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Clinical Relevance: Understanding the awareness level of diabetes and diabetes-related eye diseases will help in developing better eye health education programmes and improve health-seeking behaviour in the community., Background: Diabetes and diabetes related eye diseases are increasing in numbers both in urban and rural areas in India. There are limited data on awareness of diabetes and diabetes-related eye disease in rural communities of India. This study reports on awareness of diabetes and diabetes-related eye diseases in people aged ≥40 years from two rural districts of Telangana, India., Methods: A structured questionnaire was used to determine the awareness of diabetes and diabetes-related eye diseases among participants aged ≥40 years in the Khammam and Warangal districts of Telangana, India. Social investigators visited the participant's households and conducted the interviews. A positive response to a question on having heard about diabetes was considered as 'awareness'. For those aware, follow-up questions were asked about the effect of diabetes on vision, frequency of eye examination and source of information. A positive response on a question that diabetes could cause loss of vision was considered as awareness of diabetic eye disease., Results: A total of 3273 participants were interviewed. Among them, 56.2% ( n  = 1840) were women, 60.6% ( n  = 1985) had no formal education, and 50.2% ( n  = 1645) were from the Khammam district. The mean age of the participants was 55.3 years (standard deviation: 11.7 years). Awareness of diabetes was 52.5% ( n  = 1719). Among them, 1056 participants (61.4%) were aware that diabetes could affect vision., Conclusion: Only half of the participants were aware of diabetes and of this substantial proportion of individuals was unaware of potential vision loss due to diabetes. Improving awareness about diabetes and its impact on vision is recommended to prevent potential vision loss in this population.

Purpose: The aim of this study was to report a case of primary vitreoretinal lymphoma (PVRL) relapse presenting as occlusive retinal vasculitis with secondary neovascularization., Methods: This study was a retrospective case report., Results: A 40-year-old woman presented to the clinic with complaints of blurring of vision in the left eye for 4 months. Her best-corrected VA (BCVA) was 20/20 and 20/500 in the right and left eye, respectively. The vitreous cavities of both eyes showed vitreous opacities (2+). Both eyes fundus showed multifocal yellowish-white subretinal infiltration. A diagnostic vitreous and subretinal biopsy of the left eye revealed large lymphoid cells with CD-20 positivity, confirming the diagnosis of PVRL. The patient received 12 intravitreal methotrexate injections in both eyes over a course of 2 months, after which the lesions completely resolved. However, after 5 months, the left eye showed characteristic subretinal lesions along with perivascular exudates and retinal hemorrhages, diagnosed as PVRL relapse presenting as occlusive retinal vasculitis. Fluorescein angiography revealed retinal neovascularization, for which panretinal photocoagulation was performed along with repeated intravitreal methotrexate injections., Conclusion: Primary vitreoretinal lymphoma is a great masquerader, and although rare, PVRL relapse can present as occlusive retinal vasculitis with secondary neovascularization, thereby delaying diagnosis and subsequent treatment.

Purpose: To identify the predisposing factors, clinico-microbiological profiles, and treatment responses in patients with atypical mycobacterial keratitis., Methods: The study retrospectively analyzed patients who presented at a tertiary eyecare center in eastern India with atypical mycobacterial keratitis between 2008 and 2021. The diagnostic criteria included cases positive for acid-fast bacilli on Ziehl-Nielsen stain or culture. The antibiotic susceptibility pattern was observed, and treatment was initiated accordingly., Results: Out of the 29 cases, ocular predisposing factors were present in 62.1% with an antecedent history of trauma, and vegetative matter was the most common risk factor. There was no predisposing association with systemic conditions in any case. A long lag time was observed between the onset of corneal infection and presentation in 79.3% of cases, with the average time being 43.7 days. Clinical signs mimicked fungal keratitis in most cases. Typical cracked windshield appearance was only observed in two cases. Two patients presented with clinical pictures like peripheral ulcerative keratitis. Topical amikacin was used as treatment in 28 cases. Based on disk diffusion assay, 28 (96.5%) isolates were sensitive to amikacin. Twelve (41.3%) were sensitive to vancomycin, six (20.6%) to gatifloxacin, six (20.6%) to ciprofloxacin, and four (13.7%) to moxifloxacin. Twelve participants showed good final visual acuity posttreatment, which improved to over two lines of Snellen's visual acuity chart (44.5%)., Conclusion: Atypical mycobacteria keratitis may not present with classically described clinical features. The duration of presentation, clinical presentation, special microbiological stains, targeted therapy, and antibiotic susceptibility patterns are the key to successfully managing these intractable infections and obtaining favorable outcomes., (Copyright © 2024 Indian Journal of Ophthalmology.)

Clinical Relevance: Near Vision Impairment (NVI) is common in developing countries. A substantial proportion of NVI can be addressed by providing spectacles. Innovative eye care programmes are needed to address NVI. Population-based epidemiological studies can provide vital data to plan such eye care service delivery models., Background: To report the prevalence of NVI and effective Refractive Error Coverage (eREC) for near vision in West Godavari and Krishna districts in Andhra Pradesh, south India., Methods: A population-based cross-sectional study was carried out using a Rapid Assessment of Visual Impairment methodology. Presenting and pinhole distance visual acuity were assessed followed by near vision assessment using a N notation chart at a fixed distance of 40 cm. If the presenting near vision was worse than N8, the best corrected near visual acuity was recorded with age appropriate near vision correction. NVI was defined as presenting near vision worse than N8 among those without distance vision impairment (6/18 or better in the better eye). Effective Refractive Error Coverage for near was calculated as the proportion of individuals with an adequate correction to the total participants, including those with inadequate, adequate, and no correction for near vision., Results: Data of 2,228 participants aged ≥40 years were analysed. The mean age of these participants was 54.0 ± 10.4 years; 53.8% were women; 44.5% had no formal education. The prevalence of NVI was 27.1% (95% CI: 25.2-29.0%). NVI significantly associated with 70 and above age group (adjusted OR: 1.97; 95% CI: 1.45-3.70). Participants with formal education had lower odds for NVI (adjusted OR: 0.75; 95 % CI: 0.68-0.83). The eREC for near vision was 48.0%., Conclusion: NVI affects over a quarter of people aged ≥40 years in the West Godavari and Krishna districts of Andhra Pradesh. However, eREC is under 50% and there is scope for improving this by establishing eye care services to achieve universal eye health for all.

Purpose: The purpose of this study is to present the clinico-demographic characteristics of pseudophakic bullous keratopathy (PBK), its visual outcomes, factors associated with the choice of treatment, and poor visual outcomes of PBK., Methods: In this hospital-based retrospective study, electronic medical records data of new patients who presented to a multi-tier ophthalmology hospital network in India (November 2010-June 2022) were extracted. Patients with at least 4 weeks of follow-up were analyzed for visual outcome data. Bivariate analysis and multivariate logistic regression were used to determine the factors associated with the treatment choice and poor visual outcomes., Results: Of the 3,323,247 electronic records (with an average follow-up of 293 days) examined, 10,522 eyes of 10,158 patients (0.3%) had PBK. The majority were managed non-surgically ( n = 7372; 70.1%), with increased odds of poor visual outcome by 3.46 times (AdjOR: 3.04-3.92, P < 0.001). Those belonging to the non-paying category had higher odds of poor visual outcome (AdjOR: 1.48, 95%CI: 1.29-1.69; P < 0.001). Surgical management improved vision by 0.72 logMAR (95%CI: 0.60-0.73; P < 0.001). A total of 41.2% ( n = 113/274) of cases that underwent Descemet's membrane endothelial keratoplasty and 18.4% ( n = 285/1551) of Descemet's stripping endothelial keratoplasty attained last follow-up visual acuity (LVA) of 6/18 or better., Conclusion: About three in every thousand patients had PBK. Surgical interventions improved visual acuity significantly. About four in ten patients who underwent DMEK attained a vision of 6/18 or better at the last follow-up visit. Markers of lower socioeconomic strata were independently associated with poor visual outcomes., (Copyright © 2024 Indian Journal of Ophthalmology.)

Introduction: Understanding barriers to seeking eye care and providing evidence-based theory-informed solutions can improve the uptake of eye care services. Therefore, in this cross-sectional study, we aim to report and analyse barriers to seeking eye care services among individuals with vision impairment in the Akividu region of Andhra Pradesh, India., Methods: Out of the 3000 enumerated participants, a total of 2587 were examined. All participants with vision impairment were asked to report barriers for not seeking eye care despite noticing reduced vision using a validated questionnaire. The reported barriers were mapped to the theoretical domains framework (TDF) to explore potential individual and environmental influences on the uptake of eye care services., Results: Barriers to seeking eye care services are most frequently mapped to the 'beliefs about capabilities', 'environmental context and resources' and 'social influences' domains of the TDF. The most frequently reported barrier was 'aware of the problem but can manage' (beliefs about capabilities), expressed by 43.4% (n = 156) and 55.7% (n = 337) of participants with distance and near vision impairment, respectively. 'No one to accompany' for an appointment (social influences) was a significant barrier for participants with distance vision impairment (n = 44, 12.2%) in comparison to participants with near vision impairment (n = 19, 3.1%). Additionally, fear of losing eyesight or operation or consultation (emotion) was a major deterrent for seeking eye care services, particularly among participants with distance vision impairment (n = 31, 8.6%) when compared with near vision impairment (n = 17, 2.8%)., Conclusion: The uptake of eye care services is influenced by a complex set of interacting factors. Identification of potentially modifiable target behaviours provides an opportunity to develop theory-informed solutions to improve uptake of services and prevent avoidable vision loss., (© 2024 The Author(s). Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists.)

Objective: Visual field assessment is an important presurgical test for patients with drug-resistant epilepsy (DRE), particularly with posterior cortex epilepsy. However, the assessment using conventional perimeters like Humphrey Visual Field Analyzer (HFA) may not always be feasible in some patients. This study aims to determine if alternative methods like tangent screen perimetry or Baby Vision Screener (BaViS) can be used for such patients., Methods: This retrospective study included 17 patients (mean age: 18 ±  8.7, range: 6 to 38 years) with DRE. Visual fields were attempted first with HFA and then with one or both alternative methods, by different examiners. Visual field extent was measured using the kinetic perimetry mode in the alternative methods. With HFA, kinetic and/or static perimetry was attempted., Results: Only 12% of the patients were able to perform the HFA. Whereas the testability of BaViS was 91% and tangent screen perimetry was 87%. Comparable visual field isopters were obtained on one patient on whom all the 3 tests could be performed, and in two patients on whom at least two tests could be performed reliably. For one patient, visual field isopters could not be quantified on any device. In this patient, a gross visual field assessment was possible using BaViS., Conclusion: BaViS or tangent screen perimeter can be used to quantify visual field defects in patients with DRE when conventional perimetry is not possible. Such an approach may help the clinician in assessing the suitability of patients with DRE and visual field deficits, for epilepsy surgery., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: Author PNS has a patent on the Pediatric Perimeter device (US Patent No.:10517475 B2, India Patent No.: 425672)., (Copyright: © 2025 Thakur et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objectives: Characterise the international variation in ophthalmic trauma and determine risk factors associated with visual and anatomical outcomes for low-, middle- and high-income countries., Subjects/methods: Observational multi-centre cohort study using data from the International Globe and Adnexal Trauma Epidemiological Eye Study (IGATES) from April 2014 to August 2023. Data on acute presentations of ophthalmic injury including open/closed globe injury, and/or Adnexal/orbital involvement, and/or intraocular/ intraorbital foreign body were collected and Ocular Trauma Score (OTS) was calculated. A total of 5350 patients (5557 eyes) from 31 centres in 12 countries were included. The main outcome measures included demographics, mechanism and setting of injury, and presenting and final visual outcomes. Descriptive statistics, Kruskal-Wallis tests and multinomial logistic regression (MLR) analysis are presented, with correction performed using the Hochberg method. P values less than 0.005 were significant., Results: Age, gender, presenting and final best-corrected visual acuity were all strongly associated with country (p < 0.005). Poor final visual outcomes were strongly associated with OTS predictions, type of injury (p < 0.005) and delayed presentation as well as firework injuries. High-income countries (HIC) showing reduced duration to presentation (HIC 5 h) and increased improvement in visual acuity (HIC -0.40) compared to low to middle-income countries (LMICs) (28 h) (-0.19). MLR analysis identified a significant association between countries' income classification and BCVA worse than 6/60, presence of scleral, iris, limbus injury and surgery being undertaken (p < 0.005)., Conclusion: Data from 31 centres internationally identified differences in demographic trends for each country. Age was identified as a risk factor for eye injuries. Low- and middle-income countries were associated with longer delays to presentation, smaller gains in BCVA and poorer visual outcomes. IGATES provides an opportunity to collect global data on ophthalmic trauma to facilitate improved management and prevention strategies., Competing Interests: Competing interests: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)

Competing Interests: Competing interests: The authors declare no competing interests.

Precis: Phakomatosis pigmentovascularis, a multisystem disorder, exhibited male predominance, with Phakomatosis cesioflammea as the most prevalent type. Glaucoma affected 88% of eyes, with three-quarters requiring surgery. Systemic issues, notably epilepsy and anaemia, were prevalent in over half of all subjects., Purpose: To report the clinical profile and demographic characteristics of a large cohort with Phakomatosis pigmentovascularis (PPV)., Participants: Included 119 eyes of 60 patients with PPV between January 1996 and January 2023 (27 y)., Methods: This is a retrospective multi-centric study involving 4 tertiary network institutes in India. The diagnosis of PPV was established based on the concurrent presence of pigmentary nevi and capillary malformation, with classification conducted according to the Happle classification system. Demographic information, clinical features at the time of diagnosis (both ocular and systemic), the prevalence of glaucoma, details of management strategies employed, and the subsequent outcomes were meticulously documented., Main Outcome Measures: Key outcome measures included the prevalence of glaucoma among patients, the frequency of systemic abnormalities noted, and the various surgical interventions performed along with their respective success rates., Results: The cohort had male preponderance (male: female ratio of 67%:33%), with median age of presentation at 0.48 (range=0.12, 7.77) years. Glaucoma was observed in 105 eyes (88.2%), with bilateral involvement present in 75% of cases. The most prevalent phenotype observed within the cohort was Phakomatosis cesioflammea (Type iib), affecting 65% of patients. Systemic abnormalities were noted in 51.6% of cases, with epilepsy (45%) and anaemia (36%) being the most frequently documented conditions. Surgical intervention was required for 64.7% of eyes for intraocular pressure control, with combined trabeculotomy and trabeculectomy being the predominant procedure employed. Surgical success was noted in 87% of eyes, and 19.4% eyes had complications., Conclusion: Phakomatosis cesioflammea (Type iib) was the most common subgroup noted. Majority of patients had glaucoma, often bilateral, with two-thirds requiring surgical intervention for IOP control. Systemic abnormalities were common, emphasizing the need for comprehensive multisystem evaluation in these patients., Competing Interests: Conflict of interest: No conflicting relationship exists for any author., (Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.)

Rationale: The increasing prevalence of myopia is a growing global public health problem, in terms of rates of uncorrected refractive error and significantly, an increased risk of visual impairment due to myopia-related ocular morbidity. Interventions to slow its progression are needed in childhood, when myopia progression is most rapid. This is a review update, conducted as part of a living systematic review., Objectives: To assess the comparative efficacy and safety of interventions for slowing myopia progression in children using network meta-analysis (NMA). To generate a relative ranking of interventions according to their efficacy. To produce a brief economic commentary, summarising economic evaluations., Search Methods: We searched CENTRAL, MEDLINE, Embase, and three trial registers. The latest search date was 19 February 2024., Eligibility Criteria: We included randomised controlled trials (RCTs) of optical, pharmacological, light therapy and behavioural interventions for slowing myopia progression in children, up to 18 years old., Outcomes: Critical outcomes were progression of myopia (mean difference (MD) in the change in spherical equivalent refraction (SER, dioptres (D)), and axial length (AL, mm) in the intervention and control groups at one year or longer), and difference in the change in SER and AL following cessation of treatment (rebound)., Risk of Bias: We assessed the risk of bias (RoB) for SER and AL using the Cochrane RoB 2 tool., Synthesis Methods: We followed standard Cochrane methods. We rated the certainty of evidence using the GRADE approach for change in SER and AL at one and two years. We used the surface under the cumulative ranking curve (SUCRA) to rank the interventions for all available outcomes., Included Studies: We included 104 studies (40 new for this update) that randomised 17,509 children, aged 4 years to 18 years. Most studies were conducted in China or other Asian countries (66.3%), and North America (14.4%). Eighty-four studies (80.8%) compared myopia control interventions against inactive controls. Study durations ranged from 12 months to 48 months., Synthesis of Results: Since most of the networks in the NMA were poorly connected, our estimates are based on direct (pairwise) comparisons, unless stated otherwise. The median change in SER for controls was -0.65 D (55 studies, 4888 participants; one-year follow-up). These interventions may reduce SER progression compared to controls: repeated low intensity red light (RLRL: MD 0.80 D, 95% confidence interval (CI) 0.71 to 0.89; SUCRA = 93.8%; very low-certainty evidence); high-dose atropine (HDA (≥ 0.5%): MD 0.90 D, 95% CI 0.62 to 1.18; SUCRA = 93.3%; moderate-certainty evidence); medium-dose atropine (MDA (0.1% to < 0.5%): MD 0.55 D, 95% CI 0.17 to 0.93; NMA estimate SUCRA = 75.5%; low-certainty evidence); low dose atropine (LDA (< 0.1%): MD 0.25 D, 95% CI 0.16 to 0.35; SUCRA = 53.2%; very low-certainty evidence); peripheral plus spectacle lenses (PPSL: MD 0.45 D, 95% CI 0.16 to 0.74; SUCRA = 50.2%; very low-certainty evidence); multifocal soft contact lenses (MFSCL: MD 0.27 D, 95% CI 0.18 to 0.35; SUCRA = 49.9%; very low-certainty evidence); and multifocal spectacle lenses (MFSL: MD 0.14 D, 95% CI 0.08 to 0.21; SUCRA = 30.8%; low-certainty evidence). The median change in AL for controls was 0.33 mm (58 studies, 9085 participants; one-year follow-up). These interventions may reduce axial elongation compared to controls: RLRL (MD -0.33 mm, 95% CI -0.37 to -0.29; SUCRA = 98.6%; very low-certainty evidence); HDA (MD -0.33 mm, 95% CI -0.35 to -0.30; SUCRA = 88.4%; moderate-certainty evidence); MDA (MD -0.24 mm, 95% CI -0.34 to -0.15; NMA estimate SUCRA = 75.8%; low-certainty evidence); LDA (MD -0.10 mm, 95% CI -0.13 to -0.07; SUCRA = 36.1%; very low-certainty evidence); orthokeratology (ortho-K: MD -0.18 mm, 95% CI -0.21 to -0.14; SUCRA = 79%; moderate-certainty evidence); PPSL (MD -0.13 mm, 95% CI -0.21 to -0.05; SUCRA = 52.6%; very low-certainty evidence); MFSCL (MD -0.11 mm, 95% CI -0.13 to -0.09; SUCRA = 45.6%; low-certainty evidence); and MFSL (MD -0.06 mm, 95% CI -0.09 to -0.04; SUCRA = 26.3%; low-certainty evidence). Ortho-K plus LDA probably reduces axial elongation more than ortho-K monotherapy (MD -0.12 mm, 95% CI -0.15 to -0.09; SUCRA = 81.8%; moderate-certainty evidence). At two-year follow-up, change in SER was reported in 34 studies (3556 participants). The median change in SER for controls was -1.01 D. The ranking of interventions to reduce SER progression was close to that observed at one year; there were insufficient data to draw conclusions on cumulative effects. The highest-ranking interventions were: HAD (SUCRA = 97%); MDA (NMA estimate SUCRA = 69.8%); and PPSL (SUCRA = 69.1%). At two-year follow-up, change in AL was reported in 33 studies (3334 participants). The median change in AL for controls was 0.56 mm. The ranking of interventions to reduce axial elongation was similar to that observed at one year; there were insufficient data to draw conclusions on cumulative effects. The highest-ranking interventions were: ortho-K plus LDA (SUCRA = 94.2%); HAD (SUCRA = 96.8%); and MDA (NMA estimate SUCRA = 88.4%). There was limited evidence on whether cessation of myopia control therapy increases progression beyond the expected rate of progression with age. Adverse events and treatment adherence were not consistently reported. Two studies reported quality of life, showing little to no difference between intervention and control groups. We were unable to draw firm conclusions regarding the relative costs or efficiency of different myopia control strategies in children., Authors' Conclusions: Most studies compared pharmacological and optical treatments to slow the progression of myopia with an inactive comparator. These interventions may slow refractive change and reduce axial elongation, although results were often heterogeneous. Less evidence is available for two years and beyond; uncertainty remains about the sustained effect of these interventions. Longer term and better quality studies comparing myopia control interventions alone or in combination are needed, with improved methods for monitoring and reporting adverse effects., Funding: Cochrane Eyes and Vision US Project is supported by grant UG1EY020522, National Eye Institute, National Institutes of Health., Registration: The previous version of this living systematic review is available at doi: 10.1002/14651858.CD014758.pub2., (Copyright © 2025 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.)

Clinical Relevance: Rising myopia prevalence in Indian children necessitates an increase in the number of myopia practitioners across all states to effectively counteract its progression and prevent long-term visual impairment., Purpose: There is limited information on how eye care practitioners perceive and practice myopia control treatments in India. This study aimed to assess the current knowledge, attitudes, practices, and barriers to initiating myopia management among eye care practitioners in India., Methods: A self-administered online questionnaire was distributed through social media platforms and emails to eye care practitioners from January 8 to 23, 2022. This survey comprised a total of 12 questions to seek information related to knowledge, attitudes, practices, and barriers associated with myopia management. Basic descriptive and percentage analyses were performed., Results: Among the 423 respondents, optometrists were 66% ( n  = 279/423), followed by ophthalmologists (16%, n  = 68/423) and trainees involving optometrists and ophthalmologists (18%, n  = 76/423). Of all, only 22% ( n  = 94/423) indicated practicing myopia management. They gained knowledge through scientific articles (71%, n  = 300/423), conferences, and continuous professional education (62%, n  = 231/423). Low-concentration atropine eye drops are widely considered for myopia control by both optometrists (57%, n  = 28/49) and ophthalmologists (97%, n  = 38/39), along with behavioural and lifestyle modifications (55%, n  = 27/49; 74%, n  = 29/39). A smaller proportion preferred to under-correct myopia (20%, n  = 19/94) to counteract progression. Among myopia practitioners, combination therapy was recommended by 24% ( n  = 12/49) of optometrists and 23% ( n  = 9/39) of ophthalmologists to halt progression if a single modality was ineffective. The major barriers to initiating myopia management were lack of awareness among parents (73%, n  = 68/94), lack of education (34%, n  = 143/423) and training (26%, n  = 112/423) among practitioners, and unavailability of treatment modalities in various regions of India (18%, n  = 76/423)., Conclusion: Only 1 out of 5 practitioners was actively involved in practicing myopia management. Barriers must be minimised through various means to enable routine myopia practice in clinics.

Introduction: Rhegmatogenous retinal detachment (RRD) is a vision-threatening complication of viral retinitis, at times compounded by proliferative vitreoretinopathy (PVR) at the junction of the necrotic and unaffected retina., Methods: Retrospective review of eyes with 'junctional PVR' in RRD after viral retinitis. We define junctional PVR as presence of stiffness, transverse traction, epiretinal membrane and/or pucker at the junction of normal and necrotic retina., Results: Five eyes of four patients with a mean age at presentation of 46.5 ± 10.96 years were included. Immunosuppression due to Human immunodeficiency virus (HIV) was the underlying condition in all the cases. Posterior hyaloid removal and epiretinal membrane removal at the junctional PVR was performed in all cases. Favourable outcomes were observed in seven sites where epiretinal membrane (ERM) removal with inner limiting membrane (ILM) peeling was performed; however, one site developed localised RRD requiring re-surgery. The mean logMAR best-corrected visual acuity (BCVA) improved from 1.84 before surgery to 0.64 during the last follow-up. All patients had undergone 23 G vitrectomy and silicone oil tamponade 1500 Centistokes (cSt) was used in all patients for a mean duration of 6.8 months., Conclusion: Management of posterior hyaloid coupled with ERM removal and localised ILM peeling may be used to address junctional PVR in the eyes with RRD after viral retinitis., Competing Interests: Declarations. Conflict of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article., (© 2025. The Author(s), under exclusive licence to Springer Nature B.V.)

Purpose: To objectively assess the long-term corneal epithelial recovery after autologous simple limbal epithelial transplantation (SLET) for ocular chemical burn (OCB)-induced unilateral limbal stem cell deficiency (LSCD)., Design: Prospective, fellow-eye controlled, cross-sectional imaging and diagnostic study., Subjects: The study included 47 patients, who were 5 to 12 years post-autologous SLET done for OCB-induced unilateral LSCD., Methods: The donor and recipient eyes of all patients were assessed at a single follow-up visit with slit-lamp biomicroscopy (SLB), in vivo confocal microscopy (IVCM), impression cytology (IC), anterior segment optical coherence tomography (ASOCT), and Scheimpflug imaging (SI). The objective parameters that were assessed were corneal epithelial phenotype (CEP), thickness (CET), reflectivity (CER), and densitometry (CED). Median values with inter-quartile ranges were assessed for all parameters and analyzed using non-parametric tests., Main Outcome Measures: The primary outcome measure was successful restoration of normal CEP on SLB, IVCM, and IC. Secondary outcome measures were comparison of CET and CER on ASOCT, and CED on SI between the eyes with successful and failed CEP restoration, and donor eyes., Results: The study analyzed 94 eyes of 47 patients, with a median follow-up of 5.75 years post-SLET. Successful restoration of CEP on SLB, IVCM, and IC was observed in 32 (68%) recipient eyes, while failure was seen in 15 (32%) eyes. The CEP was normal in all 47 (100%) donor eyes. The median CET was similar in healthy donor eyes, eyes with successful CEP restoration (55.9 microns, 50.3-59.2 vs. 57.8, 49.9-63.1; p=0.47) and eyes with failure (57.7 microns, 50.9-66.2; p≥0.59). Although, the median CER (100.72, 89.9-111.2 vs. 121.6, 109.7-139.8; p=0.001) and CED (14.7, 13.4-17.1 vs. 26.5, 20.1-30.2; p=0.02) values were significantly lower in eyes with successful CEP restoration as compared to eyes with failure, they were still significantly greater than corresponding values in the healthy donor eyes for CER (90.33, 84.9-96.9; p=0.02), and CED (13.5, 11.4-15.1; p=0.03), respectively., Conclusions: Long-term five-to-twelve-year successful restoration of the corneal epithelial phenotype was seen in two-thirds of eyes post-autologous SLET. While corneal epithelial reflectivity, and densitometry were relatively better in eyes with successful outcomes, corneal epithelial thickness was similar in all eyes., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to disclose., (Copyright © 2025. Published by Elsevier Inc.)

Purpose: The purpose of this study was to examine anatomic relationships between Descemet's membrane (DM) and neighboring tissues., Methods: Human eyes enucleated due to malignant uveal melanoma were histomorphometrically examined., Results: In all 50 eyes included in the study (age = 59.2 ± 13.3 years), a cellular tissue (mean thickness at the DM end = 14.2 ± 19.5 µm), originating in the transitional zone, extended into the space between the peripheral DM and corneal stroma for a length of 142 ± 71 µm. This length decreased with the longer part of the DM covered with Hassall-Henle-bodies (beta = -0.30, B = -0.28, 95% confidence interval [CI] = -0.54 to -0.03, P = 0.03) and was not related with age (P = 0.84), axial length (P = 0.94), transitional zone length (P = 0.51), and the DM-scleral spur distance (P = 0.72). The DM thinned toward its end and the DM-like components appeared getting together and merging with transitional zone tissue fibers. The transitional zone length (mean = 267 ± 115 µm) varied from 82 µm to 586 µm, increased with longer DM-scleral spur distance (beta = 0.80, B = 0.67, 95% CI = 0.52 to 0.82, P < 0.001), and was not related with axial length (P = 0.74) or age (P = 0.18). The DM-scleral spur distance (mean = 660 ± 136 µm, range = 302 µm-979 µm) was not related with axial length (P = 0.60) or age (P = 0.06). The scleral spur dimensions (basis = 193 ± 103 µm, height = 151 ± 46 µm, length = 231 ± 75 µm) were not related with the DM-scleral spur distance (all P > 0.35), axial length (all P > 0.07), and age (all P > 0.25). In all eyes, the scleral spur tip was orientated anteriorly, with the longitudinal ciliary muscle inserting at its posterior side., Conclusions: DM is firmly connected with the transitional zone tissue, and indirectly through the corneoscleral TM, with the scleral spur. With the latter connected through the longitudinal ciliary muscle and Bruch's membrane with the optic disc, the DM is part of an anatomic spherical unit of the globe.

Competing Interests: Competing interests: The authors declare no competing interests.

Competing Interests: Competing interests: The authors declare no competing interests.

Competing Interests: Competing interests: The authors declare no competing interests.

Purpose: To report cataract surgical coverage (CSC) and effective Cataract Surgical Coverage (eCSC) from four districts in Telangana, India., Methods: Individuals aged ≥40 years were recruited from Adilabad, Mahbubnagar, Warangal and Khammam districts using two stage cluster sampling methodology. All participants had detailed eye examinations including visual acuity assessment using a standard Snellen chart at a distance of six meters, anterior segment examination and fundus imaging by trained professionals. CSC and eCSC were calculated for persons using a 6/12 visual acuity cut-off., Results: Of 12,150 individuals enumerated from four districts 11,238 (92.5%) were examined. The mean (standard deviation) age of the participants was 54.1 (±11.2) years (range: 40 to 102 years) and 54.6% ( n  = 6137) were women. Overall, the CSC (%) was 54.2%. It ranged from a highest of 59% in Khammam followed by 57.5% in Adilabad, 51.7% in Warangal, and a least of 49.7% in Mahbubnagar district. Overall, the eCSC (%) was 39.9%. It ranged from a highest of 46.1% in Adilabad followed by 43.2% in Khammam, 36.2% in Warangal district and a least of 35.8% in the Mahbubnagar district., Conclusions: CSC and eCSC varied across the districts. A significant gap between CSC and eCSC is noted suggestive of challenges with quality of services. District-wise planning of cataract surgical services with a focus on quality care is recommended to improve coverage and contribute towards achieving the goal of universal eye health coverage in the Telangana State in India.

Purpose: Post-operative vision impairment is common among patients who have undergone cataract surgery in low-resource settings, impacting quality of clinical outcomes and patient experience. This prospective, multisite, single-armed, pragmatic validation study aimed to assess whether receiving tailored recommendations via the free Better Operative Outcomes Software Tool (BOOST) app improved surgical outcomes, as quantified by post-operative unaided distance visual acuity (UVA) measured 1-3 days after surgery., Methods: During the baseline data collection round, surgeons in low and middle-income countries recorded clinical characteristics of 60 consecutive cataract cases in BOOST. Additional data on the causes of poor outcomes from 20 consecutive cases with post-operative UVA of <6/60 (4-12 weeks post-surgery) were entered to automatically generate tailored recommendations for improvement, before 60 additional consecutive cases were recorded during the follow-up study round. Average UVA was compared between cases recorded in the baseline study round and those recorded during follow-up., Results: Among 4,233 cataract surgeries performed by 41 surgeons in 18 countries, only 2,002 (47.3%) had post-operative UVA 6/12 or better. Among the 14 surgeons (34.1%) who completed both rounds of the study (1,680 cases total), there was no clinically significant improvement in post-operative average UVA (logMAR units ±SD) between baseline (0.50 ± 0.37) and follow-up (0.47 ± 0.36) rounds (mean improvement 0.03, p  = 0.486)., Conclusions: Receiving BOOST-generated recommendations did not result in improved UVA beyond what could be expected from prospective monitoring of surgical outcomes alone. Additional research is required to assess whether targeted support to implement changes could potentiate the uptake of app-generated recommendations and improve outcomes.

Aim: This study aimed to assess the impact of a mHealth and community health education intervention on diabetes awareness and promoting healthy dietary and lifestyle habits within a rural population in Andhra Pradesh, India., Methods: Using a quasi-experimental design, the mDiabetes program was implemented for 1 year, among 1,03,538 rural individuals. Under this program, 56 diabetes prevention messages (twice a week) in local language) were disseminated among the participants via voice calls for a period of 6 months. Additionally, community health education meetings were facilitated by trained community health workers and educational leaflets were distributed among the community members. Questionnaires were administered at three different time points-baseline (before the intervention), endline (after intervention), and follow-up (3 months after endline) to collect demographic data, diabetes-related knowledge, attitudes, practices, physical activity, and dietary habits. Analysis compared data from 545 subjects who participated in all the three surveys., Results: The cohort comprised 45.5% males and 54.5% females, aged 19-85 years (mean: 55.42; SD 10.3). Post-intervention, diabetes awareness rose to 97.43% at endline and 99.63% at follow-up from 82.75% at baseline. Belief in diabetes preventability increased from 25.5% to 69.5%, and awareness of lifestyle's impact on diabetes management improved from 72.6% to 80.9%. Over 90% recalled prevention messages, with significant lifestyle changes reported by 83% at endline and 73% at follow-up. Improved dietary and activity habits were evident, with fruit consumption and high-fat food avoidance at 78.5% and 67.7% in follow-up. Physical activity levels improved in both endline and follow-up groups compared to baseline. Daily participation in yoga, running, gym, and aerobics increased to 38.7% in endline and follow-up from 7.3% at baseline ( p < 0.001). Outdoor sports engagement rose significantly to 15% in endline and follow-up from 0.5% at baseline ( p < 0.001). Regular stair usage (59.8%), walking for chores (84.7%), and short walking breaks (93%) increased significantly in follow-up compared to baseline and endline ( p < 0.001)., Conclusion: The combined mHealth and community health education intervention improved diabetes awareness and healthy habits in rural areas, showing potential for lasting outcomes and guiding future public health efforts in similar settings., 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., (Copyright © 2025 Rani, Williams, Jaswal, Yandluri, Sangani, Sanagavarapu, Natarajan, Ramalingam, Saligram and Khanna.)

Worldwide, almost 10 million cancer deaths occurred in 2022, a number that is expected to rise to 16.3 million by 2040. Primary prevention has long been acknowledged as a crucial approach to reducing cancer incidence. In fact, between 30 and 50 percent of all tumors are known to be preventable by eating a healthy diet, staying active, avoiding alcohol, smoking, and being overweight. Accordingly, many international organizations have created tumor prevention guidelines, which underlie the importance of following a diet that emphasizes eating plant-based foods while minimizing the consumption of red/processed meat, sugars, processed foods, and alcohol. However, further research is needed to define the relationship between the effect of specific diets or nutritional components on cancer prevention. Interestingly, reductions in food intake and dietetic restrictions can extend the lifespan of yeast, nematodes, flies, and rodents. Despite controversial results in humans, those approaches have the potential to ameliorate health via direct and indirect effects on specific signaling pathways involved in cancer onset. Here, we describe the latest knowledge on the cancer-preventive potential of dietary restrictions and the biochemical processes involved. Molecular, preclinical, and clinical studies evaluating the effects of different fasting strategies will also be reviewed.

Purpose: To evaluate intermediate-term outcomes and complications associated with Ahmed glaucoma valve (AGV) implantation in eyes with type 1 keratoprosthesis (KPro)., Methods: We retrospectively reviewed records of 43 eyes of 43 Indian patients with type 1 KPro and AGV from 2009 to 2021 with a minimum of 6-months of follow-up. Five eyes that had AGV before KPro were excluded, leaving 38 eyes for analysis. Primary outcome measure was postoperative complications. Secondary outcome measure was stability of glaucoma, assessed by Humphrey visual fields, intraocular pressure, and best-corrected visual acuity (BCVA). Sight-threatening complications, implant removal, or repeat glaucoma surgery was considered failure., Results: Median age (interquartile range) at AGV implantation was 36.5 (23-49) years, with median post-AGV follow-up of 30.5 (6.5-53) months. Preoperative logarithm of minimal angle of resolution median BCVA was 0.6 (0.4-1). Post-AGV, median intraocular pressure as measured by scleral Schiotz reduced significantly from 30.4 (20.6-30.4) to 13.5(12.2-14.8) mm Hg (P < 0.0001), and the mean number of antiglaucoma medications significantly decreased from 3.4 to 1.7 (P < 0.0001). Mean BCVA (P = 0.24) remained stable. Humphrey visual fields mean deviation progressed from -13.5 dB (-25, -9) to -26 dB (-30, -13) at final follow-up (P = 0.05) and progression occurred in 10 eyes. Seven eyes (18.4%) had postoperative complications needing surgical intervention, including tube block [5 eyes (13.1%)] and tube exposure [2 eyes (5%)]. One failed AGV needed additional glaucoma surgery after 8 years. None had implant extrusion/explanation or endophthalmitis., Conclusions: Ahmed glaucoma valve implantation offered promising results in managing glaucoma in eyes with type 1 KPro, particularly in relatively young Indian population. However, close monitoring for tube-related complications and glaucoma progression is warranted., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.)

Competing Interests: Competing interests: The authors declare no competing interests.

Purpose: To assess the practice patterns among the Indian Pediatric Glaucoma Society (IPGS) members in the management of children with primary congenital glaucoma (PCG)., Methods: An anonymous 74-question survey was administered online via Qualtrics (Qualtrics, Provo, Utah, USA) using a link sent by email to the 88 IPGS members. The questionnaire comprised five sections and was designed to gather information regarding respondent demographics and specialty training, clinic composition and volume, surgical practices and preferences, follow-up practices, and additional services. The survey was closed after 10 weeks. Data were analyzed using descriptive statistics and Chi-square tests. Statistical significance was set at p  < .05., Results: The response rate was 82%. Of the 71 respondents, 49 (69%) reported possessing glaucoma fellowship training that included specialist training in pediatric glaucoma. By comparison, 8 respondents (11%) reported possessing pediatric ophthalmology fellowship training that included specialist training in pediatric glaucoma, and this difference was statistically significant (69% vs . 11%; χ 2  = 47.37; p  < .0001). The majority of the respondents were in ophthalmic institution-based practice (83%) and were located in South India (58%). In cases of hazy cornea, the most common surgery (95%) performed was combined trabeculotomy-trabeculectomy while goniotomy was most preferred (49%) in cases of clear cornea. Approximately, one-half of the respondents (56%) preferred to operate on each eye in separate sessions, whereas 46% preferred to operate on both eyes in the same session. One-half of the respondents (51%) preferred to use mitomycin-C in primary surgery. The most common challenges in providing care were patient-related, including delayed presentation, high travel costs, and low socioeconomic status., Conclusions: Although a substantial consensus was found in most areas of management, a few areas, for example, use of MMC in primary surgery, showed diversity. The information gathered will enable glaucomatologists to compare their practices with those of their colleagues. In addition, this survey provides a baseline, allowing future trends in management to be determined.

Vitreomacular traction (VMT) is characterised by abnormal adhesion of the posterior cortical vitreous with the macula causing distortion of the foveal contour and associated with symptoms of reduction in visual acuity and/or metamorphopsia. This review article explores the pathophysiology, clinical features, diagnostic and treatment options for VMT. Advances in imaging modalities such as optical coherence tomography (OCT) have revolutionized the understanding of the vitreoretinal interface abnormalities and helps in monitoring the disease progression. The natural history of VMT is variable and either there can be a spontaneous resolution or can present with cystoid oedema or can progress to epiretinal membrane (ERM) or macular hole. In the current manuscript, we perform a major review of the existing literature on VMT and adding the details about the current investigative modalities and surgical techniques., Competing Interests: Competing interests: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)

Extracellular vesicles (EVs), defined as membrane-bound vesicles released from all cells, are being explored for their diagnostic and therapeutic role in dry eye disease (DED). We systematically shortlisted 32 articles on the role of EVs in diagnosing and treating DED. We cover the progress in the last 2 decades on the classification and isolation of EVs and their role in DED. The diagnostic predictability of exosomes was evaluated in Sjögren syndrome (SS) patients' tears, plasma, and saliva, where upregulation of inflammatory proteins was reported uniformly across studies. Also, we evaluate the therapeutic effects of MSC-derived EVs in in vitro and in vivo studies of SS and DED mouse models. A significant response occurs at a functional level with improved tear production and saliva flow rate and at a cellular level with reduced lymphocyte infiltration, improved corneal structural integrity, decreased epithelial cell apoptosis, and dampening of the inflammatory cytokine response. The proposed mechanisms of EV action include PD-L1, PRDM, NLRP-3, and Nf-kb pathways, and an increase in M2 macrophage phenotype. Current use of exosomes in DED is limited due to their cumbersome isolation techniqus. Further research on human subjects is needed, in addition to optimizing exosome isolation and delivery methods., Competing Interests: Declaration of Competing Interest Authors have nothing to disclose and have no conflicting interests., (Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.)

Purpose: The purpose of this study was to report the safety and efficacy results of an artificial lamellar implant for the treatment of chronic corneal edema., Methods: The EndoArt (EyeYon Medical, Ness Ziona, Israel), an artificial endothelial replacement membrane designed to treat corneal edema, was implanted in 24 eyes of 24 patients with low-to-normal visual potential. We present the safety and efficacy results from a prospective, open-label, single-arm, multicenter study conducted over a 12-month period., Results: Twenty-four patients were enrolled, with no device-related serious adverse events reported. Seventeen patients completed 12-month follow-up, showing a reduction in average central corneal thickness from 759 ± 116 μm to 613 ± 135 μm. Best-corrected distance visual acuity improved from 1.88 ± 0.79 logarithmic minimum angle of resolution (logMAR) to 1.34 ± 0.57 logMAR. Sixty percent gained at least 3 early treatment diabetic retinopathy study (ETDRS) lines. The EndoArt was removed in 5 cases due to incomplete attachment and replaced by corneal transplants; 1 patient was lost to follow-up, and 1 had a procedure failure. No device-related long-term complications, infections, or inflammations were reported. The implants remained transparent throughout the study., Conclusions: The first-in-human results of EndoArt implantation demonstrated the device's potential to treat patients suffering from corneal edema with a favorable safety profile and effective edema reduction in most subjects, with no device-related serious adverse event. The EndoArt may offer a viable solution in regions facing a shortage of donor corneas, as well as for patients who have poor prognosis with human tissue., (Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc.)

Purpose: To study the role of intravitreal clindamycin with dexamethasone as an adjuvant to systemic co-trimoxazole and steroids in macular Toxoplasma retinochoroiditis., Methods: Retrospective study of Toxoplasma retinochoroiditis cases from January 2014 to December 2021 treated with a combination of oral and intravitreal therapy in immunocompetent patients., Results: 39 eyes of 39 patients were included in this study after meeting the inclusion criteria with the mean age of presentation being 25.25 years (± 9.30; range 4-52 years). Male preponderance with 61.53 % of males (n = 24) and 38.47% of females (n = 15) was observed. Active retinitis was unilateral in all eyes (20 right eyes; 19 left eyes). Five lines of improvement in vision acuity on ETDRS chart were noted at final visit. The location of retinitis was either foveal (n=24) or extrafoveal (n=15). The mean size of retinitis was 1.24 ± 0.70-disc diameter. The mean number of injections given was 1.79 with a mean interval of 1.39 weeks., Conclusions: Intravitreal clindamycin with dexamethasone when used as an adjunct to systemic therapy showed resolution of retinitis in all cases with visual improvement., Competing Interests: None of the authors report competing, proprietary or any conflict of interests.

Competing Interests: Competing interests: The authors declare no competing interests.

To examine ultrastructural changes in the trabecular meshwork (TM) in patients with primary and secondary glaucoma using scanning electron microscopy (SEM). This was a qualitative descriptive hospital-based study on the ultrastructure of the TM. Pure TM samples were collected after microincisional trabeculectomy from 26 patients with primary or secondary glaucoma and 10 control samples from eye bank donor corneas. SEM was used to analyze structural changes in the TM beams, corneoscleral meshwork (CSM), and juxtacanalicular (JCT) regions. Morphological features were compared between groups and correlated with histopathological findings. SEM revealed flattened and broadened TM beams in the JCT, resembling controls, often with a dumbbell configuration. Histopathological examination (HPE) and SEM showed rounded TM beams with considerable thinning, especially in primary angle-closure glaucoma (PACG), compared to primary open-angle (POAG) and pseudoexfoliation glaucoma (XFG). Maximum thinning in all primary glaucoma occurred in the CSM region, with minimal changes in the JCT region despite a reduction in cellularity in both regions. In steroid glaucoma, amorphous, glistening material was found on the TM beams in the JCT and CSM. XFG eyes displayed vesicular bodies adjacent to fibrillar material scattered diffusely over the TM beams, particularly in the CSM, differing from the platelet clumps seen in regular blood clots. TM beam thinning in primary glaucoma primarily affects the CSM region, sparing the JCT region. Amorphous deposits or vesicular bodies, seen only in steroid-induced glaucoma and XFG, suggest different mechanisms of TM damage in these glaucoma types., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Purpose: To describe the clinical presentation and treatment outcomes of patients undergoing Ruthenium-106 ( 106 Ru) plaque brachytherapy as salvage treatment for retinoblastoma (RB) following intravenous chemotherapy (IVC)., Methods: Retrospective chart review of 44 eyes of 42 patients. The indications for plaque brachytherapy included solid tumor recurrence (n=20; 45%), solid tumor residual (n=16; 36%), new subretinal seeds (n=5; 12%), and new solid tumor (n=3; 7%)., Results: The median age at the presentation was 12 months (range, 3-72 months). Based on ICRB classification, 8 (18%), 8 (18%), 16 (36%), and 5 (12%) tumors belonged to Groups B, C, D, and E, respectively. A median interval of 5 months (range 3-21 months) was noted between the last IVC cycle and plaque brachytherapy. The mean tumor height was four mm (range, 1.5-6 mm). All patients were treated with 106 Ru plaque (round or notch) with a median total dose of 45 Gy (range, 40-55 Gy) delivered to the tumor apex. At a mean post plaque follow-up period of 28 months (median, 23 months; range, 3-132 months), tumor completely regressed in 25 eyes (56%). Tumor recurrence within the plaque site was noted in eight eyes (18%) associated with a type 2 regression pattern (75%). At the last follow-up, the globe salvage rate was 24 eyes (55%), while 2 patients (5%) died due to metastasis., Conclusion: 106 RU plaque brachytherapy can be a useful salvage treatment for focal tumors (new or recurrent) following systemic IVC., (Copyright © 2024 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.)

Purpose: To describe the clinical course and treatment outcomes of Vogt-Koyanagi-Harada (VKH) disease during pregnancy., Methods: This retrospective study compares the clinical course and outcomes in pregnant and nonpregnant women with VKH. All VKH patients who were pregnant at presentation or on follow up and age-matched nonpregnant female controls during the study period (2013-2022) were included. Their best-corrected visual acuity (BCVA), clinical presentations, and treatment outcomes were analyzed., Results: Among the 532 female VKH patients, nine (1.7%) were included. Thirty nonpregnant patients were included as control. At presentation, the mean age in the study group was 26 years ± 6.48 standard deviation (SD) compared to the control group (mean 25.1 years ± 3.04). The mean BCVA was comparable between the two groups at presentation (study group 1.35 logarithm of the minimum angle of resolution [logMAR] vs. control group 0.76 logMAR; P = 0.05) and the final follow-up (study group 0.65 logMAR vs. control group 0.35 logMAR; P = 0.15). Participants with anterior segment inflammation (study group 77.7% vs. control group 70%; P = 0.65), the disease stage (early-stage VKH: study group 88.8% vs. control group 73.3%; P = 0.33), and disease exacerbation (study group 33.3% vs. control group 26.6%; P = 0.69) were all comparable between the study and control groups. Following treatment, 66.6% and 46.6% of the study and control groups, respectively, had sunset glow fundus ( P = 0.29). At the last follow-up, 44.4% and 26.6% of the study and control groups, respectively, had subretinal fibrosis ( P = 0.31)., Conclusion: Though pregnancy is an immunomodulatory state, the clinical course of VKH in pregnant patients can be similar to that of nonpregnant women and needs close monitoring and follow-up., (Copyright © 2024 Indian Journal of Ophthalmology.)

Objective: To study the prevalence, clinical presentation, treatment, and follow-up of ocular (dermal) melanocytosis (ODM) and its association with choroidal melanoma (CM) in Asian Indian patients., Methods: This was a retrospective case series of patients with ODM conducted in a quaternary eye care center., Results: Of the total 1.48 million patients during the study period, we identified 213 patients with ODM with a prevalence rate of 0.014%. Median age at presentation was 13 years (range 0-76 years). Unilateral presentation of ODM was noted in 87% cases. ODM involved the sclera in 100% cases, the iris in 23%, the choroid in 20%, the eyelid in 29%, and V1 and V2 dermatomes in 53% cases. Nineteen patients (9%) were found to have CM, with 1.3 times increased risk of CM compared to the Caucasian population. The most common tumor location was in the inferior quadrant (n = 8, 44%). The mean tumor thickness was 8.3 ± 2.8 mm with a mean basal diameter of 14.0 ± 4.3 mm. Primary treatment of CM included plaque brachytherapy (n = 6), enucleation (n = 9), and few patients refused for treatment (n = 3). During a mean follow-up period of 21 months, one patient died because of lung metastasis., Conclusion: Although rare, choroidal melanoma does occur in the presence of ODM with an increased risk in Asian Indians compared to the Caucasian population. Patients with ODM should be examined periodically for early detection of CM., (Copyright © 2024 Indian Journal of Ophthalmology.)

Retinal detachment following ocular trauma (TrRD) is one of the leading causes of blindness and visual impairment worldwide. In the absence of a standardized definition, the diagnosis of traumatic retinal detachment relies on identifying a history of trauma that precedes the detachment. There is an increasing pool of data regarding the etiology and epidemiology of TrRD.Various causes of TrRD mentioned in the literature include work-related eye trauma in construction and manufacturing industries, sports injuries, explosive eye injuries, road traffic accidents, and intraocular foreign bodies. Although there is extensive literature on post-trauma retinal detachments, a comprehensive discussion of its pathogenesis, management, outcomes, and complications is lacking. We offer an in-depth review of the epidemiology, risk factors, pathogenesis, diagnosis, management, and outcomes of TrRD based on the current literature., Competing Interests: Declaration of Competing Interest None., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Purpose: To study clinical features, anatomical and visual outcomes in eyes having rhegmatogenous retinal detachment (RD) as the presenting feature of acute retinal necrosis (ARN)., Materials and Methods: We conducted a retrospective cohort study of patients with ARN (active/healed) and concomitant RD at the presenting visit., Results: The median age of patients was 36 years, with a male preponderance (9:1). Bilateral ARN was observed in 60% of cases, with 50% of patients testing positive for human immunodeficiency virus. The duration between the onset of symptoms and presentation was 3.66 ± 2.26 weeks. At presentation, 53.3% of eyes had active retinitis. Vitreoretinal surgery with silicone oil tamponade was performed for 14 eyes. Visual acuity significantly improved in 3 months (P = 0.0027). Poor visual outcomes were associated with optic nerve involvement. The mean duration of silicone oil tamponade was 7.41 ± 4.48 months. Complications included recurrent RD (14.29%), epiretinal membranes (14.29%), cystoid macular edema (21.4%), and retinal scarring with atrophy., Conclusion: ARN with RD at presentation is a unique medical and surgical challenge, wherein good anatomical and functional outcomes could be achieved. The large size of retinitis and delayed presentation were the risk factors associated with poor visual outcomes., (Copyright © 2024 Indian Journal of Ophthalmology.)

Purpose: To demonstrate the treatment efficacy of intravitreal dexamethasone (DEX) implant in chronic recurrent/persistent central serous chorioretinopathy (CSC)., Design: Prospective, non-randomized, open-label study., Methods: In this study, subjects with chronic CSC without signs of choroidal neovascularization (CNV) received intravitreal DEX implant therapy. The primary outcome measure was the change in visual acuity. Changes in central macular thickness (CMT) and change in subfoveal choroidal thickness (SFCT) on optical coherence tomography (OCT), incidence of recurrent fluid, and safety of DEX implant were secondary outcome measures. Subjects were followed up for a minimum of 3 months after DEX implantation., Results: In total, 20 eyes of 20 subjects (mean age: 47 ± 9 years) with a median disease duration of 23.5 months were enrolled. With a single injection of DEX implant, a reduction in CMT was noted in 90% of eyes. Complete resolution of subretinal and intraretinal fluid was noted in 55% of eyes within 3 months of injection. A significant improvement in vision (mean Log MAR visual acuity: 0.66 ± 0.49 vs. 0.54 ± 0.45; P = 0.020), mean CMT (338 ± 110 microns to 238 ± 73 microns; P < 0.001) and SFCT (514 ± 95 microns to 445 ± 111 microns; P < 0.001) was noted over 3 months. Recurrent fluid was noted in 50% of eyes after a mean follow-up duration of 7 ± 4 months. Elevated intraocular pressure, managed by topical therapy, was noted in six eyes., Conclusion: The consistent improvement in visual acuity, fluid resolution, and reduction in choroidal thickness suggests a possible role for DEX implants in managing chronic CSC. A larger randomized trial is warranted., (Copyright © 2024 Indian Journal of Ophthalmology.)