C-8162 Refractive Surgery - Presbyopic LASIK and Multifocal Intra - Ocular Lenses
03/10/08
Presbyopia is the loss of the ability for the eye to accommodate or change focus from viewing a distant object to viewing an object up close. This loss of functionality is due to a gradual loss of amplitude of accommodation that is provided by th crystalline lens. The loss of accommodation is a slow progressive process that begins from birth. At age 8. the average amplitude of accommodation is 14.00 to 16.00 diopters (D): it declines to 10.00 + 2.0 D by age 25. to 6.00 + 2.00 D by age 40. and to 1.00 D + by age 60 (figure 1). However, the effect of accommodation loss is only felt from the age of approximately 45 as it is at this stage when the residual focusing power of the crystalline lens cannot provide sufficient near vision. A person unable to maintain 3.00 D of accommodation for any length of time is considered to have symptoms of presbyopia occurs in100% of the population and as longevity increases, presbyopes now represent one of the largest groups of patients suffering from a refractive error.
Professor Dan Reinstein
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C-9521 Clinical Decision Making - contact lens complications in routine practice
19/09/08
Contact Lens complications can affect the contact lens corrected visual acuity (VA), the lens comfort and wearing time and the lens condition. The problems arising can cause disturbances to the eyelids and ocular surfaces that can result in long - term changes and reduction in the contact lens tolerance. The clinician should try to help the patient overcome the lens - related problems, not only to promote satisfactory lens wear and to prevent the patient giving up contact lenses, but to prevent future ocular infections, inflammation and eye strain.
Christine Astin
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C-8161 The biomechanics of keratorefractive surgery
05/09/08
Corneal biomechanics is the study of the mechanical properties and the responses of the corneas. The cornea's remarkable transparency and strength allow it to contain the intraocular pressure (IOP), serve as a protective layer and act as the major refracting surface of the eye. the shape of the cornea , and hence it's refractive properties, is directly determined by it's ultrasound and biomechanical properties.
Nathaniel E Knox Catrwright
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Clinical Decision Making II: The Painful Eye
15/08/08
This article is a guide for the optometrist on how to approach the problem of a patient presenting with a painful eye. As with any other medical problems, the sequence of steps in dealing with such a patient is: 1. History 2. Examination 3. Diagnosis and Treatment. A new classification is proposed that will make diagnosis fairly simple. After examining each condition, treatment options are discussed.
Bianca Sallustio, FRCOphth, MRCOphth
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C-8160 Refractive surgery - Pre-operative assessment, selection criteria and patient counselling
25/07/08
Refractive surgery has made the transition from the fringes to the centre ground in contemporary ophthalmology, and is gaining increasing traction in the UK population as an alternative to contact kens waer or spectacle coreection. Key steps in pre-operative assessment are: procedure selection, risk evalution, and preoperative counselling. An Understanding of each of these elements is becoming integral to modern optometric practice.
Bruce Allan FRCS FRCOphth
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Clinical Decision Making I: Visual Field Interpretation
11/07/08
Visual field assessment provides a measure of the neural pathway integrity from eye to visual cortex. Certain patterns of visual field defect are associated with damage to specific regions of this pathway. Inaccurate test results can compromise interpretation leading to potentially serious consequences for diagnosis and ultimately the management decisions for that patient.
Shirley Ann Hancock PhD, BSc (Hons), MCOptom
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Refractive surgery - laser refractive surgery procedures
27/06/08
The aim of this article is to discuss modern refractive laser procedures and provide an introduction to surgical techniques, outcomes, and complications of laser refractive surgery. The optometrist as a front-line eye care provider must have a good background of general information on refractive surgery and its options. The ultimate goal is to be able to co-manage refractive surgery patients with refractive ophthalmic surgeons with the aim of giving patients the best possible advice and eye care.
Vincenzo Maurino MedC BQOphth Christophe Nguyen MD
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Dispensing VI: Spectacle lens design - New and future developments
13/06/08
Recent years have seen impressive developments in some areas of spectacle lens design, but others have appeared to stagnate. In this article some of the more recent developments in spectacle lens technology are discussed, as well as some comments about possible future trends.
Colin Fowler PhD FCOptom
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Optometric management of posterior segment eye disease – Malignancies of the posterior segment
30/05/08
Malignancies of the posterior segment are uncommon, but improved patient survival and visual outcome requires early diagnosis and treatment. The most common malignancy of the posterior segment is probably choroidal metastasis from a distant primary tumour. Of the primary intraocular malignancies, choroidal melanomas are the most frequently encountered in adults and need to be differentiated from choroidal naevi and other benign fundal lesions; retinoblastomas are the most common intraocular malignancy encountered in children. Lymphomas typically present in older adults and their diagnosis can be challenging and require specialist investigation. The epidemiology, clinical features, diagnosis, and treatment of each of these are discussed below.
Simon Taylor MA FRCOphth
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Dispensing for sport - eye dominance
16/05/08
The strength of vision science is its ability to measure visual performance, encouraged by the need to diagnose and treat ocular pathology. The relationship between vision and occupation (and the importance of dispensing in sport) is less well understood. It appears a link is missing between vision and occupation including sport, which may also affect a general understanding of orthoptics and binocular vision. This is an understanding of eye dominance.
Geraint Griffiths
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Optometric management of posterior segment eye disease-Macular disorders
07/03/08
This third article of the Optometric Management of Posterior Segment Eye Disease series will concentrate on the differential diagnosis and clinical signs and symptoms of macular disorders. Emphasis is placed on decision-making skills and available treatments will be reviewed where appropriate
Louise O'Toole
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Dispensing II: Complex lens dispensing
22/02/08
With reference to the terminology used by the General Ophthalmic Services (GOS), the expression complex appliance is defined as an optical appliance with at least one lens which has a power in any one meridian of plus or minus 10.00 or more dioptres, or is a prism-controlled bifocal lens.
Andrew Keirl and Richard Payne
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Variations in appearance of the normal eye due to differences in pigmentation and deposits
22/02/08
The vast majority of patients examined in primary eye care have normal, healthy eyes. To discriminate between ocular disease and the normal eye, it is essential to know the many presentations that a normal eye can make and a collection of photographs of normal variations due to differences in pigmentation and deposits is presented to supplement the information provided in atlases of ocular disease. The following is adapted from Clinical Procedures in Primary Eye Care (Elliott DB, 3rd edition) and its associated website (http://evolve.elsevier.com/Elliott/eyecare/).
David B Elliott and C Lisa Prokopich
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Optometric management of posterior segment eye disease-Optic nerve anomalies
08/02/08
As the saying goes, the eyes are a window to the soul. They are also a window to the brain, and one can discover a number of conditions, sometimes life-threatening, affecting the brain by their effect on optic nerve appearance and function.
Omar Mahroo and Chris Hammond
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Variations in appearance of the normal optic nerve head
08/02/08
The vast majority of patients examined in primary eye care have normal, healthy eyes. To discriminate between ocular disease and the normal eye, it is essential to know the many presentations that a normal eye can make and a collection of photographs of these normal variations at the optic nerve head is presented to supplement the information provided in atlases of ocular disease. The following is adapted from Clinical Procedures in Primary Eye Care (2007, 3rd edition) and its associated website (http://evolve.elsevier.com/ Elliott/eyecare/).
Professors David B Elliott and John G Flanagan
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Dispensing I: Simple dispensing-easy, isn't it?
25/01/08
The term 'simple dispensing' can cover a multitude of sins, but here we will be discussing the elements of dispensing that could be considered as Best Practice. Although only possible to cover these aspects briefly, the text will look at some of the perhaps forgotten or neglected aspects of dispensing simple prescriptions. Areas outside this will be dealt with in a later article on Complex Dispensing which will cover such matters as high power lenses, dispensing for children, and anisometropic prescriptions.
Duncan Counter
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Optometric management of posterior segment eye disease-examining the posterior segment
11/01/08
In this first article of the Optometric Management of Posterior Segment Eye Disease series, the various instruments used to examine the posterior segment and the techniques of ocular examination are discussed. The interpretation of examination findings and use of auxilary equipment is also detailed.
Louise O'Toole
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