FocalPoints - Clinical Modules for Ophthalmologists 2009

AAO 2018 12222 BCSC, Section 09
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February, 1 — 3. The Surgically Induced Astigmatism Calculator. Does the Capsulorrhexis Affect Refractive Outcomes? July, 48 — Hill We. Accurate Keratometry Readings. Cataract and Refractive surgery Today.

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Misaligned Toric IOL. February, February November, July, May, Evaluation of a new IOLMaster algorithm to measure axial length. Hill WE, Potvin R. Hitting Emmetropia. Chang D. Slack Incorporated, Measuring Axial Length.

New Technologies for Treating Glaucoma in Patients Undergoing Cataract Surgery

Chapter Refractive Enhancement with Piggybacking Intraocular Lenses. IOL power calculations after keratorefractive surgery.

Contents of this Issue

February, , pp. October, September 27, Cataract and Refractive Surgery Today — Supplement. August, Highly accurate IOL power calculations. IOL power calculations following keratorefractive surgery. The AcrySof Toric Calculator. April Supplement, A year old man who sustained a nonpenetrating bungee cord injury with extensive anterior segment damage is referred for management. Pars plana vitrectomy for the anterior segment surgeon. Video Journal of Ophthalmology , January Advanced Intraocular Lens Power Calculations. Springer-Verlag, Berlin, What IOL should I use in the post-keratorefractive patient?

In: CurbsideConsultation in Cataract Surgery. Cataract andRefractive Surgery Today. OcularSurgery News 24 13 , July Jan- Feb p. A Sudden Collapse of the Anterior Chamber. Astigmatism Correction. Damaged Piggyback IOL.

go to link IOL options in ; roundtable discussion. Focal Points — Clinical Modules for Ophthalmologists. Module 9, September, The American Academy of Ophthalmology. In situations where resources are limited it is often difficult to decide if steroids can be given safely.

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The purpose of this article is to briefly review the most important features of topical steroids and provide a practical and safe guideline for their use in general practice Fig. Topical steroids act locally and achieve their anti-inflammatory and immuno-suppressive effects through a combination of pathways.


The most important anti-inflammatory effect may be the inhibition of arachidonic acid release, preventing the liberation of prostaglandins and other potent inflammatory mediators. The immuno-suppressive effects include decreasing the number and functionality of leucocytes. Steroids also prevent late inflammatory responses, such as capillary and fibroblast proliferation, collagen deposition and scarring. Well-known complications of topical steroids include the formation of a geographic ulcer if given in the presence of a dendritic herpetic ulcer, cataract formation and increased intra-ocular pressure IOP.

This response can occur during any stage of treatment, and is more pronunced in children if the patient already has glaucoma, diabetes or high myopia. Regular IOP monitoring is needed to prevent damage to the optic nerve.


This may lead to new infections, exacerbate existing infections, reactivate dormant infections and mask less obvious chronic infections, leading to delayed presentation of potentially blinding conditions. Other adverse effects include delayed wound healing, mydriasis, aponeurotic ptosis and peri-ocular dermatitis. In the presence of an underlying connective tissue disease which predisposes to corneal or scleral thinning, ocular perforation may occur. Formulations with acetates are more lipophilic and penetrate through the cornea better than those formulated with phosphates, which are relatively hydrophilic.

Topical steroids should only be prescribed if the benefit outweighs the risks. In severe allergic keratoconjunctivitis, fluoromethalone alcohol suspension 0. It has a potent anti-inflammatory effect on the ocular surface, but rapid metabolism of the compound within the eye decreases the intra-ocular potency and intra-ocular side-effects.

The risk of corneal ulcers, however, remains unchanged. It penetrates the globe poorly and is even less likely to cause steroid glaucoma.

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Dexamethasone 0. It penetrates the cornea more readily and has a long half-life in ocular tissues. It is therefore more suitable for reaching deeper ocular tissues as is needed in uveitis , but has a higher risk of significant IOP elevation and cataract formation compared with fluoromethalone 0. These combinations are indicated for use in the postoperative period i. Ophthalmology , vol , isu 12, pgs 0.

Treating strabismus by injecting the agonist muscle with bupivacaine and the antagonist with botulinum toxin. Bupivacaine injection of the lateral rectus muscle to treat esotropia. Br J Ophthalmol. Lateral Rectus muscle disinsertion and reattachment to the lateral orbital wall.

Progressive restrictive strabismus acquired in infancy. Scott AB. Development of botulinum toxin therapy. In: Dermatol Clin. Chemodenervation therapy: Techniques and indications. In: Clinical Strabismus Management. Rosenbaum, Santiago eds. Saunders Co.

Recurrent UGH Syndrome in an Eye With a Scleral-Fixated IOL

Botulinum toxin treatment of strabismus. In: Strabismus. Preventing ptosis after botulinum treatment. Adaptations of the oculomotor system. Botulinum toxin treatment of ocular alignment disorders. Oxford, July , Posterior fixation: adjustable and without posterior sutures. Binocular Vision. In: Duane's Foundations of Clinical Ophthalmology. Tasman, Jaeger eds.