Optometry Commons^™

Environmental Impacts Of Contact Lens Waste, Abigail Wilhelmi

Arts & Sciences Undergraduate Showcase

Contact lenses have been used for decades to correct vision, and over 150 million people use contact lenses today. The materials used to make contact lenses have evolved drastically, but ultimately resulted in a specific plastic, silicone-derived hydrogel, which provides maximal comfort and clear vision, while also maintaining the eye health of the user. Contact lenses have enhanced the lives of many people, but a topic that is often left out of contact lens discussions is that of plastic waste. Single-use plastic and increased plastic pollution have recently been areas of concern and expanded research. Contact lenses are often forgotten …

Importance Of Optometric Practices, Nikhita Jacob

Honors Projects

This research examines what effect education has on people’s decision-making. More specifically, whether better education leads to better decisions and health outcomes, and why that is important for optometry. Every decision someone makes depends on some type of information, whether it is heard, read about, watched, or experienced. The more information someone has, the more confident someone can be in the decisions they make. Access to information and to education, whether it is through school, libraries, or news channels, is not always equal. It is important that people are informed about subjects as important as their health, by those who …

Basic And Applied Studies Of Human Visual Function: Implications For Visually Demanding Occupations, Julie Lovell

Theses & Dissertations

Color vision is a complex process providing important information about objects within our environment. Color vision deficiency either congenital or acquired can impact real world performance. Current working environments either require normal color vision or utilize color as a tool to highlight critical information. The use of color in the workplace provides several advantages. Hence, color vision screening is required for entry into professions and occupational certifications. Acquired color vision deficiency may also impact job performance requiring clinical screening. The present dissertation focused on the considerations outlined by the Commission on Behavior and Social Sciences when choosing a clinical test …

Understanding Blue Light Retinal Damages And The Methods Of Prevention, Amelia Lee

Senior Honors Theses

Light emitting diode (LED) lights that comprise television screens, phone displays, laptops, and tablets have been studied by scientists in order to understand the implications of blue light radiation and the effects that it has on the human body—especially the retina of the eye. The retina is comprised of highly metabolic cells, and when those cells are placed under oxidative stress, death occurs causing ocular disease. Additionally, excess blue light exposure causes shifts in biological rhythms that govern patterns of alertness and sleep. Recently scientists began studying the methods of blue light prevention. Some studies show that blue light radiation …

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 …

Occlusive Retinal Vasculitis Secondary To Sjogren’S Syndrome: A Case Report And Review, Lynn Finnegan Od, Danielle Kalberer Od

Optometric Clinical Practice

Background: To bring attention to the potential and serious ophthalmic sequalae of Sjogren’s syndrome, specifically occlusive retinal vasculitis.

Case: A 70-year-old male patient without previous ocular pathology presented with acute onset, bilateral, painless vision loss. Fundus evaluation revealed extensive retinal occlusive disease with bilateral disc edema, cystoid macular edema, and diffuse phlebitis. The patient was admitted, received a full systemic work-up and was carefully co-managed by ophthalmology, neurology, infectious disease, vascular surgery, dermatology, rheumatology and medicine. Evaluation supported a leading diagnosis of Sjogren’s syndrome associated vasculitis.

Conclusion: The patient underwent treatment with oral steroids and intravitreal injections of anti-vascular endothelial …

Occipital Lobe Abscess Causing Homonymous Hemianopsia After A Dental Procedure, Kristin Mcdougall Od, Julie Staats Od, Ashley Fritz Od

Optometric Clinical Practice

Background: A homonymous hemianopsia visual field defect is defined as vision loss on the same side of the vertical midline in both eyes. Although the vast majority are caused by an ischemic stroke, other neurologic etiologies must be considered and ruled out. This case highlights the importance of a rapid and thorough investigation of a patient’s symptoms using both clinical examination and imaging to reduce the risk of permanent complications and potential fatality.

Case Report: A 67-year-old Caucasian male presented to the eye clinic with sudden onset reduced peripheral vision to his right side in both eyes. Entering visual acuities …

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

Super-Resolution Microscopy Reveals Photoreceptor-Specific Subciliary Location And Function Of Ciliopathy-Associated Protein Cep290, Valencia L Potter, Abigail R Moye, Michael A Robichaux, Theodore G Wensel

Faculty, Staff and Students Publications

Mutations in the cilium-associated protein CEP290 cause retinal degeneration as part of multiorgan ciliopathies or as retina-specific diseases. The precise location and the functional roles of CEP290 within cilia and, specifically, the connecting cilia (CC) of photoreceptors, remain unclear. We used super-resolution fluorescence microscopy and electron microscopy to localize CEP290 in the CC and in the primary cilia of cultured cells with subdiffraction resolution and to determine effects of CEP290 deficiency in 3 mutant models. Radially, CEP290 localizes in close proximity to the microtubule doublets in the region between the doublets and the ciliary membrane. Longitudinally, it is distributed throughout …

Structure And Dynamics Of Photoreceptor Sensory Cilia, Theodore G Wensel, Valencia L Potter, Abigail Moye, Zhixian Zhang, Michael A Robichaux

Faculty, Staff and Students Publications

The rod and cone photoreceptor cells of the vertebrate retina have highly specialized structures that enable them to carry out their function of light detection over a broad range of illumination intensities with optimized spatial and temporal resolution. Most prominent are their unusually large sensory cilia, consisting of outer segments packed with photosensitive disc membranes, a connecting cilium with many features reminiscent of the primary cilium transition zone, and a pair of centrioles forming a basal body which serves as the platform upon which the ciliary axoneme is assembled. These structures form a highway through which an enormous flux of …

Transitional Vocational Program For Persons With Low Vision And Other Visual Impairments, Andria Lubben, Karen Park, Susan Macdermott, Becki Cohill

Summer 2021 Virtual OTD Capstone Symposium

Background: Low Vision is a life-altering visual disability (CDC, 2015). OTs work with individuals with low vision and work in the workplace and education, however, there is no research on OTs working with individuals with low vision in work or post educational settings (Butler, 2016). Vocational and educational needs are often not being met for individuals with low vision (Barbieri et al., 2019).

Problem: OTs have a limited role in adolescent transition to the workplace and higher education in individuals with low vision and other visual impairments.

Purpose: To understand transitional programs that support vocational and educational development of individuals …

‘Missing The Target’ – A Critical Examination Of Policy Frameworks For Aboriginal And Torres Strait Islander Inclusion Into The Allied Health Professions, Andrea Simpson, Tim Pitman

Australian Indigenous HealthBulletin

Objective

This paper focuses on critically examining the inclusion of Aboriginal and Torres Strait Islander people in policy frameworks by regulatory health peak bodies against the backdrop of the Government’s response to the Closing the Gap (2020) report.

Method

Websites of ten allied health professional bodies were searched and analysed as policy as text.

Results

Of the ten professions examined, the search strategy identified 9 professions were signatories or co-signatories on Reconciliation Action Plans (RAP) and three professions made mention of Aboriginal and Torres Strait Islander equity strategies to enter the profession as part of accreditation standards.

Conclusions

Professional bodies …

Evaluation Of The Spot™ Photoscreener’S Efficacy For Detecting Amblyopia Risk Factors Compared To Optometrists’ Examinations In 305 South Dakota Children, Jeremy J. Kudrna Md, Eric Habbe Md, Andrea Bordewyk Md, Hadly Carson Eisenbeisz Ms-Iv, Ryan Scarborough Od, Terrence Spencer Md

Aesculapius Journal (Health Sciences & Medicine)

Purpose: This study sought to further validate the efficacy of the SPOT^TM photoscreener version (v) 3.0.0500 as a screening device for amblyopia risk factors (ARF).

Methods: This was a cross-sectional study from five different western South Dakota outpatient clinics. Data from 610 eyes of 305 children aged 6 months to 13.5 years collected between July 2018 to September 2018 were analyzed, using both the out-of-box referral criteria and the 2013 American Association for Pediatric Ophthalmology and Strabismus (AAPOS) referral criteria. Optometrist (eye care provider or ECP) cycloplegia practice patterns were deferred to each clinics’ specific protocols. Power vector and …

Preventing Ocular Surface Disease In The Pediatric Intensive Care Unit, Emily Mallette

Dissertations

Preventing Ocular Surface Disease in the Pediatric Intensive Care Unit

Problem: Ocular surface disease in the Pediatric Intensive Care Unit is a significant problem in intubated patients due to altered eye protective mechanics, leading to exposure of the eye surface and dry eye. The purpose of this quality improvement project was to evaluate how an eye care protocol affected the frequency of artificial tear ointment administration.

Method: A descriptive, cohort design utilizing a retrospective chart review with convenience sampling of intubated children in the PICU from two cohorts was used. Comparisons were made between the preintervention cohort in 2020 and …

What Type Of Soft Contact Lens Works Best For Reverse Piggyback?, Claire E. Mcdonnell, Emma Chaney, Tara Kennedy, Aoife Farrell

Conference Papers

Aim

To determine which type of soft contact lens works best in a reverse piggyback lens system.

Background

A reverse piggyback lens system comprises of a soft contact lens worn over a rigid gas permeable lens. Several uses of this system include prevention of rigid gas permeable lens decentration during sporting activities and reduction of rigid gas permeable lens intolerance due to lid sensitivity.

Methods

Four different types of soft contact lenses; Senofilcon A, Omafilcon A, Etafilcon A and Delefilcon A, were assessed in a reverse piggyback system, in both eyes of twelve subjects (n=24). Over refraction, best corrected visual …

Search For Palladin, An Actin-Associated Protein, In Pig Retinal Pigmented Epithelium And Its Role In Epithelial-Mesenchymal Transition, Katrina Powell

Undergraduate Theses

This study investigates the expression of Palladin, a phosphoprotein product of the PALLD gene, in the retinal pigmented epithelium (RPE). Palladin is an actin cross-linking protein and plays a role in cell adhesion and motility. Published reports have demonstrated that a down regulation of Palladin in colon cancer cells results in a reorganization of the actin cytoskeleton, causing the cells to lose their typical shape, become proliferative and migratory. This process is otherwise known as epithelial-mesenchymal transition (EMT). A similar EMT phenomenon is observed when the RPE is exposed to the vitreous humor in patients with proliferative vitreoretinopathy (PVR). In …

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.

Novel Genetic Mutations In Genes Agbl5 And Tulp1 For Presumed Unilateral Retinitis Pigmentosa Managed With Low Vision Rehabilitation: A Case Report And Review, Maggie Man Ki Ho Od, Ms, Faao, Stephanie Schmiedecke-Barbieri Od, Faao, Abcmo, Dip Low Vision, Patricia C. Sanchez-Diaz Phd, Dvm, Faao, Carolyn E. Majcher Od, Faao, Fors

Optometric Clinical Practice

Background: Retinitis pigmentosa is a group of hereditary retinal diseases characterized by the degeneration of rod and cone photoreceptors. It commonly results in night blindness followed by tunnel vision and central vision reduction. The classic triad of clinical signs includes pigmented bone spicules, waxy disc pallor, and arterial attenuation. Unilateral retinitis pigmentosa is rare and can be supported with ancillary testing including genetic and laboratory studies to rule out differential diagnoses.

Case Report: A 68-year-old Hispanic female was referred to the low vision rehabilitation clinic due to progressive vision loss in the left eye (OS) that began 15 years ago. …

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 …

A Case Report Of Advanced Neglected Basal Cell Carcinoma, Loren W. Bennett Od, Mph, Faao

Optometric Clinical Practice

Background: Basal cell carcinoma is the most common skin cancer in humans and is frequently found in the periocular region. It is generally characterized by slow growth with rare metastasis and has an excellent prognosis with current surgical techniques. However, if neglected or inadequately treated it can lead to substantial localized tissue destruction and morbidity.

Case Report: This case presents an advanced basal cell carcinoma involving the left side of the nose and medial eyelids which had been neglected by the patient, causing significant functional disability and cosmetic disfigurement. The tumor was removed with a wide surgical excision which required …

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

Interdisciplinary Practice For Occupational Therapy And Low Vision Rehabilitation, Priscilla Gim, Karen Park, Becki Cohill, Susan Macdermott

Spring 2021 Virtual OTD Capstone Symposium

The purpose of this capstone project was to advocate occupational therapy in low vision rehabilitation for improved access to low vision rehabilitation (LVR) for the adult population. However, due to COVID-19 pandemic, this capstone project shifted to a research study assessing limiting factors for occupational therapy collaboration with low vision services and exploring eye physician’s perception on low vision occupational therapy.

A mixed-methods survey was conducted to explore 54 eye physicians including Doctor of Medicine (MD) specialized in ophthalmology and Doctor of Optometry (OD)’s perception on the role of low vision occupational therapy, benefit of low vision occupational therapy, current …

Single-Cell Transcriptomics Identifies Limbal Stem Cell Population And Cell Types Mapping Its Differentiation Trajectory In Limbal Basal Epithelium Of Human Cornea, De-Quan Li, Sangbae Kim, Jin-Miao Li, Qianmiao Gao, Jongsu Choi, Fang Bian, Jiaoyue Hu, Yun Zhang, Jin Li, Rong Lu, Yumei Li, Stephen C Pflugfelder, Hongyu Miao, Rui Chen

Faculty, Staff and Students Publications

PURPOSE: This study aimed to uncover novel cell types in heterogenous basal limbus of human cornea for identifying LSC at single cell resolution.

METHODS: Single cells of human limbal basal epithelium were isolated from young donor corneas. Single-cell RNA-Sequencing was performed using 10x Genomics platform, followed by clustering cell types through the graph-based visualization method UMAP and unbiased computational informatic analysis. Tissue RNA in situ hybridization with RNAscope, immunofluorescent staining and multiple functional assays were performed using human corneas and limbal epithelial culture models.

RESULTS: Single-cell transcriptomics of 16,360 limbal basal cells revealed 12 cell clusters belonging to three lineages. …

Addressing Artificial Intelligence Bias In Retinal Diagnostics, Philippe Burlina, Neil Joshi, William Paul, Katia D Pacheco, Neil M Bressler

Faculty, Staff and Students Publications

PURPOSE: This study evaluated generative methods to potentially mitigate artificial intelligence (AI) bias when diagnosing diabetic retinopathy (DR) resulting from training data imbalance or domain generalization, which occurs when deep learning systems (DLSs) face concepts at test/inference time they were not initially trained on.

METHODS: The public domain Kaggle EyePACS dataset (88,692 fundi and 44,346 individuals, originally diverse for ethnicity) was modified by adding clinician-annotated labels and constructing an artificial scenario of data imbalance and domain generalization by disallowing training (but not testing) exemplars for images of retinas with DR warranting referral (DR-referable) from darker-skin individuals, who presumably have greater …

Measuring Mitochondrial Respiration In Vivo: From Mouse To Human, Arthur Orchanian, Brennan Schilling, Bruce Berkowitz Phd

Medical Student Research Symposium

Introduction: The mitochondrial energy ecosystem can be non-invasively interrogated in photoreceptors by combing a clinical tool, optical coherence tomography (OCT), with a mitochondrial protonophore (2,4 dinitrophenol, DNP). It remains unclear if only supra-clinical doses of DNP will be useful for mouse studies or if lower but clinically relevant doses of DNP would facilitate translation from mice to humans.

Methods: The experiment was a paired longitudinal design that took place over 2 days. On day 1, C57BL/6J mice were overnight dark adapted, then light-adapted for 5 h before OCT examination before regaining consciousness; a similar procedure was followed on day 2 …