EyeWorld Today is the official daily of the ASCRS Symposium & Congress. Each issue provides comprehensive coverage editorial coverage of meeting presentations, events, and breaking news
Issue link: https://daily.eyeworld.org/i/124056
4 Monday, April 22, 2013 EW SHOW DAILY ASCRS News Today Shuttle routes 2013 Official Hotel Shuttle Routes Routes Hotels Pickup Location 1-RED *PARK 55 WYNDHAM Hotel Nikko *HILTON SAN FRANCISCO Serrano Hotel Hotel Monaco Travel Time to Convention Center: 12 minutes *HOTEL TRITON ON SUTTER *GRAND HYATT Marriott Union Square Travel Time to Convention Center: 12 minutes AT CORNER OF GRANT LOBBY ENTRANCE At Grand Hyatt Hotel 3-BLUE *CLIFT HOTEL TAYLOR STREET *WESTIN ST FRANCIS Sir Francis Drake Larkspur JW Marriott Villa Florence Handlery Hotel Prescott Hotel *PALACE HOTEL Travel Time to Convention Center: 15 minutes AT GEARY POST STREET ENTRANCE At Westin St. Francis At Westin St. Francis At Westin St. Francis At Westin St. Francis At Westin St. Francis At Westin St. Francis LOBBY ENTRANCE 4-GREEN ON MISSION, WEST OF 8TH LOBBY ENTRANCE At Stanford Court ACROSS STOCKTON ON CALIFORNIA ACROSS CALIFORNIA AT MONTGOMERY by Vanessa Caceres EyeWorld Contributing Writer CURBSIDE LOBBY ENTRANCE At Park 55 TAYLOR STREET ENTRANCE At Hilton At Hilton 2-YELLOW Discerning TASS from endophthlamitis *HOLIDAY INN CIVIC CENTER *STANFORD COURT RENAISSANCE Fairmont San Francisco *RITZ CARLTON SAN FRANCISCO *OMNI HOTEL SAN FRANCISCO Travel Time to Convention Center: 15 minutes Hotels in walking distance of Convention Center Courtyard Downtown San Francisco Marriott Hotel Palomar St Regis Hotel Four Seasons W San Francisco Hotel Intercontinental *Denotes official shuttle stop. Also serves as pickup location for other hotels listed, as indicated. Francis S. Mah, MD, highlights the difference between TASS and endophthalmitis symptoms at the Technicians and Nurses Program. T he presentation of toxic anterior segment syndrome (TASS) and endophthalmitis can look quite similar— but that's where their similarities end, said Francis S. Mah, MD, Scripps Health, La Jolla, Calif., speaking at the Technicians and Nurses Program. TASS is acute anterior segment inflammation with no infection involved, in contrast with endophthalmitis. TASS can present 12 to 48 hours after cataract surgery, and endophthalmitis usually presents as many as four to seven days postoperatively. Symptoms of TASS are signs in the anterior segment, a high IOP, severe corneal edema, and lack of vitreous inflammation, Dr. Mah said. In contrast, endophthalmitis usually involves the posterior segment and has prominent vitreous inflammation. If there is corneal edema, it is usually not severe. The number one symptom of endophthalmitis is poor vision, followed by pain and redness, he said. The incidence of endophthlamitis is anywhere between 0.7% and 0.12%, he said. Endophthalmitis can sometimes occur as an epidemic with contaminated solution. Other risk factors include a ruptured posterior capsule, wound dehiscence, a breakdown in sterile technique, and complex cataract surgery. Older patients, diabetics, and patients from nursing homes are at a greater risk for endophthlamitis, Dr. Mah said. The use of povidone-iodine, already common in cataract surgery, helps to reduce endophthalmitis risk, although surgeons and technicians need to thoroughly irrigate it out of the eye to prevent infection risk. Practices also can use topical, systemic, subconjunctival, and intracameral antibiotics to lower the risk for endophthalmitis. Although studies show that intracameral antibiotics are the most effective way to lower the risk for endophthalmitis, that approach is not commonly used in the U.S. as there are no injectables currently approved by the U.S. Food and Drug Administration, Dr. Mah said. TASS has a low but growing incidence in ophthalmic practices, ranging from 0.1% to 2%, Dr. Mah said. TASS typically occurs in clusters. Causes include problems traced back to intraocular irrigating solutions, endotoxin contamination of balanced salt solution, preservatives in ophthalmic solutions, intraocular medications, and steam sterilizer contamination issues. The typical treatment for TASS patients is intense topical corticosteroids, which can offer improvement as quickly as within a few hours of treatment. "If not, then you need to look at infection as a possibility," Dr. Mah said. TASS will usually clear in three to six weeks with treatment. Glaucoma is the worst outcome with TASS—severe cases can have permanent damage. EW Editors' note: Dr. Mah has no financial interests related to his comments.