We’re Still Learning About COVID-19

HOT TOPIC

New Handheld Rebound Tonometer Launched in the United States

Reichert Technologies has announced the launch of the Tono-Vera Tonometer with ActiView Positioning System in the United States. According to the company, this innovative handheld tonometer provides quick and reliable IOP measurements using rebound tonometer technology, eliminating the need for topical anesthetic.

The advanced, patented ActiView Positioning System guides the user to the apex of the cornea, and the Tono-Vera automatically measures when correct alignment is achieved, providing reliable results in as few as three measurements taken in less than 1 second. The Tono-Vera ActiView Positioning System also provides a full-color view of the eye combined with intuitive, interactive alignment prompts, resulting in more objective and repeatable results.

Reichert Technologies

The Tono-Vera is available in two model options: rechargeable and AA battery, both of which are portable, always ready to use, and allow for quick and easy battery change with no tools required.

My Two Cents

Reichert is well known to many of us as a driver of innovation in the IOP market. It’s interesting that the press release didn’t make it abundantly clear as to how the pressure would be taken. Upon further examination, it appears that it will be similar to the iCare line of tonometers (Icare USA) in that it will use disposable tips. In our clinic, we love our iCare tonometers, which are also strongly preferred by our patients over the dreaded “puff of air” test. One problem we have, however, is the extremely high cost of the tips. If Reichert has figured out a way to reduce the cost of these tips, it would change the game and cause them to almost instantly own this relatively new category.

OUTSIDE THE LANE

COVID-19’s Effects on Vision

Researchers at the University of Missouri School of Medicine have discovered that the SARS-CoV-2 virus, which causes COVID-19, can penetrate the blood-retinal barrier, potentially causing long-term eye damage. This breakthrough emphasizes the importance of monitoring eye health in patients with COVID-19.

As a refresher, the blood-retinal barrier protects our vision from infections by preventing microbial (and other) pathogens from reaching the retina, where they could trigger an inflammatory response with potential vision loss. However, the virus that causes COVID-19 has been found to breach this protective retinal barrier, resulting in potential long-term consequences for the eye.

The team researching new ways to prevent and treat infectious diseases found that SARS-CoV-2 can infect the inside of the eyes even when the virus doesn’t enter the body through the surface of the eyes and can induce a hyperinflammatory response, resulting in eventual cell death in the retina. The researchers also found that when viruses enter the body through inhalation, it not only infects organs such as the lungs, but it also reaches highly protected organs such as the eyes through the blood-retinal barrier by infecting the cells lining this barrier. The longer the viral remnants remain in the eye, the greater the risk of damage to the retina and visual function.

The research team suggested that the extended presence of the SARS-CoV-2 spike antigen can cause retinal microaneurysms, retinal artery and vein occlusions, and vascular leakages. They claim these findings could lead to new therapies for preventing and treating COVID-19–related eye complications.

It is recommended that those who have been diagnosed with COVID-19 have their eyes checked for potential damage (obviously after they test negative). Even those who are asymptomatic could suffer from damage to the eyes over time because of COVID-19–associated complications. This finding is crucial as we increase our understanding of the long-term effects of SARS-CoV-2 infection.

My Two Cents

Not surprisingly, we continue to learn about how the COVID-19 virus affects the eye and the entire body. It is astonishing, however, that it has taken this long to recognize these particular complications contributed to the virus (or maybe I’m just that out of the loop!). Additional studies are needed to confirm this finding, and then it should become medical standard that after a patient is no longer contagious with COVID-19, they should immediately be referred to a clinic for a complete dilated eye exam.

CAN YOU RELATE

Just 25 hours after Blake Williamson, MD, MPH, performed my EVO ICL (Staar Surgical) surgery, my acuity measurements were: 20/12.5-2 OD, 20/12.5 OS, and 20/10 OU. Yes, I had bilateral surgery on the same day. Dr. Williamson has the Williamson Eye Center’s surgery team running exceptionally efficiently.

After he completed surgery on my first eye, we checked my vision (blurry, but better than perfect), walked out of that OR into a different OR suite, which had a new set of nurses, scrub techs, surgical scrubs, etc. To put it simply, the experience was incredible. Oh, and each surgery took about 5 minutes to complete. Also, I chose to have the procedure done without general anesthesia—just some good old-fashioned proparacaine and some “sugarcane” to numb my iris/internal eye.

Williamson Eye Center

To sum up the schedule, I worked the entire morning with numerous complicated scleral cases and patients with dry eye, etc. I finished my schedule at 11:45 am, inserted a compounded tropicamide/phenylephrine drop (Imprimis), and then drove to the surgery center, arriving at 12:02 pm. After I completed my intake paperwork, I had my vitals taken, hit myself with a drop of cyclopentolate, did a few interviews, and was whisked into the OR. By 2:30 pm, I was on my way back to my regular office, where Dr. Williamson was also seeing patients. He took my IOP, checked my cornea (it was beaten up from the proparacaine and betadine washes), and gave me a good once over. I was then driven back to the surgery center, where I hopped in my car, and headed home—all by 4:00 pm. The next day, I had a few patients in the morning and then a nearly full schedule in the afternoon.

For those who are cautious about LASIK, I implore you to examine the EVO ICL surgery closely. If you’d like to watch the procedure or see multiple interviews with me throughout my surgery day (and even during the surgery), check out Williamson Eye Center’s Facebook and Instagram pages.