This document compares and contrasts AS-OCT (anterior segment optical coherence tomography) and ultrasound biomicroscopy (UBM) imaging techniques for evaluating the anterior eye segment.
It discusses that AS-OCT provides non-contact, high resolution cross-sectional imaging of the anterior segment structures without touching the eye. UBM uses high frequency ultrasound to generate detailed 2D images of the anterior segment, allowing visualization of structures like the iris and angle.
While both techniques allow qualitative and quantitative assessment of the anterior chamber angle and structures, AS-OCT has advantages of being non-contact, faster imaging, and less operator dependency compared to UBM. However, UBM can image deeper into the posterior iris and has greater penetration than
Interventions to Reduce Myopia Progression in Children (Journal Club) (health...Bikash Sapkota
DIRECT DOWNLOAD LINK ❤❤https://healthkura.com/reduce-myopia/❤❤
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Interventions to Reduce Myopia Progression in Children (Journal Club)
Objectives:
- To discuss about the different interventions to reduce myopia progression in children
- To determine the effectiveness of different interventions to slow down the progression of myopia in children
Interventions to Reduce Myopia Progression:
Environmental Considerations
- Time Spent Outdoors
- Near-Vision Activities
Spectacles & Contact Lenses
- Gas-Permeable Contact Lens Wear
- Bifocal & Multifocal Spectacles
- Soft Bifocal Contact Lenses
- Orthokeratology
Pharmacological Therapies
- Antimuscarinic Agents: Atropine & Pirenzepine
Under Correction of Myopia
Interventions to Reduce Myopia Progression in Children (Journal Club) (health...Bikash Sapkota
DIRECT DOWNLOAD LINK ❤❤https://healthkura.com/reduce-myopia/❤❤
Dear viewers Check Out my other piece of works at___ https://healthkura.com
Interventions to Reduce Myopia Progression in Children (Journal Club)
Objectives:
- To discuss about the different interventions to reduce myopia progression in children
- To determine the effectiveness of different interventions to slow down the progression of myopia in children
Interventions to Reduce Myopia Progression:
Environmental Considerations
- Time Spent Outdoors
- Near-Vision Activities
Spectacles & Contact Lenses
- Gas-Permeable Contact Lens Wear
- Bifocal & Multifocal Spectacles
- Soft Bifocal Contact Lenses
- Orthokeratology
Pharmacological Therapies
- Antimuscarinic Agents: Atropine & Pirenzepine
Under Correction of Myopia
It describes about the procedure of Hess charting. it serves as a great tool to understand the concepts involved. Suitable for optometry course. This is not a routine procedure but an important procedure which is used in diagnosis.
It describes about the procedure of Hess charting. it serves as a great tool to understand the concepts involved. Suitable for optometry course. This is not a routine procedure but an important procedure which is used in diagnosis.
National Ocular Biometry Course (NOBC) 2015 An echoslide presentation Anis Suzanna Mohamad
This powerpoint presentation is basically about ocular biometry. Echo presentation is one of the method to deliver infomation that obtain from the course we attend to other staff in our Ophthalmology Department.
A scan biometry | How to Use A-scan? Types of A-Scan Biometry?Naeem Ahmad
A-SCAN BIOMETRY | What is A-Scan Biometry? How To Use It?
A-scan is the short form of amplitude scan.
This eye ultrasound gives details about the length of the eye.
A-Scan is an essential diagnostic tool used in ophthalmology.
The measurement of the eye’s axial length through an A-scan is necessary for placing an intraocular lens (IOL, artificial lens) during cataract surgery.
The total refractive power of the emmetropic eye is approximately 60D. Of this power, the cornea provides roughly 40D, and the crystalline lens 20 diopters.
When a cataract is removed, the lens is replaced by an artificial lens implant. By measuring both the length of the eye (A-scan Biometry) and the power of the cornea (keratometry).
It may also be used to assess vision abnormalities and other diseases involving the eye such as tumors.
A-scan techniques are based on the principles of ultrasonography. Sound travels in a wave pattern. For a sound to be heard by the human ear, the frequency must be between 20 and 20,000 Hz (20 kHz).
For an eye examination through A-scan, an ultrasound of frequency of around 10 MHz is used.
LASIK or Lasik (laser-assisted in situ keratomileusis), commonly referred to as laser eye surgery or laser vision correction, is a type of refractive surgery for the correction of myopia, hyperopia, and an actual cure for astigmatism, since it is in the cornea. LASIK surgery is performed by an ophthalmologist who uses a laser or microkeratome to reshape the eye's cornea in order to improve visual acuity. For most people, LASIK provides a long-lasting alternative to eyeglasses or contact lenses.
The planning and analysis of corneal reshaping techniques such as LASIK have been standardized by the American National Standards Institute, an approach based on the Alpins method of astigmatism analysis. The FDA website on LASIK states,
"Before undergoing a refractive procedure, you should carefully weigh the risks and benefits based on your own personal value system, and try to avoid being influenced by friends that have had the procedure or doctors encouraging you to do so."
The procedure involves creating a thin flap on the eye, folding it to enable remodeling of the tissue beneath with a laser and repositioning the flap.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
1. AS-OCT AND ULTRASOUND
BIOMICROSCOPY
Dr Shylesh B Dabke
Glaucoma Fellow
Aravind Eye hospital
Download and watch in slideshow mode, online viewing will be disgusting
2. Overview
• Because anatomy plays a large role in chronic angle closure,
evaluating the angle anatomy is a critical first step in treating
this disease.
• Using a combination of various AS imaging technique examiner
wil get a clear picture of the angle anatomy and help to make
appropriate treatment decisions.
3. • Gonioscopy is the current gold standard, but imaging
techniques such as Ultrasound biomicroscopy (UBM),
Scheimpflug photography, and anterior segment optical
coherence tomography (AS-OCT) provide additional valuable
information.
4. Gonioscopy
• Gonioscopy provides the examiner with a
dynamic, broad view of the angle.
• Has ability to analyze the angle with/without
compression (PAS vs appositional angle
closure.
• Although quick, inexpensive, and valuable, it is
also subjective and difficult to perform.
• Reproduciability, quantitative information
cannot be obtained.
• Therefore less than ideal for research and in
clinical situations where repeated
measurements are needed.
5. SCHEIMPFLUG IMAGING
• This technique uses light scattering to image
the anterior chamber.
• Although the resolution of the images is high
this method is of limited usefulness for
evaluating the angle because of its inability to
image the peripheral angle in many eyes.
8. • First described using the same wavelength of light as retinal
OCT, namely 830nm.
• OCT imaging of the anterior segment with a longer
wavelength of 1310nm was developed later on and had the
advantages of better penetration through sclera
• Rapid, non contact method that maybe performed by a
technician with patient sitting Upright.
9. • Obtains a high-resolution cross-section of the anterior segment
without touching the eye.
• Enables visualisation of the form, site & position of AC
components.
• Defines & measures the distances between them.
• Machine automatically eliminates distortion induced by optical
transmission factors.
10. • Reflex Saturation Beam indicates perpendicularity of the eye
to the scanning beam and minimal tilting of the image.
• The scan dimensions are 16 x 6 mm and 4 image frames are
averaged.
• Resolution is 2-20microns which makes it suitable for
measurement of finer eye structures.
11. • Qualitative assessment
- An important landmark to identify in ASOCT images is the
scleral spur.
- This is visible as an inward projection of the sclera at the
junction between the inner scleral and corneal curvatures.
- Apposition between the iris & inner corneo-scleral wall has
been used as a qualitative method of detecting angle closure
12. • Quantitative Assessment
- Quantitative measurement of the AC angle is possible with
in-built software & requires identification of the scleral spur.
- The commonly used quantitative parameters
* Angle opening distance(AOD500/AOD750)
*Angle recess area(ARA500/ARA750)
*Trabecular space area(TISA500/TISA750)
13. Angle opening distance (in mm): Perpendicular distance between a point 500µm (AOD
500) or 750 µm (AOD750) anterior to the scleral spur and the opposing iris.
Angle recess area (in mm2): The triangular area (ARA 500 or 750) bounded by the AOD
500 or 750, the anterior iris surface and the inner corneo-scleral wall
Trabecular Iris space area (in mm2): Trapezoidal area (TISA 500 or 750) bounded by
the AOD 500 or 750, the anterior iris surface, the inner corneo-scleral wall and the
perpendicular distance between the scleral spur and the opposing iris.
14.
15.
16. • SL – OCT(Heidelberg Engineering)
Visante (Carl Zeiss Meditec, Inc.)
• The Visante OCT (Carl Zeiss Meditec) is a time-domain OCT
device that scans the anterior segment, generating images that
extend from limbus to limbus.
• Newer Fourier-domain OCT (FD-OCT) intended for posterior
segment imaging are increasingly evolving to include anterior
segment imaging.
• FD-OCT units have shorter wavelengths (typically 800-840 nm)
17. Newer Modalities
• A new swept source FD-OCT device (Casia SS-1000; Tomey
Corporation) can rapidly obtain high-resolution scans with
3D reconstruction of the anterior segment.
18. Clinical use in glaucoma
• An adjunct to gonioscopy as well as a substitute when
gonioscopy is not feasible.
• Useful as a patient education tool, especially when laser
peripheral iridotomy is being recommended.
• Phototherapeutic keratectomy to assess the depth of corneal
opacity.
• LASIK for CCT & to measure flap thickness.
• Keratoconus & INTACS for CCT & positioning of INTACS.
• Cysts of anterior segment to diagnose etiology.
• Biometry for phakic IOL.
19. AS-OCT & Glaucoma
• Useful tool for evaluating filtering bleb or GDD in post-op
period.
• Clinical description of bleb is subjective & there may be cases in
which clinical appearance does not correlate with bleb
function.
• Visualising intra-bleb morphology with AS-OCT may enhance
our understanding of different surgical outcomes.
20. AS-OCT over Gonioscopy
• Two common flaws in the performance of clinical gonioscopy
include the placement of pressure on the cornea and the use of
excessive amounts of light.
• Both typically produce the illusion of an open angle in a
patient who otherwise may have narrow or even appositionally
closed angles.
• AS-OCT provides little light artifact. It can actually dynamically
show how an angle imaged in bright light may appear open but
look narrow when assessed in the dark.
21. Newer Uses for AS-OCT
• Measuring the tear film
Although this work is still mostly showing value in research
situations
• Measuring contact lens fit
22. Advantages
• Non contact.
• More physiological.
• Shorter imaging time.
• Less learning curve for operator.
• Target may be used to induce accommodation in eye
imaged.
• Less inter operator variability.
Limitations
• No penetration of pigmented iris epithelium.
23.
24.
25.
26.
27.
28.
29. Failed flat bleb.Trabeculectomy site seen but no subconjunctival bleb
High elevated tense encapsulated bleb
Same patient with scanned section of bleb only
36. Ultrasound Biomicroscopy(UBM)
• High frequency
ultrasound technology.
• Detailed 2D gray scale
image of ant segment.
• Probe Frequency – 20, 35
and 50MHz.
37. Principle
• It acts on a principle similar to that of the B-scan (10Mhz)
• Frequency 50Mhz
• More frequency, less penetration(5mm) and more resolution
• Limited depth of penetration is also associated with a
smaller angular field (4x4 mm)
38. Patient in supine position
Local anesthetic
Eye cup (plastic or silicone) which is used
to create a small water bath
The crystal of the transducer is placed in
saline approximately 2 mm from the eye
surface.
Methyl cellulose or normal saline can
be used as coupling solution
39.
40.
41. Qualitative and Quantitative
Examination
• Structures
- Conjunctive, cornea, Ant Sclera
- Ant. Chamber angle structures
- Ciliary Body
- Ant. layers of lens, zonules & IOL
- Pars plana
• UBM pro 200 software in the machine automatically
measures all angle parameters by marking the scleral spur.
44. GLAUCOMA
Determine the mechanism of elevated intraocular
pressure (angle-closure versus open-angle) by showing
the relationship between the peripheral iris and
trabecular meshwork.
Open-angle Glaucoma
• Measure the anterior chamber
angle in degrees
• Assess the configuration of the
peripheral iris
• Evaluate the iris insertion in relation
to the trabecular meshwork
• See if there is an anterior insertion
of the iris or an anteriorly displaced
ciliary body
Narrow angles
• UBM shows the extent of angle closure
• Depth of the anterior and posterior
chambers
• Identifies pathologic processes pushing
the lens and iris forward.
45. PUPIL BLOCK GLAUCOMA
(A) The angle shows appositional closure owing to anterior bowing of the iris.
(B) The angle is open with a flattened iris after laser peripheral iridotomy.
46. To Determine Occludability of the Angle
• Perform dark room provocative testing with the UBM, to
study the spontaneous occlusion of the angle under
conditions of decreased illumination.
• Better than dark room gonioscopy because the latter is time
consuming and standardization of slit-lamp illumination is
difficult
50. Functional Status of Filtering Surgery
• Whether the sclerostomy aperture is patent or blocked
internally.
• whether the peripheral iridectomy is patent.
• whether the filtering bleb is flat, shallow or deep.
55. TUMOURS
• Iris tumors, ciliary body tumors and anterior choroidal tumors
can be imaged.
• Borders of the tumor are usually detectable by the change in
reflectivity from surrounding structures.
56.
57. The most common clinical presentation of an irido-ciliary
cyst is a peripheral iris elevation - the typical UBM finding
of a thin walled structure with no internal reflectivity is
diagnostic.
63. INTRAOCULAR LENSES
• Analysing IOL position
• AC depth after surgery can be measured with a high degree
of accuracy.
• Margins of the optic can be easily imaged & decentration
analysed.
• Haptic location in relationship to surrounding structures can
be determined.
68. AS-OCT VS UBM
• Optical VS Ultrasound
• Resolution : 15m VS 50m
• Scan Dimension : 16*6mm VS 5*5mm
• Image posterior iris : No vs Yes
69. Limitations
• Contact investigations - patient discomfort
• Supine position
• Cannot be used in
- Immediate Post op period
- Suspected open globe injury
- Younger children
• Time consuming
• Operator dependent
Editor's Notes
Tin aung
Give a brief overview of the presentation. Describe the major focus of the presentation and why it is important.
Introduce each of the major topics.
To provide a road map for the audience, you can repeat this Overview slide throughout the presentation, highlighting the particular topic you will discuss next.
This is another option for an Overview slides using transitions.
Two examiners looking at the same angle often disagree on what they see.
it must be noted that the degree of apposition may be variable and does not correlate exactly with appositional closure as defined by gonioscopy. In addition, several studies have shown that the when using the Anterior Segment Scan protocol which does not utilize image averaging, the scleral spur is not visible in about 25% of cases [7] – in this situation, it is still possible to qualitatively assess irido-corneal apposition in most images.