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one of these sequelae. For these reasons, frequent and careful monitoring of a patient with uveitis is essential. This should be performed as for patients with immune- mediated disease elsewhere with gradual tapering of medications and re-examination at doubling intervals presuming there is improvement; more often if there is not. Re-examination and tapering of medications should be continued until there is complete resolution of every clinical sign of active uveitis. I believe that tonometry
is the most sensitive test with which to monitor uveitis during treatment because subtle hypotony (sometimes only relative to the contralateral eye) can continue long after other more overt signs have normalized. Continued treatment of these patients may prevent or delay development of sight-threatening ocular complications.
WSV18-0049
SVA REHABILITATION
LASER: CLASS 3 VS CLASS 4 - WHERE DO I BEGIN
J. Van Dyke1
1CRI, Faculty, Wellington, USA
LASER: CLASS 3 VS CLASS 4 - WHERE DO I BEGIN? Janet B. Van Dyke, DVM,
Diplomate American College of Veterinary Sports Medicine and Rehabilitation
Wellington, Florida USA janetvandyke@me.com
Laser therapy, also called photobiomodulation, uses electromagnetic energy to stimulate tissues in the body. Laser is an acronym for Light Amplification by Stimulated Emission of Radiation, and by definition is collimated and monochromatic. The depth of penetration of laser energy is determined by the wavelength of the light energy.Lasers a classified as Class 1, Class 2, Class 3a, Class 3b, and Class 4. These classes are determined
by the milliwatts (mW) of power and were created to describe levels of danger associated with the use of each. Class 1 lasers have less than 0.5mW of power.
A typical example would be a garage door opener or television remote control. Class 2 lasers are between 0.5 and 1.0mW. Most laser pointers are in this class. Class 3 lasers have between 1 and 500mW. This group is referred to as therapeutic ‘cold’ lasers and come with ‘eye caution to eye danger’. Class 4 lasers have more than 500mW and are referred to as ‘hot’ lasers. Surgical and industrial lasers are in this class, which has the precautions of ‘fire hazard and fire danger’.Terminology related to laser usage can be quite confusing. “Low level laser therapy”, “LLLT”, “Cold Laser”, “Class 4 laser therapy”, and “High intensity laser therapy” are often used incorrectly and are generally misleading. It is safer to use the terms photobiomodulation or therapeutic laser or laser therapy.The physiological effects of
laser include accelerated cell division via mitochondrial stimulation, increased leukocyte phagocytosis, stimulation of fibroblasts and collagen stimulation, enhanced synthesis of ATP, and angiogenesis. These effects lead to vasodilation, decreased inflammation, decreased edema, slowed nerve conduction and inhibited peripheral nociception.Indications for laser therapy include wound healing, pain relief (both acute and chronic), muscle spasms (including, perhaps, delayed onset muscle soreness or ‘DOMS’), and edema reduction. Laser is used in pain management practice to speed wound healing and control inflammation. Contraindications include use near the eye, over neoplasia, over open growth plates, pregnant uterus or
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