Effectiveness of EScoop® lenses on a Select Group of Veterans

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\u27 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 was with traumatic brain injury (12 of 23), and they preferred the orange-tinted lens (10 of 12). The orange 9 mm LT with 4 prism diopters BU was the most commonly chosen EScoop® lens overall (5 of 23). Pre and post lens visual acuity testing with Sloan EDTRS LogMAR Low Contrast Chart at 25% contrast was available for 13 of the 23 patients. A small but statistically significant improvement of 0.11 decimal mean acuity (about one-line Snellen) under a low contrast condition was noted while wearing the preferred EScoop ® lenses (Wilcoxon Signed Rank P=0.015). Conclusion: Our retrospective study reviewed visually impaired patients with varied clinical conditions, including traumatic brain injury, age-related macular degeneration, glaucoma, and optic atrophy. Upon informal questioning, the patients reported improvements in glare, photophobia, and night glare symptoms. Objectively, we measured approximately one line of improvement in contrast Snellen acuity, which was statistically significant. Further research is needed to discern the actual effectiveness of this lens

Book Review: Visual Secrets for School Success

Book Revie

Herpes Simplex Keratitis after PRK

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 considered in any PRK post-op patient that presents with unusual signs and symptoms such as decreased vision, increased IOPs, ocular pain, photophobia, iritis and corneal haze. When diagnosed in a timely manner, the prognosis is generally favorable. Current treatments for HSV keratitis include antiviral coverage as well as immunosuppression with topical steroids. Case Report: This case involves a patient that developed HSV keratitis while on topical steroid therapy following PRK. The weeks following the initial presentation were spent battling corneal haze, iritis, pain, increased IOPs and decreased visual acuity. After close monitoring and treatment changes based on each clinical presentation, the patient recovered with good vision and minimal corneal scarring. The findings and recommended treatment options are discussed. Conclusion: HSV affects much of the world’s population. Reactivation of the latent virus can lead to vision threatening corneal disease. HSV is capable of causing inflammation and pathology throughout most of the anterior segment of the eye, and therefore should be considered when managing any new or recalcitrant anterior pathology. Although the diagnosis is usually clinical, laboratory testing can be used to confirm a diagnosis. Treatment aims to decrease the viral load and to limit stromal scarring

Expanding Your Professional Experience Through the Fulbright Program

Expanding the Bo

Headache and Vision Loss as Initial Symptoms for an Acute Invasive Rhino-orbital-cerebral Mucormycosis

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 scan showed mild inflammatory mucosal thickening in the sinuses. Initially, he was diagnosed and treated for giant cell arteritis. The patient’s vision deteriorated to no light perception in the right eye with persistent 10 out of 10 headache and eye pain despite various treatments. Further evaluation revealed ROCM involving the sphenoid sinus. This was confirmed by a positive smear and culture of Rhizopus species from the sinus and from the patient’s symptoms improving with antifungal treatment. Conclusion: Sphenoid sinusitis is an unusual site of involvement with ROCM. The absence of nasal drainage adds to the difficulty of diagnosis without contrast imaging. Although rare, acute invasive ROCM should always be considered in any uncontrolled diabetic or immunosuppressed patient with acute headache and vision loss

Results of a VOSH Trip to Panama

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 mean refractive error was low hyperopia, however, most astigmatism was oriented against-the-rule. There was also an earlier need for an additional near correction. There were 488 instances of non-refractive ocular conditions documented with cataracts constituting 75.6% of these. Documented measurement of intraocular pressures (IOP) demonstrated most findings fell within the accepted normal range of 11-22mmHg, however, there were occurrences above and below this range. Conclusion: The trip benefited many individuals while also highlighting the need for a long-term solution by improving the public health infrastructure. It demonstrated the immediate impact possible with short-term intervention while also diagnosing ocular conditions that would require long term management. Without an improvement in access to local care these conditions cannot be successfully treated or managed

Sometimes there is more to reading than reading!

Editoria

Burnout in Optometry.....How do we compare?

Letter to the Edito

Book Review: The Paradox of the Immune System: Protection, Chronic Inflammation, Autoimmune Disease, Cancer, and Pandemics

Book Review: Pandemics, Artificial Intelligence, Optometrists, COVID-19, Immune System Diseases, inflammatio

Mentorship in Academia and Career: A Scholarly Personal Narrative of a Latina Millennial’s Experience

This dissertation, my scholarly professional narrative (SPN), is a self-reflection of mentoring experiences as a Latina millennial in academia and professional settings. These experiences are told through the art of storytelling using testimonio, which promotes a critical awareness of cultural intersectionality and intercultural understanding through first person narrative. My experiences with mentorship in personal, academic, and professional workspaces include mentors who may or may not have influenced my own journey as a doctoral student and business professional as a Latina millennial. Using testimonio helps explain certain cultural challenges, specific scenarios or experiences, familial responsibilities, and cultural barriers, and how identities are preserved, used, and recognized in individual social contexts. This deeply reflective SPN-testimonio introduces a deeper, meaningful, and mutual learning relationship for audiences to connect with the researcher. This dissertation follows a non-traditional format because many personal experiences serve as the data of experiences for this SPN-testimonio. The goal of this study is to use SPN-testimonio to emphasize the weight of responsibility one Latina woman has had to complete a doctorate program and maintain a professional career outside of academia and how the umbrella of mentorship has been a part of that journey. Most importantly, this study shows the capability and adaptability of a Latina’s experiences within multiple personal and professional environments and how identities are often created because of cultural influences, decision making, and personal motivation