Optometry Commons^™

Loss Of Class Iii Phosphoinositide 3-Kinase Vps34 Results In Cone Degeneration, Ammaji Rajala, Feng He, Robert E Anderson, Theodore G Wensel, Raju V S Rajala

Faculty, Staff and Students Publications

The major pathway for the production of the low-abundance membrane lipid phosphatidylinositol 3-phosphate (PI(3)P) synthesis is catalyzed by class III phosphoinositide 3-kinase (PI3K) Vps34. The absence of Vps34 was previously found to disrupt autophagy and other membrane-trafficking pathways in some sensory neurons, but the roles of phosphatidylinositol 3-phosphate and Vps34 in cone photoreceptor cells have not previously been explored. We found that the deletion of Vps34 in neighboring rods in mouse retina did not disrupt cone function up to 8 weeks after birth, despite diminished rod function. Immunoblotting and lipid analysis of cones isolated from the cone-dominant retinas of the …

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 …

Alternative Therapies For Treatment Of Keratoconjunctivitis Sicca Associated With Sjogren's Syndrome, Brittney M. Brady Od, Faao, Michelle K. Man Od, Faao

Optometric Clinical Practice

Background: Sjogren’s syndrome is a chronic, systemic autoimmune disorder, which often results in significant ocular surface disease. Dry eye associated with Sjogren’s syndrome is a multifactorial disease which leads to decreased function of the lacrimal glands and altered tear composition. There currently are numerous anti-inflammatory methods used for treatment of this disease.

Case Report: This case report will focus on the use of amniotic membrane placement and autologous serum tears to facilitate a successful scleral contact lens fit allowing for reduced ocular inflammation and discomfort associated with Keratoconjunctivitis sicca due to Sjogren’s syndrome.

Conclusion: Clinical management of keratoconjunctivitis sicca due …

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

Investigation Of Surrogate Biomarkers Associated With Macular Pigment Status In A Group Of Older Irish Adults, Grainne Scanlon, John S. Butler, Daniel Mccartney, Ekaterina Lostutova, Rose Anne Kenny, James Loughman

Articles

SIGNIFICANCE: Macular pigment (MP) confers potent antioxidant and anti-inflammatory effects at the macula; however, its optical density in the eye is not routinely measured in clinical practice.

PURPOSE: This study explored a range of surrogate biomarkers including anthropometric, clinical, and plasma measures that may be associated with lower MP optical density (MPOD).

METHODS: Two thousand five hundred ninety-four subjects completed a full MP assessment as part of wave 1 of The Irish Longitudinal Study of Aging. Macular pigment optical density was measured using customized heterochromatic flicker photometry. Clinical (blood pressure), plasma (lipoproteins, inflammatory markers), and anthropometric (waist, hip, height, weight) …

Mtor-Initiated Metabolic Switch And Degeneration In The Retinal Pigment Epithelium, Young-Mi Go, Jing Zhang, Jolyn Fernandes, Christopher Litwin, Rui Chen, Theodore G Wensel, Dean P Jones, Jiyang Cai, Yan Chen

Faculty, Staff and Students Publications

The retinal pigment epithelium (RPE) is a particularly vulnerable tissue to age-dependent degeneration. Over the life span, the RPE develops an expanded endo-lysosomal compartment to maintain the high efficiency of phagocytosis and degradation of photoreceptor outer segments (POS) necessary for photoreceptor survival. As the assembly and activation of the mechanistic target of rapamycin complex 1 (mTORC1) occur on the lysosome surface, increased lysosome mass with aging leads to higher mTORC1 activity. The functional consequences of hyperactive mTORC1 in the RPE are unclear. In the current study, we used integrated high-resolution metabolomic and genomic approaches to examine mice with RPE-specific deletion …

Pterygium Recurrence And Corneal Stabilization Point After Pterygium Excision Using The Controlled Partial Avulsion Fibrin Glue Technique, Mohd Radzi Hilmi, Khairidzan Mohd Kamal, Mohd Zulfaezal Che Azemin

Makara Journal of Health Research

Background: This study aimed to evaluate the pterygium recurrence rate and corneal stabilization point after pterygium excision via the controlled partial avulsion fibrin glue technique using multiple corneal parameters.

Methods: One hundred eyes of 100 patients who had undergone primary pterygium excision surgery via the controlled partial avulsion fibrin glue technique were retrospectively reviewed. Corneal stabilization points were determined over four follow-up sessions (i.e., the 1st, 3rd, 6th, and 12th months after surgery) based on changes in Simulated-K, corneal irregularity measurement, shape factor, and toric mean keratometry. Post-operative courses were followed for 12 months after surgery. Recurrence was …

Effects Of Oral Antihistamines On Tear Volume, Tear Stability, And Intraocular Pressure, Brian K. Foutch, Kyle A. Sandberg, Edward S. Bennett, Leonard L. Naeger

Educator Preparation & Leadership Faculty Works

The goal of this study was to investigate the effects of two commonly used oral antihistamines—diphenhydramine and loratadine—on tear volume, tear breakup time, and intraocular pressure. Placebo, diphenhydramine, and loratadine were administered for one week to 33 subjects experimentally blind to the treatment given. All the subjects received all three treatments over a period of six weeks. The outcome measures were the change in phenol red thread test (PRT), the tear breakup time (TBUT), and the intraocular pressure (IOP) of both eyes evaluated by experimentally masked observers. Neither of the mean changes in TBUT or IOP depended on the treatment …

Access To Eye Care Before And After Vision Loss: A Qualitative Study Investigating Eye Care Among Persons Who Have Become Blind, Tosha Zaback, Stephanie Lam, Joan Randall, Teresa Field, Mitchell V. Brinks

The Qualitative Report

Navigating access to eye care requires that patients recognize the need for screening and care, employ limited financial and social resources, manage complex health insurance policies, and access specialty clinical care. We investigated the experience of patients through the progression of vision loss to blindness, utilizing qualitative methods. We conducted structured telephone interviews with 28 persons with blindness throughout Oregon. Utilizing closed and open-ended questions, we explored patient experience on the events preceding avoidable blindness. Coding for emergent themes was conducted independently by two researchers using a constant comparative method. Participants described important barriers to accessing eye care: at the …

A Comparison Of Emoji Characters To Picture Optotypes, Simran Brar

Research Days

No abstract provided.

A Look Into The Impacts Of Tele-Optometry Expansion, Anna Hulsey

Honors Theses

Objective This study aims to assess the health and economic costs and benefits to society and patients resulting from the expansion of telemedicine into online refractive exams and to determine the likelihood of potential consumers to utilize such services. Methods A paper survey was distributed at the Inaugural Cempa Health Fair in October of 2019 to both vendors and participants. 105 responses were used to evaluate personal perceptions, practices, and likelihood across a diverse range of demographics. Responses were then entered and analyzed using descriptive statistics and percentages/frequencies. Results Results showed respondents were most attracted to online refractive exams due …

Determining Age-Related Visual Memory And Line Length Perception In Children And Adults, Katie Exline

Undergraduate Honors Thesis Projects

There is little research in the field of visual memory and perceptual abilities of children as compared to adults. This thesis seeks to understand and provide new perspectives to this field with potential implications in the fields of optometry and education. Through two basic experiments, this thesis evaluates the abilities of individuals to perceive a visual stimulus and compare it other visual stimuli, while also observing their abilities to learn and remember various visual stimuli. Through experimentation using line length as the visual stimulus, the method of constant stimuli (MCS) evaluates subjects’ visual perception and the method of single stimuli …

Transitioning From Episodic To Sustained Care In Humanitarian Service, W Howard Mcalister Od, Ma, Mph, Jeffrey L. Weaver Od, Ms, Timothy A. Wingert Od, Kristen Kramlich Od

Optometric Clinical Practice

Background: Humanitarian missions serve populations needing care and usually provide short term interventions. Traditionally, care provided through humanitarian agencies like VOSH International has been episodic, consisting of a short-term mission placing a team in country for several days. There have been discussions that episodic care is a short term measure which impedes the systematic development of a long term solution to providing the necessary health care. The move toward sustained care is a step in the direction of improving the public health in developing countries.

Method: A survey instrument was mailed to the 26 VOSH chapters in the United States …

A Vision- And Life-Threatening Case Of Peripheral Ulcerative Keratitis, Len V. Koh Od, Megan E. Mcchesney Md, Chad E. Gosnell Od, Ryan N. Ngo Od

Optometric Clinical Practice

Background: Peripheral ulcerative keratitis (PUK) is a rare but severe ocular manifestation most commonly associated with rheumatoid arthritis amongst other autoimmune diseases. Quick diagnosis and co-management with corneal specialist and rheumatologist are crucial to preserve vision and life. A rare case of PUK associated with rheumatoid arthritis (RA) is presented with updates on current understanding and co-management of this condition.

Case Report: A 76 year-old Caucasian male presented to the eye clinic on a Friday as a new patient, with a chief complaint of a red right eye started two weeks ago and was treated with erythromycin ointment, but it …

Silent Sinus Syndrome: An Uncommon Cause Of Diplopia, Tyler V. Mullen Od, Ruth Hyatt Od, Faao, Diplomate, Darcy Eberle Od

Optometric Clinical Practice

Background: Silent sinus syndrome is a rare condition with multiple ophthalmic findings of significance. Chronic, subclinical maxillary sinus inflammation alters the pressure gradient, leading to eventual maxillary sinus collapse, orbital floor depression, enophthalmos, and diplopia.

Case Report: Functional endoscopic sinus surgery may be indicated to correct diplopia and/or cosmesis.

Conclusion: Patients unbothered by facial asymmetry may be managed with prism in eyeglasses.

Case Series: Discordance Between Visible Retinal Nerve Fiber Layer Defects And Spectral Domain Optical Coherence Tomographic Analysis In Patients With Glaucoma, Joseph Sowka Od, Leticia Rousso Od

Optometric Clinical Practice

Background: Spectral domain optical coherence tomography (SD-OCT) has become a common modality in glaucoma diagnosis. Ease of use, comfort, and a comparative normative database makes this technology very popular with patients and practitioners. However, despite the sophistication of this technology, it may miss pathologic abnormalities of the retinal nerve fiber layer (RNFL) or be misinterpreted by practitioners based upon comparisons to a normative database.

Purpose: To illustrate discordance between clinical examination and SD-OCT analysis in patients with glaucoma.

Case Reports: Examples of three patients with glaucoma who had photographically and ophthalmoscopically visible RNFL defects who had SD-OCT analyses that fell …

Optometry's Contribution, Paul B. Freeman Od

Optometric Clinical Practice

Letter from the Editor-in-Chief

The Dominant Eye: Dominant For Parvo- But Not For Magno-Biased Stimuli?, Brian K. Foutch, Carl J. Bassi

Educator Preparation & Leadership Faculty Works

Eye dominance is often defined as a preference for the visual input of one eye to the other. Implicit in this definition is the dominant eye has better visual function. Several studies have investigated the effect of visual direction or defocus on ocular dominance, but there is less evidence connecting ocular dominance and monocular visual thresholds. We used the classic “hole in card” method to determine the dominant eye for 28 adult observers (11 males and 17 females). We then compared contrast thresholds between the dominant and non-dominant eyes using grating stimuli biased to be processed more strongly either by …

The Relationship Between Serum Zinc Levels And Myopia, Niamh Burke, John Butler, Daniel Ian Flitcroft, James Loughman

Articles

Clinical significance: Myopia is inherently associated with eye growth and thereby possibly amenable to nutritional influence. However, little attention has been given to possible die- tary influences. This study demonstrates that serum zinc does not play a role in myopia development. Background: Myopia is inherently associated with eye growth and thereby possibly amena- ble to nutritional influence. A number of Asian studies have reported lower levels of serum zinc in myopic children. This study was designed to assess the relationship between serum zinc and myopia in the Korean population – using a subsample of participants from nation- ally representative data.

Macular Pigment And Diabetes Mellitus, Grainne Scanlon

Doctoral

The macula is a specialised part of the retina responsible for detailed central and colour vision. The carotenoids lutein, zeaxanthin and meso-zeaxanthin are uniquely concentrated in the inner and central layers of the primate macula, where they are collectively known as macular pigment (MP). Macular pigment confers potent antioxidant and anti-inflammatory effects in the eye. Many studies have suggested that these carotenoids are lower in age-related macular degeneration (AMD) and that increased levels of MP may confer protection against AMD, especially the late form of the disease. Research is now beginning to focus on MP optical density (MPOD) and carotenoid …

Investigation Of The Prevalence Of Receded Near Point Of Convergence In School-Aged Children With Attention-Deficit/Hyperactivity Disorder, Lorig Sildiryan

Student Theses, Dissertations and Capstones

PURPOSE: The intention of this study was to determine if there was an association between receded near point ofconvergence (NPC) and diagnosis of attention-deficit/hyperactivity disorder (ADHD) in school-agedchildren as compared to neuro-normal children. Differences in accommodative amplitude were investigated as well.

METHODS: This retrospective study was done by analyzing the data from examination records of fifty school-agedchildren between the ages of seven and seventeen. Twenty-five children in the experimental group withADHD were age and gender matched to twenty-five neuro-normal children in the control group. The average of each patient’s NPC break and accommodative amplitude values were used to conduct a …

A Comparison Of Dietary Intake Of Children/Adolescents With And Without Myopia, Niamh Burke, John Butler, Daniel Ian Flitcroft, James Loughman

Conference Papers

Myopia is caused by an eye which has grown too long. The prevalence of myopia has increased drastically in recent years and half of the world’s population is expected to be myopic by 2050.(1) Consequently, a significant increase in sight threatening diseases will follow.(1) Myopia most commonly develops in youth, and we now know that environmental factors affect its development. Nutritional status strongly influences growth and development, including that of the eye. It has been hypothesised, therefore, that nutrition may play a role in this excessive eye growth. Current findings are conflicted, with a clear gap in the evidence.(2,3) Therefore, …

Investigation And Management Of Demodex Folliculorum Blepharitis In Clinical Practice, Orla Murphy

Doctoral

Introduction: Blepharitis is a chronic inflammatory disorder of the eyelid margin. Blepharitis patients routinely present to and are managed by optometrists and ophthalmologists in practice. Demodex folliculorum is associated with anterior blepharitis. Presently, treatment with 50% tea tree oil is recommended by the American Academy of Ophthalmology for Demodex blepharitis. However, over-the-counter products have been developed and marketed at being effective for treating Demodex blepharitis. Purpose: To examine the efficacy of over-the-counter lid hygiene products and warm compress therapy for the treatment of Demodex blepharitis. Methods: Two hundred and forty-six participants were examined at multiple visits over four studies, for …

Optimising Subjective Anterior Eye Grading Precision, Marta Vianya-Estopa, Manbir Nagra, Arnold Cochrane Arnold Cochrane, Neil Retallic Neil Retallic, Dean Dunning, Louise Terry Louise Terry, Aoife Lloyd, James Wolffsohn

Articles

To establish the optimum grading increment which ensured parity between practitioners while maximising clinical precision.

The Spatial Frequency Content Of Urban And Indoor Environments As A Potential Risk Factor For Myopia Development, Daniel Ian Flitcroft, Elise Harb, Christine F Wildsoet

Articles

To examine the hypothesis that the spatial frequency spectra of urban and indoor environments differ from the natural environment in ways that may promote the development of myopia. Methods: A total of 814 images were analyzed from three datasets; University of California Berkeley (UCB), University of Texas (UT), and Botswana (UPenn). Images were processed in Matlab (Mathworks Inc) to map the camera color characteristics to human cone sensitivities. From the photopic luminance images generated, two-dimensional spatial frequency (SF) spectra were calculated and converted to one-dimensional spectra by rotational averaging. The spatial filtering profile of a 0.4 Bangerter foil, which has …

Macular Pigment Optical Density Fluctuation As A Function Of Pupillary Mydriasis: Methodological Considerations For Dual-Wavelength Autofluorescence, Ekaterina Loskutova, John Butler, Gabriela Hernandez-Martinez, Daniel Ian Flitcroft, James Loughman

Articles

Macular pigment (MP), comprising the dietary carotenoids lutein, zeaxanthin and meso-zeaxanthin, is believed to benefit eye health and vision. Numerous clinical and research devices and techniques are currently available to facilitate MP optical density (MPOD) measurement. One of those techniques, dual-wavelength fundus autofluorescence (AF) is being increasingly used for measurement of MP in the eye. There is substantial methodological variation across the published studies that have employed this technique, including in relation to the use of mydriasis, the possible influence of which does not appear to have been addressed in the literature. This prospective cross-sectional study was designed to investigate …