Common Ocular Symptoms Research Articles

Presbyopia, Dry Eye, and Retinal Thickness in the Middle-Aged Population: Focusing on Sex Differences.

Risk factors for presbyopia have not been fully determined although previous studies suggested presbyopia was associate with age, dry eye, and retinal ganglion cell complex thickness (GCC). We accessed these signs and common ocular symptoms in the middle-aged population focusing on sex differences when women have drastic hormonal change. This cohort study consecutively enrolled 2743 patients aged 36-45 years (n=1000), 46-55 years (n=1000), and 56-65 years (n=743). All underwent ocular surface tests and had near add power and GCC measured. Common ocular symptoms were asked using questionnaire. Among female participants, visual symptoms (eye strain and photophobia) were more prevalent in the age group 46-55, whereas non-visual symptoms (dryness, irritation, and pain) were not. We identified symptomatic presbyopia (near add power ≥ 1.5D) in 14.4%, 73.8%, and 97.8%, positive corneal staining in 29.1%, 23.8%, and 23.9%, and a mean GCC of 98.2 μm, 105.3 μm, and 89.6 μm in the age groups 36-45, 46-55, and 56-65, respectively. Mean tear break-up time were 3.3, 3.5, and 3.3 seconds, respectively. Results indicated a large progression of presbyopia (P<0.01) from the period of 36-45 years onward and significantly increased GCC (P<0.01) in women of age group 46-55. No notable tendency was observed in symptoms and GCC for male participants. Visual symptoms in women were worse between 46 and 55 years than before or after these ages. The increase of symptomatic presbyopia and GCC may be contributing to visual symptoms in addition to menopausal transition symptoms in this age group.

Real-world analysis of belantamab mafodotin (belamaf): Care patterns in relapsed/refractory multiple myeloma.

e19507 Background: Belamaf is an anti-B cell maturation antigen immunoconjugate for relapsed/refractory multiple myeloma that has shown efficacy and safety in the DREAMM clinical trials. Additional long-term real-world data on its use patterns, efficacy, and tolerability are needed. Methods: This retrospective review (NCT05986682) analyzed adults with multiple myeloma receiving ongoing care at Duke Cancer Institute who began belamaf monotherapy (not in a clinical trial) between 8/5/2020 and 11/22/2022. We abstracted data for 30 patients through 9/18/2023. We described baseline clinical characteristics, disease response (per International Myeloma Working Group [IMWG] criteria, as possible given available marrow biopsy data), belamaf use patterns, and ocular adverse events (AEs) (per the Keratopathy Visual Acuity [KVA] scale). Results: Our sample was 53% (n=16) female, 47% (14) White, and 47% (14) Black; median age was 68 years at the beginning of belamaf therapy. 67% (20) had ≥4 prior lines of therapy (median: 4, min-max: 2-19), 87% (26) were triple-/quad-/penta-refractory, and 23% (7) had high-risk cytogenetics (per IMWG). Overall response rate (ORR) was 67% (11 very good partial response, 9 partial response). Median (min-max) time to best response was 1.5 (0.7-9.9) months. Median (min-max) response duration was 9.8 (1.1-20.2) months. Progression occurred in 73% (22) of patients; median progression-free survival (PFS) was 8.4 months (95% CI 6.6-12.7). Median overall survival was not reached. Median (min-max) number of cycles was 6.5 (2-13). 63% of patients (19) had a dose reduction from 2.5 to 1.9 mg/kg; 65% (13) were due to corneal AEs and 30% (6) due to hematologic AEs. 93% (28) had ≥1 cycle delay, and the median (min-max) number of delays was 5 (1-14); 85% of delays (n=153) were due to corneal AEs. Cycle length changed for 33% (10) from every 3 weeks to every 4 (1) or 6 (9) weeks; 91% (n=10) of cases were due to corneal AEs. 93% (28) had keratopathy (any grade); among all events (n=323), 2% were grade ≥3. Median (min-max) time to resolution of grade ≥2 keratopathies was 6 (2-22) weeks. 90% (27) experienced a visual acuity change; among all events (n=244), 3.3% were grade ≥3. Median (min-max) time to resolution of grade ≥2 visual acuity events was 6 (2.9-53) weeks. The most common ocular symptoms were blurry vision (53% of symptoms), dry eyes (17%), and photophobia (14%). Belamaf was discontinued in 13% (4) due to ocular AEs and 20% (6) to patient/physician choice or other reason. Median (min-max) time to last dose/discontinuation was 9.3 (0.7-21.6) months. Conclusions: In our study, ORR and median PFS were greater than other real-world studies. Corneal AEs were also more common, but severity was consistent with these and DREAMM-3 findings. Despite a higher rate of dose reductions and delays than other real-world studies, our study adds promise to the benefit of belamaf over an extended time with dose modifications.

Metastatic nose and paranasal sinus masses – A case series

Metastases to the nose and paranasal sinuses are unusual. These tumors are commonly seen in the 4th to 6th decades of life. The clinical presentation may be analogous to that of primary sino-nasal tumors. They usually present with common nasal and ocular symptoms due to which diagnosis may be missed and delayed. Hence, high level of suspicion is necessary for patients with known malignancies presenting with inconsistent or repeated nasal and ocular symptoms. Otorhinolaryngologists should be familiar with these metastases to paranasal sinuses from unusual primary elsewhere in the body, to evaluate and manage these tumors. Retrospective data was collected from the hospital records from 2020-2023. A total 14 cases of sino-nasal malignancies were identified. On further analysis three cases were found to be having distant metastases from primary sites such as kidney, breast and lymph nodes. We are reporting three metastatic malignancies. Each was systematically evaluated, confirming their origin as metastases from other primary sites. They were then managed appropriately. Keywords: metastases; paranasal sinuses, renal cell carcinoma; breast carcinoma; non-Hodgkin’s lymphoma; sinus surgery

Review of Ocular Manifestations and Drugs Used for the Treatment of Ocular Complaints in COVID-19

SARS-CoV-2 has been infrequently isolated from conjunctival swabs; it is associated with ocular manifestations, including conjunctivitis, blurred vision, dry eye, and hyperemia in patients with confirmed COVID-19. In some cases, ocular manifestations may be the first and only symptoms of COVID-19 related to the greater severity of the systemic disease. According to the eye manifestations, physicians have prescribed different medications. For example, drugs such as azithromycin eye drops, dexamethasone, moxifloxacin, and ganciclovir ophthalmic gel have been used for the treatment of conjunctivitis. The role of ophthalmologists in the prevention and screening of COVID-19 is highlighted due to the ocular manifestations. The most common ocular symptoms associated with COVID-19 infection, treatment, and potential side effects of drugs utilized to combat these complications are reviewed in this article.

Study of health seeking behaviour in parents of children in a population-based childhood visual impairment study in North India - "CHVI 2".

The background of this study is to determine the awareness about health seeking behaviour (HSB) in parents of visually impaired children in a population-based study. The study was conducted in population <16 years in urban area of North India. A total of 20,955 (97.3%) children underwent visual acuity examination. Of these, 789 children were referred to the centrally based clinic with unaided visual acuity <6/12 in any eye for undergoing detailed ophthalmic examination. Along with ocular examination, the parents of these 789 referred children, were interviewed for the questions related to HSB, the most common ocular symptom known to them was redness of eyes followed by watering and diminution of vision, 249 (34.6%) denied for any ocular problem in their children previously, amongst the remaining 469 parents/care takers with any ocular problem, a total of 367 (51.1%) referred children wore glasses and the proportion of parents wearing glasses was similar amongst these children (11.7% fathers and 11% mothers). Amongst the 118 respondents of visually impaired children (presenting visual acuity less than 6/18 in better eye with available correction), 56 (47.5%) denied for any ocular problem in their children previously, of the remaining 62 (52.5%), parents, 58 (93.5%) had consulted various healthcare agencies, 45.8% of the respondents reported not said that their children wore glasses prescribed to them. Only 24 (20.3%) respondents were aware that Vitamin A is good for eye health. Diminution of vision, watering and redness of eyes were the most common ocular symptoms known to parents of referred children. HSB can be further improved via primary healthcare physicians by primary healthcare creating awareness about importance of wearing glasses and healthy diet in parents of visually impaired children.

Digital Eye strain among Undergraduate Medical students of Nepal Medical College and Teaching Hospital during COVID-19 Pandemic

During Covid-19 Pandemic, there was declaration of lockdown which led to increased usage of digital devices due to starting of online classes. Increased duration of digital device usage predisposed students to Digital eye strain (DES). This study aimed at estimation of the prevalence of DES among medical students of Nepal Medical College and Teaching Hospital during Covid pandemic. It also analyzed the pattern of digital device usage, risk factors for DES, awareness and practice of preventive measures taken by students during online classes. This was a cross-sectional questionnaire-based survey which included one hundred and sixteen undergraduate medical students. The mean age of the students was 22±1.30 years. Sixty-two students (53.4%) were male and fifty-four (46.6%) were female. There was a significant increase in the duration of digital device usage during Covid -period as compared to pre-Covid period (P=&lt;0.001). The prevalence of the DES was 68.1% of which 60.34% had mild DES and 7.76% had moderate DES. The most common ocular symptoms were burning sensation (69.8%) followed by eyesight worsening (60.3%) and eyepain (56%). This study didn’t find significant association between DES and its risk factors like duration of digital device usage, distance from screen, posture, frequency of break and level of screen during online classes. Preventive measures like uses of lubricating eyedrop and use of anti-reflective coated glasses/ blue ray cut glasses were significantly associated with less frequency of DES (P=0.03,0.01 respectively). DES is an emerging eye health problem due to increase screentime exposure, so limitation of screentime and practice of 20-20-20 rule is recommended to reduce DES related symptoms.

Belantamab Mafodotin in Patients with Relapsed/Refractory Multiple Myeloma Included in the Compassionate Use or the Expanded Access Program. Experience with a Spanish Cohort

Background. Treatment of multiple myeloma (MM) has improved with novel therapies emerged in the last decade. However, patients refractory to treatment with standard drug classes including proteasome inhibitors, immunomodulatory drugs, and anti-CD38 monoclonal antibodies (RRMM patients) still constitute an unmet medical need, with median survival ranges no longer than 9 months (Richardson et al, 2007). Belantamab Mafodotin (Belamaf) is a novel anti-BCMA antibody conjugated to microtubule-disrupting agent monomethyl auristatin F. Belamaf showed anti-myeloma activity with an acceptable safety profile in RRMM patients in phase 1 (Trudel et al, 2019) and phase 2 trials (Lonial et al, 2020 & 2021). Belamaf is the first antibody drug conjugate approved in RRMM patients and real-life evaluations are needed. We aimed to assess the efficacy and safety of Belamaf administered as monotherapy in a cohort of Spanish RRMM patients. Methods. An observational, retrospective and multicenter study was performed. RRMM patients who received at least one dose of Belamaf within compassionate use or expanded access programs in Spain between November 2019 and June 2021 were included. Researchers entered medical records in case report forms distributed to the participating sites. The primary endpoint was the overall response rate (ORR). Secondary endpoints were: overall survival (OS); duration of response (DoR); progression free survival (PFS); ocular and non-ocular treatment emergent adverse events (TEAEs) of any grade whose incidence was ≥15%, and those of grade ≥3 whose incidence was ≥5%. Results. One hundred and twenty-six patients from 59 hospitals, 67 of whom (53.2%) were women, were recruited. At MM diagnosis, median (range) age was 70 (39-89) years, and 27% of patients had R-ISS III. At study entry, 88% of patients were triple-class refractory. The median number of prior therapy lines was 5 (range, 1-10), and 67% of patients had received an autologous hematopoietic stem cell transplantation (Table 1). The median follow-up was 13 months. ORR was achieved in 52 (41.3%) patients. Thirty (23.8%) patients achieved at least very good partial response, and 11 (8.7%) and 7 (5.6%) patients showed complete response and stringent complete response, respectively. DoR and PFS were 9.6 (3.6-15.7) and 3.5 (2.4-4.7) months, respectively [median (95% CI)] Median OS was 11.1 months (8.3-13.9 months]) (Table 2). Disease progression was the most common reason for treatment discontinuation (69 patients), while 5 (5%) patients discontinued Belamaf due to adverse events (1 due to the keratopathy). Seventy (55.6%) patients had at least one ocular TEAE. Keratopathy, which was reported in 64 (50.8%) patients, was the most commonly found ocular TEAE. Twenty-five (19.8%) of these cases were of grade ≥3. The most common ocular symptoms were blurry vision and dry eye, in 28 (22.2%) and 26 (20.6%) cases, respectively. One hundred and fifteen non-ocular TEAEs were documented in 56 (44.4%) patients, 45 (39.1%) grade ≥3, and were reported in 30 (23.8%) patients. Thrombocytopenia was the only hematologic TEAE whose incidence met the criteria specified in Methods. Thrombocytopenia occurred in 18 (14.3%) patients, being of grade ≥3 in 13 (10.3%) cases. Finally, infection, documented in 18 (14.3%) patients, was the most commonly found non-hematologic toxicity. Half of infection cases were of grade ≥3. Conclusion. Belamaf showed a noticeable anti-myeloma activity, in this real-life series of RRMM patients, in the line with what has been observed in the DREAMM-2 clinical trial, when administered to a cohort of heavily pretreated RRMM patients in the context of either compassionate use or expanded access programs. The safety profile was manageable and consistent with previous studies. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

The ocular symptoms and signs during the COVID-19 pandemic.

The aim of this cohort study was to describe the change in ocular surface signs and symptoms before and during the COVID-19 pandemic, and to associate changes with potential pandemic-related events. First-visit patients from 2019 to 2021 were examined for corneal staining, lacrimal function and refraction. We assessed the presence of seven common ocular symptoms. Patients with glaucoma and macular disease were excluded. Dry eye (DE) was diagnosed according to the criteria of the Asia Dry Eye Society. The mean age of 3,907 participants was 59.6±18.6y and 63.8% were female. Mean age and the prevalence of diagnosed DE and shortened tear break-up time decreased from 2019 to 2021. The prevalence of eye fatigue, blurring and photophobia decreased in 2020. The prevalence of diagnosed DE did not increase among first-visit patients during the pandemic compared with 2019, despite many survey results suggesting that DE may have worsened due to frequent masking, increased screen time, mental stress, and depression under quarantine and social infection control. It might be considered however, that many elderly DE patients might have refrained from consulting an ophthalmologist and possibly delayed treatment of DE during the pandemic.

Periodic Trends in Internet Searches for Ocular Symptoms in the US

ABSTRACT Purpose To identify periodic trends in internet searches for ocular symptoms and to determine the seasonal peaks and troughs. Methods This cross-sectional study examined publicly available Google Trends data from the United States (01/01/2015 to 12/31/2019). A list of common ocular symptoms was compiled from the American Academy of Ophthalmology Eye Health website and Wills Eye Manual. Ocular symptoms were stratified into categories involving vision change, eye pain, or eye redness. The search volume over time for each term was modeled using periodic regression functions and the goodness-of-fit was reported. Fisher’s exact tests were used to compare the characteristics of periodic vs. non-periodic query terms. Results Seasonal trends were demonstrated by 45% (48/106) of the ocular symptoms included in this investigation. Search terms with best fit to the periodic model included stye (r2 = 0.89), pink eye (r2 = 0.82), dry eye (r2 = 0.76), blurry vision (r2 = 0.72), and swollen eye (r2 = 0.71). Periodic search terms were more likely to involve eye redness (21% vs. 11%, p = .014) and less likely to involve vision change (11% vs. 36%; p < .001). Periodic queries involving eye redness most often peaked in the spring and those involving eye pain peaked in the summer. Conclusion Ocular symptom queries directly reflect seasonal trends for allergic eye disease and ocular trauma. Search query analyses can serve as accurate epidemiological tools with research and real-world clinical applications.

Ulcerative Colitis Ocular Manifestations in Patients Admitted to a Peshawar Tertiary Care Hospital

Objective: This study aimed to see how common ocular symptoms of ulcerative colitis were in patients hospitalized in a tertiary care hospital in Peshawar. Methodology: At Hayatabad Medical Complex (HMC) and Khyber Teaching Hospital (KTH) Peshawar, 100 patients with ulcerative colitis were studied from January 2019 to December 2019 in cross-sectional research (UC). Following the inclusion and exclusion criteria application, all patients were included in the research. The eyes of each participant in the trial were thoroughly examined by a specialist Ophthalmologist. The results of the patients' visual examinations were documented. SPSS Vs. 10.0 was used to examine all of the data. For each of the variables in the research, we ran descriptive statistics. Results: Male to female ratio was 1.43:1 with 59 (59%) male and 41 (41%) female patients. Most patients (43 percent) were 30-40 years old, with a mean age of 37 (5 S.D.). Episcleritis was the most prevalent ocular ulcerative colitis symptom in this research. All individuals with ocular ulcerative colitis experienced a severe flare. 4/5 episcleritis individuals developed pan-colitis. Uveitis patient had pan-colitis. Conclusion: Patients with ulcerative colitis should have their eyes checked for any visual symptoms that might lead to blindness. If detected early enough, they may be treated immediately, which may help people like these prevent irreversible vision loss. All people with ulcerative colitis should have a complete visual examination at the time of diagnosis and frequently. Keywords: Ocular manifestations, Ulcerative colitis

Short Tear Breakup Time Could Exacerbate the Progression of Presbyopia in Women.

Purpose The contributory factors and symptoms for presbyopia progression have not been fully determined. The purpose of the study was to compare presbyopia progression in subjects with short and normal tear breakup time and to explore the severity of common ocular symptoms associated with presbyopia progression. Method We conducted a clinic-based, retrospective, cross-sectional study. Inclusion criteria were bilateral phakic patients aged 40–69 years with best-corrected distance visual acuity better than 20/30, and exclusion criteria were the use of glaucoma eye drops, any disease affecting vision, or history of ocular surgery. We measured the binocular near add power and compared the results using Kaplan-Meier analysis. Association between near add power and ocular symptoms was explored. Results There were 1411 participants (mean age of 50.1 years). There were no significant differences in age, intraocular pressure, spherical equivalent, astigmatism, or anisometropia between the sexes. Kaplan-Meier analysis indicated that women with short tear breakup time reached the endpoint (near add power of +3.00 D) significantly earlier than those with normal tear breakup time (P = 0.043; Cox-Mantel test). Eye fatigue was most severe in the group with an add power of 1.25-2.00 D. Near add power was correlated with hyperopia, astigmatic errors, and anisometropia. Conclusions This study suggests an exacerbation of presbyopia progression in women with short tear breakup time. Eye fatigue was most severe in those with an add power of 1.25-2.00 D.

Computer vision syndrome among Saudi population: An evaluation of prevalence and risk factors.

Introduction:In the recent era of technological evolution, electronic devices have become an essential part of our lives, not merely in professional work settings, but also in daily leisure activities. Although these devices have simplified our lives, they are associated with a wide variety of health complaints. Thus, the so-called computer vision syndrome (CVS) has become a growing public health problem and has gained significant attention as it plays an important role in the quality of life of each individual, which in turn has put an increased burden on the health care system. Eye symptoms are among the most reported, yet extraocular symptoms were frequently described as adding an extra load.Method:An electronic survey was distributed randomly through social media platforms among the general population in Saudi Arabia, between the period from July to December 2017, irrespective of their sociodemographic factors, aiming to determine the prevalence of CVS and to verify the most common associated risk factors.Results:In total, 690 participants were involved in our study, with a mean age of 33.8 years. Of these, 77.6% suffer from CVS, with eye-burning being the most common ocular symptoms (71%), as well as itching (67.5%), blurred vision (65%), tearing (62.3%), and other eye symptoms being reported. Neck/shoulder pain was found to be the most prevalent extra ocular symptom (85.2%); also back pain and headache are frequently expressed (78% and 70% respectively). A significant positive correlation was observed between CVS symptoms and time spent using the devices (P-value: 0.002).Conclusion:As technology advances, electronic devices have become a common tool that is used for different purposes on daily basis. We found in our study that the so-called computer vision syndrome is a growing public health problem. Thus, community education about the impact of such a lifestyle for proper handling of electronic devices must be addressed to avoid such health complaints.

Vascular emergencies in neuro-ophthalmology.

The cerebral vascularization is assured by the 2 internal carotids and 2 vertebral arteries, and the Willis circle. Carotid artery obstruction is the most common abnormality associated with ocular ischemic syndrome. Obstruction may be due to atheromatous plaque, external compression, arteritis, or dissection of the artery. An atheromatous lesion of the carotid artery is the most frequent lesion responsible for ocular ischemic syndrome. The signs and symptoms of ocular ischemic syndrome are associated with severe hypoperfusion of the eye. Inflammatory lesions of the carotid artery are responsible for decreased flow in the carotid system. Other vascular emergencies are carotid artery dissection, Horton arteritis, aneurysms and carotid-cavernous fistula. The most common ocular signs and symptoms are transient monocular blindness, persistent monocular blindness, ocular ischemia, Claude Bernard Horner syndrome and oculomotor palsies.The carotid pathology can be a life-threatening pathology and it is important to recognize all these signs and symptoms. A multi-specialty approach will prevent misdiagnosis and lead to a better patient management.Abbreviations: OIS = ocular ischemic syndrome, TMB = transient monocular blindness, TIA = transient ischemic attack, ESR = erythrocyte sedimentation rate, CRP = C reactive protein, NVE = neovascularization elsewhere in the retina, NVD = neovascularization on the disc, AION A = anterior ischemic arteritic optic neuropathy, CBH = Claude Bernard Horner syndrome, MRI = magnetic resonance imaging

16900 Dupilumab-associated ocular surface disease: Clinical characteristics and treatment

Dupilumab is the first biologic medication approved for treatment of moderate to severe atopic dermatitis (AD). While few adverse events were reported in clinical trials, increased incidence of conjunctivitis with dupilumab vs placebo was consistently observed. The optimal treatment for dupilumab-associated ocular surface disease (DAOSD) has not been well established. This study aims to describe the spectrum of clinical presentations of DAOSD, and to evaluate therapeutic responses. Retrospective chart review of patients with AD and DAOSD who received ophthalmologic evaluation at Oregon Health & Science University from 2014 to 2019 yielded 29 patients (mean age 46 years; M/F: 12/17). Facial and eyelid AD were observed in 26 (90%) and 19 (66%) patients, respectively. Common ocular symptoms included irritation (n = 26, 90%), redness (n = 24, 83%), pruritus (n = 18, 62%), and tearing (n = 18, 62%). Twenty-two patients were diagnosed with conjunctivitis, 4 blepharitis, 2 keratitis, and 1 other. Topical steroids were the most commonly utilized therapy (67%), and 89% of these experienced moderate improvement or full resolution. Other therapies included artificial tears (n = 5), antihistamine drops (n = 4), lifitegrast (n = 3), tacrolimus ointment (n = 2), and cyclosporine (n = 1). Three patients discontinued dupilumab because of severe DAOSD. This study’s results suggest that patients with facial and eyelid AD may be more susceptible to DAOSD. This study also provides insight into the common ocular symptoms associated with DAOSD, which may prove useful when screening dupilumab-treated AD patients for ophthalmology referral. Very few patients discontinued dupilumab due to DAOSD, suggesting the symptoms may be controllable with ocular therapies with high efficacy rates observed with topical steroids.

Sore eyes as the most significant ocular symptom experienced by people with COVID-19: a comparison between pre-COVID-19 and during COVID-19 states

ObjectiveConjunctivitis has been reported in people suffering from COVID-19. However, many ocular symptoms are associated with the term ‘conjunctivitis’ which may be misleading. It is also unknown whether ocular symptoms...

Ocular manifestations in SARS-CoV-2 positive patients: a systematic review

ABSTRACT Objective: Investigate the importance of optical symptoms within SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) patients.Design: Systematic reviewMethods: Databases searched included Medline, EMBASE, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Clinicaltrials.gov, ProQuest. As well, meeting abstracts from American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology and Canadian Ophthalmological Society were also considered. Articles underwent two rounds of screening before risk of bias assessment and data extraction.Results: In total, 582 studies were identified. A total of 2064 unique SARS-CoV-2 positive patients are included in this review from 13 different studies that met the inclusion criteria. We observed that the most common ocular symptoms in patients with SARS-CoV-2 were dry eyes, chemosis, epiphora, and blurred vision. The least common symptoms included hyperemia, conjunctivitis and photophobia. Additionally, we observed a unique relationship between patients with ocular manifestations and the severity of the systemic symptoms.Conclusion: Ocular symptoms do not occur commonly among SARS-CoV-2 positive patients; however, this study displays that there is an occurrence of common ocular manifestations such as dry eyes, chemosis, epiphora, and blurred vision. Therefore, increased ocular examinations may aid in diagnosis of SARS-CoV-2 infections.ABBREVIATIONS: COVID-19 (coronavirus disease 2019), SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2)

Dupilumab-Associated Ocular Surface Disease: Clinical Characteristics, Treatment, and Follow-Up.

A consecutive case series of patients with dupilumab-associated ocular surface disease (DAOSD) that describes common ocular symptoms and signs, proposes a symptom disease severity grading system, and describes treatment strategies of DAOSD patients was evaluated. A retrospective chart review of patients with concomitant dupilumab-treated atopic dermatitis and DAOSD with ophthalmic evaluation between January 2014 and May 2019 was conducted. Twenty-nine patients (mean age 46 years, M/F: 12/17) with 57 ophthalmic exams were identified. The most common ocular symptoms included irritation/pain (n = 28, 97%), redness (n = 24, 83%), pruritus (n = 18, 62%), discharge (n = 18, 62%), and light sensitivity (n = 6, 21%). The most frequent signs included conjunctival injection (n = 18, 62%), superficial punctate keratitis (n = 16, 55%), and papillary reaction (n = 8, 28%). Topical corticosteroids (TCS) (n = 23, 79%), tacrolimus (n = 6, 21%), and artificial tears (n = 7, 24%) were the most commonly used therapies. Of those with follow-up documentation (n = 21), 20 were noted to have partial or complete response with TCS based on symptoms and reduction of signs. Using our proposed symptom-based grading scale, scaled 1 to 5 based on the presence of common symptoms listed above, 66% (n = 19) requiring topical immunomodulating therapy were found in the 'severe' group (≥3 symptoms) and 17% (n = 5) were found in the 'mild' group (≤2 symptoms). This study provides insight into the commonly presenting ocular signs and symptoms associated with DAOSD and highlights the efficacy of TCS and other immunomodulators in improving symptoms associated with DAOSD. Based on our findings, we propose a symptom-based grading system that can guide nonophthalmic physicians regarding ophthalmology consult.

Case Series on Chiasmal Lesions with Ocular Manifestations seen at the Eye Center of a Tertiary Government Hospital in Philippines

Objective To identify common ocular and non-ocular signs and symptoms of patients with chiasmal lesions presenting to ophthalmologists. Methods This is a three year case series of patients who presented to Rizal Medical Center Ophthalmology OPD clinic, diagnosed as cases of chiasmal lesion with a complete neuro-ophthalmogical exam, ancillary test and neuroimaging. Data collected include patient profile, ocular and non ocular symptoms, duration of blurring of vision (BOV), best corrected visual acuity (BCVA), Color Vision, Optic nerve (ON) description, Visual field defects (VFD) and size &amp; location of chiasmal lesion. Results A total of twelve patients were included with 1:1 M:F ratio and a median age of 39 years. Blurring of Vision was the presenting symptom in 10 cases, bulging of the eyes and headaches in the remaining cases. Associated symptoms include: non specific headache in all; diplopia in 3 (1 with and 2 without motility defects); and systemic symptoms related to hormonal imbalance in 2 cases. Best corrected vision ranged from 6/6 to no light perception (NLP). Color vision was affected in all cases. ON palor was seen in 6 (50%) and disc edema in 1 case. VFD include Junctional scotoma (58.33%), bitemporal hemianopia (33.3%) and generalised scotoma (8.3%). Neuroimaging revealed pituitary lesions in 10 cases, 1 craniopharyngioma and ON glioma with chiasmal extension. Conclusion Ocular and non ocular symptoms seen were comparable to other studies except that Junctional scotoma was the most common VFD identified in the included population of our case series. This highlights the importance of VF testing among patients complaining of unilateral visual loss to rule out a chiasmal lesion.

Evaluation of habituation to visual evoked potentials using pattern reversal among migraine individuals - a cross-sectional study.

Background Migraine is a multifaceted chronic disease with common ocular symptoms. Habituation is the decremental response on repeated stimulations. The literature review indicates controversial results regarding habituation in migraine individuals. The present study aimed to compare the habituation response using visual evoked potential (VEP) measures among migraine and control subjects. Methods This was a cross-sectional study performed among migraine individuals attending the Department of Medicine and Neurology, of the age group of 18-30 years at Sri Manakula Vinayagar Medical College and Hospital, Puducherry. Habituation was evaluated in the two groups, control (n = 40) and migraine (n = 40), using pattern reversal VEP. The recording was done for 15-min duration and divided into four blocks of 3.8 min each. The results were compared employing Student t-test, and p < 0.05 was considered to be statistically significant. Results Our study indicates that latency N75, N145, and P100 amplitude showed significant differences between the two groups. In the right eye, on comparing the first and fourth block P100 amplitude in the migraine group, a significant increase (p < 0.001) was observed in the fourth block. Similarly, in the left eye, the control group showed a significant decrease in the fourth block (p = 0.002), whereas the migraine group showed a significant increase (p < 0.001). Conclusions The present study concludes that migraine individuals report deficient habituation, evaluated using pattern reversal VEP.

A cross sectional study to assess prevalence and pattern of ocular morbidity among pre-school children attending anganwadi centres of Hubballi taluk in South India

Background: About 30% of blind population of India loses their eyesight before the age of 20 years and many of them are under 5 when they become blind. Childhood blindness will have serious impact on development, education and quality of life. Therefore it is essential that ocular morbidity is detected and treated at an early stage.Methods: A cross-sectional study was conducted among 120 children aged 3-5 years attending 6 anganwadi centres of Hubballi taluk which were selected by stratified random sampling. Data was collected using pretested semi-structured questionnaire. Ocular examination was conducted to identify ocular morbidity. Test for visual acuity, colour blindness and refractive status was done using lea chart, ischihara charts and plusoptix mobile vision screener respectively. Nutrition status was assessed by clinical examination and anthropometry. Statistical analysis was done using SPSS package.Results: Out of 120 children 51.7% were male. Majority, 63.3% were residing in urban area and 40% belonged to class IV of modified B G Prasad classification of socio-economic status scale. The prevalence of ocular morbidity was found to be 20%. 15.8% of children had refractive error, 2.5% had vitamin A deficiency and 1.7% had squint. No statistically significant association was found between ocular morbidity and any risk factors.Conclusions: Refractive error was found to be the most common ocular morbidity among pre-school children. This if detected early can be corrected. Therefore it is important to screen for refractive error at the preschool age itself and to create awareness among parents and anganwadi teachers regarding common ocular symptoms.