Age-Related Macular Degeneration: Current Status and Treatment Peter Y. Chang, MD Age-Related Macular Degeneration (ARMD) is the leading cause of irreversible vision loss over the age of 50. It affects about 15 million men and women in the United States with about 200,000 new cases diagnosed each year. About 1.7 million U.S. citizens have the … Continue reading Age-Related Macular Degeneration: Current Status and Treatment
AIDS and the Eye C. Stephen Foster, MD, FACS, FACR The ocular manifestations of AIDS revolve primarily around infectious and malignant disease. Prior to the advent of multi-drug “cocktail” therapy for HIV infection, opportunistic infectious disease of the eye was extremely common, and, in fact was a sentinel “marker” for a marked reduction in CD4 … Continue reading AIDS and the Eye
Association of Ocular Inflammatory Disease with Inflammatory Bowel Disease C. Stephen Foster, M.D., F.A.C.S, F.A.C.R. Even more surprising than the association between arthritis and eye inflammation, at least to some people, is the association between bowel inflammation and eye inflammation. But history tells us that such an association exists. This may be true not only … Continue reading Association of Ocular Inflammatory Disease with Inflammatory Bowel Disease
Birdshot Retinochoroidopathy C. Stephen Foster, M.D., F.A.C.S, F.A.C.R. What is Birdshot Retinochoroidopathy? Birdshot retinochoroidopathy, commonly referred to simply as “birdshot”, is a rare form of posterior uveitis which mainly affects the retina and choroid. The disease occurs in women more often than men, typically Caucasian, and most often between the ages of 30 and 60. … Continue reading Birdshot Retinochoroidopathy
Cataract Surgery and Uveitis C. Stephen Foster, M.D., F.A.C.S, F.A.C.R. Cataract develops in patients with uveitis because of the uveitis itself and also because of the steroids which is the cornerstone of treating uveitis. Cataract developing in an eye with a history of chronic or recurrent uveitis has historically been called cataracta complicata, and, indeed, … Continue reading Cataract Surgery and Uveitis
Cataract Surgery in Ocular Cicatricial Pemphigoid C. Stephen Foster, M.D., F.A.C.S, F.A.C.R. We reported the results of our experience with cataract surgery in 20 patients (26 eyes) with biopsy-proven cicatricial pemphigoid. All patients were on systemic immunosuppression at the time of surgery (dapsone, azathioprine, cyclophsophamide, or combinations) and were treated with peri-operative oral corticosteroids. Patients … Continue reading Cataract Surgery in Ocular Cicatricial Pemphigoid
Connection Between Arthritis and Ocular Disease C. Stephen Foster, M.D., F.A.C.S, F.A.C.R. The eye is made up primarily of collagen, as are ligaments, tendons, and tissue within joint spaces. It is, perhaps, primarily because of this similarity in composition that the eye is often affected by many of the same diseases which affect joints. Some … Continue reading Connection Between Arthritis and Ocular Disease
Connection Between Skin Disorders and Ocular Disease C. Stephen Foster, M.D., F.A.C.S, F.A.C.R. Most individuals do not realize the extraordinary connection between skin and eye, much less the fact that many skin diseases have concomitant ocular manifestations. These may range from the relatively trivial, nuisance consequences of acne rosacea, with its associated chronic eye lid … Continue reading Connection Between Skin Disorders and Ocular Disease
Corneal Transplantation and Immunologic Tolerance C. Stephen Foster, M.D., F.A.C.S., F.A.C.R. Corneal transplants, more often than not, are “tolerated (i.e., not rejected), unlike solid organ transplants such as heart, lung, kidney and skin. For 40 years it was imagined that this phenomenon occurred because of the lack of blood vessels and lymphatics in the cornea, … Continue reading Corneal Transplantation and Immunologic Tolerance
Diabetes and Diabetic Retinopathy C. Stephen Foster, M.D., F.A.C.S., F.A.C.R. Diabetic retinopathy is a leading cause of blindness in the United States, and, indeed, in all developed countries. Sixteen million Americans have diabetes; only about half are aware that they have it. One type, Type 1, has its onset in childhood or young adulthood, and … Continue reading Diabetes and Diabetic Retinopathy
Dry Eye C. Stephen Foster, M.D., F.A.C.S., F.A.C.R. Dry Eye or Keratoconjunctivitis sicca syndrome (KCS or dry eye) is a problem of major epidemiologic importance. It affects literally millions of people around the globe, with women dramatically over represented, particularly those women who have entered menopause. The problem may accompany dry mouth, and may be … Continue reading Dry Eye
Episcleritis C. Stephen Foster, M.D., F.A.C.S., F.A.C.R. What is episcleritis? Episcleritis is inflammation of the episclera, which is the thin vascular outer coating of the eye wall, the sclera. Episclera lies underneath the more superficial layers of conjunctiva and other connective tissues. Unlike the more severe disease scleritis, episcleritis is a benign condition and is … Continue reading Episcleritis
Herpes and the Eye C. Stephen Foster, M.D., F.A.C.S., F.A.C.R. Herpes! The first thought in most people’s mind is venereal disease, sexual transmitted disease (STD). But, in fact most instances of herpes, at least those affecting the eye, are not sexually transmitted, and are not even the type of herpes that is usually associated with … Continue reading Herpes and the Eye
Juvenile Idiopathic Arthritis and Uveitis C. Stephen Foster, M.D., F.A.C.S., F.A.C.R. Uveitis is a serious complication of juvenile idiopathic arthritis (JIA). Approximately 6% of all cases of uveitis occur in children, and up to 80% of all cases of anterior uveitis in childhood are associated with JIA. Although remarkable progress has been made in the … Continue reading Juvenile Idiopathic Arthritis and Uveitis: What is it and what is its effect on the eye?
Keratitis C. Stephen Foster, M.D., F.A.C.S, F.A.C.R, Stephen D. Anesi, M.D., F.A.C.S What is keratitis? Keratitis is inflammation of the cornea, the clear window of the front of the eye. The cornea is an incredibly unique tissue in the body, in that it is perfectly transparent, and allows light to pass through to help us … Continue reading Keratitis
Ocular Autoimmune Disease: An Introduction C. Stephen Foster, M.D., F.A.C.S, F.A.C.R The immune system, ordinarily in the “business” of protecting us from harm, generally protecting us from germs and cancer cells, can become deranged, disregulated, with the result being an immune attack on part of our own body. This state of affairs is termed autoimmunity, … Continue reading Ocular Autoimmune Disease: An Introduction
Scleritis C. Stephen Foster, M.D., F.A.C.S, F.A.C.R Scleritis What is scleritis? Scleritis is inflammation of the tough, white structural wall of the eyeball, the sclera. The sclera is made of collagen and is continuous with the cornea, the clear window through which we see that makes up the front wall of the eye. Blood vessels … Continue reading Scleritis
This article describes our experience with a self-help group for patients with uveitis that was founded in 1996 by Dr. C. Stephen, Foster, Frances Foster MS, NP, CS and John Hurley LICSW. Our experience with this process, and the success of the group, confirms other reports about the important role of self-help groups for patients … Continue reading Support groups and their role in caring for patients with ocular inflammatory disease
Systemic Treatment of Ocular Inflammatory Disease (OID) C. Stephen Foster, M.D., F.A.C.S., F.A.C.R Most eye diseases which are treatable are treated with eye drops. In fact, the number of instances in which patients attending a general ophthalmologist’s office might be prescribed a systemic medication (i.e., one which is taken, for example, by mouth) is vanishingly … Continue reading Systemic Treatment of Ocular Inflammatory Disease (OID)
Chemotherapy: Risks and Outcomes C. Stephen Foster, M.D., F.A.C.S., F.A.C.R. Inflammatory eye disease has blinded countless numbers of individuals during both ancient and modern times. And while most of such instances have occurred on the basis of infectious inflammation, not a trivial number of instances has occurred on the basis of autoimmune inflammation. A revolution … Continue reading Chemotherapy: Risks and Outcomes
Cost of Care of Patients with Uveitis C. Stephen Foster, M.D. Increasingly restrictive “gate keeping” policies of health maintenance organizations, insurance companies, and other medical insurance plans have created increasing pressure on ophthalmologists to be parsimonious in their use of medical services in both the diagnostic and therapeutic care of patients with a variety of … Continue reading Cost of Care of Patients with Uveitis
Cataract C. Stephen Foster, M.D. CATARACT: a scum or a film or a growth on the eye: right? Wrong! A cataract is none of these. The word cataract simply means the development of an opacity in the crystalline lens inside the eye. We all have such a lens sitting just behind the pupil. And this … Continue reading Cataract!
Connection Between Arthritis and Ocular Disease C. Stephen Foster, M.D. The eye is made up primarily of collagen, as are ligaments, tendons, and tissue within joint spaces. It is, perhaps, primarily because of this similarity in composition that the eye is often affected by many of the same diseases which affect joints. Some of these … Continue reading Did you know the Connection Between Arthritis and Ocular Disease?
Glaucoma C. Stephen Foster, M.D. What is it? Some misconceptions exist regarding glaucoma. One thing that most of the public does understand, however, is that glaucoma is serious and is potentially blinding. Many people, however, harbor the misconception that glaucoma produces pain. Indeed, there is one form of glaucoma that can produce an acute onset … Continue reading Glaucoma
Great progress has been made during the latter half of this century in the care of patients with iridocyclitis associated with juvenile idiopathic arthritis (JIA), formerly juvenile rheumatoid arthritis (JRA). The most major advance was the development of corticosteroids for systemic and ophthalmic use just after the mid-way point of this century, and the second … Continue reading Treatment Algorithm for Juvenile Idiopathic Arthritis-Associated Iridocyclitis- Stephen Foster, M.D.
Of the many causes of ocular inflammation, one of the more frequently seen causes, and frankly one many patients have never before heard of, is ocular sarcoidosis, or simply “sarcoid”. Sarcoid is a systemic autoinflammatory disease that can affect multiple parts of the body and cause varying levels of inflammation. A good many people with … Continue reading April is Sarcoidosis Awareness Month
Epidemiology Age-related macular degeneration (AMD) is the number 1 cause of blindness in the Western world. It affects 8 million Americans, including more than 30% of American older than 75 years of age. Even though it is a disease that mostly affects the older population, as many as 6-7% of population of age 40 and … Continue reading Age-Related Macular Degeneration
Uveitis is the third leading cause of preventable blindness in this country, but many people who suffer from this group of diseases lose their vision via other another mechanism – glaucoma. Glaucoma is the ‘sneak thief’ of vision, a blinding disease of the optic nerve, or the structure that connects your eye and brain and … Continue reading Uveitic Glaucoma
Diabetes affects 415 million adults worldwide, and it is becoming more prevalent in children and adolescent thanks to the unhealthy diets and physical inactivity that have become the hallmarks of our modern society. Excessive hunger and thirst, frequent urination, weight loss, fatigue, and blurry vision are the classic early symptoms. However, it is estimated that … Continue reading Diabetic Retinopathy
The immune system, ordinarily in the “business” of protecting us from harm, generally protecting us from germs and cancer cells, can become deranged, with the result being an immune attack on part of our own body. This state of affairs is termed autoimmunity, or immune attack against self. A number of autoimmune diseases exist. In … Continue reading An Introduction to Ocular Autoimmune Disease
Uveitis is the third leading cause of blindness in America, and 5% to 10% of the cases occur in children under the age of 16. But uveitis in children blinds a larger percentage of those affected than in adults, since 40% of the cases occurring in children are posterior uveitis, compared to the 20% of … Continue reading Pediatric Uveitis