Editorial Understanding Ocular Surface Disease From Uncommon to Extremely Common Afflictions n the Laboratory Science section of this issue, Lakshminarayanan and colleagues provide a review of the TGFBI-associated corneal dystrophies. Exploring both clinical and genetic aspects of the dystrophies, the authors are able to associate clinicopathogenic alterations, location of deposit, and age of onset with various amino acid changes in the expressed proteins. They provide a comprehensive summary of the current state of our knowledge of the TGFBI-associated dystrophies. The Clinical Science section brings two reviews. Bergmanson and colleagues consider the reappearance of keratoconus following previous corneal transplant. Their review of the literature and two illustrative case reports address a longstanding debate among clinicians as to whether keratoconus recurs in transplanted tissue or, rather, is a progression of disease in residual host tissue. The authors conclude that keratoconus disease re-emerges in the transplanted cornea and that this is related to presence of disease in residual nontransplanted tissue. The second review by Yokoi and colleagues is a thoughtprovoking consideration of the precorneal tearfilm as a fluid shell that is influenced by blinking in both horizontal and vertical saccades of the eyes. The authors discuss the relevant effects of such ocular movements on the tear film and their possible contribution to dry eye disease. In Clinical Practice, Pflugfelder and colleagues present a timely review of the results of recent clinical trials in treatment of blepharitis. The authors provide a concise overview of the dimensions of this clinical problem and highlight the missing information about etiology and effective treatments for blepharitis. Their review of recent clinical trials affirms the importance of management of both bacterial and inflammatory aspects of the disease. In Innovative Techniques and Technology, Hassani and colleagues evaluate the clinical value of spectral domain optical coherence tomography (SD-OCT) using en-face technology in diagnosis and characterization of various corneal disorders. Their comparison of the new technique to in-vivo confocal microscopy (IVCM) showed good correlation with confocal microscopy, although discernible changes with SD-OCT were not detectable with standard clinical B-scan OCT. They identified benefits of the new technology in ease of operation and rapid image acquisition over large areas of the ocular surface. In Pipeline, Dr. Novack clarifies the phases of clinical development of new drugs. He also provides a revealing discussion of the variations encountered in the timeline of drug development trials. His insights on the outcomes of drug approval will be of value to sponsors and investigators alike. This issue of the journal does not contain a Sources in Time article, as Dr. Murube is taking a welldeserved vacation from contributing historical reviews. We look forward to welcoming him back in 2015. I wish you good reading regarding the uncommon and common features of the ocular surface.


Gary N. Foulks, MD Editor-in-Chief

THE OCULAR SURFACE / OCTOBER 2014, VOL. 12 NO. 4 / www.theocularsurface.com


Understanding ocular surface disease from uncommon to extremely common afflictions.

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