Philadelphia, PA Program Website. the contents by NLM or the National Institutes of Health. Tips for Relieving Daily Stress and Calming Down, Lisa Esposito, Elaine K. Howley and Payton SyAug. The burden of DED on affected patients is significant, with effects on visual function, activities of daily living, professional work, and quality of life.1,2 Direct costs from doctors visits, medications, and procedures and indirect costs from decreased productivity, reduced quality of life, and general impairment in functioning make DED a substantial economic burden, as well.14 A recent economic analysis estimated that the average annual direct cost of managing an American dry-eye patient was $783, which when adjusted for the prevalence of dry eye, amounted to $3.84 billion across the U.S. healthcare system.5. Lambiase A, Sullivan BD, Schmidt TA, et al. A Two-Week, Randomized, Double-masked Study to Evaluate Safety and Efficacy of Lubricin (150 mug/mL) Eye Drops Versus Sodium Hyaluronate (HA) 0.18% Eye Drops (Vismed(R)) in Patients with Moderate Dry Eye Disease, Thymosin beta4 significantly improves signs and symptoms of severe dry eye in a phase 2 randomized trial, Primary Mechanisms of Thymosin 4 Repair Activity in Dry Eye Disorders and Other Tissue Injuries, Treatment of chronic nonhealing neurotrophic corneal epithelial defects with thymosin beta 4. Dr. Nicole Langelier, MD - Richmond, VA | Ophthalmology - Doximity The nine-story tower will serve patients who have diseases of the eye or vision impairment and those who need physical rehabilitation. After serving his ophthalmology residency at Scheie Eye Institute in Philadelphia, Dr. Montzka completed his fellowship training in retina and intraocular tumors at Wills Eye Hospital in Philadelphia. Education & Training University of Pennsylvania Health System/Scheie Eye Institute Residency, Ophthalmology, 2019 - 2022 Abington Memorial Hospital Internship, Internal Medicine, 2018 - 2019 Drexel University College of Medicine Class of 2018, MD Dr. Elliott Yolles, MD - Indianapolis, IN | Ophthalmology - Doximity Tomas S. Aleman, MD. Visual Field Optic Nerve Imaging Epidemiology & International Health in Glaucoma Education & Training Medical School Harvard Medical School (Boston, MA) Masters of Public Health Johns Hopkins School of Public Health (Baltimore, MD) Residency Scheie Eye Institute University of Pennsylvania (Philadelphia, PA) Fellowship Scheie Eye Institute, the Department of Ophthalmology for the University of Pennsylvania Health System, is dedicated to excellence in patient care, educating future clinical ophthalmologists and vision scientists, and advancing research to prevent blindness and vision loss. In the same study, MMP-9 assays were positive in 50% of 114 eyes pretreatment but only 26% of eyes post-treatment (p<0.0001).44 More recently, Hagen et al. Larger, randomized, masked, placebo-control clinical trials need to be conducted in the future to further evaluate the efficacy and safety of the TearCare System. Topical prescription medications discussed here aim to decrease inflammatory mediators and are therefore likely to be most effective in patients with evidence of a significant inflammatory component to their disease, such as patients with moderate-to-severe aqueous tear deficiency (with or without Sjogrens syndrome), or graft-vs-host-disease. SCHEIE EYE INSTITUTE - 10 Photos & 15 Reviews - 51 N 39th St - Yelp In his final year of residency, Josh received a K08 grant, funded by the National Eye Institute, and joined the faculty of the Scheie Eye Institute at the University of Pennsylvania. Visualization of retinal vascular structure and perfusion with a nonconfocal adaptive optics scanning light ophthalmoscope. Cold ultrasound gel is applied to the treatment area, from tragus to tragus. Efficacy and safety of 0.1% cyclosporine A cationic emulsion in the treatment of severe dry eye disease: a multicenter randomized trial. Patients with moderate-to-severe disease will often require a combination of treatments aimed at targeting the inflammatory, evaporative, and aqueous deficient components of their disease. However, there are possible side effects including instillation-site irritation, instillation-site pain, instillation-site reaction, reduced visual acuity, and dysgeusia.17,20,21 In addition, further study is needed to determine which patients respond best to lifitegrast, such as patients with known higher levels of inflammation such as patients with Sjogrens syndrome or graft-vs-host disease. Characterization of tear production in subjects with dry eye disease during intranasal tear neurostimulation: Results from two pivotal clinical trials. However, one major limitation to the use of scleral lenses for dry eye disease is the lengthy and costly fitting process that may not be covered by insurance. Drew Scoles, Yusufu N. Sulai, Robert F. Cooper, Brian P. Higgins, Ryan D. Johnson, Joseph Carroll, Alfredo Dubra, Kimberly E. Stepien. The ITN was designed to stimulate the mucosal nerves via small electrical currents to increase natural tear production via the nasolacrimal reflex pathway of the lacrimal function unit. A Phase II/III, randomized, double-masked, vehicle-controlled, dose-ranging study of the safety and efficacy of OTX-101 in the treatment of dry eye disease. Accessibility Here are the top-scoring hospitals in Arizona for cancer treatment in 2023-2024. Commonly utilized subjective scales include the Ocular Surface Disease Index (OSDI) and the Symptom Assessment iN Dry Eye (SANDE). Evaluation of topical cyclosporine for the treatment of dry eye disease. Prosthetic replacement of the ocular surface ecosystem as treatment for ocular surface disease in patients with a history of Stevens-Johnson syndrome/toxic epidermal necrolysis, Clinical benefits of the Boston Ocular Surface Prosthesis, EyePrintPRO therapeutic scleral contact lens: indications and outcomes, Accelerated Restoration of Ocular Surface Health in Dry Eye Disease by Self-Retained Cryopreserved Amniotic Membrane, Treatment outcomes in the DRy Eye Amniotic Membrane (DREAM) study, Topical administration of lacritin is a novel therapy for aqueous-deficient dry eye disease, Reduced Levels of Tear Lacritin Are Associated With Corneal Neuropathy in Patients With the Ocular Component of Sjogrens Syndrome, Transcription, translation, and function of lubricin, a boundary lubricant, at the ocular surface. Find local businesses, view maps and get driving directions in Google Maps. Josh Dunaief The Dunaief Lab. Nakayama N, Kawashima M, Kaido M, Arita R, Tsubota K. Analysis of Meibum Before and After Intraductal Meibomian Gland Probing in Eyes With Obstructive Meibomian Gland Dysfunction. Let us know if this information is out of date or incorrect. About Us Welcome to Penn Medicine's Department of Ophthalmology, a pioneer in ophthalmic care, research, and training. Scleral lenses were previously used primarily for the treatment of corneal ectasias but more recently have been studied for use in ocular surface disorders. 7, 2023, Paul Wynn and K. Aleisha FettersAug. Director, Retinal Degenerations, Scheie Eye Institute. The scribe and clinical research coordinator programs, for example, allow post-baccalaureate students of diverse backgrounds to acquire the . In vivo dark-field imaging of the retinal pigment epithelium cell mosaic. The University of Pennsylvania Department of Ophthalmology at the Scheie Eye Institute funds fellowships. Repeat treatments were only required in 5 of the patients with an average follow-up of 11.5 months.47 In 2018, Maskin et al reported post-probing meibography results of 50 eyelids from 28 patients. Since Lane et al. 3, 2023, Best Continuing Care Retirement Community (CCRC), Best Medicare Advantage Plan Companies 2023, Best Medicare Part D Prescription Drug Plan Companies 2023, Dr. Drew Scoles is an ophthalmologist in Philadelphia, Pennsylvania and is affiliated with multiple hospitals in the area, including. Eye drops with a higher concentration of CsA than Restasis have been approved in Europe, Japan, and other countries.9093 A Phase III clinical trial is currently underway for a Seciera (Sun Pharma, Mumbai, India), which has a CsA concentration almost twice that of Restasis (0.09% vs. 0.05%). NMNAT1-ASSOCIATED CONE-ROD DYSTROPHY: EVIDENCE FOR A SPECTRUM OF FOVEAL MALDEVELOPMENT. Annual Report 2020 - Scheie Eye Institute by Rebecca Salowe - Issuu Its primary role seems to be increasing basal tear secretion.80,81 Studies have shown that lacritin levels are significantly decreased in patients with Sjogrens syndrome as compared to healthy controls.81 In a murine model of SS dry eye disease, topical lacritin has been found to increase tear secretion, decrease lissamine green staining, and reduce signs of epithelial damage.80 Phase I/II clinical trials of lacritin in patients with Primary Sjogrens disease are currently underway with estimated completion date of 2019. Donald L. Budenz, MD, MPH, graduated magna cum laude and Phi Beta Kappa from the University of Pennsylvania. My name is Jessica Watson, M.D., and as a fellowship-trained vitreoretinal surgeon, I evaluate and treat patients with medical and surgical diseases of the vitreous and retina. Dr. Brian M. Shafer is an ophthalmologist and is affiliated with multiple hospitals in the area, including Chester County Hospital and Ortonville Area Health Services. Dr. Michael E. Sulewski is an ophthalmologist in Philadelphia, Pennsylvania and is affiliated with multiple hospitals in the area, including Delaware County Memorial Hospital and Hospitals of. Scheie Eye Institute Radnor 145 King of Prussia Road Floor 2, Suite 204 South, Radnor, PA, 19087 1 other location (215) 316-5151 OVERVIEW RATINGS & REVIEWS LOCATIONS INSURANCE OVERVIEW Tear film osmolarity improved by 7% (p<0.005) in the 20 patients with abnormal results at baseline, but lipid layer thickness did not improve significantly.36, While these results are encouraging for the role of IPL in the treatment of dry eye disease, there are limitations to its use. Kloek CE, Jeng-Miller KW, Jacobs DS, Dunn IF. 51 N 39th Street Philadelphia, PA 19104 Is this information wrong? Fortunately, there is increased interest in the development of new therapeutics with several promising drugs currently undergoing clinical trials. Before Ophthalmology Residency - Penn Medicine Preparing for your first cancer appointment can be overwhelming. The procedure involves placement of single-use, flexible iLid published clinical trial applicators over each tarsal plate which deliver constant, regulated heat at 41C45C over a 12 minute treatment time, during which the patient is encouraged to blink normally to allow natural meibum expression (Figure 4). Patient ocular conditions and clinical outcomes using a PROSE scleral device, Treatment of persistent corneal epithelial defect with overnight wear of a prosthetic device for the ocular surface. Childrens Hospital of Philadelphia, Philadelphia, PA, 19104, Hospitals of the University of Pennsylvania-Penn Presbyterian, #4 on Best Children's Hospitals Honor Roll, University of Pennsylvania Health System/Scheie Eye Institute, Fellowship, Surgical Retina and Vitreous, 2020-2022, University of Rochester School of Medicine and Dentistry. (Master of Bioethics) Certifications & Licensure VA State Medical License 2016 - 2024 NC State Medical License 2015 - 2017 PA State Medical License 2011 - 2015 demonstrated the positive effects of BlephEx in treating dry eye symptoms; in the small study of 20 patients, the authors found that MGD and blepharitis grading (using Efron Grading Scale), TBUT, and OSDI improved significantly four weeks after BlephEx treatment compared to baseline.59 The group separately reported on a group 10 patients who tested positive for MMP-9 who were subsequently treated with Blephex and all found to be negative for MMP-9 after treatment.60 A randomized, masked, placebo-control clinical trial is still needed to further investigate the treatments safety and efficacy compared to other blepharitis treatments. These newer products contain three to five times the platelet concentration compared to serum drops and aim to maximize the concentration of growth factors, cell adhesion molecules and alpha-granule released cytokines.23 E-PRP and PGRF also do not contain leukocytes, which are present in serum drops and may increase levels of pro-inflammatory cytokines that are detrimental to the ocular surface.24 These higher concentrations of growth factors and other beneficial factors may result in substantial therapeutic effects on the ocular surface. Drew Scoles, Michael J. Ammar, Robert M Carroll, Stephen E. Orlin, Victoria Addis, Albert M. Maguire, Drew Scoles, Mina Massaro-Giordano, Albert M. Maguire, Vivian S. Lee. These lenses rest on the sclera, creating with a fluid-filled reservoir over the more sensitive cornea. first reported the use of topical thymosin beta4 (RGN-259) for the treatment of dry eye disease. Daniel C. Gray, Robert Wolfe, Bernard P. Gee, Drew Scoles, Ying Geng, Benjamin Masella, Alfredo Dubra, Sergio Oscar Luque, David R. Williams, William H. Merigan. I am a graduate of Dartmouth College, and I received my medical degree from the University of North Carolina at Chapel Hill. Finis D, Konig C, Hayajneh J, Borrelli M, Schrader S, Geerling G. Six-month effects of a thermodynamic treatment for MGD and implications of meibomian gland atrophy, A single LipiFlow(R) Thermal Pulsation System treatment improves meibomian gland function and reduces dry eye symptoms for 9 months, Long-Term (3 Year) Effects of a Single Thermal Pulsation System Treatment on Meibomian Gland Function and Dry Eye Symptoms, Effect of thermal pulsation treatment on tear film parameters in dry eye disease patients. University of Pennsylvania Health System/Scheie Eye Institute The ProKera SLIM is indicated for mild to moderate conditions, while the ProKera PLUS is recommended for severe indications that require longer treatment. Scheie Eye Institute, the Department of Ophthalmology for the University of Pennsylvania Health System, is dedicated to excellence in patient care, educating future clinical ophthalmologists and vision scientists, and advancing research to prevent blindness and vision loss. Request Appointment About Joshua J Ney Specialties Glaucoma Affiliations Massachusetts General Hospital Provider Gender Male Language English Expertise Education American Board of Ophthalmology Board Certification, Ophthalmology, 2013 Scheie Eye Institute Fellowship, Glaucoma, 2013 Scheie Eye Institute Residency, Ophthalmology, 2012 Notably, in a pooled analysis of the OPUS-2 and OPUS-3 studies, lifitegrast significantly improved the primary symptom outcome of change from baseline eye dryness score (EDS) (0 to 100 visual analogue scale [VAS]) score within 14 days and sustained this effect in a pooled analysis at the studys endpoints of 84 days (treatment effect 9.92 point decrease in EDS (VAS) score; 95% CI 7.0112.83; p < 0.0001).17 By comparison, topical cyclosporine typically takes 3 months to demonstrate clinical efficacy.1719 The safety of lifitegrast was well demonstrated in the SONATA study, which followed 331 patients (220 lifitegrast vs 111 placebo) for one year and found no significant adverse events. Surgical outcomes, visual field analysis, optic nerve imaging, medical adherence in glaucoma, epidemiology of glaucoma, international health. Epidemiology & International Health in Glaucoma, Harvard Medical School (Boston, MA) Inaccurate Measurements Confound the Study of Myopic Macular Hole. Effect of loteprednol etabonate 0.5% on initiation of dry eye treatment with topical cyclosporine 0.05%. An early retrospective review of 49 consecutive patients (76 eyes) with ocular surface disease treated with this lens found a 92% improvement in quality of life as a result of reduction in photophobia and pain. Cytomegalovirus retinitis in an immunocompetent host after complicated cataract surgery. Thus, the development of additional therapeutics is critical. See the top hospitals in 15 specialties of complex adult care in the 2023-2024 U.S. News Best Hospitals rankings. Fellowships in Ophthalmology - Penn Medicine Search below to find a doctor with that skillset. Alio JL, Rodriguez AE, Ferreira-Oliveira R, Wrobel-Dudzinska D, Abdelghany AA. Traditional dry eye treatments include over-the-counter artificial tears, warm compresses, and lid hygiene with baby shampoo.7 Topical cyclosporine A (CsA) 0.05%, a fungal antimetabolite that has found use as an anti-inflammatory drug due to its ability to decrease IL-2 mediated T-cell activation, received FDA approval for dry eye disease in 2003 and has been in regular clinical use for the past 15 years. Finally we will discuss new medications that are in development. Inclusion in an NLM database does not imply endorsement of, or agreement with, However, a variety of products are available without FDA regulation that are marketed for the treatment of DED and clinical trials are ongoing for use in patients with graft-vs-host disease and post-PRK dry eye.89 These drops are not covered by insurance so cost is expected to be prohibitive in many cases. The original ProKera is indicated for moderate to severe indications, including neurotrophic PED, severe infectious keratitis, post-PRK haze, and Salzmann nodular degeneration; however, Bio-tissue recently started offering the ProKera SLIM and ProKera PLUS. Investigative Ophthalmology &. Treatment settings range from 8 J/cm2 to 20 J/cm2, depending on disease severity. The Mibo Thermoflo (MiBo Medical Group, Dallas, TX) is an in-office therapeutic device for the treatment of MGD related DED, which aims to maximize meibum liquefaction and secretion, thus improving tear film quality (Figure 3). Hotels near J N Petit Institute Library; Hotels near Trafford House Z.J.M. The site is secure. While no studies on its efficacy have been published yet, preliminary data from a trial sponsored by the manufacturer showed significant improvement in TBUT, osmolarity, SPEED, and OSDI four months after treatment in 51 patients.56 However, Kendrick & Alloo reported in a case study, that the treatment was ineffective in raising the average palpebral conjunctiva temperature above 40C, the temperature required for effective meibum liquidification.57,58 A randomized, masked, placebo-control clinical trial still needs to be conducted to further investigate the treatments efficacy and safety. Dr. Berger was internationally recognized for his work on computer-based retinal imaging and was the first editor of a major textbook on age-related macular degeneration. studied 368 patients with moderate to severe dry eye treated with E-PRP six times daily in a series of one to five consecutive rounds, each lasting six weeks (64.4% of patients required only one round). The prevalence of DED is higher among women as compared to men and increases with age.1,2 One recent population based study found a prevalence of 11.3% among all adults greater than 50 years of age and as high as 22.8% among women greater than 75 years of age.1 Based on this, we can anticipate that the prevalence of DED will continue to increase as the population ages. Dr. Chen graduated with an MD at Shanghai Medical University, Shanghai, China Nguyen et al. These include diabetic retinopathy, retinal vascular occlusions, retinal detachments, macular pathology, and macular degeneration. Learn about the differences and similarities between these two plans, and find out who's eligible for Medicare supplement Plans F and G. Learn to recognize the signs and symptoms of burnout, and discover practical strategies for recovery. He has received Humanitarian of the Year awards from the American Academy of Ophthalmology and American Glaucoma Society for his work in Ghana, West Africa. Application of Intense pulsed light (IPL), In 2015, Toyos and colleagues published a retrospective review of 91 patients presenting with dry eye symptoms who were treated with IPL. A new device that was FDA-approved for the treatment of DED is the Intranasal Tear Neurostimulator (ITN, TrueTear, Allergan, plc) (Figure 5). Dr. Tapino also remarked on the outstanding teamwork and camaraderie among the residents. 3.2 miles to Mumbai Airport. Human meibum lipid conformation and thermodynamic changes with meibomian-gland dysfunction. The group that underwent probing also experienced a significantly greater increase in TBUT than the steroids-only group (8.2 +/ 2.1vs 7.0 +/ 3.0, p=0.029). Scheie Eye Institute | Resident Introduction From an accredited US hospital Watch on Overview The Penn Ophthalmology residency offers extensive clinical, surgical, and research experience with close mentoring from faculty. University of Pennsylvania (Philadelphia, PA), Glaucoma, Bascom Palmer Eye Institute There are several scleral lenses that are currently available that can be helpful in treating dry eye. Gupta PK, Vora GK, Matossian C, Kim M, Stinnett S. Outcomes of intense pulsed light therapy for treatment of evaporative dry eye disease, Combination Therapy of Intense Pulsed Light Therapy and Meibomian Gland Expression (IPL/MGX) Can Improve Dry Eye Symptoms and Meibomian Gland Function in Patients With Refractory Dry Eye: A Retrospective Analysis, Prospective trial of intense pulsed light for the treatment of meibomian gland dysfunction. Fellows will be paid at the PGY-5 level, as established by the office of Graduate Medical Education. When not at work or school, you can find us outside exploring any number of the lakes, woods, and mountains of Maine. Bethesda, MD 20894, Web Policies Looking for something else? This doctor practices at a U.S. News Best Regional Hospital. Treatment sessions were conducted at 1, 15, and 45 days from baseline and consisted of IPL treatment application to four periocular zones inferior to the eye. Suite 104 Indianapolis, IN 46260 Phone+1 317-872-8772 Fax+1 317-872-2383 Is this information wrong? Sik Sarman Z, Cucen B, Yuksel N, Cengiz A, Caglar Y. Google Maps Advances in Dry Eye Disease Treatment - PMC - National Center for Director, Retinal Function and Structure Laboratories, Scheie Eye Institute. Sacchetti M, Mantelli F, Lambiase A, Mastropasqua A, Merlo D, Bonini S. Systematic review of randomised clinical trials on topical ciclosporin A for the treatment of dry eye disease, Clinical utility of cyclosporine (CsA) ophthalmic emulsion 0.05% for symptomatic relief in people with chronic dry eye: a review of the literature. The authors recognized not only lengthening of shortened glands but also partial restoration of faded glands and speculated that there was possible new gland growth.48 Also published in the last year, Incekalan et al. These should be considered on an individualized basis for patients unresponsive to alternative therapeutic options. It is projected to be completed in late 2022. All fellows are employees of the Hospital of the University of Pennsylvania. Appropriateness of ophthalmic symptoms triage by a popular online artificial intelligence chatbot. For example, Klarity-C (Imprimis Pharmaceuticals, San Diego, California) is 0.1% CsA in a chondroitin sulfate emulsion. Dr. Chen was also an assistant professor at Scheie Eye Institute, University of Pennsylvania, in Philadelphia before she moved to Wisconsin. In vivo imaging of human cone photoreceptor inner segments. Jeffrey W. Berger, MD, PhD (1963-2001) was an Assistant Professor of Ophthalmology (Retina Service) and Director of the Computer Vision Laboratory at Penn's Scheie Eye Institute. An official website of the United States government. Incekalan TK, Harbiyeli II, Yagmur M, Erdem E. Effectiveness of Intraductal Meibomian Gland Probing in Addition to the Conventional Treatment in Patients with Obstructive Meibomian Gland Dysfunction, Intraductal meibomian gland probing for the treatment of blepharitis, Efficacy of Intraductal Meibomian Gland Probing on Tear Function in Patients With Obstructive Meibomian Gland Dysfunction. The Cyclosporin A Phase 2 Study Group. Drew Scoles, Brian P. Higgins, Robert F. Cooper, Adam M. Dubis, Phyllis Summerfelt, David V. Weinberg, Judy E. Kim, Kimberly E. Stepien, Joseph Carroll, Alfredo Dubra.

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