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Prcis: This study demonstrated that the compliance levels with International Council of Ophthalmology (ICO) Guidelines for glaucoma eye care were low for all the elements in both public and private health care settings., Purpose: To determine the compliance with the ICO guidelines for glaucoma eye care among Pakistani ophthalmologists and to compare differences among ophthalmologists practicing in public and private health care settings., Materials and Methods: This was a retrospective chart review, and the records were reviewed according to ICO guidelines. The ICO recommends that each patient with glaucoma be evaluated for 19 items from 3 elements which are history, examination, and investigations. Mean compliance was recorded for each of the 3 elements. The compliance of each item was also checked and then a compared between the 2 settings, that is, public and private health care settings., Results: A total of 394 records were analyzed, with a mean age of 51.9±14.9 years and 232 (58.9%) male patients. Most records were from private settings 339 (86%), and primary open angle glaucoma 163 (41.4%) was the most common diagnosis. Compliance was low for all elements; history (31.8%), examination (61.3%), and investigation (6%). Pupil reaction differed significantly between the 2 groups ( P =0.001)., Conclusion: Pakistan's ophthalmologists, whether in public or private health care settings, lack knowledge of ICO guidelines for glaucoma eye care. This study emphasizes the importance of implementing these guidelines in the general ophthalmology curriculum., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Adhesive hydrogels, composed of hydrophilic polymers arranged in a three-dimensional network, have emerged as a pivotal innovation in ophthalmology due to their ability to securely adhere to ocular tissues while providing sustained therapeutic effects. The eye, with its delicate structure and specific needs, presents unique challenges for drug delivery and tissue regeneration. This review explores the transformative potential of adhesive hydrogels in addressing these challenges across a range of ocular conditions, including corneal injuries, cataracts, glaucoma, vitreoretinal disorders, and ocular trauma. By detailing the mechanisms of polymerization and adhesion, this paper highlights how these materials can be customized for specific ophthalmic applications, offering insights into their current use and future possibilities. The emphasis is placed on the clinical significance and future directions of adhesive hydrogels in advancing ophthalmic therapy, potentially revolutionizing the treatment of complex eye diseases., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)

Generative artificial intelligence (AI) has revolutionized medicine over the past several years. A generative adversarial network (GAN) is a deep learning framework that has become a powerful technique in medicine, particularly in ophthalmology for image analysis. In this paper we review the current ophthalmic literature involving GANs, and highlight key contributions in the field. We briefly touch on ChatGPT, another application of generative AI, and its potential in ophthalmology. We also explore the potential uses for GANs in ocular imaging, with a specific emphasis on 3 primary domains: image enhancement, disease identification, and generating of synthetic data. PubMed, Ovid MEDLINE, Google Scholar were searched from inception to October 30, 2022, to identify applications of GAN in ophthalmology. A total of 40 papers were included in this review. We cover various applications of GANs in ophthalmic-related imaging including optical coherence tomography, orbital magnetic resonance imaging, fundus photography, and ultrasound; however, we also highlight several challenges that resulted in the generation of inaccurate and atypical results during certain iterations. Finally, we examine future directions and considerations for generative AI in ophthalmology., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to declare., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

The Schirmer strip measures tear volume in millimeters. A major limitation of the Schirmer strip is that it does not measure tear volume in a volumetric unit. Furthermore, the linearity range, lower limit of detection (LLOD), and lower limit of quantification (LLOQ) are not established. In this context, we developed a new filter paper based tear volume strip, which measures tear volume in microlitres (a volumetric unit), with a defined linearity range, LLOD, LLOQ, as well as inter-day and intra-day variability. We used standard Whatman filter paper no. 41, measuring 40 × 5 mm. Balanced salt solution (BSS) was used as a tear surrogate. By placing a specific volume of BSS at one marked end of the paper, we measured the distance travelled by the BSS after one minute. Different volumes of BSS (0.5, 1, 2, 4, 8, and 16 μl) were used, and the distance travelled by the BSS drop was recorded. Linearity was evaluated, and the LLOQ and LLOD were determined. Scale data were generated within the linearity range (10 replicates for each). Percentage recovery was calculated, and inter-day and intra-day variation as well as intra examiner and inter examiner coefficients of variation (CV%) were evaluated. High linearity (r2 = 0.976) was observed across all the tested volumes (0.5–16 μl), However, linearity improved within the tested volume range of 1–8 μl (r2 = 0.996). With an LLOD of 0.538 μl and an LLOQ of 1.63 μl, data for the scale were generated from 2–8 μl. Overall, volumetric recovery ranged from 97.34%–104%. The intra-day CV% ranged from 4.576% (for 2 μl) to 1.911% (for 5 μl) and 1.71% (for 7 μl). The inter-day CV% ranged from 1.715 (7 μl) to 4.36% (for 2 μl). The intra examiner CV% ranged from 0.422% (for 7 μl) to 2.66% (for 2 μl). The inter examiner CV% ranged from 1.93% (7 μl) to 3.69% (for 2 μl). This new tear volume measuring tool (named SI tear strip) represents a valuable tool for the measurement of tear volume (in μl) per unit time. This tool may be very helpful for the quantitative evaluation of dry eye patients and functional assessment of lacrimal glands.

AIM: To analyze the current status, research hotspots, and development trends of international studies on ocular surface microbiota based on bibliometrics.METHODS: Leveraging the Web of Science database, we conducted a targeted literature search on ocular surface flora. The retrieved data were meticulously screened and weighted to enhance relevance. The bibliometric analysis delved into publication trends, authorship patterns, institutional collaborations, and pivotal research themes. Employing Cite Space software, we visually dissected the landscape of institutional and national partnerships, citation impact, keyword co-occurrences, keyword clustering dynamics, and the emergence of new research trends.RESULTS: A total of 3 884 publications were ultimately included, with an overall upward trend in the number of publications in the field of ocular surface microbiota from 2003 to 2023, with the most rapid growth occurring from 2019 to 2022. The top three regions/countries by publication volume are the United States(1 039 papers), China(570 papers), and India(302 papers). The top three authors by publication volume are Willcox Mark(48 papers), Sharma Savitri(33 papers), and Fleiszig Suzanne M.J(27 papers). The top three institutions by publication volume, all from the United States, are the University of California, L.V. Prasad Eye Institute, and Harvard University. The citation network map of the literature includes 801 nodes and 1 508 connections, with the most frequently cited document being Temporal Stability and Composition of the Ocular Surface Microbiome. The top 5 keywords by frequency of occurrence are, in order, keratitis, bacterial flora, identification, inflammation, and endophthalmitis. The keyword clustering analysis yielded a total of 8 clusters, which are specifically reflected in three aspects: ocular-related diseases, the relationship between ocular surface microbiota and ocular surface structures, and detection methods for ocular surface microbiota. The keyword with the highest burst strength is ciprofloxacin. Keywords that have emerged in recent years and continue to the present include diversity, gut microbiome, and ocular surface microbiome.CONCLUSION: Currently, the study of ocular surface microflora is gaining momentum globally, with a particular focus on the diversity of microflora, the composition of the core microbiome, and its impact on ocular diseases. In the future, research should concentrate on elucidating the functional metabolism of the ocular surface microflora and further investigate the causality and mechanisms by which changes in the ocular surface microflora are related to diseases.

• Evaluation of robustness of different eye blinking algorithms. • Development of Low-cost imaging acquisition system and test protocol. • Montecarlo simulations to evaluate the algorithms performance with added Gaussian noise. • Algorithm based on Image correlation offers best performance with low noise level. • Algorithm based on Local binary pattern provides best results with high noise level. Robust algorithms for eye blinking detection are required due to the effects of noisy environments and varying light conditions on image-based detection methods. This paper compares five non-supervised image-based algorithms for eye blinking detection, evaluating their robustness to additive Gaussian noise. The algorithms were tested on a video dataset acquired using a smartphone and an ophthalmology chin rest. Through Monte Carlo simulation that introduces Gaussian noise at different intensities, we evaluate the algorithms' precision, sensitivity, and F1-scores for frame classification, True Positive Rate (TPR), False Discovery Rate (FDR) and F1-score for the event detector. The results of experimental tests reveal significant variations in algorithms' performance with increasing noise levels. Notably, the Image Correlation (IC) algorithm demonstrates superior eye blinking detection capabilities under various noise conditions, emerging as the most robust algorithm among those tested. This distinction highlights the potential of IC for reliable blink detection in noisy environments. [ABSTRACT FROM AUTHOR]

Myopia is an increasingly prevalent public health concern globally, with a complex pathogenesis involving the interplay of multiple signaling pathways and genes. The Wnt signaling pathway plays a crucial role in biological processes such as cell proliferation, differentiation, apoptosis, and tissue remodeling, and its role in myopia development has garnered significant attention in recent years. Studies have demonstrated that the Wnt signaling pathway influences the occurrence and progression of myopia by regulating the proliferation, differentiation, and apoptosis of retinal cells(including RPE cells and ipRGCs), as well as the proliferation of scleral fibroblasts and the expression of extracellular matrix components(such as type I collagen), thereby affecting scleral remodeling and axial length elongation. This paper summarizes the roles of the Wnt signaling pathway in myopia development within different ocular tissues(retina and sclera)and explores potential myopia prevention and treatment strategies based on this pathway, providing insights for further research and clinical management of myopia.

In his beautiful book, Consilience: The Unity of Knowledge, the eminent biologist Edward O Wilson, advocates the need for integration and reconciliation across the sciences. He defines consilience as “literally a ‘jumping together' of knowledge with a linking of facts … to create a common groundwork of explanation”. It is the premise of this paper that as much as basic biomedical research is in need of data generation using the latest available techniques-unifying available knowledge is just as critical. This involves the necessity to resolve contradictory findings, reduce silos, and acknowledge complexity. We take the cornea and the lens as case studies of our premise. Specifically, in this perspective, we discuss the conflicting and fragmented information on protein aggregation, oxidative damage, and fibrosis. These are fields of study that are integrally tied to anterior segment research. Our goal is to highlight the vital need for Wilson's consilience and unity of knowledge which in turn should lead to enhanced rigor and reproducibility, and most importantly, to greater understanding and not simply knowing.