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In 2020, the global prevalence of glaucoma was estimated to be 76 million and it was projected to increase to 111.8 million by 2040. Accurate intraocular pressure (IOP) measurement is imperative in glaucoma management since it is the only modifiable risk factor. Numerous studies have compared the reliability of IOP measured using transpalpebral tonometers and Goldmann applanation tonometry (GAT). This systematic review and meta-analysis aims to update the existing literature with a reliability and agreement comparison of transpalpebral tonometers against the gold standard GAT for IOP measurement among individuals presenting for ophthalmic examinations. The data collection will be performed using a predefined search strategy through electronic databases. Prospective methods-comparison studies published between January 2000 and September 2022 will be included. Studies will be deemed eligible if they report empirical findings on the agreement between transpalpebral tonometry and Goldmann applanation tonometry. The standard deviation and limits of agreement between each study and their pooled estimate along with weights and percentage of error will be reported using a forest plot. Cochrane's Q test and the I2 statistic will be used to assess heterogeneity, and the publication bias will be investigated using a funnel plot, Begg's and Egger's tests. The review results will provide additional evidence on the reliability of transpalpebral tonometers that, in turn, could possibly assist practitioners to make informed decision about using it as a screening or diagnostic device for clinical practice, outreach camps, or home-based screening. Institutional Ethics Committee registration number: RET202200390. PROSPERO Registration Number: CRD42022321693.

Purpose: Outbreaks of mucormycosis were reported worldwide throughout the COVID-19 pandemic. We report clinical outcomes of a treatment protocol for COVID-19-associated rhino-orbital-cerebral mucormycosis (ROCM). Methods: Patients with biopsy-proven mucormycosis and COVID-19 were included. All received intravenous amphotericin B deoxycholate 1 mg/kg and surgical endoscopic sinus debridement (FESS). Those with rhino-orbital or cerebral disease limited to the cavernous sinus were eligible for transcutaneous retrobulbar amphotericin B (TRAMB). Patients were followed with weekly imaging, endoscopic examinations, and serial debridement as necessary. Patients were discharged on oral posaconazole for 6 months. Results: In total, 264 patients were followed for a mean of 2.5 months. On presentation, 163 patients (174 eyes) had eye involvement. Of these, 141 eyes (81.0%) had light perception or worse vision. By the last follow-up, 163 patients (176 eyes) were affected, and of these, 96 eyes (54.5%) had no light perception. Twenty-one patients (8%) died and 3 orbits (0.5%) were exenterated. There was no change in mortality (p = 0.38) or exenteration (p = 0.38) in the 55 patients who received TRAMB compared to patients with rhino-orbital or cerebral disease limited to the cavernous sinus who did not. Asymptomatic COVID-19 was associated with higher mortality than symptomatic COVID-19 (p = 0.025). Uncontrolled diabetes was a risk factor for death (p = 0.022). New diabetes was associated with increased mortality versus pre-existing diabetes (p = 0.005). Conclusion: A multidisciplinary approach is crucial to manage COVID-19-ROCM. In our cohort, TRAMB therapy did not increase mortality or exenteration rates. While poor vision on presentation was profound, some vision recovery was noted with treatment. COVID-19 immune dysregulation may predispose patients to ROCM, particularly those with asymptomatic disease. [ABSTRACT FROM AUTHOR]

Background: Delivering sustainable, high-quality eye care requires a comprehensive understanding of patient conditions, clinical evidence, patients' preferences, demand patterns, quality supplies, outcomes, financial sustainability, and satisfaction metrics. Evidence-based management (EBM) offers a structured approach to align actions with evidence, enabling effective decision-making and better organizational outcomes. Evaluating current practices against EBM principles fosters awareness and promotes an EBM culture in eye hospitals, supporting improved and sustainable service delivery. Methods: A descriptive cross-sectional survey was conducted in 2023–2024 among 94 eye hospitals worldwide, selected from two networks, using the Centre for Evidence-Based Management (CEBM) assessment questionnaire. Follow-up reminders resulted in 43 responses. Data analysis utilized frequency distributions and Pearson's correlation to explore relationships between variables. Results: A strong positive correlation was observed between data accessibility and the capacity to interpret data in fostering evidence-based decision-making (r = 0.69, p < 0.01). Additionally, leveraging internal expertise and engaging stakeholders in assessing and utilizing data showed a moderate association with EBM practices (r = 0.48, p < 0.01). Conclusions: Eye hospitals demonstrate alignment with EBM principles, though regional variations exist. Organizations with robust data utilization systems, analytical expertise, and a commitment to continuous improvement are more effective in practicing EBM. Educational and peer-learning initiatives can further support hospitals in adopting EBM principles, strengthening their capacity for evidence-based decision-making, and enhancing eye care services. [ABSTRACT FROM AUTHOR]

The authors respond to comments on their study on dematiaceous fungal keratitis, highlighting a range of 1 to 180 days for symptom duration, with outliers at both ends. Factors contributing to full-thickness corneal involvement within 7 days included diabetes, prior treatment, keratitis size, and hypopyon. More than half of patients who had used steroids responded well to medical treatment, with some requiring therapeutic procedures. The study also noted delayed healing in patients with various risk factors, emphasizing the role of keratitis severity in outcomes. [Extracted from the article]