Optometry - Journal of the American Optometric Association RSS feed: Current Issue. Optometry- Journal of the American Optometric Association leads the way in providing doctors of optometry (O.D.) and optometry students with research that helps improve the quality of eye and vision care everywhere. It contains peer-reviewed articles on various clinical aspects of the profession and presents readers with educational material on current research in vision problems, eye disease, and other vision abnormalities. The content covers a range of topics with an emphasis in primary care optometry, contact lenses, sports vision, low vision, pharmaceuticals, and practice enhancement. In addition to articles, regular features include editorial perspectives, book reviews, medical abstracts, health notes, industry news, and office management.http://www.optometryjaoa.com/?rss=yesElsevier Inc.en © 2010 American Optometric Association. Published by Elsevier Inc. All rights reserved. Optometry - Journal of the American Optometric Association1529-1839813March 2010 © 2010 American Optometric Association. Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.optometryjaoa.com/article/PIIS152918391000062X/abstract?rss=yesIn the health care community, January seems to be an especially economically stressful time, as patients begin the year with a new deductible or a higher copayment, or a new (and sometimes more confusing) insurance plan. For anyone who is in need of care, particularly those with chronic or ongoing health problems, there is often concern regarding out-of-pocket expenses. Given that at some point each of us will experience the role of being someone's patient (or perhaps we already are) the reality of these dollar-and-cents concerns affects everyone; for doctors it is the other side of the health care reimbursement coin. As a patient, I am shocked at the cost of care for a relatively healthy child or adult. It was with interest and by coincidence that I came across an article stating, “Economic theory and empirical evidence suggests that patients will use fewer health services when they have to pay more for them.” And while this article identified the inverse relationship between increasing copayments and office visits, costs that might “deter patients from obtaining effective outpatient medical care, leading to greater offsetting use of acute care in the hospital,” I am particularly concerned about how this might impact patients who need to be monitored for vision-threatening conditions such as age-related macular degeneration, glaucoma, and diabetic retinopathy, to name but a few.A flip of the coinPaul B. Freeman10.1016/j.optm.2010.02.001Optometry - Journal of the American Optometric Association 81, 3 (2010)2010-03-01Optometry - Journal of the American Optometric Association2010-03-01813S1529-1839(10)X0003-3Editor's Perspective121121http://www.optometryjaoa.com/article/PIIS1529183909006654/abstract?rss=yes Glaucoma: Identification and Co-Management is a very handy reference that should be accessible to any clinician dealing with glaucoma, especially for those out of optometry school for some time but wishing to increase their knowledge of the disease process and care of patients with glaucoma. It is a composite of lecture notes from certificate courses run in the United Kingdom much like those run in the United States before practicing ODs become certified to deliver therapeutic care of the glaucoma patient.Glaucoma: Identification & Co-ManagementG. Timothy Petito10.1016/j.optm.2009.12.008Optometry - Journal of the American Optometric Association 81, 3 (2010)2010-03-01Optometry - Journal of the American Optometric Association2010-03-01813S1529-1839(10)X0003-3Book Notes122123http://www.optometryjaoa.com/article/PIIS1529183910000217/abstract?rss=yesIf it catches on, the next time you or an acquaintance is in the hospital, don't be surprised if the nurse dispensing the medication is wearing a bright yellow sash like a scout showing off merit badges.Yellow-sashed nursesByron Y. Newman10.1016/j.optm.2010.01.002Optometry - Journal of the American Optometric Association 81, 3 (2010)2010-03-01Optometry - Journal of the American Optometric Association2010-03-01813S1529-1839(10)X0003-3Health Notes124124http://www.optometryjaoa.com/article/PIIS1529183909006587/abstract?rss=yes Primary angle closure glaucoma (PACG) is a debilitating, sight-threatening disease that is commonly found in the Asian population. Although initial treatment may be obtained with laser peripheral iridotomies, the patient more often than not will require additional surgeries, such as cataract extraction and/or a trabeculectomy to obtain adequate intraocular pressure (IOP) control. This retrospective study examined the long-term efficacy and safety of cataract surgery in conjunction with trabeculectomy versus trabeculectomy alone.Combined surgery or trabeculectomy alone for patients with uncontrollable PACGStephen Hess10.1016/j.optm.2009.12.004Optometry - Journal of the American Optometric Association 81, 3 (2010)2010-03-01Optometry - Journal of the American Optometric Association2010-03-01813S1529-1839(10)X0003-3Medical Abstracts125125http://www.optometryjaoa.com/article/PIIS1529183909006575/abstract?rss=yes Whether it is referred to as shaken baby syndrome, inflicted traumatic brain injury, or inflicted head trauma, child abuse is the leading cause of death in infancy. It is estimated that the number of physically abused children in the United States increased approximately 42% from 269,700 children in 1986 to 381,700 in 1993. Very young babies (under 6 months old) have the highest risk of suffering damage or death as a result of physical abuse. Severe abuse, in particular subdural hematoma and fracture, is much more common in babies than in older children. Retinal hemorrhages are the most common ocular finding, occurring in 50% to 100% of victims. Studies have not been clear in the past as to the most common patterns associated with an abusive situation. This study seeks to remedy this confusion concerning the prevalence and pattern of retinal hemorrhages in infants to allow eye care providers the opportunity to protect these patients who cannot protect themselves.Retinal hemorrhages associated with child abuseMarc B. Taub10.1016/j.optm.2009.12.003Optometry - Journal of the American Optometric Association 81, 3 (2010)2010-03-01Optometry - Journal of the American Optometric Association2010-03-01813S1529-1839(10)X0003-3Medical Abstracts125126http://www.optometryjaoa.com/article/PIIS1529183910000564/abstract?rss=yesOptometry—Journal of the American Optometric Association is the official publication of the American Optometric Association (www.aoa.org). The journal is provided to all AOA members as a membership benefit. Optometry is also provided to libraries, schools and colleges of optometry, medical libraries, hospitals and government agencies.Guidelines for Authors10.1016/S1529-1839(10)00056-4Optometry - Journal of the American Optometric Association 81, 3 (2010)2010-03-01Optometry - Journal of the American Optometric Association2010-03-01813S1529-1839(10)X0003-3Guidelines for Authors127128http://www.optometryjaoa.com/article/PIIS1529183909005223/abstract?rss=yesAbstract: Accommodation refers to the process of obtaining and maintaining a focused foveal retinal image of an object of interest. It involves optical, sensory, motor, perceptual, cognitive, pharmacologic, and biomechanical aspects, and hence represents a complex, multilevel neurologic control process. In patients with mild traumatic brain injury (mTBI), this process frequently is disrupted and compromised neurologically because of the pervasiveness of the coup-contrecoup, swelling, and shearing aspects of the brain injury. In this report, we review the earlier literature on accommodation in mTBI and then present several new findings from our clinical research unit, along with their clinical implications.Static and dynamic aspects of accommodation in mild traumatic brain injury: A reviewWesley Green, Kenneth J. Ciuffreda, Preethi Thiagarajan, Dora Szymanowicz, Diana P. Ludlam, Neera Kapoor10.1016/j.optm.2009.07.015Optometry - Journal of the American Optometric Association 81, 3 (2010)2010-03-01Optometry - Journal of the American Optometric Association2010-03-01813S1529-1839(10)X0003-3Issue Highlight129136http://www.optometryjaoa.com/article/PIIS1529183909005958/abstract?rss=yesAbstract: Background: A cholesteatoma, also known as an epithelioma, is a mass of soft tissue that results from the accumulation of keratin protein debris enclosed by a layer of stratified squamous epithelium.Case Report: A patient with cholesteatoma surrounding both internal carotid arteries presented with cerebral ischemic symptoms expressed as visual and ocular symptoms. Because of its location, mass effect, and potential stenosis of the internal carotids, this slow-growing tumor is potentially sight threatening. Asymmetric cupping of the optic nerves associated with symptoms such as dizziness, diplopia, or facial pain should be worked up carefully.Conclusion: The primary care optometrist can play an important role in the diagnosis and continued management of a patient with a cholesteatoma, carefully monitoring early signs of progression or change. This case illustrates how an intracranial lesion, away from the eye, can impact a number of ocular and visual functions.Neuro-ophthalmic manifestations of a complicated cholesteatomaMelanie A. Crandall, Maryke N. Neiberg, Kenneth R. Seger10.1016/j.optm.2009.11.001Optometry - Journal of the American Optometric Association 81, 3 (2010)2010-03-01Optometry - Journal of the American Optometric Association2010-03-01813S1529-1839(10)X0003-3Clinical Care137141http://www.optometryjaoa.com/article/PIIS1529183909006101/abstract?rss=yesAbstract: Background: The purpose of this study was to determine if there is a consistent set of recommendations for patients who wear an ocular prosthesis or if each patient needs an individual plan.Methods: A self-report questionnaire was distributed to members of the American Society of Ocularists. The survey consisted of 4 questions regarding frequency of removal and cleaning and preferred cleaning and lubrication agents. Respondents had 4 weeks to return the survey for results to be included.Results: One hundred three surveys were sent; 8 were undeliverable, leaving a sample size of 95. Thirty-four percent (32 ocularists) responded. The reason with the most frequency for prosthesis removal was only when the prosthesis felt irritated (31%). Fifty-eight percent reported that the ocular prosthesis should be cleaned every time it is removed. Mild soap or baby shampoo was listed as the preferred cleaning agent with 24% each. A majority listed a silicone oil–based lubricant (29%), but responses varied based on the patient's needs.Conclusions: An individualized treatment plan is indicated for most patients who wear an ocular prosthesis. Despite this, some commonalities in responses were noted, specifically that the ocular prosthesis needs to be cleaned with every removal, and a silicone oil lubricant is recommended.A survey of recommendations on the care of ocular prosthesesKatherine L. Osborn, Debbie Hettler10.1016/j.optm.2009.11.003Optometry - Journal of the American Optometric Association 81, 3 (2010)2010-03-01Optometry - Journal of the American Optometric Association2010-03-01813S1529-1839(10)X0003-3Clinical Care142145http://www.optometryjaoa.com/article/PIIS1529183909004849/abstract?rss=yesAbstract: Background: Idiopathic orbital inflammatory syndrome (IOIS) is a collection of primary orbital inflammatory expressions manifested in a variety of clinical presentations. Because the process is idiopathic, it lacks association with neoplastic, infectious, or systemic immunologic and inflammatory diseases. Therefore, an extensive analysis is required to exclude secondary etiologies of orbital inflammation.Case report: Exhibited is a case of a 68-year-old white man presenting with a recent history of viral conjunctivitis and acute complaints of monocular vision loss, epiphora, photophobia, and generalized irritation without pain. On examination, he was found to have chemosis, a serous retinal detachment, and choroidal detachments. Magnetic resonance imaging found evidence of dacryoadenitis, posterior scleritis, and mild diffuse orbital inflammation. Extensive history and physical examination found no evidence of systemic inflammatory disease. IOIS was diagnosed and treated successfully with prednisone, without recurrence.Conclusions: Pain is historically considered a cardinal sign of acute inflammation and a predominant symptom of IOIS. The authors present a case of acute IOIS, atypical because of its presentation in the absence of pain. In addition, a review of the literature is conducted to identify predominant clinical and radiologic characteristics of IOIS along with current accepted and proposed treatment options. Differentials are discussed to distinguish this disease from systemic immunologic and inflammatory conditions such as syphilis, sarcoidosis, and Wegener's granulomatosis as well as potentially fatal neoplastic conditions.Idiopathic orbital inflammatory syndrome without pain: A case reportWilliam Scott Slagle, Kari H. Boothe, Angela N. Musick, Daniel R. Eckermann, Amber M. Slagle10.1016/j.optm.2009.03.021Optometry - Journal of the American Optometric Association 81, 3 (2010)2010-03-01Optometry - Journal of the American Optometric Association2010-03-01813S1529-1839(10)X0003-3Clinical Care146152http://www.optometryjaoa.com/article/PIIS1529183909006617/abstract?rss=yesAbstract: The purpose of the current study was to assess the effect of nearwork-induced transient myopia (NITM) on retinal defocus patterns during distance viewing. An empirically derived, conceptual model of human blur perception and related retinal defocus patterns has been extended to determine the effect of NITM on the relative contributions of myopic and hyperopic retinal defocus during distance viewing. Under the normal hyperfocal refractive condition during distance viewing with isolated stimulus conditions, there is very small myopic defocus (∼0.25 diopters), and no hyperopic defocus, present. After sustained nearwork generating NITM, a moderate increase in this myopic defocus contribution takes place. In the normal isolated distance viewing situation with only very small myopic defocus present, as would occur with many far outdoor activities, the paucity of overall retinal defocus may provide a “protected” condition against myopia development. In contrast, with the addition of NITM producing increased myopic retinal defocus only, there is an imbalance of retinal defocus that may be myopigenic, especially in the context of foveal and peripheral retinal interactions.Effect of nearwork-induced transient myopia on distance retinal defocus patternsKenneth J. Ciuffreda, Balamurali Vasudevan10.1016/j.optm.2009.03.022Optometry - Journal of the American Optometric Association 81, 3 (2010)2010-03-01Optometry - Journal of the American Optometric Association2010-03-01813S1529-1839(10)X0003-3Clinical Research153156http://www.optometryjaoa.com/article/PIIS1529183909005247/abstract?rss=yesAbstract: Vitreous floaters are a common complaint in the ophthalmic care setting. Patients seek explanation and advice regarding possible treatment options. Because the condition is considered benign, ophthalmic care practitioners have little to offer regarding treatment options. The majority of cases encountered are managed with patient education and reassurance. Although almost all patients accept the conservative management option, there is a small subset of patients who may desire a more aggressive treatment intervention for resolution of their visual symptoms. Information with regard to treatment options is readily available to patients through Internet searches and non–peer reviewed educational Web sites. The risks and benefits for these treatment options are not fully covered. Management of floaters should include education regarding “off-label” procedures as well as discussion about benefits and risks associated with such treatment options. It is vital that eye care practitioners advise and counsel patients with symptomatic floaters for optimum ocular health care. This article reviews the current conventional and “off-label” treatment options for symptomatic patients with vitreous floaters.Current treatment for vitreous floatersDavid P. Sendrowski, Mark A. Bronstein10.1016/j.optm.2009.09.018Optometry - Journal of the American Optometric Association 81, 3 (2010)2010-03-01Optometry - Journal of the American Optometric Association2010-03-01813S1529-1839(10)X0003-3Review Article157161http://www.optometryjaoa.com/article/PIIS1529183910000394/abstract?rss=yesElectronic health records (EHRs) can markedly improve health care quality, safety, and efficiency as well as facilitate the nation's effort to reduce health care disparities among disadvantaged populations, according to the U.S. Department of Health & Human Services (HHS). EHRs are considered a fundament element in the government's overall strategy to reform the American health care system. By now, most health care practitioners know that a Nationwide Health Information Network (NHIN), under development to provide interoperable EHRs for all Americans, is set for launch in 2014. A relatively new government entity, the Office of the National Coordinator of Health Information Technology (ONCHIT) has even been established within the HHS to oversee the new national EHR system.Why optometrists should act on electronic health records now10.1016/j.optm.2010.01.003Optometry - Journal of the American Optometric Association 81, 3 (2010)2010-03-01Optometry - Journal of the American Optometric Association2010-03-01813S1529-1839(10)X0003-3Practice Strategies162164http://www.optometryjaoa.com/article/PIIS1529183910000412/abstract?rss=yesA recent multicenter, practice-based study conducted in the United Kingdom and published in a British research journal offers some good insight into how helping patients choose their frames can result in not only generating greater revenue for eyeglasses but also spur contact lens sales. In fact, the results from the study found an average increase of 32% in spending for frames and a two and a half times greater purchase of contact lenses after the experience.Study offers interesting way to build lens practiceGary Gerber10.1016/j.optm.2010.01.005Optometry - Journal of the American Optometric Association 81, 3 (2010)2010-03-01Optometry - Journal of the American Optometric Association2010-03-01813S1529-1839(10)X0003-3Practice Strategies165166http://www.optometryjaoa.com/article/PIIS1529183910000473/abstract?rss=yesEDITOR'S PERSPECTIVE121 A flip of the coinTable of Contents10.1016/S1529-1839(10)00047-3Optometry - Journal of the American Optometric Association 81, 3 (2010)2010-03-01Optometry - Journal of the American Optometric Association2010-03-01813S1529-1839(10)X0003-3FrontmatterA1A1http://www.optometryjaoa.com/article/PIIS1529183910000485/abstract?rss=yesPaul B. Freeman, O.D., Editor-in-Chief e-mail: pbfreeman@aoa.orgEditorial Board10.1016/S1529-1839(10)00048-5Optometry - Journal of the American Optometric Association 81, 3 (2010)2010-03-01Optometry - Journal of the American Optometric Association2010-03-01813S1529-1839(10)X0003-3FrontmatterA2A2