The impact of cataract surgery on cognitive function in an aging population.

PURPOSE OF REVIEW: To review the relationship between cognitive function and cataract surgery, as it is rarely addressed, and yet is becoming increasingly important as the number of elderly people in the world continues to rise. RECENT FINDINGS: From US Census and international data, it is expected that the predicted proportion of people over 65 years of age in a number of countries will increase drastically over a half century. Therefore, the percentage of patients with cataracts and cognitive impairment, which are both age-related diseases, will be expected to rise as well. Although there are many papers reporting on the association between visual impairments and cognitive impairments, there is a relative dearth of research supporting the hypothesis that cataract surgery can improve cognitive function in patients with cognitive impairment. This reflects some inherent problems with most cognitive tests, which include both vision-dependent and vision-independent items. There may also be an element of learning from repeated cognitive tests, which may falsely elevate test scores. SUMMARY: There is an increase in reports supporting the hypothesis that cataract surgery can improve cognition; however, there is still insufficient evidence for cognitive improvement after cataract surgery. As this is a growing area of research, we expect more studies to shed light on this relationship.

Mechanisms and management of dry eye in cataract surgery patients.

PURPOSE OF REVIEW: To provide a summary of the mechanisms that may cause dry eye after cataract surgery and discuss available and upcoming treatment modalities. RECENT FINDINGS: Development or worsening of dry eye symptoms after cataract surgery is multifactorial with corneal nerve transection, inflammation, goblet cell loss, and meibomian gland dysfunction commonly cited as underlying disorders. With increasing awareness of the prevalence of dry eye disease, current surgical techniques are being analyzed for their contribution to the issue. Although many classic interventions, such as artificial tears and anti-inflammatory drops, remain first-line treatment options, they may not adequately address abnormalities of the tear film. The trend has been to create new drugs and technologies that target meibomian gland deficiencies and restore goblet cell numbers. SUMMARY: Therapy for postoperative dry eye symptoms should be determined based on symptom severity and which underlying cause is most prominent at a given time. Patients with high-level risk factors for dry eye should be evaluated preoperatively to determine whether they have preexisting dry eye disease or if they are susceptible to developing disease after surgery.

Preliminary study on the relationship between visitation in the emergency department and posttraumatic mental health.

This study documented family/friend support to patients in the Emergency Department (ED), including bedside visits and transportation of patients from the ED after discharge, and measured depression, anxiety, and stress symptoms within 2 weeks, 1 month and 3 months after motor vehicle accidents. Stress and depression symptoms significantly decreased during the initial three months. Family/friend visitation in the ED was negatively associated with anxiety and depression symptoms within 2 weeks and with stress symptoms months after trauma. This pilot study suggests family/friend visitation in the ED is associated with fewer mental health issues in the months following an accident.