Advanced Refractive Error Topics (II)

Central Serous Chorioretinopathy

fluid leakage under macula and retina moves forward causing a small hyperopic shift, usually unilateral

Etiology of CSC

unknown; associated with higher level of cortisol

Demographic of CSC

20-50 yo men

Risk Factors of CSC

medication, type A, pregnancy, Cushing’s

Symptoms of CSC

distorted, blurred, or dim central vision, blind spot, minified, abnormal color vision, asymptomatic

Treatment for CSC

typically resolves without Tx within 3-4 months

Rate of Recurrent CSC

30%

Diabetes Hyperopic Shift

after a myopic shift, eventually a hyperopic shift back to normal with controlled glucose levels

Aphakia

crystalline lens in the eye removed and no intraocular lens implanted, very hyperopic

CK Surgery

Conductive Keratoplasty, rediowaves shrink collagen in corneal periphery

Regular Astigmatism

refractive power along the meridian has curvature variation of a simple toroidal surface and the two principal meridians are perpendicular to each other

Irregular Astigmatism

principal meridians are not at a right angle, associated with coronal or lenticular pathology

Keratoconus

corneal dystrophy; middle of cornea thins and bulges forward forming a cone shape

When does Keratoconus typically begin?

often during puberty

Prevalence of Keratoconus

1/500 to 1/2000

Keratoconus Management

GL CLS, specialty CL, intacs corneal ring implant, corneal transpant, CXL

Corneal Collagen Cross-Linking

riboflavin drops saturate the cornea which is then activated by UV light, increase in collagen cross-linking in the cornea, strengthening it, slows the progression

Internal Hordeolum

Infected meibomian gland causing tender inflamed localized swelling, can push on the cornea, causing a temporary astigmatic shift

Internal Hordeolum Treatment

warm compress for 10 minutes 4 times a day, light massage, may need antibiotics

Pterygium

bulbar conjunctival mass of tissue grows onto the cornea; nasal/temporal; if not on cornea, then called a pinguecula, may induced irregular astigmatism, UV radiation

Pterygium Treatment/Management

sunglasses, artificial tears, surgery, possible re-growth

Cortical Cataract

increase the refractive index and the power along that meridian

What range of astigmatism is LASIK approved for?

0.50D to 6D

Anisometropia

refractive error of eyes differ in one meridian or both principal meridians by at least 1D

Causes of Premature Presbyopia

nutrition, drugs, corticosteroid medication, temperature, UV radiation

VIZZ

aceclidine ophthalmic solution, correction of presbyopia, 2mm pupil size to increase depth of focus, improves vision for up to 10 hours