Current opinion in ophthalmology
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Neuromyelitis optica spectrum disorder is an autoimmune disease that causes optic neuritis and transverse myelitis. Attacks can cause severe neurological damage leading to blindness and paralysis. Understanding of the immunopathogenesis of this disease has led to major breakthroughs in diagnosis and treatment. In the past 18 months, three successful phase 3 clinical trials have been published using targeted approaches to preventing relapses. ⋯ Recent research in NMOSD has resulted in improved diagnosis and approved treatments.
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To provide a summary of the neuro-ophthalmic manifestations of coronavirus disease 19 (COVID-19), documented in the literature thus far. ⋯ The literature on COVID-19 continues to evolve. Although COVID-19 primarily impacts the respiratory system, there are several reports of new onset neuro-ophthalmic conditions in COVID-infected patients. When patients present with new onset neuro-ophthalmic issues, COVID-19 should be kept on the differential. Testing for COVID-19 should be considered, especially when fever or respiratory symptoms are also present. When screening general patients for COVID-19-associated symptoms, frontline physicians can consider including questions about diplopia, eye pain, pain with extraocular movements, decreased vision, gait issues, and other neurologic symptoms. The presence of these symptoms may increase the overall probability of viral infection, especially when fever or respiratory symptoms are present. More research is needed to establish a causal relationship between COVID-19 and neuro-ophthalmic disease, and better understand pathogenesis.
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Eye pain is one of the most common presenting symptoms in ophthalmology. It can range from bothersome to debilitating for patients, and it can be vexing for clinicians, especially in the white and quiet eye. The purpose of this review is to provide updates of recent literature regarding eye pain and to communicate our current understanding regarding the evaluation and management of conditions that cause eye pain with a relatively normal examination. ⋯ Eye pain in the white and quiet eye remains a difficult-to-navigate topic for practitioners. However, a careful history and focused physical examination can elucidate the diagnosis in many cases. Recent updates to the literature have advanced our knowledge of how to identify and treat the underlying causes of eye pain.
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Curr Opin Ophthalmol · Sep 2020
ReviewTeleophthalmology: an essential tool in the era of the novel coronavirus 2019.
The aim of this article is to assess the current state of teleophthalmology given the sudden surge in telemedicine demand in response to the novel coronavirus 2019 (COVID-19). ⋯ COVID-19 created a demand for healthcare delivery that limits in-person examination and potential viral exposure. Teleophthalmology allows ophthalmologists to continue caring for patients while keeping physicians and patients safe. Although challenges still exist, the pandemic has accelerated the adoption of teleophthalmology. As a result, teleophthalmology will play an integral role in providing high-quality efficient care in the near future.
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Curr Opin Ophthalmol · Sep 2020
ReviewEbola, COVID-19, and emerging infectious disease: lessons learned and future preparedness.
To highlight the lessons learned from the Ebola outbreak that may inform our approach to the COVID-19 pandemic, particularly related to the widespread disruption of healthcare, ophthalmic disease manifestations, and vision health systems strengthening for future outbreaks. ⋯ Thoroughly understanding the ophthalmic findings and transmission risk associated with COVID-19 is paramount during this pandemic, providing additional measures of safety while resuming ophthalmic care for all patients. Vision health systems preparedness measures developed during recent EVD outbreaks and the current pandemic provide models for ophthalmic clinical practice, research, and education, as we continue to address COVID-19 and future emerging infectious disease threats.