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Sclera

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141. Pinguecula

of the eye (the sclera) and the transparent window at the front of the eye (the cornea) meet. If the cornea is imagined as a clock face, a pinguecula will generally form at the three and nine o’clock positions. This condition becomes commoner as people age, so that by 70 years most people have them. Both eyes are usually affected. There is no effect on vision. This is a mild degenerative condition, due to long-term exposure to ultra-violet (UV) light, either occurring naturally in sunlight

2018 College of Optometrists

142. Conjunctival pigmented lesions

is common in dark-skinned ethnicities. PAM typically affects older white-skinned patients (rarely in dark-skinned) Melanoma is more common with fair skin and blue eyes, extremely rare in dark-skinned races. Presentation peaks in mid-fifties Symptoms Asymptomatic except for cosmetic concern Signs Ethnic melanosis Bilateral, asymmetrical, flat, intra-epithelial (moves freely over sclera), patchy, brown pigmentation, most prominent in palpebral aperture especially at limbus or where anterior ciliary (...) arteries perforate the sclera, develops in early years (static by adulthood) C-MIN/PAM Unilateral, any part of conjunctiva (including tarsal or forniceal), flat, intraepithelial (moves freely over sclera), single or multiple, indistinct areas, light to dark brown, no cystic spaces, often extensive, can be stable or may change (enlarge, shrink, darken or lighten) Congenital Melanocytosis ocular Multifocal, slate-grey or blue grey, sub-epithelial (does not move freely over sclera) dermal Mottled, blue

2018 College of Optometrists

143. Trauma (penetrating)

. 2004;27(2):206-10 Lecuona K. Assessing and managing eye injuries. Community Eye Health. 2005;18(55):101-4 Lay summary Full or partial penetration of the outer coat of the eye (the clear part, the cornea or the white part, the sclera) can result from industrial, work-related or DIY injuries, or from assaults with sharp objects. Such injuries occur three times as frequently in males as in females. Because they are so close to the eyeball, the eyelids may be injured also. The optometrist will check

2018 College of Optometrists

144. Microbial keratitis (amoebic)

or subepithelial infiltrates pseudodendrites radial keratoneuritis (infiltrates along corneal nerves) recurrent breakdown of the corneal epithelium Later signs deep inflammation of the cornea consisting of a central or paracentral ring-shaped or disciform infiltrate or abscess stromal thinning extension of inflammation into sclera anterior chamber cells and flare hypopyon Differential diagnosis Signs may masquerade as herpes simplex with temporary improvement on anti-herpetic treatment, further delaying

2018 College of Optometrists

145. Episcleritis

Episcleritis Episcleritis submit The College submit You're here: Episcleritis Episcleritis The CMGs are guidelines on the diagnosis and management of a range of common and rare, but important, eye conditions that present with varying frequency in primary and first contact care. Share options Please login to view the images or . Aetiology Idiopathic inflammation of the vascular connective tissue layer that lies between the sclera and conjunctiva Predisposing factors Up to one third of cases

2018 College of Optometrists

146. Scleritis

Scleritis Scleritis submit The College submit You're here: Scleritis Scleritis The CMGs are guidelines on the diagnosis and management of a range of common and rare, but important, eye conditions that present with varying frequency in primary and first contact care. Share options Please login to view the images or . Aetiology Scleritis is a potentially severe inflammatory disease of the sclera which is bilateral in 50% of cases Predisposing factors Patients are usually in the middle age group (...) or severe pain (eye ‘ache’ may be referred to brow or jaw) which is exacerbated by eye movement May disturb sleep Gradual onset Tenderness of globe Photophobia Epiphora Visual loss Possible history of previous episodes Signs Scleritis may involve the anterior sclera, the posterior sclera, or both Anterior scleritis (90% of cases) (a) Non-necrotising (75% of cases) usually unilateral hyperaemia of superficial and deep episcleral vessels; does not blanch with vasoconstrictors (e.g. gutt. 2.5%) anterior

2018 College of Optometrists

147. Fibrin glue versus sutures for conjunctival autografting in primary pterygium surgery. (PubMed)

of attaching conjunctival autografts to the sclera are through suturing or fibrin glue. Each method presents its own advantages and disadvantages. Sutures require considerable skill from the surgeon and can be associated with a prolonged operation time, postoperative discomfort and suture-related complications, whereas fibrin glue may give a decreased operation time, improve postoperative comfort and avoid suture-related problems.To assess the effectiveness of fibrin glue compared to sutures

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2016 Cochrane

148. Conjunctival autograft for pterygium. (PubMed)

the visual axis.Surgery is the only effective treatment for pterygium, though recurrences are common. With simple excision techniques (that is, excising the pterygium and leaving bare sclera), the risk of recurrence has been reported to be upwards of 80%. Pterygium excision combined with a tissue graft has a lower risk of recurrence. In conjunctival autograft surgery, conjunctival tissue from another part of the person's eye along with limbal tissue is resected in one piece and used to cover the area (...) from which the pterygium was excised. Another type of tissue graft surgery for pterygium is amniotic membrane graft, whereby a piece of donor amniotic membrane is fixed to the remaining limbus and bare sclera area after the pterygium has been excised.The objective of this review was to assess the safety and effectiveness of conjunctival autograft (with or without adjunctive therapy) compared with amniotic membrane graft (with or without adjunctive therapy) for pterygium. We also planned

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2016 Cochrane

149. BSR guideline Management of Adults with Primary Sjögren's Syndrome

break-up time and Schirmer’s tests in patients with meibomian gland disease [ ]. Some patients with severe dry eye develop an associated blepharospasm. There are small case series describing a good response to botulinum toxin injections in these circumstances [ , ]. For severe dry eye bandage scleral contact lenses, designed to protect the surface and create an optimized environment for healing, may be indicated. These lenses vault over the corneal surface and rest on the sclera. They are rigid

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2017 British Society for Rheumatology

150. CRACKCast E022 – Red and Painful Eye

Pressures OVER 30 mmhg need rapid treatment Slit lamp examination – explained A systematic, magnified view of the conjunctivae and anterior chamber Will not help you with something posterior to the lens Lids and lashes Blepharitis Hordeolum (lid abscess) Dacryocystitis Conjunctiva and sclera Punctures, lacerations, inflammatory patterns Cornea (with fluorescein) Abrasions, ulcers, foreign bodies Angled beam is needed to assess depth perception Edema (white haze / cloudiness) Anterior chamber Cells (RBCs

2017 CandiEM

152. CRACKCast E066 – Child Maltreatment

of it Look for blue sclerae Brownish teeth Deficiencies: Rickets of prematurity Scurvy Infections: Congenital syphilis / rubella Encephalitis / Meningitis / Post hypoxic edema 5) What cluster of injuries is seen in shaken baby syndrome? Head trauma Traumatic axonal injury → cerebral edema With retinal hemorrhages (85% of cases have this) “Due to vitreo-retinal traction due to centrifugal forces” Seen as dot, blot, shear and flame hemorrhages Skeletal injuries Abdominal injuries: *there may be no visible

2017 CandiEM

153. CRACKCast E071 – Ophthalmology Part A

: Artificial tears Cool compresses Topical ocular decongestants, antihistamines, topical NSAIDS 5) Define pterygium and pinguecula See YouTube video: Pterygium: Wedge shaped area of conjunctival fibrovascular tissue on the NASAL side of the sclera extending onto the cornea Risks Exposure to UV light (tropical areas) Surfer’s eye Symptoms: Eye irritation, visual changes Pinguecula: White/yellow flat/raised tissue next to the cornea Doesn’t extend into the cornea Treatment Protection from wind, sunlight

2017 CandiEM

154. Orbits, Vision and Visual Loss

patients for IOIS, IgG4-related orbital disease, or other inflammatory/granulomatous disease. Currently there is little evidence to support one modality’s superiority to others in evaluating this patient population [39-41]. A hallmark of IOIS in its chronic form is fibrosis, which results in decreased signal on T2-weighted MRI sequences [48]. A small subset of patients with isolated ocular manifestation of IOIS had posterior scleritis, with inflammatory enhancement of the sclera on postcontrast imaging

2017 American College of Radiology

157. Antibacterial-coated sutures versus non-antibacterial-coated sutures for the prevention of abdominal, superficial and deep, surgical site infection (SSI)

not been established [3]. Monocryl ® Plus Antibacterial Sutures are intended for use in general soft tissue approximation and/or ligation where an absorbable material is indicated [2]. PDS ® Plus Antibacterial sutures are intended for use in general soft tissue approximation, including use in paediatric cardiovascular tissue, and in ophthalmic surgery (other than contact with cornea and sclera). These sutures are particularly useful where the combination of an absorbable suture and extended wound

2017 EUnetHTA

158. Lipid Management in Adults

hepatotoxicity arise (e.g., unusual fatigue or weakness, loss of appetite, abdominal pain, dark-colored urine or yellowing of the skin or sclera). (Class IIa; Level of Evidence C) Class IIa: Benefit >> Risk IT IS REASONABLE to perform procedure/administer treatment. 4. Decreasing the statin dose may be considered when two consecutive values of LDL-C levels are >> Risk Procedure/Treatment SHOULD be performed/administered. Please see the ICSI Lipid Management for Adults work group “Comments on Statin and New

2017 Institute for Clinical Systems Improvement

159. iStent trabecular micro-bypass stent (Glaukos Corp.) in combination with cataract surgery for treatment of open-angle glaucoma

micro-bypass stent include minimally invasive insertion, a clear corneal incision that spares the conjunctiva and sclera, and a low risk for hypotony. Patient Population: The iStent is indicated for use in conjunction with cataract surgery (often phacoemulsification) for the reduction of IOP in adult patients with mild to moderate open-angle glaucoma currently treated with ocular hypotensive medication. Final publication URL The report may be purchased from: Indexing Status Subject indexing assigned

2016 Health Technology Assessment (HTA) Database.

160. Argus II Retinal prosthesis

and transmitting coil and an electronic case fixed to the outside of the sclera (white of the eye), and an electrode array (60 electrodes) that is surgically attached to the surface of the retina. The electrode array is connected to the electronic case by a ribbon cable that passes through the sclera. 1 The camera housed within the glasses captures images that are sent to the video processing unit and converted to electronic signals. These signals are then sent to the transmitter coil on the glasses (...) Products, Inc. Implantation of the Argus II Retinal Prosthesis System can be performed by a single surgeon in a two-hour outpatient procedure under general anaesthesia. 3 Details regarding the surgery are as follows: ? At commencement of the implant procedure, antibiotics and steroids are administered by intravenous injection. ? In phakic eyes (eyes with a lens) the lens is removed. ? An incision is made into the conjunctiva surrounding the cornea, exposing the underlying sclera and extra-ocular

2016 COAG Health Council - Horizon Scanning Technology Briefs

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