The aim of this study was to investigate whether amblyopic children with stagnating best-corrected visual acuity (BCVA) would benefit from an additional stimulation therapy-specifically focal ambient visual acuity stimulation (FAVAS) integrated into a computer game-compared to occlusion therapy alone. This retrospective, multicentre study analysed clinical records of 227 children with amblyopia showing stagnation of visual acuity despite at least 90 days of occlusion therapy. Analyses were performed on an eye-based level. Eyes that had received FAVAS (Caterna Vision GmbH, Potsdam, Germany) alongside occlusion therapy were assigned to the FAVAS group, while eyes treated with occlusion therapy alone served as controls. Post hoc propensity score matching was applied. After matching, 105 patients (114 eyes; 57 eyes per group) remained for analysis. The primary endpoint was improvement in best corrected visual acuity (BCVA, logMAR); the secondary endpoint was change in stereo vision. The FAVAS group showed a significant improvement in BCVA, with a mean gain of 0.15 logMAR (95% CI [0.11;0.18], p < 0.001), compared to a non-significant improvement of 0.01 logMAR (95% CI [-0.02;0.04], p = 0.356) in the control group. No significant changes were observed in stereo vision in either group. The combination of occlusion therapy and FAVAS was superior to occlusion alone in amblyopic children with stagnating BCVA, yielding significant and clinically relevant improvements in visual acuity. These findings support the integration of digital stimulation therapy as an effective adjunct to conventional amblyopia treatment. German Clinical Trials Register (DRKS): DRKS00030216.

To evaluate patient-reported outcome measures (PROMs) and visual function across four groups of public cataract patients: emmetropia, mini-monovision, monovision with partial-range of field (RoF) narrow intraocular lenses (IOLs) and patients implanted with partial-RoF extended IOLs. This randomized controlled trial included consecutive patients with bilateral symptomatic cataract randomized to implantation of partial-RoF narrow IOLs targeting (1) emmetropia (both eyes), (2) mini-monovision (emmetropia in the dominant eye, -1.25 diopters (D) in the non-dominant), (3) monovision (emmetropia in the dominant eye, -2.50 D in the non-dominant) or (4) implantation of partial-RoF extend IOLs (+0.01 to +0.25 D in the dominant eye, -0.01 to -0.25 D in the non-dominant eye). Assessment included four PROMs, binocular uncorrected distance, intermediate and near visual acuity (VA), aniseikonia, stereoacuity and safety. 188 patients were randomized to the four groups. High levels of improvement in postoperative PROM scores were observed across all groups, with no significant differences between groups. All patients achieved binocular best corrected distance VA of logMAR 0.12 or better (range 0.12 to -0.26). Mini-monovision and partial-RoF extend yielded comparable outcomes across visual performance, spectacle independence and safety. Monovision provided superior uncorrected near VA and the lowest spectacle use but was associated with increased aniseikonia, impaired stereoacuity, worse binocular uncorrected distance VA, more frequent halos, lower recommendation rates and a 6.7% reoperation rate for binocular visual complaints. All four groups achieved high levels of improvement in visual function and PROM scores. There was no statistically significant difference in PROM scores between the groups.

Hormonal replacement therapy (HRT) in postmenopausal women appears to affect glaucoma risk, but findings are inconsistent. We aimed to explore whether the use of postmenopausal HRT plays a role in glaucoma development in Finland. The main outcome variable was glaucoma incidence measured by initiation of special reimbursement due to glaucoma. The population-based historic cohort consisted of female participants aged ≥50 years whose incident glaucoma was recorded between January 1st, 2015, and December 31st, 2017. The main exposure of interest was postmenopausal HRT with Anatomic Therapeutic Chemical codes G03C (oestrogens), G03D (progestogens), G03F (progestogens and oestrogens in combination). The HRT treatment was initiated during 2001-2010. Frequencies and odds ratios (ORs) with 95% confidence intervals (CIs) were analyzed with logistic regression models, unadjusted and adjusted for diabetes mellitus, hospital district, socioeconomic status and statin exposure. Our nested-case-control study involved 1096 cases and 5480 age-matched controls. After adjustment for confounding factors, use of any HRT was associated with an increased risk for the development of glaucoma. The risk was found in estrogen users (adjusted OR, 1.33 [95% CI, 1.17-1.52]), in progestogen users (adjusted OR, 1.25 [95% CI, 1.02-1.53]) and in combinatory estrogen-progesterone users (adjusted OR, 1.19 [95% CI, 1.01-1.39]). In the POAG subgroup, the risk remained in estrogens-only users (adjusted OR, 1.31 [95% CI, 1.10-1.56]). Our data suggests that use of any postmenopausal HRT may increase the glaucoma risk, but in POAG subgroup estrogen-only therapy remained significant. Further research is needed to confirm the associations.

To report treatment patterns, time-to-resolution (TTR) and aetiologies of bacterial keratitis (BK) infections treated in a specialized hospital-based cornea clinic in Sweden. Retrospective study based on electronic health records screened during the period 2010-2019. The study included only culture-confirmed cases of BK. TTR was defined as the number of days from the sample collection for microbiological culture to the date that the cornea healed. Factors affecting TTR were investigated with Cox regression models. Contact lens wear and severely ill/blind eye were the most common aetiologies among the 188 patients. Empirical treatment consisted of fluoroquinolones in combination with aminoglycosides in 50% of the patients. Median TTR was 22 days (95% CI: 12, 34) for contact lens-related BK and 90 days (95% CI: 55, 146) in complicated cases with miscellaneous or unknown aetiology. Hazard ratio (HR) for infections in females (HR = 1.93; 95% CI: 1.34, 2.79), contact lens wearers (HR = 2.72; 95% CI: 1.79, 4.14) and infections caused by Gram-positive pathogens (HR = 2.50; 95% CI: 1.50, 4.19) indicated that infections in these categories healed at a faster rate than their reference categories. Patients switching to treatment with chloramphenicol after it was absent in the empirical treatment had a slower rate of healing than those who received chloramphenicol as part of the empirical treatment (HR = 0.58; 95% CI: 0.38, 0.87). The current study provides unique TTR estimates for BK. The results revealed that age, sex, aetiology, empirical treatment and Gram staining can affect TTR. In our sample, empirical treatment that includes chloramphenicol could potentially reduce TTR. These findings can be used to individualize disease management and prognosis.

The relationship between dry eye disease (DED) symptoms and different demographic, clinical and lifestyle factors remains poorly understood. Norway's cold climate and dry indoor air may accelerate tear evaporation, contributing to a very high meibomian gland dysfunction prevalence, as found in multiple studies. This suggests that environmental factors and age converge to drive evaporative dry eye as a near-universal finding in the Norwegian population. This study aimed to assess demographic, clinical and lifestyle correlates of DED symptoms, with a focus on sex-related differences and diurnal variation. Between September 2021 and December 2023, 1044 individuals (303 males, 741 females) with symptoms of DED were enrolled at the Norwegian Dry Eye Clinic. All participants completed the Ocular Surface Disease Index (OSDI) and the Dry Eye Questionnaire-5 (DEQ-5) questionnaires, as well as an in-house, un-validated questionnaire. Clinical examinations and history-taking were conducted in a standardized manner by two experts. Associations between questionnaire scores and variables were analysed using Chi-squared tests, Kruskal-Wallis tests, Spearman correlations and logistic regression. Symptomatic DED above clinical cut-off levels was more prevalent in females than in males. Symptom severity was lowest in the late morning, and significant differences in both OSDI and DEQ5 scores were observed between individuals with and without reported omega-3 supplementation (with slightly higher scores in those taking omega-3). Allergies were associated with time-of-day symptom severity. Multivariable logistic regression revealed female sex, age below 65, not wearing contact lenses and refractive lens exchange surgery as significant risk factors for reporting more severe symptoms among the individuals in the database. Severity of dry eye symptoms in this symptomatic, clinic-based population was significantly associated with several demographic and clinical factors. Incorporating standardized timing of assessments may enhance diagnostic accuracy in both research and clinical settings for DED.

To describe the 10-year incidence of myopia and change in ocular biometry in older adults and their association with risk factors for myopia. The Shahroud Eye Cohort Study is a prospective single-centre cohort study conducted in Iran. Baseline and follow-up eye assessments were conducted in 2009 and 2019. A total of 5190 participants aged 40-64 years attended the baseline assessment. Refractive data from both visits were available in 6239 eyes. The main outcomes were incidence of myopia, change in spherical equivalent refraction (SER) and axial length (AL). Mean SER shifted from -0.35 ± 1.44 D at baseline to 0.08 D ± 1.67 D at follow-up (SER change: 0.43 ± 0.69 D). Males had more negative baseline SER than females (-0.41 D vs. -0.31 D, p = 0.009) and were more myopic at follow-up (-0.07 D vs. 0.18 D, p < 0.001). The 10-year myopia incidence was 4.60% (95% CI, 3.91-5.40). In myopic eyes, changes in SER were 0.27 D, and in AL 0.04 mm. Predictors of a myopic shift (≤-0.5 D) were longer baseline AL (odds ratio [OR], 1.30; 95% CI, 1.04-1.62), male sex (OR, 1.66; 95% CI, 1.14-2.42), older age (55-59 years: OR 2.26; 95% CI 1.31-3.89; 60-64 years: OR 3.56; 95% CI 1.79-7.08, vs. 40-44 years), low economic status (OR 1.62; 95% CI 1.05-2.50) and baseline SER (OR: 0.15; 95% CI 0.09-0.24). In this community-based sample, the predominant refractive trend over 10 years was a hyperopic shift, while the incidence and progression of myopia were low.

This systematic review and meta-analysis aim to evaluate the efficacy and safety of further lowering intraocular pressure (IOP) to single-digit levels in treated patients with progressive normal-tension glaucoma (NTG). A literature search was conducted in MEDLINE (via PubMed), Scopus and Web of Science. We selected studies that reported quantitative visual field (VF) data on the efficacy of the interventions. Study outcomes include VF progression rates, changes in IOP and IOP-lowering medication use. Meta-analysis was conducted for VF mean deviation (MD) slope (db/year) using R, with paired mean differences and 95% confidence intervals (CI) calculated. Nine observational studies, including 270 eyes, were analysed. Trabeculectomy was performed across all studies. One study compared trabeculectomy with prostaglandin analogues. On average, IOP decreased from 14.77 ± 0.95 mmHg preoperatively to 9.82 ± 1.55 mmHg postoperatively, reflecting a mean reduction of 33.65± 10.37%. This reduction slowed glaucoma progression, as indicated by a change in the mean VF MD slope from -0.91 ± 0.27 dB/year preoperatively to -0.25 ± 0.16 dB/year postoperatively. Meta-analysis showed a significant change in VF MD slope following trabeculectomy, with a pooled mean difference of 0.59 dB/year (95% CI: 0.38 to 0.80; p< 0.0001). Single-digit IOP levels were shown to be both achievable and sustainable. The most common postoperative complications included hypotony-related complications and hyphema. Achieving single-digit IOP levels is associated with a significant reduction in visual field progression rates. However, the balance between efficacy and safety must be considered, as aggressive IOP reduction is also associated with a higher risk of hypotony-related complications. Postoperative hypotony was relatively frequent but generally transient and did not appear to have a significant impact on long-term visual acuity. Copyright © 2026 Acta Ophthalmologica Scandinavica Foundation.