The Medical clinics of North America
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Med. Clin. North Am. · May 2021
ReviewVision Restoration: Cataract Surgery and Surgical Correction of Myopia, Hyperopia, and Presbyopia.
Cataract surgery is one of the most common surgical procedures performed in the United States. The decision to remove a cataract is determined by the patient's ability to perform activities of daily living, such as reading, driving, and watching television. ⋯ In addition, with the continuing advances in ophthalmology, patients now also have the option of selecting between traditional approaches and femtosecond laser-assisted procedures. Cataract surgery continues to be an effective and ever-improving procedure for vision restoration.
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Several neoplastic processes can involve the eye, either primarily or secondary to a systemic malignancy. The most common primary tumors of the eye include conjunctival and uveal melanoma, retinoblastoma, conjunctival and intraocular lymphoma, and ocular surface squamous neoplasia. ⋯ A combination of ophthalmologic examination, ancillary testing, and cytologic/histopathologic evaluation leads to accurate diagnosis. Management consists of surgery, radiotherapy, chemotherapy, and immunotherapy delivered in various forms.
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Med. Clin. North Am. · May 2021
ReviewOcular Complaints, Disease, and Emergencies in the General Medical Setting.
Primary care physicians see nearly half of all clinical visits, and 2% to 3% of those are for eye complaints. Taking a good ocular history is essential to establishing the diagnosis. ⋯ Primary care physicians can screen for patients at risk of vision loss from glaucoma, diabetes, and toxic medication and ensure that patients have appropriate eye evaluations. Examination techniques such as direct ophthalmoscopy, evaluation of the red reflex, eversion of the upper lid, checking pupillary response, and using fluorescein to stain the cornea are helpful in evaluating patients' ocular complaints.
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Neuro-ophthalmology is the study of the neurologic underpinnings of vision and includes a fascinating variety of disorders that span the broad spectrum of ophthalmic and neurologic disease. This subspecialty relies heavily on accurate neuroanatomic localization and examination. This article discusses neuro-ophthalmic complaints that frequently present to the internist, including acute vision loss, double vision, and unequal pupils. It focuses on pertinent clinical features of the most common causes of these chief complaints and additionally highlights salient points of history, diagnosis, examination, and management with special emphasis on the signs and symptoms that should prompt expedited evaluation.
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Med. Clin. North Am. · May 2021
ReviewOcular Side Effects of Common Systemic Medications and Systemic Side Effects of Ocular Medications.
When prescribing medications, it is important to consider the ocular side effects of common systemic therapy as well as potential systemic side effects of ocular medications. Although not an exhaustive list of medications/classes of medications, this article does include many commonly used drugs and also provides information on some topical therapies commonly used by ophthalmologists. These ocular medications may result in systemic effects and/or alter patients' management of systemic conditions.