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Purpose: Ocular rosacea is a chronic inflammatory disorder affecting the ocular surface, often associated with cutaneous rosacea. This review aims to explore its pathogenesis, treatment approaches, and future directions for management., Methods: A review of current literature on the pathophysiology, clinical features, and treatment strategies of ocular rosacea in adults and children (pediatric blepharokeratoconjunctivitis) was conducted. Emerging research on immune dysregulation, microbiome alterations, and potential therapeutic targets was analyzed., Results: Ocular rosacea involves dysregulation of the immune and neurovascular systems, with toll-like receptor activation and complement system involvement leading to chronic ocular surface inflammation. Alterations in the ocular microbiome have been implicated in disease progression. Treatment strategies emphasize a stepwise approach, incorporating ocular and skin hygiene, lifestyle modifications, and pharmacological interventions. Recent advancements in understanding the disease mechanisms have led to the exploration of targeted therapies, including biologics and small-molecule inhibitors., Conclusions: Ocular rosacea remains challenging to diagnose and treat, particularly in children (pediatric blepharokeratoconjunctivitis), often leading to delayed intervention and poor outcomes. A multidisciplinary approach, including new therapeutic options, holds promise for improving patient care. Further research into the genetic and molecular basis of ocular rosacea may enable more personalized treatments., Competing Interests: The authors have no funding or conflicts of interests to disclose., (Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc.)

Purpose: To report the surgical approach of a Lucia keratoprosthesis (KPro) on a sclerocorneal graft in the setting of recurrent graft rejection and perilimbal scleral thinning., Methods: A case report., Results: We report the case of a 26-year-old man with a history of herpes simplex keratitis, 2 penetrating keratoplasties, graft failure, secondary glaucoma, and a conjunctival flap in the right eye who underwent a Lucia KPro, lens extraction, glaucoma drainage device, and pars plana vitrectomy. The surgery involved releasing the conjunctival flap, revealing severe perilimbal scleral thinning. The use of a sclerocorneal graft to mount the Lucia KPro allowed an effective combined procedure by providing a healthy sclera. At the last follow-up (34 months), the patient had retained the Lucia KPro and had a best-corrected visual acuity of 20/400., Conclusions: The Lucia KPro on a sclerocorneal graft may be a viable option to provide healthy sclera in patients requiring combined KPro surgery., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.)

Competing Interests: Financial disclosures/conflicts of interest: None reported.

To report a case of spontaneous-onset unilateral scleritis and keratitis due to Pseudomonas aeruginosa in a patient with systemic lupus erythematosus who partially responded to antibiotic therapy and achieved complete resolution after IV immunotherapy. A 30-year-old woman with a past medical history of hypothyroidism and systemic lupus erythematosus and on irregular therapy presented with a long-history of thinning of the sclera and cornea refractory to antibiotic therapy despite a positive culture for P. aeruginosa, which eventually resolved with the implementation of immunotherapy. Infectious scleritis is an uncommon and diagnostically challenging scleral inflammation. However; we must rule it out in patients with autoimmune diseases due to the inherent risk of these patients as their immune system has been impaired., Competing Interests: Conflicts of interest None declared., (Copyright © 2025. Published by Elsevier España, S.L.U.)

Purpose: Describe complications, functional success, and retention of the Lucia Keratoprosthesis (KPro)., Design: Retrospective interventional case series METHODS: The demographic data, baseline characteristics, complications, functional success, and retention were analyzed for Lucia KPro at the Instituto de Oftalmologia Conde de Valenciana in Mexico City from 2021 to 2023. Multivariate regression analysis and Kaplan-Meier plots were performed to identify associations with functional failure. The main outcome measures were postoperative complications, functional success defined as best-corrected visual acuity (BCVA) ≥20/200 (logMAR 1.0), and device retention rate., Results: Forty-eight eyes of 48 patients (56.88% male) were studied. The mean age at implantation was 57.29 ± 15.63 years (range 27-91), with a mean follow-up of 20.5 ± 8.83 months (range 3-40). Diagnostic indications for implantation included recurrent graft rejection (54.17%), autoimmune disease (20.83%), chemical injury (12.5%), and other (12.5%). At least 1 postoperative complication occurred in 75% of patients, leading to 65 additional interventions (mean number of subsequent procedures: 1.35 ± 1.3, range 0-5). The preoperative BCVA was 2.40 ± 0.36 logMAR. At the final follow-up, 62.5% had achieved functional success and 22.92% had a BCVA of 20/40 (logMAR 0.3) or better. Glaucoma (adjusted OR 469.74, 95% CI 5.02-43939.14, P = .007) and retinal pathology before KPro (adjusted OR 372.38, 95% CI 4.18-33162.11, P = .009) were associated with functional failure. The device remained in place in 95.83% of recipients over the follow-up period., Conclusions: The Lucia KPro offers functional success in severe corneal diseases and excellent retention in the short to intermediate term., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Purpose: To report the clinical and microbiological profiles of microbial keratitis and its antimicrobial resistance before, during, and after COVID-19., Methods: This was a retrospective case-note review of all corneal scrape specimens collected from patients with microbial keratitis from January 2018 to December 2023. Case records were analyzed for demographic characteristics, microbiological diagnosis, and antibiograms. All outcome variables were collected, stratified, and compared between 3 periods: the pre-COVID-19 group (January-December 2019), the COVID-19 group (January 2020-December 2022), and the post-COVID-19 group (January-December 2023)., Results: A total of 947 corneal cultures from 947 patients were reviewed. Gram-positive bacteria predominated in all periods, with no significant differences in their distribution. Staphylococcus epidermidis was the most frequently identified organism. Pseudomonas aeruginosa was the most common Gram-negative bacterium, with its incidence significantly lower in the post-COVID period. Fungal infections showed a significant increase in the post-COVID group, with Fusarium sp. being the most common fungus and showing a significant increase in incidence in the post-COVID group., Conclusions: Despite a stable incidence of microbial keratitis, this study highlights a concerning trend in antibiotic resistance. Although some pathogens became less common, those that persisted have become increasingly difficult to treat. Understanding the clinical and microbiological profiles of microbial keratitis and antimicrobial resistance patterns before and after the COVID-19 pandemic is crucial for informed treatment decisions., Competing Interests: There is no conflict of interest. There is no funding received., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: This report aims to present a case of corneal keloid caused by chronic corneal insult after trauma and Descemet stripping automated endothelial keratoplasty (DSAEK)., Case Presentation: A 35-year-old male with a history of vision loss in the right eye was referred to our hospital. The patient underwent Ahmed Glaucoma Valve Implantation to alleviate elevated intraocular pressure after ocular trauma to the same eye. One year following the procedure, the eye developed endothelial failure, leading to the performance of Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK) with repositioning of the shunt tube. Upon initial examination, a well-circumscribed elevated white opaque lesion involving the central corneal surface of the RE was observed. Based on the patient's clinical history, slit lamp examination, and UBM findings, the diagnosis of corneal keloid was established. Superficial keratectomy was performed. Histopathological analysis confirmed the diagnosis of corneal keloid. Following the procedure, BCVA improved slightly. However, 3 months later, the patient underwent a penetrating keratoplasty for visual rehabilitation., Conclusion: Corneal keloids should be considered following any form of ocular trauma, particularly in cases involving ocular surgery. Diagnosing corneal keloids can sometimes be challenging due to the variety of potential differentials; however, by carefully evaluating the patient's medical history and clinical presentation, we can effectively narrow down the differential diagnosis of corneal conditions., (© 2024. The Author(s).)

Neurotrophic keratopathy is an uncommon degenerative corneal disorder characterized by compromised corneal sensory innervation resulting in the formation of epithelial defects and nonhealing corneal ulcers. Various treatment modalities are available to stabilize disease progression, improve patient well-being, and prevent vision loss. For eligible patients, medical and surgical reinnervation have emerged as pioneering therapies, holding promise for better management. We present a comprehensive review of the disorder, providing an update relevant to ophthalmologists on pathogenesis, diagnosis, treatment options, and novel therapies targeting pathophysiological pathways., Competing Interests: Declaration of Competing Interest None., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Purpose: The purpose of the study was to evaluate the efficacy of mitomycin C intravascular chemoembolization (MICE) for corneal neovascularization (CNV)., Methods: This is a prospective, nonrandomized, interventional study. Patients with stable CNV irrespective of the underlying etiology were enrolled in the study. 0.1% mitomycin C was injected intravascularly in CNV at the slit lamp under topical anesthesia. To evaluate the regression of vessels, the ImageJ software was used to trace and quantify vasculature by a pixel count in standardized clinical slit-lamp photographs., Results: Eight eyes from 8 patients with corneal neovascularization and lipid keratopathy were studied. The mean age at treatment was 37 ± 12.75 (range 17-64) years. The median follow-up was 419.5 days (74-1166 days). Herpes simplex keratitis was the main underlying etiology (75%). The visual axis was compromised in 75%, and 100% had stromal scarring. The mean pixel count before MICE was 5983.41 ± 5004.96 pixels. After the treatment, the mean pixel count was 2060.38 ± 3142.96 pixels (delta: 3923.03, P = 0.029). No complications were recorded during the follow-up period. No recurrence of the CNV was observed at the last follow-up. Two eyes (25%) underwent a successful keratoplasty 4 months after MICE., Conclusions: MICE effectively reduced neovascularization with no immediate safety concerns, though its impact on vision and long-term safety requires further investigation with larger, longer term studies., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: This study aimed to investigate all recorded corneal and ocular surface research by Mexican authors., Methods: The output data was extracted from SCOPUS to account for all publications regarding the corneal or ocular surface by Mexican authors. Data screening, extraction, and critical revision were performed by two of the authors to avoid duplication and ensure the authenticity of all papers. Performance analysis, science mapping, and network metrics were employed to retrieve trends in publication., Results: A total of 1,091 indexed journal documents by 3965 authors were retrieved, covering the period the period from 1919 to 2022. In performance analysis, the document types included 881 articles, 20 book chapters, 17 conference papers, three editorials, 37 letters to the editor, nine notes, and 123 reviews. A total of 3,965 contributing authors made 6,081 author appearances. In terms of total citations per country, Mexican authors received a total of 7,087 citations, with an average article citation of 8.76 per author., Conclusion: This bibliometric analysis highlights impactful research contributions to corneal and ocular surface research from Mexican authors, identifies influential authors and institutions, and also emphasizes the need for increased interaction in the international arena., Competing Interests: Human subjects: All authors have confirmed that this study did not involve human participants or tissue. 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, Jimenez-Collado et al.)

Aim: To compare the safety and effectiveness of eyelid treatment with the ILux ® -MGD Treatment System in one session versus five sessions of mechanical meibomian gland expression (MMGE) in patients with moderate to severe meibomian gland dysfunction (MGD)., Methods: A prospective, randomized, open-label, and controlled clinical trial that compared one session of the ILux ® MGD Treatment System versus five sessions of MMGE in both eyes of 130 patients aged ≥18y with Ocular Surface Disease Index (OSDI) scores ≥13, total meibomian gland scores (MGS) of <15 in the lower eyelid of each eye, and non-invasive tear break-up time (NI-TBUT) <10s, who were randomized 1:1 to ILux ® or MMGE., Results: The mean age was 58±17.49y. Baseline total MGS scores in both treatment groups were comparable. During follow-up, there were significant differences in total MGS and per sector with P <0.001. Multivariate analysis was performed using generalized estimating equations corresponding to the generalized linear model for repeated means to determine the treatment relationship with total MGS, NIBUT, and OSDI. There was a significant difference between ILux ® and MMGE ( P <0.001) at follow-up from the first to the twelfth month in MGS, NI-BUT, and OSDI scores. No adverse events were reported., Conclusion: ILux ® treatment compared to MMGE significantly improves symptoms and signs in patients with moderate to severe MGD for one year without adverse events., Competing Interests: Conflicts of Interest: Núñez MX, None; Acosta-Ortega A, None; Vera-Duarte GR, None; Gómez-Duarte C, None., (International Journal of Ophthalmology Press.)

Antarctic notothenioid fishes show wide adaptive morphological radiation, linked to habitat preferences and food composition. However, direct comparisons of phenotypic variability and feeding habits are still lacking, particularly in stages inhabiting nearshore areas. To assess these relationships, we collected juveniles and adults of the most common benthic species inhabiting shallow waters off the South Shetland Islands within a similar size range, the plunderfish Harpagifer antarcticus, the black rockcod Notothenia coriiceps, and the marbled rockcod Notothenia rossii. Individual size ranges varied from 44.0 to 98.9 mm standard length (LS) (H. antarcticus), from 95.8 to 109.3 mm LS (N. coriiceps), and from 63.0 to 113.0 mm LS (N. rossii). Notothenioid fish showed different morphospace variability, being larger for H. antarcticus than the other Notothenia species and associated with the position of the posterior end of the operculum, along with the location and relative size of the eye. The evolutionary allometry was low, but the static allometry was much higher, especially for H. antarcticus and N. rossii. The diet was mainly carnivorous, consisting of amphipods and euphausiids. Macroalgae were scarce or totally absent in the gut contents of all species. Only H. antarcticus showed an increase in the prey number and ingested prey volume with fish size. Finally, there was a significant covariation between shape changes and LS in all species (allometric effects), however, not with prey composition, probably due to the small size range or ontogenetic stage and the relative similarity (or lack of contrast) in the benthic environment that they utilized., (© 2023 Fisheries Society of the British Isles.)

The aim of this study was to report a case with the use of amniotic membrane transplant and deep anterior keratoplasty in a patient with bilateral Acanthamoeba infectious keratitis as a treatment. A 20-year-old male presented with bilateral Acanthamoeba keratitis (AK) who was initially diagnosed with herpetic keratitis receiving full antiviral and corticosteroid topical treatment without any improvement. Corneal biopsy was performed to confirm the suspected diagnosis, and Acanthamoeba stromal cysts were identified in the sample. Treatment was initiated with 0.02% chlorhexidine, 0.1% propamidine isethionate, neomycin, and tropicamide/phenylephrine. Symptoms and clinical improvement were achieved between the 8th and 10th weeks, so corticosteroids were initiated. Treatment was continued until we observed a poor response in the left eye; therefore, an epithelial scraping and amniotic membrane placement were performed. Lately, the right eye underwent a deep anterior lamellar keratoplasty. A challenging case of bilateral AK managed with topical medications, amniotic membrane, and corneal keratoplasty. The earlier the disease is diagnosed, the better the outcome. If the diagnosis is delayed, the amoebas have penetrated deep into the corneal stroma, and successful therapy becomes difficult. A surgical option can be an early solution with a good prognosis for these cases., Competing Interests: The authors have no conflicts of interest to declare., (© 2023 The Author(s). Published by S. Karger AG, Basel.)

Purpose: To describe the ocular clinical characteristics of a group of Mexican patients with lamellar ichthyosis (LI) arising from TGM1 pathogenic variants., Methods: Ophthalmological exploration, pedigree analysis and genetic screening were performed in patients with an established clinical diagnosis of lamellar ichthyosis from families located in a small community in the Southeast of Mexico., Results: Nine patients with LI in five families were identified. There were six affected females. All patients (9/9) demonstrated eye lid abnormalities with eight patients showing lid margin abnormalities. Madarosis was present in only three individuals and corneal scarring was documented in two. All nine individuals carried biallelic TGM1 variants, either homozygously or as compound heterozygous., Conclusion: Ocular anomalies are common in individuals with TGM1-related LI. The occurrence of a variety of private or rare mutations hampers the identification of a genotype-phenotype correlation for ocular anomalies in this disorder., (© 2023. The Author(s).)

Lamellar ichthyosis (LI) is an autosomal recessive congenital ichthyosis characterized by generalized dry skin and severe scaling. It is caused by biallelic mutations in the TGM1 gene, however molecular data from non-Caucasian populations are limited. Results of genetic-molecular analysis of a group of LI pedigrees originating from two close small populations from south Mexico are presented. LI affected individuals belonging to 9 apparently unrelated families were studied. Exome sequencing or Sanger sequencing in probands from each family was carried out. Furthermore, DNA from 294 unaffected subjects from one of the communities were Sanger sequenced to determine the carrier frequency of the c.427C > T TGM1 variant. Five different TGM1 pathogenic variants, either in homozygous or in compound heterozygous state, were demonstrated in affected subjects. The two most common variants were c.427C > T (p.Arg143Cys) and c.1159+1G > T. A novel c.1645+1G > T TGM1 pathogenic allele was recognized. Carrier frequency analysis identified a total of 23 individuals heterozygous for the c.427C > T variant, predicting a prevalence of 78 carriers per 1000 inhabitants in the community. A high TGM1 allelic heterogeneity with 5 different LI-causing alleles in a limited geographic area was demonstrated. While the occurrence of homozygosity for a founder mutation is expected in small populations with high frequency of a particular autosomal recessive disorder, the occurrence of multiple pathogenic alleles has been previously described, a situation known as the Reúnion paradox. Our results expand the current knowledge of the mutational spectrum of TGM1-linked LI., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Cogan syndrome is a rare disease whose etiology is still undetermined. It typically affects men and women between the second and fourth decade of life. We report a case of Cogan syndrome with ocular and audio-vestibular involvement as a systemic manifestation in a 31-year-old woman., (Copyright ©2023. All rights reserved. Reproduction in whole or in part in any form or medium without expressed written permission of the Digital Journal of Ophthalmology is prohibited.)

Purpose: To report a case of pressure-induced interlamellar stromal keratitis (PISK) 10 years after laser assisted in situ keratomileusis (LASIK)., Observations: A case of a 36-year-old man who underwent LASIK and presented with PISK 10 years later. Before presenting to our department he consulted elsewhere for red eye, decreased visual acuity, foreign body sensation, and pain on the RE for 1 week. He was then prescribed topical prednisolone six times per day and was lost to follow-up. On examination and after 1 month of continuous use of steroids uncorrected distance visual acuity (UCDV) was 20/400 in the right eye (RE) and 20/20 in the left eye (LE). Best corrected visual acuity was 20/80 on the RE. The Goldmann intraocular pressure (IOP) was 26 and 17 mmHg in the RE and LE, respectively. Slit lamp biomicroscopy revealed fluid in the interface and epithelial ingrowth. Fundoscopic examination results were normal in both eyes. Treatment was initiated with topical brimonidine tartrate 0.2%, timolol 0.5%, and dorzolamide 2.0% BID. Once the pressure was controlled the patient was scheduled for mechanical debridement of the epithelial ingrowth with significant improvement of UCVA (20/25)., Conclusions: Refractive surgeons should be aware of PISK as a potential complication of LASIK even years after the procedure. Intraocular pressure can be misleading, and diligent and careful examination are key to diagnosis and treatment of this potentially blinding complication., 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., (© 2023 Published by Elsevier Inc.)

The percentage of solid organ transplant recipients who develop extrapulmonary or disseminated tuberculosis (TB) is higher than the general population. In countries where the disease is endemic, TB should always be considered a diagnostic possibility, and extrapulmonary disease should also be considered. We present the case of a kidney transplant patient who initially presented for an abscess in the left dorsolateral region and was ultimately diagnosed with pulmonary and extrapulmonary TB. With the initiation of antibacillary treatment, a drug interaction with immunosuppressants was verified, and rifampicin was maintained at a minimum dose with other antibacillary drugs at full dose, subsequently showing an improvement in the clinical picture. The adverse effects of TB treatment present great difficulty owing to the interactions of antibacillary drugs with immunosuppressants. Most patients with conventional treatment can be cured, so prompt diagnosis and treatment are important., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Diet and morphospace of larval stages of two sympatric lanternfish Diogenichthys atlanticus and D. laternatus from the south-east Pacific Ocean were compared and the covariance between both variables was assessed for each species. Diogenichthys atlanticus stomach contents consisted mainly of copepod nauplii and digested remains and this species had a broader niche than D. laternatus, in which stomach contents were highly digested. No dietary overlap was found between both species. The covariance between skull shape and diet for D. atlanticus was given by a wider mouth gape related to the presence of copepod nauplii, whilst for D. laternatus, a shorter snout and posteriorly displaced eye were related to the presence of highly digested stomach contents. Interspecific differences between diets and skull shapes suggest that both species may have undergone morphological or niche divergence to avoid competition, such as feeding at different hours or depth stratification., (© 2019 The Fisheries Society of the British Isles.)

This study assesses seasonal variation in the morphology and diet of juveniles and adults of the Easter Island endemic goby Kelloggella disalvoi from intertidal pools during September-October 2015 (spring) and June-July 2016 (winter), utilizing geometric morphometric and gut-content analyses. A set of 16 landmarks was digitized in 128 individuals. Shape changes related to size changes (i.e. allometry) were low (18·6%) and were seasonally similar. Body shape changes were mainly dorsoventral (44·2% of variance) and comprised posteroventral displacement of the premaxilla and bending of the body. The latter included vertical displacement of the anterior portion of the first and second dorsal fins and the entire base of the caudal fin. Diets mainly comprised developmental stages of harpacticoid copepods (from eggs to adults), ostracods, isopods, gastropods and bivalves. Also, trophic niche breadth remained constant throughout development and did not vary between seasons. Nonetheless, significant dietary differences were detected in specimens collected during spring (main prey items: harpacticoid copepods and copepod eggs) and winter (harpacticoid copepods and copepod nauplii). Finally, there was weak but significant covariation between diet and morphology: molluscivores were characterized by having an inferior mouth gape, whereas planktivores had an anteriorly directed premaxilla., (© 2017 The Fisheries Society of the British Isles.)