Diagnostic ability of maximum blink interval together with Japanese version of Ocular Surface Disease Index score for dry eye diseaseDecember 29, 2020Fishman comment: Blink analysis is a simple yet under appreciated technique that helps dry eye diagnosis and treatment. This paper illustrates the utility of blink analysis. Authors: Kunihiko Hirosawa1,2, Takenori Inomata1,2,3,4,5*, Jaemyoung Sung1, Masahiro Nakamura2,6, Yuichi Okumura1,2,4, Akie Midorikawa‐Inomata5, Maria Miura1,2, Kenta Fujio1,2, Yasutsugu Akasaki1,2, Keiichi Fujimoto1,2, Jun Zhu1,7, Atsuko[...]Read More
Potential Role and Significance of Ocular Demodicosis in Patients with Concomitant Refractory Herpetic KeratitisDecember 26, 2020Fishman comment: Interesting association with HSV keratitis and Demodex and by treating for Demodex, clinical improvement was observed. Purpose: To evaluate the role of Demodex infestation of the eyelids in patients with recurrent herpetic keratitis. Patients and Methods: This is a retrospective and noncomparative case series. Twenty-seven patients with ocular[...]Read More
Intestinal microbiome: a new target for chalaziosis treatment in children?November 27, 2020What is Known: • The intestinal microbiome plays a crucial role in several inflammatory diseases of the eye and is considered a therapeutic target. • Probiotics play a role in the prevention and treatment of different conditions in children. What is New: • In children probiotic supplementation is safe and[...]Read More
Recurrent corneal erosion: a comprehensive review by Miller et.al.September 30, 2020Fishman Comments: Recurrent cornea erosions (RCE) can be a tough condition to treat. One particularly frustrating cause is LASIK or PRK. I see a number of patients who have been diagnosed with "dry eye" and/or neuropathic pain syndrome after refractive surgery. However, a careful examination of the cornea in many[...]Read More
Periocular BoTox on Tear Film HomeostasisSeptember 16, 2020Fishman comments: The effect of Botox on ocular surface disease is seriously under appreciated. While the cosmetic benefit of Botox is widely known, Botox use was actually "invented" by an Ophthalmologist (Dr. Alan Scott) to treat strabismus (eye muscle misalignment) in kids. BoTox does have some other less well known[...]Read More
4 dead DemodexSeptember 12, 2020The below video snippet is an example of dead Demodex mites on a lash. We see no leg movement on video microscopy and presume mite death. Demodex mites are parasites with a length ranging from 200-400 microns (1) . One study suggests that six or more Demodex mites per 16 lashes[...]Read More
Dry eye and MenopauseAugust 29, 2020Prevalence of ocular surface disease symptoms in peri- and postmenopausal women Garcia-Alfaro, Pascual MD; Bergamaschi, Luciana MD; Marcos, Celia MD, PhD; Garcia, Sandra BSc; Rodríguez, Ignacio MScAuthor Information Menopause: September 2020 - Volume 27 - Issue 9 - p 993-998 Conclusions: Sixty-four percent of the pre- and postmenopausal women studied[...]Read More
“Review. Neuropathic Pain and Dry Eye” by Dr. Anat GalorAugust 4, 2020Fishman comments: Dr. Galor continues to be one the TOP academic physician/ researchers in the area of dry eye and neuropathic pain. This article from 2017 by Dr. Galor et al. does a terrific job of summarizing the mechanisms, treatments and challenges of neuropathic pain and dry eye and how[...]Read More
Can Gut Microbiota Affect Dry Eye Syndrome? by Moon et al.December 16, 2020[vc_row][vc_column][vc_video link="https://www.youtube.com/watch?v=qEVGr8luZg8"][vc_column_text] "Can Gut Microbiota Affect Dry Eye Syndrome?" by Moon et al. Fishman comments: The microbiome of the gut is proving to be a very exciting new frontier in medicine in general, and in ophthalmology in particular. This paper is an excellent review highlighting how the microbiome of the gut can affect[...]Read More
Effect of IRT5 probiotics on dry eye in the experimental dry eye mouse modelDecember 4, 2020Effect of IRT5 probiotics on dry eye in the experimental dry eye mouse model Jayoon Moon, Jin Suk Ryu, Jun Yeop Kim, Sin-Hyeog Im, Mee Kum Kim Abstract Objective To investigate the clinical effects of IRT5 probiotics in the environmental dry eye model. Methods Eight week old male C57BL/6 mice[...]Read More
Rosacea and the Microbiome: A Systematic Review | SpringerLinkNovember 13, 2020Rosacea, a chronic inflammatory skin disease characterized by recurrent episodes of facial flushing, erythema, pustules, and telangiectasia, largely affect — Read on link.springer.com/article/10.1007/s13555-020-00460-1Read More
A Genomic Approach to Investigating Ocular Surface Microorganisms: Monitoring Core Microbiota on Eyelid Margin with a Dot hybridization AssayNovember 11, 2020A sound ocular surface microbiota has been recognized as a part of ocular surface health following a growing body of evidence from next-generation sequencing technique and metagenomic analysis. However, even from the perspective of contemporary precision medicine, it is difficult to directly apply these new technologies to clinical practice. Therefore,[...]Read More
Electrovestibulography (EVestG) for Post-concussion syndrome (PCS)July 12, 2020Fishman comment: Post-concussion syndrome (PCS) is a very debilitating condition in which individuals suffer from symptoms including "headaches, dizziness, fatigue, irritability, reduced concentration, sleep disturbance, memory loss, sensitivity to noise or light, double or blurred vision, nausea, anxiety and depression." Electrovestibulography (EVestG) is an objective diagnostic tool for PCS. It is an[...]Read More
Platelet-rich Plasma (PRP) may reduce pain by an Endocannabinoid-Related MechanismJuly 8, 2020Fishman Comment: I have been very impressed with the use of serum tears in the treatment of neuropathic corneal pain. At FishmanVision, we use a subset of serum tears called Plasma Rich in Growth Factors (PRGF). PRGF is itself a subset of PRP. Compared to other modalities, patients appear to[...]Read More
Tape Stripping: A Novel Noninvasive Method Using RNA Sequences for Diagnosing Ocular Surface Diseases of the Eye and EyelidJune 17, 2020Fishman comment: This is our recent work on a new method for measuring the mRNA on the ocular surface. The implications for this research range from microbiome analysis to point of care testing for infectious diseases. Abstract: Harvey Fishman MD PHD, Jonathan Mansbridge, Vera Morhenn; Tape Stripping: A Novel Noninvasive[...]Read More
Heavy eye syndrome versus sagging eye syndrome in high myopiaJune 9, 2020Fishman comment: When a patient presents with double vision, the immediate reaction is to rule out serious neurologic causes such as stroke (CVA), brain tumor, giant cell arteritis, infection, cancer, and myasthenia gravis amongst others. However, it turns out that a leading cause of double vision in older adults is[...]Read More
Association of Dietary Fatty Acid Intake With Glaucoma in the United StatesJune 7, 2020Ye Elaine Wang, MD1; Victoria L. Tseng, MD, PhD1; Fei Yu, PhD1,2; et al. Joseph Caprioli, MD1; Anne L. Coleman, MD, PhD1,3 JAMA Ophthalmol. 2018;136(2):141-147. doi:10.1001/jamaophthalmol.2017.5702 Key PointsQuestion Does an association exist between daily dietary intake of polyunsaturated fatty acids, especially ω-3 fatty acids, and the risk of glaucoma in the US[...]Read More
Relationships Between Short-Term Exposure to an Indoor Environment and Dry Eye (DE) SymptomsMay 10, 2020Air composition influences Dry Eye (DE) symptoms as demonstrated by studies that have linked the outdoor environment to DE. However, there is insufficient data on the effect of short-term exposure to indoor environments on DE symptoms. We conducted a prospective experimental research, in which an older building served as an[...]Read More
Palpebral and facial skin infestation by Demodex folliculorum – Contact Lens and Anterior EyeMay 10, 2020Purpose To evaluate facial Demodex densities in participants with varying severities of blepharitis secondary to Demodex folliculorumassessed by the highest number of cylindrical dandruff on one lid. Methods This double masked cross-sectional study included 58 participants [19 control, 21 mild/moderate and 18 severe Demodex blepharitis] who underwent a standardized skin-surface[...]Read More
Development of Feasible Methods to Image the Eyelid MarginMay 10, 2020Purpose: To develop a feasible method to image eyelid margin structures using in vivo confocal microscopy (IVCM) for use in clinical research. Second, to assess the association between IVCM and meibography images. Methods: IVCM was performed on the central upper eyelid margin of 13 healthy participants (31 ± 5 years).[...]Read More
The Ocular Surface and the Coronavirus Disease 2019: Does a Dual ‘Ocular Route’ Exist?May 10, 2020Coronavirus disease 2019 (COVID-19) is an important health problem that was defined as a pandemic by the World Health Organization on 11 March 2020. Although great concern has been expressed about COVID-19 infection acquired through ocular transmission, its underlying mechanism has not currently been clarified. In the current work, we[...]Read More
Reflectance confocal microscopy enabling full viewing of Demodex sp. – Ribeiro – – International Journal of Dermatology – Wiley Online LibraryMay 10, 2020Reflectance confocal microscopy enabling full viewing of Demodex sp. - below image from... — Read on onlinelibrary.wiley.com/doi/abs/10.1111/ijd.14911Read More
Development of an inactivated vaccine candidate for SARS-CoV-2 | ScienceMay 9, 2020Abstract The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2) has resulted in an unprecedented public health crisis. There are currently no SARS-CoV-2-specific treatments or vaccines available due to the novelty of the virus. Hence, rapid development of effective vaccines against SARS-CoV-2 are urgently needed.[...]Read More
Micro piezo drug delivery for Neurotransmitter-Based Retinal Prosthesis: Blast from the past 2003April 27, 2020Blast from the past... "Towards a Neurotransmitter-Based Retinal Prosthesis Using an Inkjet Print-head". Biomedical Microdevices 5:3, 195- 199, 2003. HA Fishman and co-workers. This work shows one of the earliest examples (2003 publication from my lab) of drug delivery using micro piezo technology from an ink- jet printer head. Abstract. Electronic chips[...]Read More
Highlights from Dr. Galor’s article, “What can photophobia tell us about dry eye?”March 7, 2020[vc_row][vc_column][vc_column_text]Dr. Fishman's comments: Light sensitivity is a very important symptom that occurs in a variety of ocular diseases including dry eye disease. Dr. Galor has done truly pioneering work in this area and has written many papers on this topic. At FishmanVision, Dr. Fishman is also been conducting research in[...]Read More
The disparity between the dry eye “DREAM” study results and real world clinical experience: Is the gut microbiome the missing link ?February 29, 2020Dr. Fishman's comments on latest DREAM study publication: Why is there is a huge disparity between the clinical experience of most well-known dry eye and corneal specialists and the results that are emerging from the DREAM study? To cut to the chase, the study lumped together all of the many[...]Read More
Death by IplFebruary 26, 2020[vc_row][vc_column][vc_column_text] [/vc_column_text][vc_column_text]Fishman comments: Our paper is the first to show direct evidence of "Demodex Death by IPL" using live video microscopy. Honored to collaborate on this important work with Dr. Periman (aka @dryeyemaster) and Dr. Shah (@sfgotox). Click the below download button for the full PDF of the paper. [...]Read More
Regional Comparison of Goblet Cell Number and Area in Exposed and Covered Dry Eyes and Their Correlation with Tear MUC5ACFebruary 23, 2020Fishman comments: Another brilliant article by Dr. Pflugfelder and co-workers. Here, they show a correlation between tear MUC5AC concentration and GC area and suggests tear MUC5AC mucin can be used as a disease-relevant biomarker for conjunctiva GC health. Authors: Khimani, K.S., Go, J.A., De Souza, R.G. et al. Sci Rep[...]Read More
Heart-Shaped Meibomian GlandFebruary 23, 2020[vc_row][vc_column][vc_column_text] Human anatomy often delights us with unexpected structures. This is a heart shaped meibomian gland in the upper eyelid of a patient. The meibomian glands are holocrine type exocrine glands. Estimates vary but there are ~20 to 30 meibomian glands on the lower lid and ~40 to 50 on the[...]Read More
MicroRNA Profiling in Benign and Malignant Conjunctival Melanocytic LesionsFebruary 19, 2020Fishman comments: The article says it best... "Conjunctival melanoma is a rare tumor with an incidence of 0.2 to 0.8 cases per 1 million people, although the incidence is increasing." "In daily practice, it can be very difficult to distinguish a benign from a malignant melanocytic lesion based on only[...]Read More
Female mouse tears contain an anti-aggression pheromoneFebruary 17, 2020Fishman comments: Super interesting article on the effects of female mouse tear fluid on male behavior. The authors found that female tears contain a factor that strongly inhibits inter-male aggression. Cavaliere, R.M., Silvotti, L., Percudani, R. et al. Female mouse tears contain an anti-aggression pheromone. Sci Rep 10, 2510 (2020). https://doi.org/10.1038/s41598-020-59293-9[...]Read More
Mmp-9 positive : ChalazionFebruary 6, 2020Matrix metalloproteinases (MMPs) are a group of enzymes that in concert are responsible for the degradation of most extracellular matrix proteins during organogenesis, growth and normal tissue turnover. Presence of MMP-9 in the tear film indicates an inflammatory process. The MMP-9 detector shown below is a nice way to track[...]Read More
Death by IPLJanuary 29, 2020Fishman comments: Our paper is the first to show direct evidence of "Demodex Death by IPL" using live video microscopy. Honored to collaborate on this important work with Dr. Periman (aka @dryeyemaster) and Dr. Shah (@sfgotox). Photobiomodul Photomed Laser Surg. 2020 Jan 27. doi: 10.1089/photob.2019.4737. [Epub ahead of print] Real-Time[...]Read More
Dietary restriction increases protective gut bacteria to rescue lethal methotrexate-induced intestinal toxicityJanuary 27, 2020Fishman comments: Methotrexate is a commonly used drug to treat various ocular autoimmune conditions including uveitis and scleritis. Unfortunately, GI side effects are a problem. This is a nice paper exploring the possibility of reducing GI toxicity by increasing the protective intestinal microbiota. Hopefully, we will continue to understand the[...]Read More
How I approach the “Hey Doc, these glasses don’t work” – Part I , opticsJanuary 25, 2020This is a very common comment that eye care professionals hear from their patients and thus an excellent opportunity to unpack many important issues in ophthalmology and optometry. I am going to break this into several blog posts and part (I) will start with optics. Future blog posts will focus[...]Read More
To plug or not to plug, that is the questionJanuary 24, 2020The American Academy of Ophthalmology (AAO) publishes guidelines called preferred practice patterns (PPP). In the staged management of dry eye disease as per the PPP, punctal occlusion (plugs) for dry eye disease has been a level II (step 2) option for many years. It has been an excellent solution for[...]Read More
Comparative portrayal of ocular surface microbe with and without dry eyeJanuary 23, 2020Fishman comments: From an analytical chemistry standpoint, the ocular microbiome is an extremely complex environment to measure. This work is interesting and adds to our understanding of the impact of the ocular microbiome and dry eye disease. We have a long way to go to truly understand these interactions. My[...]Read More
Role of Resveratrol in Transmitochondrial AMD RPE CellsJanuary 17, 2020Fishman commentary: Neat finding by Dr. Kuppermann and colleagues. Role of Resveratrol in Transmitochondrial AMD RPE Cells by Sonali Nashine 1, Anthony B. Nesburn 1,2, Baruch D. Kuppermann 1 and Maria Cristina Kenney 1,3,* Nutrients 2020, 12(1), 159; https://doi.org/10.3390/nu12010159 Abstract Resveratrol is a phytoalexin, stilbenoid compound with antioxidant properties attributable to[...]Read More
Novel, Non-Invasive Method for Addressing Acute and Chronic Chalazia: a case series- Dr. Laura PerimanJanuary 12, 2020Dr. Periman (a.k.a Dry Eye Master - @dryeyemaster) and colleagues present wonderful work on the use of IPL to treat chalazia. As described, IPL shows incredible promise of a drug-free, incision-free and injection-free method of addressing chalazia. IPL was offered to these patients to manage their acute or chronic chalazion/chalazia as[...]Read More
Dry Eye as a Mucosal Autoimmune DiseaseJanuary 7, 2020Fishman commentary. Classic review article by Dr. Pflugfelder. We need to better understand the innate immune system - " the field is rapidly realizing the complexity of other innate and adaptive immune factors involved in the development and progression of disease" Authors: Michael E. Stern, Chris S. Schaumburg & Stephen[...]Read More
Probing and expressing a meibomian gland pre-styeJanuary 4, 2020In this video, Dr. Fishman uses a Maskin Probe to first probe then express an inspissated meibomian gland. The beginning of the video shows how expressing the inspissated meibomian gland alone does not produce meibum. After probing the gland, milky meibum is expressed. [videopress MgKnELLT] Read More
Changes in brainstem excitatory and inhibitory pathways in dry eye syndromeDecember 31, 2019Fishman Commentary: In many patients, dry eye disease present with a neuropathic component, which I refer to as the "trigeminal ganglion pain continuum." In this paper, the authors show that changes at the synaptic level in the brainstem occur in dry eye disease. Highlights * Patients with dry eye have[...]Read More
Effects of Platelet-rich Plasma on Ocular Surface in Patients with Dry Eye Syndrome: Clinico-experimental AnalysisDecember 28, 2019Fishman commentary: PRP and PRGF (made at FishmanVision) are purified versions of serum tears and may have excellent efficacy in ocular surface disease including dry eye, epithelial defects, chronic inflammation. This is a nice paper on PRP for dry eye disease. Authors: Jae Uk Jung, MD,1 Sang Hee Lee, MD,[...]Read More
High-dose curcuminoids are efficacious in the reduction in symptoms and signs of oral lichen planusDecember 15, 2019Dr. Fishman's commentary: Potentially a very powerful steroid sparring way to treat oral Lichen Planus. It would be interesting if we could perform a clinical trial involving high dose curcuminoids for treating Lichen Planus of the conjunctiva. Lichen planus is an autoimmune condition of unknown aetiology affecting the skin and mucous membranes. Conjunctival[...]Read More
Confocal microscopy of a neuropathic corneaDecember 6, 2019Patient with corneal neuropathy from a refractive surgery 7 years ago.Read More
MSC Transplantation Improves Lacrimal Gland Regeneration after Surgically Induced Dry Eye Disease in MiceDecember 6, 2019Fishman Comments: Incredibly interesting work on stem cell transplantation for restoring the lacrimal gland function. MSC in 2 µl saline were injected into the LG. Important basic science in the field of dry eye disease. Authors: Jana Dietrich, Lolita Ott, Mathias Roth, Joana Witt,Gerd Geerling, Sonja Mertsch& Stefan Schrader Scientific Reports[...]Read More
Ocular inflammation induces trigeminal pain, peripheral and central neuroinflammatory mechanismsNovember 24, 2019Fishman commentary: This study provides the first demonstration that corneal inflammation induces activation of pathways within sensory trigeminal complex. These results suggest that this altered activity in intracellular signaling caused by ocular inflammation might play a priming role in the central sensitization of ocular related brainstem circuits, which represents a[...]Read More
Composition and Diversity of Bacterial Community on the Ocular Surface of Patients With Meibomian Gland DysfunctionNovember 20, 2019Fishman Commentary: The research on the microbiome of the eye continues to show potential avenues for treating chronic ocular conditions such as dry eye disease. In this study, they found that patients with MGD can have various degrees of bacterial microbiota imbalance in the conjunctival sac. Staphylococcus, Corynebacterium, and Sphingomonas may play roles[...]Read More
Nonsteroid management of residual ocular surface disease on dupilumab (ROSDD)November 18, 2019Fishman commentary: Treatment pearls for dupilumab associated ocular surface disease. Authors: JodieRaffiabRaaginiSureshaTimothyBergeraHarveyFishmancJenny E.Murasead https://doi.org/10.1016/j.ijwd.2019.08.007 International Journal of Women's Dermatology . Available online 24 August 2019. Dear Editors, Atopic dermatitis is associated with a range of ocular complications. Additionally, an increase in dupilumab-associated conjunctivitis, dry eye, and recently characterized residual[...]Read More
Investigating the role of allergic contact dermatitis in residual ocular surface disease on dupilumab (ROSDD)November 17, 2019Fishman commentary. Excellent article on ocular surface disease and dupilumab. Significant improvement after patch testing in nearly half of patients suggests that allergic contact dermatitis contributes to some cases of dupilumab-associated eye complications. Click here for PDF Authors: JodieRaffiabRaaginiSureshaHarveyFishmancNinaBottoaJenny E.Murasead Abstract Background The mechanisms underlying eye-related complications with dupilumab are[...]Read More
Eyeliner Induces Tear Film Instability and Meibomian Gland DysfunctionNovember 16, 2019Dr. Fishman commentary: Makeup can be toxic to the meibomian glands and can result in tear film abnormality. This is further evidence that patients with dry eye disease need to consider makeup very seriously.----------------------------------------- Published ahead of print in Cornea, Nov 2019. Authors: Prabhasawat, Pinnita MD*; Chirapapaisan, Chareenun MD*; Chitkornkijsin,[...]Read More
Macular pigment optical density is positively associated with academic performance among preadolescent childrenNovember 12, 2019Dr. Fishman comment: 2 interesting take aways- the use of MPOD to track diet and how brain Lutein may be important for cognitive achievement . "This is the first study to demonstrate that retinal L and Z, measured as MPOD, is positively related to academic achievement in children" Published in : Nutr[...]Read More
Dry Eye Disease Associated with Lower Gut Microbiome DiversityNovember 6, 2019Abiya Farhan Baqai; Harvey A. Fishman, MD PhD Abstract Purpose : The human microbiome has been studied for centuries and recently has been associated with health issues ranging from metabolic disorders such as obesity and diabetes to inflammatory disorders such as inflammatory bowel disease.5 However, only recently have associations of[...]Read More
Why Don’t Yellow Night Vision Glasses Work? by Dr. Robert W. MassofNovember 6, 2019Fishman comment: Excellent in JAMA by Hwang et al1 and neat follow-up commentary by Massof. Take home message that Massof makes: "yellow night vision glasses do not live up to their product claims, but more work is needed to better understand and ultimately ameliorate a ubiquitous problem that is growing with[...]Read More
Corneal Manifestations of Inflammatory Bowel DiseaseNovember 1, 2019Fishman comment: Another interesting manifestation of systemic disease in the eyes. IBD patients have thinner corneas and reduced tears. ABSTRACT Purpose: To evaluate detailed corneal parameters of inflammatory bowel disease (IBD) patients, including Crohn’s disease (CD) and ulcerative colitis (UC) patients, and to assess associations between anterior segment values and[...]Read More
Novel Light Intensity Device (LuxIQ) for Quantitative Evaluation of Dry Eye DiseaseOctober 27, 2019We report on a novel light intensity device (LuxIQ) that helps clinicians assess the severity of dry eye disease in a quantitative manner. Currently, the inability to quantify and accurately assess the severity of dry eyes is a huge impediment in the field of dry eye disease. This novel device[...]Read More
Long-term regular exercise and intraocular pressure: the Hisayama StudySeptember 8, 2019PURPOSE: To investigate the association between long-term regular exercise (exercise frequency and exercise time) and 5-year changes in intraocular pressure in a general Japanese population. METHODS: This population-based, cohort study was conducted in 2007. A total of 3119 Japanese community dwellers aged ≥ 40 years underwent eye examinations including intraocular pressure measurement[...]Read More
Ocular blood flow in course of glaucomaApril 27, 2019Study explores influence of ocular blood flow in course of glaucoma: New techniques shed light on roles of blood, perfusion pressure in ocular blood flow Many other factors, including demographic influences and individual susceptibilities, also make it challenging to study relationships between ocular blood flow and glaucoma. To overcome the[...]Read More
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