Eclipses, Climate 2018 Victoria Change, & the Eye Conference - - PDF document

▶
eclipses climate
SMART_READER_LITE
LIVE PREVIEW

Eclipses, Climate 2018 Victoria Change, & the Eye Conference - - PDF document

Sep 25, 2022 346 likes •456 views

James Kundart OD MEd FAAO FCOVD-A 7/15/18 Opt 702 Lecture #8 Eclipses, Climate 2018 Victoria Change, & the Eye Conference After this course, the practicing optometrist will know how to Pacific University prevent, differentially

slide-1
SLIDE 1

James Kundart OD MEd FAAO FCOVD-A Opt 702 Lecture #8 7/15/18 1

Eclipses, Climate Change, & the Eye

2018 Victoria Conference

Pacific University College of Optometry James Kundart OD MEd FAAO FCOVD-A Financial Disclosures: Nothing to Disclose

https://en.wikipedia.org/ wiki/Photokeratitis

Le Learn rning Ob Object ectives es

After this course, the practicing

  • ptometrist will know how to

prevent, differentially diagnose, and treat (when possible):

  • 1. Heat-induced cataract and

exfoliation

  • 2. UV-induced pterygia
  • 3. Climatic droplet keratopathy
  • 4. Retinal snow blindness
  • 5. Solar and eclipse retinopathy

Cl Climate e Va Variables Th That A Affect Hea Health Ca Care: e: UV an and Heat!

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5820813/

Ultraviolet Radiation and Climate Change

https://www.ncbi.nlm.nih.gov/pubmed/23722672

UV UV E Effects: Ba Basal Cel Cell Ca Carci cinoma

  • f
  • f the Ey

Eyelid: Ea Early or Late Ex Exposure?

https://www.ncbi. nlm.nih.gov/pub med/23722672

He Heat-In Induced (G (Gla lassb ssblo lower’s) s) Ca Cataract and Le Lens s Exfolia liatio ion Ca Case #1: 1: 83 83 YOF

https://www.jstage.jst.g

  • .jp/article/jnms/74/1/

74_1_55/_pdf/-char/en

slide-2
SLIDE 2

James Kundart OD MEd FAAO FCOVD-A Opt 702 Lecture #8 7/15/18 2

He Heat-In Induced (G (Gla lassb ssblo lower’s) s) Ca Cataract and Tr True Exfoliation Ca Case #1

https://www.jstage.jst.g

  • .jp/article/jnms/74/1/

74_1_55/_pdf/-char/en

He Heat-In Induced (G (Gla lassb ssblo lower’s) s) Ca Cataract and Le Lens s Ex Exfoliation Ca Case #2: 2: 86 86 YOM

https://www.jstage.jst.g

  • .jp/article/jnms/74/1/

74_1_55/_pdf/-char/en

He Heat-In Induced (G (Gla lassb ssblo lower’s) s) Ca Cataract and Tr True Ex Exfoliation Ca Case 2

https://www.jstage.jst.g

  • .jp/article/jnms/74/1/

74_1_55/_pdf/-char/en

UV UV Effects: Pt Ptery rygia

§The Chesapeake Bay

Study (1989) of 838 watermen in Maryland found those with the highest quartile of UV-A and UV-B exposure had a 3x higher odds ratio for pterygia

https://www.ncbi.nlm.nih.gov/pubmed/23722672

Tr Treating Pt Ptery ryigia wi with To Topical Az Azasite Ca Case #1: 1: 54 54 YOHM

https://www.pagepressjournals .org/index.php/opto/article/vi ew/optometry.2011.e2

Tr Treating Pt Ptery ryigia wi with To Topical Az Azasite Ca Case #2: 2: 58 58 YOHF

https://www.pagepressjournals .org/index.php/opto/article/vi ew/optometry.2011.e2

slide-3
SLIDE 3

James Kundart OD MEd FAAO FCOVD-A Opt 702 Lecture #8 7/15/18 3

Tr Treating Pt Ptery ryigia wi with To Topical Az Azasite Ca Case #3: 3: 37 37 YOHM

https://www.pagepressjournals .org/index.php/opto/article/vi ew/optometry.2011.e2

Tr Treating Pt Pterygia wi with Az Azasite: $185 $185 (U (US) a a bo bottl tle, , wi with co coupon

https://www.goodrx.com/az asite?drug-name=azasite

UV UV Effec ects: Cl Clima matic Dr Dropl plet Ke Kera ratopathy

https://www.ncbi.nlm.nih.gov/pubmed/23722672

Climatic Droplet Keratopathy #1

https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.12628

Climatic Droplet Keratopathy #2 Found in Labrador,Newfoundland

https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.12628

Climatic Droplet Keratopathy #3

https://onlinelibrary.wiley.com/doi/epdf/10.1111/aos.12628

slide-4
SLIDE 4

James Kundart OD MEd FAAO FCOVD-A Opt 702 Lecture #8 7/15/18 4

How Other Species Prevent Corneal Snow Blindness

  • The concentration of

vitamin C in the corneal epithelium of reindeer is 2x higher than that found in humans

  • Our corneal vitamin C

is the highest in the human body

  • Reindeer live in higher

elevations (>100m above sea level), where there is higher UV exposure

Source: Handbook of Nutrition and Ophthalmology by Richard Semba (2007)

Ph Phototoxici city an and the the R Reti tina na

M A Contín, M M Benedetto,M L Quinteros- Quintana, and M E Guido Light pollution: the possible consequences of excessive illumination on retina Eye (London). 2016 Feb; 30(2): 255

  • 263. PMID: 26541085

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4763120/

Ca Case e #1: 1: 58 58 YOM M with UV Retinopathy y (Sn Snow Blin lindness) ess): 20/2 /20 OD, 20/5 /50 OS

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4501146/

Ca Case e #1: 1: 58 58 YOM M with Sn Snow Blin lindness ess Ma Macular OCT 5-Li Line e Ra Raster er

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4501146/

Ca Case e #1: 1: 58 58 YOM M with Sn Snow Blin lindness ess Au Autofluores escen cence ce

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4501146/

Er Eryth thropsi sia in in Moun untain ain Climb Climber ers

https://julbo-canada.ca/blogs/news/33320836-the-most- common-eye-disorders-found-in-climbers

slide-5
SLIDE 5

James Kundart OD MEd FAAO FCOVD-A Opt 702 Lecture #8 7/15/18 5

Pr Prevention and Treat atment of Sn Snow w Bl Blindness (and Retinal Hemor

  • rrhage!)

http://www.mrcophth.com/ophthalmologyonstamps/phototoxicity/c.html

Case #2: Solar Retinopathy (indirectly) from Bipolar Disorder in 45 YOF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1860187/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1860187/

Case #2: Time-Domain OCT

Ca Case #3: 3: Ba Baseline Su Sungazin ing Retin inopathy

§ (A) Right eye at initial

presentation showing a retinal pigment epithelial defect at the

  • fovea. (B) Left eye at initial

presentation showing a retinal pigment epithelial defect at the

  • fovea. BCVA 20/30 OD, OS.

https://www.ncbi.nlm.nih.gov/ pmc/articles/PMC3604317/

Su Sungazin ing Retin inopathy: On One Month Follo llow-Up Up

§ (A) Right eye at 1 month:

persistent a retinal pigment epithelial (RPE) changes at the fovea

§ (B)Left eye at 1 month:

persistent RPE changes at the fovea

https://www.ncbi.nlm.nih.gov/ pmc/articles/PMC3604317/

Su Sungazin ing Retin inopathy: Six Six Month Follo llow-Up Up

Right eye at 6 months: improvement in foveal changes and (B) left eye at 6 months: improvement in foveal changes Damage is thought to be photochemical, not thermal!

https://www.ncbi.nlm.nih.gov/ pmc/articles/PMC3604317/

slide-6
SLIDE 6

James Kundart OD MEd FAAO FCOVD-A Opt 702 Lecture #8 7/15/18 6

Su Sungazin ing Retin inopathy: On One Year Follo llow-Up Up

§ (A) Right eye at 1 year;

almost full resolution of retinal pigment epithelial (RPE) changes

§ (B) Left eye at 1 year; almost

full resolution of RPE changes

https://www.ncbi.nlm.nih.gov/ pmc/articles/PMC3604317/

Ca Case #4: 38 YOWF Sol

  • lar Retinop
  • pathy

Wi Withou

  • ut Abnor
  • rmal Expos
  • sure,

Ba Baseline and Six Mon

  • nths La

Later r (20/2 /20)

http://www.scielo.br/pdf/abo/v76n2/12.pdf

Ca Case #4: 38 YOWF, Macular OCT So Solar Retinopathy w/ w/o Abnormal Exposure

http://www.scielo.br/pdf/abo/v76n2/12.pdf

Ca Case #5: 21 YOM So Solar Retinopathy OD OD, 2 20/30 B BCVA

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3149141/

Ca Case #5: 21 YOM Sol

  • lar Retinop
  • pathy

Fl Fluo uores escei ein A n Angi ngiogr graph aphy

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3149141/

Ca Case #5: 21 YOM Sol

  • lar Retinop
  • pathy

Ti Time-Dom Domain OCT OD

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3149141/

slide-7
SLIDE 7

James Kundart OD MEd FAAO FCOVD-A Opt 702 Lecture #8 7/15/18 7

Ca Case #5: 21 YOM Sol

  • lar Retinop
  • pathy

Sp Spectral-Dom Domain OCT OD OD, B BCVA 2 20/25

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3149141/

Pe Pediatric Case #6: 10 YOM So Solar Retinopathy OS OS, B BCVA 2 20/25

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3149141/

Ca Case #6: 10 YOM Sol

  • lar Retinop
  • pathy

Fl Fluo uores escei ein A n Angi ngiogr graph aphy OS OS

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3149141/

Ca Case #6: 10 YOM Sol

  • lar Retinop
  • pathy

Ti Time-Dom Domain OCT OS OS, B BCVA 2 20/20

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3149141/

Ca Case #6: 10 YOM Sol

  • lar Retinop
  • pathy

Sp Spectral-Dom Domain OCT OS

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3149141/

Eclipse Retinopathy Case #7: 29 YOM, BCVA 20/40 OD

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4213866/

slide-8
SLIDE 8

James Kundart OD MEd FAAO FCOVD-A Opt 702 Lecture #8 7/15/18 8 Eclipse Retinopathy Case #8: 29 YOF , BCVA 20/40 OD, 20/20 in 1 mo.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4213866/

Pediatric Eclipse Case #9: 13 YOF , BCVA 20/20 OD, OS

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4213866/

Pediatric Eclipse Case #10: 14 YOF , BCVA 20/80 OD x 1 year

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4213866/

Ca Case e #11: 11: 63 63 YOF F Eclipse e Re Retinopathy BCV BCVA A 20/ 20/30 30 OD

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3545138/

Ca Case e #11: 11: Ec Eclipse Re Retinopathy Au Auto- flu fluor

  • resc

scene

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3545138/

Ca Case e #11: 11: Ec Eclipse Re Retinopathy Ba Basel eline e Ma Macular OCT

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3545138/

slide-9
SLIDE 9

James Kundart OD MEd FAAO FCOVD-A Opt 702 Lecture #8 7/15/18 9 Ca Case e #11 11: Ep Epiretinal Mem Membrane 1 1 Mo

  • Mo. La

Later er BCV BCVA A 20/ 20/40 40 OD

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3545138/

Ca Case e #11: 11: Mem Membrane e Pe Peel and Vi Vitrectomy BCV BCVA 20/ 20/20 20 OD

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3545138/

Ca Case e #11: 11: Ec Eclipse Re Retinopathy 63 63 YOF Re Resolution

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3545138/

Pediatric Case #12: Eclipse Retinopathy 10 YOM, 20/40-20/30 OS

https://www.ncbi.nlm.nih.gov/pubmed/26239209

Pediatric Case #13: Eclipse Retinopathy in 8 YOF, OD > OS

https://www.ncbi.nlm.nih.gov/pubmed/26239209

Pediatric Case #14: Venus Transit Retinopathy in 11 YOF, Metamorphopsia

https://www.ncbi.nlm.nih.gov/pubmed/26239209

slide-10
SLIDE 10

James Kundart OD MEd FAAO FCOVD-A Opt 702 Lecture #8 7/15/18 10

Pr Preventing Solar and Eclipse Retinopathy

https://eclipse2017.nasa.gov/safety

Tr Treating Solar Retinopathy

  • There is no standardized

treatment for solar retinopathy, but…

  • Antioxidant vitamins and

micronutrients similar to AREDS (vitamin A, C, E, luein, zeaxnthin, and zinc) have shown promise

  • Oral prednisolone has been

tried, but it is a risk factor for central serous chorioretinopathy

https://www.retinalphysician.com/issues/2013/october- 2013/solar-retinopathy-etiology,-diagnosis,-and-treatm

Qu Questions? Th Thank You

  • u!

James Kundart OD MEd FAAO FCOVD-A Professor, Pacific University College of Optometry 3D Performance Clinic Kundart@pacificu.edu

TH THAN ANKS S FO FOR THE ME MEMO MORI RIES, MS

  • MS. JEANNE

NNE OLIV OLIVER ER!