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  • Dry eye blepharitis syndrome: The simple role of biofilm in dry eye
    By James M. Rynerson, MD
    This Current Insight proposes that blepharitis and dry eye disease are actually one simple disease process caused by biofilm.
    Current Insight
    Surgical management strategies for trachomatous trichiasis
    This Current Insight outlines current evidence supporting surgical management strategies for trachomatous trichiasis.
    Current Insight
    Donor corneoscleral rim fungal cultures in the era of endothelial keratoplasty
    By
    This Current Insight takes an in-depth look at the rising rates of postkeratoplasty fungal infections.
    Current Insight
    Corneal Crosslinking
    By
    This review describes the evolution of corneal cross-linking, and examines its future in the treatment of corneal disease.
    Current Insight
    Office procedures for ocular surface diseases
    By
    This article discusses several ocular surface disorders that a comprehensive ophthalmologist can treat with surgical procedures performed in the office or minor surgery setting.
    Current Insight
    It’s Time to Redefine Dry Eye
    By
    New research shows dry eye is a complex disease process, prompting calls to redefine this disease.
    Current Insight
    Extending the capability of IOLs: Extended depth of focus and extended range of vision IOLs
    By Cynthia Matossian, MD, FACS
    Extended depth of focus IOLs, also known as extended range of vision IOLs, are a new type of intraocular lens that allows for an extended range of crisp vision with a high rate of spectacle independence.
    Current Insight
    New computer model helps elucidate accommodation
    By Daniel B. Goldberg, MD, FACS
    By building a computer-animated model, we can advance our understanding of the underlying mechanisms of accommodation and presbyopia.
    Current Insight
    Surgical pearls for combining iStent with cataract surgery
    By Savak Teymoorian, MD, MBA
    Dr. Savak Sev Teymoorian provides some surgical pearls to help improve success when combining iStent and cataract surgery.
    Current Insight
    Corneal inlays for the surgical correction of presbyopia
    By George O. Waring IV, MD; Mona Sane, DNB, MRCOphth
    Corneal inlays have emerged as a promising surgical option for the treatment of presbyopia that could significantly improve quality of life for many people.
    Current Insight
    Managing wound leak with sealant after cataract surgery
    By John A. Hovanesian, MD, FACS
    Alternative methods of wound closure are currently being investigated, such as the use of hydrogel wound sealant.
    Current Insight
    Superficial keratectomy for Salzmann’s nodular degeneration: techniques and pointers
    By Terry Kim, MD; Jay J. Meyer, MD, MPH
    Superficial keratectomy can be used to treat the vast majority of Salzmann’s nodules, with proper instrumentation, surgical technique and postoperative management reducing the risk of recurrence.
    Current Insight
    Mini-monovision: Reducing spectacle dependence after cataract surgery
    By Cynthia Matossian, MD, FACS
    Modified monovision or "mini-monovision," which requires a smaller interocular diopteric power difference between eyes than traditional monovision, appears to be a safe and effective treatment for presbyopia. With the use of aspheric monofocal equiconvex IOLs to achieve "ble…
    Current Insight
    ASCRS, FDA: An update on TASS
    By Nick Mamalis, MD; Henry F. Edelhauser, PhD
    Toxic anterior segment syndrome (TASS) is an acute, sterile inflammatory reaction following anterior segment surgery that occurs secondary to a toxic insult during surgery or the perioperative period. There are multiple potential causes of TASS, including problems with instr…
    Current Insight
    Material world: The growing variety of foldable IOL materials
    By Liliana Werner, MD, PhD
    Since a 2003 survey on practice styles and preferences of American Society of Cataract and Refractive Surgery (ASCRS) members found that hydrophobic acrylic had been the preferred optic material since 1998,1 the U.S. market has seen increased variability in the materials use…
    Current Insight
    Liquid nitrogen cryotherapy effective for conjunctivochalasis, lymphangiectasia
    By Frederick (Rick) W. Fraunfelder, MD, MBA
    Conjunctivochalasis and lymphangiectasia are similar-appearing conjunctival conditions that can be successfully treated with liquid nitrogen cryotherapy. This therapy probably works for both conditions by tacking down the conjunctiva to the underlying globe through a cryogen…
    Current Insight
    New SLT results may change treatment of coexisting cataract and glaucoma
    By Lawrence Franklin Jindra, MD; Joe Donnelly
    The field of cataract surgery has seen several paradigm shifts that have significantly and irrevocably altered and improved our surgical procedures and outcomes, such as the introduction of the intraocular lens (IOL) by Ridley,1 phacoemulsification by Kelman 2 and viscoelast…
    Current Insight
    New treatments for central retinal vein occlusion
    By Rahul Khurana, MD
    Central retinal vein occlusion (CRVO) is a sight-threatening condition with an annual incidence of 30,000 eyes in the United States,1 while macular edema (ME) is a frequent cause of vision loss in eyes with CRVO with limited therapeutic options.2 Until recently, there were n…
    Current Insight
    Femtosecond lasers: The next disruptive technology in cataract surgery
    By Mark Packer, MD, FACS
    Laser-assisted refractive cataract surgery using femtosecond lasers has become the most recent disruptive technology to reach the cataract surgeon. The femtosecond lasers currently being brought to market are indicated for anterior capsulotomy, lens fragmentation and partial…
    Current Insight
    First impressions performing refractive laser-assisted cataract surgery
    By John Palmer Berdahl, MD
    We have been lucky enough to be one of the first sites to perform refractive laser-assisted cataract surgery (ReLACS) with the LenSx laser at Vance Thompson Vision in Sioux Falls, S.D., where I practice. Straight out of the box, I found this to be an impressive technology th…
    Current Insight
    Recent advances in the treatment of pediatric glaucoma
    By Shamil S. Patel, MD ; Carl F. Sloan, MD; Jess Thomas Whitson, MD, FACS
    Recent medical and surgical therapeutic advances have improved our ability to manage pediatric glaucoma, a potentially blinding condition characterized by elevated IOP, optic nerve damage and visual field loss. However, challenges still remain in treating this heterogeneous…
    Current Insight
    New, Consolidated Accommodation Theory May Change Future of Surgical Presbyopia Correction
    By Daniel B. Goldberg, MD, FACS
    It has become axiomatic that we still do not understand the mechanism of accommodation despite more than 200 years of scientific research and debate. However, the technological advances and research of the past decade have solved some of the mysteries surrounding accommodati…
    Current Insight
    Surgical Management of Pseudoexfoliation and Prevention of the Impending Epidemic of Pseudophakic Bag-Lens Subluxation
    By Lisa B. Arbisser, MD
    This article focuses on the consequences of zonular pathology in patients with pseudoexfoliation syndrome (PXF) and how this pathology influences cataract surgical technique and prognosis. PXF is an age-related condition associated with a LOXL1 genetic defect in which fibril…
    Current Insight
    Techniques for manual small-incision extracapsular cataract extraction
    By Leela V. Raju, MD; Madhavi Ghanta, DNB; V.K. Raju, MD FRCS FACS
    Manual small-incision extracapsular cataract extraction, or MSICS, has become an extremely efficient and financially feasible technique for cataract removal in situations in which phacoemulsification is problematic, as well as for treating patients in developing countries. N…
    Current Insight
    The glued IOL technique: Fixing a posterior chamber IOL when there’s no capsule
    By Amar Agarwal, MSOphth, FRCS, FRCOphth
    The glued IOL technique is a relatively new method for fixing a posterior chamber IOL in an eye without a capsule. It was first described by me and my colleagues in December 2007. The current article provides details about how the procedure is performed. Video demonstrating…
    Current Insight
    Retinal and Choroidal Manifestations of Toxoplasmosis
    By Juan D. Arias, MD ; J. Fernando Arevalo, MD, FACS
    Toxoplasma gondii is an ubiquitous, obligate intracellular protozoan and is considered to be the most common cause of infective retinitis in immunocompetent humans. The course of systemic disease in immunocompetent adults is usually asymptomatic and self-limiting. As soon as…
    Current Insight
    Optic disc involvement in Vogt-Koyanagi-Harada disease
    By Kumiko Nakao, MD, PhD; Taiji Sakamoto, MD, PhD
    Optic disc change is frequently associated with Vogt-Koyanagi-Harada disease (VKH) but not studied in great detail. While optic disc change may hamper the correct diagnosis of VKH, the presence of VKH may also hinder the diagnosis of optic disc disease. This article explores…
    Current Insight
    Posterior optic buttonholing: Rationale, surgical technique and pearls
    By Rupert Menapace, MD
    Posterior optic buttonholing (POBH) is a well-controlled and safe surgical procedure that provides a better alternative to standard in-the-bag placement of a sharp-edged intraocular lens (IOL). It has a steep learning curve, even in the hands of an experienced, well-informed…
    Current Insight
    Treatment options after failed nasolacrimal duct probing
    By Justin H. Arbuckle, MD; Jeffrey D. Colburn, MD; Derek T. Sprunger, MD
    There is no clear consensus on the optimal treatment of patients with nasolacrimal duct obstruction (NLDO) following failed nasolacrimal duct probing. Clinicians currently choose between repeat nasolacrimal duct probing, intubation of the nasolacrimal duct, balloon catheter…
    Current Insight
    The role of genetic AMD risk in IOL selection
    By Steve A. Arshinoff, MD, FRCSC ; Brent Zanke, MD, FRCPC, PhD
    The variety of intraocular lens (IOL) types has grown dramatically during the past decade, which has spurred much debate about appropriate IOL choices in various clinical situations. Aging populations in the developed world are growing, as is their demand for cataract surger…
    Current Insight
    Modified Capsular Tension Ring for Severe Zonular Damage
    By Robert J Cionni, MD
    Robert J. Cionni, MD, provides an overview and demonstration of how to use the Morcher capsular tension rings in patients with severe zonular damage.
    Current Insight
    Surgical Management of Duane Syndrome
    By Ronald G.W. Teed, MD
    Duane retraction syndrome (DRS) is best thought of as a special type of ocular dysmotility caused by improper innervation, or dysinnervation, of one or more extraocular muscles. A classification scheme for DRS is established in the literature; however, variability of dysinne…
    Current Insight
    The Next Evolution in Cataract Surgery
    By Stephen G. Slade, MD, FACS
    Stephen G. Slade, MD, is among the first to perform femtosecond laser cataract surgery in the United States. Three companies are currently developing these lasers: LenSx Laser (Aliso Viejo, Calif.), LensAR (Winter Park, Fla.) and Optimedica (Santa Clara, Calif.). But at this…
    Current Insight
    LASIK’s ethical dilemma
    By Warren E. Hill, MD
    Without an accurate method of predicting IOL power calculations in post-keratorefractive eyes, a tsunami is threatening to wash over ophthalmology in the near future, says ONE Cataract Editor Warren Hill,MD. Refractive surgeons need to throw out the standard practice of dest…
    Current Insight
    Immediately Sequential Bilateral Cataract Surgery: It’s time for a paradigm shift
    By Steve A. Arshinoff, MD, FRCSC
    Simultaneous bilateral cataract surgery (SBCS) is steadily growing in popularity worldwide. So much so that in September 2008, some of its practitioners formed the International Society of Bilateral Cataract Surgeons (iSBCS) to share information and promote safe procedures i…
    Current Insight
    SD-OCT: a quantum leap for anterior segment surgeons
    By Steven G. Safran, MD
    Many anterior segment surgeons are embracing the relatively new technology of spectral-domain optical coherence tomography (SD-OCT) and integrating it into their practices. SD-OCT is a painless, safe, fast, easy, reproducible and exact way to look at critical anatomy that co…
    Current Insight
    Clinical Evaluation of Pediatric Glaucoma Patients
    By Huijuan Wu, MD, PhD; Teresa C. Chen, MD
    A thorough, accurate clinical evaluation is essential for diagnosis, classification and treatment of pediatric glaucoma, which may be primary or secondary. Primary congenital glaucoma (PCG) occurs in about 1 in 10,000 births, representing 50 to 70 percent of congenital glauc…
    Current Insight
    Management of HLA-B27 acute anterior uveitis
    By Denis Wakefield, MD
    Acute anterior uveitis (AU) is the most frequent and prevalent form of uveitis, and about half of all patients with AU are HLA-B27-positive. HLA-B27 is the strongest genetic link to AU reported in most population studies. This article discusses the significant progress that…
    Current Insight
    Use of anti-VEGF agents for wound modulation after trabeculectomy
    By Malik Y. Kahook, MD
    Anti-vascular endothelial growth factor (anti-VEGF) agents have recently been introduced as potential modulators of the post-filtration surgery healing process. Newer anti-VEGF agents have become popular as intravitreal injections for choroidal and retinal neovascular diseas…
    Current Insight
    Prevention and management of Descemet’s stripping automated endothelial keratoplasty complications
    By Sonia H. Yoo, MD; Victoria Chang, BS
    Descemet's stripping automated endothelial keratoplasty (DSAEK) is becoming the treatment of choice for corneal endothelial failure due to its better preservation of the globe's integrity, typically faster visual rehabilitation and more predictable visual outcomes compared w…
    Current Insight
    Medical Management of Thyroid-associated Ophthalmopathy
    By Catherine J. Hwang, MD; Raymond S. Douglas, MD, PhD
    Graves disease is a multisystem autoimmune disease targeting the thyroid, orbit and skin. Clinically detectable thyroid-associated ophthalmopathy (TAO) occurs in approximately 10 to 45 percent of patients with Graves disease1 with manifestations ranging from mild ocular surf…
    Current Insight
    Visual rehabilitation strategies for homonymous hemianopia
    By Michael S. Lee, MD
    Spontaneous improvement can occur after homonymous hemianopia,1 although most patients do not enjoy complete resolution. This article describes three suggested strategies for ophthalmologists to try with such patients: the use of spectacle-mounted prisms that shift images fr…
    Current Insight
    Principles and Pearls in Toric Marking and Alignment
    By Joseph J.K. Ma, MD, FRCSC
    Click here for a one-page print-friendly version. It is useful to remember that a relatively small misalignment in toric lens placement can result in significant loss of astigmatic refractive effect. This relationship is sinusoidal (R=2Csinθ), where R = resulting cylinder o…
    Current Insight
    Perspectives on the Endophthalmitis Vitrectomy Study: Implementing its findings today
    By Dennis P. Han, MD
    The Endophthalmitis Vitrectomy Study (EVS) has strongly influenced the management of acute postoperative endophthalmitis since the release of its findings in 1995.1 The EVS confirmed the visual benefit of pars plana vitrectomy in patients presenting with visual acuity of lig…
    Current Insight
    Troubleshooting CMS Issues
    Lorem ipsum dolor sit amet, consectetur adipisicing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in…
    Current Insight
    Advances in Angle-supported Phakic Lens Implants
    By Simon P. Holland, MD
    Phakic lens implants (pIOLs) are increasingly being used to correct high refractive errors. Improved pIOL designs and outcomes may soon lead to their wider acceptance and use. These newer designs allow insertion through smaller incisions. Other advantages include minimal ast…
    Current Insight
    Androgen Deficiency in Ocular Surface Disease
    By Ayad A. Farjo, MD; Qais A. Farjo, MD
    Current therapeutic modalities have been helpful in treating many patients with ocular surface disease and dysfunctional tear syndrome. But there remains a subset of patients who continue to have signs and symptoms in spite of aggressive lubricant and anti-inflammatory thera…
    Current Insight
    The Evolving Role of Digital Technology in Evaluating Diabetic Retinopathy
    By Helen K. Li, MD
    Rapidly evolving computer technology is supplementing face-to-face patient examinations and expanding the reach of diabetic retinopathy evaluations. Diabetic retinopathy remains a leading cause of blindness, even though timely treatment has been proven to dramatically reduce…
    Current Insight
    Ocular Involvement in Lyme Disease
    By Robert S. Weinberg, MD
    Ocular inflammation can occur in patients with documented Lyme disease and has been reported to involve any part of the eye. Uveitis is uncommon, but case reports and small series demonstrate a wide variety of presentations including iridocyclitis, vitritis, multifocal choro…
    Current Insight
    The Ongoing Challenge of Intermittent Exotropia
    By Brian G. Mohney, MD; Sarah R. Hatt, DBO
    Intermittent exotropia is a common form of strabismus for which surgery is often performed when there appears to be evidence of poor control or loss of stereoacuity. But these indications are either poorly defined or have yet to be vigorously studied. This article discusses…
    Current Insight