Functional impairment of reading in patients with dry eye

BACKGROUND/AIMS: To evaluate the impact of dry eye on reading performance. METHODS: Out-loud and silent reading in patients with clinically significant dry eye (n=41) and controls (n=50) was evaluated using standardised texts. Dry eye measures included tear film break-up time, Schirmer's test and corneal epithelial staining. Symptoms were assessed by the Ocular Surface Disease Index (OSDI). RESULTS: The dry eye group had a greater proportion of women as compared with the control group but did not differ in age, race, education level or visual acuity (p≥0.05 for all). Out-loud reading speed averaged 148 words per minute (wpm) in dry eye subjects and 163 wpm in controls (p=0.006). Prolonged silent reading speed averaged 199 wpm in dry eye subjects versus 226 wpm in controls (p=0.03). In multivariable regression models, out-loud and sustained silent reading speeds were 10 wpm (95% CI −20 to −1 wpm, p=0.039) and 14% (95% CI −25% to −2%, p=0.032) slower, respectively, in dry eye subjects as compared with controls. Greater corneal staining was associated with slower out-loud (−2 wpm/1 unit increase in staining score, 95% CI =−3 to −0.3 wpm) and silent (−2%, 95% CI −4 to −0.6 wpm) reading speeds (p<0.02 for both). Significant interactions were found between OSDI score and word-specific features (longer and less commonly used words) on out-loud reading speed (p<0.05 for both). CONCLUSIONS: Dry eye is associated with slower out-loud and silent reading speeds, providing direct evidence regarding the functional impact of dry eye. Reading speed represents a measurable clinical finding that correlates directly with dry eye severity

Erratum

Utine CA. Update and critical appraisal of the use of topical azithromycin ophthalmic 1% (AzaSite&amp;reg;) solution in the treatment of ocular infections. Clin Ophthalmol. 2011;5:801-809.Table 2 inaccurately states that Bremond-Grignac used AzaSite&amp;reg; in their study. The ophthalmic preparation used was in fact Azyter&amp;reg;. Original Articl

Update and critical appraisal of the use of topical azithromycin ophthalmic 1% (AzaSite&amp;reg;) solution in the treatment of ocular infections

Canan Asli UtineYeditepe University, Department of Ophthalmology, Istanbul, Turkey and Ocular Surface Disease and Dry Eye Clinic, Cornea and External Disease Service, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USAAbstract: Azithromycin is an azalide that acts by binding to the 50S ribosomal subunit of susceptible microorganisms and interfering with microbial protein synthesis. Azithromycin is also noted by anti-inflammatory and immunomodulatory activity. AzaSite&amp;reg; (Inspire Pharmaceuticals, Inc, Durham, NC) is azithromycin ophthalmic solution, 1% formulated in polycarbophil (the aqueous mucoadhesive polymer contained in DuraSite&amp;reg;) that delivers high and prolonged azithromycin concentrations in a variety of ocular tissues, including the conjunctiva, cornea and particularly the eyelid. AzaSite was approved by the Food and Drug Administration (FDA) in the US in 2007, for the treatment of bacterial conjunctivitis caused by susceptible isolates. This article aims to evaluate the peer-reviewed published scientific literature and to define well-established uses of AzaSite eye drops in the field of ocular infections.Keywords: azithromycin, AzaSite, DuraSit

Effects of Lubricating Agents with Different Osmolalities on Tear Osmolarity and Other Tear Function Tests in Patients with Dry Eye

Purpose: To evaluate the effects of different artificial tear eye drops on Ocular Surface Disease Index (OSDI), tear osmolarity, Schirmer's I test, and tear break-up time (TBUT) in patients with dry eye disease. Materials and methods: This 12-week, single-institution, single-masked, randomized, pilot study was conducted in Turkey between March and July 2012 in patients with dry eye. Patients were randomly assigned to receive Systane (R) for their right eye and Eyestil (R) for their left eye or to receive Tears Naturale II (R) for their right eye and Refresh Tears (R) for their left eyes. Outcomes were assessed at baseline and weeks 2, 4 and 12 after treatment initiation. Results: Twenty-two patients received Systane (right eye) and Eyestil (left eye) and 21 patients received Tears Naturale (right eye) and Refresh (left eye). At each visit and for each outcome, each treatment group demonstrated a significant improvement from baseline (p<0.001); however, none of these outcomes were significantly different among treatment groups at any visit. At week 12, the mean OSDI improvement was similar between the Systane/Eyestil group (-26.4 +/- 10.6) and the Tears Naturale/Refresh group (-27.6 +/- 14.8). The mean tear osmolarity decrease (mOsm/L) at week 12 was -33.8 +/- 8.3 for Eyestil, -30.3 +/- 9.2 for Refresh, 28.4 +/- 8.2 for Systane and 25.7 +/- 13.1 for Tears Naturale. The mean Schirmer's test increase at week 12 (mm/5 min) was 6.7 +/- 3.4 for Eyestil, 6.4 +/- 2.9 for Systane, 4.7 +/- 2.4 for Tears Naturale and 4.7 +/- 2.8 for Refresh. The mean TBUT increase at week 12 (s) was 7.0 +/- 3.4 for Systane, 6.1 +/- 3.3 for Eyestil, 5.8 +/- 2.3 for Tears Naturale, and 5.6 +/- 2.8 for Refresh. Conclusion: All four artificial tear formulations were effective in relieving dry eye signs and symptoms. Although the greatest improvement in two of the objective tests was achieved by Eyestil, the drug with the lowest osmolality, differences among the four artificial tear eye drops were not statistically significant.Canakkale Onsekiz Mart University, Scientific Research Project Center [2010/121]This research is funded by Canakkale Onsekiz Mart University, Scientific Research Project Center. Project number: 2010/121

Boston KPro Type I: Vitreoretinal Considerations

Posterior segment complications are seen in a significant number of eyes having a keratoprosthesis (KPro) and are associated with poor visual outcomes. As the use of KPro increases dramatically, so too does the frequency of posterior segment complications seen by the vitreoretinal surgeon in this patient population, as well as the importance of addressing them expeditiously. Special consideration in diagnostic imaging and surgical planning is required in addressing the most common complications: retroprosthetic membrane (RPM), retinal detachments (RD) and other vitreous pathology, hypotony, glaucoma, epiretinal membranes (ERM), endophthalmitis, and vascular complications. This chapter seeks to summarize the diagnosis and treatment of each of these entities in the setting of KPro