EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/274531
E W MEETING REPORTER 1 03 comes along," he said. "It only tests the parasympathetic function to light and accommodation. It does n ot tell you anything about anisoco- ria in the dark, and that's the key and differentiating feature of Horner's syndrome." For the second error, he advised physicians to not rely on the tech only to check the pupils—the physi- cian should check them as well and throughout stages of care. A com- p lete eye exam must be done at every patient visit, "no short cuts," Dr. Lee said. The two most common short cuts that he sees are not swinging the flashlight for the RAPD and not doing a formal visual field or color vision test. For the third error, the issue is " not taking blurred disc margins seriously" and misusing the term "papilledema." For the fourth pearl, he advised physicians to not write "'dysconjugate gaze' or 'EOMI [extraocular muscles intact]' as your only motility evaluation." The fifth and final pearl is "thinking optic atrophy is a diagnosis." Dr. Lee said ophthalmologists must remember that they are med- ical doctors, especially in cases of Horner's syndrome, and recall how the body's systems are intercon- nected. "The most common error for an ophthalmologist dealing with Horner's syndrome is imaging only the head," he said. "If you just do an MRI of the head, you miss the two lesions that kill people with Horner's syndrome." In addition, he emphasized that physicians need to be specific when writing a patient's chief complaint. He said simply writing "blurry vision" as the patient's main com- plaint creates "worthless informa- tion," especially when referring. "What should it say there? 'Chief complaint: acute unilateral painful loss of vision, right eye yesterday.' That's helpful," he said. "Blurred vision is a waste of ink." Editors' note: Dr. Lee has no financial interests related to this presentation. Uveitis cases challenging to treat Achieving good results in often- difficult uveitis cases depends on multiple factors, a physician said. "Success in uveitis takes careful m onitoring, good communication, avoiding mistakes, and taking a step back when things aren't going very well," said Sunil K. Srivastava, MD, Cleveland, Ohio. "[Also consider] appropriate lab testing and institut- ing chronic systemic or long-term local therapy." Dr. Srivastava gave the "Uveitis u pdate 2014" talk during the "Management of the ocular surface: part I" session. Treating uveitis is not easy be- cause it is a complex disease with a high risk of vision morbidity, he said. "There's an education gap. We don't learn a lot about how to take c are of these complex patients. They take a lot of time," he said. "It's not very surgical, and when it becomes surgical, these are very difficult c ases." He said that local steroid injec- tions can be a great tool for uveitis treatment in some cases, but physi- cians should be careful when em- ploying them because they cannot be taken back once they have been used. He proposed that physicians first try a course of oral steroids t o see the patient's response to February 2014 M&S holds US Patents 7,354,155; 7,926,948; 8,425,040; 8,167,429; 8,419,184 & 8,550,631. Other Patents Pending. ©2014 M&S Technologies, Inc. Smart System and M&S are registered trademarks of M&S Technologies, Inc. All Rights Reserved. www.mstech-eyes.com 1-877-225-6101 MANUFACTURED IN THE USA A study conducted by the University of Toronto Hospital for Sick Children, published in the Journal of Ophthalmology ( Volume 120, Issue 10, October 2013), concluded that the M&S Smart System ® Computerized Visual Acuity and Contrast Sensitivity Testing System can be used as an alternative to the Pelli-Robson wall chart in measuring contrast sensitivity for a wide variety of ophthalmic conditions, in both adults and children. The Contrast Sensitivity Test on the Smart System gives you: • Fast, accurate testing via a proprietary algorithm • Consistent luminance and calibration • Repeatable results • Superior technical support For more information, please call or visit our website. Peer-Reviewed and Published The M&S Smart System ¨ Delivers Science-Based Testing Consistent with the Pelli-Robson Wall Chart M **Visit us at the ASCRS Meeting, Booth 1310** 98-105 MR Hawaii_EW February 2014-DL2_Layout 1 1/31/14 8:41 AM Page 103