Cochrane Eyes and Vision (CEV) is a collaboration of researchers and healthcare professionals who prepare systematic reviews to study interventions pertaining to the treatment of eye disease and visual impairment. Though many of the systematic reviews focus on common eye diseases, reviews have been prepared for varied eye topics, including screening prevention and rarer eye diseases.
CEV was registered as a Cochrane group in 1997, and has an editorial base at the Centre for Public Health at Queen's University Belfast which is funded by the HSC Research and Development (R&D) Division of the Public Health Agency in Northern Ireland. The co-ordinating editors of CEV are Jennifer Evans, John Lawrenson and Gianni Virgili. [1]
In 2019 Eye began to feature Cochrane Eye and Vision reviews intending to achieve wider readership. [2]
In 2002, a CEV satellite branch was created in the United States, at the Johns Hopkins Bloomberg School of Public Health. The satellite branch was led by Professor Kay Dickersin until 2018 when Dr Tianjing Li took over. The United States satellite branch is now located at University of Colorado Anschutz Medical Campus, funded by the National Eye Institute. [3] In 2011, a satellite branch was set up in Italy at the University of Florence to focus on diagnostic test accuracy (DTA) reviews and this is led by Professor Gianni Virgili.
Since 2016, CEV had a partnership with the American Academy of Ophthalmology to update their preferred practice pattern (PPP) guidelines. [4] CEV has also had a partnership with the American Glaucoma Society [5] to collaborate in research. Additionally, CEV works closely with the Wilmer Eye Institute of Johns Hopkins Hospital and the Byers Eye Institute of the Stanford University School of Medicine, as CEV Centers for Evidence-based Vision Care. [6]
CEV has conducted over 190 systematic reviews in the field of ophthalmology. The most common topics reviewed include trials studying conditions such as glaucoma, macular degeneration, and cataract. Ophthalmic treatments investigated by CEV systematic reviews include patching for corneal abrasion, [7] eyesight screening for visual impairment in the elderly, [8] vitamin supplements for cataracts, [9] NSAIDS for macular edema, [10] antimetabolites for trabeculectomy, [11] and antiviral agents for herpes simplex virus. [12]
The organisation has previously had funding from The Guide Dogs for the Blind Association, Macular Society, National Institute for Health Research (NIHR) and Sightsavers. [3]
Diabetic retinopathy, is a medical condition in which damage occurs to the retina due to diabetes. It is a leading cause of blindness in developed countries.
Glaucoma is a group of eye diseases that lead to damage of the optic nerve, which transmits visual information from the eye to the brain. Glaucoma may cause vision loss if left untreated. It has been called the "silent thief of sight" because the loss of vision usually occurs slowly over a long period of time. A major risk factor for glaucoma is increased pressure within the eye, known as intraocular pressure (IOP). It is associated with old age, a family history of glaucoma, and certain medical conditions or medications. The word glaucoma comes from the Ancient Greek word γλαυκός, meaning 'gleaming, blue-green, gray'.
Macular edema occurs when fluid and protein deposits collect on or under the macula of the eye and causes it to thicken and swell (edema). The swelling may distort a person's central vision, because the macula holds tightly packed cones that provide sharp, clear, central vision to enable a person to see detail, form, and color that is directly in the centre of the field of view.
Strabismus is a vision disorder in which the eyes do not properly align with each other when looking at an object. The eye that is pointed at an object can alternate. The condition may be present occasionally or constantly. If present during a large part of childhood, it may result in amblyopia, or lazy eyes, and loss of depth perception. If onset is during adulthood, it is more likely to result in double vision.
Phacoemulsification is a cataract surgery method in which the internal lens of the eye which has developed a cataract is emulsified with the tip of an ultrasonic handpiece and aspirated from the eye. Aspirated fluids are replaced with irrigation of balanced salt solution to maintain the volume of the anterior chamber during the procedure. This procedure minimises the incision size and reduces the recovery time and risk of surgery induced astigmatism.
Refractive error is a problem with focusing light accurately on the retina due to the shape of the eye and/or cornea. The most common types of refractive error are near-sightedness, far-sightedness, astigmatism, and presbyopia. Near-sightedness results in far away objects being blurry, far-sightedness and presbyopia result in close objects being blurry, and astigmatism causes objects to appear stretched out or blurry. Other symptoms may include double vision, headaches, and eye strain.
Macular degeneration, also known as age-related macular degeneration, is a medical condition which may result in blurred or no vision in the center of the visual field. Early on there are often no symptoms. Over time, however, some people experience a gradual worsening of vision that may affect one or both eyes. While it does not result in complete blindness, loss of central vision can make it hard to recognize faces, drive, read, or perform other activities of daily life. Visual hallucinations may also occur.
Ocular hypertension is the presence of elevated fluid pressure inside the eye, usually with no optic nerve damage or visual field loss.
Trabeculectomy is a surgical procedure used in the treatment of glaucoma to relieve intraocular pressure by removing part of the eye's trabecular meshwork and adjacent structures. It is the most common glaucoma surgery performed and allows drainage of aqueous humor from within the eye to underneath the conjunctiva where it is absorbed. This outpatient procedure was most commonly performed under monitored anesthesia care using a retrobulbar block or peribulbar block or a combination of topical and subtenon anesthesia. Due to the higher risks associated with bulbar blocks, topical analgesia with mild sedation is becoming more common. Rarely general anesthesia will be used, in patients with an inability to cooperate during surgery.
Endophthalmitis, or endophthalmia, is inflammation of the interior cavity of the eye, usually caused by an infection. It is a possible complication of all intraocular surgeries, particularly cataract surgery, and can result in loss of vision or loss of the eye itself. Infection can be caused by bacteria or fungi, and is classified as exogenous, or endogenous. Other non-infectious causes include toxins, allergic reactions, and retained intraocular foreign bodies. Intravitreal injections are a rare cause, with an incidence rate usually less than 0.05%.
Laser coagulation or laser photocoagulation surgery is used to treat a number of eye diseases and has become widely used in recent decades. During the procedure, a laser is used to finely cauterize ocular blood vessels to attempt to bring about various therapeutic benefits.
Branch retinal vein occlusion is a common retinal vascular disease of the elderly. It is caused by the occlusion of one of the branches of central retinal vein.
Glaucoma medication is divided into groups based on chemical structure and pharmacologic action. The goal of currently available glaucoma therapy is to preserve visual function by lowering intraocular pressure (IOP), below a level that is likely to produce further damage to the nerve.
Multifocal and accommodating intraocular lenses are artificial intraocular lenses (IOLs) that are designed to provide focus of both distance and near objects, in contrast to monofocal intraocular lenses which only have one focal point and correct distance vision. The issue of restoring accommodation following cataract surgery or through refractive lens exchange is becoming an increasingly important topic in ophthalmology.
Childhood blindness is an important contribution to the national prevalence of the disability of blindness. Blindness in children can be defined as a visual acuity of <3/60 in the eye with better vision of a child under 16 years of age. This generally means that the child cannot see an object 10 feet away, that another child could see if it was 200 feet away.
Cervical pessary is a medical device used to treat an incompetent cervix. Early in the pregnancy a round silicone pessary is placed at the opening to the cervix to close it, and then it's removed later in the pregnancy when the risk of a preterm birth has passed.
Micro-invasive glaucoma surgery (MIGS) is the latest advance in surgical treatment for glaucoma, which aims to reduce intraocular pressure by either increasing outflow of aqueous humor or reducing its production. MIGS comprises a group of surgical procedures which share common features. MIGS procedures involve a minimally invasive approach, often with small cuts or micro-incisions through the cornea that causes the least amount of trauma to surrounding scleral and conjunctival tissues. The techniques minimize tissue scarring, allowing for the possibility of traditional glaucoma procedures such as trabeculectomy or glaucoma valve implantation to be performed in the future if needed.
Anti–vascular endothelial growth factor therapy, also known as anti-VEGF therapy or medication, is the use of medications that block vascular endothelial growth factor. This is done in the treatment of certain cancers and in age-related macular degeneration. They can involve monoclonal antibodies such as bevacizumab, antibody derivatives such as ranibizumab (Lucentis), or orally-available small molecules that inhibit the tyrosine kinases stimulated by VEGF: sunitinib, sorafenib, axitinib, and pazopanib.
Fundal massage, also called uterine massage, is a technique used to reduce bleeding and cramping of the uterus after childbirth or after an abortion. As the uterus returns to its nonpregnant size, its muscles contract strongly, which can cause pain. Fundal massage can be performed with one hand over the pubic bone, firmly massaging the uterine fundus, or with the addition of one hand in the vagina compressing the two uterine arteries. Routine use of fundal massage can prevent postpartum or post-abortion hemorrhage and can reduce pain; it may also reduce the need for uterotonics, medications that cause the uterus to contract. It is used to treat uterine atony, a condition where the uterus lacks muscle tone and is soft to the touch instead of firm.
Secondary glaucoma is a collection of progressive optic nerve disorders associated with a rise in intraocular pressure (IOP) which results in the loss of vision. In clinical settings, it is defined as the occurrence of IOP above 21 mmHg requiring the prescription of IOP-managing drugs. It can be broadly divided into two subtypes: secondary open-angle glaucoma and secondary angle-closure glaucoma, depending on the closure of the angle between the cornea and the iris. Principal causes of secondary glaucoma include optic nerve trauma or damage, eye disease, surgery, neovascularization, tumours and use of steroid and sulfa drugs. Risk factors for secondary glaucoma include uveitis, cataract surgery and also intraocular tumours. Common treatments are designed according to the type and the underlying causative condition, in addition to the consequent rise in IOP. These include drug therapy, the use of miotics, surgery or laser therapy.