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Punctal plugs for dry eye syndrome

Dry eye syndrome, which affects 10% to 20% of adults, is a disorder of the eye's tear film and is associated with symptoms such as burning, foreign body sensation, and fluctuating vision. Punctal plugs are inserted into a small opening in the upper and/or lower eyelid. Seven randomized controlled trials (with a total of 305 participants and 601 eyes) were identified. These trials compared silicone and/or collagen punctal plugs to each other, no treatment, acrylic punctal plugs, or oral pilocarpine (a drug used to increase tear production). Punctal plugs provided symptomatic improvement and clinical outcomes also improved from baseline measurements. Adverse outcomes included epiphora (overflow of tears), foreign body sensation, eye irritation, and spontaneous plug loss. Although individual trials reported improvements among participants assigned to punctal plugs, these trials were too diverse to summarize the effects across all studies.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Efficacy of over the counter (OTC) artificial tears for dry eye syndrome

Dry eye syndrome is a long‐term condition that is known to cause eye discomfort and visual disturbances like blurred vision. This condition affects millions of people around the world, and the first‐line treatment for dry eye is typically over the counter (OTC) artificial tears. OTC artificial tears are meant to replace or supplement the tears (fluid) that naturally cover the eye’s front surface (cornea and conjunctiva). There are a great number of commercially available artificial tears, yet there is currently no agreement about whether one formulation works better than another at treating dry eye. Our review attempts to bridge this knowledge gap.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Eyedrops made from autologous serum as a treatment for dry eye

We conducted a wide range of searches for relevant trials in April 2013. We identified four randomized controlled trials with a total of 72 participants with dry eye from Chile, Australia and Japan. The trials compared autologous serum eye drops to traditional artificial tears for the treatment of dry eye. The results from the four trials could not be combined in analysis due to the variation in participant populations, follow‐up intervals, and incomplete reporting of treatment outcomes. None of the included trials reported outcomes for the primary outcome of this review, the change in participant‐reported symptoms after one month of treatment. Some improvements in participant‐reported outcomes and tear film stability were seen in two trials after two weeks, but not in the other two trials or at longer follow‐up periods. Autologous serum eye drops did not provide a benefit based on other clinical assessments of the surface of the eye compared to traditional artificial tears. Outcomes for quality or life and costs were not reported in any of the trials. One study reported that no serious harms were related to using autologous serum eye drops while the other studies did not discuss whether any adverse events occurred. Overall the results from these studies do not provide consistent information as to whether autologous serum eye drops are safe and effective for the treatment of dry eye. Future trials are needed using appropriate study designs to address participant‐centered outcomes, to determine the effects of autologous serum eye drops in the treatment of dry eye.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Tissue graft surgery to treat a wing‐shaped growth (pterygium) in the eye

We reviewed the evidence to see which surgery used to treat pterygium (a growth in the eye) is better and safer? We wanted to known which surgery was better at preventing the pterygium from growing back.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Conjunctivitis: Overview

Typical symptoms of conjunctivitis include sticky eyelids in the morning, and itchy and burning eyes. This infection is usually harmless, but it is contagious and can be quite persistent, depending on the cause. Here you can read about effective treatments and how to prevent infection.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: May 20, 2015

Treatment options for glaucoma

Glaucoma can be treated with medication (eye drops), laser therapy or surgery. The aim of treatment is to lower intraocular pressure, thereby reducing the risk of impaired vision or blindness.The term "glaucoma" is used to describe a number of different eye conditions, all of which involve damage to the optic nerve. This leads to ever larger gaps in the field of vision. The field of vision is the area you can see without moving your eyes. In advanced stages, your ability to see things sharply (visual acuity) also gets worse. One common cause is too much pressure inside the eye. This pressure is called intraocular pressure.Lowering high intraocular pressure can help to delay or stop the gradual loss of vision. Glaucoma cannot be cured, though, because existing damage to the optic nerve cannot be reversed.The following information covers the treatment options for the most common form of glaucoma, primary open-angle glaucoma (POAG).

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: May 3, 2016

Assistive technology for rheumatoid arthritis

This summary of a Cochrane review presents what we know from research about the effect of assistive technology in people with rheumatoid arthritis. Unfortunately, only one trial met the inclusion criteria for the review. The study deals with assistive technology used to administer eye drops. This is not a commonly used device.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Age-related macular degeneration (AMD): Overview

It is normal for vision to gradually worsen with age. Some people also have medical conditions that further affect their vision. One possible cause of worsening vision is age-related macular degeneration (AMD). Central vision loss makes objects appear blurry and distorted when you look at them directly. This is the type of vision we need to read, drive a car or recognize faces.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: July 29, 2015

Age-related macular degeneration (AMD): Drug therapy for wet AMD

Unlike the dry type of age-related macular degeneration (AMD), wet AMD can be effectively treated using medication. There are a number of different drugs that can help to improve vision at least temporarily or to keep it from worsening for a longer time.In wet AMD new blood vessels grow underneath the retina and into it, lifting it up. These vessels may leak blood and other fluid into the retina, damaging the part of the eye we use for our central vision.Three medications known as anti-vascular endothelial growth factor (anti-VEGF) drugs have been approved for the treatment of wet AMD:Ranibizumab (trade name: Lucentis)Aflibercept (trade name: Eylea)Pegaptanib (trade name: Macugen)Pegaptanib is hardly ever used anymore because it is less effective than the other drugs. In Germany, for example, it is no longer available.The drug bevacizumab (Avastin) is also an option, although it is approved for cancer therapies, and not the treatment of AMD. It can be prescribed off-label by a doctor (see final section below).All four medications work on a similar principle: They block specific growth factors that are responsible for the growth of abnormal blood vessels into the eye. Drug therapy aims to slow down the progression of AMD or to at least temporarily stop it.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: July 29, 2015

Aflibercept for neovascular age‐related macular degeneration

One cause of loss of sight in the center of the eye is a disease called age‐related macular degeneration (AMD). AMD causes blindness in many older people in developed countries. Around the world, nearly 9% (one in 11) of people 45 to 85 years of age are estimated to have AMD. About 10% of people with AMD develop a type of AMD called neovascular (wet) AMD, which results from new blood vessels that develop in an inner layer of the eye called the choroid. If a patient with this type of AMD is not treated, the affected eye may lose sight and may develop other problems related to blindness.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Fever in children: Overview

Nearly all parents will know what it is like to feel concerned when their child has a hot, red face and high temperature. Although most fevers in children are caused by harmless viral infections, it is still important for parents to know how to recognize the signs of a serious illness, and when to see a doctor.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: December 18, 2013

Late Effects of Treatment for Childhood Cancer (PDQ®): Patient Version

Expert-reviewed information summary about the health problems that continue or appear after cancer treatment has ended.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: May 26, 2016

Shingles: Overview

Anyone who has already had chicken pox could develop shingles later on in life. Both are caused by the same virus. A weakened immune system, possibly as a result of a cold, or extreme stress can lead to increased susceptibility to this often very painful rash. It usually takes a total of two to four weeks to clear up completely.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: November 19, 2014

Langerhans Cell Histiocytosis Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of childhood Langerhans Cell Histiocytosis.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: April 6, 2016

Testing Treatments: Better Research for Better Healthcare. 2nd edition

How do we know whether a particular treatment really works? How reliable is the evidence? And how do we ensure that research into medical treatments best meets the needs of patients? These are just a few of the questions addressed in a lively and informative way in Testing Treatments. Brimming with vivid examples, Testing Treatments will inspire both patients and professionals.

Pinter & Martin.

Version: 2011

Aflibercept (Eylea) for age-related macular degeneration: Overview

The drug aflibercept (trade name: Eylea) has been approved in Germany since November 2012 for the treatment of neovascular (wet) age-related macular degeneration (AMD) in adults.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: July 18, 2013

Obstructive sleep apnea: Overview

Obstructive sleep apnea (OSA) might be the cause if you feel absolutely beat in the morning despite getting enough sleep. Most people with sleep apnea snore and have breathing pauses at night that often go unnoticed. This can cause problems in your daily routine and increase your risk of developing other conditions.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: July 30, 2015

Sleep Disorders (PDQ®): Patient Version

Expert-reviewed information summary about causes and management of sleep disorders in people with cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: January 27, 2016

Nasopharyngeal Cancer Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of nasopharyngeal cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: May 6, 2016

Obstructive sleep apnea: CPAP breathing therapy: How to deal with common problems

CPAP therapy can improve breathing at night and significantly relieve symptoms of obstructive sleep apnea. However, wearing a sleeping mask at night takes some getting used to and may require support.CPAP stands for “continuous positive airway pressure.” In this form of treatment, people with obstructive sleep apnea wear a mask while they sleep that covers only their nose or their mouth and nose. The mask is connected to a respirator through a tube. This respirator blows compressed air into the airways. The incoming air keeps the airways open, preventing breathing pauses.Therapy with the breathing mask takes some getting used to, but most people can already handle their CPAP machine quite well after one or two nights. Others have problems and stop using the machine. This information offers some practical tips for dealing with common problems.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: July 15, 2015

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