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Corneal Reflex

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21. Safety and Effectiveness of Corneal Crosslinking (CXL): Keratoconus and Post-Refractive Ectasia

iontophoresis (I-CXL) to deliver the riboflavin to the cornea without need for removal of the corneal epithelium. Patients will be randomized to receive CXL treatment with either the Epi-On or Epi-Off technique. Condition or disease Intervention/treatment Phase Keratoconus Ectasia Drug: Ricrolin+ Drug: Epi-Off Phase 3 Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 8 participants Allocation: Randomized Intervention Model: Parallel (...) anesthesia (proparacaine), the surgeon will create a complete corneal abrasion to facilitate riboflavin diffusion into the cornea. The epithelium will be removed by gently brushing the cornea with a scalpel. A corneal abrasion diameter of ~9mm is recommended, which may be adjusted as needed at the discretion of the investigator to accommodate individual eye geometry. Ultrasound corneal pachymetry should be performed before dis-epithelialization and after dis- epithelialization. Local anesthetics

2017 Clinical Trials

22. A Study Raindrop Near Vision Inlay in Presbyopes Implanted in Corneal Pockets

; it is the first implantable device that changes the shape of the cornea to correct the refractive errors that cause near vision problems. Active Comparator: Non-Delayed Intervention: Raindrop Near Vision Inlay In the non-delayed approach, the corneal pocket is created and inlay implanted on the same surgical day. Device: Raindrop Near Vision Inlay The Raindrop Near Vision Inlay was approved by the US FDA in June of 2016 for the improvement of near vision in presbyopic emmetropes. Raindrop is a clear device (...) made of a hydrogel material and resembles a microscopic contact lens; it is the first implantable device that changes the shape of the cornea to correct the refractive errors that cause near vision problems. Outcome Measures Go to Primary Outcome Measures : Uncorrected Visual Acuity [ Time Frame: 24 Months ] After the inlay procedure, patients will attain functional near acuity in the inlay eye and functional distance vision binocularly. Secondary Outcome Measures : Incidence of Corneal Reaction

2017 Clinical Trials

23. Preliminary Evidence of Successful Near Vision Enhancement With a New Technique: PrEsbyopic Allogenic Refractive Lenticule (PEARL) Corneal Inlay Using a SMILE Lenticule. Full Text available with Trip Pro

Preliminary Evidence of Successful Near Vision Enhancement With a New Technique: PrEsbyopic Allogenic Refractive Lenticule (PEARL) Corneal Inlay Using a SMILE Lenticule. To describe a new technique (PrEsbyopic Allogenic Refractive Lenticule [PEARL] inlay) using an allogenic corneal inlay prepared from a small incision lenticule extraction (SMILE) lenticule.A SMILE lenticule of specified thickness (mean: 61.5 ± 3.32 µm) was trephined at the center to 1-mm diameter and implanted in the cornea (...) on the coaxially sighted light reflex under a femtosecond laser-created cap of 120 µm in the nondominant eye of presbyopic patients.Four emmetropic presbyopic patients underwent PEARL inlay implantation in the nondominant eye. In the operated eye, uncorrected near visual acuity at 33 cm improved from J8 to J2 in one and from J5, J6, and J7, respectively, to J2 in three operated eyes with improvement between three and five lines in all eyes. Uncorrected intermediate visual acuity ranged between J3 and J5 at 67

2017 Journal of Refractive Surgery

24. Exposure Stress Induces Reversible Corneal Graft Opacity in Recipients With Herpes Simplex Virus-1 Infections. Full Text available with Trip Pro

simplex virus type 1-infected corneas were tested for blink reflex. Opacity and vascularization were monitored in allogeneic and syngeneic corneal grafts that were transplanted to corneal beds with no blink reflex or to those that retained blink reflex in at least one quadrant following infection.Retention of any level of blink reflex significantly reduced inflammation in HSV-1-infected corneas. Corneal allografts placed on HSV-1-infected beds lacking corneal blink reflex developed opacity faster (...) Exposure Stress Induces Reversible Corneal Graft Opacity in Recipients With Herpes Simplex Virus-1 Infections. Most of the inflammation in murine herpes simplex virus type 1 (HSV-1)-induced stromal keratitis (HSK) is due to exposure stress resulting from loss of corneal nerves and blink reflex. Corneal grafts often fail when placed on corneal beds with a history of HSK. We asked if corneal exposure contributes to the severe pathology of corneal grafts on HSV-1-infected corneal beds.Herpes

2017 Investigative Ophthalmology & Visual Science

25. Changes of corneal tomography in patients with congenital blepharoptosis Full Text available with Trip Pro

Changes of corneal tomography in patients with congenital blepharoptosis The study aimed to evaluate the effect of drooped eyelid on corneal tomography in congenital blepharoptosis patients. Sixty-four patients with congenital blepharoptosis and 64 age- and sex- matched healthy subjects were included. According to the eyelid margin to corneal light reflex distance (MRD), eyes with congenital blepharoptosis were categorized as mild, moderate, or severe. The eyes were scanned using the rotating (...) than that of controls. There were significant correlations between MRD and most corneal tomographic parameters. Our findings indicated there was a trend toward subclinical keratoconus-like changes in the corneas of congenital blepharoptosis, with the increase of ptosis severity.

2017 Scientific reports

26. Neurotrophic factors and corneal nerve regeneration Full Text available with Trip Pro

Neurotrophic factors and corneal nerve regeneration The cornea has unique features that make it a useful model for regenerative medicine studies. It is an avascular, transparent, densely innervated tissue and any pathological changes can be easily detected by slit lamp examination. Corneal sensitivity is provided by the ophthalmic branch of the trigeminal nerve that elicits protective reflexes such as blinking and tearing and exerts trophic support by releasing neuromediators and growth factors (...) . Corneal nerves are easily evaluated for both function and morphology using standard instruments such as corneal esthesiometer and in vivo confocal microscope. All local and systemic conditions that are associated with damage of the trigeminal nerve cause the development of neurotrophic keratitis, a rare degenerative disease. Neurotrophic keratitis is characterized by impairment of corneal sensitivity associated with development of persistent epithelial defects that may progress to corneal ulcer

2017 Neural Regeneration Research

27. Defining a mechanistic link between pigment epithelium–derived factor, docosahexaenoic acid, and corneal nerve regeneration Full Text available with Trip Pro

Defining a mechanistic link between pigment epithelium–derived factor, docosahexaenoic acid, and corneal nerve regeneration The cornea is densely innervated to sustain the integrity of the ocular surface. Corneal nerve damage produced by aging, diabetes, refractive surgeries, and viral or bacterial infections impairs tear production, the blinking reflex, and epithelial wound healing, resulting in loss of transparency and vision. A combination of the known neuroprotective molecule, pigment (...) epithelium-derived factor (PEDF) plus docosahexaenoic acid (DHA), has been shown to stimulate corneal nerve regeneration, but the mechanisms involved are unclear. Here, we sought to define the molecular events of this effect in an in vivo mouse injury model. We first confirmed that PEDF + DHA increased nerve regeneration in the mouse cornea. Treatment with PEDF activates the phospholipase A2 activity of the PEDF-receptor (PEDF-R) leading to the release of DHA; this free DHA led to enhanced docosanoid

2017 The Journal of biological chemistry

28. THE CORNEAL REFLEX THE MOST RELIABLE GUIDE IN ANAESTHESIA Full Text available with Trip Pro

THE CORNEAL REFLEX THE MOST RELIABLE GUIDE IN ANAESTHESIA 20761914 2011 03 29 2011 03 29 0007-1447 1 2301 1905 Feb 04 British medical journal Br Med J THE CORNEAL REFLEX THE MOST RELIABLE GUIDE IN ANAESTHESIA. 244-5 Gardner H B HB eng Journal Article England Br Med J 0372673 0007-1447 2010 8 27 6 0 1905 2 4 0 0 1905 2 4 0 1 ppublish 20761914 PMC2319119

1905 British medical journal

29. THE CORNEAL REFLEX IN ANAESTHESIA Full Text available with Trip Pro

THE CORNEAL REFLEX IN ANAESTHESIA 20762065 2011 03 29 2011 03 29 0007-1447 1 2312 1905 Apr 22 British medical journal Br Med J THE CORNEAL REFLEX IN ANAESTHESIA. 880 Thomas L K LK eng Journal Article England Br Med J 0372673 0007-1447 2010 8 27 6 0 1905 4 22 0 0 1905 4 22 0 1 ppublish 20762065 PMC2320024

1905 British medical journal

30. Corneal reflex in hemisphere disease Full Text available with Trip Pro

Corneal reflex in hemisphere disease The contralateral corneal reflex may be absent in patients with a deep lesion of the parietal lobe. Frontal and temporal lobe lesions apparently do not interfere with this reflex.

1972 Journal of neurology, neurosurgery, and psychiatry

31. Pharmacology of reflex blinks in the rat: a novel model for headache research Full Text available with Trip Pro

blinks in the anaesthetised rat to determine whether such reflexes may prove useful as the basis for a novel animal model to evaluate potential anti-migraine therapeutic agents.In anaesthetised rats the electromyogram associated with the reflex blink evoked by corneal airpuff was recorded. Rats were infused with glyceryl trinitrate, sumatriptan plus glyceryl trinitrate or vehicle control. Changes in the magnitude of the reflex blink-associated electromyogram following these treatments were (...) Pharmacology of reflex blinks in the rat: a novel model for headache research Migraineurs are highly sensitive to the nitric oxide donor glyceryl trinitrate which triggers attacks in many sufferers. In animal studies, glyceryl trinitrate increases neuronal activity in the trigeminovascular pathway and elevates neurotransmitter levels in the brainstem. Many migraineurs also display alterations in blink reflexes, known to involve brainstem circuits. We investigated the effect of GTN on evoked

2016 The journal of headache and pain

32. Effect of stimulus size and luminance on the rod-, cone-, and melanopsin-mediated pupillary light reflex. Full Text available with Trip Pro

Effect of stimulus size and luminance on the rod-, cone-, and melanopsin-mediated pupillary light reflex. This study determined if the pupillary light reflex (PLR) driven by brief stimulus presentations can be accounted for by the product of stimulus luminance and area (i.e., corneal flux density, CFD) under conditions biased toward the rod, cone, and melanopsin pathways. Five visually normal subjects participated in the study. Stimuli consisted of 1-s short- and long-wavelength flashes

2015 Journal of vision

33. Understanding Neuropathic Corneal Pain-Gaps and Current Therapeutic Approaches Full Text available with Trip Pro

to elucidate the pathophysiology and neurobiology of pain resulting from initially protective physiological reflexes, to a more persistent chronic state. The goal of this clinical review is to briefly summarize the pathophysiology of neuropathic corneal pain, describe how to systematically approach the diagnosis of these patients, and finally summarizing our experience with current therapeutic approaches for the treatment of corneal neuropathic pain. (...) Understanding Neuropathic Corneal Pain-Gaps and Current Therapeutic Approaches The richly innervated corneal tissue is one of the most powerful pain generators in the body. Corneal neuropathic pain results from dysfunctional nerves causing perceptions such as burning, stinging, eye-ache, and pain. Various inflammatory diseases, neurological diseases, and surgical interventions can be the underlying cause of corneal neuropathic pain. Recent efforts have been made by the scientific community

2016 Seminars in Ophthalmology

34. Dorsally located corneal dermoid in a cat Full Text available with Trip Pro

Dorsally located corneal dermoid in a cat A 2-month-old, male kitten was presented for evaluation of unilateral blepharospasm and epiphora involving the right eye. Ocular examination revealed conjunctivitis, a superficial corneal ulcer, reflex anterior uveitis and a haired mass within the dorsal cornea of the right eye. The mass was subsequently removed surgically via a lamellar keratectomy. Histologic evaluation of the mass via light microscopy revealed it to be comprised of normal-haired skin (...) with mild inflammation. One week after surgical removal and medical management of the corneal ulcer, all ocular clinical signs had resolved with minimal corneal scarring. On re-examination 6 months following surgical excision of the mass, the kitten was noted to be comfortable with no significant corneal scarring.To our knowledge, this is the first case report of a dorsally located corneal dermoid in a cat.

2016 JFMS Open Reports

35. Corneal Sensitivity to Hyperosmolar Eye Drops: A Novel Behavioral Assay to Assess Diabetic Peripheral Neuropathy. Full Text available with Trip Pro

sophisticated instrumentation, expertise in confocal imaging, cooperative patients, and automated analysis tools to derive corneal nerve density. As an alternative, we developed a simple screening method that is based on the sensitivity of corneal nerves to cause reflex eyelid squinting in response to hyperosmolar eye drops.Eyes of control and type 2 diabetic rats were given an eye drop of a 290- to 900-mOsm solution, and the ocular response was video recorded. Other neuropathic end points including nerve (...) conduction velocity and subepithelial cornea nerve density were determined.Motor and sensory nerve conduction velocity and total nerve fiber length of corneal nerves in the subepithelial layer were significantly decreased in diabetic rats. Applying the hyperosmotic solutions to the ocular surface caused an osmolarity-dependent increase in squinting of the treated eye in control rats. Squinting was almost totally blocked by preapplication of proparacaine or N-(4-tertiarybutylphenyl)-4-(3-chloropyridin-2

2016 Investigative Ophthalmology & Visual Science

36. Optical Zone Centration Accuracy Using Corneal Fixation-based SMILE Compared to Eye Tracker-based Femtosecond Laser-assisted LASIK for Myopia. (Abstract)

treated with LASIK (the LASIK group) with VisuMax flap creation and eye tracker-based centration MEL 90 excimer laser (Carl Zeiss Meditec) ablation. In SMILE, the corneal vertex of the coaxially fixating eye was aligned with the vertex of the curved contact glass. In LASIK, the treatment was centered on the coaxially sighted corneal light reflex (first Purkinje image). A tangential (instantaneous) curvature preoperative to postoperative difference map was generated for each eye. A fixed grid and set (...) Optical Zone Centration Accuracy Using Corneal Fixation-based SMILE Compared to Eye Tracker-based Femtosecond Laser-assisted LASIK for Myopia. To compare the optical zone centration accuracy between myopic eyes treated with small incision lenticule extraction (SMILE) and LASIK.Retrospective analysis of 100 consecutive eyes treated with SMILE (the SMILE group) with the corneal fixation-based centration VisuMax femtosecond laser (Carl Zeiss Meditec, Jena, Germany) and a matched group of 100 eyes

2015 Journal of Refractive Surgery

37. Hyperosmolar Tears Induce Functional and Structural Alterations of Corneal Nerves: Electrophysiological and Anatomical Evidence Toward Neurotoxicity. Full Text available with Trip Pro

Hyperosmolar Tears Induce Functional and Structural Alterations of Corneal Nerves: Electrophysiological and Anatomical Evidence Toward Neurotoxicity. In an effort to elucidate possible neural mechanisms underlying diminished tearing in dry eye disease, this study sought to determine if hyperosmolar tears, a ubiquitous sign of dry eye disease, produce functional changes in corneal nerve responses to drying of the cornea and if these changes correlate with alterations in corneal nerve (...) morphology.In vivo extracellular electrophysiological recordings were performed in rat trigeminal ganglion neurons that innervated the cornea before, and up to 3 hours after, the ocular application of continuous hyperosmolar tears or artificial tears. In corollary experiments, immunohistochemical staining was performed to compare corneal nerve morphology in control and in eyes treated with hyperosmolar solutions.Our previous studies identified a population of corneal afferents, dry-sensitive neurons

2015 Investigative Ophthalmology & Visual Science

38. Treatment of Keratoconus With Advanced Corneal Crosslinking

Scheimflug camera and/or repeated subjective refraction and keratometry. A keratoconus diagnosis based on the Amsler-Krumeich grading and the "Total Deviation" KC quantification value from the "Belin-Ambrosio enhanced ectasia" measurements of the Pentacam Scheimpflug camera, and an altered red reflex and/or an irregular cornea seen as distortion of the keratometric mires. Minimum corneal thickness of 400 µm at the thinnest point after epithelial removal. 18-28 years of age No ocular abnormalities except (...) Study Description Go to Brief Summary: The purpose of this study was to determine whether mechanical compression of the cornea during corneal crosslinking for keratoconus using a sutured rigid contact lens can improve the optical outcomes of the treatment. Condition or disease Intervention/treatment Phase Keratoconus Procedure: Corneal reshaping/crosslinking (CRXL) Procedure: Corneal Crosslinking (CXL) Phase 2 Detailed Description: The study is designed as a prospective, open, randomized controlled

2015 Clinical Trials

39. Two target locations for corneal inlay implantation combined with laser in situ keratomileusis. (Abstract)

Two target locations for corneal inlay implantation combined with laser in situ keratomileusis. To compare the visual acuity outcomes between 2 target locations for corneal inlay implantation with concurrent laser in situ keratomileusis (LASIK) to compensate for presbyopia.Shinagawa LASIK Center, Tokyo, Japan.Retrospective cohort study.Bilateral LASIK was performed simultaneously with inlay implantation in the nondominant eye. The preoperative and 6-month postoperative uncorrected distance (...) (UDVA) and uncorrected near (UNVA) visual acuities were evaluated. Patients were divided into the following 2 groups based on the pupil center to Purkinje reflex distance (Pp-Pk): small (≤300 μm) and large (>300 μm). Each group was divided into subgroups according to the distance of the inlay center to the Purkinje reflex (I-Pk) or to the midpoint between the pupil center and Purkinje reflex (I-M). The inlay position was classified as 0 to 100 μm, 101 to 200 μm, 201 to 300 μm, and 301 to 400 μm from

2015 Journal of cataract and refractive surgery

40. Changes in corneal aesthesiometry and the sub-basal nerve plexus in benign essential blepharospasm. (Abstract)

Changes in corneal aesthesiometry and the sub-basal nerve plexus in benign essential blepharospasm. The aetiology of blepharospasm remains unclear. There is evidence that the afferent pathway is important, but this area remains under-researched.To explore the hypothesis that the afferent arm of the blink reflex is abnormal in blepharospasm by assessing a range of measures of corneal sensory function.In this prospective case-control study, 21 patients with blepharospasm and 21 age-matched (...) and gender-matched controls completed the Ocular Surface Disease Index questionnaire and underwent the following assessments: tear osmolarity, Shirmer test, tear-film break up time, corneal and conjunctival vital staining, meibomian gland dysfunction, corneal aesthesiometry and confocal microscopy.Corneal sensitivity was significantly lower in patients with blepharospasm than in controls (right eyes p=0.009; left eyes p=0.009, paired t test). The median number of main nerve trunks was lower for patients

2015 British Journal of Ophthalmology

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