Uveitis describes a group of intra-ocular inflammatory conditions, where etiology is diverse and may be characterized by inflammation of the uveal tract or indirect inflammation of adjacent tissues¹. In his paper, A Long-Term Game Plan for Non-Infectious Uveitis, Sam S. Dahr, MD, reports that the majority of uveitis cases seen in daily practice are non-infectious and idiopathic in origin. This report estimates that the disease affects approximately 300,000 American adults and 22,000 American children. Of great concern for the young, is the lack of proper treatment in the early stages of the disease, which can be attributed to a poor visual outcome ².

Proactive and effective management of non-infectious uveitis relies heavily upon developing a therapeutic strategy and a long-term plan, which may involve systemic therapy, patient counseling, close follow-up, dosing adjustments, combination therapy, and consultation with rheumatologists. In his report, however, Sam S. Dahr, MD, suggests that imaging metrics are “…more powerful than any blood test the rheumatologist can order to monitor response”; positioning ophthalmologists to “… bear the decision-making responsibility for these patients.” Many patients with non-infectious uveitis suffer “…inflammatory breakthroughs during systemic therapy, most of which tend to be fairly mild and treatable with topical, injected or …

A survey conducted by the American Academy of Ophthalmology (AAO) highlighted a significant discrepancy between the perceived versus the actual danger of the home environment being a threat for eye injuries¹. The survey determined that fewer than half of the respondents saw the home environment as a potential site for eye injuries, and those that did cited the garden and garage as the most dangerous places. In reality, however, each year it is estimated that 50 percent of all eye injuries occur in the home and most could have been prevented if proper eye protection had been worn². Sadly, only 35 percent of people surveyed claimed to follow a practice of home eye safety by always wearing eye protection when it was needed.

Statistics show that there are several ways that people are at risk of eye injury in their homes. The AAO reported that 125,000 eye injuries occur each year due to accidents involving common household products, such as bleach and oven cleaner. Unprotected eyes are also at risk where there are things that move at high speed, such as debris from yard work, power tools or nails being hammered into hard surfaces and even champagne corks.

In the …

Athletes of all levels need to protect themselves from injury. Injuries are unfortunately a part of playing sports – anyone from weekend warriors to professionals, has probably nursed some sort of injury. In some cases, these injuries happen directly to the eye, from orbital blowout fracture, ruptured globe, or a detached retina and some can be detected, along with other types of ocular and systemic pathology, by looking at the health of the eye.

There have been, and continue to be, many studies in the area of sports-related eye trauma. And with more and more interest in the effects of concussions on athletes, seeing “inside” the eye is becoming increasingly important. An x-ray, MRI, CT scan will tell you if something is broken and may confirm a diagnosis of concussion. But what about the effects of repetitive concussive injury? Can that be detected by imaging the eye itself? According to the Centers for Disease Control, up to 3.8 million sports-related concussions occur each year. And detecting these injuries is not always straightforward or based exclusively on objective signs and symptoms. Or what about treating the whole athlete and monitoring systemic as well as ocular health?

Because the retina is the …

Sports-related eye injuries often result in vision loss, and are the leading cause of blindness in children.¹ According to the National Eye Institute (NEI) and the National Eye Health Education Program (NEHEP), in the United States, sports-related eye injuries account for over 100,000 physician visits per year at an estimated cost of $175 million. Since most eye injuries are preventable, more sight may be preserved by exercising injury prevention techniques.

Protective eyewear is vitally important in the prevention of injury, but the NEI and NEHEP also strongly recommend that all people who participate in sporting activities have comprehensive eye exams as part of their regular physical examinations, especially for those with pre-existing eye conditions. optomap^® has a huge part to play in facilitating difficult eye examinations, and in supporting the early detection of peripheral retinal complications following sports-related eye injuries.

Direct, blunt force injury to the eye often causes swelling for several days, making a comprehensive retinal examination difficult. Early assessment of the eye is imperative in saving sight, as these injuries cause a high risk of retinal detachment or retinal bleed. The half-second capture speed and non-mydriatic advantages of optomap technology allow for more timely, less invasive access to …

It is estimated that in the United States, choroidal nevi can be found in 4.6 to 7.9 percent of Caucasian individuals¹ and that one in approximately 8,000 of these nevi transform into melanoma². It is this rare ability that makes these lesions clinically significant.

Choroidal nevi are typically discovered during routine dilated fundus examinations and are usually asymptomatic. However, some may be associated with central and peripheral vision loss secondary to subretinal fluid, cystoid retinal edema or, rarely, neovascularization³. Choroidal melanoma also tend to be asymptomatic, but are more likely to be symptomatic than benign nevi, presenting as decreased vision, flashes or floaters.

In their study, Cheung et al. suggest that there are phenotypical markers and environmental risk factors that predispose a person to developing choroidal melanoma. A later study⁴, using optomap^®, determined that choroidal nevi were also present in subjects who did not conform to a particular phenotype. Gordon-Shaag et al. concluded that it was the expanded view (200°) of ultra-widefield (UWF™) technology that improved their ability to locate nevi. This was further supported by Brett et al., who concluded that the optomap was the most effective device for pinpointing choroidal nevi⁵.

Historically, the challenge has been to locate …

Choroidal nevi are commonly reported as incidental findings in asymptomatic patients during routine eye exams. Nevi on the retina, similar to “freckles” on the skin, should be monitored for changes as they may turn in to melanoma¹.

With the increased use of ultra-widefield (UWF™) imaging, reports of secondary findings of choroidal nevi are increasing. Because optomap^®, captures up to 82% or 200° of the retina in a single image, it can impact the ability of eyecare professionals to detect previously unnoticed retinal anomalies. Once found, these anomalies may be closely monitored and differentiated using the optomap 3-in-1 color depth imaging in conjunction with optomap af, the latter which highlights lipofuscin in the retinal pigment epithelium (RPE) and is particularly useful for the detection of choroidal neoplasms and nevi².

Dr. Bryan Stoller reported using optomap to monitor Jeffry, a 54 year-old man with glaucoma³. Jeffry had his intra-ocular pressure (IOP) checked every four months, and returned annually for UWF imaging of his optic nerve and a small choroidal nevus. During one visit, while using optomap af, Dr. Stoller noticed that the nevus had started to autofluoresce. Although the choroidal nevus, measuring three disc diameters (DD), had not increased in size, …

Pop quiz time: What’s one of the most important things you need to do as a parent before the new school year rolls around? The answer: Schedule back to school eye exams for your whole family!

Back to School Eye Exams are a Must

There’s little question about it: Back to school eye exams are a critical component to your child’s health and quality of life. Why? Because your child’s vision will affect virtually every aspect of academics, athletics, and extracurricular activities.

Interestingly, many common eye problems first develop in young, school-aged children. If left undiagnosed and untreated, these visual problems can disrupt your child’s ability to pay attention in class. Unfortunately, in some cases, children with visual problems end up being misdiagnosed with ADD/ADHD or another type of learning disorder. Hence, it is essential to make sure that your child’s eyesight is in top condition. This ensures that all of their unique needs are met, and that they are able to participate to the best of their ability in school.

So, what kind of eye problems will an eye care provider look for in your child?

— Myopia, or nearsightedness: This makes it difficult to see things …

Age-related macular degeneration (AMD) is one of the world’s leading causes of central vision loss in industrial nations, causing significant visual morbidity. Non-exudative AMD accounts for approximately 90% of all reported cases.

There is a growing body of evidence suggesting that there may be early indicators preceding the development of AMD. Over 30 years ago, while investigating reticular degeneration of the pigment epithelium (RDPE), Lewis et al, discovered a correlation between the characteristics of macular degenerative changes and RDPE. One of their recommendations supported the value of observing the peripheral retina, when assessing patients with macular degenerative abnormalities¹.

Understanding the relevance of peripheral retinal abnormalities, to disease progression relating to AMD and other retinal conditions, continues to evidence the value of ultra-widefield (UWF^™) imaging in this process. In the 12-year follow-up of subjects from the Reykjavik Eye Study, Lengyel et al² evaluated subjects using optomap^® color and autofluorescence (AF) imaging.

The peripheral retina was phenotyped using categories defined in the International Classification of AMD which was developed to characterize the macula. The population sample was 576 subjects. Of the eyes examined, 81.1% had AMD-like changes in the macula. From this sample, 13.6% of subjects were noted to have …

Building upon two previous studies regarding the use of optomap images for studying diabetic retinopathy (DR) where optomap was found to be equivalent to Early Treatment Diabetic Retinopathy Study (ETDRS)¹, and where there was the presence of predominantly peripheral lesions, they were associated with an almost 5-fold risk in the progression of DR over 4 years², a recent study from the American Academy of Ophthalmology concludes that there is a good to excellent agreement between ultra-widefield (UWF™) images and ETDRS standard photos in determining H/Ma (hemorrhage/microaneurysm) severity, with excellent correlation of H/Ma counts within ETDRS photo fields. Utilizing the full capability of UWF peripheral fields however, produced identification of 49.8% more H/Ma suggesting a more severe H/Ma in 12.7% of eyes.

Retinal hemorrhage and/or H/Ma are critical clinical signs of early DR; similarly, the presence and severity of H/Ma are considered reliable markers for the level and risk of progression in DR. Ma (microaneurysm) counts and level also may indicate critical progression of proliferative DR and macular edema.

The objective of the study was to evaluate detection of H/Ma and/or hemorrhage comparing the two aforementioned modalities. When first evaluating a similar retinal scope of the two modalities, both UWF …

Diabetic retinopathy is one of the leading causes of vision loss and blindness around the globe, and affects approximately one-third of people with diabetes. Because the number of people with diabetes is expected to rise to more than 438 million worldwide by 2030, it can be assumed that the prevalence of diabetic retinopathy can be expected to rise, as well.

For individuals with diabetes, certain risk factors can be reduced by focusing on key elements such as education, early detection, and early treatment.

What Is Diabetic Retinopathy?

Diabetes impairs the body’s ability to control blood sugar. Because sugar can promote inflammation, a person with diabetes may experience inflammatory damage to various tissues within their body, including the retina, which is located on the inside back of your eye. High blood sugar causes damage to the blood vessels in the retina, where the small blood vessels that supply blood to their retinal tissue become leaky and irritated. Over time, this can lead to complete vision loss if not treated properly.

Why Is Early Diagnosis of Diabetic Retinopathy So Important?

The critical challenge with diabetic retinopathy is that retinal damage often begins long before symptoms ever develop. As such, …