Clinical Ophthalmology

BACKGROUND: Retinal diseases are common at high altitudes due to a cascade of changes caused by hypoxia. The aim of this study is to assess the population prevalence, pattern and associated factors of retinal disorders at high altitude in Nepal. METHODOLOGY: A cross-sectional study was conducted at three selected high-altitude districts (over 2500 meters) of Nepal. Subjects were at least 40 years old, and the target sample size was 309. A detailed history was taken...

PURPOSE: To highlight gaps in the professional ethics of ophthalmology. DESIGN: Perspective. METHODS: Presentation of problematic cases in ophthalmologic ethics with juxtaposition of ethical, legal, and conscientious viewpoints informed by relevant literature. RESULTS: What is legal, ethical, and conscientious overlap but are not identical. Professional ethical guidelines, when they exist, are stricter than what the law requires, but are silent on several contemporary controversies...

PURPOSE: We evaluated the effect of optimization of the intraocular lens (IOL) power calculation formula SRK/T and Barrett Universal II (BU II) in long eyes (≥26 mm: group L) and short eyes (≤22 mm: group S) using axial length calculated from segmented refractive indices (SRI). SETTING: Multicenter study at five sites in Japan. DESIGN: Retrospective observational study. METHODS: This study included 461 eyes of 461 patients (mean age 73...

PURPOSE: Orbital steroid injections offer a potential therapeutic avenue for managing Thyroid Eye Disease (TED). This study aimed to assess the effectiveness and potential systemic impacts of a single deep orbital triamcinolone injection in TED patients. METHODS: In a prospective investigation conducted from January 2021 to March 2023, patients diagnosed with TED were enrolled. Inclusion criteria encompassed a Clinical Activity Score (CAS) of ≥3, extraocular muscle inflammation, and upper eyelid retraction...

PURPOSE: To compare the refractive predictability of Argos measurements with Barrett Universal II (BUII) and Barrett True Axial Length (BTAL) formulas in a large sample of long, medium, and short axial length (AL) eyes. METHODS: A retrospective chart review identified 445 eyes of 247 patients for inclusion. The Argos was used for preoperative biometry, and BUII formula for intraocular lens (IOL) power calculations. Back calculations were performed using data from the Argos for the BTAL formula...

Refractive surgery has experienced substantial advancements over the past few years, driven by innovative techniques and continuous technological progress aimed at enhancing visual outcomes and patient satisfaction. Refractive errors such as myopia, hyperopia, and astigmatism affect a significant portion of the global population, impacting quality of life and productivity. Recent advancements have been fueled by a deeper understanding of ocular biomechanics and visual optics, leading to more precise and effective treatments...

PURPOSE: To estimate the economic and environmental impact of single-use instruments (SUIs) to perform standard cataract surgery in six ophthalmology centers located in Europe and in the United States. SETTING: Online survey and interview. DESIGN: Comparative cost analysis based on an online survey with follow-up questionnaire and interview. The carbon footprint calculation was made by ClimatePartner. METHODS: Annual costs of reusable instruments (RUIs) were calculated based on data provided by the centers...

PURPOSE: To analyze the patient-reported-outcomes obtained after trifocal intraocular lens (IOL) bilateral implantation in Japanese patients using three different validated questionnaires. METHODS: Fifty-three patients implanted with the FineVision HP IOLs (Beaver-Visitec International, Inc. USA) were enrolled in this prospective-study. At 3-months, refraction (spherical equivalent [SE] and cylinder), logMAR uncorrected distance visual acuity (UDVA), and corrected distance visual acuity (CDVA) were obtained...

PURPOSE: To study geographic patterns of supply and demand for uveal melanoma and other ocular oncology healthcare by ocular oncology physicians in the United States. METHODS: Google search interest data was obtained through trends.google.com. The combined-state density of ocular oncology physicians was calculated by dividing the number of practicing ocular oncologists in each state and its surrounding states by the state population. Relative search volume (RSV) values were divided by ocular oncology physician density to calculate the Google relative demand index (gRDI) for each state...

INTRODUCTION: Glaucoma is a group of eye diseases characterized by progressive and irreversible damage to the optic nerve. The aim of the study was to examine the impact of sociodemographic and psychological factors on adherence to glaucoma therapy. METHODS: The study was carried out among 190 adults treated for glaucoma at the Ophthalmology Outpatient Clinic of the University Teaching Hospital in Wroclaw between January 2019 and September 2019. Treatment adherence was measured using the Adherence to Refills and Medications Scale (ARMS)...

INTRODUCTION: Maculopathy secondary to pathologic myopia (PM) is increasingly causing visual impairment and blindness worldwide. PM is associated with tractional maculopathy that ranges from macular foveoschisis to macular hole. These disorders are treated with different options that offer variable results, reflecting the need for new techniques that address myopic maculopathy with consistent outcomes. METHODS: Since human amniotic membrane (HAM) has been reported to be safe for intraocular use and to promote retinal healing, it was incorporated as an adjuvant in pars plana vitrectomy in patients with different tractional disorders related to myopia...

PURPOSE: To share examination findings of the lens capsule which may act as an indicator for malpositioned intraocular lenses (IOL). SETTING: Single large multi-specialty private practice, Houston, Texas, USA. DESIGN: Focused, observational case series. METHODS: A review of pre-operative images of malpositioned single-piece IOLs with at least one haptic in the ciliary sulcus was conducted. The review included five cases who were referred to a single large multi-specialty private practice from June 2023 to December 2024 for an evaluation of posterior capsular opacification (PCO) and potential Nd:YAG capsulotomy...

BACKGROUND: This research aims to investigate the influence of environmental factors on the treatment efficacy of ocular lubricants in patients from urban areas with dry eye disease (DED). METHODS: A phase IV clinical trial, which included 173 patients from major cities in Mexico, was randomly assigned to use ocular lubricants four times a day for 30 days. Ocular Surface Disease Index (OSDI), noninvasive tear film break-up time (NIBUT), ocular staining, and conjunctival hyperemia (CH) among other factors like weather, and air pollution as covariates were analysed...

PURPOSE: To evaluate the efficacy and safety of slanted bilateral lateral rectus recession (BLR-rec) for treating convergence insufficiency-type intermittent exotropia (CI-IXT) in children. METHODS: In this retrospective cohort study, 26 patients aged <16 years with CI-IXT who underwent BLR-rec between August 2016 and July 2021 with six months of follow-up data post-surgery were classified into slanted BLR-rec group (n = 14) and standard BLR-rec group (n = 12; equal-length recession of the upper and lower horns of the LR muscle)...

OBJECTIVE: This cross-sectional study aimed to investigate the associations between environmental and occupational factors and the prevalence of dry eye symptoms among participants from the Ahsa region of Saudi Arabia. METHODS: Participants from urban, rural, and suburban areas seeking medical care at primary health centers were recruited through systematic random sampling. Data on demographics, exposures, and ocular health were captured using a structured questionnaire...

PURPOSE: To study the association between tear film hyperosmolarity and ocular light scatter in a cataract surgery population. PATIENTS AND METHODS: Contiguous, 20-second objective scatter index (OSI) scans were recorded in hyperosmolar (≥320 mOsm/L) and normal subjects (<308 mOsm/L) with cataract nuclear opacity ≥3. OSI was measured at screening, baseline and 90 days following surgery. Along with symptoms of ocular surface disease, slit-lamp examination included corneal staining (0-3), tear film breakup time (TBUT) and evaluation of meibomian gland disease (MGD)...

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PURPOSE: In this study, we aimed to evaluate and compare the effects of intravitreal aflibercept (IVA) and intravitreal faricimab (IVF) injections on the blood flow of retinal vessels in the peripapillary region and optic nerve head (ONH) in eyes with diabetic macular edema (DME) using laser speckle flowgraphy (LSFG). PATIENTS AND METHODS: This study included 20 eyes of 18 patients treated with IVA and 15 eyes of 11 patients treated with IVF for DME. The mean blur rate (MBR) of the ONH and retinal artery and vein of the peripapillary region were measured using LSFG at baseline and 1 month after injection...

PURPOSE: To compare the interocular symmetry and investigate the intermachine reproducibility of optic disc and macular data measured by spectral-domain high-definition optical coherence tomography (HD-OCT) Cirrus HD-OCT 4000 and HD-OCT 5000 from healthy subjects. PATIENTS AND METHODS: Forty-three volunteers were examined with both HD-OCT 4000 and HD-OCT 5000 at the same visit. Optic nerve head (ONH) and macular data were acquired using ONH Cube 200×200 scans and macular volume cube 512×128 scans, respectively...

PURPOSE: To delineate the characteristics, surgical interventions, and visual outcomes among children diagnosed with congenital cataract and persistent fetal vasculature (PFV). PATIENTS AND METHODS: Retrospective observational single-center study was conducted between January 1, 2009, and December 31, 2019, at Helsinki University Hospital. The national cohort encompassed 82 children aged from birth to 15 years who underwent lensectomy, 3-port vitrectomy, or a combined procedure, with the objective of achieving visual rehabilitation...