Familial exudative vitreoretinopathy (FEVR) and Coats’ disease, both pediatric retinal diseases that involve the peripheral retina, can be evaluated in the physician’s office using ultra-widefield fluorescein angiography (UWFFA). As reported in Journal of Pediatric Ophthalmology and Strabismus, a retrospective review  of 8 patient cases confirmed the utility of UWFFA in targeting laser photocoagulation, administered in an outpatient setting without the use of anesthesia. Furthermore, as has been shown in adults, UWFFA revealed peripheral retinal pathology, that can be difficult or impossible to visualize with conventional imaging techniques. The investigators concluded that UWFFA is useful in identifying peripheral retinal pathologies in pediatric patients, guiding management, which may potentially reduce delays in diagnosis and treatment.

Kang KB, Wessel MW, Tong J, D’Amico DJ, Chan P. Ultra-widefield imaging for the management of pediatric retinal diseases. JPediatric Ophthalmol Strabismus. 2013. [Epub ahead of print]

Clinical Point-of-View

“The availability of Optos UWF imaging is helping us improve the diagnosis and management of pediatric retinal disease, in both babies and older children. With these systems we can now readily obtain non-contact, single-pass high resolution digital images of the macula and periphery in an outpatient setting without the use of anesthesia or intravenous fluorescein. Even with patients who would not be able to cooperate with conventional imaging techniques, UWF imaging permits the identification of pathology in the periphery we might otherwise …

A new resource for eyecare practitioners is in the works. As announced in a press release, the American Academy of Ophthalmology (AAO) has started an initiative to “implement the nation’s first comprehensive eye disease patient database.” This effort is expected to create what David W. Parke II, M.D., CEO of the AAO calls “a fantastically powerful tool that will stimulate improved quality of eye care,” particularly for patients that have received medical or surgical care for issues causing vision loss.

The database, called the IRIS (Intelligent Research in Sight) Registry will be a central location for data collection and will provide ophthalmologists with a system that promotes practice innovation and achievement of clinical excellence. Some of the significant features of the IRIS Registry include the following:

Benchmark reports that are easy to read and help validate the quality of care a practitioner is providing, as well as areas in need of improvement Access to clinical data relevant to eye diseases such as age-related macular degeneration (AMD) and cataracts, among others Automatic data collection via electronic health records

According to the AAO, these features will be instrumental in helping practitioners “develop a strategic plan for improving patient outcomes.”

William …

There are tens of thousands of eyecare practitioners out there. But as Barry Farkas, OD, FAAO in New York City recently reminded us in an interview with Optometric Minute, just because they are talented and smart doctors doesn’t necessarily mean they have a notably successful practice. In fact, he suggests many practices are stagnant, and therefore, suffer because they lack a key ingredient for success – a “quality of specialness.”

Dr. Farkas shares that a successful practice exudes this specialness to its patients, meaning that they are able to sense something different about the practice when they walk in the door. This quality of specialness makes patients feel comfortable and confident that they are receiving exceptional quality of care and service. Practices that go out of their way to offer something special provide patients with added benefits that not only enhance the experience but contribute to their continued or improved health.

Dr. Farkas also shares that a part of creating a quality of specialness is finding the right people to complete the practice’s staff. All staff members should have a patient-centered attitude, becoming an extension of the doctor in providing quality care and service. And Dr. Farkas also adds …

This study, published in Ophthalmic Surgery, Lasers and Imaging Retina, was conducted to evaluate the utility of ultra-widefield fluorescein angiography (UWFFA) in children under 13. Theretrospective case series examined images from 16 patients (mean age 9.3 years) who were seen for a variety of pediatric retinal conditions, including uveitis, hereditary retinal dystrophies, retinal vascular diseases, trauma, infection, and tumors. In these patients, UWFFA revealed abnormal peripheral angiographic findings in 12 of the 16 subjects (75%). UWFFA imaging of the macula and periphery provided important information for documentation, diagnosis, and management.

Tsui I, Franco-Cardenas V, Hubschman JP, Schwartz SD. Pediatric retinal conditions imaged by ultra wide field fluorescein angiography. Ophthalmic Surgery, Lasers and Imaging Retina. 2013: 44: 59-67.

Universal design that is accessible for individuals with limited mobility continues to evolve in both the residential and commercial industries as advanced technologies and new design solutions continue to emerge. Optometry Today’s deputy editor Robina Moss recently shared, however, that some spaces still aren’t accessible enough for all.

Moss recounted a recent shopping experience with her mother, who uses a wheelchair. Some stores, she noted, were particularly difficult if not nearly impossible for them to navigate because displays were placed too closely together or aisles were simply too narrow. Point-of-sale displays, she said, were a major hurdle.

“I had to physically move several which blocked our path. With that in mind, it struck me that it is worth thinking about frame displays and store accessibility, as these factors could be costing practices additional business.”

We’d like to think that out of all places, doctors’ offices would be up-to-date on the latest universal design techniques, but as American Medical News reported earlier this year, this is unfortunately not the case. The article cites a report published in Annals of Internal Medicine revealing that up to 22 percent of medical and surgical practices indicated they couldn’t accommodate patients that …

Memory loss and confusion are just a few of the symptoms associated with Alzheimer’s disease. And sadly, the disease is already quite advanced by the time patients begin exhibiting symptoms and an official diagnosis is given, making it rather difficult to treat. Past studies have indicated that there is potential for eye exams to aid in earlier detection of Alzheimer’s disease, as have advances in research Healio Optometry recently reported on, which have revealed there may be potential for a new method of earlier detection of Alzheimer’s, perhaps long before patients start presenting symptoms.

Neurologists have determined the presence of amyloid beta protein deposits as a “biomarker” of Alzheimer’s. Amyloid can also accumulate in the eye, leading researchers to theorize, “If a correlation can be made between the amyloid in the eye and the amyloid in the brain, then it would be possible to diagnose [Alzheimer’s] by looking into the eye.”

With this theory in mind, researchers are working to develop tests that will detect these amyloid beta deposits in the eyes. One test, currently referred to as the “Retinal Amyloid Index,” takes a scan similarly to conventional retinal imaging devices, after the patient has taken a curcumin …

In the Journal of AAPOS, researchers described the first case report of the use of oral fluorescein and Optos noncontact ultra-widefield (UWF™) fundus and angiographic imaging in an office setting on a non-sedated infant with incontinentia pigmenti. The UWF imaging system also correctly identified retinal neovascularization and avascular retinal zones, which subsequently permitted targeted laser treatment of retinal capillary nonperfused areas. This approach is less invasive for pediatric patients, obviates the potential risks associated with IV fluorescein and enables the review of both healthy and diseased retinal vasculature in a single image.

Patel CK, Fung THM, Muqit MMK, Mordant DJ, Geh V. Non-contact ultra-widefield retinal imaging and fundus fluorescein angiography of an infant with incontinentia pigmenti without sedation in an ophthalmic office setting. Journal of AAPOS. 2013.

Today marks the beginning of the fourth annual National Eye Health Week (NEHW) in the UK. As Vision Matters shares, there are 1.8 million people in the UK dealing with vision loss, yet in over half of these instances, a vision test and new glasses could have helped tremendously. With that in mind, eye care charities and organizations, as well as health care professionals all across the UK formed NEHW as a way to spread the word about the importance of eye health and routine vision exams.

Optos encourages all of our UK practitioners to take NEHW as another opportunity to remind patients of the importance of routine eye exams as a part of keeping their eyes and vision healthy in order to prevent eye disease and unnecessary vision loss. It’s also an opportunity to remind patients of the range of issues – from glaucoma to diabetes – that these exams can detect. Consider some of these suggestions offered up by Vision Matters on how practitioners can participate in this important eye health awareness week:

– Display NEHW leaflets and posters in your practice, including those that encourage positive eye health messages. – Ask patients coming in for a vision …

The results of a new report commissioned by Prevent Blindness America have revealed that vision problems and eye disorders in the United States are much more costly than originally thought. The report, “Cost of Vision Problems: The Economic Burden of Vision Loss and Eye Disorders in the United States”, shows that the nation is spending an astounding $139 billion on eye and vision related conditions a year, as Review of Optometry noted.

The new study features revised methodology from a similar report conducted by Prevent Blindness America in 2007, and offers a comprehensive look at the economics of vision issues. It also covers data from an age spectrum, which for the first time ever, includes children.

According to the report, children ages 0 to 17 accounted for the least amount of money spent on vision issues, at $5.73 billion. Adults age 65 and over were the most costly group, totaling for $77.28 billion. Those ranging from 18 to 39 years of age accounted for $22.16 billion spent on vision issues, slightly more than the cost estimates for the same demographic in 2012. Adults from age 40 to 64 accounted for $39 billion spent on vision issues.

The …

If you used Child Eye Health & Safety Month as an opportunity to encourage patients with children to schedule eye exams for their kids, it’s likely that you’ll be seeing these patients within the next few months. It’s a good time, therefore, to think about how you can make these exams as kid-friendly as possible.

Visiting the eye doctor, especially for the first time, can be an overwhelming experience for kids, and it might make them a little nervous.  Below are a few tips from Optometry Today and the Association of Optometrists (AOP) which can help to make it easier for them and for you when conducting the exam.

– Exams should be scheduled when the child is most alert. Morning appointments are usually better for younger children, while afternoons are better for older kids as “binocular vision issues are more likely to be apparent.” – Make sure you see children promptly. The longer they have to wait the more restless and nervous they may become. – Always have a parent or guardian present while the exam takes place. In addition to keeping them calm, they can help explain the process in a way that their child will …