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Topic Review Peer Reviewed
Improving Compliance with Medical Treatment Using Eye Drop Aids
Achieving optimal treatment outcomes in glaucoma requires patients to adhere to their medication regimens. Possible barriers to patients’ cooperation include the misunderstanding of a treatment’s importance or errors in applying instructions, forgetfulness, financial constraints and others. Due to the fact that glaucoma usually causes no apparent symptoms or pain, on the one hand, and the significant inconvenience that the eye drops used for glaucoma treatment can cause due to local irritation, on the other, patient compliance is a challenge. To address this challenge, we require strategies for improving adherence to glaucoma treatment. The importance of proper eye drop administration techniques cannot be overstated, particularly for vulnerable populations such as the elderly, the sick and the visually handicapped. Studies have shown that failure to comply with glaucoma treatment is a significant factor affecting disease progression, emphasizing the need for interventions that improve patient compliance. Educational interventions, medication reminders and the use of assistive devices such as eye drop aids have been shown to improve adherence to glaucoma treatment. By promoting strategies that can be used to enhance treatment adherence, healthcare providers can ensure that glaucoma patients receive the full benefits of their treatment plans, reducing the risk of disease progression. Many patients struggle with the complexity of their treatment regimens and the challenges of administering eye drops. This entry provides a comprehensive overview of the different barriers to patient adherence to glaucoma eye drop treatment, emphasizing the difficulties associated with eye drop instillation. This entry examines a range of eye drop aids available to patients, evaluating their modes of action, benefits, drawbacks and effectiveness in improving patient compliance. By providing detailed information on the barriers to adherence and the range of eye drop aids available, this entry aims to support healthcare providers in helping glaucoma patients to achieve better treatment adherence and outcomes.
  • 1.1K
  • 19 Oct 2023
Topic Review
Negative Dysphotopsia after Cataract Surgery
Dysphotopsias are unwanted visual phenomena that occur after cataract surgery. They represent some of the most common reasons for patient dissatisfaction after uncomplicated surgery for cataract phacoemulsification with in-the-bag intraocular lens (IOL) implantation. Depending on the form of the optical phenomenon and the effect it poses on vision, dysphotopsias are divided into positive and negative type. Positive dysphotopsias are usually described by patients as glare, light streaks, starbursts, light arcs, rings, haloes, or flashes of light. Negative dysphotopsias (ND) are manifested as an arc-shaped shadow or line usually located in the temporal part of the visual field, similar to a temporal scotoma. ND is evoked by an external light source that is typically temporally oriented. Patients most commonly experience this phenomenon in photopic conditions when the pupil is narrow. ND is a diagnosis of exclusion where other possible ocular and neuro-ophthalmological pathologies should be excluded. The etiology of ND is not clearly defined, and the cause seems to be multifactorial. Holladay and Simpson categorized the risk factors for ND development into three groups: anatomic characteristics (pupil size, hyperopia, and angle kappa), IOL properties (IOL surface steepness, edge design, dioptricpower, and refraction index), and surgical technique for cataract removal (optic–haptic junction orientation and position of nasal anterior capsule to the IOL surface).
  • 1.1K
  • 28 Jan 2023
Topic Review
Magnification of Iris in Ocular Prosthesis
The ocular prostheses, used for the prosthetic rehabilitation of ocular defects, are generally made from acrylic resin. As the thickness of clear acrylic over the iris is increased on the ocular prosthesis, the size of the iris is also increased, due to magnification through the clear resin.
  • 1.1K
  • 22 Mar 2022
Topic Review
Endophthalmitis
Exogenous fungal endophthalmitis (EXFE) represents a rare complication after penetrating ocular trauma of previously unresolved keratitis or iatrogenic infections, following intraocular surgery such as cataract surgery.
  • 1.1K
  • 22 Sep 2021
Topic Review
Central Serous Chorioretinopathy
Central serous chorioretinopathy (CSC) is a complex and not entirely understood retinal disease.
  • 1.1K
  • 22 Sep 2021
Topic Review
Sorsby‘s Fundus Dystrophy
Sorsby‘s fundus dystrophy (SFD) is a rare, autosomal dominant inherited retinal disease with complete penetrance affecting both genders similarly, typically becoming symptomatic after the second decade of life, with an average onset in the 4th to 5th decade of life, leading to severe bilateral vision loss and blindness if left untreated.
  • 1.1K
  • 22 Jun 2021
Topic Review
Thyroid Eye Disease
Thyroid eye disease (TED) is an inflammatory disease of orbital tissue characterized by infiltration of lymphocytic cells, orbital fat expansion, and extraocular muscle swelling. The gravity of thyroid eye disease lies in its sight-threatening, debilitating, and disfiguring potential. Despite extensive ongoing research about TED, the disorder remains elusive in its exact pathophysiology, prevention, and ideal treatment.
  • 1.1K
  • 22 Dec 2022
Topic Review
Corneal Epithelial Stem Cells
In the human cornea, regeneration of the epithelium is regulated by the stem cell reservoir of the limbus, which is the marginal region of the cornea representing the anatomical and functional border between the corneal and conjunctival epithelium. In support of this concept, extensive limbal damage, e.g., by chemical or thermal injury, inflammation, or surgery, may induce limbal stem cell deficiency (LSCD) leading to vascularization and opacification of the cornea and eventually vision loss. These acquired forms of limbal stem cell deficiency may occur uni- or bilaterally, which is important for the choice of treatment. Moreover, a variety of inherited diseases, such as congenital aniridia or dyskeratosis congenita, are characterized by LSCD typically occurring bilaterally. Several techniques of autologous and allogenic stem cell transplantation have been established. The limbus can be restored by transplantation of whole limbal grafts, small limbal biopsies or by ex vivo-expanded limbal cells.
  • 1.0K
  • 08 Apr 2022
Topic Review
Pediatric Conjunctivitis
Conjunctivitis is a common pediatric problem and is broadly divided into infectious and non-infectious etiologies. Bacterial conjunctivitis makes up the majority of cases in children and often presents with purulent discharge and mattering of the eyelids. Treatment is supportive with an individual approach to antibiotic use in uncomplicated cases since it may shorten symptom duration, but is not without risks. Viral conjunctivitis is the other infectious cause and is primarily caused by adenovirus, with a burning, gritty feeling and watery discharge. Treatment is supportive. Allergic conjunctivitis is largely seasonal and presents with bilateral itching and watery discharge. Treatment can include topical lubricants, topical antihistamine agents, or systemic antihistamines. Other causes of conjunctivitis include foreign bodies and non-allergic environmental causes. 
  • 1.0K
  • 15 May 2023
Topic Review
Neuroplasticity
Neuroplasticity can be defined as the ability of the nervous system to modify its structure on the basis of different environmental changes and stimulation.
  • 1.0K
  • 28 Oct 2021
Topic Review
Normal Tension Glaucoma
Glaucoma is a neurodegenerative disease of the eye, which involves degeneration of retinal ganglion cells (RGCs): the output neurons of the retina to the brain, which with their axons comprise the optic nerve. Glaucoma is usually associated with elevated intraocular pressure (IOP), but there is a subtype of glaucoma, termed normal tension glaucoma, that presents with normal IOP.
  • 1.0K
  • 12 Feb 2021
Topic Review
Gel-Based Materials
The most common route of administration of ophthalmic drugs is the topical route because it is convenient, non-invasive, and accessible to all patients. Unfortunately, drugs administered topically are not able to reach effective concentrations. Moreover, their bioavailability must be improved to decrease the frequency of administrations and their side effects, and to increase their therapeutic efficiency. For this purpose, in recent decades, particular attention has been given to the possibility of developing prolonged-release forms that are able to increase the precorneal residence time and decrease the loss of the drug due to tearing. Among these forms, gel-based materials have been studied as an ideal delivery system because they are an extremely versatile class with numerous prospective applications in ophthalmology. These materials are used in gel eye drops, in situ gelling formulations, intravitreal injections, and therapeutic contact lenses. 
  • 1.0K
  • 08 Sep 2021
Topic Review
Small Leucine-Rich Proteoglycans in Retina
Small Leucine-Rich Proteoglycans (SLRPs) are key extracellular matrix proteins that play a role in many fundamental biological processes involved in the maintenance of retinal homeostasis. 
  • 1.0K
  • 26 Jul 2021
Topic Review
Pharmacological Treatment in Presbyopia
Pharmacological treatment of presbyopia may be an alternative for those who want a spectacle-free scenario and an easy-to-use method with lower risk of irreversible ocular adverse events. There are two main agents, miotics and lens softeners, investigated as agents for the pharmacological treatment. Miotic agents treat presbyopia by creating a pinhole effect which may increase the depth of focus at all working distances. Lens softeners increase the elasticity of the lens, which is targeted at one of the etiologic mechanisms of presbyopia. 
  • 1.0K
  • 14 Mar 2022
Topic Review
Lactoferrin in Ocular Diseases
Besides the well-known antibacterial effect of lactoferrin, novel interest has been rising towards its potential application in the field of dry eye and viral infections. A growing body of evidence supports the antimicrobial efficacy of lactoferrin, which is not limited to its iron-chelating properties but also depends on its capability to directly interact with pathogen particles while playing immunomodulatory effects. Nowadays, lactoferrin antiviral activity is of special interest, since lactoferrin-based eye drops could be adopted to treat/prevent the new severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection, which has conjunctivitis among its possible clinical manifestations. In the future, further data from randomized controlled studies are desirable to confirm the efficacy of lactoferrin in the wide range of ocular conditions where it can be used.
  • 990
  • 14 Oct 2020
Topic Review
Biomedical Applications of Lactoferrin on the Ocular Surface
Lactoferrin (LF) is a first-line defense protein with a pleiotropic functional pattern that includes anti-inflammatory, immunomodulatory, antiviral, antibacterial, and antitumoral properties. Remarkably, this iron-binding glycoprotein promotes iron retention, restricting free radical production and avoiding oxidative damage and inflammation. On the ocular surface, LF is released from corneal epithelial cells and lacrimal glands, representing a significant percentage of the total tear fluid proteins. Due to its multifunctionality, the availability of LF may be limited in several ocular disorders. Consequently, to reinforce the action of this highly beneficial glycoprotein on the ocular surface, LF has been proposed for the treatment of different conditions such as dry eye, keratoconus, conjunctivitis, and viral or bacterial ocular infections, among others.
  • 988
  • 15 Mar 2023
Topic Review
SARS-CoV-2 Affect Eyes
The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has become a worldwide threat resulting in a pandemic in 2020. SARS-CoV-2 infection manifests itself as coronavirus disease 2019 (COVID-19) that is evidenced in a vast number of either specific or nonspecific symptoms. Except for typical (but nonspecific) symptoms such as fever, dry cough, or muscle weakness, the infected patients might also present atypical symptoms including neurological, dermatological, or ophthalmic manifestations.
  • 980
  • 20 Jun 2022
Topic Review
Gene Therapy Approaches to Treat Retinitis Pigmentosa
Retinitis pigmentosa (RP) is a group of hereditary diseases that result in the progressive degeneration of the retina's photoreceptor cells, primarily starting with the rods. This gradual loss of vision is the most common form of inherited retinal dystrophy, and it imposes a significant burden on both individuals and society. RP is a leading cause of visual disability and blindness in people under 60, affecting more than 1.5 million individuals worldwide. The most common symptoms of RP include nyctalopia and gradual peripheral vision loss, which may ultimately lead to complete blindness.
  • 978
  • 06 Jun 2023
Topic Review
Suprachoroidal Delivery of Therapeutic Agents
Suprachoroidal drug delivery technology has advanced rapidly and emerged as a promising administration route for a variety of therapeutic candidates, targeting multiple ocular diseases, ranging from neovascular age-related macular degeneration to choroidal melanoma. This entry summarizes the latest preclinical and clinical progress in suprachoroidal delivery of therapeutic agents, focusing on small molecule suspensions.
  • 972
  • 22 Sep 2021
Topic Review
Nitrosative Stress in Retinal Pathologies
Nitric oxide (NO) is a gas molecule with diverse physiological and cellular functions. In the eye, NO is used to maintain normal visual function as it is involved in photoreceptor light transduction. In addition, NO acts as a rapid vascular endothelial relaxant, is involved in the control of retinal blood flow under basal conditions and mediates the vasodilator responses of different substances such as acetylcholine, bradykinin, histamine, substance P or insulin. However, the retina is rich in polyunsaturated lipid membranes and is sensitive to the action of reactive oxygen and nitrogen species. Products generated from NO (i.e., dinitrogen trioxide (N2O3) and peroxynitrite) have great oxidative damaging effects. Oxygen and nitrogen species can react with biomolecules (lipids, proteins and DNA), potentially leading to cell death, and this is particularly important in the retina.
  • 967
  • 22 Sep 2021
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