Eyeworld

33 EW GLAUCOMA January 2015 Contact information Puech: m-puech@orange.fr VuExplorer Institute. He has financial interests with Quantel Medical and Carl Zeiss Meditec. Editors' note: Dr. Puech is the manager of Explore Vision Paris and Explore Vision Rueil, and an instructor at the probe and move to the point of interest, which is one of the main points of the evolution of UBM. Process We administer UBM while patients are in a reclined position. Due to a modern closed probe, we only need to apply an anesthetic drop and gel on the cornea to administer UBM. We use Lacrigel (Thea, Clermont- Ferrand, France) between the probe and the globe for pseudo immer- sion without any speculum for the patient's comfort. We do not use a ClearScan (Reichert Technologies, Depew, N.Y.) as most of our patients are referred for narrow angle, and corneal contact with the ClearScan could modify angle opening. We observe narrow angles with four principle scans at 9, 6, 3, and 12 o'clock. For both eyes, UBM takes 6 to 7 minutes to complete. Many publications show UBM images of narrow angle with just one scan on the 3 or 9 o'clock meridian with poor correlation to the real risk of angle closure. With the modern UBM, the learning curve is quite short. We can train technicians in 1–2 months until they are confident and com- fortable enough with the machine to detect angle closure risk. We also use UBM to diagnose ciliary tumors and follow tumor evolution after treatment. In con- junction with the Institut Curie of Paris, Explore Vision Center does many UBM procedures in tumor management. Many patients are referred for iris bowing, and UBM can quickly differentiate iris cysts from solid tumors. Patients are referred for IOL imaging in cases of subluxated implant, iris indentation by IOL footplate, or posterior phakic IOL with subluxated optic. In these indications, UBM is the only way of imaging the posterior chamber with no limit of penetration. UBM is one of the most excit- ing imaging technologies available today for eyecare professionals. Being able to visualize the anterior segment is a great asset to clini- cians evaluating glaucoma patients, diagnosing iris or ciliary tumors, and evaluating cataract and refractive patients postoperatively. EW Meibomian Gland Dysfunction is treatable. Eliminate the guesswork of dry eye. Identify, diagnose and treat MGD with confidence. Ask us about our new LipiView ® II with DMI and learn more about the TearScience ® Solution for MGD. Give MGD a Second Glance structural change (severe gland atrophy and drop out) normal meibomian gland structure structural change (duct dilation, gland atrophy and drop out) tearscience.com 919-459-4880 sales@tearscience.com

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