Dengue maculopathy exhibits numerous clinical phenotypes, including foveolitis and outer maculopathy, which involve both ischemic and inflammatory mechanisms.[1] A 36-year-old male patient being treated for high fever (dengue immunoglobulin M positive) was subsequently diagnosed as human immunodeficiency virus infected with a low CD4 count (71 cells/mm3). Seven days postdischarge, blurred vision was noted in the right eye (6/12, N6). Ophthalmoscopy revealed an orangish macular lesion [Figure 1a], and a baseline optical coherence tomography (OCT) revealed a dengue outer maculopathy with hyporeflective, thickened outer retinal layers with subretinal edema [Figure 1b]. He was treated conservatively, and a spontaneous resolution was seen 15 days later with a normal-looking fundus and normal OCT [Figure 1c and d].Figure 1: (a) Fundus photo of the right eye showing an orangish macular lesion. (b) A baseline optical coherence tomography (OCT) revealing a dengue outer maculopathy with hyporeflective, thickened outer retinal layers with subretinal edema. (c) Fundus photo after 15 days revealing spontaneous resolution. (d) OCT is confirmatory of resolutionData availability statement The author had full access to all the data in this report and takes responsibility for the same. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Fungal keratitis is rare in temperate countries but is a major cause of visual loss in tropical and developing countries. Fungal keratitis can elicit a severe inflammatory response, corneal perforation is common and visual outcome is usually poor. Here, we report the case of keratitis following ocular trauma with stone particle, caused by Phoma , a rare fungal species, confirmed on fungal culture. The most common offenders among the filamentous types globally are Aspergillus spp. and Fusarium spp., whereas Candida spp. often dominates in the yeast category. In this case, the patient remained unresponsive to topical antifungals and showed good response to intrastromal injection voriconazole.

Dear Editor, Journal of Clinical Ophthalmology and Research Blurring of vision after an eye injury is a significant concern, yet not all cases of post-traumatic myopia are permanent. The phenomenon of transient pseudomyopia following blunt ocular trauma remains underrecognized in clinical practice. We present two cases illustrating this reversible form of myopic shift and emphasize the importance of careful observation rather than immediate optical correction.[1] A 17 Year male athlete was hit in the eye by a tennis ball. He experienced sudden blurring of vision, damage to the iris sphincter, and retinal commotio with initial visual acuity of 6/24 in right eye with acceptance of -0.75DS. In a separate case, a 20-year-old cricket player was directly impacted by a cricket ball and developed Berlin’s edema along with decreased vision with initial visual acuity of 6/24 with acceptance of -1.25DS/-0.50DC x 110. Both patients showed a myopic shift in refraction right after the trauma. Fortunately, these refractive changes went away on their own in the following weeks. They both fully regained their vision and did not need corrective lenses. Pseudomyopia is marked by a temporary refractive problem caused by involuntary ciliary muscle spasms, without any changes to the eyeball or cornea. This issue with focusing can briefly impact distance vision and visual performance, particularly for athletes and others involved in visually demanding tasks. It is important to tell the difference between pseudomyopia and true (structural) myopia to avoid giving unnecessary glasses or contacts and to ensure proper care.[2,3] Blunt eye trauma often causes this condition by stimulating the parasympathetic nervous system, which results in a lasting spasm of the ciliary muscle. Research shows that these shifts toward nearsightedness from trauma are usually mild to moderate, resolve within a few weeks, and are best treated with observation or short-term medication. Cycloplegic refraction and regular evaluation are crucial to tell the difference between temporary pseudomyopia and real refractive errors.[3–5] Our cases highlight an important practical point: Most instances of myopia after blunt trauma can reverse on their own and do not require immediate correction with lenses or other treatments. Rushing to correct vision can impact patient care and result in misdiagnosis. Regular monitoring and patience are usually the best approaches, as most cases tend to resolve naturally when ciliary muscle function normalizes. We emphasize the importance of increased clinical awareness of transient pseudomyopia following blunt eye injuries. A thorough refractive assessment, cycloplegic testing, and consistent follow-up should occur before making any decision about prescribing corrective lenses. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Data availability statement The data supporting our findings are available for access. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

“In teaching others, we teach ourselves.” – Seneca Ophthalmology has always stood at the crossroads of clinical precision and scientific innovation. As our specialty continues to evolve, the importance of aligning research with day-to-day practice cannot be overstated. The Journal of Clinical Ophthalmology and Research provides a unique platform to highlight this synergy, bringing together clinical observations, surgical innovations, and translational research that directly impact patient outcomes. In recent years, the landscape of ophthalmic practice has witnessed rapid changes. Advances in cataract and refractive surgery, innovations in retinal imaging, evolving approaches to glaucoma care, and the integration of artificial intelligence are reshaping how we diagnose, treat, and even predict disease. Yet, while technology continues to advance at an unprecedented pace, the foundation of good ophthalmology remains rooted in careful observation, ethical practice, and patient-centered decision-making. One of the recurring lessons in clinical ophthalmology is that “every complication is a teacher.” Whether it is an unexpected surgical challenge or a diagnostic dilemma, these moments become opportunities to refine our skills and generate new research questions. Documenting such experiences not only improves our own practice but also contributes to the collective wisdom of the ophthalmic community. Another essential aspect is the role of young ophthalmologists and postgraduates in driving research forward. The process of preparing a thesis or conducting clinical audits instills critical thinking and nurtures a culture of inquiry. It is our responsibility as mentors to encourage rigorous methodology, ethical conduct, and honest reporting of results. As we look ahead, collaboration across subspecialties will be the key to innovation. Complex cases often demand a multidisciplinary approach, where cataract surgeons, cornea specialists, retina experts, and oculoplastic surgeons work together to deliver the best outcomes. Journals such as ours serve as the connecting bridge, sharing insights that cross boundaries and inspire dialogue. In this issue, we present a diverse collection of articles that reflect both scientific rigor and clinical relevance. From original research to case series and reviews, each contribution adds to our understanding and helps shape better ophthalmic care. Ultimately, the measure of good research is not only in its statistical significance but in its ability to improve vision, preserve sight, and enhance quality of life. As clinicians, educators, and researchers, we must remain committed to integrating evidence with empathy. On behalf of the editorial team, I extend my gratitude to all authors, reviewers, and readers for their valuable contributions to this journey. Together, we continue to uphold the vision of advancing knowledge while keeping the patient at the center of all that we do.

Purpose: Evaluate the treatment outcome of cystoid macular edema (CME) following silicone oil (SO) tamponade in primary rhegmatogenous retinal detachment (RRD) or recurrent retinal detachment (RD). Materials and Methods: This retrospective case study spans from January 2019 to February 2024. A single surgeon performed all surgeries. Of 23 eyes treated with SO tamponade for RD during this period, six eyes of six patients developed CME either during SO tamponade or persisting after SO removal. The primary outcome measure was the resolution of CME on spectral-domain optical coherence tomography. Secondary outcome measures included additional treatments administered to resolve CME and visual outcomes at the final follow-up (minimum 12 months). Results: Six eyes of six patients met the inclusion criteria. Ages ranged from 50 years to 57 years (mean: 54.66 ± 2.73 years). Three eyes underwent SO removal for RRD and three for recurrent RD with additional internal limiting membrane (ILM) peeling. CME resolved in 5/6 eyes (69.44%), while one eye exhibited persistent CME with schisis and a lamellar macular hole. Conclusion: In selected cases, ILM peeling during SO removal may enhance CME resolution.

Aim: The aim of the study was to compare pars plana vitrectomy (PPV) with PPV combined with scleral buckle (SB) in the treatment of rhegmatogenous retinal detachment (RRD) in a tertiary care hospital of central India. Materials and Methods: A randomized controlled trial was conducted to compare surgical outcome of PPV + SB versus PPV in patients of RRD. A sample of 36 patients with RRD were included in the study and were divided into two groups: PPV with SB (PPV + SB, n = 19) and PPV (PPV, n = 17). All eyes had 3 months of follow-up. Results: Between the groups, there was a significant difference in eyes with inferior breaks ( P = 0.001). Single surgery anatomical success (SSAS) was 94.7% in the PPV + SB group, whereas it was 94.1% in the PPV group. Improvement in visual acuity (logMAR score) was comparable in both the groups at the end of 3 months ( P = 0.433). Furthermore, the SSAS in phakic patients in both the groups was 100%, whereas for pseudophakic patients, PPV + SB had a SSAS of 83.3%, and in the PPV group, it was 85.7%. Conclusion: We did not find significant differences in SSAS, final anatomical success, or change in visual acuity when comparing PPV with PPV/SB in the RRD.

I read with interest the article published in this journal by Simran et al. concerning the extraction of an (alleged) adult female Loa loa from the eye of an Indian woman.[1] Loiasis, as is well known, is a nematodiasis of the connective tissues endemic in some West-Central African countries, caused by the aforementioned filaria and transmitted to humans by diurnal haematophagous horseflies of the genus Chrysops. The prepatent period is typically long, so cases are sometimes reported in the nonendemic countries, where immigrant patients or tourists who contracted the infection in Africa show signs and symptoms months or even many years after transmission.[2] However, this case, as the patient denied travelling to an endemic area, fits the anecdotal pattern of reports of loiasis contracted in a nonendemic country, for which India holds the curious record. Unfortunately, even a first reading reveals inconsistencies and inaccuracies. The problem with this report - and others like it - Is not the presence or absence of potential L. loa vectors; the genus Chrysops does indeed have representatives outside Africa, and there are even some local Indian species eligible for the role. Instead, the issues lie in the incongruence between the length of the filaria extracted from the patient (105 mm) and the maximum length recorded for a female L. loa (70 mm).[3] These significant discrepancies, coupled with the complete lack of molecular confirmation, pose the greatest challenge to the credibility of all identifications in presumed indigenous Indian cases. Some authors justify the oversized measurements by suggesting the existence of an enigmatic “Indian” species or strain of the parasite. This misunderstanding originates from the work of the Australian physician Maplestone, who, in 1938, described the case of a woman in Mumbai from whom an adult female filaria was extracted from the eye.[4] Despite obvious morphological and size differences (the specimen was more than twice the length of L. loa), Maplestone wanted to attribute it to the genus Loa. Almost a century after Maplestone’s publication, no evidence has been found to support his theory and L. loa remains the only recognised species in the genus Loa. While we wait for molecular investigations to be carried out in some of the next cases, the most probable hypothesis regarding the etiology of this case, as well as many other similar ones, is that we are dealing with species already historically present in India and known for their possible ocular localisation. The examples include Wuchereria bancrofti, Brugia malayi, and Dirofilaria asiatica, or possibly even undescribed species belonging to these genera. Finally, in the interest of scientific rigor, we should also point out the errors made by the authors when reporting the names of the main vectors of L. loa: they refer to “Chrotomys silaceus,” a rodent endemic to the Philippines, and “Calopteryx dimidiata,” a damselfly endemic to the USA, instead of “Chrysops silacea” and “Chrysops dimidiata,” respectively. Data availability statement The data supporting the findings of this study will be made available upon reasonable request. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Neurotrophic keratitis (NK) is characterized by a reduction or loss of corneal sensations caused by partial or total loss of function of the trigeminal nerve, which is the V cranial nerve. Currently published studies clearly show promising results of insulin eye drops in NK. Its cost-effectiveness, ease of procurement, and administration, coupled with its effectivity and safety profile at various concentrations, mandate that we, as an ophthalmic fraternity, implement the use of topical insulin in NK.

Dear Editor, We appreciate the author’s thoughtful engagement with our article and their valid observations.[1] Indeed, there is a need to corroborate and replicate the study with a larger study group and assess other variables like extremes of age, to refine the clinical utility and limitations of the parameter under investigation. As highlighted by the author[1] and other studies,[2] pediatric optic atrophy constitutes a significant proportion of optic atrophy cases. Our study focused on correlating a subjective clinical parameter-the Kestenbaum number-with objective tests like visual field analysis and optical coherence tomography (OCT). We excluded pediatric subjects owing to the challenges in using Humphrey field analysis (HFA) and OCT in this group. HFA testing in children is often compounded by limited concentration, lack of understanding,[3] and its indices correlate modestly with OCT findings compared to adults.[4] While OCT is more feasible, it is hindered by a lack of normative data and higher motion artifacts. Our study revealed that the Kestenbaum number is the lowest in glaucomatous optic atrophy. However, the actual mechanisms and pathogenesis of this observed phenomenon will need to be examined. The understanding that a vascular compromise would be contributory to a lower Kestenbaum number is well known. It has therefore been proposed as a mechanism. The assumption that glaucomatous optic atrophy is more severe is subjective and lacks consistent objective evidence, given the diverse mechanisms and progression of various optic neuropathies. Statistically, multivariate analysis would be more informative but would require a larger database, which could be addressed in future studies. The study elegantly demonstrates the role of the Kestenbaum number in evaluating and objectively quantifying a subjective condition, which has sufficiently enhanced the ability to assess and follow a condition limited by descriptive measures and ambiguous assessments. That a forgotten clinical tool could be of use in the overloaded armamentarium of today’s technologically advanced domain of vision care is undoubtedly a paradigm shift, providing a fresh look at bedside and patient-centric assessments. The ambiguity surrounding optic disc pallor assessment can be mitigated by this objective measure, offering clarity in a field marked by heterogeneity and stochastic presentations. The recording of the appearance of the disc, as suggested by the authors of the communique, is at best an approximation, and that is well accepted by practitioners of the art of ocular examination, relegating this, therefore, to a lower relevance. Clinical appearance of the disc, even if recorded digitally, is subject to variables of examination and interpretation. The Kestenbaum number provides a more definable tool for the assessment, which is not subject to examination variations. There appears to be no end to technological advancements and the deployment of nonclinical tools of evaluation. The race for technological acquisition appears to lead clinicians to blur the existential sheet anchor of medical care. Our study emphasizes the enduring value of clinical tools like the Kestenbaum number, especially in resource-limited settings where access to sophisticated imaging is restricted. It provides robust, actionable insights that complement or even substitute for high-end diagnostics. Regards, Data availability statement Not applicable. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.