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Glaucoma is an optic neuropathy in which progressive degeneration of retinal ganglion cells and the optic nerve leads to irreversible visual loss. Glaucoma is one of the leading causes of blindness. The pathogenesis of glaucoma is determined by different pathogenetic mechanisms, including increased intraocular pressure, mechanical stress, excitotoxicity, resistance to aqueous drainage and oxidative stress. Topical formulations are often used in glaucoma treatment, whereas surgical measures are used in acute glaucoma cases. For most patients, long-term glaucoma treatments are given. Poor patient compliance and low bioavailability are often associated with topical therapy, which suggests that sustained-release, long-acting drug delivery systems could be beneficial in managing glaucoma. This review summarizes the eye's physiology, the pathogenesis of glaucoma, current treatments, including both pharmacological and nonpharmacological interventions, and recent advances in long-acting drug delivery systems for the treatment of glaucoma., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: All the authors agree to publish this article in Drug Delivery and Translational Research. Competing interests: The authors declare that they have no conflicts of interest., (© 2024. The Author(s).)

A 4-year-old female spayed mixed-breed dog received enucleation surgery of the right eye in 2018 following the diagnosis of glaucoma. The patient was presented in 2021 for recurrent swelling of the right orbit. Ultrasound confirmed the presence of a cystic structure, and chemical ablation with 1% polidocanol (compounded, Stokes Pharmacy, Mt. Laurel, NJ) and contrast cystography was elected for treatment. Iodinated contrast was injected under fluoroscopy and after no leakage was noted, the contrast was aspirated from the orbital cyst and immediately followed by an injection of 1% polidocanol solution. The orbital cyst collapsed within 24 h but returned 25 days post-injection. A second attempt was made for chemical cyst wall ablation with 1% polidocanol foam and ultrasound guidance. The orbital cyst returned 12 weeks post 1% polidocanol foam injection, and the patient presented for surgical removal. Histopathology revealed an orbital conjunctival inclusion cyst associated with granulomatous and lymphoplasmacytic inflammation. Histopathology confirmed that the draining cyst was lined by conjunctiva and likely represented conjunctival remnants from the previous enucleation. This report describes fluoroscopic guidance for sclerotherapy in the treatment of a post-enucleation orbital cyst in a dog. Contrast cystography may be useful to verify catheter position and demonstrate cyst margins prior to injection. This case report highlights the importance of complete conjunctival excision during enucleation., (© 2025 The Author(s). Veterinary Ophthalmology published by Wiley Periodicals LLC on behalf of American College of Veterinary Ophthalmologists.)

Neonatal protein C (PC) deficiency, which presents with purpura fulminans or hemorrhagic infarction, has a poor prognosis. In a sporadic case of prenatal-onset purpura fulminans, preemptive intervention saved the patient but not her vision. Among 38 survivors from 47 cases with ocular lesions and biallelic PROC variants, 23 had total blindness and eight had unilateral blindness. Only one had intact vision. Prenatal-onset ocular lesions occurred in 11 cases (29% [corneal opacities, n = 7; bilateral persistent hyperplastic primary vitreous, n = 1; both, n = 3]). The eyes are the first organ affected by heritable severe PC deficiency. Prenatal intervention is needed to improve visual outcomes., (© 2025 Wiley Periodicals LLC.)

Background: Human immunodeficiency virus (HIV) is a lentivirus. It is transmitted through sexual intercourse, shared intravenous drugs, contaminated needle use, blood transfusion, and mother-to-child transmission. Of the patients with HIV, 50%-75% have ocular manifestations and this may be the primary presentation. This study was carried out in two prevention of mother-to-child transmission (PMTCT)/HIV clinics. The aim was to determine the incidence, patterns of presentation, and determinants of ocular and adnexal diseases in HIV-positive pregnant women attending HIV clinics to develop an eye care protocol for them., Materials and Methods: The study was a cross-sectional study of HIV-positive pregnant women attending the PMTCT/HIV Clinics at University College Hospital and Adeoyo Maternity Teaching Hospital, Ibadan. Patients were interviewed using a structured questionnaire. Blood samples were taken for CD4+ count and viral load. The stage of the disease, type of antiretroviral therapy (ART), and the interval between HIV diagnosis and commencement of ART were recorded. Comprehensive ocular examination, which included visual acuity check unaided and with pinhole, lid, anterior segment examination with slit lamp and posterior segment examination with dilated binocular indirect ophthalmoscopy, was conducted. Statistical Package for Social Sciences version 23 was used to analyse the data., Results: A total of 153 pregnant women aged 23-42 years (mean, 33.5; standard deviation, ±5.6) were recruited. One hundred and fifteen (75.2%) of them were married in a monogamous setting. Multiple sexual partners (48.4%; n = 74-some women married in monogamous settings at the time of recruitment for this study had multiple sexual partners in the past) and the use of unsterilised objects (46.4%; n = 71) were major high-risk behaviours. Ocular and adnexal diseases were found in 81 (53%) participants. HIV-related ocular and adnexal diseases were found in 16 (10%) participants. Of the 16 HIV-related diseases, optic atrophy was found in seven (43.8%), presumed toxoplasmosis in three (18.7%), presumed cytomegalovirus retinitis in three (18.7%) lid warts in two (12.5%), and conjunctival microangiopathy in one (6.3%) participant. The association between HIV- related ocular and adnexal diseases and gestational age, CD4+ count, viral load and type of ART was not statistically significant., Conclusion: The few HIV-related findings in this study could be a result of the improved CD+ count/low viral load of most of the recruited participants. Ensuring that patients attending PMTCT/HIV clinic have at least one ocular examination during pregnancy by collaborating with eyecare professionals could ensure prompt detection and treatment of eye diseases, to improve the quality of life of HIV-positive pregnant women., Competing Interests: There are no conflicts of interest., (© 2024 Journal of The West African College of Surgeons.)

Fundus Fluorescein Angiography (FFA) has been extensively used for the identification, management, and diagnosis of various retinal and choroidal diseases, such as age-related macular degeneration, diabetic retinopathy, retinopathy of prematurity, among others. This exam enables clinicians to evaluate retinal morphology and the pathophysiology of retinal vasculature. However, adverse events, including from mild to severe reactions to sodium fluorescein, have been reported. Titanium dioxide nanoparticles (NPTiO 2 ) have shown significant potential in numerous biological applications. Coating or conjugating these nanoparticles with small molecules can enhance their stability, photochemical properties, and biocompatibility, as well as increase the hydrophilicity of the nanoparticles, making them more suitable for biomedical applications. This work demonstrates the potential use of ultrasmall titanium dioxide nanoparticles conjugated with sodium fluorescein to improve the quality of angiography exams. The strategy of conjugating fluorescein with NPTiO 2 successfully enhanced the fluorescence photostability of the contrast agent and increased its retention time in the retina. Preliminary in vivo and in vitro safety tests suggest that these nanoparticles are safe for the intended application demonstrating low tendency to hemolysis, and no significant changes in the retina thickness or in the electroretinography a-wave and b-wave amplitudes. Overall, the conjugation of fluorescein to NPTiO 2 has produced a nanomaterial with favorable properties for use as an innovative contrast agent in FFA examinations. By providing a clear description of our methodology of analysis, we also aim to offer better perspectives and reproducible conditions for future research., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objectives: While lumbar puncture (LP) remains gold standard for assessing intracranial pressure (ICP), LP can be difficult to perform and lead to complications. Noninvasive correlations for elevated ICP via ocular ultrasound (OUS) have shown mixed results. The primary objective of this study is to identify the frequency and test characteristics of the crescent sign on OUS for elevated ICP. Secondary objectives include comparison of test characteristics to optic nerve sheath diameter (ONSD) and optic disc elevation (ODE)., Design: Single center, prospective, observational cohort study enrolling adults (age ≥ 18 years) who presented to an outpatient Neurology LP clinic. An OUS protocol was performed prior to scheduled LP, with measurement of the opening pressure (OP) by manometry. Patients were excluded if LP was unable to be completed (for any reason) or if completed in the sitting position. Elevated OP was defined as ≥25cmH2O., Results: In total, 68 patients were enrolled; seven were excluded due to no OP measured, leaving 61 patients for analysis. Forty-six patients had normal OP, while 15 had elevated OP. The crescent sign was observed in 19 patients (31 %). Overall sensitivity, specificity, and accuracy of the crescent sign was 67 %, 80 %, and 74 %, respectively. Comparison of accuracy between the six other OUS findings demonstrated no significant differences between test characteristics (p > 0.10 for each)., Conclusions: The crescent sign was observed in 31 % of patients, with moderate sensitivity, specificity, and accuracy for elevated ICP. This study has several limitations and evaluations in the acute care setting are needed., Competing Interests: Declaration of competing interest COI: The authors have no declarations or conflicts of interest to disclose. Confirmed by authors: KH, XD, EN, JW, DR, SD, ML, RA, MD, HK., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: To describe the procedure and outcome of electrochemotherapy (ECT) with bleomycin as a first-line treatment for bilateral ocular surface squamous neoplasia (OSSN) in the eye of a horse., Animal Studied: A client-owned 5-year-old Haflinger gelding with limbal-conjunctival squamous cell carcinoma., Procedures: During general and local anesthesia, injection of bleomycin in the ocular tumor was followed by electroporation, applied with a 15 mm needle electrode, needles held parallel to the ocular surface., Results: Treatment with ECT resulted in therapeutic electric pulses and complete tumor response with no recurrence during follow-up. Tumor toxicity as a result of treatment was mild, with no adverse effect to normal tissue., Conclusions: In this case of bilateral ocular tumors, staged ECT with bleomycin was shown to be a safe and effective treatment with complete tumor remission and no recurrence during the observation period. The result suggests ECT as a possible treatment in ocular tumors, with further research recommended., (© 2024 American College of Veterinary Ophthalmologists.)

Seafood is an important resource for global nutrition and food security, with both land and marine aquaculture playing pivotal roles. High visual acuity is key for health and survival of farmed, cultured, and wild fish. Cleaner fish technology to control parasite infestation has become important in marine aquaculture and highlights the importance of visual acuity in the efficacy of cleaner fish species. New clinical diagnostic approaches towards understanding and optimising fish visual health could benefit both aquacultured and wild fish populations. Opportunities for developing and using advanced non-invasive clinical assessment and diagnosis of ocular health in wild, cultured, and experimental fish are key to more rapidly realising how threats to eye health in these animals might be better understood and mitigated. Ophthalmoscopy can rapidly and non-invasively image anatomical aspects of retinal and anterior ocular tissues and has been used in mammalian biomedicine since the turn of the 20th century. More now than ever, labour-intensive post-mortem approaches for ocular analysis such as histology are increasingly being replaced or supplemented by application of various forms of optical coherence tomography (OCT) imaging of ocular tissues in mammalian biomedicine. Advances and availability of other methodological approaches such as three-dimensional printing and computer science make instrument customisation affordable and adaptable. This review article will outline how ophthalmoscopy, OCT, and other methodologies are being applied towards understanding ocular health in teleost fish species and will describe some of the future opportunities that technological advances might afford in advancing ocular imaging in fish health and disease in general., (© 2024 John Wiley & Sons Ltd.)

Background: Ocular following responses (OFRs)-small-amplitude, short-latency reflexive eye movements-have been used to study visual motion processing, with potential diagnostic applications. However, they are difficult to record with commercial, video-based eye trackers, especially in children., Objective: We aimed to design and develop a noninvasive eye tracker specialized for measuring OFRs, trading off lower temporal resolution and a smaller range for higher spatial resolution., Methods: We developed a high-resolution eye-tracking system based on a high-resolution camera operating in the near-infrared spectral range, coupled with infrared illuminators and a dedicated postprocessing pipeline, optimized to measure OFRs in children. To assess its performance, we: (1) evaluated our algorithm for compensating small head movements in both artificial and real-world settings, (2) compared OFRs measured simultaneously by our system and a reference scleral search coil eye-tracking system, and (3) tested the system's ability to measure OFRs in a clinical setting with children., Results: The simultaneous measurement by our system and a reference system showed that our system achieved an in vivo resolution of approximately 0.06°, which is sufficient for recording OFRs. Head motion compensation was successfully tested, showing a displacement error of less than 5 μm. Finally, robust OFRs were detected in 16 children during recording sessions lasting less than 5 minutes., Conclusions: Our high-resolution, noninvasive eye-tracking system successfully detected OFRs with minimal need for subject cooperation. The system effectively addresses the limits of other OFR measurement methods and offers a versatile solution suitable for clinical applications, particularly in children, where eye tracking is more challenging. The system could potentially be suitable for diagnostic applications, particularly in pediatric populations where early detection of visual disorders like stereodeficiencies is critical., (© Aleksandar Miladinovic, Christian Quaia, Simone Kresevic, Miloš Ajčević, Laura Diplotti, Paola Michieletto, Agostino Accardo, Stefano Pensiero. Originally published in JMIR Pediatrics and Parenting (https://pediatrics.jmir.org).)

With an evolving understanding and new discoveries in extracellular vesicle (EV) biology and their implications in health and disease, the significant diagnostic and therapeutic potential of EVs for vision research has gained recognition. In 2021, the National Eye Institute (NEI) unveiled its Strategic Plan titled 'Vision for the Future (2021-2025),' which listed EV research as a priority within the domain of Regenerative Medicine, a pivotal area outlined in the Plan. In alignment with this prioritization, NEI organized a workshop inviting twenty experts from within and beyond the visual system. The workshop aimed to review current knowledge in EV research and explore gaps, needs and opportunities for EV research in the eye, including EV biology and applications of EVs in diagnosis, therapy and prognosis within the visual system. This perspective encapsulates the workshop's deliberations, highlighting the current landscape and potential implications of EV research in advancing eye health and addressing visual diseases., (© 2024 The Author(s). Journal of Extracellular Vesicles published by Wiley Periodicals LLC on behalf of International Society for Extracellular Vesicles.)

Montelukast, a Food and Drug Administration-approved drug for asthma and allergic rhinitis modulates leukotriene (LT) receptors and serves as a critical anti-inflammatory agent. Recent research suggests that the LT signaling pathway targeted by montelukast has broader implications for diseases such as fibrosis, cardiovascular diseases, cancer, cerebrovascular disease, and immune defense. This expanded understanding highlights montelukast's potential for repurposing in conditions involving aberrant stress mechanisms, including ocular diseases marked by inflammation, oxidative stress, ER stress, and apoptosis, among several others. This review delves into montelukast's therapeutic mechanisms across various diseases, draws parallels to ocular conditions, and examines clinical trials and associated adverse effects to underscore the unmet need for cysteinyl LT receptor antagonism by montelukast as an effective therapy for visual deficits.

An abnormal head position (AHP) refers to a condition where the head is deviated from the usual, upright posture considered normal. AHPs can manifest as the chin being raised or lowered, the head tilted to the right or left, the face turned to either side, or a combination of these movements. Patients with AHP may present to ophthalmologic clinics; however, there are several etiologies for AHP that may not be commonly recognized by ophthalmologists. Key words from this article were searched in PubMed, Scopus, and Google Scholar search engines from 1975 to December 2023. Various etiologies were identified, evaluated, summarized, and then categorized. The maintenance of a normal head posture during our daily activities relies on the complex interaction of different parts of the brain, with the encoding of related sensory inputs occurring in the vestibular nuclei. Abnormal head posture can stem from a variety of etiologies, including ocular, neurological, orthopedic, otolaryngological, gastroenterological, and other factors. This review provides a comprehensive overview of the different characteristics of AHP based on its etiology. Lack of awareness regarding the wide spectrum of causes may lead to patients undergoing unnecessary extensive workups. Conversely, failure to recognize potentially life-threatening causes may result in adverse outcomes for the patient.

Background: The increased utilization of digital screens is an unavoidable consequence of the technology era. Digital eye strain (DES) is a prevalent health problem among higher education students in Saudi Arabia, especially health sciences students due to the frequent use of digital sources and virtual classes. Thus, this study aimed to assess the severity of digital eye strain syndrome (DESS) symptoms and preventive ergonomic practices among higher education health science students in Saudi Arabia., Methods: A cross-sectional study using multistage cluster sampling in three cities (Dammam, Riyadh, Jeddah) in Saudi Arabia. A convenient sample of 328 health science students was selected using an equal allocation technique. The researchers designed and used an online survey of three sections: personal and digital device use-related data, the DESS questionnaire, and the self-reported preventive ergonomic practices scale., Results: DESS is a widespread problem among 72.0% of health science students, and 58.2% had unsatisfactory ergonomics. The frequently reported symptoms were blurred vision (32.9%) and increased sensitivity to light (33.5%). The severe eye-related symptoms were headache (45.85%), foreign body inside the eye (43.71%), eye burning (40.19%), and dryness (39.76%). Logistic regression analysis revealed that the female sex, years of screen utilization and the number of hours per day, screen use without rest, and frequency of virtual classes per week, eye disease, digital screen utilization for studying, nonuse of protective eye measures, and using numerous digital devices were significant predictors of DESS risk ( P < 0.05)., Conclusions: DESS is a common problem among many health science students, with headaches and foreign body sensations in the eye being the most frequent symptoms. Screen utilization time and eye disease are significant predictors of DESS, while most items' application of ergonomic practices was low. Educational programs are needed to increase student's awareness of ergonomic practices., Competing Interests: The authors declare no competing interests., (© 2024 Gushgari et al.)

There has been limited research into the role of the Pythium insidiosum antigen (PIA) in modulating immune response in patients with pythiosis. This study investigated the balance of T helper type 2 (Th2) and T helper type 1 (Th1) responses after receiving PIA immunotherapy in patients with pythiosis. Next, the phagocytic activity and phagocytic index of IFN-γ primed PIA-treated macrophages were examined. Furthermore, the phagocytosis of infective P. insidiosum zoospores by macrophages was investigated. This work showed that the PIA vaccine induced Th1 response and M1 macrophages in patients with vascular pythiosis who survived and those with localized pythiosis. Phagocytic activity and phagocytic index were increased considerably in localized pythiosis patients compared to vascular pythiosis patients with hematological diseases. IFN-γ priming of PIA-treated macrophages against P. insidiosum zoospores enhanced the phagocytic activity and phagocytic index in vascular and localized pythiosis patients. Macrophages engulfed P. insidiosum zoospores, but the zoospores continued germination, resulting in macrophage death. Overall, our results suggest that PIA can modulate the immune responses, contributing to higher levels of Th1-type cytokine and potentially improving the survival of patients with vascular pythiosis. This study is the first to uncover that P. insidiosum zoospores can survive within macrophages., (© 2024. The Author(s).)

Purpose: Pharmacokinetic evaluation of ocular penetration and systemic accumulation of preservative-free bimatoprost 0.01% ophthalmic gel (PFB 0.01% gel). Methods: In a preclinical study, pigmented rabbits received a single ocular administration of PFB 0.01% gel ( N = 15) or preserved bimatoprost 0.01% or 0.03% ophthalmic solution [PB 0.01% ( N = 15) or PB 0.03% ( N = 15)]. The aqueous humor, iris, and ciliary body were analyzed for bimatoprost+bimatoprost free acid. In a Phase 1, randomized, open-label clinical study, healthy participants received PFB 0.01% gel ( N = 20) or PB 0.01% ( N = 20) daily in each eye (Days 1-15). Bimatoprost levels in human plasma were analyzed on Days 1 and 15. All serological analyses used validated methods. Adverse events were collected throughout and ocular assessments were performed on Days 1 and 15. Results: In the preclinical study, Cmax (bimatoprost+bimatoprost free acid) for PFB 0.01% gel, PB 0.01%, and PB 0.03% was 50.2, 26.3, and 59.9 ng/mL; AUC 0.5-8 h was 134.0 ng·h/mL, 67.0 ng·h/mL, and 148.0 ng·h/mL. In the clinical study, systemic exposure to bimatoprost (AUC 0-last ) on Days 1 and 15 was lower for PFB 0.01% gel (0.5248 and 0.5645 ng·min/mL) than PB 0.01% (0.8461 and 0.7551 ng·min/mL), with no systemic accumulation of bimatoprost in either group. There were no clinically important differences between groups in ocular or systemic tolerability in the clinical study and no serious adverse events. Conclusions: PFB 0.01% gel showed improved ocular penetration compared with PB 0.01%. Systemic absorption was comparable, with a favorable clinical safety profile, supporting PFB 0.01% gel as a potential treatment for glaucoma and ocular hypertension.

Considering the limited information on the impact of PM 2.5 content on ocular health, a follow-up study was conducted on 50 healthy adults. Samples were collected twice, once before the PM 2.5 exposure season and again after exposure. Daily PM 2.5 concentration data was gathered from Thung Satok monitoring station. All subjects completed the self-structured ocular symptom questionnaire. The concentrations of 1-OHP were determined using HPLC-FLD. Logistic regression analysis investigated the relationship between PM 2.5 toxicity and ocular symptoms. The findings revealed that daily PM 2.5 concentrations surpassed the WHO-recommended range by around threefold. Exposure to PM 2.5 significantly raised the likelihood of ocular redness (adjusted OR: 12.39, 95% CI), watering (adjusted OR: 2.56, 95% CI), and dryness (adjusted OR: 5.06, 95% CI). Additionally, these symptoms had an exposure-response relationship with increasing 1-OHP levels. Ocular symptoms worsened in frequency and severity during the high PM 2.5 season, showing a strong link to elevated PM 2.5 levels. Lymphocyte counts were also positively correlated with redness, watering, and dryness during high PM 2.5 exposure. In conclusion, our study shows that subjects exposed to higher PM 2.5 levels presented more significant ocular surface alterations., (© 2024. The Author(s).)

Background: Squamous cell carcinoma (SCC) in domestic cattle is an economically significant malignant neoplasm and has been documented primarily in ocular and periocular tissues, vulva, and perineum. SCCs are often slow-growing and locally invasive, but metastasis is uncommon. Increased risk of developing SCC has been predominantly associated with high levels of sunlight exposure and hypopigmentation (skin and conjunctiva). This manuscript reports a case of ocular and perineal SCC in a Holstein Friesian cow with maxillary sinusitis secondary to tumor invasion., Case Description: An approximately 17-year-old Holstein Friesian cow was presented with a swollen, closed left eye and slow-growing perineal masses. The left eye was exenterated after showing poor response to anti-inflammatory and antimicrobial therapies, and the largest perineal mass was excised. Twelve months later, the cow developed purulent nasal discharge and dyspnea. The animal was euthanized for postmortem investigation due to health deterioration, advanced age, and suspected tumor metastasis., Conclusion: Ocular and perineal SCCs were diagnosed on biopsy and confirmed with immunohistochemistry. Postmortem gross and histological evaluations confirmed SCC invasion in the left maxillary sinus, with a secondary Trueperella pyogenes infection confirmed on aerobic culture. Histological evaluation of the enlarged lymph nodes revealed reactive lymphoid hyperplasia without evidence of tumor metastasis., Competing Interests: The authors declare that there is no conflict of interest.

Vitamin A deficiency (VAD) remains a major health issue in developing nations, contributing to preventable childhood blindness. However, there is lack of recent data on xerophthalmia, especially among school-aged children in Malaysia. We hypothesized that xerophthalmia persists among rural schoolchildren in Malaysia and potentially associated with socio-demographic status and malnutrition. We conducted a cross-sectional study on 596 schoolchildren (8-12 years) from ten rural primary schools located in five states across Malaysia. Children meeting the criteria for xerophthalmia assessment included those diagnosed with vitamin A deficiency (VAD) (plasma retinol < 0.70 µmol/L) and marginal VAD (plasma retinol 0.70 to < 1.05 µmol/L). The overall prevalence of xerophthalmia was 48.8%, with the most common ocular sign being conjunctival xerosis (38.9%). The occurrence of xerophthalmia was negatively associated with retinol-binding protein 4 (RPB4) (P=0.003), alpha-carotene (P=0.04), hemoglobin (P=0.004), weight (P=0.02), body mass index (BMI) (P=0.04) and WAZ (weight-for-age z-score) (P=0.04) status. Based on multivariate logistic regression analysis, a higher risk of xerophthalmia was observed in boys (Adjusted odd ratio [AOR]: 1.7, 95% confidence interval [CI]: 1.2-2.5) and Orang Asli (OA, indigenous) schoolchildren (AOR: 2.0, 95% CI: 1.3-3.0), while schoolchildren with overweight/obesity status (AOR: 0.5, 95% CI: 0.3-0.8) were associated with a reduced risk of xerophthalmia. The present study unveils a high prevalence of xerophthalmia among vitamin A-deficient primary schoolchildren in rural areas of Malaysia, especially among the indigenous community. The identified socio-demographic and nutritional factors associated to xerophthalmia would facilitate the implementation of more targeted interventions in addressing these issues., (Copyright © 2024 Elsevier Inc. All rights reserved.)

This study aimed to formulate and statistically optimize spanlastics loaded spongy insert (SPLs-SI) of prednisolone Na phosphate (PRED) to enhance and sustain its anti-inflammatory effect in a controlled manner. An I-optimal optimization was employed using Design-Expert® software. The formulation variables were sonication time, the Span 60: EA ratio and type of edge activator (Tween 80 or PVA) while Entrapment efficiency (EE%), Vesicles' size (VS) and Zeta potential (ZP) were set as the dependent responses. This resulted in an optimum spanlastics (SPLs) formulation with a desirability of 0.919. It had a Span60:Tween80 ratio of 6:1 with a sonication time of 9.5 min. It was evaluated in terms of its EE%, VS, ZP, release behavior in comparison to drug solution in addition to the effect of aging on its characteristics. It had EE% of 87.56, VS of 152.2 nm and ZP of -37.38 Mv. It showed sustained release behavior of PRED in comparison to drug solution with good stability for thirty days. TEM images of the optimized PRED SPLs formulation showed spherical non-aggregated nanovesicles. Then it was loaded into chitosan spongy insert and evaluated in terms of its visual appearance, pH and mucoadhesion properties. It showed good mucoadhesive properties and pH in the safe ocular region. The FTIR, DSC and XRD spectra showed that PRED was successfully entrapped inside the SPLs vesicles. It was then exposed to an in-vivo studies where it was capable of enhancing the anti-inflammatory effect of PRED in a sustained manner with once daily application compared to commercial PRED solution. The spongy insert has the potential to be a promising carrier for the ocular delivery of PRED., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Randa Mohammed Zaki reports financial support was provided by 10.13039/100009392Prince Sattam bin Abdulaziz University. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Wearable tear-based biosensors have garnered substantial interest for real time monitoring with an emphasis on personalized health care. These biosensors utilize major tear biomarkers such as proteins, lipids, metabolites, and electrolytes for the detection and recording of stable biological signals in a non-invasive manner. The present comprehensive review delves deep into the tear composition along with potential biomarkers that can identify, monitor, and predict certain ocular diseases such as dry eye disease, conjunctivitis, eye-related infections, as well as diabetes mellitus. Recent technologies in tear-based wearable point-of-care medical devices, specifically the state-of-the-art and prospects of glucose, pH, lactate, protein, lipid, and electrolyte sensing from tear are discussed. Finally, the review addresses the existing challenges associated with the widespread application of tear-based sensors, which will pave the way for advanced scientific research and development of such non-invasive health monitoring devices.

Prior to the initiation of intravenous bisphosphonate therapy for osteoporosis, the impact on ocular health is not routinely discussed with patients. This is due to the scarcity of data on the association between bisphosphonates and ocular side effects, resulting in lack of provider awareness to effectively counsel patients. Furthermore, there is little consensus among clinicians on the safety of re-challenging with intravenous bisphosphonate treatment following ocular complications. This is a case report of a patient who developed orbital inflammation four days after receiving a zoledronate infusion. This case was discussed amongst health care providers and osteoporosis experts during a meeting of Bone Health Extension for Community Healthcare Outcomes (ECHO) virtual platform, which was established in 2015., Competing Interests: Declaration of competing interest There are no disclosures or conflicts of interest for Danielle D'Annibale or for Preethika Ekanayake. E. Michael Lewiecki has the following disclosures: Amgen: investigator, consultant, speaker; Radius: investigator, consultant; Kyowa Kirin: consultant, speaker; Ultragenyx: investigator; Angitia: consultant; Ascendis: consultant., (Published by Elsevier Inc.)

Purpose: To evaluate the potency and efficacy of a library of dopamine receptor D2 (D2R) antagonists in the mitigation of fibrotic activation in retinal pigment epithelial (RPE) cells. Methods: ARPE-19 cells were cultured and treated with methotrexate or 27 district D2R antagonists using a fibronectin deposition assay. The most potent compounds were then further assessed in assays measuring cellular proliferation, cellular migration, and profibrotic gene expression. Results: The previously established antifibrotic D2R antagonist loxapine exerted a robust and dose-dependent inhibition of fibronectin deposition, whereas methotrexate exerted minimal inhibition. The most potent D2R antagonist identified, fluphenazine, effectively blocked in vitro models of fibrosis at 300-1,000 nM concentrations. Conclusions: Here we found multiple FDA-approved D2R antagonists that potently block RPE cell fibrogenesis. These findings further support the potential of D2R antagonism as a potential therapeutic for retinal fibrotic disease.

The aim of this study was to evaluate clinical and serological differences between the ocular myasthenia gravis (oMG) and generalized MG (gMG). This study is a retrospective chart review, in which data was collected from patients fulfilling 2 of 3 diagnostic MG criteria (positive antibodies, evidence of neuromuscular transmission defect on neurophysiological examination, positive effect of pyridostigmine treatment). 350 patients were included and data concerning demographics and MG medical history were collected. Patients with oMG accounted for 15.7 % of the included patients. The two subgroups differed significantly in oMG having a later age at onset, lower AChR antibody-titers, longer doctor-to-diagnosis delay and less intensive MG treatment. Additionally, patients with oMG were faster at reaching a well-controlled disease state. Thymus pathology, number of antibody-positive (95.9 % of gMG and 94.5 % of oMG), sex, number of other autoimmune diseases and delay before drug stability did not differ between oMG and gMG. In conclusion, oMG is presumably a milder form of gMG characterized by lower AChR antibody-titers, a milder phenotype, and a quicker response to a less aggressive treatment. But otherwise, oMG and gMG show very similar characteristics, including the same frequency of positive AChR antibodies, which seems new compared to previous reports., Competing Interests: Declaration of competing interest Nanna Witting reports financial grant was provided by UCB John Vissing reports a relationship with UCB that includes: consulting or advisory, speaking fees, and travel reimbursement. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

The Mpox virus (MPXV) is the causative agent of human Mpox disease - a debilitating rash illness similar to smallpox. Although Clade I MPXV has remained endemic to West and Central Africa, Clade II MPXV has been responsible for many outbreaks worldwide. The most recent outbreak in 2022 resulted from the rapid spread of a new clade of MPXV, classified into Clade IIb - a distinct lineage from the previously circulating viral strains. The rapid spread and increased severity of Mpox disease by the Clade IIb strain have raised the serious public health imperative of better understanding the host and viral determinants during MPXV infection. In addition to typical skin rashes, including in the periorbital area, MPXV causes moderate to severe ophthalmic manifestations - most commonly, ocular surface complications (e.g., keratitis, conjunctivitis, blepharitis). While ocular manifestations of Clade I Mpox within the Congo basin have been well-reported, global incidence trends of ocular Mpox cases by Clade IIb are still emerging. Given the demonstrated ability of all MPXV strains to auto-inoculate ocular tissue, alongside the enhanced transmissibility of the Clade IIb virus, there is an urgent need to elucidate the mechanisms by which MPXV causes ocular anomalies. In this review, we discuss the viral and genomic structures of MPXV, the epidemiology, and pathology of systemic and ocular Mpox, as well as potential prophylactic and therapeutic interventions., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Lichen planus (LP) is a common inflammatory condition of unknown etiology that commonly affects the skin and mucous membranes. Optical coherence tomography angiography (OCTA) is a noninvasive technique for identifying early retinal vascular impairment in systemic disease without clinical damage by imaging deep and superficial capillary networks., Aims: To assess the impacts of LP on the choroid and assess vascular changes in retinal capillary density using OCTA., Methods: This single-center prospective case-control study included 30 therapeutic-naïve LP patients and 30 age and sex-matched healthy individuals. All study subjects underwent a complete ophthalmological examination, including best-corrected visual acuity (BCVA) measurement using a Snellen chart, slit-lamp biomicroscopy, intraocular pressure (IOP) measurement, and fundus examination. They were then examined using spectral domain OCT and choroidal thickness was measured. The vessel density of the superficial and deep capillary networks was measured and assessed using OCTA., Results: Patients had significantly thicker choroidal and retinal thickness than controls, with subfoveal, nasal, and temporal areas showing a significant difference. A significantly higher vascular density in the superficial capillary plexus, particularly in the nasal perifoveal area, was found compared to the control group. Significantly, higher vascular density in the deep capillary plexus in the parafoveal area compared to controls was reported. Significant correlations were found between visual acuity and IOP, and age, duration of disease, and severity of disease., Conclusions: This study is the first to reveal that LP patients exhibit choroidal changes and retinal vascular alterations compared to healthy controls., (© 2024. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.)

Background This study compared the refraction measurements of the QuickSee wavefront autorefractor with those from clinical refraction measurements in preschool and elementary school children from public schools in Amazonas, Brazil. Methodology Refractometry was performed on 368 eyes from 368 healthy Brazilian public school students aged 4 to 7 years using both the QuickSee and subjective clinical methods under cycloplegia. Only right-eye data were analyzed. The results were converted into spherical equivalents and vector magnitudes for comparison. Results The difference in spherical equivalents between QuickSee and subjective clinical refractometry under cycloplegia was +0.38 ± 0.60 Diopters (D) (p < 0.0001). Along the 90° axis, the vector difference was +0.20 ± 0.33 D (p < 0.0001), and the oblique vector difference was +0.03 ± 0.22 D (p = 0.0395). Conclusions While a statistically significant difference was found between the QuickSee and subjective clinical refractometry results, the difference was not clinically meaningful. The strong agreement between these methods supports the utility of QuickSee as an effective tool for refractive assessment in children with limited access to eye care. These findings provide confidence in using QuickSee in public school settings as a reliable alternative for vision screening., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. UFAM – Hospital Universitário Getúlio Vargas issued approval 75560623.0.0000.9167. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Chaves Filho et al.)

In the preclinical stage of drug development, 2D and 3D cell cultures under static conditions followed by animal models are utilized. However, these models are insufficient to recapitulate the complexity of human physiology. With the developing organ-on-chip (OoC) technology in recent years, human physiology and pathophysiology can be modeled better than traditional models. In this review, the need for OoC platforms is discussed and evaluated from both biological and engineering perspectives. The cellular and extracellular matrix components are discussed from a biological perspective, whereas the technical aspects such as the intricate working principles of these systems, the pivotal role played by flow dynamics and sensor integration within OoCs are elucidated from an engineering perspective. Combining these two perspectives, bioengineering applications are critically discussed with a focus on tissue barriers such as blood-brain barrier, ocular barrier, nasal barrier, pulmonary barrier and gastrointestinal barrier, featuring recent examples from the literature. Furthermore, this review offers insights into the practical utility of OoC platforms for modeling tissue barriers, showcasing their potential and drawbacks while providing future projections for innovative technologies., (© 2024 IOP Publishing Ltd. All rights, including for text and data mining, AI training, and similar technologies, are reserved.)

Background/objectives: Ocular tools and technologies may be used in the diagnosis of sport-related concussions (SRCs), but their clinical utility can vary. The following study aimed to review the literature pertaining to the reliability and diagnostic accuracy of such assessments. Methods: The preferred reporting items for systematic reviews and meta-analysis (PRISMA) extension for scoping reviews was adhered to. Reference standard reliability (RSR ≥ 0.75) and diagnostic accuracy (RSDA ≥ 0.80) were implemented to aid interpretation. Results: In total, 5223 articles were screened using the PCC acronym (Population, Concept, Context) with 74 included in the final analysis. Assessments included the King-Devick (KD) (n = 34), vestibular-ocular motor screening (VOMs) and/or near point of convergence (NPC) (n = 25), and various alternative tools and technologies (n = 20). The KD met RSR, but RSDA beyond amateur sport was limited. NPC met RSR but did not have RSDA to identify SRCs. The VOMs had conflicting RSR for total score and did not meet RSR in its individual tests. The VOMs total score did perform well in RSDA for SRCs. No alternative tool or technology met both RSR and RSDA. Conclusion: Ocular tools are useful, rapid screening tools but should remain within a multi-modal assessment for SRCs at this time.

Objective: To compare the effects of intranasal (IN) and intramuscular (IM) midazolam-butorphanol-ketamine on intraocular pressure (IOP), tear production (TP) and sedation in rabbits., Study Design: Prospective, randomized, crossover experimental study., Animals: Fourteen male New Zealand White rabbits, aged 1-2 years, body mass 3.1 ± 0.8 kg (mean ± standard deviation)., Methods: Rabbits were administered midazolam (1 mg kg -1 ), butorphanol (1.5 mg kg -1 ) and ketamine (5 mg kg -1 ) via IN and IM routes. IOP, TP and sedation scores were assessed at 0 (before drug administration), 5, 15, 30, 45 and 60 minutes after drug administration. Heart rate (HR), respiratory rate (f R ), rectal temperature (RT), noninvasive mean arterial blood pressure (MAP) and peripheral hemoglobin oxygen saturation (SpO 2 ) were simultaneously recorded until 45 minutes after drug administration. The onset and duration of sedation and sedation scores were recorded., Results: Drug delivery route had no significant impact on mean IOP (p = 0.271) or TP (p = 0.062), and there were no significant changes over time for IOP (p = 0.711) or TP (p = 0.372). Similarly, delivery route had no significant impact on HR (p = 0.747), f R (p = 0.872), RT (p = 0.379), MAP (p = 0.217) and SpO 2 (p = 0.254). Sedation onset was faster with IN (3.0 ± 1.0 minutes) than with IM administration (4.9 ± 0.7 minutes) (p = 0.011), but sedation duration was significantly longer with IM (52.6 ± 7.2 minutes) than with IN delivery (30.7 ± 6.8 minutes) (p = 0.004). There was no significant difference in sedation scores between the two delivery routes at any of the recorded time points., Conclusions and Clinical Relevance: The combination of midazolam-butorphanol-ketamine had minimal impact on physiological and ocular variables regardless of the route of administration, whereas IN drug administration led to a shorter onset and duration of action than IM administration., (Copyright © 2024 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)

This study aimed to compare the effect of intranasal (IN) and intramuscular (IM) administration of butorphanol and zolazepam-tiletamine (ZT) combination on intraocular pressure (IOP) and tear secretion (TS) in rabbits. Fourteen healthy male New Zealand White rabbits weighing 3.05 ± 0.72 kg, aged between 1 and 2 years old, were included in the study. Animals randomly received 0.5 mg/kg butorphanol and 15 mg/kg ZT combination either with IN or IM administration. IOP and TS were measured at baseline (T0), and followed by 5, 15, 30, 45, and 60 min after drug administration. The sedation variables, the time to onset of sedation, duration of sedation, and sedation scores were also recorded. The route of administration for the butorphanol and ZT combination had no significant effect on the mean IOP (p = .301) and TS (p = .445). Furthermore, there were no significant changes observed in the IOP (p = .472) and TS (p = .348) over time. The time to onset of sedation was earlier in the IN group (4.57 ± 0.79 min) than in the IM group (5.86 ± 0.9 min; p = .0004). The duration of sedation was significantly longer for IM (57.43 ± 3.41 min) compared with IN (45.0 ± 1.91 min; p < .0001). No significant difference in the sedation score was observed between groups at all time points. In conclusion, both IN and IM administration of the butorphanol and ZT combination in rabbits had similar effects on IOP and TS., (© 2024 The Authors. Veterinary Ophthalmology published by Wiley Periodicals LLC on behalf of American College of Veterinary Ophthalmologists.)

Purpose: To evaluate the frequency of ophthalmic disorders in Shih Tzus., Animals: Five hundred client-owned Shih Tzu dogs (1000 eyes)., Procedures: Medical records of 500 Shih Tzu dogs were reviewed and ophthalmic examination data were collected and analyzed., Results: In total, out of 1000 eyes, 964 (96.4%; OD: 480 eyes, OS: 484 eyes) had at least one ophthalmic abnormality, and only 36 eyes (3.6%; OD: 20 eyes, OS: 16 eyes) were diagnosed as normal. A total of 1375 individual ophthalmic abnormalities were observed in 964 diseased eyes. Fifty-nine different unique diagnoses were made in the study population, and only three conditions [medial canthal entropion (10.4% of eyes; bilateral in 10.2% of dogs), caruncular trichiasis (21.1% of eyes; bilateral in 20.2% of dogs), and reduced tear film breakup time (17.6% of eyes; bilateral in 17.4% of dogs)] affected 49.1% of the eyes., Conclusion and Clinical Relevance: Findings suggested that the most prevalent disorders for the Shih Tzus were hairy caruncle, reduced TBUT, medial canthal entropion, keratoconjunctivitis sicca, pigmentary keratitis, lagophthalmos, and mature cataract., (© 2024 American College of Veterinary Ophthalmologists.)

Exposure to ambient ultraviolet radiation is associated with various ocular pathologies. Estimating the irradiance received by the eyes is therefore essential from a preventive perspective and to study the relationship between light exposure and eye diseases. However, measuring ambient irradiance on the ocular surface is challenging. Current methods are either approximations or rely on simplified setups. Additionally, factors like head rotation further complicate measurements for prolonged exposures. This study proposes a novel numerical approach to address this issue by developing an analytical model for calculating irradiance received by the eye and surrounding ocular area. The model takes into account local ambient irradiance, sun position, and head orientation. It offers a versatile and cost-effective means of calculating ocular irradiance, adaptable to diverse scenarios, and serves both as a predictive tool and as a way to compute correction factors, such as the fraction of diffuse irradiance received by the eyes. Furthermore, it can be tailored for prolonged durations, facilitating the calculation of radiant dose obtained during extended exposures., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Purpose: To review the evidence on the effectiveness and complications of periocular and intraocular corticosteroid therapies for noninfectious uveitic macular edema., Methods: A literature search of the PubMed database was conducted last in December 2021 and a post-assessment search was conducted in March 2023. The searches were limited to articles published in English and no date restrictions were imposed. The combined searches yielded 739 citations; 53 articles were selected for inclusion because the studies (1) evaluated periocular corticosteroid injection, intraocular corticosteroid injection or implant, suprachoroidal corticosteroid injection, or a combination thereof for uveitic macular edema; (2) had outcomes that included visual acuity (VA) or macular edema assessed clinically or imaged by OCT or fluorescein angiography; and (3) included more than 20 patients., Results: This assessment reviewed 23 articles that provided level I or level II evidence from 18 studies on the use of periocular, suprachoroidal, and intravitreal triamcinolone acetonide injections and intravitreal dexamethasone and fluocinolone acetonide implants or inserts in noninfectious uveitic macular edema. These reports consistently demonstrated that all investigated periocular and intraocular corticosteroid therapies improved VA, macular structure, or both. One comparative study showed that intravitreal triamcinolone acetonide injection and the dexamethasone intravitreal implant had effectiveness superior to that of periocular triamcinolone acetonide injection for these outcomes. As a group, the studies highlighted the potential for these therapies to elevate intraocular pressure and to accelerate cataract formation., Conclusions: The published literature provides high-quality evidence that periocular and intraocular corticosteroid therapies are effective and safe for the treatment of noninfectious uveitic macular edema. However, information on the relative effectiveness and complication rates across the different therapies is limited., Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article., (Copyright © 2024 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Introduction: Cavernous sinus thrombosis (CST) is a serious condition that carries with it a high rate of morbidity and mortality., Objective: This review highlights the pearls and pitfalls of CST, including presentation, diagnosis, and management in the emergency department (ED) based on current evidence., Discussion: CST is a potentially deadly thrombophlebitic disease involving the cavernous sinuses. The most common underlying etiology is sinusitis or other facial infection several days prior to development of CST, though other causes include maxillofacial trauma or surgery, thrombophilia, dehydration, or medications. Staphylococcus aureus, streptococcal species, oral anaerobic species, and gram-negative bacilli are the most frequent bacterial etiologies. The most prevalent presenting signs and symptoms are fever, headache, and ocular manifestations (chemosis, periorbital edema, ptosis, ophthalmoplegia, vision changes). Cranial nerve (CN) VI is the most commonly affected CN, resulting in lateral rectus palsy. Other CNs that may be affected include III, IV, and V. The disease may also affect the pulmonary and central nervous systems. Laboratory testing typically reveals elevated inflammatory markers, and blood cultures are positive in up to 70% of cases. Computed tomography of the head and orbits with intravenous contrast delayed phase imaging is recommended in the ED setting, though magnetic resonance venography demonstrates the highest sensitivity. Management includes resuscitation, antibiotics, and anticoagulation with specialist consultation., Conclusion: An understanding of CST can assist emergency clinicians in diagnosing and managing this potentially deadly disease., Competing Interests: Declaration of competing interest None of the authors have submitted a review on this topic or published previously on this topic. No AI program was utilized to construct this review., (Published by Elsevier Inc.)

Purpose: To determine the incidence and clinical characteristics of ocular adnexaltumors in Olmsted County, Minnesota., Methods: Retrospective population-based cohort study of all patients residing in Olmsted County, Minnesota diagnosed with any ocular tumor from January 1, 2006, to December 31, 2015. The medical records of all patients with an incident diagnosis of any ocular adnexal tumor were reviewed using the Rochester Epidemiology Project medical record linkage system for patient demographics, tumor type, and histopathologic confirmation. Incidence rates were calculated per 100,000 person-years. Poisson regression analysis was used to analyze changes in incidence over time., Results: There were 717 patients diagnosed with ocular adnexal tumors during the 10-year study period, yielding an age- and sex-adjusted incidence rate of 59.7 per 100,000 (95% CI 55.4 to 64.0, p  < 0.05) per year. In total, 764 tumors were diagnosed. Most tumors were eyelid lesions ( N  = 756, 99.0%), which were mostly benign ( N  = 512, 67.8%) with epidermal inclusion cysts ( N  = 275, 36.0%), hidrocystoma ( N  = 70, 9.2%), and eyelid sebaceous cysts ( N  = 46, 6.1%) accounting for the majority. Malignant eyelid lesions ( N  = 244, 31.9%) were relatively common with basal cell carcinoma ( N  = 184, 24.1%) and squamous cell carcinoma ( N  = 49, 6.4%) having the highest frequencies. Orbital tumors ( N  = 8, 1.0%) were infrequent. Of the orbital tumors, the most common was lacrimal gland adenoidcystic carcinoma ( N  = 2, 25.0%)., Conclusions: In a population-based setting, most ocular adnexal tumors were benign eyelid lesions. Understanding the epidemiology of ocular adnexal tumors is important to aid providers in diagnosing and facilitating appropriate referrals of potentially vision- and life-threatening malignancies.

Background: There is limited literature regarding equine immune mediated keratitis (IMMK) in Europe. North America-based publications describe minimal blepharospasm, rare corneal ulceration and no uveitis; clinical impression suggests these are seen in Europe., Objectives: Assess the prevalence of blepharospasm, corneal ulceration and uveitis and their impact on outcome in horses diagnosed with IMMK in Europe (UK and Finland)., Study Design: Retrospective case series., Methods: Clinical records of 94 horses with IMMK were evaluated. The UK and Finland populations were comparable; therefore, descriptive statistics were performed on combined data on subtypes of IMMK and clinical features. Odds ratios (OR) and confidence intervals (CI) were calculated for impact of blepharospasm, ulceration or presence of uveitis on the outcome of enucleation and treatment duration., Results: IMMK subtype was classified as 10/94 (10.6%) epithelial, 50/94 (53.2%) anterior stromal, 14/94 (14.9%) mid-stromal, 4/94 (4.25%) endothelial and 16/94 (17.0%) unrecorded. After excluding three horses with incidental corneal ulceration, blepharospasm was documented in 34/91 (37.4%), corneal ulceration in 26/91 (28.6%), and signs of uveitis in 23/91 (25.3%) horses. Increased odds of enucleation were significantly associated with the presence of blepharospasm (OR 5.5, 95% CI 1.6-19.4, p = 0.008) and signs of uveitis (OR 8.9, 95% CI 2.6-30.8, p < 0.001), but not corneal ulceration. The presence of blepharospasm, corneal ulceration or uveitis did not significantly alter the odds of ongoing medication., Main Limitations: Data were collected over a wide timeframe; the diagnosis was mainly made without histopathology; a broad definition of uveitis was used and there was a bias towards complicated cases being retained for follow-up., Conclusions: The clinical features of IMMK were similar between two European countries but differed to USA descriptions. Blepharospasm, corneal ulceration and signs of uveitis can occur with IMMK; presence of blepharospasm and uveitis increase the odds of enucleation., (© 2024 The Author(s). Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.)

Background: Ocular setariasis is an ectopic infection caused by a parasite under the genus Setaria. Adult worms belong to the Setariidae family and typically reside in the peritoneal cavity of ungulates. However, immature forms of these species may aberrantly migrate to the eyes of cattle, buffalo, goats, horses and several other hosts, leading to corneal opacity and blindness. Here, we have distinguished the Setaria digitata collected from both equine and buffalo hosts based on the morphology, molecular profiling of mitochondrial cytochrome c oxidase subunit 1 (Cox1), cytochrome c oxidase subunit 3 (Cox3) and, Nicotinamide Adenine Dinucleotide dehydrogenase subunit 1 (NAD1) genes., Methods and Results: A single filarial worm was collected from the eye of one equine and one bovine host. These worms were then processed for morphological examination and DNA isolation. Cox1, Cox3 and NAD1 genes were amplified using specific primers and subjected to custom sequencing. The sequences were then used for multiple sequence alignment, assessment of entropy, similarity and haplotype diversity analysis. Key morphological features confirmed the worms collected were male and female Setaria digitata from equine and buffalo hosts, respectively. Cox1, Cox3 and NAD1 gene sequence analysis showed a close association of S.digitata Indian isolates with its counterparts from Sri Lanka and China isolates., Conclusion: The phylogram of bovine S. digitata sequences shows a close relationship to other equine S. digitata sequences, indicating the need for further in-depth studies on the prevalence of infection across various host species and intermediate hosts. Although the sequence results suggest that S. digitata is likely the causative agent of ocular setariasis in India, additional samples are needed to confirm this conclusion. Comprehensive analysis of the transcriptome and proteome of S. digitata from both bovine and equine hosts is necessary to explore variations in host-parasite interactions. These findings will aid in future parasite identification, investigations into vector prevalence in India, and the development of control measures against ocular setariasis., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Background/aim: To evaluate differences in ocular complications of Stevens Johnson Syndrome (SJS)/Toxic Epidermal Necrolysis (TEN) patients receiving either systemic IVIG or Ciclosporin (CsA) as initial treatments., Methods: Retrospective review of consecutive patients admitted for SJS/TEN at the Singapore General Hospital (SGH) from 2011 to 2017 who received either IVIG or Ciclosporin at the onset of the disease and had ophthalmological follow-up of at least 6 months were included. Acute ocular severity of SJS/TEN was graded using the Gregory grading score; chronic ocular complications were graded using the Sotozono system., Results: A total of 18 subjects were included for analysis, with eight in the IVIG group and 10 in the CsA group. There were no significant differences in acute Gregory severity grading between the two groups. The CsA group had a trend towards worse overall chronic Sotozono grading scores compared to the IVIG group (median [IQR]: 2 [0-3] vs. 1 [0-6.5], p  = 0.27), with a higher incidence of acute severe cornea involvement (60% vs. 25%, p  = 0.93) and chronic corneal and eyelid involvement in the former than the latter. SJS/TEN patients with worse acute ocular involvement were more likely to have TEN and perianal mucosal involvement (50% vs. 0, p  = 0.01)., Conclusion: Compared to those who received IVIG, SJS/TEN patients who received CsA at the acute disease stage, seemed to have worse acute corneal and chronic corneal and eyelid complications. Larger studies are needed to confirm this finding., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Foo, Yueh, Mehta and Ong.)

Objective: To evaluate the pathologic ocular changes in a population of aquarium-housed Monodactylus argenteus and investigate potential underlying causes for the large number of affected fish in this exhibit., Animals: 11 Monodactylus argenteus were evaluated from a shoaling ring exhibit within an aquarium, and 19 control fish without ocular abnormalities were obtained from commercial fish suppliers., Methods: Physical and ocular examinations were performed antemortem. Postmortem samples of liver, heart, dorsal epaxial muscle, and lenses of affected and control fish were analyzed for amino acid profiles. The aqueous humor from affected and control fish was collected postmortem, and osmolality was analyzed. Tissues from affected and control fish were submitted for histopathology., Results: Ocular abnormalities in affected fish included corneal lesions, cataracts, lens capsule rupture, and unilateral left-sided lens luxation and buphthalmos. Lens luxation and buphthalmos were directly correlated. Aqueous humor osmolality in control fish differed significantly compared to affected fish but was not correlated to lens abnormality score. Affected fish had significantly lower lens concentrations of arginine, asparagine, glycine, isoleucine, serine, and tyrosine than control fish. One affected fish had severe buphthalmos, cataracts, and panophthalmitis caused by gram-positive cocci., Conclusions: Cataracts and traumatic lesions were common in affected M argenteus. Dietary amino acid content and aqueous humor osmolality imbalances were not likely a cause of the cataracts. Differences in lens amino acid concentrations between affected and control fish may be related to cataract formation., Clinical Relevance: Consideration of species-appropriate tank parameters may mitigate ocular lesions including cataracts in aquarium fish.

In patients who have lost their eye due to one or many of the following events, such as surgery, trauma, tumors, or birth eye defects, ocular prostheses play a very vital role in the recovery of their eye appearance and social appearance. This case report highlights the successful fitting and fabrication of a custom-made ocular prosthesis in a patient with an eye defect. The manufacturing process of the prostheses involved careful evaluation and fabrication involving a series of steps to achieve a successful prosthesis. A customized prosthesis guarantees excellent esthetic matching, more comfort, and increased patient confidence, thereby a better quality of life., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Pathak et al.)

Left smooth pursuit eye movement training in response to large-field visual motion (optokinetic stimulation) has become a promising rehabilitation method in left spatial inattention or neglect. The mechanisms underlying the therapeutic effect, however, remain unknown. During optokinetic stimulation, there is an error in visual localisation ahead of the line of sight. This could indicate a change in the brain's estimate of one's own direction of gaze. We hypothesized that optokinetic stimulation changes the brain's estimate of gaze. Because this estimate is critical for coding the locus of attention in the visual space relative to the body and across sensory modalities, its change might underlie the change in spatial attention. Here, we report that in healthy participants optokinetic stimulation causes not only a directional bias in the proprioceptive signal from the extraocular muscles, but also a corresponding shift of the locus of attention. Both changes outlasted the period of stimulation. This result forms a step in investigating a causal link between the adaptation in the sensorimotor gaze signals and the recovery in spatial neglect., Competing Interests: Declaration of competing interest None., (Crown Copyright © 2024. Published by Elsevier Ltd. All rights reserved.)

Background: The most significant medications in dentistry are local anesthetics, and intraoral local anesthesia is arguably the most used dental procedure. However, complications have also been reported., Aim: Evaluation of ocular complications in intraoral anesthesia., Materials and Methods: It was a prospective study involving 2,400 patients undergoing different dental procedures that were performed under intraoral local anesthesia over a 12-month period. There was a thorough ocular evaluation of all patients by ophthalmologist before and after the administration of intraoral local anesthesia., Results: There were different types of ocular complications reported including accommodation disturbance, amaurosis, diplopia, enophthalmos, miosis, mydriasis, ophthalmoplegia, and ptosis. The most common ocular complication was diplopia contributing 40.1% of all ocular complications. It was followed by ptosis (16.9%), mydriasis (14.9%), and amaourosis (13.2%)., Conclusion: The most common ocular complication in intraoral local anesthesia was diplopia., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Introduction: Ocular rosacea is an underdiagnosed form of rosacea that may occur with or without typical cutaneous signs of rosacea. One of the common manifestations is dry eyes. Although the use of intense pulsed light (IPL) in the treatment of rosacea-related dry eyes has been reported, a recent review is lacking., Methods: A scoping review was performed to summarize the efficacy of IPL in the treatment of ocular rosacea., Results: Five articles were included, representing 108 patients, with a mean age of 58.4 years. Based on available data, 59.2% (n = 58/98) were female. The studies detailed the use of IPL in combination with meibomian gland expression treatment. Overall, 91% (n = 89/98) of patients with ocular rosacea treated with IPL had a partial response and 9% (n = 9/98) had no response. IPL therapy did not lead to complete recovery in any of the included patients. One participant experienced an adverse event across the included studies., Conclusions: IPL is a promising treatment modality for ocular rosacea, as demonstrated by its ability to relieve dry eye symptoms with limited adverse events. Further research into this novel treatment is necessary to ascertain its role in the management of ocular rosacea., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Retrobulbar haematoma is a rare emergency that can potentially lead to blindness. Common causes include facial trauma and surgery. Timely surgical evacuation of the haematoma improves visual outcomes. In rural communities, patients often present to hospital after many hours and this increases the risk of poor visual outcomes. Radiological evaluation which is often not available in rural communities, results in further delay in surgical treatment. This case report highlights the need for urgent surgical intervention over radiological evaluation in patients with retrobulbar haematoma and orbital compartment syndrome., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.