Ophthalmology clinics of North America最新文献

This article provides a basis for understanding modern visual field analysis techniques. It describes some of these tests, including their advantages and disadvantages, and the settings in which different tests might be used most successfully. It also includes an examination of the value of visual field assessment from a public health standpoint with particular attention paid to morbidity, cost/benefit ratios, and quality of life correlations.

Primary angle closure glaucoma is a common cause of visual loss worldwide. Gonioscopy and other current methods of assessment of the anatomy of the anterior segment relevant to the diagnosis of this disease, such as ultrasound biomicroscopy, have significant limitations. Anterior segment optical coherence tomography, with its rapid, noncontact, and high-resolution image acquisition, seems to be a promising tool for the evaluation of the anterior chamber angle configuration, including changes induced by illumination and laser peripheral iridotomy. It has the potential for use as a rapid screening tool for detection of occludable angles. Ongoing clinical studies should help to evaluate its efficacy in this regard.

Various cellular and molecular mechanisms that may lead to apoptotic cell death of retinal ganglion cells in glaucoma are discussed. These cellular mechanisms include neurotrophic factor deprivation, ischemia, glial cell activation, glutamate excitotoxicity, and abnormal immune response. Based on experimental and clinical evidence, the rationale for various neuroprotective strategies is described.

The traditional lower lid blepharoplasty highlighted by fat removal and excision of excess skin via a transcutaneous approach has been replaced by a reconstructive blepharoplasty involving minimal fat removal, sculpting, or fat repositioning. Simultaneous application of chemical peels, microdermabrasion, or laser resurfacing procedures is an acceptable alternative to skin excision when there is minimal skin redundancy. This article reviews the anatomic changes in the lower eyelid that occur as a result of aging and addresses reconstructive techniques for rejuvenation of the lower eyelid.

Combinations of in-office and home care treatment modalities are effective in the improvement and maintenance of photodamaged skin. A regimen of daily internal supplementation and application of topical products will prolong and enhance the effects of noninvasive and surgical procedures.

Cosmetic upper eyelid blepharoplasty is not a procedure comprising skin and fat resection only. Efficient and effective functional repair of the upper lid requires brow stabilization or elevation, levator aponeurotic repair, lacrimal gland suspension, and cutaneous laser resurfacing when necessary.

This article discusses follicular unit transplantation for male and female pattern hair loss and restoring eyebrows.

Botox (and other botulinum toxins), injectable filling agents, chemical peeling agents, intense pulsed light devices, nonablative lasers, and radiofrequency instrumentation are discussed herein regarding their specific applications to different facial areas for oculofacial rejuvenation.

This article discusses the use of different chemical peels-very superficial, superficial, and medium depth. Once ophthalmologists understand the value and indications of this therapy, learn the techniques of application, and feel comfortable and confident with these methods, they should be able to treat the entire face.

In today's active society and demanding workplace, patients are frequently searching for less invasive procedures with diminished morbidity and more rapid healing to address their cosmetic concerns. The goal of face-lift surgery is to reverse the effects of aging by removing excess skin of the lower face and neck with concomitant repositioning of the deeper ptotic tissues. Recent advances in understanding facial anatomy and aging have resulted in the development of new procedures that can achieve these goals with more limited surgery. As increasingly younger patients present for early restorative procedures, it is imperative that surgeons have alternative options within their armamentarium to achieve success. This article reviews the current trends in face-lift surgery, particularly the small incision face-lift.