Etty Bitton

Université de Montréal | UdeM · School of Optometry

Blepharitis is defined as inflammation of the eyelids, classified according to anatomical location: anterior (eyelid skin, base of the lashes including the eyelash follicle) or posterior (meibomian glands) blepharitis. Although blepharitis is one of the most common ocular disorders, epidemiological data on the condition is lacking, making prevalenc...

Objective Demodex folliculorum blepharitis is typically confirmed with lash epilation and microscopic identification of mites. However, mite counts may vary with the epilation technique. As there is no gold standard to epilating lashes for the purposes of mite counts, the aim of this study was to compare three epilation techniques. Method A prospe...

The word "elective" refers to medications and procedures undertaken by choice or with a lower grade of prioritization. Patients usually use elective medications or undergo elective procedures to treat pathologic conditions or for cosmetic enhancement, impacting their lifestyle positively and, thus, improving their quality of life. However, those in...

Purpose To evaluate the short-term tolerability of five commercially available anti-demodectic eyelid cleansers; OCuSOFT Oust Demodex (OD), I-MED I-Lid’n Lash Plus (ILL+), Labtician BlephaDex (BD), Chrissanthe Eye Cleanse (EC), and Théa Blephademodex (BDdx). Methods Thirty healthy non-contact lens wearers (18 female; mean ± SD age, 33 ± 12 years)...

Demodex is the most common parasite living on humans and yet little is understood about its pathogenicity with respect to the ocular surface. An increasing interest in Demodex over the past 20 years has increased our understanding of this mite and its pathogenetic role. This article begins with a review of the anatomy, life cycle, mode of transmiss...

Purpose: To evaluate facial Demodex densities in participants with varying severities of blepharitis secondary to Demodex folliculorum assessed by the highest number of cylindrical dandruff on one lid. Methods: This double masked cross-sectional study included 58 participants [19 control, 21 mild/moderate and 18 severe Demodex blepharitis] who u...

Vision impairments are prevalent, but underdiagnosed in individuals with dementia living in long term care (LTC). Effective screening tools could identify remediable vision problems. This scoping review was conducted to identify vision screening tests used with individuals with dementia and assess their suitability for administration by nurses in L...

En 2014, le Groupe de consensus canadien sur la sécheresse oculaire a publié un document intitulé Dépistage, diagnostic et prise en charge de la sécher-esse oculaire : guide pratique à l’intention des optométristes canadiens. Ce guide pratique ne traitait pas des répercussions de la sécheresse oculaire chez les personnes en voie de subir une interv...

A brief description and overview of trehalose, a natural ocurring ingredient now available in artificial tears.

The primary role of eyelashes is to protect and maintain the health of the lid margin. However, the mechanisms to fulfill this role are not fully understood. Unraveling these mechanisms will stand to greatly improve the efficiency of eye care professionals' interventions in anomalies of the eyelashes. The aim of this article is to provide a review...

In 2014, the Canadian Dry Eye Disease Consensus Panel published Guidelines for screening, diagnosis and management of dry eye diseases (DED). These did not address the implications of DED for individuals who are being considered for or have recently undergone ocular surgery. DED is common in certain surgical cohorts, and the perisurgical setting po...

Background: Refrigerated eye-drops have been advocated in cases of ocular allergies to provide a soothing effect upon instillation. This notion continues to be promoted by practitioners for artificial tears (AT) in the management of dry eye (DE) with little support in the literature. To further substantiate claims of a soothing effect of cold eye-...

PURPOSE. This case report highlights how epithelial basement membrane dystrophy (EBMD), coupled with dry eye, can contribute to symptoms of unstable vision and discomfort. This report also reviews corneal dystrophies and offers eye care practitioners (ECPs) clinical pearls for identifying key features. CASE REPORT. A 62-year-old Caucasian female pr...

Purpose: To quantify the discomfort over time of various eyelid cleansers against Demodex. Methods: This was a prospective, randomized, controlled, crossover, open-label study that enrolled 26 participants. The cleansers used in this study were Biotissue Cliradex (CD), OCuSOFT Lid Scrubs Plus (OP), OCuSOFT OUST Demodex Swabstix (ODS), TheraTears...

Purpose: The aim of this study was to evaluate the osmolality of commercially available ocular tear lubricants. Methods: Thirty-seven (n = 37) ocular lubricants, measured three times each, were evaluated for osmolality using a vapor pressure osmometer (Wescor VAPRO 5520). The osmometer was calibrated before each use, and the order of the lubrica...

Purpose: LATISSE is marketed for the treatment of hypotrichosis (loss of eyelashes), using a prostamide analogue and preserved with benzalkonium chloride, which is an effective preservative; however, it also causes irritation to the ocular surface. LATISSE is applied to the lid margin; however, with the blink, some solution may fall onto the ocula...

A clinical roundtable on women and dry eye

Purpose: Meibomian gland dysfunction (MGD) is one of the most common causes of evaporative dry eye. Warm compresses (WC) are recommended as adjunct therapy to slowly transfer heat to the meibomian glands to melt or soften the stagnant meibum with targeted temperatures of 40-45°C. This clinical study evaluated the heat retention profiles of commerc...

A summary of Demodex and its clinical implications on the eye

This is a summary of the canadian optometric guidelines for the diagnosis and management of eye dryness.

Supernumerary punctum is an under-reported congenital anomaly, in which there is more than one lacrimal punctum. Although usually asymptomatic, supernumerary puncta have been reported to cause dry eye or epiphora (excessive tearing) and should be included in their differential diagnosis. Tearing is often associated with dry eyes and can lead to dis...

Meibomian gland dysfunction (MGD) appears to be the most common cause of evaporative dry eye, in which the meibum has an altered chemical structure that increases its melting point. Eyelid warming masks slowly transfer heat, preferably between 40 and 45°C to the inner meibomian glands, in an attempt to melt or soften the stagnant meibum. This ex vi...

Case report of how a daily disposable contact lens with enhanced lubricity features can assist in the management of superior limbus keratitis (SLK)

Poster presenting a differential diagnosis of anterior blepharitis including staphlococcal versus Demodex induced blepharitis

Heat retention comparison of eyelid warming masks in a lab setting

Demographics of a dry eye clinic

Case reports on Conjunctivochalasis and dry eye

The Schirmer test (ST) evaluates the volume of tears in potential dry eye candidates via a strip placed in the lower tear lake. Previously reported inconsistencies in the results may be in part due to the lack of standardization as to the methodology, e.g. the eye position during the test. The purpose of this study was to evaluate the effect of eye...

The impact that Demodex mite infestation of the eyelashes has on ocular dryness symptoms has been a topic of much recent discussion. While little is known about the link of such infestation with contact lens discomfort (CLD), this will certainly play a role in some patients who report CLD given the high prevalence of Demodex in the population. This...

Exploring the effects of inferior gaze on the schirmer tear test and the cotton thread test

Poster

The presence of a hypopyon and posterior segment involvement are uncommon clinical findings in HLA-B27-associated uveitis. Furthermore, first-time attacks rarely occur in the elderly. This report highlights an atypical uveitis case involving an older patient, an evident hypopyon and severe intermediate uveitis in one eye. The 60-year-old Caucasian...

La présence d’un hypopyon et l’atteinte du segment postérieur sont des signes cliniques peu fréquents dans les cas d’uvéite associée à l’antigène HLA-B27. De plus, les premières attaques sont rares chez les personnes âgées. Ce rapport décrit un cas atypique d’uvéite chez une personne âgée qui s’est présentée à la fois avec un hypopyon visible et un...

Novel technique for human tear analysis

Downloadable compliance tool to assist with contact lens wearers

Similarities in packaging, bottle size and cap design of nail glue with ophthalmic products has led to patient confusion and inadvertent use of nail glue causing ocular trauma both in the adult and pediatric population. Despite efforts and pressures from several reports, little has been achieved with respect to unregulated health and beauty product...

Tear meniscus height (TMH) is an indirect measurement of tear film volume. This study investigated the temporal changes in the TMH during the blink interval in the morning (8-9 am) and at the end of the day (5-6 pm) in both soft contact lens (CL) and nonlens wearers (NLW). Fifty participants (25 CL; 25 NLW) were evaluated for their subjective sympt...

The role of mentorship in clinical optometry

Purpose: The objective of this study was to investigate the level of student indebtedness amongst the graduates from the two Canadian optometry schools (Montreal and Waterloo). A secondary objective was to investigate the financial impact of the clinical externship program on the overall student debt. Methods: The 2007 graduating class was surveyed...

To date, few studies have correlated the overnight effects of the preocular tear film (POTF) with subjective symptoms. This study investigates the POTF volume and stability, bulbar hyperemia (BH), tear ferning (TF) and the participant's subjective symptoms, pre- and post-sleep. Thirty subjects were recruited, consisting of two evenly distributed gr...

Corneal dystrophies are relatively rare bilateral anomalies. Meesman dystrophy is typically asymptomatic with little effect on visual performance. This case highlights the use of a high modulus silicone hydrogel (SiHy) lens in the management of an atypical presentation of Meesman's dystrophy with associated visual impairment due to epithelial defec...

Tear meniscus height (TMH) is an established parameter indicative of tear film volume and has recently been determined using an optical coherence tomographer (OCT). The purpose of this study was to evaluate the inter and intra observer variability in TMH assessment using OCT. Ten subjects (6 M, 4 F; aged 32.5 +/- 6.4 years) had 10 consecutive scans...

A summary of the tear ferning technique and its clinical implications

Poster

Poster

Poster

Poster presented at the American Academy of Optometry annual meeting

Anterior polar cataracts (APC) are a relatively rare but well-documented form of congenital cataract. Occasionally, these white disc-shaped opacities protrude towards the anterior chamber with an inverse cone-like morphology and are known as anterior pyramidal cataracts. These represent three to four per cent of all types of congenital cataracts. A...

Poster

Poster

DPA/TPA utilization and types of ocular anomalies were tracked and compared with internal clinical experiences. A yearly breakdown revealed a dramatic increase in the students’ clinical exposure to ocular disease and DPA/TPA use.

The precorneal tear film is a complex structure that has attracted much attention over the years, especially in relation to dry eyes and contact lens (CL) wear. A healthy and stable tear film is essential for comfortable vision and successful CL wear.1 With an estimated 40% of the North American population suffering from dry eyes2 and some 60 milli...

Poster

The attrition of nerve fibers in the peripapillary area and the optic nerve head (ONH) in glaucoma has been attributed to mechanical compression of, or aberrant blood flow to the ganglion cell axons comprising the optic nerve ¹ . Recently, greater attention has been focussed on the vascular factors in glaucoma ² . Much of the delay in understanding...

Poster

Tilted disc syndrome is a form of coloboma characterized by situs inversus, inferonasal tilting of the optic disc, inferonasal crescent (Fuch's coloboma), and/or inferonasal fundus ectasia with an associated hypoplasia of the retinal pigment epithelium and choroid. The anomaly is an important clinical entity owing to the myopic oblique astigmatism...