Background and Objective: Idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri, is a disorder characterized by increased intracranial pressure (ICP) without identifiable secondary causes on neuroimaging and normal cerebrospinal fluid (CSF) content. The management of IIH during pregnancy raises several difficult and unique issues compared to non-pregnant patients. Diagnostic concerns include the risks of ionizing radiation and contrast agents to the fetus, as well as increased technical difficulty of performing a lumbar puncture while treatment considerations include safety risks to the fetus with commonly used medication, such as acetazolamide and topiramate. Challenges associated with surgical intervention further complicate matters, including anesthesia risk to the fetus, intraoperative fetal monitoring that generally precludes outpatient surgery, and the need for anticoagulation after shunt placement. This review summarizes the current literature regarding the diagnostic and management considerations for IIH in pregnancy and highlights areas requiring further research. Methods: A literature review was conducted using PubMed and MEDLINE, emphasizing recent studies. Search terms included “idiopathic intracranial hypertension”, “pregnancy”, “pathophysiology”, and “surgical management”. Key Content and Findings: Current evidence outlines various diagnostic and management considerations for IIH in pregnancy. Medical management is limited due to concerns about fetal safety, particularly with acetazolamide and common agents for headaches. Surgical interventions, while effective in some cases, pose logistical and safety challenges. There remains no consensus on preferred surgical method or anesthesia approach in these patients. Conclusions: As the incidence of IIH continues to rise, especially in populations overlapping with reproductive-age women, understanding its management during pregnancy is critical. Continued research is needed to establish safe and effective medical and surgical strategies to optimize outcomes for both the mother and fetus.

Abstract: Medical trainees frequently experience challenges in clinical education requiring educators to be prepared with possible informal remediation strategies. Educators can apply familiar clinical problem-solving techniques to address the struggling learner. This article will apply and expand upon the subjective, objective, assessment, and plan (i.e., “SOAP”) format, commonly used in medicine, to create a guide for addressing the struggling ophthalmology learner. The SOAP format provides for “S” subjective self-reflection by the learner; “O” objective institutional metrics for improvement over time; an accurate “A” assessment of the root causes for any deficiencies; and a structured, measurable, and timed “P” plan for performance improvement that ensures due diligence and, if necessary, due process. The root cause of a learner’s deficiency is often multifactorial, with cognitive elements (difficulty with organization, incomplete knowledge base, etc.) and non-cognitive personal elements (personal responsibilities, mental health challenges, etc.). Additionally, there are steps that can be added to the SOAP format to create a more comprehensive approach. Learner difficulties may be prevented by providing an orientation at the beginning of rotations to outline learner expectations. To recognize learner deficits rapidly, learners can be screened for challenges using frequent assessments. After remediation has been completed, the learner should be reassessed to determine if competence was achieved. This process can assist learners and educators across specialties, but tools and resources specific to ophthalmology education will be included in this article.

Abstract: Conjunctivitis, inflammation of the conjunctiva, is a common clinical problem. It typically presents as eye redness with discharge and discomfort. The eyelids, eyelashes, and cornea can also be affected, although specific signs and symptoms vary based on disease. Conjunctivitis can be a challenge to diagnose correctly, but identifying the condition accurately is crucial for proper management. Broadly, conjunctivitis can be considered as infectious or non-infectious. Infectious conjunctivitis is most commonly viral or bacterial with an acute onset and is typically self-limited. Non-infectious causes can be categorized as allergic or non-allergic, and may be secondary to underlying systemic disease, genetic conditions, or mechanical or toxic triggers. These are often chronic conditions and may require treatment of an underlying disease. Given the range of possible etiologies and often overlapping manifestations of these conditions, thorough history taking and physical examination are imperative for proper diagnosis. Other conditions of variable severity such as dry eye syndrome, iritis, keratitis, scleritis, and acute angle-closure glaucoma can also present with red eye and need to be considered as a part of the differential diagnosis for conjunctivitis. This review describes different forms of conjunctivitis as well as other select ocular conditions that belong on the conjunctivitis differential, highlighting risk factors, pathophysiology, clinical signs and symptoms, and key distinguishing features of these conditions.

Background and Objective: Advancements in technology, including virtual reality (VR), artificial intelligence (AI), and simulation-based learning, are transforming ophthalmic surgery training by improving precision, adaptability, and accessibility. While traditional methods remain indispensable, the integration of digital learning tools within structured, constructively aligned curricula as well as ongoing assessment is increasingly essential to meet contemporary training needs and improve patient outcomes. The aim of the narrative review was to provide a synthesis of current literature on digital learning tools in ophthalmic surgery training by examining emerging technologies and trends, and their integration into educational programmes. Methods: With the assistance of a librarian, a literature search across multiple databases, such as Scopus and EBSCOhost databases, was conducted, including all English-language articles with available abstracts. A total of 403 articles were reviewed, with 10 duplicates removed and 172 full texts analysed to identify key themes using Rayyan software. Key Content and Findings: This narrative review explores how digital tools—such as software, videos, gaming and VR—enhance ophthalmic surgery training by overcoming time and location barriers. Simulation-based learning is most effective when it is preceded by strong foundational knowledge and supported by structured mentorship. A structured curriculum incorporating wet labs and simulators is preferred to support procedural skills development. VR provides step-by-step surgical training, immersive simulations and performance assessments. Combining VR simulation with wet lab training could transfer surgical skills to the operating theatre. Constructive alignment ensures that learning outcomes, assessment methods, teaching strategies and course content are cohesively integrated to optimise educational effectiveness. This review employed the principles represented by Miller’s pyramid as a framework to explore the application of digital tools and advancements in ophthalmic surgery training. This holistic approach fosters authentic, learner-centred training and assessment, progressing from knowledge acquisition to clinical performance through diverse metrics, simulations and workplace-based evaluations. Conclusions: By incorporating technologies such as VR, AI and augmented reality (AR), ophthalmic surgery training becomes more efficient, standardised and accessible, improving surgeons’ knowledge, skills, and behaviours despite existing challenges.

Background and Objective: Dry eye disease (DED) is a multifactorial disorder increasingly prevalent among patients with diabetes mellitus (DM), a global metabolic disease with significant systemic and ocular complications. While diabetic retinopathy is well-recognized, the impact of DM on the anterior segment, particularly the ocular surface, remains underdiagnosed and undertreated. Existing reviews often describe the association between DM and DED but lack an in-depth analysis of the specific ocular surface changes. This narrative review aims to explore the pathophysiological mechanisms linking DM to ocular surface alterations and DED. Methods: A literature search was conducted in PubMed for English-language articles published between January 2020 and January 2025. Search terms included “diabetes mellitus”, “dry eye disease”, “ocular surface”, “diabetic keratopathy”, and related keywords. Key Content and Findings: Chronic hyperglycemia in DM drives metabolic dysregulation, corneal nerve fiber loss, and dysfunction of the lacrimal and meibomian glands. These mechanisms collectively disrupt tear film homeostasis, promote ocular surface inflammation, and increase the risk and severity of DED in diabetic patients. Poor glycemic control, longer disease duration, and comorbidities like autonomic neuropathy further exacerbate these effects. The review also highlights the role of intraocular surgeries, such as cataract extraction, in worsening ocular surface conditions, and explores the potential protective effects of certain antidiabetic medications, including SGLT2 inhibitors and GLP-1 receptor agonists. Advances in diagnostic tools and imaging techniques are also discussed for their role in early detection and management. Conclusions: DED is a significant yet often overlooked complication of diabetes. Enhanced awareness, routine screening, and individualized care strategies are essential to mitigate its impact. Further research is needed to develop targeted therapies and optimize ocular surface health in the diabetic population.