Survey of Ophthalmology RSS feed: Current Issue. Survey of Ophthalmology is a clinically oriented review journal designed to keep ophthalmologists up to date. Comprehensive major review articles, written by experts and stringently refereed, integrate the literature on subjects selected for their clinical importance. Survey also includes feature articles, section reviews, book reviews, and abstracts. To view video files associated with published manuscripts, click here .http://www.surveyophthalmol.com/?rss=yesElsevier Inc.en © 2010 Published by Elsevier Inc. Survey of Ophthalmology0039-62575524 March 2010 © 2010 Published by Elsevier Inc. healthpermissions@elsevier.comhttp://www.surveyophthalmol.com/article/PIIS0039625709002677/abstract?rss=yesThe old saw about the three degrees of fictitiousness—lies, damned lies, and statistics—is an exaggeration. Closer to the truth is that statistical analysis lies at the basis of our understanding of disease and other natural phenomena. Consider the pivotal importance of statistical analysis in the sequencing of the genome.Degrees of FictitiousnessJohn W. Gittinger10.1016/j.survophthal.2009.10.003Survey of Ophthalmology 55, 2 (2010)2010-03-04Survey of Ophthalmology2010-03-04552S0039-6257(10)X0002-9Editorial107107http://www.surveyophthalmol.com/article/PIIS003962570900191X/abstract?rss=yesAbstract: Nonsteroidal anti-inflammatory drugs (NSAIDs) are increasingly employed in ophthalmology to reduce miosis and inflammation, manage scleritis, and prevent and treat cystoid macular edema associated with cataract surgery. In addition, they may decrease postoperative pain and photophobia associated with refractive surgery and may reduce the itching associated with allergic conjunctivitis. In recent years, the U.S. Food and Drug Administration has approved new topical NSAIDs, and previously approved NSAIDs have been reformulated. These additions and changes result in different pharmacokinetics and dosing intervals, which may offer therapeutic advantages. For example, therapeutic effects on diabetic retinopathy and age-related macular degeneration may now be achievable. We provide an updated review on NSAIDs and a summary of their current uses in ophthalmology with attention to potential future applications.Nonsteroidal Anti-inflammatory Drugs in OphthalmologyStephen J. Kim, Allan J. Flach, Lee M. Jampol10.1016/j.survophthal.2009.07.005Survey of Ophthalmology 55, 2 (2010)2010-03-04Survey of Ophthalmology2010-03-04552S0039-6257(10)X0002-9Major Review108133http://www.surveyophthalmol.com/article/PIIS0039625709001593/abstract?rss=yesAbstract: The terms uveal effusion, choroidal effusion, ciliochoroidal effusion, ciliochoroidal detachment, and choroidal detachment have been used interchangeably in the literature. These labels all describe an abnormal collection of fluid that expands the suprachoroidal space, producing internal elevation of the choroidal. There are various inflammatory and hydrostatic conditions that can cause uveal effusion, but in some cases no obvious cause exists. In this setting, patients are thought to have a distinct, primary abnormality of the choroid or sclera, called uveal effusion syndrome (UES). UES may be idiopathic, or associated with hypermetropia, and should be considered a diagnosis of exclusion. Histological studies show amorphous glycosaminoglycan-like material filling the interfibrillary spaces of excised scleral tissue, with disruption of collagen fibers. In some patients there may be reduced macromolecular diffusion that interferes with the normal transscleral egress of albumin out of the eye, perhaps causing choroidal fluid retention due to altered osmotic forces. An alternative, and perhaps complementary hypothesis, is that swollen sclera compresses the transscleral vessels with resulting fluid retention. Patients with UES are most typically middle-aged men who have a relapsing remitting clinical course. There is often co-existing, shifting subretinal fluid that may involve the macula. Chronic disease may lead to secondary retinal pigment epithelial (leopard spot) changes and permanently reduced visual acuity. Treatment with systemic steroids does not appear to be effective. Surgical decompression of the vortex veins as they pass through the sclera has been described, but the most common treatment is full-thickness sclerectomies to provide an exit for choroidal fluid. The largest case series suggests that this produces an anatomic improvement in approximately 83% of treated eyes after a single procedure and in about 96% after one or two procedures. Final visual acuity improves by two or more lines in 56% of the eyes, is stable in 35%, and worsens in 9%. Although extremely rare, UES is a serious condition that is difficult to treat and can lead to severe and permanent visual loss in both eyes.Uveal Effusion SyndromeMohammed Elagouz, Dinu Stanescu-Segall, Timothy L. Jackson10.1016/j.survophthal.2009.05.003Survey of Ophthalmology 55, 2 (2010)2010-03-04Survey of Ophthalmology2010-03-04552S0039-6257(10)X0002-9Major Review134145http://www.surveyophthalmol.com/article/PIIS003962570900157X/abstract?rss=yesAbstract: Review of the substantial literature reveals that the importance of performance-based measures of visual function is becoming increasingly recognized. Alone, or in combination with other assessment modalities, they have been shown to provide a reliable and valid means of evaluating visual ability. Further, they have been demonstrated to predict outcomes better than self-report or clinical measures alone.Performance-based Measures of Visual FunctionKevin J. Warrian, Undraa Altangerel, George L. Spaeth10.1016/j.survophthal.2009.06.006Survey of Ophthalmology 55, 2 (2010)2010-01-13Survey of Ophthalmology2010-01-13552S0039-6257(10)X0002-9Major Review146161http://www.surveyophthalmol.com/article/PIIS0039625709001581/abstract?rss=yesAbstract: A 23-year-old pregnant woman presented with a rapidly progressive unilateral optic neuropathy. The evaluation was complicated by her being pregnant and the issues surrounding the evaluation and management of the pregnant patient with a neuro-ophthalmic finding is discussed. Eventually an orbital apex lesion was found and proved to be an orbital schwannoma. Rapid growth of an orbital schwannoma should be included in the differential diagnosis of progressive visual loss in a pregnant patient.A Pregnant PauseEmily S. Birkholz, Andrew G. Lee, Jeffrey A. Nerad, Katherine A. Lane, Jurij R. Bilyk10.1016/j.survophthal.2009.03.007Survey of Ophthalmology 55, 2 (2010)2009-09-25Survey of Ophthalmology2009-09-25552S0039-6257(10)X0002-9Clinical Challenges162168http://www.surveyophthalmol.com/article/PIIS0039625709001878/abstract?rss=yesAbstract: A 60-year-old man presented with vitritis and optic neuropathy in the setting of headaches and behavioral changes. MRI brain revealed bilateral temporal lobe inflammation consistent with limbic encephalitis. He was subsequently diagnosed with small cell lung cancer with a paraneoplastic syndrome characterized by CRMP5 IgG as a cause of his symptoms. His visual symptoms improved markedly after anti-inflammatory therapy and his cognitive symptoms were mildly better following systemic chemotherapy. The clinical presentation, pathophysiology, and therapy of CRMP5 associated paraneoplastic syndromes are discussed.Glazed (Vision) and ConfusedHeather E. Moss, Grant T. Liu, Josep Dalmau10.1016/j.survophthal.2009.03.008Survey of Ophthalmology 55, 2 (2010)2009-10-05Survey of Ophthalmology2009-10-05552S0039-6257(10)X0002-9Clinical Challenges169173http://www.surveyophthalmol.com/article/PIIS0039625709001611/abstract?rss=yesAbstract: The growth of the eye results in a myopic shift in aphakic and pseudophakic eyes during childhood. Cataract surgery after the age of 6 months, with or without lens implantation, appears to have little effect on the rate of refractive growth. Most children with pseudophakia have a large amount of myopic shift. This myopic shift is greatest in children with surgery at younger ages. It is also greater in eyes with high-power intraocular lenses due to an optical phenomenon analogous to the effect of vertex distance. The amount of myopic shift and the variance in rate of refractive growth can be predicted using an empiric, logarithmic model. We describe a revision of this logarithmic model to extend it patients with surgery before 3 months of age. We also analyze the variance in the rate of refractive growth, based on data from pseudophakic children with the longest follow-up in proportion to age.The Optics of Aphakic and Pseudophakic Eyes in ChildhoodScott K. McClatchey, Elizabeth M. Hofmeister10.1016/j.survophthal.2009.07.001Survey of Ophthalmology 55, 2 (2010)2009-09-29Survey of Ophthalmology2009-09-29552S0039-6257(10)X0002-9Refractions and Reflections174182http://www.surveyophthalmol.com/article/PIIS003962570900160X/abstract?rss=yesAbstract: More than 200 universal languages have been proposed to replace the nearly 3,000 existing languages. Esperanto, developed by the Polish-Jewish ophthalmologist Ludwik Zamenhof in 1887, became the most widely used artificial language of the 20th century. It is estimated that between one million and 15 million people in the world can speak or read Esperanto. Zamenhof was nominated 14 times for the Nobel Peace Prize, and also received the French Legion of Honor, and the Medal of Isabelle of Spain the Catholic. Ludwik Zamenhof started his professional training in ophthalmology at the Jewish Hospital in Warsaw, later spent several months in Vienna, and finally started a private ophthalmology practice in Warsaw, where he remained for most of his life. His son Adam was an associate professor of ophthalmology at the University of Warsaw and head of ophthalmology in the Jewish Hospital in Czyste, the biggest and most modern hospital in Warsaw at that time. Some lesser known aspects of Zamenhof's life and work drawn from the original 19th century Russian and 20th century Esperanto documents are described.Ludwik Zamenhof: A Major Contributor to World Culture, on the 150th Anniversary of His BirthAndrzej Grzybowski10.1016/j.survophthal.2009.06.007Survey of Ophthalmology 55, 2 (2010)2009-09-28Survey of Ophthalmology2009-09-28552S0039-6257(10)X0002-9Remembrances of Things Past183188http://www.surveyophthalmol.com/article/PIIS0039625709002045/abstract?rss=yesTo the Editor: On page 330 of the article “Topical Ophthalmic Cyclosporine: Pharmacology and Clinical Uses” by Donnenfeld et al published in the May–June 2009 issue (Surv Ophthalmol. 2009;54:321–38) under section VII.D. Treatment of Lasik-Associated Dry Eye, the authors state, “Increasing the hinge width and placement of the hinge superiorly have been found to decrease the risk of exacerbating or causing dry eye.” However the reference cited (Donnenfeld et al. The effect of hinge position on corneal sensation and dry eye after LASIK. Ophthalmology. 2003;110:1023–9) states that,The long posterior corneal nerves, which innervate the cornea, enter the eye at 3- and 9- O'clock. A superior-hinge flap transects both arms of the neuroplexus, whereas a nasal hinge transects only the temporal arm. LASIK results in a significant reduction in corneal sensation. Corneal sensation and dry eye signs and symptoms decreased immediately after LASIK and improved at all time periods between one week and six months in eyes with both a nasal-hinge flap and a superior-hinge flap. However, the loss of corneal sensation and presence of dry eye syndrome were greater in eyes with a superior-hinge flap than in eyes with a nasal-hinge flap.Topical Ophthalmic Cyclosporine: Pharmacology and Clinical UsesWilliam Lipsky10.1016/j.survophthal.2009.08.001Survey of Ophthalmology 55, 2 (2010)2010-03-04Survey of Ophthalmology2010-03-04552S0039-6257(10)X0002-9Letters189189http://www.surveyophthalmol.com/article/PIIS0039625709002586/abstract?rss=yesI would like to thank Dr. Lipsky for pointing out that in the study referenced a superior hinge actually increased dry eye signs and symptoms as compared to a nasal hinge. As the first author of both “Topical ophthalmic cyclosporine: pharmacology and clinical uses” in Survey of Ophthalmology and the reference in question “The effect of hinge position on corneal sensation and dry eye after LASIK” in the journal Ophthalmology I am doubly appreciative of having the opportunity to correct my own reference in this paper. In addition he is correct that it was 0.05% cyclosporine that was favored in the FDA trials.Author's ResponseEric Donnenfeld10.1016/j.survophthal.2009.09.001Survey of Ophthalmology 55, 2 (2010)2010-03-04Survey of Ophthalmology2010-03-04552S0039-6257(10)X0002-9Letters189189http://www.surveyophthalmol.com/article/PIIS0039625709003063/abstract?rss=yesIn ophthalmology One hundred years ago,One Hundred Years AgoMichael F. Marmor10.1016/j.survophthal.2009.11.003Survey of Ophthalmology 55, 2 (2010)2010-03-04Survey of Ophthalmology2010-03-04552S0039-6257(10)X0002-9Time Oph190190http://www.surveyophthalmol.com/article/PIIS0039625710000238/abstract?rss=yesEzra D.G., Beaconsfield M., and Collin R. Floppy Eyelid Syndrome: Stretching the Limits. Surv Ophthalmol. 2010;55:35-46 On page 36, top of right column, of the above article, the reference number 39 is incorrectly cited in place of reference number 23. The correct set references is “11,23,24,69,76,82” and the sentence should read, “The mean age was 51 (range 31—80 years). In recent years, the understanding of the demographic spectrum of FES has expanded as more cases have been reported, and we now know that women and children are also ffected,11,23,24,69,76,82 although the most commonly affected group remains obese men aged 40–69.”Erratum10.1016/j.survophthal.2010.01.001Survey of Ophthalmology 55, 2 (2010)2010-03-04Survey of Ophthalmology2010-03-04552S0039-6257(10)X0002-9Erratum191191http://www.surveyophthalmol.com/article/PIIS0039625710000068/abstract?rss=yesTable of Contents10.1016/S0039-6257(10)00006-8Survey of Ophthalmology 55, 2 (2010)2010-03-04Survey of Ophthalmology2010-03-04552S0039-6257(10)X0002-9FrontmatterA1A2