Could blue light-blocking lenses decrease the risk of age-related macular degeneration?

Epidemiologic and experimental evidence suggests that blue light-blocking lenses could theoretically benefit patients with age-related macular degeneration. Clinical trials are needed to determine the effect of yellow lenses in preventing the progression of age-related macular degeneration.

Transmission of retinal laser wavelengths through blood.

PURPOSE: Treatment of retinal and choroidal diseases may be influenced by overlying blood. We compared the penetration through blood of various laser wavelengths used in thermal photocoagulation, photodynamic therapy, and transpupillary thermotherapy. METHODS: Laser light of wavelengths 514 nm, 568 nm, 647 nm, 689 nm, and 810 nm was directed through normal saline (control), whole blood with a hematocrit of 40%, and serial dilutions of whole blood until a steady-state reading of laser power output was obtained. Laser power output was measured with an Orion Laser Power/Energy monitor (Ophir Optronics LTD). Laser power was measured in milliwatts and expressed as a percentage of control. RESULTS: Five hundred fourteen-nanometer and 568-nm laser wavelengths penetrated the least through all dilutions of blood tested (>60% attenuation through the highest dilution tested); 647-nm, 689-nm, and 810-nm laser wavelengths penetrated most effectively through blood but were still significantly attenuated ( approximately 46%, 49.6%, and 47.0% attenuation, respectively, at the highest dilution tested). CONCLUSIONS: The presence of hemorrhage may have a significant effect on the delivery of laser energy to underlying structures/tissue. This may affect parameters used in thermal and nonthermal laser treatment of ocular diseases such as choroidal neovascularization.

Malignant solitary fibrous tumor metastatic to the orbit.

A 61-year-old man with a history of malignant solitary fibrous tumor of the chest had development of unusual sites of metastasis involving the sphenoid wing of the orbit and soft tissues of the cheek. He was found to have a solitary fibrous tumor, an uncommon type of spindle cell neoplasm that most often arises in the pleura, which was metastatic to the orbit. This is the first reported case of malignant solitary fibrous tumor metastatic to the orbit. The clinical and histopathologic findings of metastatic malignant solitary fibrous tumor are described.

Transient Vision Loss.

Transient vision loss often presents a diagnostic dilemma and may occur in many different settings. Episodic vision loss is a common complaint and the physician must distinguish whether the transient vision loss is benign or representative of a more serious underlying condition. Common causes of transient vision loss include ischemia and primary ocular pathology. Ischemic causes of vision loss include retinal vascular disease, intermittent optic nerve vascular compromise, or cerebrovascular disease. Many pathologic ocular processes may lead to transient vision loss, including tear film abnormalities and corneal diseases. The authors discuss the clinical presentation and management of transient vision loss, with special attention on characteristics that differentiate vascular disease from primary ocular pathology.

Central retinal vein occlusion immediately following cardiac surgery.

The relationship between cardiac surgery and central retinal vein occlusion (CRVO) has been previously documented; however, in all of these cases the occlusion occurred months after the cardiac surgery. This is the first report of a patient awakening from cardiac surgery with ophthalmoscopically documented CRVO. This diagnostic case report describes a patient who developed CRVO immediately following extensive cardiac surgery including aortic valve, aortic root, and proximal aortic arch replacements, as well as coronary artery bypass grafts. Ophthalmologists and cardiac surgeons alike should be aware that CRVO is a potential complication of cardiac surgery, especially when cardiopulmonary bypass is necessary.

The detection of a relative afferent pupillary defect.

PURPOSE: To describe a simple technique that detects a subtle relative afferent pupillary defect. DESIGN: Observational report. METHODS: With the patient seated at a slit lamp and the slit illumination turned off, a transilluminator light is swung back and forth between the eyes. The examiner observes the direct pupil light response and the consensual light response under slit-lamp magnification. CONCLUSION: Using slit-lamp magnification, the examiner may observe small amplitudes of pupillary movement in the evaluation of a relative afferent pupillary defect.