Thyroid eye disease Pathogenesis: organ-specific autoimmune reaction in which a humoral agent (IgG antibody) produces inflammation and swelling of orbital tissue, especially extraocular muscles. It consists of an active inflammatory stage (<3 years) followed by a quiescent/fibrotic stage. Diagnosis Lid…
Acquired obstruction Primary punctal stenosis Causes: (a) idiopathic, (b) chronic marginal blepharitis, (c) herpetic (simplex, zoster) lid infection, and (d) conjunctival cicatrization. Diagnosis: narrow inferior punctum in the absence of punctal malposition. Treatment: dilatation alone ( Fig. 2.1 ) rarely…
Benign nodules and cysts Chalazion (meibomian cyst) Definition: very common chronic sterile inflammation of a meibomian gland that may resolve spontaneously. Diagnosis Signs: (a) gradually enlarging tarsal nodule ( Fig. 1.1 ); (b) conjunctival granulomatous extension is common, and (c)…
Key Points There can be several contributing factors to a refractive surprise after cataract surgery, such as incorrect intraocular lens (IOL) calculations as a result of keratometry and/or axial length measurements, postrefractive surgery eyes, or toric IOL rotation (see Chapter…
Key Points Dysphotopsias (positive, negative, and diffractive optic) represent undesirable subjective optical phenomena that may occur after uncomplicated, seemingly “perfect” cataract surgery. They are, in part, related to IOL design and IOL position. Positive dysphotopsia (PD) is described by patients…
Key Points Posterior capsular opacification is very common after cataract extraction. Nd:YAG laser capsulotomy is the treatment of choice. Nd:YAG laser can also be used to perform laser peripheral iridotomy and anterior hyaloid vitreolysis to address pupillary block glaucoma. For…
Key Points Detailed ocular examination in patients with subluxated IOLs is a must, including undilated gonioscopy and dilated slit lamp evaluation to reveal the status of the zonules, capsular bag, and any endocapsular device in situ. Subluxated IOLs may result…
Key Points It is important for the cataract surgeon to assess for preoperative and intraoperative risk factors for retinal complications. The anterior segment surgeon can take several key steps during and after surgery to maximize visual outcomes despite the occurrence…
Key Points Clear corneal phacoemulsification generally reduces intraocular pressure (IOP) in glaucoma and ocular hypertensive eyes. A list of differential diagnoses should exist in the minds of all cataract surgeons when evaluating patients with elevated IOP after cataract surgery. Immediate…
Key Points The etiology of postoperative corneal edema is broad. Thorough preoperative evaluation can help elicit patients at higher risk for postoperative corneal edema. Corneal edema can lead to acute and chronic changes in visual acuity and to eye pain.…