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Today’s Ocular Surface Disease: Optimizing Your Diagnosis, Diagnostics, and Therapeutic Approach

This course has expired. You can still review the content but course credit is no longer available.

Supplement Credits: 1

Jointly sponsored by the Dulaney Foundation and Cataract & Refractive Surgery Today.
This continuing medical educational activity is supported by an unrestricted educational grant from Allergan, Inc.
Release date: September 2014. Expiration date: September 2015.

Expiration Date: Wednesday, September 30, 2015
Release Date: September 2014

Learning Objectives

Upon completion of this activity, participants should be able to:
• Diagnose acute dry eye conditions and chronic ocular surface disease
• Identify patient groups at risk for ocular surface disease in the practice
• Recognize the chronic nature and inflammatory processes in ocular surface disease
• Understand new ocular surface disease diagnostic technologies
• Differentiate palliative versus therapeutic treatment of ocular surface disease
• Discuss the impact of ocular surface disease on surgical outcomes

Accreditation and Designation Statement

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the Dulaney Foundation and Cataract & Refractive Surgery Today. The Dulaney Foundation is accredited by the ACCME to provide continuing education for physicians. The Dulaney Foundation designates this print activity for a maximum of 1 AMA PRA Category 1 Credit.™ Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Statement of Need

According to several key articles published in 2004 by the Eye Diseases Prevalence Research Group, the number of persons in the United States with cataracts is projected
to rise dramatically by the year 2020 to more than 30 million, and the number of open-angle glaucoma cases will increase by 50%.1,2 Ocular surface disease continues
to be an issue for many patients, especially in older individuals who may have additional needs for ocular surgery for cataracts or retinal degenerative disease.3

The landscape of new diagnostic techniques and technologies available to help ophthalmologists diagnose ocular surface disease in their patients continues to rapidly develop. New diagnostic devices using tear film video and image analysis are providing additional means to quantify baseline tear film function and the monitoring of prescribed therapeutics over time. Accompanying therapeutic methods of eyelid disease to improve the production of tear film components is also allowing clinicians to address ocular surface disease in new ways.4

Point-of-care laboratory technologies can now provide new means of uncovering subclinical and overt dry eye, including tear osmolarity analysis, which in turn can allow ophthalmologists to better address patient needs before long-term ocular surface disease symptoms develop.5 Educating ophthalmologists on the latest developments in new patient diagnosis methods, such as the in-office detection of matrix metalloproteinase-9 (MMP-9), an inflammatory component of dry eye disease, is directly linked to bridging the gaps in clinical diagnostic patterns and treatment decision making.6

In August 2011, a poll by Review of Ophthalmology discussed how improved familiarity with clinical trials reporting and critical analysis of outcomes should improve the implementation of new techniques into clinical practice.7 Understanding the available and near-to-market ocular surface disease therapeutics in the pipeline is a key element of coordinating the needs of a patient with the available clinical strategies. Possession of this knowledge can have a direct impact on ophthalmologists’ ability to more effectively communicate with patients and address their expectations.

1. Congdon N, Vingerling JR, Klein BE,et al; Eye Diseases Prevalence Research Group. Prevalence of cataract and pseudophakia/aphakia among adults in the United States. Arch Ophthalmol. 2004;122(4):487-494.
2. Friedman DS, Wolfs RC, O’Colmain BJ, et al; Eye Diseases Prevalence Research Group. Prevalence of open-angle glaucoma among adults in the United States. Arch Ophthalmol. 2004;122(4):532-538.
3. Galor A, Feuer W, Lee DJ, et al. Prevalence and risk factors of dry eye syndrome in a United States veterans affairs population. Am J Ophthalmol. 2011;152(3):377-384.e2.
4. TearScience, Inc. Study: long-term efficacy of LipiFlow Thermal Pulsation demonstrated. EyeWire.com. November 13, 2013. Available at: http://www.eyewiretoday.com/view.asp?20131113-study_long-term_efficacy_of_lipiflow_thermal_pulsation_demonstrated. Accessed September 8, 2014.
5. Reuters.com. TearLab gets FDA nod for wider use of eye test. December 5, 2011. Available at: http://www.reuters.com/article/2011/12/05/us-tearlab-idUSTRE7B41B720111205. Accessed September 8, 2014.
6. Rapid Papthogen Screening, Inc. RPS announces FDA clearance of rapid, point-of-care test for dry eye disease – InflammaDry. EyeWireToday.com. November 25, 2013. Available at: http://www.eyewiretoday.com/view.asp?20131125-rps_announces_fda_clearance_of_rapid_point-of-care_test_for_dry_eye_disease__inflammadry. Accessed September 8, 2014.
7. Review of Ophthalmology Online. September 12, 2011. Available at: at: http://www.revophth.com/e-newsletters/rponlinenl/c/29982/. Accessed September 8, 2014.

Faculty and Disclosures

Faculty Credentials

Christopher E. Starr, MD (Moderator), is an associate professor of ophthalmology; director of refractive surgery service; director of cornea, cataract & refractive surgery fellowship; and director of ophthalmic education at Weill Cornell Medical College, New York Presbyterian Hospital in New York City. Dr. Starr may be reached at cestarr@med.cornell.edu.

Terry Kim, MD, is a professor of ophthalmology at Duke University Eye Center in Durham, North Carolina. Dr. Kim may be reached at (919) 681-3568; terry.kim@duke.edu.

Marguerite B. McDonald, MD, is a corneal/refractive specialist with Ophthalmic Consultants of Long Island in New York, a clinical professor of ophthalmology at the NYU School of Medicine in New York, and an adjunct clinical professor of ophthalmology at the Tulane University Health Sciences Center in New Orleans. Dr. McDonald may be reached at (516) 593-7709; margueritemcdmd@aol.com.

William B. Trattler, MD, is the director of cornea at the Center for Excellence in Eye Care in Miami. Dr. Trattler may be reached at (305) 598-2020; wtrattler@earthlink.net. Darrell E. White, MD, is the president and CEO of Sky Vision Center in Cleveland. Dr. White may be reached at (440) 892-3931; they@skyvisioncenters.com.

Faculty/Staff Disclosures

Christopher E. Starr, MD, has had a financial agreement or affiliation during the past year with the following commercial interests: Alcon Laboratories, Inc.; Allergan, Inc.; Bausch & Lomb Incorporated; Merck & Co. Inc.; Rapid Pathogen Screening, Inc.; and TearLab Corporation.

Terry Kim, MD, has had a financial agreement or affiliation during the past year with the following commercial interest: Alcon Laboratories, Inc.; Bausch & Lomb Incorporated; Ocular Systems Inc.; Ocular Therapeutix, Inc.; Omerus; PowerVision, Inc.; Shire; and TearScience, Inc.

Marguerite B. McDonald, MD, has had a financial agreement or affiliation during the past year with the following commercial interests: Abbott Medical Optics Inc.; Allergan, Inc.; Bausch & Lomb Incorporated; Nexis Vision Group; OCuSOFT; TearLab Corporation; and TearScience, Inc.

William B. Trattler, MD, has had a financial agreement or affiliation during the past year with the following commercial interests: Abbott Medical Optics Inc.; Allergan, Inc.; Bausch & Lomb Incorporated; and CXL Ophthalmolics, LLC.

Darrell E. White, MD, has had a financial agreement or affiliation during the past year with the following commercial interests: Allergan, Inc.; Bausch & Lomb Incorporated; Eyemaginations, Inc.; and Nicox, Inc.

All of those involved in the planning, editing, and peer review of this educational activity report no relevant financial relationships.

Disclosure Policy

In accordance with the disclosure policies of the Dulaney Foundation and to conform with ACCME and US Food and Drug Administration guidelines, anyone in a position to affect the content of a CME activity is required to disclose to the activity participants (1) the existence of any financial interest or other relationships with the manufacturers of any commercial products/devices or providers of commercial services and (2) identification of a commercial product/device that is unlabeled for use or an investigational use of a  product/device not yet approved.

 

Disclaimer

The views and opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of the Dulaney Foundation, Cataract & Refractive Surgery Today, and Allergan, Inc.

Today’s Ocular Surface Disease: Optimizing Your Diagnosis, Diagnostics, and Therapeutic Approach

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