Education Commons^™

Burnout In Optometry.....How Do We Compare?, Jeffrey L. Weaver Od, Mba

Optometric Clinical Practice

Letter to the Editor

Book Review: Visual Secrets For School Success, Paul B. Freeman Od

Optometric Clinical Practice

Book Review

Herpes Simplex Keratitis After Prk, Joshua Graf Od

Optometric Clinical Practice

Background: Herpes simplex virus (HSV) is a double stranded DNA virus that infects much of the world’s population. The World Health Organization estimates 67% of people under the age of 50 have HSV-1 and 11% of people under the age of 50 have HSV-2. While most systemic infections remain inactive and do not cause symptoms, the activation and appearance of ocular HSV can be a destructive and vision-threatening issue. HSV keratitis can be epithelial, stromal or a combination. Patients who have recently undergone photorefractive keratectomy (PRK) have a higher risk of HSV keratitis. Because of this, HSV keratitis should be …

Effectiveness Of Escoop® Lenses On A Select Group Of Veterans, Connie Chronister Od, Denise T. Wilcox Od, Stanley Hatch Od, Mph

Optometric Clinical Practice

Purpose: The purpose of this study was to perform a retrospective chart review to see if the use of EScoop® lenses improved the referred veterans' contrast acuity and subjective visual discomfort of glare, photophobia, or difficulty with night driving. Methods: We retrospectively reviewed examinations of 23 veterans aged 36 to 91 who chose EScoop ® for their spectacle prescription. The EScoop ® set available in our clinic included two shades, yellow or orange, two center lens thicknesses (LT), 6 or 9 mm, and with or without 4 prism diopters yoked base up (BU) prism. Results: The largest diagnostic group tested …

Results Of A Vosh Trip To Panama, Raelyn Ottenbreit Od, Aubrey Breithaupt Od, Allan Mccleary Od, Timothy Wingert Od, Emily Burnette Od

Optometric Clinical Practice

Background: Optometric services in many parts of the world are unavailable, or when available, limited to those individuals who have the resources and proximity to gain access to them. Recognizing this disparity in availability of eyecare services, teams from developed countries have been volunteering to provide eyecare in these areas with such a need for many years. Over time, these groups have also adopted a mission of enhancing the local infrastructure to create long-term improvement. Method: All records from a VOSH clinical trip to Panama were retrospectively analyzed to determine the prevalence of ocular conditions diagnosed. Results: As expected, the …

Headache And Vision Loss As Initial Symptoms For An Acute Invasive Rhino-Orbital-Cerebral Mucormycosis, Thanh Le Od, Gregg Wentworth Od

Optometric Clinical Practice

Background: Acute invasive rhino-orbital-cerebral mucormycosis (ROCM) is a rare fungal infection commonly caused by Rhizopus species. It occurs in immune- compromised individuals who have acquired immune deficiency syndrome (AIDS), leukemia, uncontrolled diabetes mellitus, or organ transplant patients who are on immunosuppressive therapy. Diagnosing invasive ROCM is challenging because its clinical presentation can be nonspecific, and it is not frequently observed in ophthalmic practices. Case Report: A 66-year-old Hispanic male with poorly controlled diabetes mellitus presented with the complaint of severe headache and retrobulbar pain in the right eye. An ophthalmic examination revealed normal ocular health in both eyes. Computerized tomography …

Expanding Your Professional Experience Through The Fulbright Program, Timothy Wingert Od

Optometric Clinical Practice

Expanding the Box

Sometimes There Is More To Reading Than Reading!, Paul Freeman Od

Optometric Clinical Practice

Editorial

Idiopathic Intracranial Hypertension: A Case Report, Christopher Bugajski Od

Optometric Clinical Practice

Background: Optic nerve head edema is a serious finding for which multiple etiologies need to be considered. When optic nerve head edema is observed bilaterally, among the top differentials is idiopathic intracranial hypertension (IIH), also known as primary pseudotumor cerebri. An emergent magnetic resonance image with and without contrast as well as venography and lumbar puncture with opening pressure measurement must be performed to diagnose and determine management. Case Report: This case specifically features a 30-year-old Caucasian female with bilateral optic disc edema secondary to IIH. In addition to discussing the details regarding this patient’s case, this report …

Sagging Eye Syndrome--An Overlooked Diagnosis, Zachary Tlumak Od, Theresa Zerilli-Zavgorodni Od, Nancy Shenouda-Awad Od

Optometric Clinical Practice

Abstract

Background: Sagging Eye Syndrome (SES) is a relatively unknown cause for binocular distance diplopia. SES presents with an acquired comitant or non-comitant small angle esotropia and/or hypotropia commonly occurring in the elderly population. Inferior displacement of the lateral rectus secondary to age-related degeneration of orbital connective tissue and extraocular muscles appears to be responsible for the ocular misalignment. SES patients often present with new onset or progressively worsening distance diplopia, typically warranting neuroimaging. However, through understanding SES, eye care practitioners may identify these cases, avoiding unnecessary imaging studies. Case Report: A 90-year-old male presented with complaints of intermittent horizontal …

Pupil Involving Oculomotor Palsy- Examination, Cause And Outcome, Robert Binkley Od, Karen Neal Od

Optometric Clinical Practice

BACKGROUND: A patient with a third cranial nerve (CN III) palsy can be a stress inducing event for an optometrist due to the potentially life-threatening etiologies and infrequency of their presentation. The pathogenesis of a CN III palsy can vary from innocuous to life threatening. Palsy of the third cranial nerve results in an impairment of eye movement and / or pupillary response to light depending on the extent of the palsy. CASE REPORT: This case reviews a recent onset of a complete right oculomotor palsy. Literature of similar cases detail the likelihood of variable causes, and while a diagnostic …

The Art Of Prescribing Low Amounts Of Prism: Basic Clinical Applications, Leonard J. Press Od

Optometric Clinical Practice

Expanding the Box

It's How You Ask The Question....., Paul Freeman Od

Optometric Clinical Practice

Letter from the Editor

Book Review: The Paradox Of The Immune System: Protection, Chronic Inflammation, Autoimmune Disease, Cancer, And Pandemics, Lourdes A. Fortepiani, Md, Phd

Optometric Clinical Practice

Book Review:

Pandemics, Artificial Intelligence, Optometrists, COVID-19, Immune System Diseases, inflammation

Limitations Of Telemedicine Vs. Face-To-Face Eye Examination In A Patient With New Headaches, Joseph Hallak, Od, Danielle Kalberer, Od

Optometric Clinical Practice

Background: During the emergence and rise of COVID-19, precaution directives and limitations on in-person eye examinations re-routed a significant portion of care to telemedicine and virtual modalities. While these technologies allowed for healthcare communications that otherwise could not occur during such trying times, there are major limitations to these sanctioned applications. This report will present a seemingly benign case that could have easily been re-routed from an in-person examination to a telemedicine version due to the patient’s seemingly “routine” vision complaints.

Case Report: A 50-year-old male patient contacted the eye clinic with a complaint of a minor, new, unexplained headache …

Lyme Disease Neuroretinitis: A Case Report And Review Of Immunologic Workup, Michael Wingard, Od, Jeffery Curry, Od, Jeffrey L. Weaver, Od, Ms

Optometric Clinical Practice

Background: Lyme disease is an infection caused by a bacterial spirochete of the borrelia genus. The human vector is from a tick bite by an infected tick of the ixodes genus, commonly referred to as the deer tick or black legged tick. The incidence of Lyme disease is increasing in the United States. Once infected, Lyme disease manifestations usually depend on the stage of infection with late stage infection often causing debilitating illness.¹

Case Report: Neuroborreliosis refers to borrelia, causing neurological infection and can occur as acute or late manifestation of Lyme disease. Neuroretinitis is a rare …

Ocular Manifestations Of Septo-Optic Dysplasia, Rena Cappelli, Od, Tiffany Tucker Christiansen, Od, Danielle Vance Taylor, Od

Optometric Clinical Practice

Background: Septo-optic dysplasia (SOD) is a congenital deformity of the brain which can result in neurologic, systemic, and physical malformation.Due to the proximity of these deformities to the optic chiasm and optic nerves, ocular manifestations are common.

Case Report: A 28-year-old male with a long-standing history of reduced vision presented for a routine eye examination. Upon examination he was found to have an afferent pupillary defect, bilateral optic nerve pallor with corresponding nerve fiber layer thinning by optical coherence tomography. Humphrey visual field testing revealed a bi-temporal visual field defect. Neurological imaging was obtained with a subsequent diagnosis …

Multimodal Imaging Reveals Bilateral Idiopathic Multiple Retinal Pigment Epithelial Detachments: A Case Report, Diana H. Ho, Od, Joseph J. Pizzimenti, Od, Patricia C. Sanchez-Diaz, Dvm, Phd, Stephanie Schmiedecke-Barbieri, Od, Alexandra Zuercher, Od

Optometric Clinical Practice

Background: Retinal pigment epithelial detachment (RPED) is a nonspecific finding that is common in several ocular diseases; however, cases of bilateral idiopathic multiple RPEDs are rare. Less than 50 cases have been reported to date. Bilateral multiple RPEDs are usually idiopathic and benign in nature but can infrequently be associated with various ocular and systemic diseases, including central serous chorioretinopathy (CSC). The potential role of genetic factors in this condition remains elusive. We present a case where multimodal imaging assisted in revealing the diagnosis as well as discuss the potential implications of some of the genetic findings for this …

Acute Syphilitic Posterior Placoid Chorioretinitis; A Case Report And Review, Kristin Wilson, Od, Amy Garbo Maxey, Od

Optometric Clinical Practice

Background: Acute syphilitic posterior placoid chorioretinopathy (ASPPC) is a rare but defining characteristic of ocular syphilis. Clinical findings are subtle, geographic, yellowish, macular lesions, affecting the outer-retina and inner choroid, and often associated with subretinal fluid in the early phase. This case report will review the clinical signs of ASPPC to aid the practitioner in identification and recognition of its clinical importance as it relates to early diagnosis, treatment and prognosis.

Case Report: A 79-year-old African American male presented to clinic with a chief complaint of blur in the right eye for the past two days. Spectral Domain Optical Coherence …

Optic Disc Drusen Resulting In Disqualifying Field Loss, Robert C. Binkley, Od

Optometric Clinical Practice

Background: Optic nerve (or disc) drusen is the presence of hyaline bodies at the optic nerve head. The drusen may be visible upon funduscopic examination or may present as buried. Timely diagnosis and responsible imaging may help inform the patient of the potential for future concerns. The long-term prognosis is good for most patients, however, they may experience progressive peripheral vision loss that may reduce the patient’s quality of life. Neuroprotective options have previously been discussed with minimal clinical effectiveness, however, new medications may aid in future treatment.

Case Report: A patient presenting with mild and slowly progressing vision loss …

You Can Lead A Horse To Water, Paul B. Freeman, Od

Optometric Clinical Practice

Letter from the Editor

Thank You To Our 2021-2022 Reviewers, Paul B. Freeman Od

Optometric Clinical Practice

Thank you 2021-2022 Reviewers!

Book Review: Applied Concepts In Vision Therapy 2.0, Paul B. Freeman Od

Optometric Clinical Practice

Press LJ, Taub MB, Schnell PH. Applied Concepts in Vision Therapy 2.0. Santa Ana: Optometric Extension Program; 2022, $159.00, 543 pages, Paperback, ISBN: 9780929780542

Ischemic Cranial Nerve Iii Palsy: Diagnosis, Management, And Follow-Up, Brittney M. Brady Od

Optometric Clinical Practice

Background: Acquired cranial nerve III palsies (CN3P) can be ischemic in nature due to underlying vasculopathy, trauma, or by compressive damage due to aneurysm or tumor. In most cases, neuroimaging is completed to rule out a life-threatening etiology. This case outlines an acute oculomotor palsy due to ischemic microvascular disease with the appropriate diagnostic testing, treatment, and follow-up course.

Case Report: A 67-year-old African American female presented with complaints of a drooping left eyelid and intermittent diagonal diplopia. She had a known diagnosis of type 2 diabetes and hypertension. Entering visual acuity was 20/25-1 in the right eye (OD) and …

Occult Adenocarcinoma Presenting As Presumed Periorbital Cellulitis, Kirk Halvorson Od, Jonathon Thomas Od, Jennifer Prunty Od, Omaya H. Youssef Md, Mba

Optometric Clinical Practice

Background: Orbital tumors are uncommon entities seen by optometrists. They may initially present as common, benign conditions, but if not appropriately diagnosed can lead to devastating results.

Case Report: This case report demonstrates an atypical presentation of adenocarcinoma that was initially diagnosed as preseptal cellulitis. The patient in this case was ultimately referred for imaging and biopsy to reveal the correct diagnosis. Despite treatment, this patient died about 1 year after his clinical presentation.

Conclusion: The detection of orbital tumors and the subsequent management of patients with orbital tumors can be challenging. When considering orbital tumors as a possible diagnosis, …

Diagnosis And Excision Of A Solitary Trichoepithelioma, Leonid Skorin Jr., Do, Od, Ms

Optometric Clinical Practice

Abstract

Background: Solitary trichoepithelioma is a rare benign tumor of hair follicle origin. Although trichoepithelioma has a predilection for the face and neck, it is not usually found on the eyelids. It has similar clinicopathological features to basal cell carcinoma. Surgical excision and histopathologic analysis is helpful for correct diagnosis.

Case Report: A 59-year-old Caucasian female presented with a raised, reddish oval mass on the right lower eyelid. The mass had telangiectatic blood vessels on its surface, was non-pigmented and slightly umbilicated. It was in close approximation of the eyelid margin causing distortion and poor apposition of the lid to …

A Reactivation Of Ocular Toxoplasmosis During Pregnancy, Brett Garee Od, Ms, Sarah Dieter Od, Pete Liette Od

Optometric Clinical Practice

Background: Toxoplasma gondii is a parasite estimated to affect over 500 million people worldwide. The feline is the definitive host for the parasite and infection may be acquired or congenital via maternal transmission. Humans may acquire the infection by ingestion of raw or undercooked meats and vegetables, contaminated water, or exposure to infected cat feces. The infection is often benign, self-limiting, and asymptomatic for humans, but potentially life threatening to infants or the immunocompromised patient.

Case Report: A 22 year-old Caucasian female, pregnant at 12 weeks gestation, presented to the optometry service with acute symptoms of hazy vision …

Just When You Thought It Was Safe To Go Back In The Water, Paul B. Freeman Od

Optometric Clinical Practice

Letter from the Editor

Book Review: The Ophthalmic Laser Handbook, William L. Miller Od, Ms, Phd

Optometric Clinical Practice

Book Review: Freisberg L, Lighthizer N, Skorin, Jr. L, Stonecipher K, and Zimmerman A. The Ophthalmic Laser Handbook. First Edition. Wolters Kluwer Health; 2021. $102.00, 350 pages, Paperback ISBN: 978-1975170172, e-book ISBN: 978-1975170219

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. …