Thesis--University of Wisconsin--Madison. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 245-265).

Therapeutic Ocular Surface Medium (TOSM) is a potential new treatment for patients with ocular surface disorders such as dry eye and persistent epithelial defect (PED). New therapies are needed as many patients with dry eye and PED continue to suffer despite maximal standard therapy, and while efficacious autologous serum therapy is not routinely available. Like serum, TOSM contains tear components and was expected to have some of the physiological effects of tears. Clinical and in vitro studies were used to evaluate two similar formulations of TOSM. To comply with local pharmacy manufacturing policies, components were omitted from TOSM v1 to produce TOSM v2. In pilot studies, conducted over 1 month, TOSM v1 improved dry eye signs and symptoms and healed over a quarter of PED. In a 2 month randomised double-masked trial, TOSM v2 improved the signs and symptoms of dry eye but was not superior to saline (placebo). No serious or irreversible side-effects occurred. The altered composition of TOSM v2 may have reduced its efficacy. However, a significant improvement in blepharitis (eyelid margin disease) and conjunctival impression cytology (an objective measure of ocular surface health) was found with TOSM v2. Improvement in blepharitis is an encouraging finding as it has not been reported in other dry eye trials. It was hypothesised that TOSM would benefit ocular surface disorders by improving ocular surface health. In vitro, primary and cell line human corneal epithelial cells were supported by TOSM v1 and TOSM v2. Outgrowth from limbal explants and corneal reepithelialisation following wounding occurred with TOSM v2. This and the impression cytology findings support our hypothesis. Further, ocular surface damage with dry eye and PED may activate the corneal wound healing response. For wound healing, compared to human serum, TOSM v1 and TOSM v2 had beneficial effects in vitro on epithelial cells and human corneal fibroblasts. This may translate into a reduction in potentially vision-threatening corneal scarring in vivo with TOSM. However, ocular surface disorders are a heterogenous group and wound healing is a complex process such that different preparations of TOSM may be needed for use in different disorders and at different stages of the disease process.

Therapeutic Ocular Surface Medium (TOSM) is a potential new treatment for patients with ocular surface disorders such as dry eye and persistent epithelial defect (PED). New therapies are needed as many patients with dry eye and PED continue to suffer despite maximal standard therapy, and while efficacious autologous serum therapy is not routinely available. Like serum, TOSM contains tear components and was expected to have some of the physiological effects of tears. Clinical and in vitro studies were used to evaluate two similar formulations of TOSM. To comply with local pharmacy manufacturing policies, components were omitted from TOSM v1 to produce TOSM v2. In pilot studies, conducted over 1 month, TOSM v1 improved dry eye signs and symptoms and healed over a quarter of PED. In a 2 month randomised double-masked trial, TOSM v2 improved the signs and symptoms of dry eye but was not superior to saline (placebo). No serious or irreversible side-effects occurred. The altered composition of TOSM v2 may have reduced its efficacy. However, a significant improvement in blepharitis (eyelid margin disease) and conjunctival impression cytology (an objective measure of ocular surface health) was found with TOSM v2. Improvement in blepharitis is an encouraging finding as it has not been reported in other dry eye trials. It was hypothesised that TOSM would benefit ocular surface disorders by improving ocular surface health. In vitro, primary and cell line human corneal epithelial cells were supported by TOSM v1 and TOSM v2. Outgrowth from limbal explants and corneal reepithelialisation following wounding occurred with TOSM v2. This and the impression cytology findings support our hypothesis. Further, ocular surface damage with dry eye and PED may activate the corneal wound healing response. For wound healing, compared to human serum, TOSM v1 and TOSM v2 had beneficial effects in vitro on epithelial cells and human corneal fibroblasts. This may translate into a reduction in potentially vision-threatening corneal scarring in vivo with TOSM. However, ocular surface disorders are a heterogenous group and wound healing is a complex process such that different preparations of TOSM may be needed for use in different disorders and at different stages of the disease process.

Therapeutic Ocular Surface Medium (TOSM) is a potential new treatment for patients with ocular surface disorders such as dry eye and persistent epithelial defect (PED). New therapies are needed as many patients with dry eye and PED continue to suffer despite maximal standard therapy, and while efficacious autologous serum therapy is not routinely available. Like serum, TOSM contains tear components and was expected to have some of the physiological effects of tears. Clinical and in vitro studies were used to evaluate two similar formulations of TOSM. To comply with local pharmacy manufacturing policies, components were omitted from TOSM v1 to produce TOSM v2. In pilot studies, conducted over 1 month, TOSM v1 improved dry eye signs and symptoms and healed over a quarter of PED. In a 2 month randomised double-masked trial, TOSM v2 improved the signs and symptoms of dry eye but was not superior to saline (placebo). No serious or irreversible side-effects occurred. The altered composition of TOSM v2 may have reduced its efficacy. However, a significant improvement in blepharitis (eyelid margin disease) and conjunctival impression cytology (an objective measure of ocular surface health) was found with TOSM v2. Improvement in blepharitis is an encouraging finding as it has not been reported in other dry eye trials. It was hypothesised that TOSM would benefit ocular surface disorders by improving ocular surface health. In vitro, primary and cell line human corneal epithelial cells were supported by TOSM v1 and TOSM v2. Outgrowth from limbal explants and corneal reepithelialisation following wounding occurred with TOSM v2. This and the impression cytology findings support our hypothesis. Further, ocular surface damage with dry eye and PED may activate the corneal wound healing response. For wound healing, compared to human serum, TOSM v1 and TOSM v2 had beneficial effects in vitro on epithelial cells and human corneal fibroblasts. This may translate into a reduction in potentially vision-threatening corneal scarring in vivo with TOSM. However, ocular surface disorders are a heterogenous group and wound healing is a complex process such that different preparations of TOSM may be needed for use in different disorders and at different stages of the disease process.

D.Phil. / Efficient ocular saccadics with a clear visual memory are essential functions in reading fluently. A child needs to sequence the eyes in a controlled jump called a saccade in order to form a picture in the mind of what is being read. The child is therefore primarily aware of a story rather than individual words. This sequential visual input of the written text contributes to efficient reading skills. The letter sequencing therapy used in this research is designed to improve the ocular saccadics and also to simultaneously develop an efficient visual memory. This improves the reading skills and creates good comprehension. The above exercise program illustrated that visual therapy, in general, done not only as a physical exercise but by improving the visual memory, will integrate very quickly into a child's perceptual development. Visual therapy can therefore improve the learning skills in an effective and efficient manner. The development of learning skills can be expanded to benefit children that have poor reading skills as a result of cultural deprivation. Until recently, due to apartheid and cultural differences at the pre school level disadvantaged children were deprived of the same standard of education as advantaged children. This research compared the average visual skills in reading of educationally advantaged children to educationally disadvantaged children. This illustrated the gap created by apartheid, differences in culture and preschool stimulation in the two levels of education. 167 children with no particular learning or visual problems were randomly selected from a group of pupils at an average middle class educationally advantaged white school and an average middle class disadvantaged black school. 100 of the children came from two standard 2 and two standard 3 classes of the educationally advantaged school while 67 of the children came from one standard 2 and one standard 3 class of the educationally disadvantaged school. All the children were evaluated before the therapy program began with respect to ocular fixations, ocular regressions, reading rate, directional attack, span of recognition and relative efficiency. All the children were given letter sequencing therapy under supervision of the class teacher. Strict controls were applied.

The primary aim of this research is to test the therapeutic potential of certain new generation corticosteroid drugs in order to develop safe and effective treatment for eye diseases that result in oedema, or swelling. The rising incidence of diabetes and the ageing population of developed countries mean that the prevalence of uveitis, diabetic retinopathy and age related macular degeneration will rise. Often, oedema is one of the reasons for vision loss. Corticosteroids are often used to reduce inflammation. Inflammation is one of several sources of oedema. Glucocorticoids, a class of corticosteroids that have anti-inflammatory properties, are thus used to treat ocular oedema. There is an unmet need to support clinical experience of the efficacy of steroids for ocular inflammation and oedema with more substantial scientific evidence. None of the drugs under investigation, with the exceptions of dexamethasone and triamcinolone, have been used for any ocular therapeutic purpose before. This thesis investigates “repurposing” fludrocortisone to the ophthalmic area. 11-Desoxycorticosterone (11D) and Deoxycorticosterone (DCS), other potentially valuable mineralocorticoids, remain completely untested. Lastly, Kenacort ®, or triamcinolone acetonide (TCA), is only used off-label by ophthalmologists. Methods: In the first study, corticosteroids, and especially mineralocorticoids, were investigated for their treatment efficacy in experimental uveitis, or intraocular inflammation (using a model known as endotoxin induced uveitis). In the second study, endothelial cells from choroidal blood vessels in the back of the eye were used in vitro to study whether corticosteroids reduce paracellular (between cells) permeability. Lastly, since endophthalmitis due to frequent injections is a side effect of corticosteroid use, the pharmacokinetics of different size formulations of corticosteroids were studied in an effort to find a formula that would have a prolonged dwell time within the eye.

published_or_final_version / Anatomy / Master / Master of Philosophy

Thesis (Ph. D.)--School of Pharmacy and Dept. of Chemistry. University of Missouri--Kansas City, 2004. / "A dissertation in pharmaceutical sciences and chemistry." Advisor: Ashim K. Mitra. Typescript. Vita. Description based on contents viewed Feb. 23, 2006; title from "catalog record" of the print edition. Includes bibliographical references (leaves 142-169). Online version of the print edition.

M.Cur. / Daar is nie genoeg effektiewe, bekostigbare oogsorgdienste in Suid-Afrika nie. Suid-Afrika beskik oor meer geregistreerde verpleegkundiges as algemene praktisyns, oftalmoloe of optometriste. Daar bestaan reeds 'n goedgekeurde kursus in oftalmologiese verpleging en daarom is geregistreerde verpleegkundiges die mees geskikte vir opleiding in oftalmologie. Dit sal meer kosteeffektief wees om 'n verpleegkundige in primere oogsorg aan te wend. Tans is daar 'n groot aanvraag vir oogsorg op primere vlak. In Suid-Afrika, wat gedeeltelik 'n derdewereldland en gedeeltelik 'n eerstewereldland is, is primere oogsorg nog heeltemal ontoereikend, aangesien die meeste van die oogsorgdienste in die hoofstede gesentreer is. Dit veroorsaak dat die oftalmologiese departemente heeltemal oorlaai word deur oogtoestande wat op primere vlak gehanteer kan word. Navorsing het getoon dat 85% van pasiente wel op primere of sekondere vlak gehanteer kan word (Community Eye Health Workshop, 1996). Die persentasie mense met belemmerde visie (tydelik of permanent) word jaarliks meer, en die beste manier om dit te verhoed is die vroegtydige opsporing van daardie pasiente op primere vlak. In Suid-Afrika word die dienste van oftalmologiese verpleegkundiges nog nie ten voile benut nie, terwyl hulle, as gevolg van hul opleiding, 'n groot rol behoort te speel in die voorkoming van belemmerde visie. Dit geld veral op plattelandse gebiede, waar die oftalmologiese verpleegkundige die eerste kontakpersoon is. In stedelike gebiede, waar daar lang waglyste is by openbare gesondheidsorghospitale, behoort die oftalmologiese verpleegkundige ook aangewend te word om waglyste te verkort. Die vraag ontstaan dus: Wat is die rol van die oftalmologiese verpleegkundige in primere oogsorg?