10 years ago, if you complained of redness, dryness, irritation, and a feeling of “tired” eyes, I would have likely told you that you are not making enough tears. It is only recently that we have realized that these symptoms are a result, NOT from tear quantity, NOT from tear production, but rather, a result of poor tear quality – leading to tear film instability and inflammation, a result from an inadequate and improper contribution from the oil/lipid-producing meibomian glands. Fortunately there is a painless, safe, effective, FDA-approved, 12-minute treatment that is remarkably beneficial in treating this problem that is […]
The online etymology dictionary goes back to the 14th century. However, if we dig a little deeper, we can go back much further. In the ancient Hebrew over 3000 years ago, we find the word כְּאִישׁ֥וֹן
This is a masculine noun that in modern pronunciation would be ishon (ee-shone’) and is felt to mean “little man” presumably from the reflection seen during ancient examination limited by the technology of that era. It was considered of great value as it was concluded that sight corresponded to this specific location of the eye.
This highly valued association with sight was eventually tied to the […]
I want to credit the insight given to me from Dr. Doug Rett, OD, FAAO:
“In 1958 Muro Pharmacal Labs was founded and it manufactured ophthalmic drugs. It was named Muro for the Italian word for “wall,” which I think is fitting given the barrier that the cornea plays in penetration of ocular drugs. With tight junctions, pH sensitivity and the hydrophobic nature of the epithelium and hydrophilic nature of the stroma, it’s difficult for modern-day drug companies to pass medication through the cornea, let alone in the 1950s. In 1968 Muro was sold to George Behrakis, a pharmacist from Lowell, […]
Corneal hydrops involving a rupture or break in Descemet’s membrane is a relatively uncommon event occurring in patients with advanced keratoconus or other or corneal ectasia – possibly caused by aggressive eye rubbing – is characterized by stromal edema due to leakage of aqueous humor through a tear in Descemet’s membrane. It was the Greek physician Hippocrates (ca. 460 BC–370 BC) who is often credited with developing the theory of the four humors—blood, yellow bile, black bile, and phlegm—and the influence of these “fluids” on the body and its emotions. Swelling associated with disease became known as oidêma (swelling) and […]
While much of our surgery in Ophthalmology has moved away from needing sutures, there are still procedures that require very delicate suturing, including corneal transplant procedures, deep anterior lamellar keratoplasty, traumatic injuries, sutured intraocular lens implants, and other procedures. I am grateful to Doug Mastel and the great folks at John Weiss & Son International for their help in bringing into production the Carlson-Troutman needle holder that serves as an extremely precise needle driver while simultaneously serving as a tying forcep – allowing the passage of a needle and also tying the suture without exchanging instrumentation – improving efficiency, precision, […]
What is a lens? A lens is a transmissive optical device that focuses or disperses a light beam by means of refraction. A simple lens consists of a single piece of transparent material, while a compound lens consists of several simple lenses (elements), usually arranged along a common axis.
Lenses are made from materials such as glass or plastic and ground and polished or molded to a desired shape. A lens can focus light to form an image unlike a prism, which refracts light without focusing. Devices that similarly focus or disperse radiation oth
er than visible light are also called lenses, […]
Panuveitis Treated with Cataract Surgery, Intraocular Lens Insertion, Synechialysis, Retisert Steroid Implant, and Glaucoma Filtration Tube
Panuveitis can be one of the most challenging problems in Ophthalmic Surgery as this type of severe and pervasive inflammation can affect multiple aspects of the eye resulting in loss of vision. This particular patient needs the Retisert steroid implant for the treatment of severe inflammatory complications. Alan N. Carlson, M.D., Professor of Ophthalmology and Chief of the Corneal and Refractive Surgery Service at the Duke Eye Center in Durham, NC works closely with Glenn Jaffe, MD and Pratap Challa MD to treat this patient with removal of scar tissue (synechialysis and removal of pupillary membrane), cataract removal, intraocular lens […]
The LipiView diagnostic instrumentation and LipiFlow Thermal Pulsation Units by TearScience bring an enormous advance for our patients suffering from one of the most common conditions seen in virtually every optometric and ophthalmic practice – including the Duke Eye Center in Durham, NC. This condition is dry eye and the most common cause resulting in dry eye is tear film instability rather than tear production. If you asked me 15 years ago about dryness of the ocular surface, I would relate the problem to aging, hormonal changes, and inadequate tear production. We have witnessed a dramatic shift in our understanding […]
New & Noteworthy Journal Articles
Compiled by Andrew E. Mathis, PhD, Medical Editor
► Keratoconus and sleep apnea. Noting the sparseness of post-keratoplasty patients among their elderly patients, ophthalmologists Preeya Gupta, M.D., Assistant Professor of Ophthalmology and Alan N. Carlson, M.D., Professor of Ophthalmology and Chief of the Corneal Service at the Duke Eye Center in Durham, NC, undertook a study to determine whether there was any correlation between keratoconus and mortality, looking specifically at sleep apnea as a primary symptom. They report their findings in the June 2012 issue of Cornea.
The authors conducted telephone interviews with 101 patients diagnosed with […]
LipiFlow is a thermal pulsation treatment produced by TearScience (Morrisville, NC) invented by Dr. Donald Korb (Boston, MA) that received FDA approval in July 2011 established as safe and effective in the treatment of meibomian gland dysfunction (MGD) and its role leading to evaporative dry eye. This treatment has been available at Duke Eye Center since October 2011 when Duke became the first medical center in the country to offer this treatment on a commercial, non-experimental basis. Alan N. Carlson, M.D., Professor of Ophthalmology and Chief of the Corneal and Refractive Surgery Service at the Duke Eye Center has found […]