Abstract Purpose: To evaluate the correlation between lens thickness (LT), cataract grading, and anterior chamber depth (ACD) in patients with age-related cataract. Materials and Methods: This hospital-based observational study included 100 eyes of age-related cataract patients. Patients with previous ocular surgery, glaucoma, secondary cataract, or high myopia were excluded. Detailed ophthalmic examination done which included vision assessment, anterior segment examination, and posterior segment examination using indirect ophthalmoscope. Cataract grading was done using lenticular opacification classification system (LOCS) III. LT and ACD were measured using Zeiss intraocular lens Master 700. Statistical analysis was done using the SPSS software version 29.0 with Pearson correlation. Results: Mean age 61.7 ± 8.3 years; 68% female. Mean LT was 4.61 ± 0.35 mm and mean ACD was 2.92 ± 0.42 mm. LT showed a positive correlation with cataract grade ( r = 0.452, P < 0.01) and a negative correlation with ACD ( r = −0.635, P < 0.001). Conclusion: LT increases with advancing cataract grade and inversely correlates with ACD. Biometric evaluation of LT and ACD is recommended for surgical planning.

Abstract Background: Corneal blindness accounts as most important public health concern among adults in India. Less number of corneal grafts limits the surgical intervention. To determine the awareness regarding eye donation among students studying in allied health sciences (AHS) and non-AHS (N-AHS) students at a university. Methodology: A cross-sectional survey-based approach was made to assess the awareness. A 15-closed-ended questions in a questionnaire was circulated among the students from June, 2024 to October 2024. Final year students were included. The ones who completed the full survey were considered for further analysis. Results: In a study of 521 participants, 49.7% were from AHS and 50.3% from N-AHS, with average ages of 21.3 and 21.6 years, respectively. AHS students showed higher awareness of eye donation (92.7% vs. 84.0%, P < 0.001) and lower odds of misconceptions (odds ratio [OR] = 0.65, P = 0.01). Field of study, year of study, and information sources were independent predictors of awareness, with adjusted odds of 2.18 for AHS students ( P = 0.003) and higher awareness for those in later years (adjusted OR [AOR] = 1.63, P = 0.04). Additionally, awareness was the strongest predictor of the desire to donate, with adjusted odds 3.42 times higher among those aware ( P = 0.001), and attitudes were influenced by the absence of religious concerns (AOR = 2.31, P = 0.04). Conclusion: AHS students have higher awareness of eye donation parameters, necessitating regular awareness programs in communities and colleges to increase awareness and improve the nation’s eye donation program.

Abstract Access to eye care remains a major global public health challenge, particularly in low- and middle-income countries and rural areas. Financial constraints, geographic inaccessibility, and limited awareness continue to hinder timely utilization of eye care services, leading to preventable vision loss and blindness. This systematic review and meta-analysis followed PRISMA 2020 guidelines and synthesized evidence from PubMed, Scopus, and Google Scholar for studies published between 2000 and March 2024. A total of 45 studies across 28 countries involving approximately 1,200,000 adults were included. Data were analyzed using a random-effects model to estimate pooled prevalence of financial, geographic, and awareness-related barriers. Subgroup analyses and odds ratios assessed differences by income level, geography, and gender. Heterogeneity was evaluated using the I 2 statistic, and publication bias using Egger’s test and funnel plots. Financial barriers showed the highest pooled prevalence at 58.7%, followed by geographic barriers at 41.2% and awareness-related barriers at 39.8%. Individuals in LMICs had significantly higher odds of barriers compared to high-income settings. Women experienced greater financial, geographic, and awareness barriers than men, with statistically significant differences. High heterogeneity was observed across studies. These findings highlight persistent and overlapping inequities in access to eye care. Targeted interventions such as telemedicine, mobile eye units, and community-based education are essential to improve access and support global initiatives including Vision 2030 and the Sustainable Development Goals. Strengthening health systems, reducing financial burden, and addressing gender and rural disparities should be prioritized to ensure equitable and timely eye care delivery worldwide for all populations globally.

Abstract Objective: To assess the knowledge and perceptions of artificial intelligence (AI) among ophthalmologists and ophthalmology residents in Brazil and its applicability in clinical practice. Subjects and Methods: This observational, cross-sectional, descriptive, and analytical study used a 19-item structured questionnaire covering sociodemographic data, professional profile, AI knowledge, clinical applications, perceived benefits, and ethical concerns. The online survey was distributed nationwide using convenience and snowball sampling. Data were analyzed using appropriate statistical tests with a significance level of 0.05 (Jamovi v. 2.3.28). Ethical approval was granted by the Fundação Altino Ventura Institutional Review Board (approval no. 6.631.825). Results: A total of 165 participants completed the survey, including 120 ophthalmologists (73%) and 45 residents (27%), with a mean age of 38.8 ± 11 years. Moderate AI knowledge was reported by 48% of respondents, good knowledge by 27%, and limited knowledge by 22%. AI was considered relevant to ophthalmology by 58% of participants, and 88% expressed moderate trust in AI-generated data. Ethical concerns were reported by 84%. The most frequent AI applications were differential diagnosis (93%), report preparation (81%), therapeutic guidance (59%), and reduction of diagnostic errors (58%). Most participants (73%) viewed AI as a complementary tool to clinical practice, whereas 22% anticipated partial and 1% full professional replacement. Conclusion: Brazilian ophthalmologists recognize AI as a relevant and promising adjunct in clinical practice, particularly for diagnostic support. Although knowledge levels are predominantly moderate, AI is largely perceived as complementary rather than substitutive, with ongoing ethical and reliability concerns emphasizing the need for education, regulation, and continuous evaluation.

Abstract Purpose: To evaluate the correlation between preoperative myopic severity, central corneal thickness (CCT), and residual stromal bed (RSB) across wavefront-optimized (WFO) laser-assisted in situ keratomileusis (LASIK), Contoura LASIK, and StreamLight photorefractive keratectomy (PRK) and to assess their safety and refractive predictability over 6 months. Materials and Methods: This retrospective study included 84 eyes from 42 patients aged 18–35 years who underwent one of the three refractive procedures between December 2024 and June 2025 at a tertiary eye center in northern India. Data collected preoperatively and up to 6 months postoperatively included spherical equivalent (SE), CCT, and RSB. Pearson’s correlation assessed relationships among SE, CCT, and RSB. Technique-specific outcomes were evaluated for safety, efficacy, and predictability. Results: Eighty-four eyes (mean age: 26.4 ± 2.1 years; 64.3% female) were analyzed. Mean preoperative SE was −4.61 D, CCT: 529.8 μm, and RSB: 357.1 μm. Moderate myopia predominated (65.4%). WFO LASIK had the highest mean SE (−4.99 D) and RSB (364.4 μm); PRK was used in thinner corneas. SE did not correlate significantly with RSB ( r = −0.12, P = 0.27) but had a mild inverse correlation with CCT ( r = −0.27, P = 0.01). CCT showed a positive correlation with RSB ( r = 0.38, P < 0.001). All techniques demonstrated effective stromal preservation. Conclusions: Both LASIK and PRK are safe and effective for myopic correction. SE did not significantly influence RSB when individualized planning was applied. CCT remained the strongest predictor of surgical safety, supporting personalized technique selection.

Abstract Purpose: Neural tumors of the orbit and eyelid are defined as proliferations of neurofibrous cells and/or Schwann cells. Merkel cell carcinomas (MCC) are rare neuroendocrine tumors that have characteristic histopathological features to differentiate them, particularly to metastatic disease. This series aims to identify clinical, epidemiological, and histopathological presentations to assess the implications for diagnosis, management, and prognosis. Materials and Methods: A retrospective analysis of 36 patients was obtained from the MUHC – McGill University Ocular Pathology and Translational Research Laboratory between 2009 and 2022. Demographic information regarding age, sex, and anatomical location was collected along with clinical and histopathological diagnosis. Results: Of the 36 tumors, 67% ( n = 24) of them affected females, 17% ( n = 7) had a right upper eyelid laterality, and the average age was 57 years. Seventeen percent ( n = 6) were correctly diagnosed clinically. Of the 36 tumors, 16 were neurofibromas. The average age was 53 years old, 63% were female ( n = 10), with the majority being on the eyelid ( n = 13). Schwannomas were diagnosed in 11 biopsies. The average age was 54 years, and the majority were females (82%, n = 9). Moreover, 6 MCC were identified histopathologically with panels of various immune markers. The average age was 77, where 67% ( n = 4) were female, and 50% ( n = 3) were found on the left lower eyelid. Conclusion: Neural tumors of the orbit and eyelid comprise a heterogeneous group of periocular lesions with variable clinical behavior which makes accurate clinicopathological and histopathological correlation essential for timely diagnosis and appropriate management.

Abstract Aim and Background: Idiopathic intracranial hypertension (IIH) causes elevated intracranial pressure (ICP) and papilledema. This study evaluated changes in the retinal pigment epithelium (RPE) angle on optical coherence tomography (OCT) before and after treatment and their relationship with ICP. Methods: This retrospective case series included eight patients with IIH and papilledema. ICP was measured by lumbar puncture before and after treatment. Spectral-domain OCT was used to quantify the RPE angle in both eyes on radial B-scans through the optic nerve head. All analyses were performed in Stata v14, including descriptive statistics, paired comparisons, and linear correlation between ΔICP and ΔRPE. Results: Eight patients (75% female; mean age 37.0 ± 18.6 years) were included in the study. Mean ICP decreased from 40.0 ± 16.2 to 21.6 ± 6.0 mmHg after treatment (ΔICP = −18.4 ± 15.0 mmHg; P < 0.01). RPE angles showed modest, nonsignificant reductions in both eyes (OD: −3.25° ± 5.52°; OS: −1.0° ± 2.78°). No correlation was observed between ΔICP and ΔRPE, and Bland–Altman analysis demonstrated good interocular agreement with minimal bias. Conclusion: Although ICP normalized after treatment, changes in the RPE angle were small and variable, suggesting that peripapillary structural recovery may lag behind ICP reduction. Larger studies are needed to clarify the role of RPE angulation as a complementary OCT marker in monitoring IIH.

Abstract Purpose: To describe the six-year evolution of Ojo Pampa, a tele-screening program for diabetic retinopathy (DR) implemented in rural areas of La Pampa, Argentina, and to characterize temporal patterns in DR detection and referral. Methodology: A descriptive, observational study was conducted including all individuals with a prior diagnosis of diabetes mellitus residing in rural areas of La Pampa who participated in the Ojo Pampa program between January 2019 and December 2024. Fundus photographs were obtained using a non-mydriatic retinal camera during community-based visits and uploaded to a centralized database. Images were graded asynchronously by ophthalmologists and classified as gradable or non-gradable; gradable images were categorized by DR severity using the International Clinical Diabetic Retinopathy Scale. Results: A total of 16,717 individuals were screened; 2,266 (13.6%) had non-gradable images. The proportion of patients without DR increased from 77.5% in 2019 to 83.5% in 2024 (p<0.001). Mild non-proliferative DR (NPDR) decreased from 11.1% to 5.3% (p<0.001), while moderate NPDR declined modestly from 7.8% to 7.1% (p=0.012). Advanced DR stages showed no consistent variation over time. Referral rates ranged from 8.5% to 11.2% throughout the study period, without a clear temporal trend. Conclusion: Over six years, the Ojo Pampa program expanded access to diabetic retinopathy screening in underserved rural communities and enabled systematic identification and referral of patients requiring ophthalmologic evaluation. These findings support the feasibility of teleophthalmology as an integrated public health strategy to reduce access barriers and strengthen coordinated diabetic eye care in low- and middle-income settings.

Abstract This study aimed to assess whether pupillary monitoring improves intraoperative sufentanil dosing and patient stability. A systematic search through July 14, 2025 identified randomized controlled trials using pupillary indices (e.g., pupillary pain index, ultrasound pupillometry) to guide sufentanil in adult surgical patients. Five trials with 371 participants were included in the study. Data on opioid consumption, hemodynamic stability, postoperative pain, intensive care unit stay, and adverse events were extracted. Risk of bias was evaluated. Pupillometry-guided titration reduced intraoperative sufentanil use and improved hemodynamic stability, especially in cardiac surgery. Postoperative outcomes were similar to standard monitoring. Pupillary monitoring may enhance intraoperative opioid titration safely. Larger studies are needed to confirm clinical utility.

Abstract Introduction: Faricimab is the first bispecific antibody approved for the treatment of neovascular age-related macular degeneration (nAMD), combining dual inhibition of VEGF-A and angiopoietin-2. Although it has demonstrated efficacy in the TENAYA/LUCERNE trials, evidence in Latin American populations and in real-life settings is limited. Methods: Retrospective observational study in 28 eyes of 24 patients treated with faricimab for nAMD in a tertiary center in Chile. Visual and structural changes at month 12 were evaluated by automated quantitative analysis with artificial intelligence (RetinAI Discovery™), including biomarkers such as subretinal fluid (SRF), intraretinal fluid (IRF), pigment epithelial detachment, retinal thickness, retinal pigment epithelium (RPE), and EZ. Linear mixed models, logistic regression, and negative binomial regression were used. Results: Best-corrected visual acuity (BCVA) improved significantly at 12 months (+0.08 logarithm of the minimum angle of resolution; P = 0.02), with no differences between naïve patients and switchers. SRF and IRF volumes were reduced, mainly in the first 3 months. No significant correlations were found between biomarker change and visual improvement. BCVA was the only significant predictor of visual response (odds ratio = 680; P = 0.042). The mean number of injections was 6.4 ± 2.9, with no significant differences between groups. Conclusions: In this Latin American cohort, faricimab showed sustained functional and anatomical effectiveness in real life. However, visual outcomes were more modest than in pivotal trials. The structural response was greater in eyes with higher baseline fluid load, without necessarily translating into greater visual gain. Prospective studies are required to validate these findings.