Exploring Advances in Anterior Segment Care

The cornea and the anterior segment are crucial components of our visual system, and keeping them healthy and intact is paramount in providing quality vision. Corneal dystrophies, keratoconus, irregular astigmatism, and keratoconjunctivitis are all conditions that can affect a patient’s vision and quality of life. Advances in technology and treatment options continue to provide improved outcomes for individuals affected by these conditions. In this issue, we dive into an up-to-date overview of a variety of anterior segment conditions. Below is a rundown of what to expect.

Identifying and managing corneal dystrophies can be a challenge, as you will find out when Ashley Wallace-Tucker, OD, FAAO, FSLS, Dipl ABO, takes you through key clinical findings for these conditions (pg 20). With hundreds of corneal dystrophies possibly affecting the cornea, how do we know which are vision-threatening and which we can take a wait-and-watch approach with?

The previous management paradigm for keratoconus was diagnosis, then vision rehabilitation with spectacle lenses and/or contact lenses. However, a shift recently occurred, with early identification, progress cessation with corneal crosslinking, and finally, vision optimization. Contact lenses and spectacle lenses are still excellent options, but what about those patients who would like some independence? There are now surgical considerations, such as topography-guided photorefractive keratectomy and corneal tissue addition to decrease the irregularity of the cornea, and Grace Liao, OD, FAAO, FSLS; Florencia Yeh, OD, FAAO, FSLS; and Clark Chang, OD, MSA, MSC, FAAO, FSLS, describe an updated approach to restoring the vision of patients with keratoconus (pg 28).

Other areas of anterior segment disease management continue to evolve, and Selina McGee, OD, FAAO, reviews the long-term exposure to preservatives in treating chronic ocular conditions (pg 54). As she states, dry eye is the number-one reason patients seek medical attention. ODs are in a prime position to make a big impact in this all-too-common condition in our clinic. If you are like me, at times you look at a pterygium and wonder, “Is that normal?” Jacob Lang, OD, FAAO, and Noa Robson, OD, MBA, provide some key identifiers of cancerous conjunctival lesions in this issue’s edition of our popular Snapshot column (pg 52).

In typical Modern Optometry fashion, we don’t limit our coverage to just one area of interest, and in this issue, we also offer a subfocus on neuro-optometry, featuring two leaders in the field: Jacqueline Theis, OD, FAAO, and Vittorio Mena, OD, MS. They discuss vestibular disorders and visual functions (pg 39), and explain how to recognize the symptoms of a brain injury (pg 41). There are also two bonus features in this issue, but I want to leave those as surprises for you, so I won’t go into detail about them. I will give you some hints, though: One article has to do with glaucoma, and the other with changing a perception. I don’t think you will be disappointed! Enjoy the issue!

— Justin Schweitzer, OD, FAAO