How dry is your office?

I was horrified to hear from someone recently that when requested, their employer tested their office humidity level and determined average humidity to be 7%.

Ow.

Do you know what the humidity level in your office is?

The US's OSHA says:

RECOMMENDATIONS FOR THE EMPLOYER

The following are general recommendations which, where relevant, should be standard procedure. If followed, they will help prevent or alleviate many indoor air-quality problems...

3. Air Treatment. Air treatment is the removal of air contaminants and/or the control of room temperature and humidity. Recommendations for air treatment include:

• The use of filtration, electronic cleaners, chemical treatment with activated charcoal or other sorbents;

• Humidity control in the range of 20%-60%; and

• Temperature control in the range of 68-76 F.

Frankly, you can be pretty miserable at 20% and would be justified in pushing for an improvement on this.

Canadian OHS says:

Are there any standards on office temperatures?
The CSA Standard CAN/CSA Z412-00 (R2011) - "Office Ergonomics" gives acceptable ranges of temperature and relative humidity for offices in Canada. These values are the same as recommended by the American Society of Heating, Refrigerating, and Air Conditioning Engineers (ASHRAE) Standard 55 - 2010 "Thermal Environmental Conditions for Human Occupancy". The recommended temperature ranges have been found to meet the needs of at least 80% of individuals. Some people may feel uncomfortable even if these values are met. Additional measures may be required.

Temperature / Humidity Ranges for Comfort
Conditions	Relative Humidity	Acceptable Operating Temperatures
		°C	°F
Summer (light clothing)	If 30%, then If 60%, then	24.5 - 28 23 - 25.5	76 - 82 74 - 78
Winter (warm clothing)	If 30%, then If 60%, then	20.5 - 25.5 20 - 24	69 - 78 68 - 75

Lobob's Miraflow equivalent

Miraflow fans... yes lots of us still miss that product (discontinued a coupla years ago)... Lobob now has an equivalent product and I'll have it available in the shop ready to ship starting Monday the 22nd. 

It's called Sof/Pro2 'Extra Strength' Daily Cleaner - but for those of you purchasing direct from Lobob, or Amazon or wherever, please be careful because there are two different products under the same name. If you want this for PROSE / plasma treated scleral type products, the one you want is the one that says "for soft hydrophilic lenses including silicone hydrogel contact lenses", NOT the one that just says "for soft contact lenses".

Sof/Pro2 'Extra Strength' Daily Cleaner

$11.95 in the Dry Eye Shop

DryEyeShop special: Night eye protection

For one week, 15% off all night eye protection items, e.g. Tranquileyes, Quartz, sleep masks & goggles, etc. Enjoy!

http://www.dryeyeshop.com/night-eye-protection-c74.aspx?Coupon=NightStuff

Just one more day to use the 15% off eyewear coupon

Good through midnight Friday

http://www.dryeyeshop.com/eyewear-c71.aspx?Coupon=Eyewear2013

Abstract: Beware eye whitening procedures.

Some people with chronic dry eye suffer from chronic redness. In some of those cases, the redness is much more noticeable to themselves than to anyone else, but in others it's obvious and unsightly and can be very distressing. Not a lot of fun to have others (think: potential employers?) think you're stoned. The emotional impact of chronic redness makes people quite vulnerable to promises of improvement through surgeries. They figure, the worst that can happen is that it just doesn't work or doesn't last.

Wrong.

Here's a good reason to resist the temptation.

Necrotizing scleritis as a complication of cosmetic eyewhitening procedure.

BACKGROUND:
We report necrotizing scleritis as a serious complication of a cosmetic eye whitening procedure that involves the use of intraoperative and postoperative topical mitomycin C.
FINDINGS:
This is a single case report. A 59-year-old Caucasian male with a history of blepharitis status post uncomplicated LASIK refractive surgery reported chronic conjunctival hyperemia for 15 years prior to undergoing a cosmetic eye whitening procedure. He presented to our clinic 12 months after the cosmetic eye whitening procedure with progressive bilateral necrotizing scleritis and scleral calcification.
CONCLUSIONS:
Chronic conjunctival hyperemia may prompt patients to seek surgical correction with cosmetic eye whitening procedures. However, conjunctival hyperemia secondary to tear deficiency and evaporative dry eye may predispose to poor wound healing. Serious complications including necrotizing scleritis may result from cosmetic eye whitening procedures and the use of topical mitomycin C.

J Ophthalmic Inflamm Infect. 2013 Feb 22;3(1):39. doi: 10.1186/1869-5760-3-39.

Leung TG, Dunn JP, Akpek EK, Thorne JE.

Source

The Division of Ocular Immunology, The Wilmer Eye Institute, Johns Hopkins School of Medicine, 600 North Wolfe Street, Woods Building, Room 476, Baltimore, MD 21287, USA. tgan1@jhmi.edu.

Abstract: PROSE

It's really good to see a study spanning a variety of indications for PROSE.

Patient ocular conditions and clinical outcomes using aPROSE scleral device.

PURPOSE:
To determine the type and distribution of ocular conditions cared for in a clinic dedicated to scleral devices and to report the clinical outcomes afforded by this approach.
METHODS:
Fifty-one charts of patients fitted unilaterally or bilaterally with a scleral device (Prosthetic Replacement of the Ocular Surface Ecosystem - PROSE) in a two year period were retrospectively reviewed. Patient demographics, ocular diagnoses, associated systemic conditions, best corrected visual acuity (BCVA) before and after fitting, Visual Function Questionnaire score (VFQ-25), and ocular surface disease index (OSDI) score were collected.
RESULTS:
All 51 patients were successfully wearing the PROSE device for a period of anywhere from weeks to years. The most common reasons for fitting were to relieve symptoms of moderate to severe dry eye syndrome ("DES", n = 25), management of refractive problems ("refractive", n = 23) with keratoconus being the most common (n = 14), and to manage other anomalies ("other", n = 3). Best corrected visual acuity (logMAR) improved with the wearing of the PROSE device for both the DES (17 letters) and the refractive group (10 letters), but not the "other" group. No serious complications were recorded for any of the patients.
CONCLUSIONS:
The PROSE device is a useful option not only for the management of ocular surface disease and optical imperfections, but also for other ophthalmic conditions. Moderate to severe dry eye was the most common anomaly managed, followed by eyes with irregular corneal astigmatism. DES and refractive patients experienced improvement in visual acuity with wearing of the PROSE device.

Cont Lens Anterior Eye. 2013 Mar 14. pii: S1367-0484(13)00031-3. doi: 10.1016/j.clae.2013.02.004. [Epub ahead of print]

Dimit R, Gire A, Pflugfelder SC, Bergmanson JP.

Source

Alkek Eye Center, Baylor College of Medicine, Houston, TX, USA. Electronic address: dimit@bcm.edu.

Abstract: GvHD

Nice to see more progressive treatments increasingly mentioned in literature on GvHD.

Graft versus host disease: clinical evaluation, diagnosisand management.

Graft versus H\host disease (GVHD) can be a devastating complication following bone marrow transplantation. Acute or chronic systemic GVHD can be lethal, and severe damage of different organs and tissues can occur with both types of GVHD. Ocular involvement, either in an acute or chronic presentation, may range from mild to severe with accompanying vision loss present in 60-90 % of patients. Chronic ocular GVHD, the most common form of GVHD, affects mainly the lacrimal gland, meibomian glands, cornea and conjunctiva, mimicking other immunologically mediated inflammatory diseases of the ocular surface without specific symptoms or signs. However, dry eye disease is the main manifestation of GVHD. The long-term treatment of ocular GVHD continues to be challenging and involves a multidisciplinary approach wherein the ophthalmologist plays a major role. Besides systemic immunosuppression and ocular lubricants, topical steroids and topical cyclosporine are commonly prescribed. Newer therapeutic interventions for moderate and severe ocular GVHD include the use of serum eye drops and scleral contact lenses. In this manuscript, we review the mechanisms, clinical findings, and treatment of ocular GVHD.

Espana EM, Shah S, Santhiago MR, Singh AD.

Graefes Arch Clin Exp Ophthalmol. 2013 Mar 17. [Epub ahead of print]

Source

Department of Cornea, External Disease and Refractive Surgery, Department of Ophthalmology, University of South Florida, Tampa, FL, USA.

Abstract: Impact of LED timer device on blink rate

Effect of a light-emitting timer device on the blink rate of non-dry eye individuals and dry eye patients.

PURPOSE:
To evaluate blink rate effects by a novel light-emitting diode (LED) timer device (PISC) on non-dry eye (DE) subjects and DE patients during a reading task on liquid crystal display (LCD) screens, in different environmental conditions.
METHODS:
This was a case-control study that included 15 DE patients and 15 non-DE subjects as controls. Participants had their blink rates measured while they read an electronic format text. These tasks were performed in four different conditions: with and without a LED timer device in two visits, and with and without air conditioning. All participants completed the Ocular Surface Disease Index and were examined by best spectacle-corrected visual acuity exam, biomicroscopy, Schirmer test 1, fluorescein staining and break-up time and lissamine green staining (Oxford scale grading).
RESULTS:
Outcomes between reading tasks conditions were compared independently for each group and blink rate frequency was higher in tasks with LED timer device, with and without air conditioning, for the DE group (p < 0.0001), and with air conditioning for the control group (p < 0.05).
CONCLUSIONS:
An LED timer device increased blink frequency for DE and control groups. Further studies need to be carried out in order to evaluate long-term effects of this new device, as well as its assessment with different reading scenarios.

Br J Ophthalmol. 2013 Mar 15. [Epub ahead of print]

Miura DL, Hazarbassanov RM, Yamasato CK, E Silva FB, Godinho CJ, Gomes JA.

Source

School of Medicine, Federal University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil.

Abstract: OCT in measuring tear film meniscus

Funny, I see abstracts about OCT in dry eye diagnosis pretty frequently. I dutifully post some of them. But unlike most other diagnostics covered so prolifically in the literature I hardly seem to hear about this one at all in 'real life'. Am I just out of touch? Who's using this?

Optical Coherence Tomography for Measuring the Tear Film Meniscus: Correlation with Schirmer Test and Tear-Film Breakup Time.

Abstract Purpose: To compare tear meniscus height (TMH) and area (TMA) values obtained by optical coherence tomography (OCT) with the Schirmer test and tear-film break-up time (TBUT) values. Materials and methods: In this prospective cross-sectional study, the right eyes of 300 consecutive patients were studied. All patients underwent routine ophthalmologic examination. Schirmer and TBUT measurements were taken, and tear-film OCT images were obtained. Using OCT, the TMH (i.e. the line connecting the intersection of the meniscus with the cornea and eyelid) and cross-sectional TMA were calculated. Patients were divided into Groups 1 (Schirmer values ≤ 5 mm) and 2 (Schirmer values > 5 mm). Data were analyzed using SPSS 13.0 software. The Mann-Whitney U-test was used for the comparison of groups. Correlations between tear parameters were analyzed. Results: There were no significant differences in age, logMAR, or IOP values (p = 0.480, 0.077 and 0.146, respectively) between the two groups. Mean TBUTs were 5.1 ± 2.9 and 9.5 ± 4.2 s for Groups 1 and 2, respectively (p < 0.001). Mean TMHs were 237.9 ± 108.9 and 324.3 ± 158.9 μm for Groups 1 and 2, respectively (p < 0.001). Mean TMAs were significantly lower in Group 1 compared to Group 2 (p < 0.001; 0.027 ± 0.028 versus 0.055 ± 0.059 mm2, respectively). Correlations between Schirmer values and TMH, and between Schirmer values and TMA, were significant (p = 0.001 and < 0.001, respectively). Conclusions: OCT values were significantly lower in patients with Schirmer values of < 5 mm. Tear meniscus measurements obtained by OCT are reliable for establishing a diagnosis of dry eye.

Curr Eye Res. 2013 Mar 14. [Epub ahead of print]

Altan-Yaycioglu R, Sizmaz S, Canan H, Coban-Karatas M.

Source

Faculty of Medicine, Adana Teaching & Medical Research Center, Baskent University , 01250 Adana , Turkey.

Abstract: Rebamipide + sodium hyaluronate

A Randomized, Multicenter Phase 3 Study Comparing 2%Rebamipide (OPC-12759) with 0.1% Sodium Hyaluronate in the Treatment of DryEye.

OBJECTIVE:
To investigate the efficacy of 2% rebamipide ophthalmic suspension compared with 0.1% sodium hyaluronate ophthalmic solution for the treatment of patients with dry eye.
DESIGN:
Randomized, multicenter, active-controlled parallel-group study.
PARTICIPANTS:
One hundred eighty-eight patients with dry eye.
METHODS:
Following a 2-week screening period, patients were allocated randomly to receive 2% rebamipide or 0.1% sodium hyaluronate, administered as 1 drop in each eye 4 or 6 times daily, respectively, for 4 weeks.
MAIN OUTCOME MEASURES:
There were 2 primary end points: changes in the fluorescein corneal staining (FCS) score to determine noninferiority of 2% rebamipide and changes in the lissamine green conjunctival staining (LGCS) score to determine superiority. Secondary objective end points were Schirmer's test results and tear film breakup time (TBUT). Secondary subjective end points were dry eye-related ocular symptoms (foreign body sensation, dryness, photophobia, eye pain, and blurred vision) score and the patients' overall treatment impression score.
RESULTS:
In the primary analysis, the mean change from baseline in FCS scores verified noninferiority, indicated significant improvement, and, in LGCS scores, verified the superiority of 2% rebamipide to 0.1% sodium hyaluronate. Values for the Schirmer's test and TBUT were comparable between the 2 groups. For 2 dry eye-related ocular symptoms-foreign body sensation and eye pain-2% rebamipide showed significant improvements over 0.1% sodium hyaluronate. Patients had a significantly more favorable impression of 2% rebamipide than of 0.1% sodium hyaluronate; 64.5% rated treatment as improved or markedly improved versus 34.7%, respectively. No serious adverse events were observed.
CONCLUSIONS:
Administration of 2% rebamipide was effective in improving both the objective signs and subjective symptoms of dry eye. Those findings, in addition to the well-tolerated profile of 2% rebamipide, clearly show that it is an effective therapeutic method for dry eye.

Ophthalmology. 2013 Mar 12. pii: S0161-6420(12)01203-1. doi: 10.1016/j.ophtha.2012.12.022. [Epub ahead of print]

Kinoshita S, Oshiden K, Awamura S, Suzuki H, Nakamichi N, Yokoi N; Rebamipide Ophthalmic Suspension Phase 3 Study Group(⁎).

Source

Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan. Electronic address: shigeruk@koto.kpu-m.ac.jp.

Abstract: Detection of meibomian glands and classification of meibography images

SWEET!

Detection of meibomian glands and classification ofmeibography images.

Computational methods are presented that can automatically detect the length and width of meibomian glands imaged by infrared meibography without requiring any input from the user. The images are then automatically classified. The length of the glands are detected by first normalizing the pixel intensity, extracting stationary points, and then applying morphological operations. Gland widths are detected using scale invariant feature transform and analyzed using Shannon entropy. Features based on the gland lengths and widths are then used to train a linear classifier to accurately differentiate between healthy (specificity 96.1%) and unhealthy (sensitivity 97.9%) meibography images. The user-free computational method is fast, does not suffer from inter-observer variability, and can be useful in clinical studies where large number of images needs to be analyzed efficiently.

J Biomed Opt. 2012 Aug;17(8):086008. doi: 10.1117/1.JBO.17.8.086008.

Koh YW, Celik T, Lee HK, Petznick A, Tong L.

Bioinformatics Institute, 30 Biopolis Street, 07-01, Matrix, Singapore 138671. patrickk@bii.a-star.edu.sg

Eyewear special... 15% off!

Get ready for summer with protective moisture retaining eyewear at a discount...

15% off anything in the Eyewear category, for one week (April 5 to 11).

If you've been saving up for some 7Eyes or Wileys, or need a spare pair of something you already have, or need spare eyecups, now's the time :)

Click on the link above to activate, or type "Eyewear2013" in the coupon box.

PROSE & scleral users: Hydrogen peroxide system now available in the shop

At long last I've got a hydrogen peroxide system available in the shop. It's not Clear Care but it's similar.

Ocusoft Lens Care System $9.75

Contains 12 oz bottle of 3% hydrogen peroxide plus lens case with catalyst. As with the Clear Care system, this case is NOT suitable for PROSE or other scleral lenses so you have to remove the catalyst and install it in a PROSE case (sold separately).

In the case in this kit, the catalyst disc is attached to the bottom of the case rather than the bottom of the unit that holds the lenses, so removing it is a little different but can still be done. The disc fits the receptacle on the PROSE case but you have to put it on the right direction - if it's backwards, you'll know because it slides off.

Abstract: Herpes zoster and corneal nerve alteration

Unilateral herpes zoster ophthalmicus results in bilateralcorneal nerve alteration: an in vivo confocal microscopy study.

PURPOSE:
Herpes zoster ophthalmicus (HZO), thought to be a unilateral disease, results in loss of corneal sensation, leading to neurotrophic keratopathy. This study aimed to analyze bilateral corneal nerve changes in patients with HZO by in vivo confocal microscopy (IVCM) and their correlation with corneal sensation as a measure of nerve function.
DESIGN:
Prospective, cross-sectional, controlled, single-center study.
PARTICIPANTS:
Twenty-seven eyes with the diagnosis of HZO and their contralateral clinically unaffected eyes were studied and compared with normal controls (n = 15).
METHODS:
In vivo confocal microscopy (Confoscan 4; Nidek Technologies, Gamagori, Japan) and corneal esthesiometry (Cochet-Bonnet; Luneau Ophthalmologie, Chartres, France) of the central cornea were performed bilaterally in all patients and controls. Patients were grouped into normal ( > 5.5 cm), mild ( > 2.5-5.5 cm), and severe ( < 2.5 cm) loss of sensation.
MAIN OUTCOME MEASURES:
Changes in corneal nerve density, total nerve number, main nerve trunks, branching, and tortuosity were evaluated after IVCM and were correlated to corneal sensation, disease duration, and number of recurrences.
RESULTS:
Eyes with herpes zoster ophthalmicus had a significant (P < 0.001) decrease in total nerve length (595.8±358.1 vs. 2258.4±989.0 μm/frame), total number of nerves (5.4±2.8 vs. 13.1±3.8), number of main nerve trunks (2.3±1.1 vs. 4.7±1.2), and number of nerve branches (3.2±2.3 vs. 8.4±3.7) as compared with controls. In the contralateral clinically unaffected eyes, total nerve length (1053.1±441.4 μm/frame), total number of nerves (8.3±2.9), and main nerve trunks (3.1±1.0) also were decreased significantly as compared with controls (P < 0.01). Reduced nerve density, total nerve count, main trunks, and tortuosity was correlated significantly with corneal sensation across all subgroups (P < 0.001).
CONCLUSIONS:
Patients with unilateral HZO demonstrated a profound and significant bilateral loss of the corneal nerve plexus as compared with controls, demonstrating bilateral changes in a clinically unilateral disease. Loss of corneal sensation strongly correlated with subbasal nerve plexus alterations as shown by IVCM.
FINANCIAL DISCLOSURE(S):
The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Ophthalmology. 2013 Jan;120(1):40-7. doi: 10.1016/j.ophtha.2012.07.036. Epub 2012 Sep 19.

Hamrah P, Cruzat A, Dastjerdi MH, Prüss H, Zheng L, Shahatit BM, Bayhan HA, Dana R, Pavan-Langston D.

Ocular Surface Imaging Center and Cornea & Refractive Surgery Service, Massachusetts Eye & Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts 02114, USA. pedram_hamrah@meei.harvard.edu

Abstract: Restasis & MGD

A randomized double-masked study of 0.05% cyclosporineophthalmic emulsion in the treatment of meibomian gland dysfunction.

PURPOSE:
To compare the efficacy of topical cyclosporine [0.05% cyclosporine A (CsA)] and preservative-free artificial tears in the treatment of meibomian gland dysfunction (MGD).
METHODS:
A 3-month prospective, randomized, double-masked, parallel-group controlled trial enrolled 70 patients with symptomatic MGD and unstable tear film [tear breakup time (TBUT) < 8 seconds]. Patients were randomized to topical CsA (0.05%; group A) and 0.5% carboxymethylcellulose (control; group B) instilled twice daily for 3 months. Ocular Surface Disease Index (OSDI), lid margin inflammation, meibomian gland expression, conjunctival injection, corneal and interpalpebral dye staining, noninvasive tear breakup time (NIBUT) using the Tearscope Plus and invasive fluorescein tear breakup time (FBUT), and Schirmer I test were performed.
RESULTS:
At the 3-month evaluation, mean OSDI, NIBUT and FBUT, lid margin inflammation, meibomian gland expressibility, and tarsal injection showed significant improvement from baseline in group A (P < 0.01, P < 0.01, P < 0.001, P < 0.05, and P < 0.001, respectively). In group B, only the OSDI improved significantly from baseline at 3 months (P = 0.003). TBUTs (NIBUT and FBUT) were significantly longer in group A at all visits, and the mean change of TBUTs from baseline was also significantly greater in group A at 3 months (P < 0.001).
CONCLUSIONS:
Topical CsA 0.05% twice daily may be helpful in the treatment of MGD mainly by improving tear film stability.

Cornea. 2012 Dec;31(12):1386-93. doi: 10.1097/ICO.0b013e31823cc098.

Prabhasawat P, Tesavibul N, Mahawong W.

Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. sippb@mahidol.ac.th