Survey of Ophthalmology RSS feed: Current Issue. Survey of Ophthalmology is a clinically oriented review journal designed to keep ophthalmologists up to date. Comprehensive major review articles, written by experts and stringently refereed, integrate the literature on subjects selected for their clinical importance. Survey also includes feature articles, section reviews, book reviews, and abstracts. To view video files associated with published manuscripts, click here .http://www.surveyophthalmol.com/?rss=yesElsevier Inc.en © 2010 Elsevier Inc. All rights reserved. Survey of Ophthalmology0039-625755510 September 2010 © 2010 Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.surveyophthalmol.com/article/PIIS0039625710000391/abstract?rss=yesAbstract: Tilted optic disks are a common finding in the general population. An expression of anomalous human development, the tilted disk appears rotated and tilted along its axes. Visual sequelae described with tilted optic disks include myopia, astigmatism, visual field loss, deficient color vision, and retinal abnormalities. Although the natural course of tilted optic disks is nonprogressive, the anomaly can be mistaken for tumors of the anterior visual pathway, edema of the optic nerve head, or glaucoma. A thorough examination of patients with tilted disk includes refraction, dilated fundus examination, and visual field testing. At times, neuroimaging may be necessary to arrive at the correct diagnosis. Until normative data are validated for tilted disks, the role of new imaging technologies for the optic nerve head is limited. Familiarity with the spectrum of ophthalmoscopic appearance and the clinical manifestations of tilted disks may be the most critical factors in avoiding misdiagnosis.Tilted Optic DisksMatthew T. Witmer, Curtis E. Margo, Mitchell Drucker10.1016/j.survophthal.2010.01.002Survey of Ophthalmology 55, 5 (2010)2010-07-12Survey of Ophthalmology2010-07-12555S0039-6257(10)X0005-4Major Review403428http://www.surveyophthalmol.com/article/PIIS0039625709003142/abstract?rss=yesAbstract: Wegener's granulomatosis (WG) is a systemic inflammatory disease whose histopathologic features often include necrosis, granuloma formation, and vasculitis of small-to-medium-sized vessels. WG involves many interrelated pathogenic pathways that are genetic, cell-mediated, neutrophil-mediated, humoral, and environmental. WG most commonly involves the upper respiratory tract, lungs, and kidneys, but has been reported to affect almost any organ. Ophthalmologic involvement is an important cause of morbidity in WG patients, occurring in approximately one-half of patients. The presence of unexplained orbital inflammatory disease, scleritis, peripheral ulcerative keratitis, cicatricial conjunctivitis, nasolacrimal duct stenosis, retinal vascular occlusion, or infrequently uveitis should raise the question of possible WG. A thorough clinical examination, laboratory testing, radiologic imaging, and histologic examination are essential to diagnosing WG and excluding potential mimics. Previously a uniformly fatal disease, treatment with cytotoxic and immunosuppressive agents has greatly improved survival. Treatment-related morbidity is a serious limitation of conventional therapies, leading to numerous ongoing studies of alternative agents.Wegener's Granulomatosis: Clinical Manifestations, Differential Diagnosis, and Management of Ocular and Systemic DiseaseAhmad B. Tarabishy, Mark Schulte, George N. Papaliodis, Gary S. Hoffman10.1016/j.survophthal.2009.12.003Survey of Ophthalmology 55, 5 (2010)2010-07-20Survey of Ophthalmology2010-07-20555S0039-6257(10)X0005-4Major Review429444http://www.surveyophthalmol.com/article/PIIS0039625709003130/abstract?rss=yesAbstract: Although glaucoma is a multifactorial disease, elevated intraocular pressure (IOP) remains the most important known risk factor. Different systemic and local factors are thought to influence an individual's IOP. There can be a clinically significant rise in IOP when going from upright to horizontal or inverted body positions. Although there is a significant interindividual variability, the magnitude of the IOP change is greater in glaucomatous eyes. As patients usually spend a significant portion of their lives in the horizontal position, mainly during sleep, this is highly relevant. In this review we discuss the relationship between postural changes and IOP fluctuation, including changes in both body and head position. The possible mechanisms involved and the main implications for glaucomatous eyes are discussed. Finally, considerations with regard to sleep position in glaucoma patients are made based on evidence in the literature.Posture-induced Intraocular Pressure Changes: Considerations Regarding Body Position in Glaucoma PatientsTiago Santos Prata, Carlos G.V. De Moraes, Fabio N. Kanadani, Robert Ritch, Augusto Paranhos10.1016/j.survophthal.2009.12.002Survey of Ophthalmology 55, 5 (2010)2010-07-20Survey of Ophthalmology2010-07-20555S0039-6257(10)X0005-4Major Review445453http://www.surveyophthalmol.com/article/PIIS0039625710000755/abstract?rss=yesAbstract: In 1997, Ebrahimzadeh, Davalos, and Lee wrote in this journal that only 32% of the ophthalmic patient educational materials reviewed were written at or below the recommended eighth-grade reading level. Since that time, the National Assessment of Adult Literacy found that more than one-third of adult Americans possess only basic or below basic health literacy skills, defined as the ability to understand written information in a healthcare setting. Subsequently, investigators have shown that poor health literacy skills are associated with poor prescription medication adherence, increased hospital admissions, and increased mortality. We review the readability of currently available ophthalmic educational materials, with particular attention to the health literacy status of the patient population for which the materials are intended. Examples of prose at various readability levels are provided. Optimizing patient education and improving clinical outcomes requires understanding the attributes that the patient brings to the patient–physician relationship, including health literacy.Health Literacy and Ophthalmic Patient EducationKelly W. Muir, Paul P. Lee10.1016/j.survophthal.2010.03.005Survey of Ophthalmology 55, 5 (2010)2010-07-22Survey of Ophthalmology2010-07-22555S0039-6257(10)X0005-4Core Competencies in Ophthalmology454459http://www.surveyophthalmol.com/article/PIIS0039625709003051/abstract?rss=yesAbstract: A 57-year-old man developed acute bilateral vision loss clinically consistent with bilateral optic neuritis. Within 1 month of diagnosis, he developed progressive and severe neurologic dysfunction, and repeat MRI demonstrated enhancement of the optic chiasm and optic tracts, as well as a large enhancing lesion within the right parieto-occipital lobe. Stereotactic-guided brain biopsy demonstrated demyelination consistent with multiple sclerosis. A diagnosis of fulminant multiple sclerosis was made. The patient died within 2 months of diagnosis. Multiple sclerosis and a fulminant subtype known as Marburg disease are discussed.Multiple Sclerosis on SteroidsMatthew S. Johnson, Michael S. Lee, Brian R. Younge, Valerie Purvin10.1016/j.survophthal.2009.11.002Survey of Ophthalmology 55, 5 (2010)2010-03-29Survey of Ophthalmology2010-03-29555S0039-6257(10)X0005-4Clinical Challenges460466http://www.surveyophthalmol.com/article/PIIS0039625709003129/abstract?rss=yesAbstract: A 37-year-old man presented with a facial abscess that progressed to external ophthalmoplegia and proptosis. Neuroimaging was consistent with cavernous sinus thrombosis. The diagnosis, management options, and management controversies of septic cavernous sinus thrombosis are discussed, including neuroimaging, antibiotic choice, and the role of corticosteroids and anticoagulation.Forget Me NotBehin Barahimi, Ann P. Murchison, Jurij R. Bilyk10.1016/j.survophthal.2009.12.001Survey of Ophthalmology 55, 5 (2010)2010-03-29Survey of Ophthalmology2010-03-29555S0039-6257(10)X0005-4Clinical Challenges467480http://www.surveyophthalmol.com/article/PIIS0039625710000718/abstract?rss=yesAbstract: The keratometer, or ophthalmometer as it was originally known, had its origins in the attempt to discover the seat of accommodation in the eye. Since that early beginning, it has been re-invented a number of times, with improvements and modifications made in the original principles of its design for new applications that arose as ophthalmology advanced. The cornea is not only responsible for the majority of the refraction in the eye, but is also readily accessible for measurement and modification. The keratometer's ability to measure the cornea has allowed it to play a central role in critical advances in ophthalmic history. This review describes the origins and principles of this instrument, the novel applications that led to the keratometer's continued resurgences over its nearly 250-year history, and the modern devices that have borrowed its basic principles and are beginning to replace it in common clinical practice.Origins of the Keratometer and its Evolving Role in OphthalmologyRon Gutmark, David L. Guyton10.1016/j.survophthal.2010.03.001Survey of Ophthalmology 55, 5 (2010)2010-07-01Survey of Ophthalmology2010-07-01555S0039-6257(10)X0005-4History of Ophthalmology481497http://www.surveyophthalmol.com/article/PIIS0039625710001207/abstract?rss=yesThe human beast has two good eyes, Which all of us do dearly prize,The Ayes Have ItMichael F. Marmor10.1016/j.survophthal.2010.07.001Survey of Ophthalmology 55, 5 (2010)2010-09-10Survey of Ophthalmology2010-09-10555S0039-6257(10)X0005-4Time Oph498499http://www.surveyophthalmol.com/article/PIIS0039625710001256/abstract?rss=yesTable of Contents10.1016/S0039-6257(10)00125-6Survey of Ophthalmology 55, 5 (2010)2010-09-10Survey of Ophthalmology2010-09-10555S0039-6257(10)X0005-4FrontmatterA3A4