Page 26 - The Indian Optician Digital Edition September-October 2022

THYROID EYE the type 2 diabetes group (58.8% vs. 54.9%; P = .007).

DISEASE SEVERE “Knowing that thyroid eye disease patients with diabetes may
IN DIABETIC be at an increased risk for optic nerve injury is important and may
warrant closer monitoring and earlier referral to a thyroid eye disease
PATIENTS specialist,” Padnick-Silver said. “Further, the finding that proptosis
may be less common and muscle involvement more common
indicates that patients with diabetes and Graves’ disease may
require special attention and monitoring for visual and ocular muscle
People who have thyroid eye
disease as well as diabetes are abnormalities characteristic of thyroid eye disease, particularly eye
at a greater risk for developing misalignment and double vision,” he stated.
diplopia, strabismus and sight-
threatening disease as compared
to those without diabetes. HEAT WARMERS CAN
According to Lissa Padnick- REDUCE LENS FOGGING
Silver, PhD, senior manager of
medical affairs, publications New research indicates that lens warmers can possibly reduce
and data management for lens fogging from mask wear during slit lamp examinations.
Horizon Therapeutics, their study
provided evidence that thyroid Ever since the start of the pandemic, retinal exams have become
eye disease is more severe in ever more difficult – the mandatory wearing of masks has led to
patients with diabetes. “More increased lens fogging at the slit lamp during retinal exams as room-
frequent severity manifested in temperature lenses often accumulate condensation in mask-wearing
higher rates of optic neuropathy, patients. However, according to a study published in Optometry and
perhaps because of greater Vision Science, lens warmers may be able to reduce lens fogging and,
optic nerve vulnerability in turn, remove the would-be disturbances during the exam.
stemming from diabetes-related The lens warming technology to reduce fogging has been used by
vasculopathies,” she said. professional photographers since many decades, according to lead

The study findings published researcher Marta C. Fabrykowski, OD, of the Manhattan Eye, Ear and
in Endocrine Practice, also Throat Hospital ophthalmology department.
reveals that thyroid eye disease As part of the study, Dr Marta and her team evaluated the degree
patients with diabetes were of lens fogging in mask-wearing patients using ImageJ to measure
noted to have less proptosis lens surface areas fogged in slit lamp photos of 90D lenses pre-and
and more extraocular muscle post the use of a lens warmer. They also conducted a survey asking
involvement than patients eye care providers to rate their experience with diagnostic lens
without diabetes. fogging during retinal exams in mask-wearing patients with and
The study results showed that without lens warmers.
out of the study cohort, 13.5% had According to the results, the lens warmers proved to be highly
at least one thyroid eye disease- effective. For subjects who wore masks, the percent of the fogged
related surgery. Patients without lens area in the 90D lens was roughly 33% with unheated lenses
diabetes had a higher surgical compared to about 1% when a heated lens was used. The survey
rate compared with those with participants also noted less fogging of the 78D and 90D lenses when
type 2 diabetes (14% vs. 12.3%; P < using the lens warmer and said that this addition helped simplify the
.001). Additionally type 2 diabetic retinal exam.
patients also had a higher rate
of full-thickness keratoplasty in However, some of the survey respondents opined that while
comparison to those without heating the lens improved their retinal exam, the heating platform
diabetes (1.9% vs. 0.7%; P < .001), could be more user-friendly.
whereas eyelid surgery rates Another possible improvement is to develop a lens case with
were higher among those a built-in warmer and temperature gauge, said one of the study
without diabetes compared with team members.

22 | THE INDIAN OPTICIAN | SEPT-OCT 2022 OPHTHALMIC NEWS