Ophthalmology Commons^™

Preparation And Immunofluorescence Staining Of Bundles And Single Fiber Cells From The Cortex And Nucleus Of The Eye Lens, Michael P Vu, Catherine Cheng

Faculty, Staff and Student Publications

The lens is a transparent and ellipsoid organ in the anterior chamber of the eye that changes shape to finely focus light onto the retina to form a clear image. The bulk of this tissue comprises specialized, differentiated fiber cells that have a hexagonal cross section and extend from the anterior to the posterior poles of the lens. These long and skinny cells are tightly opposed to neighboring cells and have complex interdigitations along the length of the cell. The specialized interlocking structures are required for normal biomechanical properties of the lens and have been extensively described using electron microscopy …

Test-Retest Reliability Of Virtual Reality Devices In Quantifying For Relative Afferent Pupillary Defect, Prithul Sarker, Nasif Zaman, Joshua Ong, Phani Paladugu, Molly Aldred, Ethan Waisberg, Andrew G. Lee, Alireza Tavakkoli

Student Papers, Posters & Projects

Background: The swinging flashlight test (SFT) is one of the most prominent clinical tests for detecting the relative afferent pupillary defect (RAPD). A positive RAPD localizes the lesion to the affected afferent pupil pathway and is a critical part of any ophthalmic exam. Testing for an RAPD, however, can be challenging (especially when small), and there is significant intrarater and interrater variability.

Methods: Prior studies have shown that the pupillometer can improve the detection and measurement of RAPD. In our previous research, we have demonstrated an automatic SFT by utilizing virtual reality (VR), named VR-SFT. We applied our methods to …

Effects Of Different Spectrum Of Leds On Retinal Degeneration Through Regulating Endoplasmic Reticulum Stress, Wenyi Chen, Rong Lin, Kunhong Xiao, Kun Yuan, Zhongjiang Chen, Yan Huang

Faculty, Staff and Student Publications

PURPOSE: To evaluate the impact of full-spectrum light-emitting diodes (LEDs) on albino guinea pigs' retina and investigate the roles of short-wavelength opsin (S-opsin) and endoplasmic reticulum (ER) stress in light-induced retinal degeneration (LIRD).

METHODS: Three-week-old albino guinea pigs (n = 30) were distributed into five groups under 12/12 light/dark cycles with indoor natural light (NC; 300-500 lux, n = 6), full-spectrum LEDs (FL; 300 lux, n = 6; 3000 lux, n = 6), and commercial cold-white LEDs (CL; 300 lux, n = 6; 3000 lux, n = 6) and raised for 28 days. Hematoxylin and eosin staining and transmission electron …

Test-Retest Reliability Of Virtual Reality Devices In Quantifying For Relative Afferent Pupillary Defect, Prithul Sarker, Nasif Zaman, Joshua Ong, Phani Paladugu, Molly Aldred, Ethan Waisberg, Andrew G Lee, Alireza Tavakkoli

Faculty, Staff and Student Publications

Background: The swinging flashlight test (SFT) is one of the most prominent clinical tests for detecting the relative afferent pupillary defect (RAPD). A positive RAPD localizes the lesion to the affected afferent pupil pathway and is a critical part of any ophthalmic exam. Testing for an RAPD, however, can be challenging (especially when small), and there is significant intrarater and interrater variability.

Methods: Prior studies have shown that the pupillometer can improve the detection and measurement of RAPD. In our previous research, we have demonstrated an automatic SFT by utilizing virtual reality (VR), named VR-SFT. We applied our methods to …

Acute Diplopia After Glabellar Hyaluronic Acid Filler Injection, Caroline W. Chung, Eric J. Shiuey, César A. Briceño, Vivian Lee

SKMC Student Presentations and Publications

Purpose: Blindness is a well-known complication of filler injection in the glabellar region. Acute diplopia from filler injection without vision loss is a rare complication that typically results in clinical ophthalmoplegia which can have permanent sequelae. Here, we describe a patient who presented with acute diplopia with grossly intact full extraocular motility after glabella hyaluronic acid filler injection that resolved after 1 month.

Observations: A previously healthy 43-year-old woman underwent her first hyaluronic acid injection in the glabella and developed immediate binocular double vision with severe pain and skin mottling above her right eyebrow and central forehead. Hyaluronidase injections, nitroglycerin …

Extracellular-Vesicle-Based Therapeutics In Neuro-Ophthalmic Disorders, Hamed Massoumi, Sohil Amin, Mohammad Soleimani, Bita Momenaei, Mohammad Javad Ashraf, Victor H Guaiquil, Peiman Hematti, Mark I Rosenblatt, Ali R Djalilian, Elmira Jalilian

Wills Eye Hospital Papers

Extracellular vesicles (EVs) have been recognized as promising candidates for developing novel therapeutics for a wide range of pathologies, including ocular disorders, due to their ability to deliver a diverse array of bioactive molecules, including proteins, lipids, and nucleic acids, to recipient cells. Recent studies have shown that EVs derived from various cell types, including mesenchymal stromal cells (MSCs), retinal pigment epithelium cells, and endothelial cells, have therapeutic potential in ocular disorders, such as corneal injury and diabetic retinopathy. EVs exert their effects through various mechanisms, including promoting cell survival, reducing inflammation, and inducing tissue regeneration. Furthermore, EVs have shown …

Pou4f1-Tbr1 Transcriptional Cascade Controls The Formation Of Jam2-Expressing Retinal Ganglion Cells, Takae Kiyama, Halit Y Altay, Tudor C Badea, Chai-An Mao

Faculty, Staff and Student Publications

More than 40 retinal ganglion cell (RGC) subtypes have been categorized in mouse based on their morphologies, functions, and molecular features. Among these diverse subtypes, orientation-selective Jam2-expressing RGCs (J-RGCs) has two unique morphologic characteristics: the ventral-facing dendritic arbor and the OFF-sublaminae stratified terminal dendrites in the inner plexiform layer. Previously, we have discovered that T-box transcription factor T-brain 1 (Tbr1) is expressed in J-RGCs. We further found that Tbr1 is essential for the expression of Jam2, and Tbr1 regulates the formation and the dendritic morphogenesis of J-RGCs. However, Tbr1 begins to express in terminally differentiated RGCs around …

The Effectiveness And Outcomes Of Oculomotor And Visual Field Deficit Rehabilitation Secondary To Ischemic Cerebrovascular Accident: A Literature Review, Maanas Chiplunkar

Rowan-Virtua Research Day

Visual field loss and oculomotor dysfunctions are two common vision deficits caused by cerebrovascular accidents. Oftentimes these deficits can result in a loss of independence for patients and depression. Neurovisual rehabilitation is a frequently overlooked aspect of stroke rehabilitation, so investigating the current rehab approaches and the factors that play a role in the effectiveness of these methods is crucial so that clinicians can provide more direct and focused treatment for their patients. This literature review research process used PubMed, NCBI, and EbscoHost as primary databases. Preliminary results showed that restitutive and compensatory rehabilitation approaches are effective for treating visual …

Case Report: Ocular Capsaicin Toxicity With Chemosis From Jalapeño Peppers, Duwayne Campbell, James Espinosa, Eric Maddock, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

A 42 year old female presented to an Emergency Department (ED) with the abrupt onset of left eye pain, tearing and eye redness of a one hour duration. Her symptoms were due to ocular toxicity from contact exposure to capsicum, through preparation of Jalapeño peppers.

Improving Diabetic Retinopathy Screening Practices With Qi Methodology In Family Medicine Offices, Rea Isaac, Anne Jones

Rowan-Virtua Research Day

Early detection and treatment of diabetic retinopathy (DR) is crucial in preventing vision loss and blindness in vulnerable diabetics. With around 7.7 million patients having DR, and the target population being 20 -75 years old, the potential for improving their quality of life is substantial (WHO, 2022). Despite the importance of timely and routine eye exams, 45% of diabetic patients do not complete an exam despite physicians recommendations (Lu, 2014). This project aims to standardize eye exams, improve process flow, and improve patient understanding of the urgency of timely and comprehensive eye exams for DR. Multiple PDSA cycles and QI …

Herpesviriae Infection Of The Corneal Endothelium, Behnam Rabiee, Chandani Patel, Mansab Jafri, Hamad Hussain, Michael Gaspari, Muhamad Festok, Imtiaz Chaudhry, Iftikhar Chaudhry, Asim Farooq

Rowan-Virtua Research Day

Background

- The corneal endothelium plays a vital role in maintaining corneal clarity by regulating the amount of fluid in the corneal stroma.

- Corneal endotheliitis is defined as inflammation of the corneal endothelial layer that leads to corneal edema and haziness, and subsequent loss of vision.

- Most common causes include cytomegalovirus (CMV), herpes simplex virus (HSV), and varicella zoster virus (VZV).

- Because corneal endothelial cells cannot regenerate following injury, early diagnosis is essential in proper management and preventing loss of corneal endothelial cells.

In this review we aim to gather the most recent knowledge on viral corneal …

Smartphone-Based Fundus Imaging For Evaluation Of Retinopathy Of Prematurity In A Low-Income Country: A Pilot Study, Roha Ahmad Choudhary, Shiraz Hashmi, Haroon Tayyab

Department of Ophthalmology & Visual Sciences

Objectives: To evaluate the feasibility of a novel and simple smart phone-based Retinopathy of Prematurity (ROP) screening approach in a resource-constrained setting.
Methods: This cross-sectional validation study was conducted at the Department of Ophthalmology and Neonatal Intensive Care Unit (NICU) of The Aga Khan University Hospital, Pakistan, from January 2022 to April 2022. A total of 63 images of eyes with active ROP (stage-1, 2, 3, 4 and/or plus or pre-plus disease) were included in this study. The stage of ROP was documented by the principal investigator using an indirect ophthalmoscope and retinal images were obtained using this novel technique. …

Effect Of Phacoemulsification On Intraocular Pressure In Eyes With Functioning Tube Shunts, Wesam Shamseldin Shalaby, Sonali Patel, Sophia Lam, Allen Ganjei, Aakriti Garg Shukla, Natasha Kolomeyer, Daniel Lee, L. Jay Katz, Marlene Moster, Jonathan Myers, Reza Razeghinejad

Wills Eye Hospital Papers

Purpose: To evaluate the effect of phacoemulsification on intraocular pressure (IOP) in eyes with functioning tube shunts.

Methods: This was a retrospective chart review of primary open-angle glaucoma (POAG) patients with a functioning tube who underwent phacoemulsification and had ≥24 months of follow-up. The primary end point was defined as surgical failure (IOP > 21 mmHg) at month 24, progression to no light perception (NLP) vision, glaucoma reoperation, or implant removal. Surgical failure defined as IOP >18 and >15 mmHg, changes in visual acuity (VA), IOP, and number of medications were assessed.

Results: Twenty-seven eyes of 27 patients with moderate or …

Incidence And Risk Factors For Retinal Detachment And Retinal Tear After Cataract Surgery: Iris® Registry (Intelligent Research In Sight) Analysis, Michael J. Morano, M. Ali Khan, Qiang Zhang, Colleen P. Halfpenny, Douglas M. Wisner, James Sharpe, Alexander Li, Maurizio Tomaiuolo, Julia A A. Haller, Leslie Hyman, Allen C. Ho

Wills Eye Hospital Papers

Objective To report the incidence of and evaluate demographic, ocular comorbidities, and intraoperative factors for rhegmatogenous retinal detachment (RRD) and retinal tear (RT) after cataract surgery in the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight).

Design Retrospective cohort study.

Participants Patients aged ≥ 40 years who underwent cataract surgery between 2014 and 2017.

Methods Multivariable logistic regression was used to evaluate demographic, comorbidity, and intraoperative factors associated with RRD and RT after cataract surgery.

Main Outcome Measures Incidence and risk factors for RRD or RT within 1 year of cataract surgery.

Results Of the 3 177 195 …

Current Barriers To Eye Care, Annika Samuelson, Bs

inSIGHT

Barriers to care penetrate all aspects within our healthcare system and ophthalmology is no exception. The World Health Organization (WHO) estimates 2.2 billion people worldwide have vision impairment, half of which are due to preventable causes and/or remain untreated. In the United States, 6 million people are reported to have visual impairment and over one million people are blind.² The leading causes of blindness within the United States are macular degeneration, cataract, glaucoma, and diabetic retinopathy.³ Management of these diseases require access to early detection, therapeutic intervention, and follow up care at regular intervals; for example, nearly half …

Thyroid Eye Disease: Overview And Treatment, Michelle Omega, Ms

inSIGHT

Your immune system consists of a guided molecular army of antibodies equipped to recognize millions of foreign enemy antigens. However, in autoimmune conditions, antibodies are produced which target the cells of your own body. This is how many autoimmune diseases begin, including thyroid eye disease.

Ophthalminute Highlight: A Look Into The Popular, Educational One-Minute Videos, Anza Rizvi, Bs

inSIGHT

Ophthalminute is a series of one-minute videos designed to provide information on different, essential topics in ophthalmology. What separates the Ophthalminute videos from many of the other videos currently available is their unique ability to effectively and succinctly present information into a one-minute video to help viewers learn and better understand the fundamentals of ophthalmology. The videos showcase witty banter, enthusiastic energy, and stimulating visuals. Across YouTube, Twitter, and Instagram, Ophthalminute has received an astonishing over 2000 followers or subscribers and over 20,000 views!

Room To Wiggle, Holden Caplan, Bs

inSIGHT

Uveitis – inflammation of the inside of the eye and the fifth leading cause of vision loss in the USA. Uveitis (of which there are 30-40 types) may be infectious or non-infectious, unilateral or bilateral, of sudden onset or progressing over months to years, and present in any age group. Different etiologies cause different presentations, including both onset and location (front, middle, or back; Table 1) in the eye.

Exploring The Debate: Dmek And Dsek In Corneal Transplantation, Christian Raimondo, Bs

inSIGHT

Scientific progress is rarely a linear process. This notion is especially true as it pertains to the development of surgical techniques that have the potential to shape future clinical landscapes. Corneal transplantation is no exception. From the very first iterations of full corneal transplants performed in the 19th century to the highly nuanced endothelial procedures available today, corneal medicine has served — and continues to foster — an academic arena where research discoveries and surgical innovations come together to advance the field.

Review Of Surgical Management For Closed-Angle Glaucoma, Scott Kozarsky, Ba

inSIGHT

Closed-angle glaucoma, also known as angle-closure glaucoma, is one of the major types of glaucoma. Glaucoma is a term used to describe a broad group of ocular diseases that damage the optic nerve. The type of angle closure with which the patient presents, whether acute, subacute, or chronic, will dictate their treatment. Management of these three presentations will be discussed at length later in this article. In the United States, closed-angle glaucoma is less common than open-angle glaucoma, which often has a gradual onset of intraocular pressure (IOP) elevation and optic nerve damage.