Optometry Podcast: Study Up! With Dr. Jaclyn Garlich of 20/20 Glance

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Want to stay up on the latest publications, new tech, and eyecare pop culture references without having to read every journal hat piles up on your desk and every discussion post on ODs on Facebook? That’s Dr. Garlich’s brainchild 20/20 Glance: a short and sweet email breaking down the top news of the week with humor and brevity sitting in your inbox every Monday morning.  We sat down with Dr. Garlich to talk how she broke into the world of optometric media, and to discuss the most interesting and impactful study publications that are poised to change optometry in the coming years.

The Studies

 1.  Corneal Collagen Cross-Linking in Advanced Keratoconus: A 4-year Follow-up Study.

• Published July 2016 in Journal of Refractive Surgery
• The Set Up: Case study of 40 patients (average age 22.5) with advanced progressive keratoconus who underwent CXL.
• The Run Down: Patients were checked at 1, 2, and years for changes. No changes were seen in uncorrected and corrected vision. Apical keratometry values did improve at the 4 year mark versus the 1 year mark. Endothelial cell count didn’t change. Only 5% of patients experienced treatment failure or progression over the 4 years.

2.  Preeclampsia and Long Term Risk of Maternal Retinal Disorders

• Published January 2017 in Obstetrics and Gynecology
• The Set Up: Longitudinal study of 1,108,541 women in Canada.
• The Run Down: Women with a history of preeclampsia had higher incidence of retinal detachment, retinopathy, and retinal disorders.  Preeclampsia was most highly associated with tractional RD, retinal breaks, and diabetic retinopathy.  Early onset preeclampsia and more severe preeclampsia had higher associated risks. 
• There is evidence that preeclampsia is associated with long-term risk of cardiovascular and renal disease too. These studies suggest preeclampsia has lifelong health implications and not just at the time of pregnancy as previously thought.

3.  Impact of Duration of Contact Lens Wear on The Structure and Function of Meibomian Glands

• Published March 2016 in Ophthalmic and Physiological Optics
• The Set Up: Cross-sectional study of 100 patients age 18-35. Groups were divided into existing lens wearers, previous lens wearers (stopped at least 6 months ago), and nonwearers (never worn contact lenses).
• The Run Down: The nonwearer group was statistically significantly better than either contact lens wearer group in meibomian gland expression, number of plugged glands, meibomian gland dropout, debris on the line of Marx, palpebral redness, TBUT, and phenol red thread.  The results suggest alterations to meibomian gland morphology and function is associated with contact lens wear. Cessation of contact lens wear does not lead to resolution of these changes. 

4.  Longitudinal Examination of Frequency of and Risk Factors for Severe Dry Eye Symptoms in US Veterans

• Published December 2016 in the Journal of American Medical Association Ophthalmology
• The Set Up: 120 patients average age 64 (mostly male since done at VA)
• The Run Down: -44.8% of patients with either mild symptoms or asymptomatic dry eye disease progressed to more severe symptoms by year 1. 74.2% of patients with severe symptoms at baseline persisted with severe symptoms at year 1. Who was most at risk for severe dry eye symptoms? Those with complaints of ocular pain, neuropathic pain-like symptoms, sleep disturbances (sleep apnea, insomina), mental health status (PTSD, Depression), nonocular pain, and those on medications for mental health status or chronic pain and discomfort (anti-anxiety, analgesices).

5. Smartphone use is a risk factor for pediatric dry eye disease

Published October 2016 in BMC Ophthalmology

• The Set Up: 916 children in Korea were enrolled with a diagnosis of dry eye (SPK, shortened TBT, subjective symptoms or OSDI score) and compared against a control group without dry eye disease (DED).
• The Run Down: The main daily duration of smartphone use was longer in the DED group than in controls; the main daily duration of outdoor activities was shorter in the DED group than in controls. After cessation of smartphone use for 4 weeks in the DED group, both subjective symptoms and objective dry eye scores had statistically significant improvement.
• Do you have a topic you think deserves 20/20 Glance coverage? Reach out to Dr. Garlich at 2020glance@gmail.com and you can subscribe to get her weekly newsletters at 2020glance.com.