Eyeworld

EW NEWS & OPINION 24 August 2017 Research highlight by Maxine Lipner EyeWorld Senior Contributing Writer P upil dilating eye drops are often part of a routine examination of the back of the eye, but patients often dislike these. What if it was possible to develop a portable, inexpensive camera that didn't require dilation? That's what investigators reported in the Journal of Ophthalmology that they have accomplished. 1 The investigators were spurred by several factors, according to Shizuo Mukai, MD, associate pro- fessor of ophthalmology, Harvard Medical School, Boston. "Most of the time, patients complain about dilation because it has two effects: Near vision becomes blurred so that it's hard to read, and it lets in a lot of light," Dr. Mukai said. "If patients need to drive home during the day, that's an issue." For those with dark eyes, such annoyances can last several hours longer. "In some eyes, dilation can cause a kind of glauco- ma acutely that becomes an emer- gency," he said, adding that certain eyes are predisposed to the problem, and this can usually be ascertained beforehand. Developing a portable model The idea for the portable camera came from Bailey Shen, MD, the study co-author. An intern at the time, Dr. Shen noticed the difficulty that internists were having master- ing use of a direct ophthalmoscope, Dr. Mukai explained. "Many of the young doctors not only hate using it, but they don't know how to use it," he said, adding that the device was old and cumbersome. Dr. Shen was convinced that he could come up with something better. "He wanted to make something that he could carry around in his pocket that might replace that," Dr. Mukai said, adding that Dr. Shen put forth the idea as an entry in a contest that Dr. Mukai had in place to try to encourage trainees to come up with innovative ideas. This was ultimate- ly the winning entry. There are other non-mydriatic cameras, but these are mostly desk- top models that cost tens of thou- sands of dollars. The available pock- et direct ophthalmoscopes, which attach to smartphones, only allow practitioners to photograph a very small area of the retina, Dr. Mukai said, and they can still be difficult to use and are a bit pricey. The camera that the two de- veloped takes its cue from larger desktop models that use infrared light to trick the eye, which does not perceive this, into dilating on its own and then taking a white light flash once everything is aligned to take a regular photograph, Dr. Mukai explained. At the heart of the innovative new device is a simple computer made for school children in Britain called the Raspberry Pi. This is inex- pensive and has a camera that hooks up to the computer. The developers also found a Japanese company that makes prototype dual LED to serve as the light source. "It's one LED that has both infrared and white Researchers report on development of a camera to be used for eye exams instead of dilation Novel ophthalmic camera A new camera allows physicians to dilate patients' eyes without the use of drops. Source: Shizuo Mukai, MD ACRYSOF ® IQ TORIC IOL IMPORTANT PRODUCT INFORMATION CAUTION: Federal (USA) law restricts this device to the sale by or on the order of a physician. INDICATIONS: The AcrySof ® IQ Toric posterior chamber intraocular lenses are intended for primary implantation in the capsular bag of the eye for visual correction of aphakia and pre-existing corneal astigmatism secondary to removal of a cataractous lens in adult patients with or without presbyopia, who desire improved uncorrected distance vision, reduction of residual refractive cylinder and increased spectacle independence for distance vision. WARNING/PRECAUTION: Careful preoperative evaluation and sound clinical judgment should be used by the surgeon to decide the risk/benefit ratio before implanting a lens in a patient with any of the conditions described in the Directions for Use labeling. Toric IOLs should not be implanted if the posterior capsule is ruptured, if the zonules are damaged, or if a primary posterior capsulotomy is planned. Rotation can reduce astigmatic correction; if necessary lens repositioning should occur as early as possible prior to lens encapsulation. All viscoelastics should be removed from both the anterior and posterior sides of the lens; residual viscoelastics may allow the lens to rotate. Optical theory suggests that high astigmatic patients (i.e. > 2.5 D) may experience spatial distortions. Possible toric IOL related factors may include residual cylindrical error or axis misalignments. Prior to surgery, physicians should provide prospective patients with a copy of the Patient Information Brochure available from Alcon for this product informing them of possible risks and benefits associated with the AcrySof ® IQ Toric Cylinder Power IOLs. Studies have shown that color vision discrimination is not adversely affected in individuals with the AcrySof ® Natural IOL and normal color vision. The effect on vision of the AcrySof ® Natural IOL in subjects with hereditary color vision defects and acquired color vision defects secondary to ocular disease (e.g., glaucoma, diabetic retinopathy, chronic uveitis, and other retinal or optic nerve diseases) has not been studied. Do not resterilize; do not store over 45° C; use only sterile irrigating solutions such as BSS ® or BSS PLUS ® Sterile Intraocular Irrigating Solutions. ATTENTION: Reference the Directions for Use labeling for a complete listing of indications, warnings and precautions.* © 2016 Novartis 11/16 US-TOR-16-E-4883 Advancing CATARACT SURGERY AcrySof ® IQ Toric ASTIGMATISM-CORRECTING IOL

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