Similar to TarLab osmolarity test, the InflammaDry test is quick to perform which measures and monitors a tear film component indicative of dry eyes. Elevated levels of matrix metalloproteinase-9 (MMP-9), which is a marker for inflammation found in the tears of a dry eye can be detected by inflammaDry. In the normal tear film, the level of MMP-9 is normally between 3 and 40 ng/mL. Greater level than 40 ng/mL indicates ocular surface inflammation. However as this is a nonspecific marker of inflammation, patient history and other clinical signs have to be confirmed before diagnosing dry eyes. This tool is not expensive and it’s highly portable which can be easily administered by a technician. In a recent FDA clinical trial, InflammaDry demonstrated 85% sensitivity and 94% specificity. [5].
The TearLAb device allows the practitioner to monitor and supervise the tear film’s osmolarity, which is an important factor correlated with dry eye. In normal patients tear osmolarity is low and very similar to blood osmolarity (290 milliosmoles per litter). This indicates that tears are in proper homeostasis. On the other hand, dry eye patients have elevated (> 316 mOsm/L) and unstable tear osmolarity which can vary both over time and between eyes.[4]. This test is simple and quick to perform which can be easily delegated to a consultant or a technician
This device illuminates the tear film and records and measures the interference pattern of the reflected light. This “interferogram” is then captured, monitored and analysed by software which allows the thickness of the lipid layer to be measured with nanometre accuracy. If the tear film composition is abnormal or the lipid layer is too thin, then treatment (associated LipiFlow Thermal Pulsation System) can be advised, provided the meibomian glands remain expressible. This tool offers valuable data to practitioners and it’s not difficult to perform.
OCT is, highly accurate, non-invasive and has successfully documented tear film changes in response to punctal occlusion and cyclosporine therapy. [6, 7] OCT is less affected by the reflex tearing than traditional tear film assessments as it does not require any contact with the ocular surface or use of dyes. Recent ultra-high resolution OCT is able to create a map of epithelial irregularity and quantify it. This can accurately indicate the severity of the dryness and is useful for both diagnosis and monitoring during treatment.
The EyePrim device is also very quick, painless and reliable which allows sampling of conjuctival cells which allows further analysis of those cells for markers of dry eyes.
The patient is a 43 year-old female insurance sale agent who came to the clinic for annual eye examination. She complained from symptoms of ocular irritation and burning when she wakes up in the morning. She felt ocular dryness in the afternoon and the eyes look red. She has also noted different height of her eyelids when putting make-up on. She denied significant problems with driving, TV watching, computer use or reading. She also denied flashes, floaters or diplopia. The patient was myopia with no prior eye surgeries, previous history of eye trauma, amblyopia or strabismus. She did not use any medication. The past ocular family history was negative. Social history was negative, too.
Saxena, Rohit, Diguijay Singh, and Praveen Vashist. “Glaucoma: An Emerging Peril.” Indian Journal of Community Medicine 38.3 (2013): 135-7: Proquest. Web. 7 Jan 2014.
Over-corrections occur when excess corneal tissue is removed. This complication is difficult to correct as compared to the under-corrections.
1-Day Acuvue is a more convenient and comfortable contact which leads to far better compliance compared to other lenses (Exhibit 22), reduction in ocular complications which can range from corneal abrasions to infections, fewer unscheduled visit to ECPs and higher patient satisfaction (p10). Cost and ECP recommendation would likely be the major factors a patient would consider when choosing type of disposable lens. This was evidenced by the differences in adoption between the two trials (p13). Other considerations would likely include travel frequency, activity level and ocular symptoms (p10, 13 & 22).
Injection of the intended volume of the study drug was stopped when there was fullness of the orbit and/or drooping of the upper eyelid during injection. Gentle ocular massage was done , the eye pad was removed every 2 min to assess ocular movements and the orbicular muscle. Corneal anesthesia was also evaluated using a small cotton wool at the same time intervals. To assess ocular akinesia, patients were asked to look in four directions: Lateral, medial, superior, and inferior. Ocular movement in each direction was scored as 2 if it was normal, 1 if it was limited, and 0 if there was no directional movement (total score 0–8). The patient was then asked to forcefully close his/her eyes to assess the orbicularis muscle on a scale of 0–2 (0 = complete akinesia, 1 = partial movement, 2 = pronounced
Techniques." Journal of Postgraduate Medicine 56.2 (2010): 98-102. Academic Search Premier. Web. 19 Nov. 2013.
Carol Weihrer visited an eye specialist that told her she had corneal erosion syndrome. Once she received this diagnosis, she decided she would go through treatments in order to try to better her quality of life. In 1998, she had had 17 operations but had gained no relief to her diagnosis. She then decided she would undergo an operation to remove her eye on January 14, 1998. Her troubles began that day but also led to a new journey for her. (Beck, 2005)
The diagnosis of conjunctivitis is suggested based on symptoms, history, and physical examination. The diagnosis is highly suggested in an individuals with red eye and discharge who has no visual changes or evidence of keratitis, iritis, or angle closure glaucoma. These later conditions often lead to significant eye pain and loss of vision, and are considered eye emergencies that requires urgent ophthalmologic evaluation.
20/20 with no corrections, O.D. 20/20 with no corrections. Peripheral vision is intact. Corneal light reflex is symmetric bilaterally. Extraocular movements are smooth and symmetric, with no nystagmus noted. Eyelids are symmetrical bilaterally with no drooping present. No redness, discharge, or crusting noted on lid margins bilaterally. Bulbar conjunctivas in left and right eye are pink, moist, and smooth; sclera is white. No swelling, tenderness, or redness over lacrimal gland bilaterally. Puncta is visible, without swelling or redness bilaterally. No drainage present. Cornea is transparent, smooth, and moist with no opacities bilaterally. Irises are round, flat, and evenly colored. Pupils are round, reactive to light and accommodation, 4 mm is the size bilaterally. Pupils can converge evenly. Red reflex is present bilaterally. Optic discs are creamy white in color, margins are present and retinal vessels are red in color bilaterally. Retinal background free of lesions and orange-red in color bilaterally. Unable to find macula upon
Other than that, this chart can also reduce the time taken for the measurement of visual acuity. Amblyopia is also known as lazy eyes. According to American Optometry Association (AOA), amblyopia is defined as loss or lack of development of central vision in one eye that is unrelated to any eye health problem and is not correctable with lenses. Amblyopia which occur 3%-5% is the major public health issue. It can be unilateral or bilateral and have best corrected visual acuity less than 6/6. There are several type of amblyopia for example; Strabismic Amblyopia, Anisometropic Amblyopia, Meridional Amblyopia and Bilateral Refractive Amblyopia. The major concern for this research is about Strabismic Amblyopia because it is related with the eccentric fixation. Based on the current studies, 51% of children with esotropia were found to have amblyopia compared to exotropia which is 14% (Mohney, 2001 and Mohney&Huffaker, 2003). Because of the relationship between strabismic and amblyopia, it is important to diagnose strabismus as soon as possible in order to reduce the risk of amblyopia (von Noorden
We look for capillary refill to monitor dehydration and amount of blood flow to the tissue.
Warrington, N (2013). Standard Operating Procedure: Artsana Mercury Sphygmomanometer. University of Malta Faculty of Medicine & Surgery Pharmacy Department
Ophthalmic products are intended for application to the conjunctiva, the conjunctival sac, or the eyelids .Similar to suspensions, ointments can be more difficult to formulate in sterile form. They can be terminally sterilized, or, otherwise, they must be manufactured from sterile ingredients in an aseptic atmosphere. Filtration through a suitable membrane or dry heat sterilization is often used. The ointment base chosen for an ophthalmic ointment must be nonirritating to the eye and must permit the diffusion of the active ingredient throughout the secretions washing the eye. Ointment bases which used for ophthalmics have a melting or softening point close to body temperature. Ophthalmic ointments have a longer visual contact time when compared to many ophthalmic solutions. Researches published that the visual contact time is two to four times bigger when ointments are used than when a saline solution is used. Ophthalmic ointments are preferred for nighttime applications as they spread over the entire corneal and conjunctival surface and cause unclear vision that occurs as the ointment base melts and is spread across the