Education Commons^™

Case Report: Bartonella Quintana-Associated Neuroretinitis, Kelly Seidler Od, Kelly A. Malloy Od

Optometric Clinical Practice

Background: Neuroretinitis is a self-limiting condition which typically causes monocular vision loss with good potential for visual recovery. It may be idiopathic or associated with infectious or inflammatory conditions which can carry systemic implications. Neuroretinitis classically presents with disc edema followed by development of a macular star pattern of exudates. It is most commonly attributed to Cat Scratch Disease, or Bartonella henselae infection. However, there have been few published reports of Bartonella quintana associated neuroretinitis.

Case Report: A 60-year-old patient presented with unilateral vision loss preceded by flu-like illness. The patient had exposure to a recently adopted cat. …

Bilateral, Full-Thickness Macular Holes While Undergoing Chemotherapy, Sarah Dieter Od, Brett Garee Od Ms, Susan Zacatelco Od, Julie Henry Od

Optometric Clinical Practice

Background: Bilateral, full-thickness macular holes are a rare condition that can substantially affect quality of life. Macular hole diagnosis and treatment is key for these patients.

Case Report: A 71 year old Caucasian male presented with a chief complaint of distance blur in both eyes, worsening over the past 1-2 weeks. He had no diagnosis of diabetes. He added that his prostate cancer had spread and that his last treatment ended 9 days ago. He was ultimately diagnosed with bilateral, full-thickness macular holes. Referral to a retinal specialist for surgical management yielded good results.

Conclusion: This is …

Cefuroxime-Induced Toxic Maculopathy: A Cataract Co-Management Conundrum, Leonid Skorin Jr., Do, Od, Ms

Optometric Clinical Practice

Background: Cefuroxime-induced toxic maculopathy can occur when an incorrect dilution is injected intracamerally after cataract surgery. This results in a guarded visual prognosis. Cefuroxime-induced toxic maculopathy can also occur sporadically even when the medication dilution is the standard correct dosage. These patients usually recover their vision by the first postoperative week.

Case Report: A 72-year-old Caucasian female developed cefuroxime-induced toxic maculopathy after uneventful cataract surgery. Investigation of the case confirmed that she had a sporadic response to the cefuroxime. It was verified that she received the standard correct dilution of cefuroxime intracamerally. The patient showed a significant improvement in her …

Medication-Induced Oculomotor Dysfunction: A Report Of Two Cases, Eric Lee Od

Optometric Clinical Practice

Background: Consideration of current medications and their interactions as a source of new onset oculomotor dysfunction is imperative for providing good eye care. Medication etiology should be particularly suspected when the symptoms begin with the initiation of a new medication and resolved with discontinuation of the same medication.

Case Reports: Presented are two cases demonstrating that it is prudent to be aware of medications capable of inducing oculomotor dysfunction. Each case reveals instances of acute oculomotor dysfunction after the initiation of a central nervous system affecting medication. Case 1 details a partial pupil sparing third nerve palsy after initiating the …

Longstanding Crystalline Retinopathy Secondary To Intravitreal Triamcinolone Injection, Katherine Thomas Od, Jeffery Curry Od

Optometric Clinical Practice

Background: Crystalline retinopathy has many disparate etiologies with varying potentials in visual outcome. Due to the potential severity of these outcomes, differentiation of etiology is critical to guide both follow up and treatment regimen. Diagnosis can be facilitated with a thorough medical history, clinical presentation, and imaging such as optical coherence tomography (OCT).

Case Report: This case demonstrates a rare incidence of crystalline retinopathy in a 65-year-old male attributed to a single intravitreal triamcinolone acetonide (IVTA) injection with 8 year follow up data, followed by a review of other types of crystalline retinopathy secondary to pharmaceutical agents.

Conclusion: A complete …

It’S As Easy As Learning To Fly A Plane, Paul B. Freeman Od

Optometric Clinical Practice

Letter from the Editor-in-Chief

Thank You Reviewers, Paul B. Freeman Od

Optometric Clinical Practice

Thank you to all the reviewers!

Conjunctival Intraepithelial Neoplasia: A Case Report, Christopher Bugajski Od

Optometric Clinical Practice

Background: Gelatinous, vascularized lesions of the conjunctiva are a subset of ocular surface tumors that are derived from various cell types. The more worrisome origins include diagnoses of conjunctival intraepithelial neoplasia (CIN) and squamous cell carcinoma (SCC). Topical treatments such as mitomycin-C, 5-fluorouracil, and interferon alfa-2b are now used as single therapy or in conjunction with surgical excision.

Case Report: This case features a 78-year-old Caucasian male with CIN treated with surgical removal and topical interferon alfa-2b. In addition to discussing the details of this case, this report highlights important caveats of the treatment and management of the …

Choroidal Melanoma: Screening For Metastasis And Frequency Of Incidental Second Primary Cancer Diagnosis., Ethan Leyda Od

Optometric Clinical Practice

Background: Choroidal melanoma is the most common primary intraocular malignancy in adults. This case report reviews clinical diagnostic features, imaging techniques, treatment, prognosis, and systemic work-up of choroidal melanomas. It also addresses choroidal melanoma metastasis and the incidental finding of second primary cancers through whole-body screening.

Case Report: A 71-year-old white male reported to the Cleveland VA Medical Center optometry retina clinic for a second opinion exam of an asymptomatic choroidal lesion in the right eye. The lesion was a 6 mm gray choroidal mass in the inferior peripheral fundus, with orange pigmentation, retinal pigmented epithelial hypertrophy along the superior …

Ocular Characteristics Of Non-Covid-19 Patients: A Retrospective Study Of Time-Sensitive Ophthalmic Care During The Pandemic, Yun-Ping Moore Od, Laura Ward Msph, Farah Gulaid Od, Susan A. Primo Od, Mph

Optometric Clinical Practice

Purpose: To analyze the cohort of clinical patients seen during the COVID-19 pandemic shutdown at Emory Eye Center in comparison with prior weeks.

Method: We conducted a retrospective chart review from three outpatient clinical sites over a period of eighteen weeks, which covered pre-COVID-19 dates as well as the dates of when our clinics were closed near the beginning of the COVID-19 pandemic. We utilized data from providers assigned to daily triage coverage for in-person exams. Primary diagnosis and visit type data were extracted to look for trends and commonalities among urgent or time-sensitive patients.

Results: For the nine weeks …

Dean's View, Timothy Wingert Od

Optometric Clinical Practice

Dean of University of the Incarnate Word-Rosenberg School of Optometry shares insight.

Perfect Storm, Paul B. Freeman Od

Optometric Clinical Practice

Letter from the Editor-in-Chief

Book Review: Foundations Of Artificial Intelligence In Healthcare And Bioscience, Paul B. Freeman Od

Optometric Clinical Practice

Book Review:

Catania LJ. Foundations of Artificial Intelligence in Healthcare and Bioscience. Cambridge: Academic Press; 2020, $150.00, 524 pages, Paperback ISBN:9780128244777, e-book ISBN: 9780323860055.

Break The Fall: Orbital Blowout Fracture, Christopher Bugajski Od, Faao

Optometric Clinical Practice

Background: Head trauma can lead to multiple ocular complications, among the most concerning is an orbital blowout fracture. Common associations with an orbital fracture would include periorbital ecchymosis, subconjunctival hemorrhage, eyelid edema, and crepitus, among others. Concerning complications, such as retinal detachment, need to be ruled out at the time of presentation. Surgical intervention may be warranted in certain cases. An emergent head computed tomography scan must be performed to evaluate and determine management.

Case Report: This case features a 66-year-old Caucasian male with an orbital blowout fracture following a fall. In addition to discussing the details regarding …

Herpetic Keratitis, Patience Is A Virtue: Hsk In Immunocompromised Patient, Robert Binkley Od, Faao

Optometric Clinical Practice

Background: The Herpes virus is ubiquitous in our patient population. Often it is present without symptoms, however, it may present with pain, irritation, and decreased vision. In high-risk populations a longer course of treatment is often required.

Case Report: This case report will detail the treatment options and outcome in a patient with herpes keratitis who also is HIV positive and addresses concerns about treating immunocompromised patients.

Conclusion: This case serves as a review of common and uncommon treatment options for herpes keratitis as well as a review of potential causes of this presentation. Herpetic keratitis is likely to be …

The New (?) Look Of Precaution, Paul B. Freeman Od

Optometric Clinical Practice

Letter from the Editor-in-Chief

Evidence-Based Clinical Practice Guideline: Comprehensive Pediatric Eye And Vision Examination, American Optometric Association

Optometric Clinical Practice

Republished with the written permission granted from the American Optometric Association, October 2, 2020.

Developed by the AOA Evidence-Based Optometry Guideline Development Group

Approved by the AOA Board of Trustees February 12, 2017

Diane T. Adamczyk, O.D., Chair – State University of New York, College of Optometry, New York, New York

John F. Amos, O.D., M.S. – University of Alabama at Birmingham School of Optometry, Birmingham, Alabama, Dean and Professor Emeritus

Felix M. Barker, II, O.D., M.S. – W. G. (Bill) Hefner VAMC, Salisbury, North Carolina

Benjamin P. Casella, OD – Private Practice – Casella Eye Center, Augusta, Georgia

Linda …

Metachronous Eyelid Basal Cell Carcinoma On Opposite Eye And Lid: A Case Report, Danielle C. Kalberer Od, Faao, Matthew A. Delmauro Md

Optometric Clinical Practice

Background: Basal cell carcinoma (BCC) is the most common eyelid malignancy, accounting for approximately 90% of malignant eyelid lesions.¹ Despite its high occurrence rates, it is frequently misdiagnosed as one of the benign “lumps and bumps” that can be present on the eyelid. In the present case, a patient with a past BCC on the right upper eyelid presented with a left lower eyelid lesion which persisted for months before the patient sought evaluation by an eyecare provider. This benign-looking lash-line lesion was the only external sign of the malignancy found on the deep surface of the eyelid and …

Case Report: The Dilemma Of Imaging An Isolated Sixth Nerve Palsy, Shannon Santapaola Od, Faao, Cheryl Haskes Od, Richard Sui Od, Faao

Optometric Clinical Practice

Background: Traditionally, eyecare providers employ a wait-and-see approach with respect to older patients presenting with a presumed vasculopathic isolated sixth nerve palsy. However, given review of recent literature and the potential of morbidity in these patients, acute neuroimaging should be strongly considered. Eyecare providers are often faced with challenging decisions when patients present with acute isolated oculomotor nerve palsies. This case highlights the diagnostic dilemma of an older patient with significant vasculopathic risk factors who presents with an isolated sixth nerve palsy. For patients older than 50, a vasculopathic etiology is the most likely cause, however, a small but significant …

Optic Disc Pits: A Case Report And Review, Jeffrey A. Sterling Od, Faao, Fsls

Optometric Clinical Practice

Background: Congenital optic disc pits (ODP) are a rare clinical finding affecting approximately 1 in 11,000 people. Affected individuals are generally asymptomatic unless fluid accumulates in the macula resulting in severe vision loss. The management of ODPs depends mostly on clinical findings and can range from observation to surgery. Optometrists need to be aware of clinical presentations and possible complications of ODPs.

Case Report: This report will review a case of an asymptomatic optic disc pit and discuss the potential treatment options if complications arise.

Conclusion: Although rare, congenital optic disc pits need to be accurately assessed and diagnosed. Symptoms …

The Art Of Prescribing Low Amounts Of Prism, Leonard J. Press Od

Optometric Clinical Practice

Expanding the Box

Why Don't More Of Us Write Scholarly Papers?, Paul B. Freeman Od

Optometric Clinical Practice

Letter from the Editor-in-Chief

Welcome Readers, Barbara Aranda-Naranjo, Phd

Optometric Clinical Practice

Interim provost would like to welcome you as readers to our new journal, Optometric Clinical Practice.

Inaugural Editorial, Paul B. Freeman Od

Optometric Clinical Practice

Letter from the Editor-in-Chief

Welcome Letter Of Introduction To Our New Journal - Optometric Clinical Practice, Timothy Wingert Od

Optometric Clinical Practice

On behalf of the entire editorial board, Timothy Wingert, OD, dean at the University of the Incarnate Word - Rosenberg School of Optometry, welcomes you to the inaugural issue of Optometric Clinical Practice. (ISSN: 2575-7717)

The Relationship Between Body Mass Index, Fitness, Socioeconomics, And Academic Accountability School Rating: A Texas Study, Serena S. Bahe

Theses & Dissertations

Between 1980 and 2000, obesity rates in the United States have doubled for adults and tripled for children (Centers for Disease Control [CDC], 2015). In addition, Texas, the second largest state, ranks 10th for the highest percentage of obesity among youth age 10-17 (CDC, 2015). Nationally, the United States falls behind other countries in high school and college completion rates (Greenstone, Harris, Li, Looney, & Patashnik, 2012), and since 2001 when the No Child Left Behind Act (NCLB) began, school administrators have reduced physical education, art, music, and recess by 44% to increase the time students spent in reading and …

Fall Prevention Among Older Adults Living In The Community, Clarissa Silva Lopez

Theses & Dissertations

Older adults are within the fastest population growth rate in the United States, and as the population ages, the potential for falls increases (DHHS, 2011). This was a mixed-method explanatory study that investigated the perceptions of older adults regarding the usefulness, adequacy, and positive experience of fall information among older adults living in the community when received from healthcare professionals during physician’s office visits. The research questions were: 1. What is the relationship among perceptions of usefulness, adequacy, and positive experience of fall information among older adults? 2. Is there a difference in the perceptions of usefulness and adequacy among …