EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/78712
AS C RS World view The official publication of the American Society of Cataract & Refractive Surgery April 2012 Publisher Donald R. Long dlong@eyeworld.org Editorial Editor Stephanie Graham stephanie@eyeworld.org Assistant Editor Stacy Majewicz smajewicz@eyeworld.org EyeWorld Staff Writers Faith Hayden faith@eyeworld.org Jena Passut jena@eyeworld.org Production Graphic Designer Julio Guerrero jguerrero@eyeworld.org Production Manager Cathy Stern cstern@eyeworld.org 703-383-5702 Production Assistant Karen Salerni ksalerni@eyeworld.org Contributing Editors Vanessa Caceres Lakeland, Florida Michelle Dalton Reading, Pennsylvania Rich Daly Arlington, Virginia Volume 17 • No. 4 PUBLISHING STAFF Enette Ngoei Singapore Matt Young Malaysia Senior Contributing Editor Maxine Lipner Nyack, New York Advertising Sales ASCRSMedia 4000 Legato Road Suite 700 Fairfax, VA 22033 703-591-2220 fax: 703-591-0614 eyeworld@eyeworld.org www.eyeworld.org Advertising Sales Managers Jeff Brownstein jbrownstein@eyeworld.org 703-788-5745 Paul Zelin pzelin@eyeworld.org 703-383-5729 Classified Sales Cathy Stern cstern@eyeworld.org 703-383-5702 EyeWorld Special Projects and Events Jessica Donohoe jdonohoe@eyeworld.org 703-591-2220 Clara Chan, M.D., cornea editorial board member I n ophthalmology, there are many sys- temic conditions that have ocular mani- festations. For example, diabetic and hypertensive retinopathy along with systemic malignancies may be diag- nosed by retina specialists; neuro-ophthal- mologists are able to diagnose life- threatening elevated intracranial pressure or brain tumors with findings of optic nerve edema or optic nerve atrophy, respectively; and in cornea, there are a variety of condi- tions where a spot diagnosis can be made by the clinician that could save a patient's life. In this month's issue of EyeWorld, we focus on the relationship between corneal diagnoses and systemic diseases. While there are a myriad of entities to cover, a few select ones will be highlighted. When noticing corneal verticillata, one may immediately associate a patient with being on amiodarone medication. While this is likely to be the most common cause for this corneal finding, in this issue, experts share pearls on how to ensure that a diagnosis of Fabry's disease, a treatable condition that would otherwise lead to renal failure and death, is not missed. While most ophthalmologists may be cognizant of the association between floppy eyelid syndrome and sleep apnea, the additional asso- ciation with keratoconus is less recognized. These clinical entities and key questions to ask your patients will be discussed in this issue since sleep apnea, if untreated, can lead to a significantly shortened lifespan. With increasing obesity rates, there are increasing numbers of patients undergoing gastric bypass surgery. Why do some of these patients develop severe dry eye problems? The answer lies in this month's issue. Peripheral ulcerative keratitis (PUK) can be an ocular manifestation ASCRS Publisher: EYEWORLD (ISSN 1089-0084) is published monthly by ASCRS Ophthalmic Services Corp., 4000 Legato Road, Suite 700, Fairfax, VA 22033-4003; telephone: 703-591-2220; fax: 703-591-0614. Printed in the U.S. Editorial Offices: EYEWORLD News Service, 4000 Legato Road, Suite 700, Fairfax, VA 22033-4003; toll-free: 800-451-1339, 703-591-2220; fax: 703-591-0614; email: eyeworld@eyeworld.org. Advertising Offices: ASCRSMedia, 4000 Legato Road, Suite 700, Fairfax, VA 22033-4003; toll-free: 800-451-1339, 703-591-2220; fax: 703-591-0614; email: eyeworld@eyeworld.org. Copyright 2012, ASCRS Ophthalmic Services Corp., 4000 Legato Road, Suite 700, Fairfax, VA 22033-4003. All rights reserved. No part of this publication may be reproduced without written permission from the publisher. Letters to the editor and other unsolicited material are assumed intended for publication and are subject to editorial review and acceptance. Subscriptions: Requests should be addressed to the publisher. Annual subscription prices: Individual: 1 year, $120; 2 years, $220; 3 years, $320. Institutional: 1 year, $250; 2 years, $330; 3 years, $425. Foreign: 1 year, $240, 2 years $470, 3 years, $700. Back copies: Subject to availability. Contact the publisher. Cost per copy is $15; $30 foreign. All orders for individual or back copies must be accompanied by payment. Requests to reprint, use, or republish: Requests to reprint or use material published herein should be made in writing only to Cathy Stern, EYEWORLD, 4000 Legato Road, Suite 700, Fairfax, VA 22033-4003; toll-free: 800-451-1339, 703-591-2220; fax: 703-591-0614; email: eyeworld@eyeworld.org. EYEWORLD reprints: To order reprints of material published in EYEWORLD, contact Cathy Stern, EYEWORLD, 4000 Legato Road, Suite 700, Fairfax, VA 22033-4003; toll-free: 800-451-1339, 703-591-2220; fax: 703-591-0614; email: cstern@eyeworld.org or your salesperson. Change of address: Notice should be sent to the publisher six weeks in advance of effective date. Include old and new addresses and label from recent issue. The publisher cannot accept responsibility for undelivered copies. POSTMASTER: Send change of address to EYEWORLD, 4000 Legato Road, Suite 700, Fairfax, VA 22033. Periodical postage paid at Fairfax, VA 22033 and at additional mailing offices. The ideas and opinions expressed in EYEWORLD do not necessarily reflect those of the editors, publisher, or its advertisers. of a collagen vascular disease or systemic vasculitis. The death rate in such patients, if untreated, is around 50% five years from the onset of their ocular findings. Pearls on how to determine the underlying etiol- ogy for PUK, treatment strategies, and concerns for future surgery in these patients will be discussed. Also, we review how to distinguish corneal ulcers that are non-vision and non-life threatening from PUK. The ophthalmologist may be the first to alert a patient and his or her internist of a systemic problem that could potentially be a life- threatening condition. In this issue, experts provide advice on what salient features are crucial to recognize so that these conditions are not overlooked. As ophthalmologists, it is important to remember that not only do we have the privilege of being able to save vision, but we may have the opportunity to save a life as well. Clara Chan, M.D., cornea editorial board member Life-saving findings from the anterior segment