Dr Vincent Lee
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Angle closure can be missed by Van Herick technique

19/11/2018

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While simple to perform and generally fairly accurate, a recent study has shown that the Van Herick technique for estimating anterior chamber angle depth can be unreliable in some circumstances.

This applies to males and myopes (people with short sight). The other risk factors are when this technique is performed on individuals of Asian and black race.

​Click the button to read an abstract of the study:
Missed diagnosis with Van Herick technique
As such, it is recommended that when examining people in this demographic, a more reliable test is gonioscopy, especially when performed in a dark room.
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One system of grading the anterior chamber angle depth is the Shaffer grading system, as depicted below:
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​

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Zovirax eye ointment discontinued

2/11/2018

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Zovirax® (aciclovir) 3% eye ointment will be discontinued and deleted from the market in February 2019 after GSK ceased manufacturing in the 3rd quarter of 2018.
 
When existing supplies of Zovirax® (aciclovir) 3% eye ointment are exhausted the following options may be considered: 
  1. Alternate brand aciclovir 3% eye ointment. AciVision® has been temporarily approved for supply under Section 19A of the Therapeutic Goods Act 1989 (exemption in the event of shortage or product unavailability) until 31 August 2019. This means that SAS approval is currently not required to supply this product, and it is now available in the community. AciVision® is not a TGA registered product and currently not subsidised on the Pharmaceutical Benefits Scheme (PBS). It will be necessary to check with individual pharmacies for availability and cost. (*see footnote below)
  2. Oral valaciclovir 500mg bd or tds orally, combined with epithelial debridement, and chloramphenicol ointment. Dose reduction to 500mg daily is recommended in patients with renal impairment where creatinine clearance is less than 15mL/min. Note that Valaciclovir is not listed in the PBS for HSV keratitis. Oral aciclovir is recommended in paediatric patients.
  3. Ganciclovir 0.15% (Virgan®) gel, three times per day. Virgan gel requires SAS Category B approval

*Please note that I have made arrangements for the Pharmacy Departments at St John of God Hospital and South West Health Care to ensure they carry stocks of AciVision® for prescribers in Warrnambool. Patients will simply need to present their prescriptions to access the drug. I will be speaking to Pharmacy Departments in Colac and Hamilton soon to ensure this brand of aciclovir is made available. If prescribers have difficulty accessing this drug for their patients, please contact me directly - Dr Vincent Lee.

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    ​Ophthalmologist

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  • Home
  • Services
    • Vision Correction Solutions >
      • Over 40s Vision Correction
      • Refractive Lens Exchange
      • Intraocular Collamer Lens ICL/ Phakic IOL
      • Multifocal and Toric Intraocular Lenses
      • ASLA/ PRK
      • LASIK
    • Cataracts >
      • Cataract Surgery
    • Glaucoma
    • Laser Floater Treatment
    • Dry Eye Laboratory
    • Macular Degeneration >
      • 2RT - Retinal Rejuvenation Therapy
    • Diabetes
    • Retinal Vein Occlusion
    • Oculoplastic Surgery
  • Information
    • Your visit to the clinic
    • Structure of the Eye
    • Eye Conditions
    • Self Help
    • Procedures
    • Postoperative Instructions
    • Collaborative Care
  • About
    • Technology
  • News
  • Contact
    • Ask a question
  • Referrals