Eyeworld

EW MEETING REPORTER 124 March 2011 Cases that challenge the clinician Sessions on the morning of Sunday, Jan. 30 focused on tough topics in ophthalmology. In the Challenging Cases for the Comprehensive Clini- cian session, a distinguished panel led by Eric D. Donnenfeld, M.D., clinical professor of ophthalmology, New York University, and Dr. Holland debated with the audience on a number of difficult, multidisci- plinary cases. "The fun part about this meet- ing and the reason I've been to it every year is that it combines the best of both worlds," said Dr. Donnenfeld. "It's not just a cataract meeting; you also get experts in re- fractive, cornea, glaucoma, and retina." Topics discussed included a case study of a patient with an infectious corneal perforation, mature cataract, and angle-closure glaucoma; trau- matic cataract with zonular dialysis and traumatic mydriasis; and macu- lar abnormalities that involve cataract and glaucoma issues. Dr. de Luise gave a talk on rosacea keratitis. "This is not such a benign disease," he said. "First of all, it's a much more common disease than we think, and it's a much more common disease than dermatolo- gists think. There have been several studies that show that ophthalmolo- gists are more apt to make this diag- nosis, perhaps because of our slit lamps and our ability to see very fine detail on the periocular skin." Dr. de Luise described rosacea as a "chronic ocular dermatological in- flammation." He noted that there is mounting evidence that demodex fol- liculorum is at the root of the disease. "In fact, in the hindgut flora of D. folliculorum you'll often find Bacillus oleronius, which has very po- tent bacterial antigens that create a significant amount of periocular in- flammation, limbal inflammation, and corneal inflammation," he ex- plained. Dr. de Luise recommended a number of ways to manage ocular rosacea including oral azithromycin, bacitracin ointment, and tea tree oil. He also stressed that these patients require careful, close follow-up, not- ing that corneal thinning and perfo- ration can occur. Also in this session, Dr. Holland Reporting live from ASCRS Winter Update, Palm Beach, Fla. by Jena Passut and Faith A. Hayden Editors' note: This Meeting Reporter contains original reporting by the EyeWorld news team. continued from page 123 continued on page 126

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