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Drs. Doug Devries and Walt Whitley presented some of their favorite anterior segment ocular disease cases during a 2-hour continuing education course at the annual meeting of the American Optometric Association, at the San Diego Convention Center yesterday. The course, titled Adventures in the Anterior Segment, discussed some of their most interesting cases as center directors at co-management centers.
“Over 90% of referral cases at tertiary care centers come from optometric referrals,” Dr. Whitley noted. A common referral condition is acute conjunctivitis. The doctors discussed their protocol for treating acute red eye, which first entails isolating the patient from the patients in the waiting room. “This patient is kept in a single exam room and not moved form one exam room to another to prevent the possibility of contaminating other areas,” Dr. Devries noted. The protocol also includes the use of the AdenoPlus adenovirus detector. “More than 90% of acute conjunctivitis cases are caused by adenovirus subtypes,” Dr. Whitley said, “yet both bacterial conjunctivitis and viral conjunctivitis have many overlapping symptoms. The AdenoPlus detector provides point-of-care testing that allows for the differential diagnosis of the condition.”
Dr. Devries discussed his testing protocol for dry eye disease. In addition to the clinical history, he makes use of symptom questionnaires; tear film break-up time; ocular surface staining with both Lissamine Green and sodium fluorescein; tear volume testing with Schirmer’s strips or the Phenol Red thread test; tear meniscus height; lid and meibomian gland morphology, and expression of the meibomian glands. Both doctors also make use of tear film osmolarity testing. “Tear film osmolarity is becoming a greater player in dry eye disease diagnosis,” said Dr. Devries. “Dry eye disease can cause vision fluctuations,” added Dr. Whitley. Deal with any dry eye or ocular surface disease for good refractive results.”ODT