergent and water and then disinfected with 10% bleach. All the lenses were cultured after inoculation, after washing with detergent and water, and after disinfecting with the bleach. Bacterial cultures in thioglycollate broth were observed for 3 weeks, and viral cultures were observed for 2 weeks. The presence of viruses was also detected by multiplex polymerase chain reaction (PCR). All 20 lenses inoculated with S. epidermidis, C. straitum, adenovirus, and HSV-1 showed growth after inoculation but no growth after washing with detergent/water and after disinfecting with the bleach. All lenses showed positive HSV and adenovirus PCR results after inoculation and negative PCR results after washing with detergent/water and after disinfecting with bleach. All methicillin-resistant S. aureus-contaminated lenses showed growth after inoculation and no growth after washing with detergent and water. However, 1 lens showed positive growth after disinfecting with bleach. Cleaning with detergent and water seemed to effectively eliminate bacteria and viruses from the surface of contaminated ophthalmic lenses. Further studies are warranted to design practical disinfection protocols that minimize lens damage.

  14. Postoperative analgesic efficacy of single high dose and low dose rectal acetaminophen in pediatric ophthalmic surgery

    PubMed Central

    Gandhi, Ranju; Sunder, Rani

    2012-01-01

    Background: Analgesic efficacy of rectal acetaminophen is variable in different surgical procedures. Little data is available on its efficacy in ophthalmic surgeries. We conducted this prospective, randomized, double blind study to evaluate and compare the efficacy of single high dose and low dose rectal acetaminophen in pediatric ophthalmic surgery over a 24 hour period. Materials and Methods: 135 children scheduled for elective ophthalmic surgery were randomly allocated to one of the three groups, high, low, or control (H, L, or N) and received rectal acetaminophen 40 mg/kg, 20 mg/kg or no rectal drug respectively after induction of general anesthesia. Postoperative observations included recovery score, hourly observational pain score (OPS) up to 8 hours, time to first analgesic demand, and requirement of rescue analgesics and antiemetics over a 24 hour period. Results: Nineteen of 30 (63%) of children in group N required postoperative rescue analgesic versus 5/48 (10%) of group H (P <0.0001) and 10/47 (23%) of group L (P =0.0005) during 24 hour period. Mean time to requirement of first analgesic was 206±185 min in group H, 189±203min in group L, and 196 ±170 min in group N (P=0.985). OPS was significantly lower in group H and L compared to group N during first 8 hours. Requirement of rescue antiemetic was 18.7% in group H as compared to 23% each in group L and group N (P >0.5). Conclusions: Single dose rectal acetaminophen can provide effective postoperative analgesia for pediatric ophthalmic surgery at both high dose (40 mg/kg) and low dose (20 mg/kg) both in early postoperative and over a 24 hour period. PMID:23225924

  15. Outcomes, impact on management, and costs of fungal eye disease consults in a tertiary care setting.

    PubMed

    Ghodasra, Devon H; Eftekhari, Kian; Shah, Ankoor R; VanderBeek, Brian L

    2014-12-01

    To determine the frequency of clinical management changes resulting from inpatient ophthalmic consultations for fungemia and the associated costs. Retrospective case series. Three hundred forty-eight inpatients at a tertiary care center between 2008 and 2012 with positive fungal blood culture results, 238 of whom underwent an ophthalmologic consultation. Inpatient charts of all fungemic patients were reviewed. Costs were standardized to the year 2014. The Student t test was used for all continuous variables and the Pearson chi-square test was used for categorical variables. Prevalence of ocular involvement, rate of change in clinical management, mortality rate of fungemic patients, and costs of ophthalmic consultation. Twenty-two (9.2%) of 238 consulted patients with fungemia had ocular involvement. Twenty patients had chorioretinitis and 2 had endophthalmitis. Only 9 patients (3.7%) had a change in management because of the ophthalmic consultation. One patient underwent bilateral intravitreal injections. Thirty percent of consulted patients died before discharge or were discharged to hospice. The total cost of new consults was $36 927.54 ($204.19/initial level 5 visit and $138.63/initial level 4). The cost of follow-up visits was $13 655.44 ($104.24/visit). On average, 26.4 patients were evaluated to find 1 patient needing change in management, with an average cost of $5620.33 per change in 1 patient's management. Clinical management changes resulting from ophthalmic consultation in fungemic patients were uncommon. Associated costs were high for these consults in a patient population with a high mortality rate. Together, these data suggest that the usefulness of routine ophthalmic consultations for all fungemic patients is likely to be low. Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  16. An ex vivo human aqueous humor-concentration comparison of two commercial bromfenac formulations

    PubMed Central

    Walters, Thomas R; Smyth-Medina, Robert J; Cockrum, Paul C

    2018-01-01

    Purpose The purpose of this study was to quantify the concentration of bromfenac in the aqueous humor utilizing high-performance liquid chromatography mass spectrometry between two commercial nonsteroidal anti-inflammatory drugs, using aqueous humor concentrations to characterize pharmacokinetic proportional differences between 0.075% bromfenac ophthalmic solution in DuraSite (BromSite®) and 0.09% bromfenac ophthalmic solution (Bromday®). Methods In this multicenter, randomized, double-masked, two-arm, parallel-group, comparative, Phase II clinical trial, subjects were assigned to receive bromfenac in DuraSite or bromfenac ophthalmic solution in a 1:1 ratio. One drop of the masked test article was instilled into the study eye once a day for 2 days prior to and 3 hours prior (last instillation) to the subject’s cataract surgery. Aqueous humor samples were collected upon initial cataract incision for analysis of bromfenac levels. The primary end point was aqueous humor concentration of bromfenac at Day 3, at the initiation of cataract surgery. Aqueous humor samples were collected and analyzed for bromfenac levels. Results A total of 60 subjects completed the study, 30 in each group. The mean bromfenac aqueous humor concentration in subjects who received bromfenac in DuraSite was more than twice (49.33±41.87 ng/mL, P=0.004) that of subjects who received bromfenac ophthalmic solution (23.65±16.31 ng/mL) after three doses. Conclusion Mean bromfenac aqueous humor concentration in subjects receiving the DuraSite-containing bromfenac in DuraSite (0.075%) was significantly higher compared to subjects receiving bromfenac ophthalmic solution (0.09%) after 3 days of dosing. PMID:29849449

  17. Determination of permeability coefficients of ophthalmic drugs through different layers of porcine, rabbit and bovine eyes.

    PubMed

    Loch, Christian; Zakelj, Simon; Kristl, Albin; Nagel, Stefan; Guthoff, Rudolf; Weitschies, Werner; Seidlitz, Anne

    2012-08-30

    To treat ophthalmic diseases like glaucoma or inflammatory disorders topically applied ophthalmic formulations such as eye drops are usually used. In addition, novel ophthalmic implants releasing drug substances locally into different parts of the eye are available today. In the work presented here, the permeability coefficients of selected drugs (ciprofloxacin hydrochloride, lidocaine hydrochloride, timolol maleate) for ophthalmic tissues were determined using side-by-side diffusion chambers (so-called Ussing chambers). Sclera, conjunctiva, cornea, choroidea-retina-complex and a complex of conjunctiva-sclera-choroidea-retina were excised from fresh porcine, rabbit and bovine eyes. In the porcine eye tissues the highest P(app) values were obtained for conjunctiva with the exception of lidocaine. Therefore, it can be estimated that a certain amount of drug diffuses or is transported through conjunctiva after application. The P(app) values for sclera were also higher than those for cornea and even more, the surface area of sclera which is available for drug absorption is much larger than that of cornea when applying an implant. The obtained permeability coefficients for sclera and conjunctiva indicate that the administration of periocular implants can be an alternative to topically applied formulations. The complexes of the tissues were a significantly (p<0.01) stronger barrier to the investigated substances than the separated tissues. Distinct differences in permeability coefficients between the investigated animal tissues were observed. Overall the highest P(app) values for all mounted tissues were obtained with the rabbit, followed by porcine and bovine eyes. Because of these distinct interspecies differences one must be very careful when selecting the proper animal model for the permeability experiments. Copyright © 2012 Elsevier B.V. All rights reserved.

  18. Changes in the retrobulbar arterial circulation after decrease of the elevated intraocular pressure in men and women with primary open angle glaucoma.

    PubMed

    Marjanović, Ivan; Martinez, Antonio; Marjanović, Marija; Kontić, Djordje; Hentova-Senćanić, Paraskeva; Marković, Vujica; Bozić, Marija

    2013-01-01

    An altered perfusion of the optic nerve head has been proposed as a pathogenic factor of glaucoma. The aim of this study was to evaluate the changes of the hemodynamic parameters in the retrobulbar arterial circulation after decrease of the elevated intraocular pressure (IOP) in women and men with primary open angle glaucoma. The study included 60 patients (33 males and 27 females) older than 50 years, with diagnosed and treated primary open angle glaucoma (77 eyes of 39 patients had increased IOP, > 25 mm Hg).They were examined at the Clinic of Eye Diseases (complete ophthalmologic exam) and Clinic of Neurology, Clinical Center of Serbia, Belgrade, from December 2009 to December 2010. Imaging of hemodynamic parameters of three retrobulbar arterial vessels: ophthalmic, central retinal and posterior ciliary arteries with color Doppler was performed. Among women, hemodynamic arterial parameter of the peak-systolic velocity was increased in the central retinal artery and decreased in the ophthalmic artery and posterior ciliary arteries; end-diastolic velocity was increased in all three retrobulbar vascular levels; Pourcelot resistivity index was increased, but pulsatility index was decreased in all three vessels. Among men, peak-systolic velocity, end-diastolic velocity and pulsatility index were decreased in all three vessels; resistivity index was increased in the ophthalmic artery, but decreased in the central retinal artery and posterior ciliary arteries. There was a significant change of the ophthalmic artery pulsatility index in women, and the end-diastolic velocity of the ophthalmic artery in men. There was a difference of the retrobulbar arterial circulation between women and men with primary open angle glaucoma after decrease of the elevated intraocular pressure.The role of vascular factors in the supply of the optic disc neuroretinal rim is important.

  19. [Bibliometric analysis of the current international ophthalmic publications].

    PubMed

    Ohba, Norio

    2005-03-01

    To assess the current status of international ophthalmic publications. A collection of 55,591 original articles were found by an on-line National Library of Medicine database Medline search for 32 international ophthalmic journals during a 15-year period from 1988 to 2002 (internet access, November 11-13, 2003). The contributions to international ophthalmic publications were by 49.5% from North America, 31.3% from Western Europe, 15.1% from Asia and Oceania, 2.2% from Middle East, 0.85% from Central and South America, 0.53% from Eastern Europe, and 0.47% from Africa. Countries of Asia and Oceania showed an increasing trend in contributions while North America had a decreasing productivity in a relative sense. The top 10 productive countries were USA, United Kingdom, Japan, Germany, Canada, Australia, Italy, Netherlands, Sweden, and France. Among the Asian countries India ranked 13th, China 18th, and Korea 21st. When related to population, small countries such as Israel, France, Finland, Sweden, and Denmark were more productive. When related to economic productivity as defined by GDP, Israel, the United Kingdom, Australia, Finland, and Sweden were among the most productive countries, whereas rich countries such as Japan and Germany had a lower number of publications relative to their GDP. As regards clinical research in terms of randomized controlled trials, The USA was by far the most productive. The number of authors per article has shown an increasing trend worldwide, so that Japan and France had a significantly larger proportion of multiauthored articles. There is an increasing trend in the productivity of international ophthalmic publications from non-English-speaking countries including Japan, China, and Korea.

  20. Risk of Visual Impairment and Intracranial Hypertension After Space Flight: Evaluation of the Role of Polymorphism of Enzymes Involved in One-Carbon Metabolism

    NASA Technical Reports Server (NTRS)

    Smith, S. M.; Gregory, J. F.; Zeisel, G. H.; Gibson, C. R.; Mader, T. H.; Kinchen, J.; Ueland, P.; Ploutz-Snyder, R.; Heer, M.; Zwart, S. R.

    2016-01-01

    Data from the Nutritional Status Assessment protocol provided biochemical evidence that the one-carbon metabolic pathway may be altered in individuals experiencing vision-related issues during and after space flight (1, 2). Briefly, serum concentrations of homocysteine, cystathionine, 2-methylcitric acid, and methylmalonic acid were significantly (P<0.001) higher (25-45%) in astronauts with ophthalmic changes than in those without such changes (1). These differences existed before, during, and after flight. Serum folate was lower (P<0.01) during flight in individuals with ophthalmic changes. Preflight serum concentrations of cystathionine and 2-methylcitric acid, and mean in-flight serum folate, were significantly (P<0.05) correlated with postflight changes in refraction (1). A follow-up study was conducted to evaluate a small number of known polymorphisms of enzymes in the one-carbon pathway, and to evaluate how these relate to vision and other medical aspects of the eye. Specifically, we investigated 5 polymorphisms in MTRR, MTHFR, SHMT, and CBS genes and their association with ophthalmic changes after flight in 49 astronauts. The number of G alleles of MTRR 66 and C alleles of SHMT1 1420 both contributed to the odds of visual disturbances (3). Block regression showed that B-vitamin status at landing and genetics were significant predictors for many of the ophthalmic outcomes studied (3). In conclusion, we document an association between MTRR 66 and SHMT1 1420 polymorphisms and space flightinduced vision changes. These data document that individuals with an altered 1-carbon metabolic pathway may be predisposed to anatomic and/or physiologic changes that render them susceptible to ophthalmic damage during space flight.

  1. Resistance to blood flow in the rabbit ophthalmic artery after topical treatment with timolol.

    PubMed

    Liu, John H K; Li, Ruixia; Nelson, Thomas R; Weinreb, Robert N

    2007-04-01

    The aim of this study was to investigate the resistance to blood flow in the ophthalmic artery of rabbits receiving topical treatment with timolol. Eight (8) New Zealand albino rabbits received 20 mul of timolol treatment (vehicle, 0.1%, 0.33%, 1%, and 3.3%) on the right eye. Blood-flow velocity in the ophthalmic artery was determined in the treated eye using color Doppler imaging (CDI) with a 12-MHz linear ultrasound transducer prior to the treatment and at 0.5, 1, 1.5, 2, and 3 h after the treatment. Intraocular pressure (IOP) was measured in both eyes, using a pneumatonometer at the same time points. Pourcelot's resistive index of blood flow was calculated, using the peak systolic velocity and the end diastolic velocity. A control experiment was performed with CDI obtained from the right eye when the left eye was treated with 1% timolol. In the eye treated with 1% and 3.3% timolol, a dose-dependent increase in the resistive index of blood flow occurred in the ophthalmic artery. No change in the resistive index occurred when the contralateral eye was treated with 1% timolol. Changes of IOP were not different between the two eyes under all the experimental conditions. Timolol, at all concentrations, caused a significant reduction of heart rate. A similar reduction of heart rate occurred when either eye was treated with 1% timolol. Topical treatment with timolol in rabbits can increase the resistance to blood flow in the ophthalmic artery. This effect is caused by a mechanism local to the eye and is not dependent on an IOP change.

  2. The effects of topical aqueous sirolimus on tear production in normal dogs and dogs with refractory dry eye.

    PubMed

    Spatola, Ronald; Nadelstein, Brad; Berdoulay, Andrew; English, Robert V

    2018-05-01

    To evaluate the effect of twice daily aqueous 0.02% sirolimus drops on tear production in normal dogs and dogs with refractory keratoconjunctivitis sicca (KCS). Two groups of dogs were studied. Ten normal dogs with no signs of ocular disease were administered topical 0.02% sirolimus ophthalmic solution in right eye, and a vehicle control in the left eye twice daily for 4 weeks. Complete ophthalmic examinations, including Schirmer tear test were performed weekly. Eighteen dogs with refractory KCS were randomly assigned to receive 0.02% sirolumus ophthalmic solution or 0.02% tacrolimus ophthalmic solution twice daily. Complete ophthalmic examinations were was performed at 2 and 6 weeks following treatment. Tear production in the sirolimus-treated eyes of normal dogs was greater when compared to vehicle controls with a mean difference over all time points of 3.46 mm (95% CI 1.17, 5.75; P = 0.006). After 4 weeks of treatment, the mean difference was 5 mm (95% CI 1.95, 8.05; P = 0.002). In dogs with refractory dry eye, 37.5% of eyes treated with sirolimus exhibited increased tear production >4 mm/min after 6 weeks of treatment, compared to 20% of eyes receiving tacrolimus (P = 0.433). One normal dog experienced topical irritation to both sirolimus and vehicle-treatment. Side effects were not reported in any treated eyes with chronic KCS. Topical 0.02% sirolimus might be an alternative treatment for canine patients with keratoconjunctivits sicca. The drug appears safe when applied topically in an aqueous suspension for up to 6 weeks. While initial results are promising, further studies are warranted. © 2017 American College of Veterinary Ophthalmologists.

  3. Bioavailability and biochemical effects of diclofenac sodium 0.1% ophthalmic solution in the domestic chicken (Gallus gallus domesticus).

    PubMed

    Griggs, Angela N; Yaw, Taylor J; Haynes, Joseph S; Ben-Shlomo, Gil; Tofflemire, Kyle L; Allbaugh, Rachel A

    2017-03-01

    To determine if topical ophthalmic diclofenac sodium 0.1% solution alters renal parameters in the domestic chicken, and to determine if the drug is detectable in plasma after topical ophthalmic administration. Thirty healthy domestic chickens. Over 7 days, six birds were treated unilaterally with one drop of artificial tear solution (group 1), 12 birds were treated unilaterally (group 2) and 12 bilaterally (group 3) with diclofenac sodium 0.1% ophthalmic solution. Treatments were provided every 12 h in all groups. Pre- and post-treatment plasma samples from all birds were evaluated for changes in albumin, total protein, and uric acid. Post-treatment samples of all birds, collected 15 min post-administration, were analyzed by high-performance liquid chromatography with mass spectrometry for diclofenac sodium detection. A randomly selected renal sample from each group was submitted for histopathologic review. Changes in pre- and post-treatment plasma albumin were significant (P < 0.05) in groups 2 and 3, but not for group 1. Pre- and post-treatment changes in total protein and uric acid were not significant for any group. Diclofenac sodium was not detectable (limit of detection = 0.10 ng/mL) in plasma samples from birds in group 1. Post-treatment concentration of diclofenac in group 3 was statistically greater than group 2 (P = 0.0008). Histopathologic changes did not identify diclofenac-induced acute renal tubular necrosis. Ophthalmic diclofenac sodium 0.1% administered topically every 12 h in one or both eyes for 7 days is detectable in systemic circulation in the domestic chicken, but does not cause overt significant changes in plasma uric acid or total protein. © 2016 American College of Veterinary Ophthalmologists.

  4. Evaluation of a stereoscopic camera-based three-dimensional viewing workstation for ophthalmic surgery.

    PubMed

    Bhadri, Prashant R; Rowley, Adrian P; Khurana, Rahul N; Deboer, Charles M; Kerns, Ralph M; Chong, Lawrence P; Humayun, Mark S

    2007-05-01

    To evaluate the effectiveness of a prototype stereoscopic camera-based viewing system (Digital Microsurgical Workstation, three-dimensional (3D) Vision Systems, Irvine, California, USA) for anterior and posterior segment ophthalmic surgery. Institutional-based prospective study. Anterior and posterior segment surgeons performed designated standardized tasks on porcine eyes after training on prosthetic plastic eyes. Both anterior and posterior segment surgeons were able to complete tasks requiring minimal or moderate stereoscopic viewing. The results indicate that the system provides improved ergonomics. Improvements in key viewing performance areas would further enhance the value over a conventional operating microscope. The performance of the prototype system is not at par with the planned commercial system. With continued development of this technology, the three- dimensional system may be a novel viewing system in ophthalmic surgery with improved ergonomics with respect to traditional microscopic viewing.

  5. Electrophysiologic and morphologic effects of ophthalmic preparations on rabbit cornea epithelium.

    PubMed

    Burstein, N L; Klyce, S D

    1977-10-01

    The effects of several components of ophthalmic preparations on isolated rabbit cornea were studied by continuous electrophysiologic monitoring followed by fixation for scanning electron microscopy (SEM). Benzalkonium chloride (0.001 percent), thimerosal (0.0004 percent), and amphotericin B (0.0025 percent) all briefly increased ion transport, then greatly decreased epithelial resistance. Severe disruption of surface cell layers occurred simultaneously with resistance decrease. Silver nitrate (0.00017 percent) stimulated transport with less accompanying morphologic damage. Tetracaine (0.05 percent) disrupted epithelial function and caused exfoliation of several cell layers. Chlorobutanol (0.1 percent) produced a nearly complete loss of the squamous cell layer. Chloramphenicol, epinephrine, and pilocarpine produced minor changes in structure and electrophysiology at full clinical concentration. It was concluded that low concentrations of preservatives in ophthalmic preparations disrupt the barrier and transport properties of the corneal epithelium.

  6. Paediatric cataract blindness in the developing world: surgical techniques and intraocular lenses in the new millennium

    PubMed Central

    Wilson, M E; Pandey, S K; Thakur, J

    2003-01-01

    Paediatric cataract blindness presents an enormous problem to developing countries in terms of human morbidity, economic loss, and social burden. Managing cataracts in children remains a challenge: treatment is often difficult, tedious, and requires a dedicated team effort. To assure the best long term outcome for cataract blind children, appropriate paediatric surgical techniques need to be defined and adopted by ophthalmic surgeons of developing countries. The high cost of operative equipment and the uneven world distribution of ophthalmologists, paediatricians, and anaesthetists create unique challenges. This review focuses on issues related to paediatric cataract management that are appropriate and suitable for ophthalmic surgeons in the developing world. Practical guidelines and recommendations have also been provided for ophthalmic surgeons and health planners dealing with childhood cataract management in the developing world. PMID:12488254

  7. Comparison of surgical time and IOP spikes with two ophthalmic viscosurgical devices following Visian STAAR (ICL, V4c model) insertion in the immediate postoperative period.

    PubMed

    Ganesh, Sri; Brar, Sheetal

    2016-01-01

    To compare the effect of two ocular viscosurgical devices (OVDs) on intraocular pressure (IOP) and surgical time in immediate postoperative period after bilateral implantable collamer lens (using the V4c model) implantation. A total of 20 eligible patients were randomized to receive 2% hydroxypropylmethylcellulose (HPMC) in one eye and 1% hyaluronic acid in fellow eye. Time taken for complete removal of OVD and total surgical time were recorded. At the end of surgery, IOP was adjusted between 15 and 20 mmHg in both the eyes. Mean time for complete OVD evacuation and total surgical time were significantly higher in the HPMC group (P=0.00). Four eyes in the HPMC group had IOP spike, requiring treatment. IOP values with noncontact tonometry at 1, 2, 4, 24, and 48 hours were not statistically significant (P>0.05) for both the groups. The study concluded that 1% hyaluronic acid significantly reduces total surgical time, and incidence of acute spikes may be lower compared to 2% HPMC when used for implantable collamer lens (V4c model).

  8. Comparison of surgical time and IOP spikes with two ophthalmic viscosurgical devices following Visian STAAR (ICL, V4c model) insertion in the immediate postoperative period

    PubMed Central

    Ganesh, Sri; Brar, Sheetal

    2016-01-01

    Purpose To compare the effect of two ocular viscosurgical devices (OVDs) on intraocular pressure (IOP) and surgical time in immediate postoperative period after bilateral implantable collamer lens (using the V4c model) implantation. Methods A total of 20 eligible patients were randomized to receive 2% hydroxypropylmethylcellulose (HPMC) in one eye and 1% hyaluronic acid in fellow eye. Time taken for complete removal of OVD and total surgical time were recorded. At the end of surgery, IOP was adjusted between 15 and 20 mmHg in both the eyes. Results Mean time for complete OVD evacuation and total surgical time were significantly higher in the HPMC group (P=0.00). Four eyes in the HPMC group had IOP spike, requiring treatment. IOP values with noncontact tonometry at 1, 2, 4, 24, and 48 hours were not statistically significant (P>0.05) for both the groups. Conclusion The study concluded that 1% hyaluronic acid significantly reduces total surgical time, and incidence of acute spikes may be lower compared to 2% HPMC when used for implantable collamer lens (V4c model). PMID:26869754

  9. Ophthalmologic manifestations of celiac disease

    PubMed Central

    Martins, Thiago Gonçalves dos Santos; Costa, Ana Luiza Fontes de Azevedo; Oyamada, Maria Kiyoko; Schor, Paulo; Sipahi, Aytan Miranda

    2016-01-01

    Celiac disease is an autoimmune disorder that affects the small intestine of genetically predisposed individuals. Ophthalmic manifestations are within the extra-intestinal manifestations, and can be divided into those of autoimmune disorders or those due to absorptive disabilities. This article reviewed the ophthalmologic manifestation of celiac disease. Ophthalmic symptoms are rare, but should be investigated in patients with celiac disease and taken into consideration as the first systemic manifestation. PMID:26949627

  10. THE DYNACELL AND FOCAL PLANE CONCEPTS OF PHOTOTROPIC SYSTEMS APPLICATION TO OPHTHALMIC NUCLEAR FLASH-PROTECTIVE DEVICES

    DTIC Science & Technology

    Two concepts of phototropic systems application are presented in this report. These concepts, when considered individually or in combination, make...possible the development of improved, directly or indirectly actuated, phototropic , ophthalmic, nuclear flash-protective devices. By the application...of a phototropic filter at the focal plane of an optical system, the attenuation of the phototropic response due to distance is minimized. Using a

  11. Ophthalmic manifestations of maxillary sinus mucoceles.

    PubMed

    Ormerod, L D; Weber, A L; Rauch, S D; Feldon, S E

    1987-08-01

    Mucoceles involving any of the paranasal sinuses may present with ophthalmic disturbances. Maxillary antral mucoceles can encroach on the inferior orbit with ocular displacement and compression, proptosis or enophthalmos, lower lid distortion, tethering of extraocular muscles, and ptosis. Periocular pain, erosion of the inferior orbital rim, infraorbital nerve compression, epiphora, and inner canthal swellings are other important presentations. Postoperative mucoceles may involve only a portion of the antrum. Five illustrative cases are presented.

  12. Retinitis Pigmentosa Sine Pigmento Mimicking a Chiasm Disease.

    PubMed

    Pellegrini, Francesco; Prosdocimo, Giovanni; Romano, Francesco; Interlandi, Emanuela

    2017-08-01

    A 75-year-old woman presented to her ophthalmologist complaining of visual loss for several years. The ophthalmic examination was remarkable for a bitemporal visual field defect. Magnetic resonance imaging (MRI) scan of the brain was normal without evidence of chiasm compression. Neuro-ophthalmic examination was consistent with a retinal rather than a chiasmal disease. Retinal multimodal imaging helped in the correct diagnosis of retinitis pigmentosa, later confirmed by genetic testing.

  13. Syphilitic retinitis and uveitis in HIV-positive adults.

    PubMed

    Hughes, Edward H; Guzowski, Magdalena; Simunovic, Matthew P; Hunyor, Alex P; McCluskey, Peter

    2010-12-01

    The incidence of new infection with syphilis is increasing, particularly in men who have sex with men, with HIV co-infection common. There has been a corresponding increase in ophthalmic manifestations that can be varied in presentation. Thirteen consecutive patients with syphilitic uveitis presenting to two ophthalmic departments in Sydney are described. Twelve patients were male, of whom 10 were homosexual and six HIV-positive. Peripheral retinitis with panuveitis was the commonest ophthalmic presentation (n = 7, 54%), and six cases were initially treated with vitreous tap and intravitreal foscarnet as a precaution in case of viral retinitis. Retinitis was present in six of six (100%) HIV-positive and only one of seven (14%) HIV-negative patients (χ² 10.6, P < 0.01). Other ophthalmic presentations included anterior uveitis, vitritis, multifocal choroiditis, scleritis and papillitis. All patients responded to 10-14 days' intravenous penicillin with good final visual outcomes (6/12 or better in all eyes). This case series reinforces the importance of considering syphilis in the differential diagnosis of many ocular presentations, but in particular retinitis. Retinitis appears to be the predominant presentation in HIV-infected individuals, suggesting that HIV infection may somehow modulate the disease. © 2010 The Authors. Clinical and Experimental Ophthalmology © 2010 Royal Australian and New Zealand College of Ophthalmologists.

  14. Effect of work-related ultraviolet exposure and ophthalmic changes in Austrian farmers: the SVB-UV study.

    PubMed

    Schmid-Kubista, Katharina E; Kellner, Lukas; Maier, Harald; Felke, Stefan; Wanka, Alexandra; El Modeir, Adel; Schmidt, Jolanta B; Cabaj, Alexander; Schmalwieser, Alois; Rohn, Herbert; Stadelmann, Heinrich; Spiess, Johannes; Fischer, Wolfgang; Hönigsmann, Herbert; Binder, Susanne

    2010-01-01

    Epidemiological screening to examine possible ultraviolet-induced ocular changes and pathologies in Austrian farmers. The study was performed on behalf of the Austrian farmer insurance (Sozialversicherungsanstalt der Bauern). Randomly selected farmers and office workers as controls, both at the age of 35-55 years, underwent ophthalmic screening examinations. All subjects underwent complete ophthalmic examinations by slit lamp examination and Schirmer's test 1. A survey, regarding personal habits in the sun, was also conducted. Three hundred and ninety-two subjects underwent ophthalmic examinations of whom 297 were farmers and 95 were controls. Due to the survey, 89.7% of the farmers claimed to protect themselves from the sun during work. From these subjects, 83.7% wear a head protection, 71.0% wear sunglasses, and 54.4% usually work in the shade. There were significant differences in lid (p = 0.021) and conjunctival pathologies (p < 0.0001) between farmers and controls. Austrian farmers are at a higher risk for developing lid and conjunctival tumours which require treatment at some point. We believe that the study group was too young to show significant differences within the lens and the posterior pole. A 5-year follow-up is planned. Copyright 2010 S. Karger AG, Basel.

  15. Description of Ophthalmic Pharmaceutical and Device Start-Up Companies.

    PubMed

    Sharpe, R Allan; Austin, Jennifer P; Kruft, Bonnie; Nelson, Lindsay A; Stewart, Jeanette A; Stewart, William C

    2015-01-01

    To describe the number, type and location of ophthalmic companies and their associated product areas and indications. A retrospective, non-patient-based, observational review of ophthalmic pharmaceutical and device companies with a new product in development. Data was compiled by Internet searches. We identified 190 companies currently developing ophthalmic products: 134 (71%) were privately held and 56 (29%) publicly held, while 136 (72%) were in the United States and 53 (28%) were outside the United States. There were 436 total products of which 338 (78%) were pharmaceuticals and 98 (22%) devices. With pharmaceuticals we identified 46 separate indications with age-related macular degeneration (n = 75), glaucoma (n = 52) and dry eye (n = 46) as most common; anti-vascular endothelial growth factor, hormone therapy and anti-inflammatory products were also common classes. With devices there were 30 indications with glaucoma (n = 26), age-related macular degeneration (n = 19) and dry eye (n = 6) as most common; drug delivery, ocular implants and prostheses were less common classes. Ophthalmology as a specialty is benefited by a wide effort in new medicine and device development. However, a concentration of effort into relatively few indications suggests a potential lack of market analysis and possible difficulty for many companies in commercializing their product. © 2015 S. Karger AG, Basel.

  16. Clinical utility of 3% diquafosol ophthalmic solution in the treatment of dry eyes

    PubMed Central

    Koh, Shizuka

    2015-01-01

    Diquafosol is a drug used for dry eye treatment with a novel mechanism of action. It stimulates the secretion of tear fluid and mucin on the ocular surface, thus enabling us to selectively treat the tear film layer, playing an important role in the establishment of the concept of “Tear Film Oriented Therapy (TFOT)”, an effective therapeutic approach to dry eye in Japan. The 3% diquafosol ophthalmic solution has been widely used for the treatment of dry eye in clinical practice, and it is currently available in Japan and South Korea. This review provides an overview of the clinical utility of 3% diquafosol ophthalmic solution, focusing on the results of clinical studies on various types of dry eye, including aqueous-deficient dry eye, short tear film breakup time-type dry eye, and post dry eye after laser in situ keratomileusis. It also introduces the additive effect of diquafosol on sodium hyaluronate monotherapy for dry eye, and the effect of 3% diquafosol ophthalmic solution for dry eye-related conditions. Additionally, it summarizes the ocular effects of diquafosol in healthy human eyes. Lastly, the importance of improving tear film stability in dry eye treatment, as well as general advances in dry eye treatments, are described. PMID:26028958

  17. Clinical utility of 3% diquafosol ophthalmic solution in the treatment of dry eyes.

    PubMed

    Koh, Shizuka

    2015-01-01

    Diquafosol is a drug used for dry eye treatment with a novel mechanism of action. It stimulates the secretion of tear fluid and mucin on the ocular surface, thus enabling us to selectively treat the tear film layer, playing an important role in the establishment of the concept of "Tear Film Oriented Therapy (TFOT)", an effective therapeutic approach to dry eye in Japan. The 3% diquafosol ophthalmic solution has been widely used for the treatment of dry eye in clinical practice, and it is currently available in Japan and South Korea. This review provides an overview of the clinical utility of 3% diquafosol ophthalmic solution, focusing on the results of clinical studies on various types of dry eye, including aqueous-deficient dry eye, short tear film breakup time-type dry eye, and post dry eye after laser in situ keratomileusis. It also introduces the additive effect of diquafosol on sodium hyaluronate monotherapy for dry eye, and the effect of 3% diquafosol ophthalmic solution for dry eye-related conditions. Additionally, it summarizes the ocular effects of diquafosol in healthy human eyes. Lastly, the importance of improving tear film stability in dry eye treatment, as well as general advances in dry eye treatments, are described.

  18. Preparation, pharmacokinetics and pharmacodynamics of ophthalmic thermosensitive in situ hydrogel of betaxolol hydrochloride.

    PubMed

    Huang, Weiwei; Zhang, Nan; Hua, Haiying; Liu, Tuanbing; Tang, Yafang; Fu, Lingling; Yang, Yanan; Ma, Xiujie; Zhao, Yongxing

    2016-10-01

    Conventional ophthalmic formulations often eliminate rapidly after administration and cannot provide and maintain an adequate concentration of the drug in the precorneal area. To solve those problems, a thermosensitive in situ gelling and mucoadhesive ophthalmic drug delivery system was prepared and evaluated, the system was composed of poloxamer analogs and polycarbophil (PCP) and betaxolol hydrochloride (BH) was selected as model drug. The concentrations of poloxamer 407 (P407) (22% (w/v)) and poloxamer 188 (P188) (3.5% (w/v)) were identified through central composite design-response surface methodology (CCD-RSM). The BH in situ hydrogel (BH-HG) was liquid solution at low temperature and turned to semisolid at eye temperature. BH-HG showed good stability and biocompatibility, which fulfilled the requirements of ocular application. In vitro studies indicated that addition of PCP enhanced the viscosity of BH-HG and the release results of BH from BH-HG demonstrated a sustained release behavior of BH because of the gel dissolution. In vivo pharmacokinetics and pharmacodynamics studies indicated that the BH-HG formulation resulted in an improved bioavailability and a significantly lower intraocular pressure (IOP). The results suggested BH-HG could be potentially used as an in situ gelling system for ophthalmic delivery to enhance the bioavailability and efficacy. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  19. Safety, efficacy, and patient acceptability of lidocaine hydrochloride ophthalmic gel as a topical ocular anesthetic for use in ophthalmic procedures

    PubMed Central

    Page, Michael A; Fraunfelder, Frederick W

    2009-01-01

    Purpose: To review the current literature on safety, efficacy, and measures of surgeon and patient satisfaction with lidocaine hydrochloride gel as a tool for ocular anesthesia. Methods: Pubmed search using keywords “lidocaine gel,” “ophthalmic,” and “surgery” and compiling cross-references. Twenty-six total references were reviewed, including 15 prospective randomized controlled trials (RCTs, total N = 933, average N = 62), 6 nonrandomized prospective studies (total N = 234, average N = 39), 2 animal studies, 1 microbiologic study, and 2 letters to the editor. Results: The RCTs and nonrandomized prospective studies evaluated a number of measures including timing of onset of anesthesia, duration of anesthesia, intraoperative and postoperative pain, need for additional anesthetic applications, intracameral lidocaine levels, and adverse effects. Control groups received topical drops, subconjunctival anesthetic, retrobulbar anesthetic, or sham gel. Lidocaine gel was shown to be at least as effective for pain control as alternative therapies in all studies, with longer duration of action than topical drops. Patient and surgeon satisfaction were high, and adverse effects were rare and comparable to those for anesthetic drop formulations. Surgical settings included cataract, pterygium, trabeculectomy, strabismus, intravitreal injection, vitrectomy, and penetrating keratoplasty. Conclusions: Lidocaine gel is a safe, effective, and potentially underutilized tool for ophthalmic surgery. PMID:19898665

  20. How to interpret a healthcare economic analysis.

    PubMed

    Brown, Melissa M; Brown, Gary C

    2005-06-01

    The purpose of the review is to present guidelines to help the clinician to interpret healthcare economic analyses and review pertinent recent analysis in the ophthalmic literature. There are four variants of healthcare economic analyses: (1) cost-minimization analysis; (2) cost-benefit analysis; (3) cost-effectiveness analysis and (4) cost-utility analysis. Cost-utility utility analysis has assumed an increasingly important role in healthcare, with increasing number of analyses occurring in the peer-reviewed ophthalmic literature. These include cost-utility analyses of cataract surgery in the first and second eyes, amblyopia treatment, and cost-utility analyses encompassing the vitreoretinal interventions of the following: (1) laser photocoagulation for exudative macular degeneration; (2) laser treatment for diabetic retinopathy; (3) laser photocoagulation for branch retinal vein obstruction; (4) diabetic vitrectomy; (5) treatment of proliferative retinopathy of prematurity and (6) treatment of retinal detachment associated with proliferative vitreoretinopathy. As an increasing number of cost-utility analyses become available they will provide the information system for the practice of value-based medicine, or medicine based upon the patient-perceived value conferred by interventions. Increasing numbers of cost-utility analysis in the ophthalmic literature suggest that ophthalmic interventions, including vitreoretinal interventions, are cost effective. Cost-utility analysis is a major tool in value-based medicine, the practice of medicine based upon the patient-perceived value conferred by healthcare interventions.

  1. Enduring Influence of Elizabethan Ophthalmic Texts of the 1580s: Bailey, Grassus, and Guillemeau

    PubMed Central

    Leffler, Christopher T; Schwartz, Stephen G; Davenport, Byrd; Randolph, Jessica; Busscher, Joshua; Hadi, Tamer

    2014-01-01

    Three English ophthalmic texts of the 1580s were frequently republished: 1) Walter Bailey’s A Briefe Treatise Touching the Preseruation of the Eie Sight, 2) The Method of Phisicke, an adaptation of the medieval treatise of Benevenutus Grassus, and 3) A Worthy Treatise of the Eyes, a translation of Jacques Guillemeau’s treatise. Their history is intertwined through composite publications, some of which lacked clear attribution. At least 21 editions incorporated these texts. Although not previously realized, major elements of all 3 works are found in Two Treatises Concerning the Preseruation of Eie-sight, first published in 1616. To preserve eyesight, Bailey recommended eyebright (Euphrasia officinalis), fennel (Fæniculum vulgare), and a moderate lifestyle incorporating wine. In the works of Grassus and Guillemeau, cataracts were believed to lie anterior to the ‘crystalline humor,’ and were treated by the ‘art of the needle,’ or couching. Links are found between Grassus, Guillemeau, and eighteenth century glaucoma concepts. Although one of his students has traditionally received credit, it was English oculist John Thomas Woolhouse who first combined the early concepts and used the term glaucoma to describe the palpably hard eye in the early eighteenth century. The three primary ophthalmic texts of 1580s England influenced ophthalmic thought for over a century. PMID:24959303

  2. Correlation of genetic and clinical findings in Spanish patients with X-linked juvenile retinoschisis.

    PubMed

    Riveiro-Alvarez, Rosa; Trujillo-Tiebas, Maria-Jose; Gimenez-Pardo, Ascension; Garcia-Hoyos, Maria; Lopez-Martinez, Miguel-Angel; Aguirre-Lamban, Jana; Garcia-Sandoval, Blanca; Vazquez-Fernandez del Pozo, Silvia; Cantalapiedra, Diego; Avila-Fernandez, Almudena; Baiget, Montserrat; Ramos, Carmen; Ayuso, Carmen

    2009-09-01

    X-linked juvenile retinoschisis (XLRS) is one of the most common causes of juvenile macular degeneration in males, characterized by microcystic changes, splitting within the inner retinal layer (schisis), and the presence of vitreous veils. This study was conducted to describe and further correlate specific genetic variation in Spanish patients with XLRS with clinical characteristics and additional ophthalmic complications. The study was performed in 34 Spanish families with XLRS, comprising 51 affected males. Thorough clinical ophthalmic and electrophysiological examinations were performed. The coding regions of the RS1 gene were amplified by polymerase chain reaction and directly sequenced. Haplotype analyses were also performed. Twenty different mutations were identified. Ten of the 20 were novel and 3 were de novo mutational events. The most common mutation (p.Gln154Arg; 6/20) presented a common haplotype. RS1 variants did not correlate with ophthalmic findings and were not associated with additional ophthalmic complications. The prevalent p.Gln154Arg mutation is first reported in this work and presents a common origin in Spanish patients with XLRS. In addition, de novo mutations mainly occur in CG dinucleotides. Despite the large mutational spectrum and variable phenotypes, no genotype-phenotype correlations were found. Identifying the causative mutation is helpful in confirming diagnosis and counseling, but cannot provide a prognosis.

  3. A System Approach to Navy Medical Education and Training. Appendix 32- Competency Curricula for Ophthalmic Clinic Assistant and Ophthalmic Technician

    DTIC Science & Technology

    1974-08-31

    chamber fluid, and gonioscopy exam (Conditions) With direct supervision (Criteria) In accordance with physician’s instructions (Consequence) Completion of...posterior chambers Gonioscopy techniques Slit-lamp biomicroscopy techniques Smear and culture techniques Accuracy in recording ard charting Manual...CILIARY BODY/ANGLE STRUCTURE TESTS I TASXS a. Assist with gonioscopy PERFO-RANCE OBJECTIVE (Stimulus) Upon physician’s orders (Behavior) The OPHTA

  4. Retinitis Pigmentosa Sine Pigmento Mimicking a Chiasm Disease

    PubMed Central

    Pellegrini, Francesco; Prosdocimo, Giovanni; Romano, Francesco; Interlandi, Emanuela

    2017-01-01

    ABSTRACT A 75-year-old woman presented to her ophthalmologist complaining of visual loss for several years. The ophthalmic examination was remarkable for a bitemporal visual field defect. Magnetic resonance imaging (MRI) scan of the brain was normal without evidence of chiasm compression. Neuro-ophthalmic examination was consistent with a retinal rather than a chiasmal disease. Retinal multimodal imaging helped in the correct diagnosis of retinitis pigmentosa, later confirmed by genetic testing. PMID:29344059

  5. Ophthalmic optical coatings: The real world can be more aggressive than you think

    NASA Astrophysics Data System (ADS)

    Mildebrath, Mark; Klemm, Karl

    2007-01-01

    Ophthalmic antireflection coatings are not normally considered to be in the same category as other traditional optical coatings with respect to environmental damage. However, as a group, eyeglass lens wearers tend to subject their optical-coated eyewear to a broader and more aggressive range of environmental aggressions than at first imagined. This paper presents the environmental aggressions and, in some detail, the resultant coating defects observed in coated ophthalmic optics. Further, development of test methods for defect replication, to enable product improvements will be discussed. Real-life environments combine thermal, chemical, and mechanical "aggressions" which spectacle lenses are subjected to. These aggressions generate optical coating defects and failure modes involving abrasion, corrosion, and loss of adhesion. In addition, market forces driven by retail customer perceptions lead to product liabilities not normally considered to be of any consequence in traditional optical coating applications.

  6. Health literacy and ophthalmic patient education

    PubMed Central

    Muir, Kelly W.; Lee, Paul P.

    2010-01-01

    In 1997, Ebrahimzadeh, Davalos and Lee wrote in this journal that only 32% of the ophthalmic patient educational materials reviewed were written at or below the recommended eighth grade reading level. Since that time, the National Assessment of Adult Literacy found that more than one third of adult Americans possess only basic or below basic health literacy skills, defined as the ability to understand written information in a healthcare setting. Subsequently, investigators have shown that poor health literacy skills are associated with poor prescription medication adherence, increased hospital admissions and increased mortality. We review the readability of currently available ophthalmic educational materials, with particular attention to the health literacy status of the patient population for which the materials are intended. Examples of prose at various readability levels are provided. Optimizing patient education and improving clinical outcomes requires understanding the attributes that the patient brings to the patient–physician relationship, including health literacy. PMID:20650503

  7. Are we pharmacovigilant enough in ophthalmic practice?

    PubMed Central

    Dubey, Ashok; Handu, Shailendra S

    2013-01-01

    No drug is absolutely safe. Pharmacovigilance is the science related to detection, assessment, understanding and prevention of adverse effects or any other possible drug-related problems. The ocular medications and devices can cause localized and systemic adverse effects. Not all adverse effects are known when a drug or device is launched in market because of limitations of clinical trials. Many adverse effects are recognized due to the spontaneous reporting of the vigilant doctors who observe and report such events encountered in their practice. Despite a large ophthalmic patient population base, India does not have robust adverse drug reaction (ADR) database because of lack of reporting culture. Government of India recently launched the Pharmacovigilance Programme of India (PvPI) to monitor ADRs and create awareness among the healthcare professionals about the importance of ADRs. Suspecting and reporting a possible drug reaction is very important in developing a safe and rational ophthalmic practice. PMID:23571233

  8. In situ-forming hydrogels for sustained ophthalmic drug delivery.

    PubMed

    Nanjawade, Basavaraj K; Manvi, F V; Manjappa, A S

    2007-09-26

    Ophthalmic drug delivery is one of the most interesting and challenging endeavors facing the pharmaceutical scientist. The conventional ocular drug delivery systems like solutions, suspensions, and ointments show drawbacks such as increased precorneal elimination, high variability in efficiency, and blurred vision respectively. In situ-forming hydrogels are liquid upon instillation and undergo phase transition in the ocular cul-de-sac to form visco-elastic gel and this provides a response to environmental changes. In the past few years, an impressive number of novel temperature, pH, and ion induced in situ-forming systems have been reported for sustain ophthalmic drug delivery. Each system has its own advantages and drawbacks. The choice of a particular hydrogel depends on its intrinsic properties and envisaged therapeutic use. This review includes various temperature, pH, and ion induced in situ-forming polymeric systems used to achieve prolonged contact time of drugs with the cornea and increase their bioavailability.

  9. Bilateral ophthalmic artery occlusion in rhino-orbito-cerebral mucormycosis.

    PubMed

    Song, Yoo Mi; Shin, Sun Young

    2008-03-01

    To report a case of bilateral ophthalmic artery occlusion in rhino-orbito-cerebral mucormycosis. Reviewed clinical charts, photographs, and fluorescein angiography An 89-year-old man with poorly controlled diabetes developed sudden bilateral ptosis, complete ophthalmoplegia of the right eye, and superior rectus palsy of the left eye. Brain and orbit magnetic resonance imaging showed midbrain infarction and mild diffuse sinusitis. On the 2nd day of hospitalization, sudden visual loss and light reflex loss developed. There were retinal whitening, absence of retinal arterial filling, and a total lack of choroidal perfusion on fluorescein angiography of the right eye. The left eye showed a cherry red spot in the retina and the absence of retinal arterial filling and partial choroidal perfusion on fluorescein angiography. On rhinologic examination, mucormyosis was noticed. Despite treatment, visual acuity and light reflex did not recover and he died 4 days after admission. Bilateral ophthalmic artery occlusion can occur in rhino-orbital-cerebral mucormycosis.

  10. Ophthalmic artery obstruction and cerebral infarction following periocular injection of autologous fat.

    PubMed

    Lee, Chang Mok; Hong, In Hwan; Park, Sung Pyo

    2011-10-01

    We report a case of ophthalmic artery obstruction combined with brain infarction following periocular autologous fat injection. The patient, a 44-year-old woman, visited our hospital for decreased visual acuity in her left eye and dysarthria one hour after receiving an autologous fat injection in the periocular area. Her best corrected visual acuity for the concerned eye was no light perception. Also, a relative afferent pupillary defect was detected in this eye. The left fundus exhibited widespread retinal whitening with visible emboli in several retinal arterioles. Diffusion-weighted magnetic resonance imaging of the brain showed a hyperintense lesion at the left insular cortex. Therefore, we diagnosed ophthalmic artery obstruction and left middle cerebral artery infarction due to fat emboli. The patient was managed with immediate ocular massage, carbon dioxide, and oxygen therapy. Following treatment, dysarthria improved considerably but there was no improvement in visual acuity.

  11. Models for joint ophthalmology-optometry patient management.

    PubMed

    Kim, John J; Kim, Christine M

    2011-07-01

    American Academy of Ophthalmology (AAO) and American Society of Cataract and Refractive Surgery (ASCRS) presented a joint position paper in February 2000 declaring that they do not support routine comanagement of patients with the optometrists. American Optometric Association and American Academy of Optometry quickly responded in support of AAO and ASCRS. All four entities did not preclude legitimate and proper comanagement arrangements. Since that time, the pattern of practice has changed, requiring us to rethink our positions. This paper is written to provide a possible model for the ophthalmology-optometry practice management in ophthalmic surgeries including refractive surgery. Since the publication of the Joint Position Paper, the concept of comanagement has faded and a new model of integrated management has evolved. This has occurred as the changes in the employment pattern of the ophthalmic practice have incorporated optometrists into its fold. This evolution allowed ophthalmic and optometric community to co-exist and thrive to provide better patient care.

  12. [Demography and age-dependency in ophthalmic diseases].

    PubMed

    Wolfram, C

    2015-01-01

    This article explains key terms in demography and describes current and future changes in the composition of the German population. The ratio of older persons is greatly increasing as age groups from higher birth rates are growing older and as the life expectancy continues to rise particularly for older age groups. Ophthalmology is highly affected by these societal changes as eye diseases particularly affect the elderly. The prevalence of blindness and low vision is increasing in the older population even though this increase is being overlapped by a general reduction in the risk of blindness. Up to more than 30% more age-related eye diseases are expected in the population by the year 2030, which will lead to an additional roughly 7.7 million ophthalmic consultations in the population of more than 60 years of age. The healthcare units need to be adjusted to the rising demand for ophthalmic care.

  13. Ophthalmic Vascular Events after Primary Unilateral Intra-arterial Chemotherapy for Retinoblastoma in Early and Recent Eras.

    PubMed

    Dalvin, Lauren A; Ancona-Lezama, David; Lucio-Alvarez, J Antonio; Masoomian, Babak; Jabbour, Pascal; Shields, Carol L

    2018-06-16

    To assess risk factors for ophthalmic vascular events after intra-arterial chemotherapy (IAC) for retinoblastoma. Retrospective cohort study. Patients who received unilateral IAC as primary treatment for retinoblastoma from January 1, 2009, to November 30, 2017, at a single center. Records were reviewed for patient demographics, tumor features, IAC parameters, and treatment-related vascular events in the early IAC era (2009-2011) compared with the recent era (2012-2017) using the t test and Fisher exact test. Change in event rates over time was assessed using Poisson regression analysis, with Spearman's rho used to test correlation. Rate of IAC-induced ophthalmic vascular events. There were 243 chemotherapy infusions in 76 eyes of 76 patients, divided into early (22 eyes, 57 infusions) and recent (54 eyes, 186 infusions) eras. Intra-arterial chemotherapy consisted of melphalan (243 infusions), topotecan (124 infusions), and carboplatin (9 infusions). A comparison (early vs. recent era) revealed fewer mean number of infusions (2.6 vs. 3.4, P = 0.02) with similar mean patient age and presenting tumor features. Event rates decreased over time (P < 0.01), with fewer ophthalmic vascular events (early era vs. recent era) in the recent era (59% vs. 9% per eye, 23% vs. 3% per infusion, P < 0.01), including peripheral retinal nonperfusion (5% vs. 2% per eye, P = 0.50), vitreous hemorrhage (9% vs. 2%, P = 0.20), subretinal hemorrhage (0% vs. 2%, P = 0.99), branch retinal vein occlusion (5% vs. 0%, P = 0.29), choroidal ischemia (14% vs. 4%, P = 0.14), and ophthalmic artery spasm/occlusion (27% vs. 0%, P < 0.01). Events did not correlate to patient age (P = 0.75), tumor diameter (P = 0.32), tumor thickness (P = 0.59), or cumulative dosage of melphalan (P = 0.13) or topotecan (P = 0.59). There were no IAC-induced vascular events in 72 infusions of 21 consecutively treated eyes in 2016 to 2017. Ophthalmic vascular events after IAC have decreased from the early era (2009-2011) through the current era (2012-2017) at this center. Experience performing this highly specialized procedure could be an important factor predicting IAC-related vascular events. Copyright © 2018 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  14. Mapping human resources for eye health in 21 countries of sub-Saharan Africa: current progress towards VISION 2020.

    PubMed

    Palmer, Jennifer J; Chinanayi, Farai; Gilbert, Alice; Pillay, Devan; Fox, Samantha; Jaggernath, Jyoti; Naidoo, Kovin; Graham, Ronnie; Patel, Daksha; Blanchet, Karl

    2014-08-15

    Development of human resources for eye health (HReH) is a major focus of the Global Action Plan 2014 to 2019 to reduce the prevalence of avoidable visual impairment by 25% by the year 2019. The eye health workforce is thought to be much smaller in sub-Saharan Africa than in other regions of the world but data to support this for policy-making is scarce. We collected HReH and cataract surgeries data from 21 countries in sub-Sahara to estimate progress towards key suggested population-based VISION 2020 HReH indicators and cataract surgery rates (CSR) in 2011. Routinely collected data on practitioner and surgery numbers in 2011 was requested from national eye care coordinators via electronic questionnaires. Telephone and e-mail discussions were used to determine data collection strategies that fit the national context and to verify reported data quality. Information was collected on six practitioner cadres: ophthalmologists, cataract surgeons, ophthalmic clinical officers, ophthalmic nurses, optometrists and 'mid-level refractionists' and combined with publicly available population data to calculate practitioner to population ratios and CSRs. Associations with development characteristics were conducted using Wilcoxon rank sum tests and Spearman rank correlations. HReH data was not easily available. A minority of countries had achieved the suggested VISION 2020 targets in 2011; five countries for ophthalmologists/cataract surgeons, four for ophthalmic nurses/clinical officers and two for CSR. All countries were below target for optometrists, even when other cadres who perform refractions as a primary duty were considered. The regional (sample) ratio for surgeons (ophthalmologists and cataract surgeons) was 2.9 per million population, 5.5 for ophthalmic clinical officers and nurses, 3.7 for optometrists and other refractionists, and 515 for CSR. A positive correlation between GDP and CSR as well as many practitioner ratios was observed (CSR P = 0.0042, ophthalmologists P = 0.0034, cataract surgeons, ophthalmic nurses and optometrists 0.1 > P > 0.05). With only a minority of countries in our sample having reached suggested ophthalmic cadre targets and none having reached targets for refractionists in 2011, substantially more targeted investment in HReH may be needed for VISION 2020 aims to be achieved in sub-Saharan Africa.

  15. Mapping human resources for eye health in 21 countries of sub-Saharan Africa: current progress towards VISION 2020

    PubMed Central

    2014-01-01

    Background Development of human resources for eye health (HReH) is a major focus of the Global Action Plan 2014 to 2019 to reduce the prevalence of avoidable visual impairment by 25% by the year 2019. The eye health workforce is thought to be much smaller in sub-Saharan Africa than in other regions of the world but data to support this for policy-making is scarce. We collected HReH and cataract surgeries data from 21 countries in sub-Sahara to estimate progress towards key suggested population-based VISION 2020 HReH indicators and cataract surgery rates (CSR) in 2011. Methods Routinely collected data on practitioner and surgery numbers in 2011 was requested from national eye care coordinators via electronic questionnaires. Telephone and e-mail discussions were used to determine data collection strategies that fit the national context and to verify reported data quality. Information was collected on six practitioner cadres: ophthalmologists, cataract surgeons, ophthalmic clinical officers, ophthalmic nurses, optometrists and ‘mid-level refractionists’ and combined with publicly available population data to calculate practitioner to population ratios and CSRs. Associations with development characteristics were conducted using Wilcoxon rank sum tests and Spearman rank correlations. Results HReH data was not easily available. A minority of countries had achieved the suggested VISION 2020 targets in 2011; five countries for ophthalmologists/cataract surgeons, four for ophthalmic nurses/clinical officers and two for CSR. All countries were below target for optometrists, even when other cadres who perform refractions as a primary duty were considered. The regional (sample) ratio for surgeons (ophthalmologists and cataract surgeons) was 2.9 per million population, 5.5 for ophthalmic clinical officers and nurses, 3.7 for optometrists and other refractionists, and 515 for CSR. A positive correlation between GDP and CSR as well as many practitioner ratios was observed (CSR P = 0.0042, ophthalmologists P = 0.0034, cataract surgeons, ophthalmic nurses and optometrists 0.1 > P > 0.05). Conclusions With only a minority of countries in our sample having reached suggested ophthalmic cadre targets and none having reached targets for refractionists in 2011, substantially more targeted investment in HReH may be needed for VISION 2020 aims to be achieved in sub-Saharan Africa. PMID:25128163

  16. Ocular drug metabolism of the bioactivating antioxidant N-acetylcarnosine for vision in ophthalmic prodrug and codrug design and delivery.

    PubMed

    Babizhayev, Mark A

    2008-10-01

    The basic idea in this study relates to the interesting research problem to employ with the knowledgeable pharmacy staff N-acetylcarnosine (NAC) in the developed suitable compounded prodrug ophthalmic preparations, which are currently used for the treatment of cataract and have antioxidant effect, in order to provide the molecular support to one of the most popular beliefs of the growing market for the treatment of senile cataract in patients and animals with efficacious NAC drug formulations worldwide patented by the author. This work presents the progress in ocular NAC prodrug and codrug design and delivery in light of revealed ocular metabolic activities. There is a considerable interest in the ophthalmic codrug design including NAC prodrug based on the strategies to improve ophthalmic drug delivery of the active peptide principal L-carnosine through the sustained intraocular metabolic activation of a dipeptide while making it resistant to enzymatic hydrolysis. Novel approaches to ocular NAC drug delivery, developed by Innovative Vision Products, Inc. (IVP), aim at enhancing the drug bioavailability by ensuring a prolonged retention of the medication in the eye, and/or by facilitating transcorneal penetration. IVP team studied the effects of lubricant eye drops designed as 1% NAC prodrug of L-carnosine containing a mucoadhesive cellulose-based and corneal absorption promoters in a drug delivery system. The predicted responses of the corneal and conjunctival penetrations to the synergistic promoters are useful in controlling the extent and pathway of the ocular and systemic absorptions of instilled NAC prodrug in designed ophthalmic formulations thereof. Utility of peptidase enzyme inhibitors in the codrug formulation to modulate the transport and metabolism of NAC prodrug appears to be a promising strategy for enhancing dipeptide drug transport across the cornea. The developed and officially CE mark registered by IVP NAC prodrug and codrug lubricating eye drop systems (including principal regulatory registered eye drops design and lubricating eye drops marketed under numerous brand labels), increase the intraocular uptake of the active principle L-carnosine from its ophthalmic carrier NAC in the aqueous humor and the permeability of a drug into the eye, and so enhance the ocular bioavailability, bioactivating universal antioxidant, and anti-cataract efficacy (in human and in canine eyes) of the developed NAC eye drops.

  17. Determination of feasibility and utility of microscope-integrated optical coherence tomography during ophthalmic surgery: the DISCOVER Study RESCAN Results.

    PubMed

    Ehlers, Justis P; Goshe, Jeff; Dupps, William J; Kaiser, Peter K; Singh, Rishi P; Gans, Richard; Eisengart, Jonathan; Srivastava, Sunil K

    2015-10-01

    Optical coherence tomography (OCT) has transformed the clinical management of a myriad of ophthalmic conditions. Applying OCT to ophthalmic surgery may have implications for surgical decision making and patient outcomes. To assess the feasibility and effect on surgical decision making of a microscope-integrated intraoperative OCT (iOCT) system. Report highlighting the 1-year results (March 2014-February 2015) of the RESCAN 700 portion of the DISCOVER (Determination of Feasibility of Intraoperative Spectral Domain Microscope Combined/Integrated OCT Visualization During En Face Retinal and Ophthalmic Surgery) study, a single-site, multisurgeon, prospective consecutive case series regarding this investigational device. Participants included patients undergoing ophthalmic surgery. Data on clinical characteristics were collected, and iOCT was performed during surgical milestones, as directed by the operating surgeon. A surgeon questionnaire was issued to each surgeon and was completed after each case to evaluate the role of iOCT during surgery and its particular role in select surgical procedures. Percentage of cases with successful acquisition of iOCT (ie, feasibility). Percentage of cases in which iOCT altered surgical decision making (ie, utility). During year 1 of the DISCOVER study, a total of 227 eyes (91 anterior segment cases and 136 posterior segment cases) underwent imaging with the RESCAN 700 system. Successful imaging (eg, the ability to acquire an OCT image of the tissue of interest) was obtained for 224 of 227 eyes (99% [95% CI, 98%-100%]). During lamellar keratoplasty, the iOCT data provided information that altered the surgeon's decision making in 38% of the cases (eg, complete graft apposition when the surgeon believed there was interface fluid). In membrane peeling procedures, iOCT information was discordant with the surgeon's impression of membrane peel completeness in 19% of cases (eg, lack of residual membrane or presence of occult membrane), thus affecting additional surgical maneuvers. The DISCOVER study demonstrates the feasibility of real-time iOCT with a microscope-integrated iOCT system for ophthalmic surgery. The information gained from iOCT appears to allow surgeons to assess subtle details in a unique perspective from standard en face visualization, which can affect surgical decision making some of the time, although the effect of these changes in decision making on outcomes remains unknown. A prospective randomized masked trial is needed to confirm these results.

  18. Acceptability, Usability, and Views on Deployment of Peek, a Mobile Phone mHealth Intervention for Eye Care in Kenya: Qualitative Study.

    PubMed

    Lodhia, Vaishali; Karanja, Sarah; Lees, Shelley; Bastawrous, Andrew

    2016-05-09

    The Portable Eye Examination Kit (Peek) is a mobile phone-based ophthalmic testing system that has been developed to perform comprehensive eye examinations. Shortages in ophthalmic personnel, the high cost, and the difficulty in transporting equipment have made it challenging to offer services, particularly in rural areas. Peek offers a solution for overcoming barriers of limited access to traditional ophthalmic testing methods and has been pilot tested on adults in Nakuru, Kenya, and compared with traditional eye examination tools. This qualitative study evaluated the acceptability and usability of Peek in addition to perceptions regarding its adoption and nationwide deployment. Semistructured interviews were conducted with patients and analyzed using a framework approach. This included analysis of interviews from 20 patients, 8 health care providers (HCPs), and 4 key decision makers in ophthalmic health care provision in Kenya. The participants were purposefully sampled. The coding structure involved predefined themes for assessing the following: (1) the context, that is, environment, user, task, and technology; (2) patient acceptability, that is, patients' perceived benefits, patient preference, and patient satisfaction; (3) usability, that is, efficiency, effectiveness, learnability, and flexibility and operability of Peek; and (4) the benefits of Peek in strengthening eye care provision, that is, capabilities enhancer, opportunity creator, social enabler, and knowledge generator. Emerging themes relating to the objectives were explored from the data using thematic analysis. Patients found Peek to be acceptable because of its benefits in overcoming the barriers to accessing ophthalmic services. Most thought it to be fast, convenient, and able to reach a large population. All patients expressed being satisfied with Peek. The HCPs perceived it to satisfy the criteria for usability and found Peek to be acceptable based on the technology acceptance model. Peek was also found to have features required for strengthening ophthalmic delivery by aiding detection and diagnosis, provision of decision support, improving communication between provider and patient and among providers, linking patients to services, monitoring, and assisting in education and training. Some of the deployment-related issues included the need for government and community involvement, communication and awareness creation, data protection, infrastructure development including capacity creation, and training and maintenance support. According to all parties interviewed, Peek is an acceptable solution, as it provides a beneficial service, supports patients' needs, and fulfills HCPs' roles, overall contributing to strengthening eye health.

  19. Incremental Revisions across the Life Span of Ophthalmic Devices after Initial Food and Drug Administration Premarket Approval, 1979-2015.

    PubMed

    Gopal, Anand D; Rathi, Vinay K; Teng, Christopher C; Del Priore, Lucian; Ross, Joseph S

    2017-08-01

    To characterize the frequency, nature, and regulatory mechanisms by which ophthalmic devices are iteratively modified after initial Food and Drug Administration (FDA) Premarket Approval (PMA). Retrospective cross-sectional analysis using publicly available FDA data. Ophthalmic devices initially approved via the FDA's PMA pathway between January 1, 1979 and December 31, 2015. We used the FDA's PMA Database to identify and characterize initial approvals and subsequent postmarket modifications to Class III ophthalmic devices. The FDA Recalls Database was used to identify associated safety events. Median iterated life span (timespan across which modifications occurred after initial PMA) and median number of supplements approved per device, by device type, and overall, stratified by regulatory pathway and modification type. Between 1979 and 2015, the FDA approved 168 original ophthalmic devices via the PMA pathway and 2813 subsequent modifications. More than one third (n = 64; 38%) of original approvals were intraocular lenses. Overall, devices underwent a median of 11 postmarket modifications (interquartile range [IQR], 3-24.8) across a median 10.0-year iterated life span (IQR, 4.1-16.7). The majority of devices (n = 144; 86%) underwent more than 1 postapproval modification, including more than 1 design modification (n = 84; 50%). The median number of changes altering device design or labeling was 3.5 (IQR, 1-9). Although manufacturing alterations (n = 834 of 2813; 30%) were the most frequent type of revision, changes involving device design (n = 667; 24%) and labeling (n = 417; 15%) were common. Recalled devices underwent more frequent postapproval modifications per year (median, 1.4; IQR, 0.7-2.3; mean, 1.5; 95% confidence interval, 1.1-1.9) in the period preceding recall than did nonrecalled devices (median, 0.5; IQR, 0.2-1.1; mean, 0.8; 95% confidence interval, 0.7-1.0) across their market approval period (P < 0.001). Most ophthalmic devices approved via the FDA's PMA pathway have undergone extensive revisions, including serial design and labeling changes, since their initial approvals, often without supporting clinical data. Ophthalmologists should take into consideration that cumulative revisions may render the clinical evidence that supported an original FDA approval less relevant to newer device models. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  20. Development of the Veterans Healthcare Administration (VHA) Ophthalmic Surgical Outcome Database (OSOD) project and the role of ophthalmic nurse reviewers.

    PubMed

    Lara-Smalling, Agueda; Cakiner-Egilmez, Tulay; Miller, Dawn; Redshirt, Ella; Williams, Dale

    2011-01-01

    Currently, ophthalmic surgical cases are not included in the Veterans Administration Surgical Quality Improvement Project data collection. Furthermore, there is no comprehensive protocol in the health system for prospectively measuring outcomes for eye surgery in terms of safety and quality. There are 400,000 operative cases in the system per year. Of those, 48,000 (12%) are ophthalmic surgical cases, with 85% (41,000) of those being cataract cases. The Ophthalmic Surgical Outcome Database Pilot Project was developed to incorporate ophthalmology into VASQIP, thus evaluating risk factors and improving cataract surgical outcomes. Nurse reviewers facilitate the monitoring and measuring of these outcomes. Since its inception in 1778, the Veterans Administration (VA) Health System has provided comprehensive healthcare to millions of deserving veterans throughout the U.S. and its territories. Historically, the quality of healthcare provided by the VA has been the main focus of discussion because it did not meet a standard of care comparable to that of the private sector. Information regarding quality of healthcare services and outcomes data had been unavailable until 1986, when Congress mandated the VA to compare its surgical outcomes to those of the private sector (PL-99-166). 1 Risk adjustment of VA surgical outcomes began in 1987 with the Continuous Improvement in Cardiac Surgery Program (CICSP) in which cardiac surgical outcomes were reported and evaluated. 2 Between 1991 and 1993, the National VA Surgical Risk Study (NVASRS) initiated a validated risk-adjustment model for predicting surgical outcomes and comparative assessment of the quality of surgical care in 44 VA medical centers. 3 The success of NVASRS encouraged the VA to establish an ongoing program for monitoring and improving the quality of surgical care, thus developing the National Surgical Quality Improvement Program (NSQIP) in 1994. 4 According to a prospective study conducted between 1991-1997 in 123 VA medical centers by Khuri et al., the 30-day mortality and morbidity rates for major surgeries had decreased by 9% and 30%, respectively. 5 Recently renamed the VA Surgical Quality Improvement Program (VASQIP) in 2010, the quality of surgical outcomes has continued to improve among all documented surgical specialties. Ophthalmic surgery is presumed to have a very low mortality rate and therefore has not been included in the VASQIP database.

  1. Automated Comprehensive Evaluation of mTBI Visual Dysfunction

    DTIC Science & Technology

    2016-10-01

    of this study is to validate the Neuro-Ophthalmic Device (NODe) test battery that provides the highest sensitivity and specificity for the detection...that the tests within the NODe test battery can serve as objective biomarkers for acute mTBI. Two hundred acute mTBI (≤72 hrs post injury) and 200 age...post-mTBI-related vision problems. The purpose of this study is to validate the Neuro-Ophthalmic Device (NODe) test battery that provides the

  2. An update on ocular complications of Ebola virus disease

    PubMed Central

    Shantha, Jessica G.; Crozier, Ian; Yeh, Steven

    2018-01-01

    Purpose of review This review provides a summary of our current understanding of the ophthalmic manifestations of Ebola virus disease (EVD), pathogenesis, treatment options and directions for future study. The individual, public health and global health implications of eye disease in EVD survivors are discussed. Recent findings The West Africa EVD outbreak was of unprecedented magnitude, leading to the largest survivor cohort since the first documented EVD outbreak in 1976. Because of the magnitude of the recent outbreak, thousands of survivors are at-risk of systemic and ophthalmic sequelae termed the ‘post Ebola virus disease syndrome’. Uveitis is the most common finding during EVD convalescence and may lead to severe vision impairment or blindness in 40% of affected individuals. Ocular complications leading to vision loss include cataract, retinal scarring, optic neuropathy, hypotony and phthisis bulbi. The pathogenesis of eye disease in EVD survivors likely involves Ebola virus persistence, severe inflammation and tissue edema, which present as acute, rapidly progressive disease or chronic, smoldering disease. Further studies into disease pathogenesis including mechanisms of viral persistence may provide guidance into therapies for uveitis secondary to EVD. Summary Uveitis is the most common ophthalmic finding in EVD survivors and can lead to vision loss. Further studies into the clinical manifestations and mechanisms of disease are needed to improve therapies for EVD survivors who often have limited access to ophthalmic medical and surgical care. PMID:28872492

  3. Gasserian Ganglion and Retrobulbar Nerve Block in the Treatment of Ophthalmic Postherpetic Neuralgia: A Case Report.

    PubMed

    Huang, Jie; Ni, Zhongge; Finch, Philip

    2017-09-01

    Varicella zoster virus reactivation can cause permanent histological changes in the central and peripheral nervous system. Neural inflammatory changes or damage to the dorsal root ganglia sensory nerve fibers during reactivation can lead to postherpetic neuralgia (PHN). For PHN of the first division of the fifth cranial nerve (ophthalmic division of the trigeminal ganglion), there is evidence of inflammatory change in the ganglion and adjacent ocular neural structures. First division trigeminal nerve PHN can prove to be difficult and sometimes even impossible to manage despite the use of a wide range of conservative measures, including anticonvulsant and antidepressant medication. Steroids have been shown to play an important role by suppressing neural inflammatory processes. We therefore chose the trigeminal ganglion as an interventional target for an 88-year-old woman with severe ophthalmic division PHN after she failed to respond to conservative treatment. Under fluoroscopic guidance, a trigeminal ganglion nerve block was performed with lidocaine combined with dexamethasone. A retrobulbar block with lidocaine and triamcinolone settled residual oculodynia. At 1-year follow-up, the patient remained pain free and did not require analgesic medication. To our knowledge, this is the first reported case of ophthalmic division PHN successfully treated with a combination of trigeminal ganglion and retrobulbar nerve block using a local anesthetic agent and steroid for central and peripheral neural inflammatory processes. © 2016 World Institute of Pain.

  4. The effect of live classical piano music on the vital signs of patients undergoing ophthalmic surgery.

    PubMed

    Camara, Jorge G; Ruszkowski, Joseph M; Worak, Sandra R

    2008-06-25

    Music and surgery. To determine the effect of live classical piano music on vital signs of patients undergoing ophthalmic surgery. Retrospective case series. 203 patients who underwent various ophthalmologic procedures in a period during which a piano was present in the operating room of St. Francis Medical Center. [Note: St. Francis Medical Center has recently been renamed Hawaii Medical Center East.] Demographic data, surgical procedures, and the vital signs of 203 patients who underwent ophthalmic procedures were obtained from patient records. Blood pressure, heart rate, and respiratory rate measured in the preoperative holding area were compared with the same parameters taken in the operating room, with and without exposure to live piano music. A paired t-test was used for statistical analysis. Mean arterial pressure, heart rate, and respiratory rate. 115 patients who were exposed to live piano music showed a statistically significant decrease in mean arterial blood pressure, heart rate, and respiratory rate in the operating room compared with their vital signs measured in the preoperative holding area (P < .0001). The control group of 88 patients not exposed to live piano music showed a statistically significant increase in mean arterial blood pressure (P < .0002) and heart rate and respiratory rate (P < .0001). Live classical piano music lowered the blood pressure, heart rate, and respiratory rate in patients undergoing ophthalmic surgery.

  5. Tests for malingering in ophthalmology

    PubMed Central

    Incesu, Ali Ihsan

    2013-01-01

    Simulation can be defined as malingering, or sometimes functional visual loss (FVL). It manifests as either simulating an ophthalmic disease (positive simulation), or denial of ophthalmic disease (negative simulation). Conscious behavior and compensation or indemnity claims are prominent features of simulation. Since some authors suggest that this is a manifestation of underlying psychopathology, even conversion is included in this context. In today's world, every ophthalmologist can face with simulation of ophthalmic disease or disorder. In case of simulation suspect, the physician's responsibility is to prove the simulation considering the disease/disorder first, and simulation as an exclusion. In simulation examinations, the physician should be firm and smart to select appropriate test(s) to convince not only the subject, but also the judge in case of indemnity or compensation trials. Almost all ophthalmic sensory and motor functions including visual acuity, visual field, color vision and night vision can be the subject of simulation. Examiner must be skillful in selecting the most appropriate test. Apart from those in the literature, we included all kinds of simulation in ophthalmology. In addition, simulation examination techniques, such as, use of optical coherence tomography, frequency doubling perimetry (FDP), and modified polarization tests were also included. In this review, we made a thorough literature search, and added our experiences to give the readers up-to-date information on malingering or simulation in ophthalmology. PMID:24195054

  6. Asymmetric flow field flow fractionation for the characterization of globule size distribution in complex formulations: A cyclosporine ophthalmic emulsion case.

    PubMed

    Qu, Haiou; Wang, Jiang; Wu, Yong; Zheng, Jiwen; Krishnaiah, Yellela S R; Absar, Mohammad; Choi, Stephanie; Ashraf, Muhammad; Cruz, Celia N; Xu, Xiaoming

    2018-03-01

    Commonly used characterization techniques such as cryogenic-transmission electron microscopy (cryo-TEM) and batch-mode dynamic light scattering (DLS) are either time consuming or unable to offer high resolution to discern the poly-dispersity of complex drug products like cyclosporine ophthalmic emulsions. Here, a size-based separation and characterization method for globule size distribution using an asymmetric flow field flow fractionation (AF4) is reported for comparative assessment of cyclosporine ophthalmic emulsion drug products (model formulation) with a wide size span and poly-dispersity. Cyclosporine emulsion formulations that are qualitatively (Q1) and quantitatively (Q2) the same as Restasis® were prepared in house with varying manufacturing processes and analyzed using the optimized AF4 method. Based on our results, the commercially available cyclosporine ophthalmic emulsion has a globule size span from 30 nm to a few hundred nanometers with majority smaller than 100 nm. The results with in-house formulations demonstrated the sensitivity of AF4 in determining the differences in the globule size distribution caused by the changes to the manufacturing process. It is concluded that the optimized AF4 is a potential analytical technique for comprehensive understanding of the microstructure and assessment of complex emulsion drug products with high poly-dispersity. Published by Elsevier B.V.

  7. In vivo eye surface residence determination by high-resolution scintigraphy of a novel ion-sensitive hydrogel based on gellan gum and kappa-carrageenan.

    PubMed

    Fernández-Ferreiro, Anxo; Silva-Rodríguez, Jesús; Otero-Espinar, Francisco Javier; González-Barcia, Miguel; Lamas, María Jesús; Ruibal, Alvaro; Luaces-Rodríguez, Andrea; Vieites-Prado, Alba; Lema, Isabel; Herranz, Michel; Gómez-Lado, Noemí; Blanco-Mendez, José; Gil-Martínez, María; Pardo, María; Moscoso, Alexis; Cortes, Julia; Sánchez-Martínez, María; Pardo-Montero, Juan; Aguiar, Pablo

    2017-05-01

    In last years, sensitive hydrogels have become a breakthrough in ophthalmic pharmaceutical technology aimed at developing new strategies to increase the residence time of active substances. In a previous paper, we qualitatively demonstrated the capacity of a new ion sensitive hydrogel to increase the residence time. Nevertheless, the clearance of the gel from the ocular surface was not quantifiable with the used methodology. The aim of the present work was to use a well-established approach based on scintigraphy to quantitatively estimate the residence time of the previously proposed hydrogel. The rat corneal residence time of a topic ophthalmic formulation containing gellan gum and kappa carragenan (0.82% w/v) labeled with 99m Tc-DTPA radiotracer was evaluated and compared with the residence of an aqueous solution. Ophthalmic safety studies such as eye irritation or passage through the cornea were also carried out. After 1.5h of contact, 77% of the hydrogel remained in the ocular surface, presenting kinetics of disappearance one-phase decay and a half time of 262min. We conclude that the novel ophthalmic hydrogel developed with kappa carrageenan and gellan gum remains for long periods of time on the corneal surface, presenting a drop that fits an exponential decay. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Retinal protective effects of topically administered agmatine on ischemic ocular injury caused by transient occlusion of the ophthalmic artery

    PubMed Central

    Hong, S.; Hara, H.; Shimazawa, M.; Hyakkoku, K.; Kim, C.Y.; Seong, G.J.

    2012-01-01

    Agmatine, an endogenous polyamine and putative neuromodulator, is known to have neuroprotective effects on various neurons in the central nervous system. We determined whether or not topically administered agmatine could reduce ischemic retinal injury. Transient ocular ischemia was achieved by intraluminal occlusion of the middle cerebral artery of ddY mice (30-35 g) for 2 h, which is known to also induce occlusion of the ophthalmic artery. In the agmatine group (N = 6), a 1.0 mM agmatine-containing ophthalmic solution was administered four times daily for 2 weeks before occlusion. In the control group (N = 6), a 0.1% hyaluronic acid ophthalmic solution was instilled at the same times. At 22 h after reperfusion, the eyeballs were enucleated and the retinal sections were stained by terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL). Transient ocular ischemia induced apoptosis of retinal cells in the entire retinal layer, and topically administered agmatine can significantly reduce this ischemic retinal injury. The proportion of apoptotic cells was definitely decreased (P < 0.001; Kruskal-Wallis test). Overall, we determined that topical agmatine application effectively decreases retinal damage in an in vivo ocular ischemic injury model. This implies that agmatine is a good candidate as a direct neuroprotective agent for eyes with ocular ischemic diseases. PMID:22331138

  9. Effect of diquafosol ophthalmic solution on the optical quality of the eyes in patients with aqueous-deficient dry eye.

    PubMed

    Koh, Shizuka; Maeda, Naoyuki; Ikeda, Chikako; Oie, Yoshinori; Soma, Takeshi; Tsujikawa, Motokazu; Watanabe, Hitoshi; Nishida, Kohji

    2014-12-01

    To investigate the short- and long-term effects of diquafosol ophthalmic solution on the optical quality of the eyes in patients with aqueous-deficient dry eye. Sixteen eyes in 16 patients with mild or moderate aqueous-deficient dry eye were treated with 3% diquafosol ophthalmic solution. Ocular higher-order aberrations (HOAs) were measured with a wavefront sensor before and at 15 min after diquafosol instillation at the baseline visit and at 4 weeks after treatment initiation. Dry eye symptoms, tear break-up time (BUT), corneal/conjunctival fluorescein staining and Schirmer's test were also evaluated before and after treatment with diquafosol. Treatment with diquafosol ophthalmic solution significantly improved dry eye symptoms, corneal staining and BUT. Compared with mean total HOAs at baseline (0.180 ± 0.06 μm), those at 4 weeks after treatment significantly decreased (0.148 ± 0.039 μm; p = 0.035), whereas those 15 min after diquafosol instillation at the baseline visit did not change significantly (0.170 ± 0.049 μm; p = 0.279). Although no significant change in HOAs was observed as a short-term effect of a single-drop instillation of diquafosol, long-term use of diquafosol to treat aqueous-deficient dry eye reduced HOAs as well as improved corneal epithelial damage and tear film stability. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  10. Perspectives of using the 223-nm wavelength of the KrCl excimer laser for refractive surgery and for the treatment of some eye diseases

    NASA Astrophysics Data System (ADS)

    Bagayev, Sergei N.; Chernikh, Valery V.; Razhev, Alexander M.; Zhupikov, Andrey A.

    2000-06-01

    The new surgical UV ophthalmic laser system Medilex based on the KrCl (223 nm) excimer laser for refractive surgery was created. The comparative analysis of using the UV ophthalmic laser systems Medilex based on the ArF (193 nm) and the KrCl (223 nm) excimer lasers for the correction of refractive errors was performed. The system with the radiation wavelength of 223 nanometer of the KrCl excimer laser for refractive surgery was shown to have several medical and technical advantages over the system with the traditionally used radiation wavelength of 193 nanometer of the ArF excimer laser. In addition the use of the wavelength of 223 nanometer extends functional features of the system, allowing to make not only standard for this type systems surgical and therapeutic procedures but also to treat such ocular diseases as the glaucoma and herpetic keratities. For the UV ophthalmic laser systems Medilex three variations of the beam delivery system including special rotating masks and different beam homogenize systems were developed. All created beam delivery systems are able to make the correction of myopia, hyperopia, astigmatism and myopic or hyperopic astigmatism and may be used for therapeutic procedures. The results of the initial treatments of refractive error corrections using the UV ophthalmic laser systems Medilex for both photorefractive keratectomy (PRK) and LASIK procedures are presented.

  11. Formulation and process factors influencing product quality and in vitro performance of ophthalmic ointments.

    PubMed

    Xu, Xiaoming; Al-Ghabeish, Manar; Rahman, Ziyaur; Krishnaiah, Yellela S R; Yerlikaya, Firat; Yang, Yang; Manda, Prashanth; Hunt, Robert L; Khan, Mansoor A

    2015-09-30

    Owing to its unique anatomical and physiological functions, ocular surface presents special challenges for both design and performance evaluation of the ophthalmic ointment drug products formulated with a variety of bases. The current investigation was carried out to understand and identify the appropriate in vitro methods suitable for quality and performance evaluation of ophthalmic ointment, and to study the effect of formulation and process variables on its critical quality attributes (CQA). The evaluated critical formulation variables include API initial size, drug percentage, and mineral oil percentage while the critical process parameters include mixing rate, temperature, time and cooling rate. The investigated quality and performance attributes include drug assay, content uniformity, API particle size in ointment, rheological characteristics, in vitro drug release and in vitro transcorneal drug permeation. Using design of experiments (DoE) as well as a novel principle component analysis approach, five of the quality and performance attributes (API particle size, storage modulus of ointment, high shear viscosity of ointment, in vitro drug release constant and in vitro transcorneal drug permeation rate constant) were found to be highly influenced by the formulation, in particular the strength of API, and to a lesser degree by processing variables. Correlating the ocular physiology with the physicochemical characteristics of acyclovir ophthalmic ointment suggested that in vitro quality metrics could be a valuable predictor of its in vivo performance. Published by Elsevier B.V.

  12. Periorbital and Intraorbital Studies of the Terminal Branches of the Ophthalmic Artery for Periorbital and Glabellar Filler Placements.

    PubMed

    Tansatit, Tanvaa; Apinuntrum, Prawit; Phetudom, Thavorn

    2017-06-01

    Filler injections for sunken upper eyelid correction and glabellar augmentation at the orbitoglabellar region need to be performed correctly. Precise knowledge of the emerging sites of all terminal branches of the ophthalmic artery is essential for these procedures to be conducted safely. The terminal branches of the ophthalmic artery were studied in both periorbital and intraorbital dissections. The aim of this study was to verify the critical positions of the emerging sites at the orbital septum that may act as potential retrograde channels for filler emboli. In the 40 eyes examined, the branches of the ophthalmic artery were found to emerge from four different sites. Two substantial emerging sites were situated on both sides of the trochlea of the superior oblique muscle. These sites were located at the superior part of the medial orbital rim (SMOR) and are alternatively named as the epitrochlear and the subtrochlear emerging sites. The other two sites can be regarded as accessory emerging sites due to the comparably smaller artery. Dissection of the intraorbital region revealed small periosteal branches of the infraorbital artery which coursed anteriorly on the orbital floor to form anastomoses with the lacrimal artery. In other areas of the orbital floor, no branches extended from the infraorbital artery. In front of the lacrimal gland, very minute branches descended and coursed along both margins of the superior tarsus but did not course outside the lateral orbital rim. A danger zone was located at the SMOR, where the ophthalmic branches emerge to form anastomotic channels. Compression at the trochlea guarantees safe injection of filler, reducing the risk of complication. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  13. Ophthalmic regional blocks: management, challenges, and solutions

    PubMed Central

    Palte, Howard D

    2015-01-01

    In the past decade ophthalmic anesthesia has witnessed a major transformation. The sun has set on the landscape of ophthalmic procedures performed under general anesthesia at in-hospital settings. In its place a new dawn has ushered in the panorama of eye surgeries conducted under regional and topical anesthesia at specialty eye care centers. The impact of the burgeoning geriatric population is that an increasing number of elderly patients will present for eye surgery. In order to accommodate increased patient volumes and simultaneously satisfy administrative initiatives directed at economic frugality, administrators will seek assistance from anesthesia providers in adopting measures that enhance operating room efficiency. The performance of eye blocks in a holding suite meets many of these objectives. Unfortunately, most practicing anesthesiologists resist performing ophthalmic regional blocks because they lack formal training. In future, anesthesiologists will need to block eyes and manage common medical conditions because economic pressures will eliminate routine preoperative testing. This review addresses a variety of topical issues in ophthalmic anesthesia with special emphasis on cannula and needle-based blocks and the new-generation antithrombotic agents. In a constantly evolving arena, the sub-Tenon’s block has gained popularity while the deep angulated intraconal (retrobulbar) block has been largely superseded by the shallower extraconal (peribulbar) approach. Improvements in surgical technique have also impacted anesthetic practice. For example, phacoemulsification techniques facilitate the conduct of cataract surgery under topical anesthesia, and suture-free vitrectomy ports may cause venous air embolism during air/fluid exchange. Hyaluronidase is a useful adjuvant because it promotes local anesthetic diffusion and hastens block onset time but it is allergenic. Ultrasound-guided eye blocks afford real-time visualization of needle position and local anesthetic spread. An advantage of sonic guidance is that it may eliminate the hazard of globe perforation by identifying abnormal anatomy, such as staphyloma. PMID:26316814

  14. Influence of medical student career aims on ophthalmic surgical simulator performance (part of the international forum for ophthalmic simulation studies).

    PubMed

    Gillan, S N; Okhravi, N; O'Sullivan, F; Sullivan, P; Viswanathan, A; Saleh, G M

    2016-03-01

    To evaluate whether medical students who have expressed a strong desire to pursue ophthalmology as a career perform simulated ophthalmic surgical tasks to a higher level than medical students whose interests lie elsewhere. All participants were fourth or fifth year students at University College London (UCL) Medical School, London, UK. One cohort was recruited from the Moorfields Academy, an ophthalmic forum designed to enhance collaboration and innovation within the specialty. These students were therefore seen as highly motivated, expressing a desire to pursue a career in ophthalmology. The other cohort of students was invited to participate during their fourth year UCL Ophthalmology attachment, but expressed interest in non-ophthalmic disciplines. Participants carried out a single attempt of three modules on the Eyesi Surgical Simulator, and total and mean scores were calculated out of 100. 13 academy and 15 non-academy students were enrolled. The overall mean scores were 51/100 for the academy group, range 0-97, and 45.5/100 for the non-academy group, range 0-90 (p=0.49). Scores for precision testing, forceps training and capsulorrhexis training for academy versus non-academy were 45.8 versus 37.8 (p=0.61), 57.1 versus 52.3 (p=0.8) and 50.2 versus 46.4 (p=0.55), respectively. This study is the first to suggest that medical students with a strong career interest in ophthalmology do not perform microsurgical tasks to a higher level than medical students who have no goal in this area. This also indicates variation in scores between novices, which may serve as a pitfall in the use of simulators as a tool for entry into training. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  15. [Tibolone's effect on retinal and ophthalmic arteries flowmetry].

    PubMed

    Souza, Marco Aurélio Martins de; Geber, Selmo

    2008-11-01

    to evaluate the effect of tibolone use on doppler-velocimetric parameters of ophthalmic and retinal arteries. clinical, prospective, longitudinal, randomized, placebo-controlled, triple-blind study, in which among 100 menopausal women, 50 have used 2.5 mg of the active principle tibolone (Tib Group) and 50, placebo as a means to form the control-group (Plac Group). In the Tib Group, 44 of the 50 women returned after 84 days to finish the exams, and in the Plac Group, 47. The ophthalmic and retinal arteries were studied to determine the resistance index (RI), the pulsatility index (PI) and the systole/diastole ratio (S/D). Assessments have been done before and 84 days after medication. The t-Student test has been used for the comparison of means between the groups in independent samples, as well as for within-group comparisons in dependent samples. in both groups, the women's characteristics were similar in age, menopause duration, body mass index, arterial blood pressure, deliveries and cardiac rate. The Tib Group presented the following values in the ophthalmic artery: RI(pre)=0.71+/-0.05, RI(post)0.72+/-0.08 (p=0.43); PI(pre)=1.29+/-0.22, PI(post)=1.30+/-0.25 (p=0.4) and S/D(pre)=3.49+/-0.77, SD(post)=3.65+/-0.94 (p=0.32). In the retinal artery, the following values have been found: RI(pre)=0.67+/-0.09, RI(post)=0.69+/-0.10 (p=0.7); PI(pre)=1.20+/-0.29, PI(post)=1.22+/-0.3 (p=0.2) and SD(pre)=3.29+/-0.95, SD(post)=3.30+/-1.07 (p=0.3). Also, the tibolone and control groups did not show any significant difference in regard to the above indexes in the end of the study. the 2.5 mg dose of tibolone had no effect on the Doppler velocimetry indexes of the ophthalmic and retinal arteries.

  16. Update on conjunctival pathology

    PubMed Central

    Mudhar, Hardeep Singh

    2017-01-01

    Conjunctival biopsies constitute a fairly large number of cases in a typical busy ophthalmic pathology practice. They range from a single biopsy through multiple mapping biopsies to assess the extent of a particular pathological process. Like most anatomical sites, the conjunctiva is subject to a very wide range of pathological processes. This article will cover key, commonly encountered nonneoplastic and neoplastic entities. Where relevant, sections will include recommendations on how best to submit specimens to the ophthalmic pathology laboratory and the relevance of up-to-date molecular techniques. PMID:28905821

  17. Effect of three ophthalmic solutions on chemical conjunctivitis in the neonate.

    PubMed

    Yasunaga, S

    1977-02-01

    In an attempt to reduce chemical conjunctivitis after silver nitrate prophylaxis, three different ophthalmic solutions (sodium chloride, sterile water, and a boric acid-sodium borate solution) were used to irrigate the eyes immediately after prophylaxis in 450 neonates. Sterile water significantly reduced (P less than .02) the prevalence of chemical conjunctivitis when compared to the conventional sodium chloride rinse. A significantly greater prevalence of chemical irritation in low-birth-weight infants was also noted (P less than .02).

  18. Novel Use of Ophthalmic pH Paper to Diagnose Malicious Caustic Ingestion in a Pediatric Patient

    PubMed Central

    Bruno, Eric C.

    2018-01-01

    Occult caustic ingestion in the pediatric population is a challenging diagnosis to make in the emergency department. Failure to suspect and diagnose a caustic ingestion can lead to potentially life-changing comorbidities. Historically, the diagnosis of caustic ingestion has been clinical without any suitable diagnostic tools to aid in the suspicion of occult cases. In this case, we describe a novel use of ophthalmic pH paper to diagnose caustic ingestion in a three-year-old.

  19. Choosing wisely and the use of antibiotics in ophthalmic surgery: There is more than meets the eye.

    PubMed

    Grosso, Andrea; Ceruti, Piero; Scarpa, Giuseppe; Giardini, Franco; Marchini, Giorgio; Aragona, Emanuela; Bert, Fabrizio; Bandello, Francesco; Siliquini, Roberta

    2018-02-01

    One of the directions of modern ophthalmology is toward an odontoiatric model, and new settings of eye care are becoming the standard of care: one day surgery and also office-based therapies. Retrospective analysis of three tertiary-care centers in Italy and analysis of the literature. We provide readers with state-of-the-art measures of prophylaxis in ophthalmic surgery. Role of antibiotics is criticized in the light of stewardship antimicrobial paradigm.

  20. Programmable diffractive lens for ophthalmic application

    NASA Astrophysics Data System (ADS)

    Millán, María S.; Pérez-Cabré, Elisabet; Romero, Lenny A.; Ramírez, Natalia

    2014-06-01

    Pixelated liquid crystal displays have been widely used as spatial light modulators to implement programmable diffractive optical elements, particularly diffractive lenses. Many different applications of such components have been developed in information optics and optical processors that take advantage of their properties of great flexibility, easy and fast refreshment, and multiplexing capability in comparison with equivalent conventional refractive lenses. We explore the application of programmable diffractive lenses displayed on the pixelated screen of a liquid crystal on silicon spatial light modulator to ophthalmic optics. In particular, we consider the use of programmable diffractive lenses for the visual compensation of refractive errors (myopia, hypermetropia, astigmatism) and presbyopia. The principles of compensation are described and sketched using geometrical optics and paraxial ray tracing. For the proof of concept, a series of experiments with artificial eye in optical bench are conducted. We analyze the compensation precision in terms of optical power and compare the results with those obtained by means of conventional ophthalmic lenses. Practical considerations oriented to feasible applications are provided.

  1. Audit of patients' awareness of ophthalmic diagnoses.

    PubMed

    Sudesh, S; Downes, S M; McDonnell, P J

    1993-09-01

    Providing information to patients about their medical condition and treatment options is important in medical management. To assess patients' knowledge of their ocular disease, prognosis, and treatment a questionnaire based survey was performed. 219 patients selected by random systematic sampling during six months from patients attending general ophthalmic clinics in Selly Oak Hospital, Birmingham, were questioned and 217 questionnaires were analysed. The findings showed that patients' knowledge of their diagnosis depended on their condition: patients with common conditions such as glaucoma and cataract had a better understanding of their condition, its treatment, and prognosis compared with patients with rarer conditions such as retinal detachment or patients with multiple diagnoses. In all, 152 patients (70%) wanted more information about their condition; 49 (23%) did not (although 12 (25%) had attempted to obtain information); and 16 (7%) were undecided. In view of the few patients with a precise understanding of their ophthalmic diagnosis and prognosis and the majority's wish for access to further information, that access needs improvement and different modes of disseminating the information should be implemented.

  2. Ophthalmic plastic and orbital surgery in Taiwan.

    PubMed

    Hsu, Chi-Hsin; Lin, I-Chan; Shen, Yun-Dun; Hsu, Wen-Ming

    2014-06-01

    We describe in this paper the current status of ophthalmic plastic and orbital surgery in Taiwan. Data were collected from the Bureau of National Health Insurance of Taiwan, the Bulletin of the Taiwan Ophthalmic Plastic and Reconstructive Society, and the Statistics Yearbook of Practicing Physicians and Health Care Organizations in Taiwan by the Taiwan Medical Association. We ascertained that 94 ophthalmologists were oculoplastic surgeons and accounted for 5.8% of 1621 ophthalmologists in Taiwan. They had their fellowship training abroad (most ophthalmologists trained in the United States of America) or in Taiwan. All ophthalmologists were well trained and capable of performing major oculoplastic surgeries. The payment rates by our National Health Insurance for oculoplastic and orbital surgeries are relatively low, compared to Medicare payments in the United States. Ophthalmologists should promote the concept that oculoplastic surgeons specialize in periorbital plastic and aesthetic surgeries. However, general ophthalmologists should receive more educational courses on oculoplastic and cosmetic surgery. Copyright © 2014. Published by Elsevier B.V.

  3. Evaluation of retinoic acid ophthalmic emulsion in dry eye.

    PubMed

    Selek, H; Unlü, N; Orhan, M; Irkeç, M

    2000-01-01

    An oil in water emulsion of 0.01% all-trans-retinoic acid (tretinoin) was prepared and clinically evaluated in dry eye patients. The ophthalmic emulsion consisted of 10% of arachis oil and 90% of the hydrogel of Carbopol 940. To evaluate retinoic acid emulsion clinically, a placebo-controlled, open-labeled, randomized study was performed with 22 dry-eye patients. Symptoms were recorded before and after the treatments. The Schirmer I test, measurement of tear film break-up time (BUT), rose Bengal and fluorescein staining of cornea and conjunctiva, and mucus fern test were done. Retinoic acid did not improve the dryness, photophobia and foreign body sensation more than placebo. Schirmer test and BUT were significantly improved by retinoic acid treatment. Corneal and conjunctival epithelium maintained their characteristics during the use of retinoic acid, as indicated by rose Bengal and fluorescein staining. Ophthalmic emulsion of retinoic acid can be suggested as a promising approach for the treatment of dry eye.

  4. Stability of pilocarpine hydrochloride and pilocarpine nitrate ophthalmic solutions submitted by U.S. hospitals.

    PubMed

    Kreienbaum, M A; Page, D P

    1986-01-01

    The stability of pilocarpine hydrochloride and pilocarpine nitrate ophthalmic solutions stored in hospital pharmacies across the United States was studied. Through a voluntary drug stability program, FDA selected 252 samples (representing 11 manufacturers) from pharmacies representing an adequate cross section of the country. The samples were analyzed for strength, identification, pH, and isopilocarpine and pilocarpic acid impurities. All samples of pilocarpine nitrate met USP requirements. Eight samples of pilocarpine hydrochloride had tablets that exceeded the USP upper limit for strength. All of these samples were in 1- and 2-mL bottles. The amount of isopilocarpine found ranged from 1 to 6.4%, and the amount of pilocarpic acid from 1.5 to 10.1%. Although pilocarpine salts in ophthalmic solution decompose into isopilocarpine and pilocarpic acid under various conditions of storage, an amount of pilocarpine is maintained that is within the compendial limits. However, there is a problem of evaporation from some of the 1- and 2-mL containers in which this product is supplied.

  5. Mucoadhesive ophthalmic vehicles: evaluation of polymeric low-viscosity formulations.

    PubMed

    Saettone, M F; Monti, D; Torracca, M T; Chetoni, P

    1994-01-01

    A series of polyanionic natural or semi-synthetic polymers (polygalacturonic acid, hyaluronic acid, carboxymethylamylose, carboxymethylchitin, chondroitin sulfate, heparan sulfate and mesoglycan) were evaluated as potential mucoadhesive carriers for ophthalmic drugs. Solutions containing cyclopentolate (CY) or pilocarpine (PI) as salts (or polyanionic complexes) with the acidic polymers, all showing a low viscosity, were tested for miotic (resp. mydriatic) activity in albino rabbits. In the case of some polymeric complexes, small but significant increases of the areas under the activity vs. time curves (AUC) over reference cyclopentolate hydrochloride (CYHC1) or pilocarpine nitrate (PINO3) vehicles, and significant AUC decreases after removal of precorneal mucin by treatment with N-acetylcysteine were observed. A correlation was found between these data, considered indicative of the occurrence of a mucoadhesive interaction "in vivo", and "in vitro" viscometric data expressing the polymers-mucin force of interaction. The advantages and limitations of the mucoadhesive non-viscous approach in the formulation of ophthalmic vehicles are presented and discussed.

  6. Pulsed UV laser technologies for ophthalmic surgery

    NASA Astrophysics Data System (ADS)

    Razhev, A. M.; Chernykh, V. V.; Bagayev, S. N.; Churkin, D. S.; Kargapol'tsev, E. S.; Iskakov, I. A.; Ermakova, O. V.

    2017-01-01

    The paper provides an overview of the results of multiyear joint researches of team of collaborators of Institute of Laser Physics SB RAS together with NF IRTC “Eye Microsurgery” for the period from 1988 to the present, in which were first proposed and experimentally realized laser medical technologies for correction of refractive errors of known today as LASIK, the treatment of ophthalmic herpes and open-angle glaucoma. It is proposed to carry out operations for the correction of refractive errors the use of UV excimer KrCl laser with a wavelength of 222 nm. The same laser emission is the most suitable for the treatment of ophthalmic herpes, because it has a high clinical effect, combined with many years of absence of recrudescence. A minimally invasive technique of glaucoma operations using excimer XeCl laser (λ=308 nm) is developed. Its wavelength allows perform all stages of glaucoma operations, while the laser head itself has high stability and lifetime, will significantly reduce operating costs, compared with other types of lasers.

  7. Ophthalmic compensation of visual ametropia based on a programmable diffractive lens

    NASA Astrophysics Data System (ADS)

    Millán, Maria S.; Pérez-Cabré, Elisabet; Romero, Lenny A.; Ramírez, Natalia

    2013-11-01

    Pixelated liquid crystal displays have been widely used as spatial light modulators to implement programmable diffractive optical elements (DOEs), particularly diffractive lenses. Many different applications of such components have been developed in information optics and optical processors that take advantage of their properties of great flexibility, easy and fast refreshment, and multiplexing capability in comparison with equivalent conventional refractive lenses. In this paper, we explore the application of programmable diffractive lenses displayed on the pixelated screen of a liquid crystal on silicon spatial light modulator (LCoS-SLM) to ophthalmic optics. In particular, we consider the use of programmable diffractive lenses for the visual compensation of some refractive errors (myopia, hyperopia). The theoretical principles of compensation are described and sketched using geometrical optics and paraxial ray tracing. A series of experiments with artificial eye in optical bench are conducted to analyze the compensation accuracy in terms of optical power and to compare the results with those obtained by means of conventional ophthalmic lenses. Practical considerations oriented to feasible applications are provided.

  8. Direct Surgery of Previously Coiled Large Internal Carotid Ophthalmic Aneurysm for the Purpose of Optic Nerve Decompression

    PubMed Central

    Kawabata, Shuhei; Toyota, Shingo; Kumagai, Tetsuya; Goto, Tetsu; Mori, Kanji; Taki, Takuyu

    2017-01-01

    Background Progressive visual loss after coil embolization of a large internal carotid ophthalmic aneurysm has been widely reported. It is generally accepted that the primary strategy for this complication should be conservative, including steroid therapy; however, it is not well known as to what approach to take when the conservative therapy is not effective. Case Presentation We report a case of a 55-year-old female presenting with progressive visual loss after the coiling of a ruptured large internal carotid ophthalmic aneurysm. As the conservative therapy had not been effective, we performed neck clipping of the aneurysm with optic canal unroofing, anterior clinoidectomy, and partial removal of the embolized coils for the purpose of optic nerve decompression. After the surgery, the visual symptom was improved markedly. Conclusions It is suggested that direct surgery for the purpose of optic nerve decompression may be one of the options when conservative therapy is not effective for progressive visual disturbance after coil embolization. PMID:28229036

  9. Vascular resistance of central retinal and ophthalmic arteries in postmenopausal women after use of tibolone.

    PubMed

    de Souza, Marco Aurélio Martins; de Souza, Bruno Martins; Geber, Selmo

    2012-03-01

    The aim of this study was to evaluate the effect of tibolone on vascular resistance of the central retinal and ophthalmic artery in postmenopausal women and to compare this effect with that of placebo using transorbital ultrasound with Doppler velocimetry. We performed a prospective randomized, double-blinded, placebo-controlled study. A total of 100 healthy postmenopausal women (follicle-stimulating hormone, >40 IU/L) younger than 65 years were studied. The participants were randomly allocated to two groups: placebo (n = 50) and tibolone (2.5 mg; n = 50). Transorbital Doppler velocimetric ultrasound was performed before treatment and 80 days after. The mean age was similar in both groups. Participants who received tibolone did not show any difference in pulsatility index, resistance index, and systole/diastole ratio of the central retinal and ophthalmic arteries after treatment. The same was observed in participants who received placebo. Our study demonstrates that tibolone administration to healthy postmenopausal women does not affect the resistance of small-caliber cerebral arteries.

  10. Occult glove perforation during ophthalmic surgery.

    PubMed Central

    Apt, L; Miller, K M

    1992-01-01

    We examined the latex surgical gloves used by 56 primary surgeons in 454 ophthalmic surgical procedures performed over a 7-month period. Of five techniques used to detect pinholes, air inflation with water submersion and compression was found to be the most sensitive, yielding a 6.80% prevalence in control glove pairs and a 21.8% prevalence in postoperative study glove pairs, for a 15.0% incidence of surgically induced perforations (P = 0.000459). The lowest postoperative perforation rate was 11.4% for cataract and intraocular lens surgery, and the highest was 41.7% for oculoplastic procedures. Factors that correlated significantly with the presence of glove perforations as determined by multiple logistic regression analysis were oculoplastic and pediatric ophthalmology and strabismus surgical procedures, surgeon's status as a fellow in training, operating time, and glove size. The thumb and index finger of the nondominant hand contained the largest numbers of pinholes. These data suggest strategies for reducing the risk of cross-infection during ophthalmic surgery. PMID:1494836

  11. Pattern of ophthalmic lesions at two histopathology centres in Ethiopia.

    PubMed

    Assegid, A

    2001-05-01

    To describe the distribution of ocular, orbital and eyelid lesions that required histopathologic analysis in Ethiopian children and adults. A retrospective study. Tikur Anbessa and Menelik II Teaching hospitals, Addis Ababa, Ethiopia, during 1995 and 1999 period. Two hundred and ninety ophthalmic specimens were examined, 20% of which came from children. Half of the lesions had epithelial origin, about 30% were malignant, 22.6% were benign and 16.4% were potentially malignant. Squamous cell carcinoma was the leading conjunctival (26%), eyelid (33%), orbital (33%) and ocular (20%) lesion among adults and elderly people whereas only 6% of eyelid lesion were basal cell carcinomas. In children the most frequent intra-ocular as well as orbital tumour was retinoblastoma, 39%, followed by miscellaneous benign lesions (24%). More than half of the request forms were incomplete. In Addis Ababa, squamous cell carcinoma and retinoblastoma should be considered when evaluating ophthalmic lesions in adults and children, respectively. Clinicians and pathologists should improve their communication by filling in request forms, providing clear reports and making dialogue.

  12. Ophthalmic findings in a family with early-onset isolated ectopia lentis and the p.Arg62Cys mutation of the fibrillin-1 gene (FBN1).

    PubMed

    Zhao, Jun-Hong; Jin, Tian-Bo; Liu, Qing-Bo; Chen, Chao; Hu, Hai-Tao

    2013-01-01

    The purpose of this paper is to describe ophthalmic findings in a family with isolated ectopia lentis (EL) caused by a specific FBN1 mutation. Detailed family histories and clinical data were recorded for six isolated EL patients of 11 family members. The ophthalmological and systematic examinations were performed on patients and unaffected members of the investigated family. The detailed ocular examinations included visual acuity, anterior chamber depth, pupil size, lens location, optometry, central corneal thickness, keratometry, slitlamp examination, fundus examination, axial length, ocular B-ultrasound, gonioscope checking, ultrasound biomicroscopy (UBM) and intraocular pressure (IOP; Goldmann applanation tonometer). Systematic examinations included the measurement of echocardiogram, height, arm span, skull, face, jaw, tooth, breast bone, spinal column, and skin. Genomic DNA was extracted using the phenol-chloroform extraction method for all subjects, and sequencing was carried out on an ABI Prism 3730 Genetic Analyzer. A heterozygous mutation, c.184C>T (p.Arg62Cys) in exon 2 of FBN1 was identified in all affected members but was not found in any unaffected member of the family. Our study presented detailed clinical manifestations, including some novel ophthalmic findings, such as pupillary abnormality, different types of glaucoma, and progressive hyperopia. Ophthalmic findings and the p.Arg62Cys mutation of FBN1 gene were reported in a family with early-onset isolated ectopia lentis.

  13. Bimatoprost 0.03% preservative-free ophthalmic solution versus bimatoprost 0.03% ophthalmic solution (Lumigan) for glaucoma or ocular hypertension: a 12-week, randomised, double-masked trial

    PubMed Central

    Day, Douglas G; Walters, Thomas R; Schwartz, Gail F; Mundorf, Thomas K; Liu, Charlie; Schiffman, Rhett M; Bejanian, Marina

    2013-01-01

    Background/Aim To evaluate efficacy and safety of bimatoprost 0.03% preservative-free (PF) ophthalmic solution versus bimatoprost 0.03% (Lumigan) ophthalmic solution for glaucoma or ocular hypertension. Methods In this double-masked, parallel-group study, patients were randomised to bimatoprost PF or bimatoprost for 12 weeks. The primary analysis for non-inferiority was change from baseline in worse eye intraocular pressure (IOP) in the per-protocol population at week 12. For equivalence, it was average eye IOP in the intent-to-treat population at each time point at weeks 2, 6 and 12. Results 597 patients were randomised (bimatoprost PF, n=302 and bimatoprost, n=295). The 95% CI upper limit for worse eye IOP change from baseline was <1.5 mm Hg at each week 12 time point, meeting prespecified non-inferiority criteria. The 95% CI upper limit for the treatment difference for average IOP was 0.69 mm Hg and the lower limit was −0.50 mm Hg at all follow-up time points (hours 0, 2 and 8 at weeks 2, 6 and 12), meeting equivalence criteria. Both treatments showed decreases in mean average eye IOP at all follow-up time points (p<0.001), were safe and well tolerated. Conclusions Bimatoprost PF is non-inferior and equivalent to bimatoprost in its ability to reduce IOP-lowering with a safety profile similar to bimatoprost. PMID:23743437

  14. Bimatoprost 0.03%/timolol 0.5% preservative-free ophthalmic solution versus bimatoprost 0.03%/timolol 0.5% ophthalmic solution (Ganfort) for glaucoma or ocular hypertension: a 12-week randomised controlled trial

    PubMed Central

    Goldberg, Ivan; Gil Pina, Rafael; Lanzagorta-Aresti, Aitor; Schiffman, Rhett M; Liu, Charlie; Bejanian, Marina

    2014-01-01

    Aim To compare the efficacy and safety of single-dose bimatoprost 0.03%/timolol 0.5% preservative-free (PF) ophthalmic solution with bimatoprost 0.03%/timolol 0.5% ophthalmic solution in patients with open-angle glaucoma or ocular hypertension. Methods In this multicentre, randomised, parallel-group study, patients were randomised to bimatoprost/timolol PF or bimatoprost/timolol once daily in the morning for 12 weeks. Primary efficacy endpoints, reflecting differing regional regulatory requirements, included change from baseline in worse eye intraocular pressure (IOP) in the per-protocol population at week 12, and the average eye IOP at weeks 2, 6 and 12 in the intent-to-treat population. Results 561 patients were randomised (278 to bimatoprost/timolol PF; 283 to bimatoprost/timolol); 96.3% completed the study. Both treatment groups showed statistically and clinically significant mean decreases from baseline in worse eye IOP and in average eye IOP at all follow-up time points (p<0.001). Bimatoprost/timolol PF met all pre-established criteria for non-inferiority and equivalence to bimatoprost/timolol. Ocular adverse events were similar between treatment groups, with conjunctival hyperaemia being the most frequent. Most were mild or moderate in severity. Conclusions Bimatoprost/timolol PF demonstrated non-inferiority and equivalence in IOP lowering compared with bimatoprost/timolol, with no significant differences in safety and tolerability. Trial registration number NCT01177098. PMID:24667994

  15. Influence of drug loading and type of ointment base on the in vitro performance of acyclovir ophthalmic ointment.

    PubMed

    Al-Ghabeish, Manar; Xu, Xiaoming; Krishnaiah, Yellela S R; Rahman, Ziyaur; Yang, Yang; Khan, Mansoor A

    2015-11-30

    The availability of in vitro performance tests such as in vitro drug release testing (IVRT) and in vitro permeation testing (IVPT) are critical to comprehensively assure consistent delivery of the active component(s) from semisolid ophthalmic drug products. The objective was to study the impact of drug loading and type of ointment base on the in vitro performance (IVRT and IVPT) of ophthalmic ointments using acyclovir as a model drug candidate. The in vitro drug release for the ointments was evaluated using a modified USP apparatus 2 with Enhancer cells. The transcorneal permeation was carried out using rabbit cornea on modified vertical Franz cells. The drug retention in cornea (DRC) was also determined at the end of transcorneal drug permeation study. The in vitro drug release, transcorneal drug permeation as well as DRC exhibited a proportional increase with increasing drug loading in the ointment. On comparing the in vitro drug release profile with transcorneal permeation profile, it appears that drug release from the ointment is controlling acyclovir transport through the cornea. Furthermore, enhanced in vitro transcorneal permeation relative to the in vitro drug release underscores the importance of the interplay between the physiology of the ocular tissue and ointment formulation. The results indicated that IVRT and IVPT could be used to discriminate the impact of changes in drug load and formulation composition of ophthalmic ointments. Copyright © 2015. Published by Elsevier B.V.

  16. Thiolated hyaluronan-based hydrogels crosslinked using oxidized glutathione: an injectable matrix designed for ophthalmic applications.

    PubMed

    Zarembinski, Thomas I; Doty, Nathaniel J; Erickson, Isaac E; Srinivas, Ramya; Wirostko, Barbara M; Tew, William P

    2014-01-01

    Future ophthalmic therapeutics will require the sustained delivery of bioactive proteins and nucleic acid-based macromolecules and/or provide a suitable microenvironment for the localization and sustenance of reparative progenitor cells after transplantation into or onto the eye. Water-rich hydrogels are ideal vehicles for such cargo, but few have all the qualities desired for novel ophthalmic use, namely in situ gelation speed, cytocompatibility, biocompatibility and capacity to functionalize. We describe here the development of an ophthalmic-compatible crosslinking system using oxidized glutathione (GSSG), a physiologically relevant molecule with a history of safe use in humans. When GSSG is used in conjunction with an existing hyaluronate-based, in situ crosslinkable hydrogel platform, gels form in less than 5 min using the thiol-disulfide exchange reaction. This GSSG hydrogel supports the 3-D culture of adipose-derived stem cells in vitro and shows biocompatibility in preliminary intracutaneous and subconjunctival experiments in vivo. In addition, the thiol-disulfide exchange reaction can also be used in conjunction with other thiol-compatible chemistries to covalently link peptides for more complex formulations. These data suggest that this hydrogel could be well suited for local ocular delivery, focusing initially on front of the eye therapies. Subsequent uses of the hydrogel include delivery of back of the eye treatments and eventually into other soft, hyaluronan-rich tissues such as those from the liver and brain. Copyright © 2013 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  17. Ocular perfusion pressure and color Doppler imaging of the external ophthalmic artery of rabbits treated with sildenafil citrate.

    PubMed

    Costa, Ana Paula Araujo; Lima, Aline Maria Vasconcelos; da Silva, Luiz Henrique; de Oliveira Alves Carvalho, Rosângela; do Amaral, Andréia Vitor Couto; Borges, Naida Cristina

    2016-07-22

    It has been proposed that sildenafil citrate can increase ocular blood flow, and that this property can be used to treat ocular disorders that involve reflex vasoconstriction. This study therefore proposes to ascertain the vasodilator effect of the drug on retrobulbar circulation in healthy rabbits. For this matter rabbits treated with sildenafil citrate or saline solution had their intraocular pressure (IOP), mean arterial pressure (MAP), ocular perfusion pressure (OPP) and color Doppler imaging of the external ophthalmic artery measured prior to treatment and on days one (moment M1), seven (when M2), fourteen (moment M3), twenty-one (moment M4), and thirty (moment M5) of treatment. The MAP and OPP values of treated group were lower than those of control group at all times, and the mean values differed statistically at moments M1 (S = 71.52 mmHg, C = 84.76 mmHg, p = 0.0356) and M5 (S = 71.38 mmHg, C = 85.52 mmHg, p = 0.0252). The IOP and color Doppler values of the external ophthalmic artery did not differ between tested groups. The dose of 10 mg of sildenafil citrate administered to healthy rabbits causes systemic vasodilation and consequently lower values of MAP and OPP. However, it does not induce changes in IOP and retrobulbar hemodynamics identifiable by color Doppler assessment of the external ophthalmic artery.

  18. The Effect of Live Classical Piano Music on the Vital Signs of Patients Undergoing Ophthalmic Surgery

    PubMed Central

    Camara, Jorge G.; Ruszkowski, Joseph M.; Worak, Sandra R.

    2008-01-01

    Context Music and surgery. Objective To determine the effect of live classical piano music on vital signs of patients undergoing ophthalmic surgery. Design Retrospective case series. Setting and Patients 203 patients who underwent various ophthalmologic procedures in a period during which a piano was present in the operating room of St. Francis Medical Center. [Note: St. Francis Medical Center has recently been renamed Hawaii Medical Center East.] Intervention Demographic data, surgical procedures, and the vital signs of 203 patients who underwent ophthalmic procedures were obtained from patient records. Blood pressure, heart rate, and respiratory rate measured in the preoperative holding area were compared with the same parameters taken in the operating room, with and without exposure to live piano music. A paired t-test was used for statistical analysis. Main outcome measure Mean arterial pressure, heart rate, and respiratory rate. Results 115 patients who were exposed to live piano music showed a statistically significant decrease in mean arterial blood pressure, heart rate, and respiratory rate in the operating room compared with their vital signs measured in the preoperative holding area (P < .0001). The control group of 88 patients not exposed to live piano music showed a statistically significant increase in mean arterial blood pressure (P < .0002) and heart rate and respiratory rate (P < .0001). Conclusion Live classical piano music lowered the blood pressure, heart rate, and respiratory rate in patients undergoing ophthalmic surgery. PMID:18679538

  19. Initial clinical experience with the trabecular micro-bypass stent in patients with glaucoma.

    PubMed

    Spiegel, Detlev; Wetzel, Wolfgang; Haffner, David S; Hill, Richard A

    2007-01-01

    This study was undertaken to evaluate the efficiency of a trabecular micro-bypass stent designed to allow direct aqueous drainage from the anterior chamber into Schlemm's canal in patients with glaucoma. In this prospective case series of 6 patients with open-angle glaucoma, the microstent was inserted ab interno under local anesthesia in an ophthalmic operating room. Patients were seen postoperatively at 1 to 2 d, 1 wk, and 1, 2, 6, and 12 mo. All stents were successfully placed within Schlemm's canal. Mean intraocular pressure (IOP) at preoperative baseline was 20.2+/-6.3 mm Hg (range, 14-31 mm Hg). Mean IOP decreased during the immediate postoperative period to approximately 12 to 13 mm Hg and was stabilized at 14 to 15 mm Hg with reduction of medication throughout 1 y of follow-up. No major complications occurred. According to observations reported in this feasibility study, the microstent was effective in reducing IOP and in decreasing the number of glaucoma medications required to control IOP. Implantation procedures were safe, and stents remained in place throughout the follow-up period. None of the complications traditionally associated with filtering surgery were reported. Further research on this stent in a larger group of patients is needed to assess its role in glaucoma therapy.

  20. Simulation of realistic retinoscopic measurement

    NASA Astrophysics Data System (ADS)

    Tan, Bo; Chen, Ying-Ling; Baker, K.; Lewis, J. W.; Swartz, T.; Jiang, Y.; Wang, M.

    2007-03-01

    Realistic simulation of ophthalmic measurements on normal and diseased eyes is presented. We use clinical data of ametropic and keratoconus patients to construct anatomically accurate three-dimensional eye models and simulate the measurement of a streak retinoscope with all the optical elements. The results show the clinical observations including the anomalous motion in high myopia and the scissors reflex in keratoconus. The demonstrated technique can be applied to other ophthalmic instruments and to other and more extensively abnormal eye conditions. It provides promising features for medical training and for evaluating and developing ocular instruments.

  1. Smartphones in ophthalmology

    PubMed Central

    Chhablani, Jay; Kaja, Simon; Shah, Vinay A

    2012-01-01

    The potential usefulness of smartphones in the medical field is evolving everyday. This article describes various tools available on smartphones, largely focusing on the iPhone, for the examination of an ophthalmic patient, for patient and physician education, as well as reference tools for both ophthalmologists and vision researchers. Furthermore, the present article discusses how smartphones can be used for ophthalmic photography and image management, and foremost, the usefulness of the applications such as the Eye Handbook for the ophthalmologist and interested students, patients, physicians, and researchers, currently available in the iPhone. PMID:22446908

  2. Ophthalmic manifestations of head injury.

    PubMed

    Kowal, L

    1992-02-01

    Head injuries are frequently associated with ophthalmic problems. The commonest problems seen in this series of 161 patients with head injury were problems with poor accommodation (16% of patients; 58% of these persisted), convergence (14% of patients; 35% of these persisted), pseudomyopia (19%; 55% persisted) and optic atrophy (26% of the patients; 78% of these were mild and easily missed on routine testing, and 22% were severe). Motility disorders were common, especially cranial nerve palsies. Other less frequent motility disturbances included apparent inferior oblique palsy, comitant esotropia, and exotropia which was often of the convergence insufficiency type.

  3. Ocular manifestations of drug and alcohol abuse

    PubMed Central

    Peragallo, Jason; Biousse, Valérie; Newman, Nancy J.

    2015-01-01

    Purpose of review To review commonly encountered adverse ocular effects of illicit drug use. Recent findings Drug and alcohol abuse can produce a variety of ocular and neuro-ophthalmic side effects. Novel, so-called “designer,” drugs of abuse can lead to unusual ocular disorders. Legal substances, when used in manners for which they have not been prescribed, can also have devastating ophthalmic consequences. Summary In this review we will systematically evaluate each part of the visual pathways and discuss how individual drugs may affect them. PMID:24100364

  4. The procedure for isolation of neoplasms on the retina of the eye

    NASA Astrophysics Data System (ADS)

    Komkova, S. V.

    2018-01-01

    In operation, a computer diagnostic procedure on the human retina neoplasms. The use of this technique in medical institutions in the operation of the ophthalmic practitioner allows earlv detection of the disease, at periodic inspection of a pictorial pattern of disease progression. The test procedure is performed on a set of real human retinal photographs taken from international STARE database with known diagnoses. Given the numerous experiments which show the possibility of using this technique, developed on the basis of the diagnostic system in a doctor’s office-ophthalmic.

  5. Ethmoidal sinus adenocarcinoma with orbital invasion.

    PubMed

    Koukoulomatis, P; Charakidas, A; Papakrivopoulos, A; Giotakis, I

    2001-01-01

    To report a rare case of massive ethmoidal adenocarcinoma with orbital invasion but minimal ophthalmic symptoms on presentation. Case report of a 69-year-old, otherwise healthy, retired carpenter who was referred for treatment of bilateral senile cataract. A relative afferent pupillary defect and sectorial disc atrophy on ophthalmic examination led to further investigation and identification of an extensive ethmoidal neoplasm with orbital invasion. An incisional biopsy was performed and histopathologic examination revealed an adenocarcinoma of low-grade malignancy. Ethmoidal adenocarcinomas with orbital involvement may occasionally be relatively asymptomatic and masked by coexisting ocular disease.

  6. Pharmacokinetic Studies of Sustained-Release Depot of Dexamethasone in Beagle Dogs.

    PubMed

    Blizzard, Charles; Desai, Ankita; Driscoll, Arthur

    2016-11-01

    To examine the pharmacokinetic characteristics of sustained-release dexamethasone depots in two separate canine studies. Dexamethasone depots loaded with a clinically representative (0.4 mg) dose (DEXTENZA™; Ocular Therapeutix) or an elevated (0.7 mg) dose were inserted into the canaliculi of beagle eyes (n = 37 and n = 34, respectively). Tear fluid was collected for pharmacokinetic analysis of dexamethasone in both studies at predetermined time points. Explanted 0.4 mg depots were collected weekly to measure remaining drug level. Clinical observations and ophthalmic examinations were performed in both studies at each visit. The 0.4 mg depots released a median 308 μg by day 15 and tapered to complete drug release by day 28. Median dexamethasone tear fluid concentrations in the 0.4 mg study group decreased from 2,805 ng/mL at day 7 to 0 ng/mL on day 28. Median dexamethasone tear fluid concentrations in the 0.7 mg study group decreased from 4,370 ng/mL at 6 h post insertion to 830 ng/mL on day 35. Mean ± standard deviation intraocular pressures in the 0.4 and 0.7 mg study groups were 20.7 ± 2.8 and 19.0 ± 4.1 mmHg at baseline, respectively, and demonstrated no meaningful change (20.5 ± 3.0 and 20.6 ± 2.9 mmHg, respectively) over the studies' durations. No ocular toxicities were attributed to the dexamethasone depot. Sustained-release dexamethasone produced no identifiable ocular toxicity in this animal model, and pharmacokinetics demonstrated a sustained and tapered drug release over 28 days at a 0.4 mg dose and exceeded 35 days at a 0.7 mg dose.

  7. Vision-Related Quality of Life Associated with Unilateral and Bilateral Ocular Conditions.

    PubMed

    Brown, Gary C; Brown, Melissa M; Stein, Joshua D; Smiddy, William E

    2018-02-21

    To present ophthalmic patient time-tradeoff vision utilities for quantifying vision-related quality-of-life when the fellow eye still has good vision. These utilities are important for performing reliable cost-utility analyses. Consecutive time-tradeoff vision utilities were obtained from ophthalmic patients with good vision (20/20-20/25) in one eye and vision ranging from 20/20 to no light perception in the fellow eye over a 15-year period from 2000 through 2014. Five hundred eighty-six ophthalmic participant interviews from Wills Eye Hospital, New York Eye and Ear Hospital, and ophthalmology office practices in Pennsylvania and New Jersey. Participants underwent a full ophthalmic examination, after which time-tradeoff vision utilities were obtained by personal interview by the authors using a standardized, validated instrument. Time-tradeoff vision utilities. Mean time-tradeoff vision utilities were as follows in participants with good vision (20/20-20/25) in at least one eye and the following visions in the fellow eyes: no light perception, 0.79; counting fingers to light perception, 0.87; 20/200 to 20/400, 0.88; 20/60 to 20/100, 0.88; 20/30 to 20/50, 0.87; and 20/20 to 20/25, 0.94. In people with good vision (20/20-20/25) in one eye, the associated mean time-tradeoff vision utility is a remarkably consistent 0.87 to 0.88 when vision in the fellow eye ranges from 20/30 to light perception. Vision of 20/20 to 20/25 in the fellow eye results in a significantly higher associated utility of 0.94 (P < 0.01), whereas vision of no light perception in the fellow eye results in a significantly lower utility of 0.079 (P < 0.01). These utilities are important for calculating reliable patient value (quality-adjusted life-year) gains in ophthalmic cost-utility analysis populations in which there is unilateral and bilateral disease involvement. Copyright © 2018 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  8. Health services experiences of parents of recently diagnosed visually impaired children

    PubMed Central

    Rahi, J S; Manaras, I; Tuomainen, H; Lewando Hundt, G

    2005-01-01

    Aim: To investigate the health service experiences and needs of parents in the period around diagnosis of ophthalmic disorders in their children. Methods: Parents of children newly diagnosed with visual impairment and/or ophthalmic disorders at a tertiary level hospital in London participated in a questionnaire survey, using standard instruments, followed by in-depth individual interviews, to elicit their views about the processes of care, their overall level of satisfaction, and their unmet needs. Results: 67% (147) of eligible families (135 mothers, 76 fathers) participated. Overall satisfaction with care was high, being greater among parents of children with milder visual loss or isolated ophthalmic disorders than those with more severe visual loss or multiple impairments. Nevertheless, parents’ reported greatest need was the provision of general information, including about their child’s ophthalmic disorder and educational and social services and support. Mothers reported greater information needs than fathers, as did white parents compared to those from ethnic minorities. White parents also regarded the processes of care to be less comprehensive and coordinated, as well as less enabling, than did parents from ethnic minorities. Conclusions: Although parents reported high overall satisfaction with services, improving the medium, content, and scope of general information provided by professionals to parents of visually impaired children emerges as a priority. Equitable planning and provision of health services for families of children with visual impairment needs to take into account that informational and other needs vary by whether the parent is the primary carer or not and their ethnicity, as well as by the severity and complexity of their child’s visual loss. PMID:15665355

  9. Formulation and development of ophthalmic in situ gel for the treatment ocular inflammation and infection using application of quality by design concept.

    PubMed

    Patel, Nirav; Thakkar, Vaishali; Metalia, Viral; Baldaniya, Lalji; Gandhi, Tejal; Gohel, Mukesh

    2016-09-01

    The conventional liquid ophthalmic delivery systems exhibit short pre-corneal residence time and the relative impermeability to the cornea which leads to poor ocular bioavailability. The aim of this study was to apply quality by design (QbD) for development of dexamethasone sodium phosphate (DSP) and tobramycin sulfate (TS)-loaded thermoresponsive ophthalmic in situ gel containing Poloxamer 407 and hydroxyl propyl methyl cellulose (HPMC) K4M for prolonging the pre-corneal residence time, ocular bioavability and decreases the frequency of administration of dosage form. The material attributes and the critical quality attributes (CQA) of the in situ gel were identified. Central composite design (CCD) was adopted to optimize the formulation. The ophthalmic in situ forming gels were prepared by cold method. Materials attributes were the amount of Poloxamer 407 and HPMC and CQA identified were Gel strength, mucoadhesive index, gelation temperature and % of drug release of both drug. Optimized batch (F*) containing 16.75% poloxamer 407 and 0.54% HPMC K4M were exhibited all results in acceptable limits. Compared with the marketed formulation, optimized in situ gel showed delayed Tmax, improved Cmax and AUC in rabbit aqueous humor, suggesting the sustained drug release and better corneal penetration and absorption. According to the study, it could be concluded that DSP and TS would be successfully formulated as in situ gelling mucoadhesive system for the treatment of steroid responsive eye infections with the properties of sustained drug release, prolonged ocular retention and improved corneal penetration.

  10. Comparing the Efficacy of Ophthalmic NSAIDs in Common Indications: A Literature Review to Support Cost-effective Prescribing.

    PubMed

    Wilson, Daniel J; Schutte, Scott M; Abel, Steven R

    2015-06-01

    To review the commercially available ophthalmic nonsteroidal anti-inflammatory drugs (NSAIDs), identify opportunities for therapeutic substitutions within and outside of their Food and Drug Administration (FDA)-approved indications, and identify clinically superior drugs within the class for specific indications. A PubMed search (1992 through January 2014) was performed on the terms diclofenac, ketorolac, flurbiprofen, bromfenac, and nepafenac. Clinical trials, meta-analyses, and review articles were evaluated if they were written in English and pertained to human subjects. Studies were excluded if they were in vitro studies, solely evaluated pharmacokinetic or pharmacodynamic properties, did not relate to the topical ophthalmic route, did not evaluate the FDA-approved indications of any available ophthalmic NSAID, or compared a reviewed drug with a nonreviewed drug (without placebo comparison). A total of 67 articles met the criteria for evaluation. Article quality, study design, and dosing of the medications were assessed to determine the clinical applicability of the results. The quality of the article was determined using the Oxford Centre for Evidence-based Medicine Levels of Evidence 1. Many formulations of the 5 reviewed NSAIDs have been studied across the 4 primary indications. These indications are (1) pain and inflammation associated with cataract surgery, (2) pain associated with corneal refractive surgery, (3) inhibition of intraoperative miosis, and (4) seasonal allergic conjunctivitis. Several studies have directly compared drugs within this class and have identified instances in which certain selections are therapeutically superior or equivalent to another. This information provides practitioners with guidance in selecting an optimal medication. © The Author(s) 2015.

  11. Progesterone increases resistance of ophthalmic and central retinal arteries in climacteric women.

    PubMed

    Souza, M A M De; Souza, B M De; Geber, S

    2013-04-01

    To evaluate the effect of a synthetic progestin on the vascular resistance of the ophthalmic and central retinal arteries in climacteric women, compared to placebo, using transorbital ultrasound with Doppler velocimetry. We performed a prospective, randomized, double-blinded, placebo-controlled study with 216 climacteric women. Subjects were randomly allocated to one of two groups: either the group receiving placebo (one pill/day for 30 days) (n = 108) or the group receiving progestin (5 mg medroxyprogesterone acetate/day for 30 days) (n = 108). Transorbital Doppler velocimetric ultrasound was performed, before and after treatment; we measured the pulsatility index, resistance index and systole/diastole ratio. The mean ages of the participants in the study group and the control group were 54 ± 6.2 years (range 48-59 years) and 55 ± 6.8 years (range 46-60 years), respectively. When we compared the effect of the progestin on the central retinal artery before and after treatment, we observed a significant increase after the treatment in all Doppler indices. The same was observed when we compared the effect of the progestin on the ophthalmic artery. In the group of women receiving placebo, the Doppler indices were similar before and after treatment. Our results demonstrate the existence of a progestogenic vasoconstrictive effect in the ophthalmic and central retinal arteries. As this study provides new data, the observed effect needs further investigations to better elucidate its extent. Moreover, our findings may be particularly useful to others interested in understanding the vascular dynamics of the cerebral vessels and to researchers running clinical trials related to hormone replacement therapy.

  12. Measuring Hemodynamic Changes in the Ophthalmic Artery During Applied Force for Noninvasive Intracranial Pressure Monitoring: Test Results in a Porcine Model.

    PubMed

    Twedt, Max; Pfeifer, Chase; Thorell, William; Bashford, Greg

    2017-03-01

    Possible traumatic brain injury victims would greatly benefit from a handheld, noninvasive intracranial pressure (ICP) monitoring tool, which a medic could operate in a remote area. Such a device would also benefit the transport of injured soldiers during en route medical care and critical care air transport. This study demonstrates the use of noninvasive blood flow measurements in the eye by ultrasound as a proxy for ICP. ICP was artificially raised in a porcine model and resultant blood flow change in the ophthalmic artery was measured. In addition, the ultrasound transducer itself was used to compress the eye further altering ophthalmic hemodynamics. Blood flow velocities at a range of applied forces and ICP were compared. It was found that 3.25 N of force applied to the cornea was sufficient to produce significant changes in ophthalmic artery blood dynamics regardless of the ICP value. Specifically, the change in resistivity index (RI) and pulsatility index (PI) as force was applied to the cornea correlated with ICP levels. In multiple animal experiments, the magnitude of PI/RI percent change was inversely related to differences in ICP. Force applied to the cornea at baseline ICP resulted in a 15% increase in PI/RI. Results indicate that as ICP increases, the percent change in PI/RI while force is applied decreases. The consistency of data collected indicates that a trend line developed with this data and from similar experiments could be used as a predictive measurement of ICP. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  13. Effects of 5% sodium chloride ophthalmic ointment on thickness and morphology of the normal canine cornea.

    PubMed

    Samuel, Michelle; Thomasy, Sara M; Calderon, Allison S; Kass, Philip H; Collins, Keith; Murphy, Christopher J

    2018-06-21

    To determine the effect of 5% sodium chloride ophthalmic ointment (5% NaCl) on thickness and morphology of the normal canine cornea using ultrasonic pachymetry (USP), in vivo confocal microscopy (IVCM), and Fourier-domain optical coherence tomography (FD-OCT). Five healthy laboratory Beagles received ophthalmic examinations including USP, IVCM, and FD-OCT prior to and at fixed intervals following treatment. The right and left eyes were treated with 5% NaCl and artificial tears ophthalmic ointment (AT), respectively, every 2 hours for 4 treatments/d (days 2-9), and then hourly for 7 treatments/d (day 10). Treatment groups were statistically compared using mixed-effects linear regression. Treatment with 5% NaCl resulted in a 12 μm decrease in corneal thickness from baseline (P < .001), while there was no significant difference in corneal thickness between values obtained at baseline and following treatment with AT (P = .82). Epithelial cell density significantly increased from baseline (530 ± 52 cells/mm 2 ) to 577 ± 43 and 567 ± 15 cells/mm 2 with 5% NaCl and AT, respectively (P = .003 and .005, respectively). However, keratocyte cell density in the anterior and posterior stroma and endothelial cell density did not significantly differ following treatment with 5% NaCl or AT ointment (P > .05). Short-term topical treatment with 5% NaCl decreased corneal thickness in normal dogs with no observable changes in corneal morphology or signs of ocular toxicity. © 2018 American College of Veterinary Ophthalmologists.

  14. Integrative advances for OCT-guided ophthalmic surgery and intraoperative OCT: microscope integration, surgical instrumentation, and heads-up display surgeon feedback.

    PubMed

    Ehlers, Justis P; Srivastava, Sunil K; Feiler, Daniel; Noonan, Amanda I; Rollins, Andrew M; Tao, Yuankai K

    2014-01-01

    To demonstrate key integrative advances in microscope-integrated intraoperative optical coherence tomography (iOCT) technology that will facilitate adoption and utilization during ophthalmic surgery. We developed a second-generation prototype microscope-integrated iOCT system that interfaces directly with a standard ophthalmic surgical microscope. Novel features for improved design and functionality included improved profile and ergonomics, as well as a tunable lens system for optimized image quality and heads-up display (HUD) system for surgeon feedback. Novel material testing was performed for potential suitability for OCT-compatible instrumentation based on light scattering and transmission characteristics. Prototype surgical instruments were developed based on material testing and tested using the microscope-integrated iOCT system. Several surgical maneuvers were performed and imaged, and surgical motion visualization was evaluated with a unique scanning and image processing protocol. High-resolution images were successfully obtained with the microscope-integrated iOCT system with HUD feedback. Six semi-transparent materials were characterized to determine their attenuation coefficients and scatter density with an 830 nm OCT light source. Based on these optical properties, polycarbonate was selected as a material substrate for prototype instrument construction. A surgical pick, retinal forceps, and corneal needle were constructed with semi-transparent materials. Excellent visualization of both the underlying tissues and surgical instrument were achieved on OCT cross-section. Using model eyes, various surgical maneuvers were visualized, including membrane peeling, vessel manipulation, cannulation of the subretinal space, subretinal intraocular foreign body removal, and corneal penetration. Significant iterative improvements in integrative technology related to iOCT and ophthalmic surgery are demonstrated.

  15. Application of a wide-field phantom eye for optical coherence tomography and reflectance imaging.

    PubMed

    Corcoran, Anthony; Muyo, Gonzalo; van Hemert, Jano; Gorman, Alistair; Harvey, Andrew R

    2015-12-15

    Optical coherence tomography (OCT) and reflectance imaging are used in clinical practice to measure the thickness and transverse dimensions of retinal features. The recent trend towards increasing the field of view (FOV) of these devices has led to an increasing significance of the optical aberrations of both the human eye and the device. We report the design, manufacture and application of the first phantom eye that reproduces the off-axis optical characteristics of the human eye, and allows the performance assessment of wide-field ophthalmic devices. We base our design and manufacture on the wide-field schematic eye, [Navarro, R. J. Opt. Soc. Am. A , 1985, 2 .] as an accurate proxy to the human eye and enable assessment of ophthalmic imaging performance for a [Formula: see text] external FOV. We used multi-material 3D-printed retinal targets to assess imaging performance of the following ophthalmic instruments: the Optos 200Tx, Heidelberg Spectralis, Zeiss FF4 fundus camera and Optos OCT SLO and use the phantom to provide an insight into some of the challenges of wide-field OCT.

  16. Mobility experiments with microrobots for minimally invasive intraocular surgery.

    PubMed

    Ullrich, Franziska; Bergeles, Christos; Pokki, Juho; Ergeneman, Olgac; Erni, Sandro; Chatzipirpiridis, George; Pané, Salvador; Framme, Carsten; Nelson, Bradley J

    2013-04-23

    To investigate microrobots as an assistive tool for minimally invasive intraocular surgery and to demonstrate mobility and controllability inside the living rabbit eye. A system for wireless magnetic control of untethered microrobots was developed. Mobility and controllability of a microrobot are examined in different media, specifically vitreous, balanced salt solution (BSS), and silicone oil. This is demonstrated through ex vivo and in vivo animal experiments. The developed electromagnetic system enables precise control of magnetic microrobots over a workspace that covers the posterior eye segment. The system allows for rotation and translation of the microrobot in different media (vitreous, BSS, silicone oil) inside the eye. Intravitreal introduction of untethered mobile microrobots can enable sutureless and precise ophthalmic procedures. Ex vivo and in vivo experiments demonstrate that microrobots can be manipulated inside the eye. Potential applications are targeted drug delivery for maculopathies such as AMD, intravenous deployment of anticoagulation agents for retinal vein occlusion (RVO), and mechanical applications, such as manipulation of epiretinal membrane peeling (ERM). The technology has the potential to reduce the invasiveness of ophthalmic surgery and assist in the treatment of a variety of ophthalmic diseases.

  17. Effect of gellan gum on the thermogelation property and drug release profile of Poloxamer 407 based ophthalmic formulation.

    PubMed

    Dewan, Mitali; Sarkar, Gunjan; Bhowmik, Manas; Das, Beauty; Chattoapadhyay, Atis Kumar; Rana, Dipak; Chattopadhyay, Dipankar

    2017-09-01

    The effect of gellan gum on the gelation behavior and in-vitro release of a specific drug named pilocarpine hydrochloride from different ophthalmic formulations based on poloxamer 407 is examined. The mixture of 0.3wt% gellan gum and 18wt% poloxamer (PM) solutions show a considerable increase in gel strength in physiological condition. Gel dissolution rate from PM based formulation is significantly decreased due to the addition of gellan gum. FTIR spectra analysis witnesses an interaction in between OH groups of two polymers which accounts for lowering in gelation temperature of PM-gellan gum based formulations. It is also observed from the cryo-SEM study that the pore size of PM gel decreases with an addition of gellan gum and in-vitro release studies indicate that PM-gellan gum based formulation retain drug better than the PM solution alone. Therefore, the developed formulation has the potential to be utilized as an in-situ ophthalmic drug carrier. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Application of a wide-field phantom eye for optical coherence tomography and reflectance imaging

    NASA Astrophysics Data System (ADS)

    Corcoran, Anthony; Muyo, Gonzalo; van Hemert, Jano; Gorman, Alistair; Harvey, Andrew R.

    2015-12-01

    Optical coherence tomography (OCT) and reflectance imaging are used in clinical practice to measure the thickness and transverse dimensions of retinal features. The recent trend towards increasing the field of view (FOV) of these devices has led to an increasing significance of the optical aberrations of both the human eye and the device. We report the design, manufacture and application of the first phantom eye that reproduces the off-axis optical characteristics of the human eye, and allows the performance assessment of wide-field ophthalmic devices. We base our design and manufacture on the wide-field schematic eye, [Navarro, R. J. Opt. Soc. Am. A, 1985, 2.] as an accurate proxy to the human eye and enable assessment of ophthalmic imaging performance for a ? external FOV. We used multi-material 3D-printed retinal targets to assess imaging performance of the following ophthalmic instruments: the Optos 200Tx, Heidelberg Spectralis, Zeiss FF4 fundus camera and Optos OCT SLO and use the phantom to provide an insight into some of the challenges of wide-field OCT.

  19. Microgravity-Induced Fluid Shift and Ophthalmic Changes

    PubMed Central

    Nelson, Emily S.; Mulugeta, Lealem; Myers, Jerry G.

    2014-01-01

    Although changes to visual acuity in spaceflight have been observed in some astronauts since the early days of the space program, the impact to the crew was considered minor. Since that time, missions to the International Space Station have extended the typical duration of time spent in microgravity from a few days or weeks to many months. This has been accompanied by the emergence of a variety of ophthalmic pathologies in a significant proportion of long-duration crewmembers, including globe flattening, choroidal folding, optic disc edema, and optic nerve kinking, among others. The clinical findings of affected astronauts are reminiscent of terrestrial pathologies such as idiopathic intracranial hypertension that are characterized by high intracranial pressure. As a result, NASA has placed an emphasis on determining the relevant factors and their interactions that are responsible for detrimental ophthalmic response to space. This article will describe the Visual Impairment and Intracranial Pressure syndrome, link it to key factors in physiological adaptation to the microgravity environment, particularly a cephalad shifting of bodily fluids, and discuss the implications for ocular biomechanics and physiological function in long-duration spaceflight. PMID:25387162

  20. Ten years of Nd:YAG Q-switched/mode-locked ophthalmic laser system clinical treatment

    NASA Astrophysics Data System (ADS)

    Jelinkova, Helena; Pasta, Jiri; Hamal, Karel; Cech, Miroslav; Prochazka, Ivan

    1999-06-01

    Plasma breakdown generated by high power lasers is used in ophthalmic microsurgery for perforation of the various membranes. We report on ten years of clinical experiences with the ophthalmic Nd:YAG laser system operating alternatively in both Q-switched or mode-locked regimes. This option gives the surgeon a possibility to compare the effect of treatments with nanosecond or picosecond pulses. The pulse duration in the picosecond regime is 25 ps, the length of a nanosecond pulse is 4 ns and the energy is variable up to 70 mJ. In the ten year period the laser system was used for more than 10 000 treatments. From the results is possible to conclude that in clinical practice the picosecond pulses are better for the posterior capsule opacification treatment and that there are not retinal complications. The nanosecond pulses are useful for iridectomies. Our constructed Nd:YAG laser system provides the surgeons with the possibility to use different photodisruptive regimes for special indications, which can be very useful for the ophthalmologists.

  1. [Research and realization of signal processing algorithms based on FPGA in digital ophthalmic ultrasonography imaging].

    PubMed

    Fang, Simin; Zhou, Sheng; Wang, Xiaochun; Ye, Qingsheng; Tian, Ling; Ji, Jianjun; Wang, Yanqun

    2015-01-01

    To design and improve signal processing algorithms of ophthalmic ultrasonography based on FPGA. Achieved three signal processing modules: full parallel distributed dynamic filter, digital quadrature demodulation, logarithmic compression, using Verilog HDL hardware language in Quartus II. Compared to the original system, the hardware cost is reduced, the whole image shows clearer and more information of the deep eyeball contained in the image, the depth of detection increases from 5 cm to 6 cm. The new algorithms meet the design requirements and achieve the system's optimization that they can effectively improve the image quality of existing equipment.

  2. Dual-thread parallel control strategy for ophthalmic adaptive optics.

    PubMed

    Yu, Yongxin; Zhang, Yuhua

    To improve ophthalmic adaptive optics speed and compensate for ocular wavefront aberration of high temporal frequency, the adaptive optics wavefront correction has been implemented with a control scheme including 2 parallel threads; one is dedicated to wavefront detection and the other conducts wavefront reconstruction and compensation. With a custom Shack-Hartmann wavefront sensor that measures the ocular wave aberration with 193 subapertures across the pupil, adaptive optics has achieved a closed loop updating frequency up to 110 Hz, and demonstrated robust compensation for ocular wave aberration up to 50 Hz in an adaptive optics scanning laser ophthalmoscope.

  3. Dual-thread parallel control strategy for ophthalmic adaptive optics

    PubMed Central

    Yu, Yongxin; Zhang, Yuhua

    2015-01-01

    To improve ophthalmic adaptive optics speed and compensate for ocular wavefront aberration of high temporal frequency, the adaptive optics wavefront correction has been implemented with a control scheme including 2 parallel threads; one is dedicated to wavefront detection and the other conducts wavefront reconstruction and compensation. With a custom Shack-Hartmann wavefront sensor that measures the ocular wave aberration with 193 subapertures across the pupil, adaptive optics has achieved a closed loop updating frequency up to 110 Hz, and demonstrated robust compensation for ocular wave aberration up to 50 Hz in an adaptive optics scanning laser ophthalmoscope. PMID:25866498

  4. Computer numeric control generation of toric surfaces

    NASA Astrophysics Data System (ADS)

    Bradley, Norman D.; Ball, Gary A.; Keller, John R.

    1994-05-01

    Until recently, the manufacture of toric ophthalmic lenses relied largely upon expensive, manual techniques for generation and polishing. Recent gains in computer numeric control (CNC) technology and tooling enable lens designers to employ single- point diamond, fly-cutting methods in the production of torics. Fly-cutting methods continue to improve, significantly expanding lens design possibilities while lowering production costs. Advantages of CNC fly cutting include precise control of surface geometry, rapid production with high throughput, and high-quality lens surface finishes requiring minimal polishing. As accessibility and affordability increase within the ophthalmic market, torics promise to dramatically expand lens design choices available to consumers.

  5. Effect of Rebamipide Ophthalmic Suspension on Intraocular Light Scattering for Dry Eye After Corneal Refractive Surgery.

    PubMed

    Igarashi, Akihito; Kamiya, Kazutaka; Kobashi, Hidenaga; Shimizu, Kimiya

    2015-08-01

    To assess the changes in intraocular scattering before and after instillation of rebamipide ophthalmic suspension in patients with dry eye after corneal refractive surgery. This study enrolled 60 eyes of 30 dry eye patients undergoing corneal refractive surgery. Patients were randomly assigned to start topical administration of rebamipide ophthalmic suspension (rebamipide group) or artificial tears (control group) 4 times daily for 4 weeks. Tear secretion, tear break-up time (TBUT), and the fluorescein score were measured before and after treatment. Intraocular light scattering was also measured as the objective scattering index (OSI) at 0.5-second intervals over 10 seconds. In the rebamipide group, the Schirmer I test, TBUT, and fluorescein score improved significantly, from 11.4 ± 9.0 mm, 2.2 ± 0.7 seconds, and 4.3 ± 1.3 to 14.9 ± 7.4 mm, 4.5 ± 1.7 seconds, and 1.9 ± 1.0, respectively (P = 0.006, P < 0.001, P < 0.001, Wilcoxon signed rank test). We found significant improvements in OSI at 5.0 to 10.0 seconds after blinking (5-8 seconds, P = 0.01; 9 seconds, P = 0.02; 10 seconds, P < 0.001). The mean OSI, the OSI change rate, and the OSI slope of the linear regression line improved significantly, from 2.73 ± 1.52, 74.7 ± 69.5%, and 0.10 ± 0.12 to 2.19 ± 1.19, 28.6 ± 48.7%, and 0.04 ± 0.08, respectively (P = 0.02, 0.003, and 0.03). Rebamipide ophthalmic suspension was effective for improving both ocular surface parameters and optical quality in patients with dry eye undergoing corneal refractive surgery, suggesting that it may hold promise for the treatment of such patients.

  6. Antimicrobial activity of a new preservative for multiuse ophthalmic solutions.

    PubMed

    Ghelardi, Emilia; Celandroni, Francesco; Gueye, Sokhna A; Salvetti, Sara; Campa, Mario; Senesi, Sonia

    2013-01-01

    The aim of this study was to examine the antimicrobial activity and the preservative efficacy of a novel preservative solution containing sodium hydroxymethyl glycinate (SHMG) and edetate disodium (EDTA), which is used for preservation of some commercial ophthalmic formulations. In vitro susceptibility assays were performed against several gram-positive (Staphylococcus aureus, Staphylococcus epidermidis, and Bacillus cereus) and gram-negative (Escherichia coli and Pseudomonas aeruginosa) bacteria representative of the microbial flora of epithelial surfaces or colonizing the conjunctiva, as well as against Candida albicans and Aspergillus niger. Using different concentrations of SHMG alone or in combination with EDTA, the minimal inhibitory and microbicidal concentrations against these organisms were assessed. In addition, 8 brands of multidose eye drops containing 0.002% SHMG and 0.1% EDTA as preservative were tested for antimicrobial activity using the antimicrobial effectiveness test recommended by the international pharmacopoeias. The minimal inhibitory and bactericidal/fungicidal concentration values of SHMG ranged from 0.0025% to 0.0125% for bacteria and from 0.125% to 0.50% for mold and yeast. Susceptibility testing demonstrated that the addition of EDTA substantially increased the SHMG activity against all bacterial and fungal strains. The preservative effectiveness test was applied to commercial eye drops. All the drop solutions met the criteria reported by the U.S. Pharmacopeia for parenteral and ophthalmic preparations. All products also satisfied the major acceptance criteria of the European Pharmacopeia with respect to the antifungal activity. With regard to the antibacterial activity, the less-stringent criteria of the European Pharmacopeia were fulfilled. The present study demonstrates the efficacy of a novel preservative for ophthalmic solutions (SHMG/EDTA) and its activity in protecting selected commercial artificial tears against microbial contamination.

  7. [Role of community pharmacist in the management of patients in ophthalmology].

    PubMed

    Delolme, M-P; Law-Ki, A; Belon, J-P; Creuzot-Garcher, C; Bron, A

    2011-03-01

    To assess the role of community pharmacists in ophthalmology, to evaluate the frequency of giving patients advice, and to report their difficulties in daily practice. An anonymous questionnaire consisting of 13 questions was sent to 620 community pharmacists of Burgundy (France). Pharmacists were asked about their ophthalmic products, their ophthalmic activity in giving patients advice on ocular symptoms, and patients' expectations. For analysis, community pharmacies were separated into three groups: pharmacies in rural areas (under 2000 inhabitants), pharmacies in an urban zone with fewer than 10,000 inhabitants, and pharmacies in an urban zone with more than 10,000 inhabitants. The response rate was 46.9%. Ophthalmic products were mainly glasses for presbyopia (84.5%), eye care hygiene products (76.0%), and contact lens solutions (55.3%). Ophthalmic vitamin supplements were sold by 36.8% of pharmacists, mainly in urban areas. On average, the pharmacist was consulted for ocular problems seven times a week. Acute benign symptoms were most frequent. Advice on prescriptions came next. Then, information on contact lenses and chronic ocular disease were given (cataract, glaucoma, visual acuity loss, age-related maculopathy). Finally, the pharmacist either sold the patient an ocular treatment or oriented the patient to an ophthalmologist when needed. The pharmacist and his staff are active players in providing advice on ocular diseases and taking care of patients. Moreover, pharmacists have to manage ocular therapeutics, urgent symptoms, and chronic diseases. However, in our study, 46.0% of pharmacists felt confident with their knowledge on ophthalmology, 36.4% did not give their opinion, and 7.0% were uncomfortable with some questions. Most community pharmacists mentioned a lack of continuing education from pharmaceutical companies and postgraduate education on ocular diseases and treatment, mainly for age-related maculopathy. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  8. Use of traditional eye medicine and self-medication in rural India: A population-based study.

    PubMed

    Gupta, Noopur; Vashist, Praveen; Tandon, Radhika; Gupta, Sanjeev K; Kalaivani, Mani; Dwivedi, S N

    2017-01-01

    To determine the type and nature of traditional eye medicine (TEM), their sources and use and practices related to self-medication for ophthalmic diseases in a rural Indian population. A population-based, cross-sectional study was conducted in 25 randomly selected clusters of Rural Gurgaon, Haryana, India as part of CORE (Cornea Opacity Rural Epidemiological) study. In addition to comprehensive ophthalmic examination, health-seeking behavior and use of self-medication and TEM was assessed in the adult population using a semi-structured questionnaire. Physical verification of available ophthalmic medications in the enumerated households was conducted by the study team. Descriptive statistics were computed along with multivariable logistic regression analysis to determine associated factors for use of self-medication and TEM. Of the 2160 participants interviewed, 396 (18.2%) reported using ophthalmic medications without consulting an ophthalmologist, mainly for symptoms like watering (37.1%), redness (27.7%), itching (19.2%) and infection (13.6%). On physical verification of available eye drops that were being used without prescription, 26.4% participants were practicing self-medication. Steroid, expired/unlabeled and indigenous eye drops were being used by 151(26.5%), 120(21.1%) and 75 (13.2%) participants respectively. Additionally, 25.7% (529) participants resorted to home remedies like 'kajal'(61.4%), honey (31.4%), ghee (11.7%) and rose water (9.1%). Use of TEM is prevalent in this population. The rampant use of steroid eye drops without prescription along with use of expired or unlabelled eye drops warrants greater emphasis on safe eye care practices in this population. Public awareness and regulatory legislations must be implemented to decrease harmful effects arising due to such practices.

  9. Colour Doppler analysis of ophthalmic vessels in the diagnosis of carotic artery and retinal vein occlusion, diabetic retinopathy and glaucoma: systematic review of test accuracy studies.

    PubMed

    Bittner, Mario; Faes, Livia; Boehni, Sophie C; Bachmann, Lucas M; Schlingemann, Reinier O; Schmid, Martin K

    2016-12-07

    Colour Doppler analysis of ophthalmic vessels has been proposed as a promising tool in the diagnosis of various eye diseases, but the available diagnostic evidence has not yet been assessed systematically. We performed a comprehensive systematic review of the literature on the diagnostic properties of Colour Doppler imaging (CDI) assessing ophthalmic vessels and provide an inventory of the available evidence. Eligible papers were searched electronically in (Pre) Medline, Embase and Scopus, and via cross-checking of reference lists. The minimum requirement to be included was the availability of original data and the possibility to construct a two-by-two table. Study selection, critical appraisal using the QUADAS II instrument and extraction of salient study characteristics was made in duplicate. Sensitivity and specificity was computed for each study. We included 11 studies (15 two-by-two tables) of moderate methodological quality enrolling 820 participants (range 30 to 118). In 44.4% participants were female (range 37-59% in specific subgroups). CDI was assessed for internal carotid stenosis, diabetic retinopathy, glaucoma, and branch or central retinal vein occlusion diagnosis. There was insufficient data to pool the results for specific illnesses. For the assessments of ophthalmic arteries, mean sensitivity was 0.69 (range 0.27-0.96) with a corresponding mean specificity of 0.83 (range 0.70-0.96). Mean sensitivity of the central retinal artery assessments was 0.58 (range 0.31-0.84) and the corresponding mean specificity was 0.82 (range 0.63-0.94). Robust assessments of the diagnostic value of colour Doppler analysis remain uncommon, limiting the possibilities to extrapolate its true potential for clinical practice. PROSPERO 2014:CRD42014014027.

  10. Multimodal ophthalmic imaging using handheld spectrally encoded coherence tomography and reflectometry (SECTR)

    NASA Astrophysics Data System (ADS)

    Leeburg, Kelsey C.; El-Haddad, Mohamed T.; Malone, Joseph D.; Terrones, Benjamin D.; Tao, Yuankai K.

    2018-02-01

    Scanning laser ophthalmoscopy (SLO) provides high-speed, noninvasive en face imaging of the retinal fundus. Optical coherence tomography (OCT) is the current "gold-standard" for ophthalmic diagnostic imaging and enables depth-resolved visualization of ophthalmic structures and image-based surrogate biomarkers of disease. We present a compact optical and mechanical design for handheld spectrally encoded coherence tomography and reflectometry (SECTR) for multimodality en face spectrally encoded reflectometry (SER) and cross-sectional OCT imaging. We custom-designed a double-pass telecentric scan lens, which halves the size of 4-f optical relays and allowed us to reduce the footprint of our SECTR scan-head by a factor of >2.7x (volume) over our previous design. The double-pass scan lens was optimized for diffraction-limited performance over a +/-10° scan field. SECTR optics and optomechanics were combined in a compact rapid-prototyped enclosure with dimensions 87 x 141.8 x 137 mm (w x h x d). SECTR was implemented using a custom-built 400 kHz 1050 nm swept-source. OCT and SER were simultaneously digitized on dual input channels of a 4 GS/s digitizer at 1.4 GS/s per channel. In vivo human en face SER and cross-sectional OCT images were acquired at 350 fps. OCT volumes of 1000 B-scans were acquired in 2.86 s. We believe clinical translation of our compact handheld design will benefit point-of-care ophthalmic diagnostics in patients who are unable to be imaged on conventional slit-lamp based systems, such as infants and the bedridden. When combined with multi-volumetric registration methods, handheld SECTR will have advantages in motion-artifact free imaging over existing handheld technologies.

  11. Comparative studies of various hyaluronic acids produced by microbial fermentation for potential topical ophthalmic applications.

    PubMed

    Guillaumie, Fanny; Furrer, Pascal; Felt-Baeyens, Olivia; Fuhlendorff, Birgit L; Nymand, Søren; Westh, Peter; Gurny, Robert; Schwach-Abdellaoui, Khadija

    2010-03-15

    This work presents a comparative study of various hyaluronic acids (HA) produced by fermentation of either Bacillus subtilis or Streptococcus towards the selection of an optimal molecular weight (MW) HA for the preparation of topical ophthalmic formulations. The influence of HA MW on water binding capacity, sterile filtration, rheological properties, precorneal residence time and ocular tolerance of ophthalmic solutions was investigated. Molecular weight did not affect hydration of hyaluronic acid according to differential scanning calorimetry (DSC). In general, medium MW HA (0.6-1 MDa) resulted in solutions that were superior in terms of sterile filtration and kinematic viscosity requirements compared to high MW HA (>1 MDa). Moreover, all HA-based solutions exhibited well-defined viscoelastic properties that depend on MW. Gamma scintigraphic data indicated that HA MW at 0.1% concentration (w/v) and HA origin did not significantly affect the corneal residence time on rabbit eyes. A 0.3% solution of high MW HA had a prolonged residence time in the precorneal area compared to a medium MW HA at the same concentration. Finally, an in vivo ocular irritation test based on confocal laser scanning ophthalmoscopy (CLSO) conclusively showed the excellent tolerance of both Bacillus-derived HA and Streptococcus-derived HA after topical instillation onto the corneal surface. Overall, this comprehensive work highlights the superiority of medium MW hyaluronic acid for topical ophthalmic formulations based on their physico-chemical and biological properties, tolerance and handling. Such solutions are expected to enhance tear film stability, to allow for maximum comfort, and to exhibit high residence times, while being biocompatible and easy to sterile filter. (c) 2009 Wiley Periodicals, Inc.

  12. Degree of corneal anaesthesia after topical application of 0.4% oxybuprocaine hydrochloride and 0.5% proparacaine hydrochloride ophthalmic solution in clinically normal cattle.

    PubMed

    Little, W B; Jean, G St; Sithole, F; Little, E; Jean, K Yvorchuk-St

    2016-06-01

    The use of corneal anaesthesia is necessary for a range of clinical purposes. Therefore, we assessed and compared the efficacy of corneal anaesthesia after application of 0.4% oxybuprocaine hydrochloride and 0.5% proparacaine hydrochloride ophthalmic solution in clinically normal cattle. The 24 clinically normal cows were allocated into two groups. Cows in group 1 (n = 12) received 0.2 mL of 0.4% oxybuprocaine hydrochloride with fluorescein ophthalmic solution in one eye and 0.2 mL of sterile saline (0.9% NaCl) with fluorescein in the contralateral eye (control). Group 2 (n = 12) received 0.2 mL of 0.4% oxybuprocaine hydrochloride with fluorescein ophthalmic solution in one eye and 0.2 mL of 0.5% proparacaine hydrochloride with fluorescein in the contralateral eye (control). In each group, corneal touch threshold was determined by Cochet-Bonnet aesthesiometer for both eyes immediately prior to topical administration of solutions, at 1 min and 5 min after administration of topical solutions and every 5 min thereafter for a total of 75 min. Significant corneal anaesthesia was noted immediately following topical application of both oxybuprocaine and proparacaine as compared with controls, with maximal corneal anaesthesia noted 1 min after administration. Both oxybuprocaine and proparacaine produced significant corneal anaesthesia for the duration of the 75-min study. Neither oxybuprocaine hydrochloride nor proparacaine hydrochloride treatment resulted in visible adverse effects. There are limited data available demonstrating the efficacy and duration of corneal anaesthetic agents in cattle. Both oxybuprocaine hydrochloride and proparacaine hydrochloride should be considered practical options for providing corneal anaesthesia in cattle in a clinical setting. © 2016 Australian Veterinary Association.

  13. The knowledge and attitude of non-ophthalmic medical doctors towards glaucoma in two tertiary institutions in south eastern Nigeria.

    PubMed

    Achigbu, E O; Chuka-Okosa, C M

    2014-06-01

    This study is aimed at determining how much knowledge of glaucoma the non-ophthalmic medical doctors still possess and their personal attitudes toward glaucoma. Self- administered questionnaires were randomly distributed to the non-ophthalmic medical doctors in two specialist hospitals in south eastern Nigeria: The data obtained were the age, sex, professional and number of years of practice of the participants, their knowledge of the symptoms/ aetiology/risk factors, examination/investigation, treatment of glaucoma as well as their personal attitude towards glaucoma. There were two hundred respondents; one hundred and forty two males and fifty eight females (M:F=2.4:1); comprising 82.5% Resident doctors; 51% of whom had been in practice for less than 5 years.All the doctors had heard of glaucoma; approximately seventy two per cent (72.5%) had a good knowledge of glaucoma symptoms and 52.0% of these had been in practice for only 5 years or less. Similarly, of the 83% of the doctors who correctly answered the questions on the aetiology of glaucoma, majority (84.3%) had been in practice for 5 years or less. Only 24.5% and 38.5% respectively of the doctors had a good knowledge of the basic examination and treatment required for the management of glaucoma.There was no statistically significant relationship between most variables tested. Only the relationship between the knowledge of the symptoms of glaucoma and the duration of practice of the doctors was statistically significant (p< 0.005). Most of the non-ophthalmic medical doctors have a basic knowledge of glaucoma and how to investigate it but showed a poor knowledge of examination and treatment modalities. They also acknowledged the importance of regular eye checks but only very few had had their eyes examined.

  14. Integrative Advances for OCT-Guided Ophthalmic Surgery and Intraoperative OCT: Microscope Integration, Surgical Instrumentation, and Heads-Up Display Surgeon Feedback

    PubMed Central

    Ehlers, Justis P.; Srivastava, Sunil K.; Feiler, Daniel; Noonan, Amanda I.; Rollins, Andrew M.; Tao, Yuankai K.

    2014-01-01

    Purpose To demonstrate key integrative advances in microscope-integrated intraoperative optical coherence tomography (iOCT) technology that will facilitate adoption and utilization during ophthalmic surgery. Methods We developed a second-generation prototype microscope-integrated iOCT system that interfaces directly with a standard ophthalmic surgical microscope. Novel features for improved design and functionality included improved profile and ergonomics, as well as a tunable lens system for optimized image quality and heads-up display (HUD) system for surgeon feedback. Novel material testing was performed for potential suitability for OCT-compatible instrumentation based on light scattering and transmission characteristics. Prototype surgical instruments were developed based on material testing and tested using the microscope-integrated iOCT system. Several surgical maneuvers were performed and imaged, and surgical motion visualization was evaluated with a unique scanning and image processing protocol. Results High-resolution images were successfully obtained with the microscope-integrated iOCT system with HUD feedback. Six semi-transparent materials were characterized to determine their attenuation coefficients and scatter density with an 830 nm OCT light source. Based on these optical properties, polycarbonate was selected as a material substrate for prototype instrument construction. A surgical pick, retinal forceps, and corneal needle were constructed with semi-transparent materials. Excellent visualization of both the underlying tissues and surgical instrument were achieved on OCT cross-section. Using model eyes, various surgical maneuvers were visualized, including membrane peeling, vessel manipulation, cannulation of the subretinal space, subretinal intraocular foreign body removal, and corneal penetration. Conclusions Significant iterative improvements in integrative technology related to iOCT and ophthalmic surgery are demonstrated. PMID:25141340

  15. Vancomycin Ophthalmic Ointment 1% for methicillin-resistant Staphylococcus aureus or methicillin-resistant Staphylococcus epidermidis infections: a case series

    PubMed Central

    Sotozono, Chie; Fukuda, Masahiko; Ohishi, Masao; Yano, Keiko; Origasa, Hideki; Saiki, Yoshinori; Shimomura, Yoshikazu; Kinoshita, Shigeru

    2013-01-01

    Objectives To investigate the efficacy and safety of Vancomycin Ophthalmic Ointment 1% (Toa Pharmaceutical Co., Ltd, Toyama, Japan) in patients with external ocular infections caused by methicillin-resistant Staphylococcus aureus (MRSA) or methicillin-resistant Staphylococcus epidermidis (MRSE). Design A case series. Setting This study was a multicentre, open-label, uncontrolled study in Japan approved as orphan drug status. Participants Patients with MRSA or MRSE external ocular infections unresponsive to the treatment of fluoroquinolone eye drops. Interventions Vancomycin Ophthalmic Ointment 1% was administered four times daily. Primary and secondary outcome measures The subjective and objective clinical scores and bacterial cultures were collected at days 0 (baseline), 3, 7 and 14. The primary outcome was clinical response evaluation (efficacy rate) determined as complete response, partial response, no response and worsening. Secondary outcome was the eradication of the bacteria. Safety was assessed by adverse events including cases in which neither MRSA nor MRSE was detected. Results Twenty-five cases with MRSA (20) or MRSE (5) infections were enrolled. Of these 25 cases, 4 discontinued the treatment due to the negative results for bacterial culture during screening or at baseline. Of the 21 cases with conjunctivitis (14), blepharitis (3), meibomitis (1), dacryocystitis (2) or keratitis (1), 14 (66.7%) cases were evaluated as being excellently (complete response, 2 cases) or well (partial response, 12 cases) treated. The eradication rates were 68.4% in MRSA (13 of 19 cases) and 100% in MRSE (2 of 2 cases). Ten adverse events occurred in 7 (28.0%) of 25 cases at the local administration site. Conclusions Vancomycin Ophthalmic Ointment 1% was considered to be useful for the treatment of intractable ocular MRSA/MRSE infections. PMID:23364319

  16. The effect of the corneal epithelium on the intraocular penetration of fluoroquinolone ophthalmic solution.

    PubMed

    Fukuda, Masamichi; Inoue, Amane; Sasaki, Kazuyuki; Takahashi, Nobuo

    2004-01-01

    Pharmacokinetic studies of antibacterial agents for infectious eye diseases have usually been performed on normal rabbit eyes. In this study, the intraocular penetration of fluoroquinolone ophthalmic solutions was determined in normal rabbit eyes and in rabbit eyes that had the corneal epithelium intentionally removed. We determined the intraocular penetration of ofloxacin (OFLX), levofloxacin (LVFX), and norfloxacin (NFLX), fluoroquinolone ophthalmic solutions that are already on the market and undergoing clinical studies, by injecting 50 microl of each solution into the cul-de-sacs of rabbit eyes three times at 15-min intervals. The drug concentration at 10, 30, 60, 120, and 240 min after final instillation was determined by high-performance liquid chromatography. The maximum concentration in the aqueous humor of normal rabbit eyes was 2.09 +/- 1.56 microg/ml (60 min, OFLX), 2.57 +/- 1.00 microg/ml (30 min, LVFX), and 0.42 +/- 0.12 microg/ml (120 min, NFLX). The drug concentration in the aqueous humor of eyes with intentionally removed corneal epithelium was 12.50 +/- 5.62 microg/ml (30 min, OFLX), 9.02 +/- 2.45 microg/ml (60 min, LVFX), and 8.54 +/- 5.17 microg/ml (30 min, NFLX). The drug penetration of the eye drops into eyes with removed corneal epithelium was around 6 times (OFLX), 3.5 times (LVFX), and 20 times (NFLX) higher than the penetration into the eye with normal cornea. Among the pharmacokinetic parameters of the three ophthalmic solutions according to the one-compartment model, the maximum concentration in the aqueous and the area under the concentration-time curve in the aqueous tended to be higher in the eyes with intentionally removed corneal epithelia than in those with normal corneas.

  17. Use of traditional eye medicine and self-medication in rural India: A population-based study

    PubMed Central

    Gupta, Noopur; Tandon, Radhika; Gupta, Sanjeev K.; Kalaivani, Mani; Dwivedi, S. N.

    2017-01-01

    Objective To determine the type and nature of traditional eye medicine (TEM), their sources and use and practices related to self-medication for ophthalmic diseases in a rural Indian population. Methods A population-based, cross-sectional study was conducted in 25 randomly selected clusters of Rural Gurgaon, Haryana, India as part of CORE (Cornea Opacity Rural Epidemiological) study. In addition to comprehensive ophthalmic examination, health-seeking behavior and use of self-medication and TEM was assessed in the adult population using a semi-structured questionnaire. Physical verification of available ophthalmic medications in the enumerated households was conducted by the study team. Descriptive statistics were computed along with multivariable logistic regression analysis to determine associated factors for use of self-medication and TEM. Results Of the 2160 participants interviewed, 396 (18.2%) reported using ophthalmic medications without consulting an ophthalmologist, mainly for symptoms like watering (37.1%), redness (27.7%), itching (19.2%) and infection (13.6%). On physical verification of available eye drops that were being used without prescription, 26.4% participants were practicing self-medication. Steroid, expired/unlabeled and indigenous eye drops were being used by 151(26.5%), 120(21.1%) and 75 (13.2%) participants respectively. Additionally, 25.7% (529) participants resorted to home remedies like ‘kajal’(61.4%), honey (31.4%), ghee (11.7%) and rose water (9.1%). Conclusion Use of TEM is prevalent in this population. The rampant use of steroid eye drops without prescription along with use of expired or unlabelled eye drops warrants greater emphasis on safe eye care practices in this population. Public awareness and regulatory legislations must be implemented to decrease harmful effects arising due to such practices. PMID:28829812

  18. Formulation and stability of an extemporaneous 0.02% chlorhexidine digluconate ophthalmic solution.

    PubMed

    Lin, Shu-Chiao; Huang, Chih-Fen; Shen, Li-Jiuan; Wang, Hsueh-Ju; Lin, Chia-Yu; Wu, Fe-Lin Lin

    2015-12-01

    Acanthamoeba keratitis is difficult to treat because Acanthamoeba cysts are resistant to the majority of antimicrobial agents. Despite the efficacy of 0.02% chlorhexidine in treating Acanthamoeba keratitis, a lack of data in the literature regarding the formulation's stability limits its clinical use. The objective of this study was to develop an optimal extemporaneous 0.02% chlorhexidine digluconate ophthalmic formulation for patients in need. With available active pharmaceutical ingredients, 0.02% chlorhexidine digluconate sample solutions were prepared by diluting with BSS Plus Solution or acetate buffer. Influences of the buffer, type of container, and temperature under daily-open condition were assessed based on the changes of pH values and chlorhexidine concentrations of the test samples weekly. To determine the beyond-use date, the optimal samples were stored at 2-8°C or room temperature, and analyzed at time 0 and at Week 1, Week 2, Week 3, Week 4, Week 5, Week 8, Week 12, and Week 24. Despite chlorhexidine exhibiting better stability in acetate buffer than in BSS solution, its shelf-life was < 14 days when stored in a light-resistant low-density polyethylene container. The acetate-buffered 0.02% chlorhexidine digluconate solution stored in light-resistant high-density polyethylene eyedroppers did not exhibit significant changes in pH or strength at any time interval. The acetate-buffered 0.02% chlorhexidine digluconate ophthalmic solution stored in light-resistant high-density polyethylene eyedroppers demonstrated excellent stability at 2-25°C for 6 months after being sealed and for 1 month after opening. This finding will enable us to prepare 0.02% chlorhexidine digluconate ophthalmic solutions based on a doctor's prescription. Copyright © 2014. Published by Elsevier B.V.

  19. Efficacy and safety of retinol palmitate ophthalmic solution in the treatment of dry eye: a Japanese Phase II clinical trial.

    PubMed

    Toshida, Hiroshi; Funaki, Toshinari; Ono, Koichi; Tabuchi, Nobuhito; Watanabe, Sota; Seki, Tamotsu; Otake, Hiroshi; Kato, Takuji; Ebihara, Nobuyuki; Murakami, Akira

    2017-01-01

    The purpose of this study was to investigate the efficacy and safety of the administration of retinol palmitate (VApal) ophthalmic solution (500 IU/mL) for the treatment of patients with dry eye. This study included 66 patients with dry eye. After a 2-week washout period, patients were randomized (1:1) into either a VApal ophthalmic solution or a placebo group, and a single drop of either solution was administered six times daily for 4 weeks. Efficacy measures were 12 subjective symptoms, rose bengal (RB) and fluorescein staining scores, tear film breakup time, and tear secretion. Safety measures included clinical blood and urine analyses and adverse event recordings. In comparisons of the two groups, the mean change in RB staining score from baseline was significantly lower in the VApal group at 2 and 4 weeks ( P <0.05 and P <0.01, respectively). Furthermore, the fluorescein clearance rate (fluorescein staining score) was significantly higher in the VApal group at 4 weeks ( P <0.05). The VApal group showed a significant improvement in blurred vision at 1 and 2 weeks ( P <0.01 and P <0.05, respectively), and the mean change in the total score for subjective symptoms from baseline was significantly lower in the VApal group at 1 week ( P <0.05). In before- and after-intervention comparisons, the fluorescein and RB staining scores showed improvement in both groups. Improvement was noted for 11 subjective symptoms in the VApal group and for seven symptoms in the placebo group. No significant differences in adverse events and reactions were found between the groups. VApal ophthalmic solution (500 IU/mL) is safe and effective for the treatment of patients with dry eye.

  20. Virtual Guidance Ultrasound: A Tool to Obtain Diagnostic Ultrasound for Remote Environments

    NASA Technical Reports Server (NTRS)

    Caine,Timothy L.; Martin David S.; Matz, Timothy; Lee, Stuart M. C.; Stenger, Michael B.; Platts, Steven H.

    2012-01-01

    Astronauts currently acquire ultrasound images on the International Space Station with the assistance of real-time remote guidance from an ultrasound expert in Mission Control. Remote guidance will not be feasible when significant communication delays exist during exploration missions beyond low-Earth orbit. For example, there may be as much as a 20- minute delay in communications between the Earth and Mars. Virtual-guidance, a pre-recorded audio-visual tutorial viewed in real-time, is a viable modality for minimally trained scanners to obtain diagnostically-adequate images of clinically relevant anatomical structures in an autonomous manner. METHODS: Inexperienced ultrasound operators were recruited to perform carotid artery (n = 10) and ophthalmic (n = 9) ultrasound examinations using virtual guidance as their only instructional tool. In the carotid group, each each untrained operator acquired two-dimensional, pulsed, and color Doppler of the carotid artery. In the ophthalmic group, operators acquired representative images of the anterior chamber of the eye, retina, optic nerve, and nerve sheath. Ultrasound image quality was evaluated by independent imaging experts. RESULTS: Eight of the 10 carotid studies were judged to be diagnostically adequate. With one exception the quality of all the ophthalmic images were adequate to excellent. CONCLUSION: Diagnostically-adequate carotid and ophthalmic ultrasound examinations can be obtained by untrained operators with instruction only from an audio/video tutorial viewed in real time while scanning. This form of quick-response-guidance, can be developed for other ultrasound examinations, represents an opportunity to acquire important medical and scientific information for NASA flight surgeons and researchers when trained medical personnel are not present. Further, virtual guidance will allow untrained personnel to autonomously obtain important medical information in remote locations on Earth where communication is difficult or absent.

  1. Are All Retinal Nerve Fiber Layer Defects on Optic Coherence Tomography Glaucomatous?

    PubMed Central

    Gür Güngör, Sirel; Ahmet, Akman

    2017-01-01

    Objectives: In this study, we investigated the patients who were referred to our clinic with a prediagnosis of glaucoma based on retinal nerve fiber layer (RNFL) defects on optic coherence tomography (OCT) but were determined to have nonglaucomatous RNLF defects upon detailed examination. Materials and Methods: The ophthalmic examination notes, OCT images, Heidelberg retinal tomography (HRT) II and fundus photographs of 357 patients were retrospectively evaluated. Final diagnoses of these patients were investigated. Results: Of the 357 patients, 216 (60.5%) were diagnosed as open angle glaucoma, 33 (9.2%) as low-tension glaucoma, 39 (10.9%) as pre-perimetric glaucoma. The ophthalmic examinations of 14 patients (3.9%) were normal and there were no RNFL defects in OCT examinations after dilatation. In 39 patients (10.9%), the ophthalmic and optic disc examinations were completely normal and no etiologic factor explaining RNFL defects was found. Twenty-two eyes of 16 patients (4.5%) were included in this study (the mean age was 53.8±11.5 years; 9 men and 7 women). After detailed questioning of the medical history and systemic and neurologic examinations, a diagnosis of ischemic optic neuropathy was made in 11 eyes (10 patients) (2.8%), optic neuritis in 3 eyes (2 patients) (0.6%), optic disc drusen in 4 eyes (2 patients) (0.6%), pseudotumor cerebri in 2 eyes (1 patient) (0.3%), and cerebral palsy in 2 eyes (1 patient) (0.3%). Conclusion: Decrease in RNFL thickness on OCT images alone may be misleading in glaucoma examination. In cases where optic disc cupping is not evident, diagnosis should not be based on OCT RNFL examinations alone, and the patient’s medical history, detailed ophthalmic examination, OCT optic disc parameters, HRT, and visual field tests should all be carefully evaluated together. PMID:29109895

  2. [Estimation of the quality of life 8-year-old child with bilateral anophthalmia].

    PubMed

    Sredzińska-Kita, Dorota; Mrugacz, Małgorzata; Bakunowicz-Łazarczyk, Alina

    2009-01-01

    The main aim of our work was to estimate the physical and psychomotor development and the arrangement to the daily life for a 8-year-old girl with inborn bilateral anophthalmia. The basic ophthalmic, pediatric and neurological examinations were performed with additional genetic and radiological examinations. The ophthalmic and MRI examination find out the absence of the eyeballs, optic nerves, optic chiasm, optic tracts and optic radiation. Anophthalmia limits in a big grade an independent life of the child. However, currently the girl's development indicates for good intellectual abilities what is promising for future independent life and professional work.

  3. Advancements in ocular drug delivery.

    PubMed

    Weiner, Alan L; Gilger, Brian C

    2010-11-01

    This review covers both noninvasive and invasive ophthalmic drug delivery systems that can have application to therapy of veterinary ophthalmic diseases. Noninvasive approaches include gel technologies, permeation enhancement via pro-drug development, solubilization agents and nanoparticle technologies, iontophoresis, microneedles, drug-eluting contact lenses and eye misters, and microdroplets. More invasive systems include both eroding implants and noneroding technologies that encompass diffusion based systems, active pumps, intraocular lenses, suprachoroidal drug delivery, and episcleral reservoirs. In addition to addressing the physiologic challenges of achieving the necessary duration of delivery, tissue targeting and patient compliance, the commercial development factors of biocompatibility, sterilization, manufacturability and long-term stability will be discussed. © 2010 American College of Veterinary Ophthalmologists.

  4. Vision Issues and Space Flight: Evaluation of One-Carbon Metabolism Polymorphisms

    NASA Technical Reports Server (NTRS)

    Smith, Scott M.; Gregory, Jesse F.; Zeisel, Steven; Ueland, Per; Gibson, C. R.; Mader, Thomas; Kinchen, Jason; Ploutz-Snyder, Robert; Zwart, Sara R.

    2015-01-01

    Intermediates of the one-carbon metabolic pathway are altered in astronauts who experience vision-related issues during and after space flight. Serum concentrations of homocysteine, cystathionine, 2-methylcitric acid, and methylmalonic acid were higher in astronauts with ophthalmic changes than in those without (Zwart et al., J Nutr, 2012). These differences existed before, during, and after flight. Potential confounding factors did not explain the differences. Genetic polymorphisms could contribute to these differences, and could help explain why crewmembers on the same mission do not all have ophthalmic issues, despite the same environmental factors (e.g., microgravity, exercise, diet). A follow-up study was conducted to evaluate 5 polymorphisms of enzymes in the one-carbon pathway, and to evaluate how these relate to vision and other ophthalmic changes after flight. Preliminary evaluations of the genetic data indicate that all of the crewmembers with the MTRR GG genotype had vision issues to one degree or another. However, not everyone who had vision issues had this genetic polymorphism, so the situation is more complex than the involvement of this single polymorphism. Metabolomic and further data analyses are underway to clarify these findings, but the preliminary assessments are promising.

  5. Ocular larva migrans caused by Toxocara cati in Mongolian gerbils and a comparison of ophthalmologic findings with those produced by T. canis.

    PubMed

    Akao, N; Takayanagi, T H; Suzuki, R; Tsukidate, S; Fujita, K

    2000-10-01

    To elucidate the pathogenic potential of Toxocara cari, we observed the ophthalmologic changes of the fundi in Mongolian gerbils, Meriones unguiculatus, after oral inoculation of 17 embryonated eggs/g body weight. Ophthalmic conditions in 8 T. cati-infected gerbils were monitored using an ophthalmoscope from day 0 to day 156 and were compared with those of 57 T. canis-infected gerbils. The results showed that T. cati larvae migrated into the eye of the gerbil and then elicited ophthalmic changes, including retinal (25%) and vitreous (50%) hemorrhaging, vasculitis (37.5%), and exudative lesions (25%). Lesions were less prevalent, however, in T. cati-infected than in T. canis-infected gerbils. Unlike in T. canis-infected gerbils, the hemorrhagic lesions did not reappear in T. cati-infected gerbils after they were absorbed. These findings suggested that T. cati larvae are a potentially hazardous pathogen for ocular toxocariasis and that Mongolian gerbils infected with T. cati may be a useful model for the study of human ocular toxocariasis caused by T. cati. This is the first study to report that T. cati larvae can induce ophthalmic lesions in the retina of gerbils.

  6. Polyethylene Naphthalate Scintillator: A Novel Detector for the Dosimetry of Radioactive Ophthalmic Applicators.

    PubMed

    Flühs, Dirk; Flühs, Andrea; Ebenau, Melanie; Eichmann, Marion

    2015-09-01

    Dosimetric measurements in small radiation fields with large gradients, such as eye plaque dosimetry with β or low-energy photon emitters, require dosimetrically almost water-equivalent detectors with volumes of <1 mm(3) and linear responses over several orders of magnitude. Polyvinyltoluene-based scintillators fulfil these conditions. Hence, they are a standard for such applications. However, they show disadvantages with regard to certain material properties and their dosimetric behaviour towards low-energy photons. Polyethylene naphthalate, recently recognized as a scintillator, offers chemical, physical and basic dosimetric properties superior to polyvinyltoluene. Its general applicability as a clinical dosimeter, however, has not been shown yet. To prove this applicability, extensive measurements at several clinical photon and electron radiation sources, ranging from ophthalmic plaques to a linear accelerator, were performed. For all radiation qualities under investigation, covering a wide range of dose rates, a linearity of the detector response to the dose was shown. Polyethylene naphthalate proved to be a suitable detector material for the dosimetry of ophthalmic plaques, including low-energy photon emitters and other small radiation fields. Due to superior properties, it has the potential to replace polyvinyltoluene as the standard scintillator for such applications.

  7. Safety in the use of compressed air versus oxygen for the ophthalmic patient.

    PubMed

    Rodgers, Laura A; Kulwicki, Anahid

    2002-02-01

    Oxygen, routinely administered during surgery to avoid hypoxia, poses risks including increased likelihood of surgical room fires and predisposition to retinal phototoxicity in patients. Compressed air to supplement ventilation may be safer than oxygen. The purpose of this study was to determine whether hypoxia occurs more frequently when compressed air replaces supplemental oxygen during ophthalmic surgery. A convenience sample of 111 patients was randomly assigned to receive supplemental oxygen (group 1) or compressed air (group 2). Patients with serious cardiac or pulmonary disease were excluded. Blood oxygen levels were monitored during surgery by pulse oximetry. Oxygen was administered to all group 2 patients whose oxygen saturation fell to less than 90% or by more than 5% below baseline. No differences were observed between groups in age, ASA classification, type of surgery, or anesthetic drugs or doses. Minor, but statistically higher oxygen values were observed in group 1. The frequency with which oxygen saturation decreased below 90% or below 5% of baseline was similar in both groups. Supplemental oxygen is not required routinely in selected patients undergoing ophthalmic surgery. By using compressed air, the risk of operating room fires and retinal phototoxicity may be reduced.

  8. Survey on allied health personnel in Canadian ophthalmology: the scalpel for change.

    PubMed

    Astle, William F; El-Defrawy, Sherif; LaRoche, G Robert; Lafontaine, Marc D; Anderson, Lynn D; Dukes, Margaret; Anderson, Inika; Weirens, Nicholas

    2011-02-01

    To determine the recruiting and training needs for ophthalmic medical personnel (OMP), assess the value of their certification, and compare the ophthalmic practice productivity and performance of non-certified and certified OMP, as rated by both ophthalmologists and OMP. Comparative analysis. One hundred and sixteen Canadian ophthalmologists and 98 OMP. An invitation to complete an online survey on OMP recruitment, training, certification, and productivity performance in a clinical setting was sent to 1081 ophthalmologists and OMP. Fifteen percent of ophthalmologists and 31% of OMP completed the survey. Ophthalmologists (61%) reported difficulty hiring OMP; employee referrals was the best method (40%). Awareness of formal OMP training programs was high and 50% of respondents supported developing additional training programs; 55% of OMP were encouraged by their employers to obtain certification. Personal challenge and achievement (79%) and improved skills (71%) were the main reasons for OMP to obtain certification. The majority of OMP and ophthalmologists felt that certified OMP enhanced most practice productivity measures. Higher wages associated with certification were reported by 73% of respondents. Training of qualified OMP was identified as a need by ophthalmologists. Ophthalmic practices can increase their overall productivity by adding certified OMP to their staff.

  9. Preparation and evaluation of a timolol maleate drug-resin ophthalmic suspension as a sustained-release formulation in vitro and in vivo.

    PubMed

    Qin, Fuhong; Zeng, Li; Zhu, Yongtao; Cao, Jingjing; Wang, Xiaohui; Liu, Wei

    2016-01-01

    The aim of this work was to assess the performance of resin as an ocular delivery system. Timolol maleate (TM) was chosen as the model drug and an ion exchange resin (IER) as the carrier. The drug-resin complex was prepared using an oscillation method and then characterized regarding particle size, zeta potential, morphology, and drug content. After in vitro drug release study and corneal permeation study were performed, in vivo studies were performed in New Zealand albino rabbits using a suspension with particles sized 4.8 ± 1.2 μm and drug loading at 43.00 ± 0.09%. The results indicate that drug released from the drug-resin ophthalmic suspension permeated the cornea and displayed a sustained-release behavior. Drug levels in the ocular tissues after administration of the drug-resin ophthalmic suspension were significantly higher than after treatment with an eye drop formulation but were lower in body tissues and in the plasma. In conclusion, resins have great potential as effective ocular drug delivery carriers to increase ocular bioavailability of timolol while simultaneously reducing systemic drug absorption.

  10. Improvements in Topical Ocular Drug Delivery Systems: Hydrogels and Contact Lenses.

    PubMed

    Ribeiro, Andreza Maria; Figueiras, Ana; Veiga, Francisco

    2015-01-01

    Conventional ophthalmic systems present very low corneal systemic bioavailability due to the nasolacrimal drainage and the difficulty to deliver the drug in the posterior segment of ocular tissue. For these reasons, recent advances have focused on the development of new ophthalmic drug delivery systems. This review provides an insight into the various constraints associated with ocular drug delivery, summarizes recent findings in soft contact lenses (SCL) and the applications of novel pharmaceutical systems for ocular drug delivery. Among the new therapeutic approaches in ophthalmology, SCL are novel continuous-delivery systems, providing high and sustained levels of drugs to the cornea. The tendency of research in ophthalmic drug delivery systems development are directed towards a combination of several technologies (bio-inspired and molecular imprinting techniques) and materials (cyclodextrins, surfactants, specific monomers). There is a tendency to develop systems which not only prolong the contact time of the vehicle at the ocular surface, but also at the same time slow down the clearance of the drug. Different materials can be applied during the development of contact lenses and can be combined with natural inspired strategies of drug immobilization and release, providing successful tools for ocular drug delivery systems.

  11. Enucleation and Evisceration in the Palestinian Territories

    PubMed Central

    Keenan, Tiarnan D. L.; Sargent, Nicholas J.

    2011-01-01

    Purpose: To examine the demographics and indications in patients undergoing eye removal at St. John Eye Hospital (SJEH) in Jerusalem, the largest single provider of ophthalmic care in the Palestinian Territories. Materials and Methods: In this retrospective study, medical records were reviewed for patients undergoing enucleation or evisceration at SJEH from November 2004 to March 2007. Calculation of percentage, mean and median was performed for the demographics, and indications for enucleation and evisceration. Results: Thirty-three eyes of 32 patients were removed during the period under study. Twelve enucleations and 21 eviscerations were performed. Mean age was 39 years, and 19 patients were male. Indications included severe trauma (8 eyes), painful blind eye with (5 eyes) or without (9 eyes) infection, and ophthalmic neoplasm (3 eyes). Conclusion: The incidence of surgical eye removal at SJEH from 2004 to 2007 was around one patient per month for a population over three million. This rate appears far lower than those reported in previous studies of similar Palestinian populations. Prompt access to medical care for Palestinians is required to mitigate ophthalmic morbidity. Approximately half of the cases were caused by severe trauma or infection, with rubber bullet injuries responsible for 20% of the traumatic cases. PMID:21731330

  12. Can the route of Toxoplasma gondii infection affect the ophthalmic outcomes?

    PubMed

    Ashour, Dalia S; Saad, Abeer E; Bakary, Reda H El; Barody, Mohamed A El

    2018-06-14

    Ocular toxoplasmosis is the most common cause of retinochoroiditis worldwide in humans. Some studies highlighted the idea that ocular lesions differ according to the route of infection but none of them mimicked the natural route. The current study aimed to investigate the ophthalmic outcomes in congenital and oral routes of infection with Toxoplasma in experimental animals. Mice were divided into three groups; group I: congenital infection, group II: acquired oral infection and group III: non-infected. We used Me49 chronic low-virulence T. gondii strain. We found that retina is the most affected part in both modes of infections. However, the retinal changes are different and more pronounced in case of congenital infection. The congenitally infected mice showed retinal lesions e.g. total detachment of retinal pigment epithelium from the photoreceptor layer and irregular arrangement of retinal layers. More severe damage was observed in mice infected early in pregnancy. While the postnatal orally infected mice showed fewer changes. In conclusion, the routes of Toxoplasma infection affect the ophthalmic outcomes and this may be the case in human disease. Although both are vision threatening, it seems that the prognosis of postnatal acquired ocular toxoplasmosis is better than that of congenital disease.

  13. Forskolin: upcoming antiglaucoma molecule.

    PubMed

    Wagh, V D; Patil, P N; Surana, S J; Wagh, K V

    2012-01-01

    Forskolin is the first pharmaceutical drug and product derived from a plant to be approved in India by the DCGI in 2006. Forskolin (7beta-acetoxy-8, 13-epoxy-1a, 6β, 9a-trihydroxy-labd-14-en-11-one) is a diterpenoid isolated from plant Coleus forskohlii (Lamiaceae). It is a lipid-soluble compound that can penetrate cell membranes and stimulates the enzyme adenylate cyclase which, in turn, stimulates ciliary epithelium to activate cyclic adenosine monophosphate, which decreases intraocular pressure (IOP) by reducing aqueous humor inflow. The topical application of forskolin is capable of reducing IOP in rabbits, monkeys, and humans. In its drug interactions, forskolin may act synergistically with epinephrine, ephedrine and pseudoephedrine. Whereas the effects of anti-clotting medications like warfarin, clopidogre, aspirin, anoxaparin, etc., may be enhanced by forskolin. Forskolin is contraindicated in the medications for people with ulcers as forskolin may increase acid level. Forskolin has a very good shelf-life of five years. Recently, its Ophthalmic inserts and in situ gels for sustained and delayed-release drug delivery systems were tested in New Zealand Albino Rabbits for its antiglaucoma efficacy. This drug review explains Forskolin as a drug, its antiglaucoma potential and recent findings of forskolin as an antiglaucoma agent. The literature search method used for this review was different databases and search engines like PubMed, International Pharmaceutical Abstracts, Google, Medicinal and Aromatic Plants (MAPA).

  14. Wavefront correction and high-resolution in vivo OCT imaging with an objective integrated multi-actuator adaptive lens.

    PubMed

    Bonora, Stefano; Jian, Yifan; Zhang, Pengfei; Zam, Azhar; Pugh, Edward N; Zawadzki, Robert J; Sarunic, Marinko V

    2015-08-24

    Adaptive optics is rapidly transforming microscopy and high-resolution ophthalmic imaging. The adaptive elements commonly used to control optical wavefronts are liquid crystal spatial light modulators and deformable mirrors. We introduce a novel Multi-actuator Adaptive Lens that can correct aberrations to high order, and which has the potential to increase the spread of adaptive optics to many new applications by simplifying its integration with existing systems. Our method combines an adaptive lens with an imaged-based optimization control that allows the correction of images to the diffraction limit, and provides a reduction of hardware complexity with respect to existing state-of-the-art adaptive optics systems. The Multi-actuator Adaptive Lens design that we present can correct wavefront aberrations up to the 4th order of the Zernike polynomial characterization. The performance of the Multi-actuator Adaptive Lens is demonstrated in a wide field microscope, using a Shack-Hartmann wavefront sensor for closed loop control. The Multi-actuator Adaptive Lens and image-based wavefront-sensorless control were also integrated into the objective of a Fourier Domain Optical Coherence Tomography system for in vivo imaging of mouse retinal structures. The experimental results demonstrate that the insertion of the Multi-actuator Objective Lens can generate arbitrary wavefronts to correct aberrations down to the diffraction limit, and can be easily integrated into optical systems to improve the quality of aberrated images.

  15. "All-laser" endothelial corneal transplant in human patients

    NASA Astrophysics Data System (ADS)

    Rossi, Francesca; Menabuoni, Luca; Malandrini, Alex; Canovetti, Annalisa; Lenzetti, Ivo; Pini, Roberto

    2012-03-01

    Femtosecond laser sculpturing of corneal tissue is commonly used for the preparation of endothelial flaps. Diode laser welding of ocular tissues is a procedure that enables minimally invasive suturing of tissues. The combination of these laser based techniques results in a new approach to minimally invasive ophthalmic surgery, such as in endothelial corneal transplant (or endothelial keratoplasty - EK). In this work we present the "all laser" EK performed in human subjects. 24 pseudophakic patients with bullous keratopathy underwent EK: the femtosecond laser was used to prepare the 100 ìm thick and 8.5 mm diameter donor Descemet endothelial flap. After staining the stromal layer of the donor flap with a liquid ICG solution, the donor flap was inserted in the recipient eye by the use of the Busin injector. Then, the endothelial layer was laser-welded to the recipient eye (10 laser spots around the periphery of the flap), in order to reduce the risk of postoperative dislocation of the transplanted flap. A transplanted flap engraftment was observed in all the treated eyes. The staining procedure used to perform laser welding also enabled to evidence the stromal side of the donor flap, so as the flap was always placed in the right side position. The endothelial cells counts in both the laserwelded flaps and in a control group were in good agreement. The proposed technique is easy to perform and enables the reduction of postoperative endothelial flap dislocations.

  16. Omni-focal refractive focus correction technology as a substitute for bi/multi-focal intraocular lenses, contact lenses, and spectacles

    NASA Astrophysics Data System (ADS)

    Ben Yaish, Shai; Zlotnik, Alex; Raveh, Ido; Yehezkel, Oren; Belkin, Michael; Lahav, Karen; Zalevsky, Zeev

    2009-02-01

    We present novel technology for extension in depth of focus of imaging lenses for use in ophthalmic lenses correcting myopia, hyperopia with regular/irregular astigmatism and presbyopia. This technology produces continuous focus without appreciable loss of energy. It is incorporated as a coating or engraving on the surface for spectacles, contact or intraocular lenses. It was fabricated and tested in simulations and in clinical trials. From the various testing this technology seems to provide a satisfactory single-lens solution. Obtained performance is apparently better than those of existing multi/bifocal lenses and it is modular enough to provide solution to various ophthalmic applications.

  17. Numerical Modeling of Ophthalmic Response to Space

    NASA Technical Reports Server (NTRS)

    Nelson, E. S.; Myers, J. G.; Mulugeta, L.; Vera, J.; Raykin, J.; Feola, A.; Gleason, R.; Samuels, B.; Ethier, C. R.

    2015-01-01

    To investigate ophthalmic changes in spaceflight, we would like to predict the impact of blood dysregulation and elevated intracranial pressure (ICP) on Intraocular Pressure (IOP). Unlike other physiological systems, there are very few lumped parameter models of the eye. The eye model described here is novel in its inclusion of the human choroid and retrobulbar subarachnoid space (rSAS), which are key elements in investigating the impact of increased ICP and ocular blood volume. Some ingenuity was required in modeling the blood and rSAS compartments due to the lack of quantitative data on essential hydrodynamic quantities, such as net choroidal volume and blood flowrate, inlet and exit pressures, and material properties, such as compliances between compartments.

  18. Developmental neurogenetics and neuro-ophthalmology.

    PubMed

    Bennett, Jeffrey L

    2002-12-01

    The field of developmental neurogenetics has burgeoned over the past decade. Through the combined efforts of developmental biologists, geneticists, and clinicians, genetic defects resulting in neuro-ophthalmic disorders such as holoprosencephaly, microphthalmia, dominant optic atrophy, and optic nerve colobomas have been identified and characterized at the molecular level. Experimental studies in model organisms are continuing to identify novel genes critical for ocular and central nervous system development. Mutations in some of these genes have revealed a spectrum of pathology similar to that observed in septo-optic dysplasia, Möebius syndrome, and Duane retraction syndrome. This review examines our current knowledge of the molecular genetics of neuro-ophthalmic disease and focuses on several candidate genes for afferent and efferent visual system disorders.

  19. Laser tissue welding in ophthalmic surgery.

    PubMed

    Rossi, Francesca; Matteini, Paolo; Ratto, Fulvio; Menabuoni, Luca; Lenzetti, Ivo; Pini, Roberto

    2008-09-01

    Laser welding of ocular tissues is an alternative technique or adjunct to conventional suturing in ophthalmic surgery. It is based on the photothermal interaction of laser light with the main components of the extracellular matrix of connective tissues. The advantages of the welding procedure with respect to standard suturing and stapling are reduced operation times, lesser inflammation, faster healing and increased ability to induce tissue regeneration. The procedure we set up is based on the use of an infrared diode laser in association with the topical application of the chromophore Indocyanine Green. Laser light may be delivered either continuously or in pulses, thus identifying two different techniques that have been applied clinically in various types of transplants of the cornea.

  20. Big data and ophthalmic research.

    PubMed

    Clark, Antony; Ng, Jonathon Q; Morlet, Nigel; Semmens, James B

    2016-01-01

    Large population-based health administrative databases, clinical registries, and data linkage systems are a rapidly expanding resource for health research. Ophthalmic research has benefited from the use of these databases in expanding the breadth of knowledge in areas such as disease surveillance, disease etiology, health services utilization, and health outcomes. Furthermore, the quantity of data available for research has increased exponentially in recent times, particularly as e-health initiatives come online in health systems across the globe. We review some big data concepts, the databases and data linkage systems used in eye research-including their advantages and limitations, the types of studies previously undertaken, and the future direction for big data in eye research. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. National Strategies of Ophthalmic Education in Iran

    PubMed Central

    Entezari, A; Javadi, MA; Einollahi, B

    2012-01-01

    Background: Academic medicine is in a state of dramatic transformation. For this reason strategic thinking is the most essential part of educational planning. The main purpose of the present study was developing the strategic educational planning of Ophthalmology in Iran from 2007 to 2010 Methods: A qualitative investigation using focus group discussion has been implemented successfully for developing educational planning. Six to twelve representatives of key stakeholders in the ophthalmic education of Iran participated to this study. Results: Strengths, weaknesses, opportunities and threats of ophthalmology education in Iran were analyzed. Strategic goals in education, research, and health service providing domains were being developed. Educational goals were defined as training of human resources in accordance with the community needs at the level of general practitioner, specialist, and fellowships in ophthalmology. Research goals of the program were defined as scientific inter-departmental and international communications, in order to promote the level of education, research, and treatment in the country. Also, in the field of health services according to the community needs, providing services by the means of advanced and cost effective methods were defined as strategic objectives. Conclusion: Based on this strategic plan in the last three years ophthalmic education in Iran shall be many changes in educational, research and health care provision for social accountability. PMID:23113125

  2. Bimatoprost in the treatment of eyelash hypotrichosis

    PubMed Central

    Law, Simon K

    2010-01-01

    Eyelashes hypotrichosis is a condition indicated by an inadequate amount of eyelashes. Hypertrichosis of eyelashes, characterized by excessive eyelash growth, is a regular phenomenon associated with ophthalmic prostaglandin and prostamide analogs. Recently, the US Food and Drug Administration approved Latisse® (bimatoprost 0.03% solution), identical to the ophthalmic solution for glaucoma treatment, for increasing eyelash length, thickness and darkness in patients with hypotrichosis of the eyelashes. When prostaglandin and prostamide analogs interact with the prostanoid receptors in the hair follicle, this most likely stimulates the resting follicles (telogen phase) to growing follicles (anagen phase). Prostaglandin and prostamide analogs may also prolong the anagen phase of eyelashes, leading to an increase of eyelash length. Although bimatoprost is effective in promoting increased growth of healthy eyelashes and adnexal hairs, its effectiveness in patients with eyelash alopecia areata is debatable and its protective effect is not yet studied in patients with eyelash loss secondary to radiation or chemotherapy. Bimatoprost is generally safe when applied to the base of the eyelashes at the lid margin with minimum side effects. However, other ocular or systemic side effects associated with ophthalmic prostaglandin and prostamide analogs may occur when instilled on the surface of the eye, and patients must be informed and monitored. PMID:20463804

  3. Polyethylene Naphthalate Scintillator: A Novel Detector for the Dosimetry of Radioactive Ophthalmic Applicators

    PubMed Central

    Flühs, Dirk; Flühs, Andrea; Ebenau, Melanie; Eichmann, Marion

    2015-01-01

    Background Dosimetric measurements in small radiation fields with large gradients, such as eye plaque dosimetry with β or low-energy photon emitters, require dosimetrically almost water-equivalent detectors with volumes of <1 mm3 and linear responses over several orders of magnitude. Polyvinyltoluene-based scintillators fulfil these conditions. Hence, they are a standard for such applications. However, they show disadvantages with regard to certain material properties and their dosimetric behaviour towards low-energy photons. Purpose, Materials and Methods Polyethylene naphthalate, recently recognized as a scintillator, offers chemical, physical and basic dosimetric properties superior to polyvinyltoluene. Its general applicability as a clinical dosimeter, however, has not been shown yet. To prove this applicability, extensive measurements at several clinical photon and electron radiation sources, ranging from ophthalmic plaques to a linear accelerator, were performed. Results For all radiation qualities under investigation, covering a wide range of dose rates, a linearity of the detector response to the dose was shown. Conclusion Polyethylene naphthalate proved to be a suitable detector material for the dosimetry of ophthalmic plaques, including low-energy photon emitters and other small radiation fields. Due to superior properties, it has the potential to replace polyvinyltoluene as the standard scintillator for such applications. PMID:27171681

  4. CHECKPOINT INHIBITOR IMMUNE THERAPY: Systemic Indications and Ophthalmic Side Effects.

    PubMed

    Dalvin, Lauren A; Shields, Carol L; Orloff, Marlana; Sato, Takami; Shields, Jerry A

    2018-06-01

    To review immune checkpoint inhibitor indications and ophthalmic side effects. A literature review was performed using a PubMed search for publications between 1990 and 2017. Immune checkpoint inhibitors are designed to treat system malignancies by targeting one of three ligands, leading to T-cell activation for attack against malignant cells. These ligands (and targeted drug) include cytotoxic T-lymphocyte antigen-4 (CTLA-4, ipilimumab), programmed death protein 1 (PD-1, pembrolizumab, nivolumab), and programmed death ligand-1 (PD-L1, atezolizumab, avelumab, durvalumab). These medications upregulate the immune system and cause autoimmune-like side effects. Ophthalmic side effects most frequently manifest as uveitis (1%) and dry eye (1-24%). Other side effects include myasthenia gravis (n = 19 reports), inflammatory orbitopathy (n = 11), keratitis (n = 3), cranial nerve palsy (n = 3), optic neuropathy (n = 2), serous retinal detachment (n = 2), extraocular muscle myopathy (n = 1), atypical chorioretinal lesions (n = 1), immune retinopathy (n = 1), and neuroretinitis (n = 1). Most inflammatory side effects are managed with topical or periocular corticosteroids, but advanced cases require systemic corticosteroids and cessation of checkpoint inhibitor therapy. Checkpoint inhibitors enhance the immune system by releasing inhibition on T cells, with risk of autoimmune-like side effects. Ophthalmologists should include immune-related adverse events in their differential when examining cancer patients with new ocular symptoms.

  5. A case report of ophthalmic artery emboli secondary to Calcium Hydroxylapatite filler injection for nose augmentation- long-term outcome.

    PubMed

    Cohen, Eyal; Yatziv, Yossi; Leibovitch, Igal; Kesler, Anat; Cnaan, Ran Ben; Klein, Ainat; Goldenberg, Dafna; Habot-Wilner, Zohar

    2016-07-08

    Filler injection for face augmentation is a common cosmetic procedure in the last decades, in our case report we describe long-term outcomes of a devastating complication of ophthalmic artery emboli following Calcium Hydroxylapatite filler injection to the nose bridge. A healthy 24-year-old women received a Calcium Hydroxylapatite filler injection to her nose bridge for the correction of nose asymmetry 8 years post rhinoplasty. She developed sudden right eye ocular pain and visual disturbances. Visual acuity was 20/20 in both eyes and visual field in the right eye showed inferior arch with fixation sparing and supero-temporal central scotoma. Examination revealed marked periorbital edema and hematoma, ptosis, ocular movements limitation, an infero-temporal branch retinal artery occlusion and multiple choroidal emboli. Eighteen months post initial presentation ptosis and eye movements returned normal and choroidal emboli absorbed almost completely. However, visual acuity declined to 20/60, visual field showed severe progressive deterioration with a central and supero-nasal field remnant and the optic disc became pallor. Cosmetic injection of calcium hydroxylapatite to the nose bridge can result in arterial emboli to the ophthalmic system with optic nerve, retinal and choroidal involvement causing long term severe visual acuity and visual field impairment.

  6. A fluid-structure interaction model of the internal carotid and ophthalmic arteries for the noninvasive intracranial pressure measurement method.

    PubMed

    Misiulis, Edgaras; Džiugys, Algis; Navakas, Robertas; Striūgas, Nerijus

    2017-05-01

    Accurate and clinically safe measurements of intracranial pressure (ICP) are crucial for secondary brain damage prevention. There are two methods of ICP measurement: invasive and noninvasive. Invasive methods are clinically unsafe; therefore, safer noninvasive methods are being developed. One of the noninvasive ICP measurement methods implements the balance principle, which assumes that if the velocity of blood flow in both ophthalmic artery segments - the intracranial (IOA) and extracranial (EOA) - is equal, then the acting ICP on the IOA and the external pressure (Pe) on the EOA are also equal. To investigate the assumption of the balance principle, a generalized computational model incorporating a fluid-structure interaction (FSI) module was created and used to simulate noninvasive ICP measurement by accounting for the time-dependent behavior of the elastic internal carotid (ICA) and ophthalmic (OA) arteries and their interaction with pulsatile blood flow. It was found that the extra balance pressure term, which incorporates the hydrodynamic pressure drop between measurement points, must be added into the balance equation, and the corrections on a difference between the velocity of blood flow in the IOA and EOA must be made, due to a difference in the blood flow rate. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Development and validation of a stability-indicating high performance liquid chromatographic assay for benoxinate.

    PubMed

    Chorny, Michael; Levy, Daniel; Schumacher, Ilana; Lichaa, Chaim; Gruzman, Boris; Livshits, Oleg; Lomnicky, Yossi

    2003-04-24

    Benoxinate is a local anaesthetic used for ophthalmic applications. The aim of this study was to develop a rapid and simple stability-indicating method for the determination of benoxinate formulated for ophthalmic use, evaluate its long-term stability and identify its major degradation product. Benoxinate was eluted on a 10 microm Spherisorb phenyl column, 250 x 3.2 mm, with a mobile phase consisting of acetonitrile-buffer (pH 3.5) (35:65, v/v), pumped at 0.8 ml min(-1) flow rate. The buffer was composed of sodium dihydrogen phosphate (50 mM), sodium hydrogen sulfate (2.5 mM) and 1-heptanesulfonic acid sodium salt (5 mM). The analyte was quantified spectrophotometrically at 308 nm. The chromatograms of benoxinate formulations obtained by this method showed benoxinate (t = 4.5 min) well resolved from its degradation product (t = 2.3 min), which was separately identified by means of HPLC-MS as 4-amino-3-butoxybenzoic acid. The assay was demonstrated to have high accuracy, precision and linearity. The method was implemented in investigating the long-term stability of benoxinate 0.4% ophthalmic solutions. The method was found to be simple, quick and selective in determining benoxinate concentrations in fresh and aged preparations.

  8. Preparation and In Vitro/Ex Vivo Evaluation of Moxifloxacin-Loaded PLGA Nanosuspensions for Ophthalmic Application.

    PubMed

    Mudgil, Meetali; Pawar, Pravin K

    2013-01-01

    The aim of the present investigation was to prepare a colloidal ophthalmic formulation to improve the residence time of moxifloxacin. Moxifloxacin-loaded poly(dl-lactide-co-glycolide) (PLGA) nanosuspensions were prepared by using the solvent evaporation technique. The nanosuspensions were characterised physically by using different techniques like particle size, zeta potential, FTIR, DSC, and XRD analysis. In vitro and ex vivo studies of nanosuspensions were carried out using a modified USP dissolution apparatus and all-glass Franz diffusion cells, respectively. The antibacterial activities of the nanosuspension and marketed formulations were performed against S. aureus and P. aeroginosa. The moxifloxacin-loaded PLGA nanosuspensions showed uniform particle size, ranging between 164-490 nm with negative zeta potential for all batches. The percentage entrapment efficiency of the drug-loaded nano-suspension was found to be between 84.09 to 92.05%. In vitro drug release studies suggest that all of the formulations showed extended drug release profiles and follow Korsemeyer-Peppas release kinetics. In vitro corneal permeability was found to be comparable with that of the marketed formulation across isolated goat cornea, indicating the suitability of the nanosuspension formulation in the ophthalmic delivery of moxifloxacin. The optimised nano-suspension was found to be more active against S. aureus and P. aeruginosa compared to the marketed eye drops.

  9. The Rule of Five for Non-Oral Routes of Drug Delivery: Ophthalmic, Inhalation and Transdermal

    PubMed Central

    Choy, Young Bin; Prausnitz, Mark R.

    2011-01-01

    The Rule of Five predicts suitability of drug candidates, but was developed primarily using orally administered drugs. Here, we test whether the Rule of Five predicts drugs for delivery via non-oral routes, specifically ophthalmic, inhalation and transdermal. We assessed 111 drugs approved by FDA for those routes of administration and found that >98% of current non-oral drugs have physicochemical properties within the limits of the Rule of Five. However, given the inherent bias in the dataset, this analysis was not able to assess whether drugs with properties outside those limits are poor candidates. Indeed, further analysis indicates that drugs well outside the Rule of Five limits, including hydrophilic macromolecules, can be delivered by inhalation. In contrast, drugs currently administered across skin fall within more stringent limits than predicted by the Rule of Five, but new transdermal delivery technologies may make these constraints obsolete by dramatically increasing skin permeability. The Rule of Five does appear to apply well to ophthalmic delivery. We conclude that although current non-oral drugs mostly have physicochemical properties within the Rule of Five thresholds, the Rule of Five should not be used to predict non-oral drug candidates, especially for inhalation and transdermal routes. PMID:20967491

  10. Identification of leachable impurities in an ophthalmic drug product originating from a polymer additive Irganox 1010 using mass spectroscopy.

    PubMed

    Singh, Gagandeep; Gollapalli, Ramarao; Blinder, Alejandro; Patel, Milan

    2018-04-15

    Pharmaceutical packaging employs a wide variety of polymers owing to their desirable features, but the compounds that could leach from the polymers into the drug products can pose serious health risks. Therefore, it is extremely important to identify such compounds so that they can be adequately quantified and evaluated for toxicological impact/safety assessments. Not only the polymer components and the additives should be considered as sources for leachable impurities, their reaction/degradation products should also be evaluated. Irganox 1010 is a common commercial antioxidant (polymer additive) used in the manufacturing of polyolefin materials for container closure systems. In our study, we identified two Irganox1010 related leachable impurities in an ophthalmic drug product using rapid and straightforward orthogonal mass spectroscopy (LC-MS and GC-MS) methods The identified impurities were 7,9-Di-tert-butyl-1 oxaspiro[4.5]deca-6,9-diene-2,8-dione and 3-[3,5-bis(tert-butyl)-1-hydroxy-4-oxocyclohexa-2,5-dienyl]propanoic acid which leached into the ophthalmic drug solution during storage. The analytical methods employed could potentially be used to identify the similar class of compounds as is or in drug products. Copyright © 2018 Elsevier B.V. All rights reserved.

  11. [The specific features of Doppler ultrasound study of ophthalmic vessels in young persons with peripheral vitreochorioretinal dystrophies].

    PubMed

    Pozdeeva, O G

    2005-01-01

    Hemodynamic parameters were studied in the ophthalmic artery, short posterior ciliary arteries (SPCA), long posterior ciliary arteries (LPCA), and central artery of the retina (CAR). Doppler ultrasound study (DUSS) was performed on an Acuson Aspen multipurpose diagnostic system using a linear transducer at a frequency of 7.5 MHz in the pulse mode. Chelyabinsk students aged 17-25 years were examined. A number of specific features of retinal blood supply were detected in young persons with dystrophic diseases of the periphery of the fundus oculi. These included decreased blood flow velocities and less systolic flow acceleration time in SPCA, LPCA, and CAR in peripheral vitreochorioretinal dystrophies (PVCRD). The higher pulsatile index (PI) in the LPCA system characterized a possible mechanism responsible for compensation of impaired blood supply in the retinal periphery in the development of PVCRD. The high values of the pulsatile index and the vascular wall resistivity index in CAR reflected the changes determining the absence of complications as retinal ruptures and detachment. There were neither changes in ophthalmic arterial blood flow depending on the type of PVCRD and the nature of its course nor significant differences in blood supply to the eye in different types of refraction.

  12. The effects of 2% rebamipide ophthalmic solution on the tear functions and ocular surface of the superoxide dismutase-1 (sod1) knockout mice.

    PubMed

    Ohguchi, Takeshi; Kojima, Takashi; Ibrahim, Osama M; Nagata, Taeko; Shimizu, Takahiko; Shirasawa, Takuji; Kawakita, Tetsuya; Satake, Yoshiyuki; Tsubota, Kazuo; Shimazaki, Jun; Ishida, Susumu

    2013-11-21

    To investigate the efficacy of 2% rebamipide ophthalmic solution on the tear functions and ocular surface status of the superoxide dismutase-1(Sod1(-/-)) mice. Two percent Rebamipide ophthalmic solution was applied to 40-week-old male Sod1(-/-) and wild-type (WT) mice four times a day for 2 weeks. We examined the cytokine concentrations in the tear fluid (by CytoBead assay), tear film break-up time, amount of tear production, and expressions of mucins 1, 4, and 5AC, by RT-PCR. We also performed vital staining of the ocular surface, PAS staining for muc5AC, and immunohistochemical stainings for 4-hydroxy-2-nonenal (4-HNE), 8-hydroxy-2'-deoxyguanosine (8-OHdG), in the conjunctiva to compare the results before and after rebamipide instillations. The tear functions and ocular surface epithelial damage scores were significantly worse in the Sod1(-/-) than in the WT mice. Application of 2% rebamipide for 2 weeks significantly improved the tear film break-up time, the amount of tear production, and the corneal epithelial damage scores, which also significantly increased the conjunctival goblet cell density and muc5 mRNA expression, in the Sod1(-/-) mice. The mean IL-6, IL-17, TNF-α, and IFN-γ levels in the tear fluid were reduced significantly along with a significant decrease in the density of cells positive for 4-HNE and 8-OHdG in the conjunctiva. Two percent Rebamipide ophthalmic solution significantly improved the tear stability and corneal epithelial damage, and enhanced the expression of muc5 mRNA on the ocular surface. We also observed anti-inflammatory effects in the tear film together with antioxidative effects in the conjunctiva, suggesting the efficacy of rebamipide in age-related dry eye disease attributable to SOD1 knockout.

  13. Effectiveness and relevant factors of 2% rebamipide ophthalmic suspension treatment in dry eye.

    PubMed

    Ueda, Kaori; Matsumiya, Wataru; Otsuka, Keiko; Maeda, Yoshifumi; Nagai, Takayuki; Nakamura, Makoto

    2015-06-06

    Rebamipide with mucin secretagogue activity was recently approved for the treatment of dry eye. The efficacy and safety in the treatment of rebamipide were shown in two pivotal clinical trials. It was the aim of this study to evaluate the effect of 2% rebamipide ophthalmic suspension in patients with dry eye and analyze relevant factors for favorable effects of rebamipide in clinical practice. This was a retrospective cohort study of 48 eyes from 24 patients with dry eye treated with 2% rebamipide ophthalmic suspension. Dry eye-related symptom score, tear film break-up time (TBUT), fluorescein ocular surface staining score (FOS) and the Schirmer test were used to collect the data from patients at baseline, and at 2, 4, 8, and 12 week visits. To determine the relevant factors, multiple regression analyses were then performed. Mean dry eye-related symptom score showed a significant improvement from the baseline (14.5 points) at 2, 4, 8 and 12 weeks (9.80, 7.04, 7.04 and 7.83 points, corrected P value < 0.001, respectively). Median FOS showed a significant improvement from the baseline (3.0 points) at 2, 4, 8 and 12 weeks (2.0, 2.0, 1.0 and 1.0 points, corrected P value < 0.001, respectively). TBUT and Schirmer test values were not significantly improved after the treatment. For ocular symptoms, three parameters (foreign body sensation, dry eye sensation and ocular discomfort) showed significant improvements at all visits. The multiple regression analyses showed that the fluorescein conjunctiva staining score was significantly correlated with the changes of dry eye-related symptom score at 12 weeks (P value = 0.017) and dry eye-related symptom score was significantly correlated with independent variables for the changes of FOS at 12 weeks (P value = 0.0097). Two percent rebamipide ophthalmic suspension was an effective therapy for dry eye patients. Moreover the fluorescein conjunctiva staining score and dry eye-related symptom score might be good relevant factors for favorable effects of rebamipide.

  14. Double-masked, randomized, dose-response study of AR-13324 versus latanoprost in patients with elevated intraocular pressure.

    PubMed

    Bacharach, Jason; Dubiner, Harvey B; Levy, Brian; Kopczynski, Casey C; Novack, Gary D

    2015-02-01

    AR-13324 is a small-molecule inhibitor of Rho kinase and a norepinephrine transporter. The objective of this 28-day study was to evaluate the ocular hypotensive efficacy and safety of AR-13324 ophthalmic solution compared with a positive control, latanoprost ophthalmic solution, in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT). Double-masked, randomized study in 22 private practice ophthalmology clinics. Participants were required to be adults with a diagnosis of OAG or OHT with unmedicated intraocular pressure (IOP) in the range of 22 to 36 mmHg. Patients were randomized to receive AR-13324 ophthalmic solution 0.01%, daily (pm), AR-13324 ophthalmic solution 0.02% daily (pm), or latanoprost 0.005% daily (pm) for 28 days. The primary efficacy endpoint was the mean diurnal IOP across subjects within the treatment group at day 28. Randomized and treated were 224 patients, 213 (95.1%) of whom completed the study. On day 28, mean diurnal IOP was 20.1, 20.0, and 18.7 mmHg in the AR-13324 0.01%, 0.02%, and latanoprost groups, respectively, representing a decrease from unmedicated baseline of 5.5, 5.7, and 6.8 mmHg (P<0.001). The 5.7-mmHg reduction in IOP by AR-13324 0.02% did not meet the criterion for noninferiority to latanoprost. The most frequently reported adverse event was conjunctival/ocular hyperemia, with a combined incidence of 52%, 57%, and 16%, respectively. On day 28 at 08:00 hours, the incidence of mild to moderate hyperemia by biomicroscopy was 18%, 24%, and 11%, respectively. AR-13324 0.02% was less effective than latanoprost by approximately 1 mmHg in patients with unmedicated IOPs of 22 to 35 mmHg. The major safety finding was ocular hyperemia, which was more common for both concentrations of AR-13324 than for latanoprost. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  15. Ocular findings and reference values for selected ophthalmic diagnostic tests in the macaroni penguin (Eudyptes chrysolophus) and southern rockhopper penguin (Eudyptes chrysocome).

    PubMed

    Bliss, Cassandra D; Aquino, Susette; Woodhouse, Sarah

    2015-01-01

    To describe ophthalmic examination findings and standard diagnostic test results in 2 penguin species. Macaroni & Southern Rockhopper Penguins. Complete ophthalmic examinations including Schirmer tear test (STT), modified phenol red thread test (PTT), tonometry, and echobiometry were performed on penguins housed at the Detroit Zoo. Mean and standard deviation of ophthalmic tests are reported and compared for significance using two sample t-tests with significance set at P < 0.05. Correlations between variables were assessed using Pearson's correlation coefficient. Cataracts were the most common finding, present in 64% of Macaroni Penguins, and 68% of Rockhopper Penguins. There were anterior segment anomalies in all eyes with cataracts consistent with lens-induced uveitis. The mean modified PTT for the Macaronis was 24.7 ± 6.37 mm/15 s and 25.1 ± 7.07 mm/15 s in the Rockhoppers. The mean STT value for the Macaronis was 12.1 ± 5.43 mm/min and 11.0 ± 3.96 mm/min in the Rockhoppers. Mean intraocular pressure (IOP) for the Macaronis was 21.9 ± 7.05 mmHg measured by applanation tonometry and 29.1 ± 7.16 mmHg using rebound tonometry. The Rockhoppers had a mean IOP of 20.0 ± 5.77 mmHg and 24.1 ± 5.09 mmHg for applanation and rebound tonometry, respectively. In both populations, there was a significant difference in IOP measurement between the two instruments. In the Macaroni penguins, the presence of cataracts correlated significantly with increased age and lower IOP readings. Anterior chamber distance and axial globe length were significantly greater in males than in females in both penguin species. © 2013 American College of Veterinary Ophthalmologists.

  16. Development of an Aqueous Ophthalmic Solution with an Enhanced-Solubility Enrofloxacin Crystal, and its Clinical Evaluation in Dogs.

    PubMed

    Miranda-Calderon, Jorge E; Gutierrez, Lilia; Ocampo, Luis; Garcia-Gutierrez, Ponciano; Tapia, Graciela; Sumano, Hector

    2018-01-01

    The concern about the frequent use of ciprofloxacin in veterinary medicine is linked to increased antimicrobial resistance. The corresponding fluoroquinolone for veterinary use is enrofloxacin. A new solvate form of enrofloxacin, as dihydrate-hydrochloride (enro-C) with higher water solubility than the parent compound, was formulated as an ophthalmic solution (pH 5). A multicentre, longitudinal, non-inferiority clinical study in a non-hospital environment was designed to treat 36 dogs affected by tobramycin-unresponsive conjunctivitis with either the experimental 0.5% enro-C ophthalmic preparation (enro-CG) or a commercial preparation of ciprofloxacin (cipro-G). Other causes of conjunctivitis were ruled out. Pathogens were isolated and minimum inhibitory concentration (MIC) studies of tobramycin were carried out. Three blocks of bacterial resistance were set up, beginning at the established breakpoint i.e., 4 µg/mL; 8 µg/mL and 16 µg/mL. Eighteen dogs were randomly assigned to each block. The enro-CG group was treated with two drops of the referred preparation (10 mg/eye) twice a day for 7 days, and the cipro-G group was treated with four drops of a 0.3% commercially available ciprofloxacin eye-drop preparation (9 mg/eye) twice a day, also for 7 days. Clinical and bacteriological cure rates were evaluated. Enro-C-treated dogs achieved a clinical cure one day earlier than ciprofloxacin-treated dogs, and unlike this latter group, enro-CG achieved bacteriological cure in all cases. No side effects were observed in either group, but dogs treated with enro-C showed no discomfort, allowing easier treatment-compliance. This is the first study reported on the successful formulation of enrofloxacin as an ophthalmic solution. Clinical assessment reveals outstanding clinical efficacy. It is necessary to conduct further research on clinical efficacy and toxicity, with the chronic use of this preparation under different clinical challenges. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  17. Flow Diversion versus Standard Endovascular Techniques for the Treatment of Unruptured Carotid-Ophthalmic Aneurysms.

    PubMed

    Di Maria, F; Pistocchi, S; Clarençon, F; Bartolini, B; Blanc, R; Biondi, A; Redjem, H; Chiras, J; Sourour, N; Piotin, M

    2015-12-01

    Over the past few years, flow diversion has been increasingly adopted for the treatment of intracranial aneurysms, especially in the paraclinoid and paraophthalmic carotid segment. We compared clinical and angiographic outcomes and complication rates in 2 groups of patients with unruptured carotid-ophthalmic aneurysms treated for 7 years by either standard coil-based techniques or flow diversion. From February 2006 to December 2013, 162 unruptured carotid-ophthalmic aneurysms were treated endovascularly in 138 patients. Sixty-seven aneurysms were treated by coil-based techniques in 61 patients. Flow diverters were deployed in 95 unruptured aneurysms (77 patients), with additional coiling in 27 patients. Complication rates, clinical outcome, and immediate and long-term angiographic results were retrospectively analyzed. No procedure-related deaths occurred. Four procedure-related thromboembolic events (6.6%) leading to permanent morbidity in 1 case (1.6%) occurred in the coiling group. Neurologic complications were observed in 6 patients (7.8%) in the flow-diversion group, resulting in 3.9% permanent morbidity. No statistically significant difference was found between complication (P = .9) and morbidity rates (P = .6). In the coiling group (median follow-up, 31.5 ± 24.5 months), recanalization occurred at 1 year in 23/50 (54%) aneurysms and 27/55 aneurysms (50.9%) at the latest follow-up, leading to retreatment in 6 patients (9%). In the flow-diversion group (mean follow-up, 13.5 ± 10.8 months), 85.3% (35/41) of all aneurysms were occluded after 12 months, and 74.6% (50/67) on latest follow-up. The retreatment rate was 2.1%. Occlusion rates between the 2 groups differed significantly at 12 months (P < .001) and at the latest follow-up (P < .005). Our retrospective analysis shows better long-term occlusion of carotid-ophthalmic aneurysms after use of flow diverters compared with standard coil-based techniques, without significant differences in permanent morbidity. © 2015 by American Journal of Neuroradiology.

  18. Management and outcome of topical beta-blockerinduced atrioventricular block

    PubMed Central

    Özcan, Kazım Serhan; Güngör, Barış; Tekkeşin, Ahmet İlker; Altay, Servet; Ekmekçi, Ahmet; Toprak, Ercan; Yıldırım, Ersin; Çalık, Nazmi; Alper, Ahmet Taha; Gürkan, Kadir; Erdinler, İzzet; Osmonov, Damirbek

    2015-01-01

    Summary Background Topical beta-blockers have a well-established role in the treatment of glaucoma. We aimed to investigate the outcome of patients who developed symptomatic atrioventricular (AV) block induced by topical beta-blockers. Methods All patients admitted or discharged from our institution, the Siyami Ersek Training and Research Hospital, between January 2009 and January 2013 with a diagnosis of AV block were included in the study. Subjects using ophthalmic beta-blockers were recruited and followed for permanent pacemaker requirement during hospitalisation and for three months after discontinuation of the drug. A permanent pacemaker was implanted in patients in whom AV block persisted beyond 72 hours or recurred during the follow-up period. Results A total of 1 122 patients were hospitalised with a diagnosis of AV block and a permanent pacemaker was implanted in 946 cases (84.3%) during the study period. Thirteen patients using ophthalmic beta-blockers for the treatment of glaucoma and no other rate-limiting drugs were included in the study. On electrocardiography, eight patients had complete AV block and five had high-degree AV block. The ophthalmic beta-blockers used were timolol in seven patients (55%), betaxolol in four (30%), and cartelol in two cases (15%). The mean duration of ophthalmic beta-blocker treatment was 30.1 ± 15.9 months. After drug discontinuation, in 10 patients the block persisted and a permanent pacemaker was implanted. During follow up, one more patient required pacemaker implantation. Therefore in total, pacemakers were implanted in 11 out of 13 patients (84.6%). The pacemaker implantation rate did not differ according to the type of topical beta-blocker used (p = 0.37). The presence of infra-nodal block on electrocardiography was associated with higher rates of pacemaker implantation. Conclusion Our results indicate that topical beta-blockers for the treatment of glaucoma may cause severe conduction abnormalities and when AV block occurs, pacemaker implantation is required in a high percentage of the patients. PMID:26659434

  19. Ophthalmic diagnostic tests in captive red-footed tortoises (Chelonoidis carbonaria) in Salvador, northeast Brazil.

    PubMed

    Oriá, Arianne P; Silva, Renata M Monção; Pinna, Melissa H; Oliveira, Alberto Vinícius D; Ferreira, Paulo Roberto B; Martins Filho, Emanoel F; Meneses, Iris Daniela S; Requião, Kátia G; Ofri, Ron

    2015-01-01

    The aim of this study was to establish normal ophthalmic parameters for select diagnostic tests in red-footed tortoises (Chelonoides carbonaria). A total of 52 animals, approximately 20-30 years old, were studied. Ophthalmic diagnostic tests included culturing of the normal conjunctival bacterial flora in summer and winter, evaluation of tear production using Schirmer tear test (STT) and endodontic absorbent paper point tear test in two different environmental temperatures (EAPPTT-1 at 32 °C and EAPPTT-2 at 18 °C), cytology of conjunctival cells, B-mode ultrasonography, measurement of palpebral fissure length (PFL), and applanation tonometry (in two different positions). In both seasons, Gram-positive bacteria were predominant. Median (± IQR/2) STT was 12.0 ± 3.5 mm/min, EAPPTT-1 was 15.9 ± 0.7 mm/15 s, and EAPPTT-2 was 15.4 ± 0.4 mm/min (OD) and 17.8 ± 1.0 mm/min (OS). Anterior chamber depth was 1.0 ± 0.1 mm, lens axial length was 2.3 ± 0.1 mm, vitreous chamber depth was 4.3 ± 0.2 mm, and axial globe length was 7.7 ± 0.3 mm. PFL was 11.7 ± 1.7 mm. Intraocular pressure was 11.5 ± 2.8 mmHg for males and 14.0 ± 3.5 mmHg for females (dorsoventral position) and 18.0 ± 3.2 mmHg for males and 24.1 ± 3.0 mmHg for females (ventrodorsal position with inclination of 45°). The ophthalmic parameters reported here can aid in the diagnosis of eye diseases in red-footed tortoises (Chelonoides carbonaria). © 2014 American College of Veterinary Ophthalmologists.

  20. Clinical Course of Ophthalmic Findings and Potential Influence Factors of Herpesvirus Infections: 18 Month Follow-Up of a Closed Herd of Lipizzaners

    PubMed Central

    Rushton, James O.; Kolodziejek, Jolanta; Tichy, Alexander; Nowotny, Norbert; Nell, Barbara

    2013-01-01

    Background To date the influence of herpesviruses on the development of equine ocular diseases has not been clearly determined. Objective The purpose of this study was to illustrate the course of equine ocular findings over a period of 18 months at 6 month intervals, in correlation with the results of herpesvirus detection. Methods 266 Lipizzaners in 3 federal states of Austria underwent complete ophthalmologic examination 4 times. Blood samples, nasal- and conjunctival swabs were obtained at the same time and used for the detection of the equid gammaherpesviruses EHV-2 and EHV-5 using consensus herpesvirus PCR and type-specific qPCRs. Ophthalmic findings and results of herpesvirus PCRs were recorded and statistically analysed using one-way ANOVA, and multiple logistic regression analysis to determine the influence of herpesvirus infections and other contributing factors on the presence of ophthalmic findings. Results In the first, second, third and fourth examination period 266, 261, 249 and 230 horses were included, respectively. Ophthalmic findings consistent with herpesvirus infections included conjunctival- and corneal pathologies. Statistical analysis revealed that the probability of positive herpesvirus PCR results decreased with progressing age; however the presence of corneal findings increased over time. At the time of each examination 45.1%, 41.8%, 43.0%, and 57.0% of horses with conjunctival or corneal findings, respectively, were positive for EHV-2 and/or EHV-5. However, 31.6%, 17.6%, 20.1%, and 13.0% of clinically sound horses were positive for these herpesviruses at each examination period, too. Conclusion Based on the results of our study there is a significant influence of young age on EHV-2 and/or EHV-5 infection. Corneal pathologies increased over time and with progressing age. Whether the identified findings were caused by herpesviruses could not be unequivocally determined. PMID:24278206

  1. Ultrahigh speed 1050nm swept source / Fourier domain OCT retinal and anterior segment imaging at 100,000 to 400,000 axial scans per second

    PubMed Central

    Potsaid, Benjamin; Baumann, Bernhard; Huang, David; Barry, Scott; Cable, Alex E.; Schuman, Joel S.; Duker, Jay S.; Fujimoto, James G.

    2011-01-01

    We demonstrate ultrahigh speed swept source/Fourier domain ophthalmic OCT imaging using a short cavity swept laser at 100,000–400,000 axial scan rates. Several design configurations illustrate tradeoffs in imaging speed, sensitivity, axial resolution, and imaging depth. Variable rate A/D optical clocking is used to acquire linear-in-k OCT fringe data at 100kHz axial scan rate with 5.3um axial resolution in tissue. Fixed rate sampling at 1 GSPS achieves a 7.5mm imaging range in tissue with 6.0um axial resolution at 100kHz axial scan rate. A 200kHz axial scan rate with 5.3um axial resolution over 4mm imaging range is achieved by buffering the laser sweep. Dual spot OCT using two parallel interferometers achieves 400kHz axial scan rate, almost 2X faster than previous 1050nm ophthalmic results and 20X faster than current commercial instruments. Superior sensitivity roll-off performance is shown. Imaging is demonstrated in the human retina and anterior segment. Wide field 12×12mm data sets include the macula and optic nerve head. Small area, high density imaging shows individual cone photoreceptors. The 7.5mm imaging range configuration can show the cornea, iris, and anterior lens in a single image. These improvements in imaging speed and depth range provide important advantages for ophthalmic imaging. The ability to rapidly acquire 3D-OCT data over a wide field of view promises to simplify examination protocols. The ability to image fine structures can provide detailed information on focal pathologies. The large imaging range and improved image penetration at 1050nm wavelengths promises to improve performance for instrumentation which images both the retina and anterior eye. These advantages suggest that swept source OCT at 1050nm wavelengths will play an important role in future ophthalmic instrumentation. PMID:20940894

  2. Aqueous penetration and biological activity of moxifloxacin 0.5% ophthalmic solution and gatifloxacin 0.3% solution in cataract surgery patients.

    PubMed

    Kim, Dianne H; Stark, Walter J; O'Brien, Terrence P; Dick, James D

    2005-11-01

    To measure the achievable perioperative aqueous concentration of the commercially available topically administered fourth generation fluoroquinolones, moxifloxacin 0.5% ophthalmic solution, and gatifloxacin 0.3% ophthalmic solution, and to correlate this concentration with the agents' biological efficacy in the aqueous humor of patients undergoing routine cataract surgery. Prospective, randomized, parallel, double-masked, clinical trial. Fifty patients undergoing cataract extraction. Patients (n = 25) were given perioperative topical moxifloxacin 0.5% or topical gatifloxacin 0.3% (n = 25). One drop of antibiotic was administered every 10 minutes for 4 doses beginning 1 hour prior to surgery. Aqueous humor was sampled via paracentesis and antibiotic concentrations were determined using validated high performance liquid chromatography (HPLC) procedures. Dilution analyses were performed to determine the biological efficacy of the agents in the aqueous against Staphylococcus epidermidis, the most common cause of postcataract endophthalmitis. Aqueous humor antibiotic concentrations were measured using HPLC and microdilution bioassay techniques. Biological activity was measured as minimal inhibitory dilution and minimal bactericidal dilution. Aqueous humor concentrations for moxifloxacin via HPLC analysis were 1.80 (+/-1.21) microg/ml, whereas those for gatifloxacin were 0.48 (+/-0.34) microg/ml. This 3.8-fold difference in aqueous humor antibiotic concentrations was statistically significant (P = 0.00003). Similarly, the biological dilution analysis of the aqueous humor samples showed that moxifloxacin attained an estimated activity of 2.1 microg/ml, whereas the gatifloxacin activity was approximately 0.4 mug/ml, which represented a 4.9-fold difference. This study demonstrated that after topically administered perioperative antibiotics with cataract surgery, moxifloxacin 0.5% ophthalmic solution achieved a statistically significantly higher concentration in aqueous humor compared with gatifloxacin (P = 0.00003). Results from the broth dilution analysis showed that moxifloxacin 0.5% was biologically more active against S. epidermidis than gatifloxacin 0.3% in aqueous humor after topical application. There were no adverse events reported, and incision wounds healed quickly and as expected.

  3. WE-DE-201-05: Evaluation of a Windowless Extrapolation Chamber Design and Monte Carlo Based Corrections for the Calibration of Ophthalmic Applicators

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hansen, J; Culberson, W; DeWerd, L

    Purpose: To test the validity of a windowless extrapolation chamber used to measure surface dose rate from planar ophthalmic applicators and to compare different Monte Carlo based codes for deriving correction factors. Methods: Dose rate measurements were performed using a windowless, planar extrapolation chamber with a {sup 90}Sr/{sup 90}Y Tracerlab RA-1 ophthalmic applicator previously calibrated at the National Institute of Standards and Technology (NIST). Capacitance measurements were performed to estimate the initial air gap width between the source face and collecting electrode. Current was measured as a function of air gap, and Bragg-Gray cavity theory was used to calculate themore » absorbed dose rate to water. To determine correction factors for backscatter, divergence, and attenuation from the Mylar entrance window found in the NIST extrapolation chamber, both EGSnrc Monte Carlo user code and Monte Carlo N-Particle Transport Code (MCNP) were utilized. Simulation results were compared with experimental current readings from the windowless extrapolation chamber as a function of air gap. Additionally, measured dose rate values were compared with the expected result from the NIST source calibration to test the validity of the windowless chamber design. Results: Better agreement was seen between EGSnrc simulated dose results and experimental current readings at very small air gaps (<100 µm) for the windowless extrapolation chamber, while MCNP results demonstrated divergence at these small gap widths. Three separate dose rate measurements were performed with the RA-1 applicator. The average observed difference from the expected result based on the NIST calibration was −1.88% with a statistical standard deviation of 0.39% (k=1). Conclusion: EGSnrc user code will be used during future work to derive correction factors for extrapolation chamber measurements. Additionally, experiment results suggest that an entrance window is not needed in order for an extrapolation chamber to provide accurate dose rate measurements for a planar ophthalmic applicator.« less

  4. Are ultrasound-guided ophthalmic blocks injurious to the eye? A comparative rabbit model study of two ultrasound devices evaluating intraorbital thermal and structural changes.

    PubMed

    Palte, Howard D; Gayer, Steven; Arrieta, Esdras; Scot Shaw, Eric; Nose, Izuru; Lee, Elizabete; Arheart, Kristopher L; Dubovy, Sander; Birnbach, David J; Parel, Jean-Marie

    2012-07-01

    Since Atkinson's original description of retrobulbar block in 1936, needle-based anesthetic techniques have become integral to ophthalmic anesthesia. These techniques are unfortunately associated with rare, grave complications such as globe perforation. Ultrasound has gained widespread acceptance for peripheral nerve blockade, but its translation to ocular anesthesia has been hampered because sonic energy, in the guise of thermal or biomechanical insult, is potentially injurious to vulnerable eye tissue. The US Food and Drug Administration (FDA) has defined guidelines for safe use of ultrasound for ophthalmic examination, but most ultrasound devices used by anesthesiologists are not FDA-approved for ocular application because they generate excessive energy. Regulating agencies state that ultrasound examinations can be safely undertaken as long as tissue temperatures do not increase >1.5°C above physiological levels. Using a rabbit model, we investigated the thermal and mechanical ocular effects after prolonged ultrasonic exposure to single orbital- and nonorbital-rated devices. In a dual-phase study, aimed at detecting ocular injury, the eyes of 8 rabbits were exposed to continuous 10-minute ultrasound examinations from 2 devices: (1) the Sonosite Micromaxx (nonorbital rated) and (2) the Sonomed VuMax (orbital rated) machines. In phase I, temperatures were continuously monitored via thermocouples implanted within specific eye structures (n = 4). In phase II the eyes were subjected to ultrasonic exposure without surgical intervention (n = 4). All eyes underwent light microscopy examinations, followed at different intervals by histology evaluations conducted by an ophthalmic pathologist. Temperature changes were monitored in the eyes of 4 rabbits. The nonorbital-rated transducer produced increases in ocular tissue temperature that surpassed the safe limit (increases >1.5°C) in the lens of 3 rabbits (at 5.0, 5.5, and 1.5 minutes) and cornea of 2 rabbits (both at 1.5 minutes). A secondary analysis of temporal temperature differences between the orbital-rated and nonorbital transducers revealed statistically significant differences (Bonferroni-adjusted P < 0.05) in the cornea at 3.5 minutes, the lens at 2.5 minutes, and the vitreous at 4.0 minutes. Light microscopy and histology failed to elicit ocular injury in either group. The nonorbital-rated ultrasound machine (Sonosite Micromaxx) increases the ocular tissue temperature. A larger study is needed to establish safety. Until then, ophthalmic ultrasound-guided blocks should only be performed with ocular-rated devices.

  5. Are Ultrasound-Guided Ophthalmic Blocks Injurious to the Eye? A Comparative Rabbit Model Study of Two Ultrasound Devices Evaluating Intraorbital Thermal and Structural Changes

    PubMed Central

    Palte, Howard D.; Gayer, Steven; Arrieta, Esdras; Shaw, Eric Scot; Nose, Izuru; Lee, Elizabete; Arheart, Kristopher L.; Dubovy, Sander; Birnbach, David J.; Parel, Jean-Marie

    2012-01-01

    Background Since Atkinson’s original description of retrobulbar block in 1936, needle-based anesthetic techniques have become integral to ophthalmic anesthesia. These techniques are unfortunately associated with rare, grave complications such as globe perforation. Ultrasound has gained widespread acceptance for peripheral nerve blockade but its translation to ocular anesthesia has been hampered because sonic energy, in the guise of thermal or biomechanical insult, is potentially injurious to vulnerable eye tissue. The United States Food and Drug Administration have defined guidelines for safe use of ultrasound for ophthalmic examination but most ultrasound devices used by anesthesiologists are not Food and Drug Administration-approved for ocular application because they generate excessive energy. Regulating agencies state that ultrasound examination can be safely undertaken as long as tissue temperatures do not increase >1.5°C above physiological levels. Methods Using a rabbit model, we investigated the thermal and mechanical ocular effects after prolonged ultrasonic exposure to single orbital and non-orbital-rated devices. In a dual-phase study, aimed at detecting ocular injury, the eyes of 8 rabbits were exposed to continuous 10-minute ultrasound examinations from two devices: 1) the Sonosite Micromaxx (non-orbital-rated) and 2) the Sonomed VuMax (orbital-rated) machines. In Phase I temperatures were continuously monitored via thermocouples implanted within specific eye structures (n=4). In Phase II the eyes were subjected to ultrasonic exposure without surgical intervention (n=4). All eyes underwent light microscopy examinations followed, at different intervals, by histology evaluations conducted by an ophthalmic pathologist. Results Temperature changes were monitored in the eyes of four rabbits. The non-orbital-rated transducer produced increases in ocular tissue temperature that surpassed the safe limit (increases> 1.50C ) in the lens of three rabbits (at 5.0, 5.5 and 1.5 minutes) and cornea of two rabbits (both at 1.5 minutes). A secondary analysis of temporal temperature differences between the orbital-rated and non-orbital transducers revealed statistically significant differences (Bonferroni-adjusted p < 0.05) in the cornea at 3.5 minutes, the lens at 2.5 minutes and the vitreous at 4.0 minutes. Light microscopy and histology failed to elicit ocular injury in either group. Conclusions The non-orbital-rated ultrasound machine (Sonosite Micromaxx) increases the ocular tissue temperature. A larger study is needed to establish safety. Until then, ophthalmic blocks performed with ultrasound should be performed only with ocular-rated devices. PMID:22504211

  6. Comparison of ophthalmic sponges and extraction buffers for quantifying cytokine profiles in tears using Luminex technology

    PubMed Central

    Inic-Kanada, Aleksandra; Nussbaumer, Andrea; Montanaro, Jacqueline; Belij, Sandra; Schlacher, Simone; Stein, Elisabeth; Bintner, Nora; Merio, Margarethe; Zlabinger, Gerhard J.

    2012-01-01

    Purpose Evaluating cytokine profiles in tears could shed light on the pathogenesis of various ocular surface diseases. When collecting tears with the methods currently available, it is often not possible to avoid the tear reflex, which may give a different cytokine profile compared to basal tears. More importantly, tear collection with glass capillaries, the most widely used method for taking samples and the best method for avoiding tear reflex, is impractical for remote area field studies because it is tedious and time-consuming for health workers, who cannot collect tears from a large number of patients with this method in one day. Furthermore, this method is uncomfortable for anxious patients and children. Thus, tears are frequently collected using ophthalmic sponges. These sponges have the advantage that they are well tolerated by the patient, especially children, and enable standardization of the tear collection volume. The aim of this study was to compare various ophthalmic sponges and extraction buffers to optimize the tear collection method for field studies for subsequent quantification of cytokines in tears using the Luminex technology. Methods Three ophthalmic sponges, Merocel, Pro-ophta, and Weck-Cel, were tested. Sponges were presoaked with 25 cytokines/chemokines of known concentrations and eluted with seven different extraction buffers (EX1–EX7). To assess possible interference in the assay from the sponges, two standard curves were prepared in parallel: 1) cytokines of known concentrations with the extraction buffers and 2) cytokines of known concentrations loaded onto the sponges with the extraction buffers. Subsequently, a clinical assessment of the chosen sponge-buffer combination was performed with tears collected from four healthy subjects using 1) aspiration and 2) sponges. To quantify cytokine/chemokine recovery and the concentration in the tears, a 25-plex Cytokine Panel and the Luminex xMap were used. This platform enables simultaneous measurement of proinflammatory cytokines, Th1/Th2 distinguishing cytokines, nonspecific acting cytokines, and chemokines. Results We demonstrated the following: (i) 25 cytokines/chemokines expressed highly variable interactions with buffers and matrices. Several buffers enabled recovery of similar cytokine values (regulated and normal T cell expressed and secreted [RANTES], interleukin [IL]-13, IL-6, IL-8, IL-2R, and granulocyte-macrophage colony-stimulating factor [GM-CSF]); others were highly variable (monocyte chemotactic protein-1 [MCP-1], monokine induced by interferon-gamma [MIG], IL-1β, IL-4, IL-7, and eotaxin). (ii) Various extraction buffers displayed significantly different recovery rates on the same sponge for the same cytokine/chemokine. (iii) The highest recovery rates were obtained with the Merocel ophthalmic sponge except for tumor necrosis factor-α: the Weck-Cel ophthalmic sponge showed the best results, either with cytokine standards loaded onto sponges or with tears collected from the inner canthus of the eye, using the sponge. (iv) IL-5, IL-10, and interferon-α were not detected in any tear sample from four normal human subjects. Twenty-two cytokines/chemokines that we detected were extracted from the Merocel sponge to a satisfactory recovery percentage. The recovery of IL-7 was significantly lower in the extracted Merocel sponge compared to the diluted tear samples. The cytokine/chemokine extraction from tears showed the same pattern of extraction that we observed for extracting the standards. Conclusions Simultaneous measurement of various cytokines using ophthalmic sponges yielded diverse results for various cytokines as the level of extraction differs noticeably for certain cytokines. A second set of controls (standard curves “with sponges”) should be used to delineate the extent of extraction for each cytokine to be analyzed. Many cytokines/chemokines were detected in tear samples collected with the Merocel sponge, including many that have been implicated in ocular surface disease. Luminex detection of cytokine/chemokine profiles of tears collected with Merocel sponges and extracted with buffer EX1 may be useful in clinical studies, for example, to assess cytokine profiles evaluation in ocular surface diseases. PMID:23233782

  7. Comparison of ophthalmic sponges and extraction buffers for quantifying cytokine profiles in tears using Luminex technology.

    PubMed

    Inic-Kanada, Aleksandra; Nussbaumer, Andrea; Montanaro, Jacqueline; Belij, Sandra; Schlacher, Simone; Stein, Elisabeth; Bintner, Nora; Merio, Margarethe; Zlabinger, Gerhard J; Barisani-Asenbauer, Talin

    2012-01-01

    Evaluating cytokine profiles in tears could shed light on the pathogenesis of various ocular surface diseases. When collecting tears with the methods currently available, it is often not possible to avoid the tear reflex, which may give a different cytokine profile compared to basal tears. More importantly, tear collection with glass capillaries, the most widely used method for taking samples and the best method for avoiding tear reflex, is impractical for remote area field studies because it is tedious and time-consuming for health workers, who cannot collect tears from a large number of patients with this method in one day. Furthermore, this method is uncomfortable for anxious patients and children. Thus, tears are frequently collected using ophthalmic sponges. These sponges have the advantage that they are well tolerated by the patient, especially children, and enable standardization of the tear collection volume. The aim of this study was to compare various ophthalmic sponges and extraction buffers to optimize the tear collection method for field studies for subsequent quantification of cytokines in tears using the Luminex technology. Three ophthalmic sponges, Merocel, Pro-ophta, and Weck-Cel, were tested. Sponges were presoaked with 25 cytokines/chemokines of known concentrations and eluted with seven different extraction buffers (EX1-EX7). To assess possible interference in the assay from the sponges, two standard curves were prepared in parallel: 1) cytokines of known concentrations with the extraction buffers and 2) cytokines of known concentrations loaded onto the sponges with the extraction buffers. Subsequently, a clinical assessment of the chosen sponge-buffer combination was performed with tears collected from four healthy subjects using 1) aspiration and 2) sponges. To quantify cytokine/chemokine recovery and the concentration in the tears, a 25-plex Cytokine Panel and the Luminex xMap were used. This platform enables simultaneous measurement of proinflammatory cytokines, Th1/Th2 distinguishing cytokines, nonspecific acting cytokines, and chemokines. WE DEMONSTRATED THE FOLLOWING: (i) 25 cytokines/chemokines expressed highly variable interactions with buffers and matrices. Several buffers enabled recovery of similar cytokine values (regulated and normal T cell expressed and secreted [RANTES], interleukin [IL]-13, IL-6, IL-8, IL-2R, and granulocyte-macrophage colony-stimulating factor [GM-CSF]); others were highly variable (monocyte chemotactic protein-1 [MCP-1], monokine induced by interferon-gamma [MIG], IL-1β, IL-4, IL-7, and eotaxin). (ii) Various extraction buffers displayed significantly different recovery rates on the same sponge for the same cytokine/chemokine. (iii) The highest recovery rates were obtained with the Merocel ophthalmic sponge except for tumor necrosis factor-α: the Weck-Cel ophthalmic sponge showed the best results, either with cytokine standards loaded onto sponges or with tears collected from the inner canthus of the eye, using the sponge. (iv) IL-5, IL-10, and interferon-α were not detected in any tear sample from four normal human subjects. Twenty-two cytokines/chemokines that we detected were extracted from the Merocel sponge to a satisfactory recovery percentage. The recovery of IL-7 was significantly lower in the extracted Merocel sponge compared to the diluted tear samples. The cytokine/chemokine extraction from tears showed the same pattern of extraction that we observed for extracting the standards. Simultaneous measurement of various cytokines using ophthalmic sponges yielded diverse results for various cytokines as the level of extraction differs noticeably for certain cytokines. A second set of controls (standard curves "with sponges") should be used to delineate the extent of extraction for each cytokine to be analyzed. Many cytokines/chemokines were detected in tear samples collected with the Merocel sponge, including many that have been implicated in ocular surface disease. Luminex detection of cytokine/chemokine profiles of tears collected with Merocel sponges and extracted with buffer EX1 may be useful in clinical studies, for example, to assess cytokine profiles evaluation in ocular surface diseases.

  8. Prednisolone Ophthalmic

    MedlinePlus

    Poly-Pred® (as a combination product containing Neomycin, Polymyxin B, Prednisolone) ... the following symptom, call your doctor immediately: eye pain If you experience a serious side effect, you ...

  9. Bacitracin Ophthalmic

    MedlinePlus

    ... of medications called antibiotics. It works by killing bacteria that cause infections. ... infection may not be completely cured and the bacteria may become resistant to antibiotics.To use the ...

  10. Ciprofloxacin Ophthalmic

    MedlinePlus

    ... antibiotics called fluoroquinolones. It works by killing the bacteria that cause infection. ... infection may not be completely cured and the bacteria may become resistant to antibiotics.To instill the ...

  11. Besifloxacin Ophthalmic

    MedlinePlus

    ... medications called fluoroquinolones. It works by killing the bacteria that cause infection. ... infection may not be completely treated and the bacteria may become resistant to antibiotics.When you use ...

  12. Standard eye exam

    MedlinePlus

    Standard ophthalmic exam; Routine eye examination; Eye exam - standard; Annual eye exam ... Comprehensive adult medical eye evaluation preferred practice pattern guidelines. Ophthalmology . 2016;123(1):209-236. PMID: 26581558 ...

  13. A New Generation Fiber Optic Probe: Characterization of Biological Fluids, Protein Crystals and Ophthalmic Diseases

    NASA Technical Reports Server (NTRS)

    Ansari, Rafat R.; Suh, Kwang I.

    1996-01-01

    A new fiber optic probe developed for determining transport properties of sub-micron particles in fluids experiments in a microgravity environment has been applied to characterize particulate dispersions/suspensions in various challenging environments which have been hitherto impossible. The probe positioned in front of a sample delivers a low power light (few nW - 3mW) from a laser and guides the light which is back scattered by the suspended particles through a receiving optical fiber to a photo detector and to a digital correlator. The probe provides rapid determination of macromolecular diffusivities and their respective size distributions. It has been applied to characterize various biological fluids, protein crystals, and ophthalmic diseases.

  14. Ophthalmic laser system integrated with speckle variance optical coherence tomography for real-time temperature monitoring

    NASA Astrophysics Data System (ADS)

    Lee, Soohyun; Lee, Changho; Cheon, Gyeongwoo; Kim, Jongmin; Jo, Dongki; Lee, Jihoon; Kang, Jin U.

    2018-02-01

    A commercial ophthalmic laser system (R;GEN, Lutronic Corp) was integrated with a swept-source optical coherence tomography (OCT) imaging system for real-time tissue temperature monitoring. M-scan OCT images were acquired during laser-pulse radiation, and speckle variance OCT (svOCT) images were analyzed to deduce temporal signal variations related to tissue temperature change from laser-pulse radiation. A phantom study shows that svOCT magnitude increases abruptly after laser pulse radiation and recovered exponentially, and the peak intensity of svOCT image was linearly dependent on pulse laser energy until it saturates. A study using bovine iris also showed signal variation dependence on the laser pulse radiation, and the variation was more distinctive with higher energy level.

  15. Kindler syndrome.

    PubMed

    Sharma, Ramesh Chander; Mahajan, Vikram; Sharma, Nand Lal; Sharma, Ashok K

    2003-09-01

    Kindler syndrome is a rare genodermatosis characterized by acral bullae and photosensitivity. The photosensitivity improves with advancing age and results in progressive poikiloderma and cutaneous atrophy, and many additional features have also been described. This report describes two male Kindler syndrome patients with classical features of acral blistering and photosensitivity in childhood, and subsequent development of poikiloderma, leukokeratosis of oro-ano-genital mucosae, phimosis and meatal stenosis. The first patient had additional ophthalmic features of chronic simple conjunctivitis caused by persistent irritation, multiple stromal nebular corneal opacities and thickened corneal nerves. The second patient showed skeletal changes, namely a dome-shaped skull (turri-cephaly), bifid fourth rib, missing fifth rib, short fourth and fifth metacarpals and mandibular abnormalities. This is the first report of such ophthalmic and skeletal features of Kindler syndrome.

  16. Automatic segmentation of closed-contour features in ophthalmic images using graph theory and dynamic programming.

    PubMed

    Chiu, Stephanie J; Toth, Cynthia A; Bowes Rickman, Catherine; Izatt, Joseph A; Farsiu, Sina

    2012-05-01

    This paper presents a generalized framework for segmenting closed-contour anatomical and pathological features using graph theory and dynamic programming (GTDP). More specifically, the GTDP method previously developed for quantifying retinal and corneal layer thicknesses is extended to segment objects such as cells and cysts. The presented technique relies on a transform that maps closed-contour features in the Cartesian domain into lines in the quasi-polar domain. The features of interest are then segmented as layers via GTDP. Application of this method to segment closed-contour features in several ophthalmic image types is shown. Quantitative validation experiments for retinal pigmented epithelium cell segmentation in confocal fluorescence microscopy images attests to the accuracy of the presented technique.

  17. Automatic segmentation of closed-contour features in ophthalmic images using graph theory and dynamic programming

    PubMed Central

    Chiu, Stephanie J.; Toth, Cynthia A.; Bowes Rickman, Catherine; Izatt, Joseph A.; Farsiu, Sina

    2012-01-01

    This paper presents a generalized framework for segmenting closed-contour anatomical and pathological features using graph theory and dynamic programming (GTDP). More specifically, the GTDP method previously developed for quantifying retinal and corneal layer thicknesses is extended to segment objects such as cells and cysts. The presented technique relies on a transform that maps closed-contour features in the Cartesian domain into lines in the quasi-polar domain. The features of interest are then segmented as layers via GTDP. Application of this method to segment closed-contour features in several ophthalmic image types is shown. Quantitative validation experiments for retinal pigmented epithelium cell segmentation in confocal fluorescence microscopy images attests to the accuracy of the presented technique. PMID:22567602

  18. Neuroimaging in ophthalmology

    PubMed Central

    Kim, James D.; Hashemi, Nafiseh; Gelman, Rachel; Lee, Andrew G.

    2012-01-01

    In the past three decades, there have been countless advances in imaging modalities that have revolutionized evaluation, management, and treatment of neuro-ophthalmic disorders. Non-invasive approaches for early detection and monitoring of treatments have decreased morbidity and mortality. Understanding of basic methods of imaging techniques and choice of imaging modalities in cases encountered in neuro-ophthalmology clinic is critical for proper evaluation of patients. Two main imaging modalities that are often used are computed tomography (CT) and magnetic resonance imaging (MRI). However, variations of these modalities and appropriate location of imaging must be considered in each clinical scenario. In this article, we review and summarize the best neuroimaging studies for specific neuro-ophthalmic indications and the diagnostic radiographic findings for important clinical entities. PMID:23961025

  19. OCT Angiographic Findings in Glucose-6-Phosphate Dehydrogenase Deficiency.

    PubMed

    Jiang, Shangjun; Choudhry, Netan

    2017-08-01

    Fovea plana (FP) describes the abnormal absence of the foveal pit in the retina. It is a sign that is associated with prematurity, albinism, and other ophthalmic disorders. The authors present the optical coherence tomography angiographic findings in a case of a 19-year-old male with FP and glucose-6-phosphate dehydrogenase (G6PD) deficiency. G6PD deficiency is a very common condition that typically presents with hemolytic anemia and jaundice. G6PD deficiency is also known to affect vision, but these pathologies have been less well-characterized. To the authors' knowledge, this is the first report of G6PD deficiency in FP. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:664-667.]. Copyright 2017, SLACK Incorporated.

  20. Statistical methods for conducting agreement (comparison of clinical tests) and precision (repeatability or reproducibility) studies in optometry and ophthalmology.

    PubMed

    McAlinden, Colm; Khadka, Jyoti; Pesudovs, Konrad

    2011-07-01

    The ever-expanding choice of ocular metrology and imaging equipment has driven research into the validity of their measurements. Consequently, studies of the agreement between two instruments or clinical tests have proliferated in the ophthalmic literature. It is important that researchers apply the appropriate statistical tests in agreement studies. Correlation coefficients are hazardous and should be avoided. The 'limits of agreement' method originally proposed by Altman and Bland in 1983 is the statistical procedure of choice. Its step-by-step use and practical considerations in relation to optometry and ophthalmology are detailed in addition to sample size considerations and statistical approaches to precision (repeatability or reproducibility) estimates. Ophthalmic & Physiological Optics © 2011 The College of Optometrists.

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