Eye Corneal Research Articles

Revitalizing Vision: Eye Drops and Corneal Limbal Stem Cells Survival.

In the quest to transform vision care, researchers have been investigating novel methods to boost the efficacy of eye drops and enhance the survival of corneal limbal stem cells. Aimed at rejuvenating vision, these innovations seek to tackle a range of ocular conditions and restore sight to those in need. This article examines the most recent advancements in eye drops and corneal limbal stem cells, highlighting their potential to revolutionize ophthalmology. Findings from various studies indicate that the drive to rejuvenate vision has resulted in significant progress within the field of ophthalmology, especially regarding eye drops and corneal limbal stem cells. By improving the effectiveness of eye drops and increasing the survival rates of CLSCs, researchers are creating pathways for more sustainable and effective treatment options. These advancements offer great hope for patients experiencing various ocular issues, suggesting a future where vision restoration is attainable. As research continues to refine these strategies, we can look forward to an era marked by better visual outcomes and an enhanced quality of life for many individuals around the world.

Pilot study on the dynamic interactions between cardiac activity and corneal biomechanics during eye movements

Background and objectiveThe study examines the relationship between ocular rotations and cardiovascular functions through detailed biomechanical analysis. The study documents specific patterns of ocular movements and their synchronization with cardiovascular activity, highlighting significant correlations. These findings provide a basis for understanding the opto-biomechanical interplay between ocular and cardiovascular dynamics.MethodsAuthors employed a custom-designed prototype, integrating a camera and numerical pulse oximeter, to analyze the right eyeballs of participants. The corneal surface reflections were recorded, along with concurrent blood pulsation (BP) signal acquisition. Numerical analysis helped determine the reflection positions and orientations to study eye movements and corneal deformations. Time and frequency domain analyses, including coherence functions, were utilized.ResultsSignificant correlations were found between variations in corneal curvature, selected fixational eye movements (FEM) parameters, and Pulsatile ocular blood flow (POBF), revealing synchronized expansions of the corneal surfaces with cardiovascular activity. Furthermore, FEM displayed spectral correlations with BP, indicating an interrelation between ocular rotations and cardiovascular functions.ConclusionThese findings reveal the complex interactions between the cornea and Pulsatile Ocular Blood Flow (POBF), as well as between Fixational Eye Movements (FEM) and POBF. While the influence of POBF on both corneal dynamics and FEM is clear, further research is necessary to directly link corneal dynamics and FEM. These insights hold potential for non-invasive diagnostic applications and provide a deeper understanding of ocular biomechanics.

The Effect of Rosuvastatin on Facial Nerve Regeneration After Facial Nerve Injury: An Experimental Animal Study.

Rosuvastatin is an antihyperlipidemic statin group pharmacological agent with antioxidant, neuroprotective, and anti-inflammatory effects. In this study, we aimed to examine the functional, electrophysiological, and histopathological effects of rosuvastatin or in combination with corticosteroids on facial nerve regeneration in rats with traumatic peripheral facial paralysis (PFP). PFP was induced in 28 female Sprague Dawley rats that we divided into 4 groups: group 1, control group; group 2, methylprednisolone group; group 3, rosuvastatin group; group 4, rosuvastatin and methylprednisolone group. Electrophysiological, functional, and histopathological examinations were performed before and after the medications. Electrophysiological threshold values of group 3 and group 4 were found to be significantly lower than the control group on day 21 after treatment (P = .002, P = .001; P < .01).In the histopathological evaluation, axonal degeneration, macrovacuolization, and vascular congestion levels were compared between the groups, and a statistically significant difference was observed in group 4 compared to the control group. The recovery time of the eye corneal reflex was found to be significantly higher in the control group than in groups 3 and 4 when comparing postoperative day 1 to day 7 and postoperative day 1 to day 14. Rosuvastatin, especially when combined with methylprednisolone was found to significantly increase the facial nerve electrophysiological, functional, and histopathological recovery in injury-induced traumatic PFP.

Prevalence of Keratoconus and Keratoconus Suspect among a sample of Iraqi Children with Refractive Errors: A Cross-Sectional Study

Background: Keratoconus (KC) is a chronic, bilateral, non-inflammatory degenerative condition with severe consequences. Objective: To assess the prevalence of KC and Keratoconus Suspect (KCS) in a pediatric population with astigmatic error ≥1 diopter (D) and non-axial myopia. Methods: Between March and October 2022, a cross-sectional study was done with a group of 6–18-year-old kids with an astigmatic error of ≥1 D or non-axial myopia who went to the pediatric ophthalmology clinic at Ibn Al-Haitham Teaching Eye Hospital in Baghdad, Iraq, for regular checkups. All patients got a thorough eye examination and corneal imaging using the Corneal Tomography System (CSO) Sirius equipment and Scheimpflug technology. Results: The majority of patients were females aged 110–14 years (55%). The frequencies of KC and SKC were 13.5 and 119.6%, respectively. The proportion of KC was substantially higher for those above the age of 14. Patients with KC exhibited considerably larger cylinder and axis measurements. Participants with inferior cones and an asymmetric Bow Tie exhibited greater rates of KC (51.2% and 29.4%, respectively). Except for Pachy-Thin and corneal volume mean values, all other metrics were considerably greater in KC and KCS patients than in control patients. Conclusions: The high prevalence of KC and KCS emphasizes the importance of this issue and the necessity for a systematic strategy for screening in pediatric age groups with refractive error.

Novel ophthalmic hyaluronic acid-hydrogel with curcumin nanoparticles for enhanced healing of ulcerative keratitis in rabbit model

Corneal ulcers, whether melting or indolent, are common in humans and companion animals. Treatment involves local administration of antibiotic eye drops and corneal healing drugs. Compared to traditional treatments for ulcerative keratitis, herbal medicines offer unique advantages, such as potent anti-inflammatory effects and inhibition of proinflammatory cytokines. Curcumin, extracted from the Curcuma Longa plant, possesses extensive pharmacological properties, such as anti-inflammatory, anti-cancer, and antioxidant properties, and is used in various medicines. In this study, we developed a novel ophthalmic drop hydrogel using a formulation of Curcumin NPs encapsulated with β-cyclodextrin and hyaluronic acid, to accelerate corneal healing and improve the quality of healed structures. The formation of Curcumin NPs into Hyaluronic acid-based hydrogels was characterized by zeta, FTIR, and scanning electron microscope (SEM) analyses. A total of 25 healthy male New Zealand Albino rabbits were experimentally induced with ulcerative keratitis and treated individually with topical medication. Rabbits were divided into five groups. Fluorescein dye staining, corneal clarity score, Schirmer tear test, proinflammatory cytokine measurement, and pathologic factors assessments were used to evaluate the optimised Curcumin NPs with β-cyclodextrin in Hyaluronic acid hydrogel. Our results demonstrated that the optimized Curcumin NPs with β-cyclodextrin in hyaluronic acid hydrogel significantly reduced the frequency of medication administration compared to conventional therapies, enhancing the quality of healed structures and effectively treating ulcerative keratitis. All findings in this study provide new insight into designing and fabricating novel ophthalmic medicine for ulcerative keratitis for topical usage.

Effectiveness of 0.3% Hyaluronic Acid Eye Drops for Benign Essential Blepharospasm and Hemifacial Spasm with Botulinum Toxin-induced Dry Eye.

This study evaluates the effectiveness of 0.3% hyaluronic acid (HA) eye drops in patients receiving concurrent botulinum toxin (BoNT) injections for benign essential blepharospasm (BEB) or hemifacial spasm (HFS). This randomized controlled cross-over trial study involved 14 patients with BEB and 33 patients with HFS randomized into two groups (early treatment and deferred treatment) for 3 months of treatment with 0.3% HA eye drops. Data collected at baseline, 3 months, and 6 months included Blepharospasm Severity Scale (BSS) score in patients with BEB; Samsung Medical Class Grading Scale score in patients with HFS; and dry eye symptoms, lower eyelid tear meniscus height (TMH), tear breakup time (TBUT), and corneal fluorescein staining in both groups. After 3 months of 0.3% HA instillation, patients with BEB in both groups showed significant improvement in BSS, TMH, TBUT, and the amelioration of subjective dry eye symptoms and corneal staining (P < 0.05). However, discontinuation of 0.3% HA eye drops worsened BSS, TMH, and TBUT. Patients with HFS also experienced significant improvement in Samsung Medical Class score, subjective dry eye symptoms, and objective corneal findings (P < 0.05). Treatment with 0.3% HA eye drops led to significant improvement in spasm severity, and dry eye parameters, after 3 months of instillation in patients with BEB or HFS during concurrent treatment with BoNT injections. The 0.3% HA eye drops were safe and might serve as an add-on treatment for symptom improvement.

Modification of contact lenses via metal‐organic frameworks for glaucoma treatment

AbstractThe prevention of blindness from glaucoma requires multiple treatments to lower intraocular pressure. Here, human contact lenses are modified with highly porous metal‐organic frameworks with sustained release of brimonidine for prolonged glaucoma treatment. Various metal‐organic frameworks were screened for their attachment to lenses, loading with brimonidine, and drug‐release properties. Optimized therapeutic ocular lenses conjugated with MIL‐101(Cr) frameworks maintain optical transparency and power. Coating of lenses with MIL‐101(Cr) nanoparticles reduced brimonidine washout with tears and ensured a gradual and localized release of the drug into the eyeball through the cornea. The hybrid lenses provided a 4.5‐fold better decrease in eye pressure, compared by area under the curve (AUC) value to a commercially available brimonidine tartrate solution. Therapeutic lenses did not induce any notable eye irritation or corneal damage in vivo. The newly developed hybrid lenses are expected to provide a robust platform for the therapy and prevention of various ocular diseases.

Efficacy and safety of artificial tears containing Artemia salina extract with dinucleotides for dry eye

ABSTRACT Clinical relevance This clinical trial was conducted as part of the marketing procedures for a medical device comprising artificial tears containing Artemia salina extract with dinucleotides. These molecules previously demonstrated secretagogue properties by enhancing the production of aqueous, mucinous, and lipidic components of the tears. Background After confirming the efficacy of artificial tears containing Artemia salina extract in an animal model, this study proceeded to evaluate their efficacy and safety on dry eye participants. Methods A randomised controlled clinical trial was performed on 36 dry eye participants (41.6 ± 20.6 years). Half of the participants were treated with saline solution as a placebo for four weeks, while the other half were treated with artificial tears containing Artemia salina, randomly assigned. After a wash-out period of two weeks, the treatments were crossed for another four weeks. Participants were assessed at baseline and after one week, two weeks, and four weeks. Efficacy variables were: eye dryness frequency (primary), eye comfort, visual satisfaction, tear secretion, tear break-up time, corneal staining, conjunctival staining, and conjunctival hyperaemia. Safety variables were: high- and low-contrast visual acuity, intraocular pressure, and eye fundus images analysis. Results Compared with the baseline, the saline solution showed no significant changes in any of the studied variables after four weeks of treatment (p ≥ 0.05). However, the topical instillation of the artificial tears with Artemia salina for four weeks significantly improved eye dryness frequency (p = 0.014) and corneal staining (p = 0.010). No systemic or ocular adverse events were reported during the clinical trial. Conclusion The topical instillation of artificial tears containing Artemia salina in mild to moderate dry eye participants for four weeks slightly improved their symptoms related to eye dryness frequency and reduced corneal damage, with no undesirable side effects observed.

Biochemical component analysis of human myopic corneal stroma using the Raman spectrum.

This study aimed to measure the Raman spectrum of the human corneal stroma lens obtained from small incision lenticule extraction surgery (SMILE) in Asian myopic eyes using a confocal Raman micro-spectrometer built in the laboratory. Forty-three myopic patients who underwent SMILE with equivalent diopters between - 4.00 and - 6.00 D were selected, and the right eye data were collected. Corneal stroma lenses were obtained during surgery, and the Raman spectra were measured after air drying. The complete Raman spectrum of human myopic corneal stroma lens tissue was obtained within the range of 700-4000cm-1. Thirteen characteristic peaks were found, with the stronger peaks appearing at 937cm-1, corresponding to proline, valine, and the protein skeleton of the human myopic corneal stroma lens; 1243cm-1, corresponding to collagen protein; 1448cm-1, corresponding to the collagen protein and phospholipids; and 2940cm-1, corresponding to the amino acid and lipids, which was the strongest Raman peak. These results demonstrated that Raman spectroscopy has much potential as a fast, cost-effective, and reliable diagnostic tool in the diagnosis and treatment of eye diseases, including myopia, keratoconus, and corneal infection.

Full Thickness Prophylactic Scleral Windows Decrease the Rate of Choroidal Effusion and Drainage Surgery after Ahmed Glaucoma Valve Implantation.

To evaluate the effect of creating a full-thickness prophylactic scleral window (PSW) during Ahmed glaucoma valve (AGV) surgery on the rate of postoperative choroidal effusion and choroidal drainage surgery. In this retrospective matched case-control study, after insertion of AGV tube a PSW was created in one group. The control-matched group had AGV without a PSW. Primary outcome measures were the rate of choroidal effusion formation and choroidal drainage surgery. In total, 544 patients (604 eyes) had undergone AGV implantation from 2013 to 2017. The PSW group consisted of 111 eyes of 111 patients and the control group had 111 eyes of 98 matched patients. There were no differences for systemic diseases, number of anti-glaucoma drugs, aspirin use, smoking, laterality of the operated eye, axial length, and central corneal thickness between the groups. Out of 12 eyes with choroidal effusion, only one belonged to the PSW group (P=0.02). Six eyes in the control group needed choroidal drainage surgery, but none of the eyes in the PSW group required this procedure (P=0.02). No intra- and postoperative issues were observed at the site of the scleral window in the PSW group. PSW creation during AGV surgery is a safe method to decrease the rate of choroidal effusion and choroidal drainage surgery.

The expanding roles of eye banks in India: Past, present, and future.

This review highlights the evolution in the scope of eye banking activities in India. The roles and responsibilities of the eye banks have expanded to match the requirements and necessities that arose because of advancements in keratoplasty techniques and the need for corneal surgeons. Adoption of different types of corneal preservation solutions and methods of donor cornea preservation was a consequence of the changing and unprecedented times. The growth of eye banking in India has been a commendable journey and has placed the country in an "almost sufficient" category in eye banking and corneal transplantation. There exists a potential to reach the status of cornea surplus country in the future. The rules and laws governing eye banking operations need dynamic amendments based on the trends in keratoplasty, surgical practice patterns, and status of self-sufficiency. Newer technological advances and quality measures must be adopted in donor cornea evaluation and tissue preparation. Research should be integrated as an important component of eye banking, especially in developing novel methods of donor preservation, and evaluating and validating the existing and changing practices of eye banking.

Advancing ocular safety research: A comprehensive examination of benzocaine acute exposure without animal testing

Benzocaine is a widely employed local anaesthetic; however, there is a notable dearth of preclinical and clinical evidence regarding its safety in ophthalmological products. To address this, a comprehensive strategy incorporating in silico and in vitro methodologies was proposed for assessing benzocaine's ocular toxicity without animal testing. To collect the in silico evidence, the QSAR Toolbox (v4.5) was used. A single exposure to two benzocaine concentrations (2% and 20%) was evaluated by in vitro methods. Hen’s Egg Chorioallantoic Membrane Test (HET-CAM) was performed to evaluate the effects on the conjunctiva. To study corneal integrity, Short Time Exposure test (STE) and Bovine Corneal Opacity and Permeability (BCOP) assay, followed by histopathological analysis, were carried out. Results from both in silico and in vitro methodologies categorize benzocaine as non-irritating. The histopathological analysis further affirms the safety of using benzocaine in eye drops, as no alterations were observed in evaluated corneal strata. This research proposes a useful combined strategy to provide evidence on the safety of local anaesthetics and particularly show that 2% and 20% benzocaine solutions do not induce eye irritation or corneal damage, supporting the potential use of benzocaine in the development of ophthalmic anesthetic products.

Performance of ChatGPT in Diagnosis of Corneal Eye Diseases.

The aim of this study was to assess the capabilities of ChatGPT-4.0 and ChatGPT-3.5 for diagnosing corneal eye diseases based on case reports and compare with human experts. We randomly selected 20 cases of corneal diseases including corneal infections, dystrophies, and degenerations from a publicly accessible online database from the University of Iowa. We then input the text of each case description into ChatGPT-4.0 and ChatGPT-3.5 and asked for a provisional diagnosis. We finally evaluated the responses based on the correct diagnoses, compared them with the diagnoses made by 3 corneal specialists (human experts), and evaluated interobserver agreements. The provisional diagnosis accuracy based on ChatGPT-4.0 was 85% (17 correct of 20 cases), whereas the accuracy of ChatGPT-3.5 was 60% (12 correct cases of 20). The accuracy of 3 corneal specialists compared with ChatGPT-4.0 and ChatGPT-3.5 was 100% (20 cases, P = 0.23, P = 0.0033), 90% (18 cases, P = 0.99, P = 0.6), and 90% (18 cases, P = 0.99, P = 0.6), respectively. The interobserver agreement between ChatGPT-4.0 and ChatGPT-3.5 was 65% (13 cases), whereas the interobserver agreement between ChatGPT-4.0 and 3 corneal specialists was 85% (17 cases), 80% (16 cases), and 75% (15 cases), respectively. However, the interobserver agreement between ChatGPT-3.5 and each of 3 corneal specialists was 60% (12 cases). The accuracy of ChatGPT-4.0 in diagnosing patients with various corneal conditions was markedly improved than ChatGPT-3.5 and promising for potential clinical integration. A balanced approach that combines artificial intelligence-generated insights with clinical expertise holds a key role for unveiling its full potential in eye care.

Development of antifungal fibrous ocular insert using freeze-drying technique

Candida species is one of the pathogenic fungi of the eye responsible for keratitis that frequently causes vision impairment and blindness. Effective treatment requires long-term use of antifungal drugs, which is opposed by the defensive mechanisms of the eye and inadequate corneal penetration. The objective of this study was to develop a carrier for prolonged ocular application of fluconazole (FLZ) to treat keratitis. FLZ was encapsulated into chitosan fibrous matrices (F1–F4) using different chitosan concentrations (0.02, 0.1, 0.5, and 1%w/v, respectively) by freeze-drying as a single-step technique. Studying the morphology and surface properties of the inserts revealed a porous matrix with fibrous features with a large surface area. Thermal stability and chemical compatibility were confirmed by DSC/TGA/DTA and FT-IR, respectively. Loading capacity (LC) and entrapment efficiency (EE) were determined. According to the in vitro release study, F4 (0.11 mg mg−1 LC and 87.53% EE) was selected as the optimum insert because it had the most sustained release, with 15.85% burst release followed by 75.62% release within 12 h. Ex vivo corneal permeation study revealed a 1.2-fold increase in FLZ permeation from F4 compared to FLZ aqueous solution. Also, in the in vivo pharmacokinetic study in rabbits, F4 increased the AUC0-8 of FLZ by 9.3-fold and its concentration in aqueous humor was maintained above the MIC through the experimentation time. Studies on cytotoxicity (MTT assay) provide evidence for the safety and biocompatibility of F4. Therefore, the freeze-dried FLZ-loaded chitosan fibrous insert could be a promising candidate for treating ocular keratitis.Graphical

Ocular Manifestation of Monkeypox: A Systematic Reviews

Introduction &amp; Objectives : On July 23, 2022, the World Health Organization declared the monkeypox epidemic a global public health emergency. The majority of clinical studies on monkeypox have concentrated on its dermatological symptoms, but mounting data raises questions regarding its ocular side effects.&#x0D; Methods : Thirteen studies were found among the 541 distinct articles that were evaluated. Overall, ten studies were case reports, two studies of case series, and one observational cohort study. Ocular manifestations of monkeypox were vesicopapular lesions on the eyelid and conjunctiva, conjunctivitis, epiphora, photophobia, foreign body sensation, eye edema, vision changes, eye pain, itchy eyes, eye discharge, bilateral eye involvement, corneal involvement, keratitis, and subconjunctival nodules.&#x0D; Results : The most prevalent ocular symptoms of monkeypox were conjunctivitis, followed by eye pain and photophobia. It is still unknown whether the ocular involvement is due to self-inoculation or the systemic transmission of the virus during the early viral phase of the illness. Despite some theories involving the transit of monkeypox into the conjunctival secretions via the plasma compartment, this study also showed that conjunctival swab PCR is 100% positive, equal to skin lesion swabs.&#x0D; Conclusion : In conclusion, to the best of our knowledge, this is the first review with a larger sample and the newest study to report the ocular manifestations of monkeypox disease. The primary ocular symptoms were conjunctivitis, eye pain, and photophobia. In addition, it is advised that healthcare professionals, especially ophthalmologists, use eye protection goggles when close to patients.

CICATRICIAL ECTROPION REPAIR DUE TO TRAUMA : A CASE REPORT

Introduction : Cicatricial ectropion is a complication that can occur after trauma. Scar tissue formation causes anterior lamellae shortening (skin and orbicularis muscle), resulting in outward lid margins rotation.&#x0D; Case Illustration : A 16 y.o male patient came with complaints of the left upper and lower eyelids folding outwards since 3 months ago after trauma, watery eye. Examination VOD 20/20, VOS 20/50. Scar on the superior and inferior lids, the inferior lid margin is folded out, inferior tarsal conjunctiva is visible, lagophthalmus 4 mm, fissure palpebral vertical (FPV) 12 mm, margin reflex distance (MRD) 1 = 4 mm, MRD2 = 8 mm, fissure palpebral horizontal (FPH) 30 mm, conjunctival injection. Corneal (macular) scars central-peripherally at 3-6 o'clock. Patient was diagnosed with cicatrical ectropion with left eye corneal scar and ectropion repair was performed with full-thickness skin graft from retroarticular. One week and six weeks after surgery, FPV improved to 10 mm, MRD1 = 4, MRD2 = 6 mm, FPH 30 mm, and lagophthalmos 2 mm became 1 mm.&#x0D; Discussion : Cicatricial ectropion is usually treated in 3 procedures: release vertical scar traction, horizontal lid tightening, repair anterior lamella can be done with full-thickness skin graft. horizontal lid tightening in this case not carried out because of no laxity.&#x0D; Conclusion : Scar traction release and repair anterior lamella with full-thickness skin graft from retroauricular was choice in this case because extensive defect and ectropion grade 3. After surgery anatomical structure of the lids and looks better aesthetically.

Prosthetic Contact Lens Combined with Strabismus Surgery : Confronting Psychosocial Prejudice in Anomalous and Misaligned Eyes

Introduction : Patients with defects in the cornea such as abnormal size, opacities as well as misalignment of the eyes may feel inferior about their physical appearance. Such patients will benefit from prosthetic contact lenses (CL) and strabismus surgery to restore anatomical appearance. The majority of patients also seek strabismus surgery for both cosmetic and psychosocial reasons along with decreased levels of anxiety and depression. Our goal not merely cosmetic, but also improving psychosocial health and quality of life.&#x0D; Case Illustration : We reported a 14-year-old male with complaints of white spot on his left eye and squint since birth. On ophthalmology examination, we found 45 degree esotropia with BCVA 6/6 in the right eye and 1/300 in the left eye. Corneal diameter was 10 mm and 9 mm on the right and left eye, respectively. He was diagnosed with right eye posterior embryotoxon, left eye corneal dystrophy, microcornea on both eye, congenital esotropia and deprivative amblyopia. He had developed low self-esteem due to his eyes. To enhance his appearance, left eye lateral rectus resection and medial rectus recession with adjustable suture was done to align the eye. Afterwards, brown-tinted soft contact lens with power -0.50 D, diameter 14,2 mm, and base curve 8,5 mm was given to disguise the corneal opacities and microcornea. Patient felt very satisfied with the result.&#x0D; Discussion : &#x0D; Conclusion : Prosthetic contact lens combined with strabismus surgery provides satisfactory cosmetic and psychosocial benefit with minimal complications. As clinicians, functional, cosmetic and psychosocial indications must be considered for a comprehensive management.

Alteration Ocular Motility in Retinitis Pigmentosa: Case-Control Study.

To evaluate ocular motility (OM) disorders and strabismus in a sample of patients with retinitis pigmentosa (RP) and a control sample. In this cross-sectional retrospective analysis, we studied a sample of RP patients with a mean age of 48.74 years and an average visual acuity of 7/10 based on Snellen optotype and a sample of control patients with similar mean age (49 years [men], 47 years [women]) and sex and an average visual acuity of 9.9/10, with the aim of assessing correlations between alteration of OM and strabismus in RP patients based on age, high refractive defect, or severely impaired binocular vision. The examination followed a protocol of testing for anamnesis and best-corrected visual acuity, as well as a complete eye examination, corneal reflex, cover test, OM, Hess screen, and Lang test. At the first orthoptic evaluation, 45.16% of patients showed strabismus, 41.93% exotropia (25% of cases intermittent), 3.22% esotropia, and 6.45% vertical deviation. Later evaluation showed strabismus in 25.80% of patients, exotropia in 19.35% (9.67% intermittent), esotropia in 3.22%, and vertical deviation in 3.22%. Assessment of eye motility study showed 51.6% overaction of the inferior oblique and hypofunction of the superior rectus, and 18% overaction of the lateral rectus and hypofunction of the medial rectus. According to our results, alterations in OM and strabismus in RP patients are not correlated with age or high refractive defect. Therefore, motility disorders and strabismus are attributed to a genetic factor to which men are more susceptible. The incidence of OM disorder was 77.42%, and strabismus was present in 45.16% of patients.

In‐depth study of the mucoadhesive and lubricating properties of Hyalistil SYNFO and other sodium hyaluronate‐based eye drops

Purpose: Several sodium hyaluronate (SH) eye drops formulations are widely used for the management of dry eye disease (DED). Hyalistil SYNFO is an eye drops based on SH and xanthan gum and osmoprotectants (glycine and betaine). The aim of our study was to evaluate viscosity and mucoadhesion profiles of Hyalistil SYNFO with respect to other SH‐based eye drops, and to investigate their ability to protect the corneal surface from dehydration.Methods: The physicochemical properties, in term of viscoelastic and mucoadhesive behaviour, were evaluated by means of a rheometer, TA‐XT2 texture analyzer and zeta potential determination. An in vitro dehydration model was used to demonstrate the lubricant effect of Hyalistil SYNFO compared to other commercially available SH‐based eye drops on human corneal epithelial cells (HCE).Results: The rheological profiles indicated that Hyalistil SYNFO exhibits a viscoelastic behaviour under shear strain showing a characteristic curve owing to its specific molecular properties. Evaluations of detachment force of tested formulations resulting in a strengthening of the mucin‐formulation interface showed that Hyalistil SYNFO exhibited a stronger and significant mucoadhesion calculated as percentage compared to mucin and other SH‐based products. The occurring interaction between formulation and mucin was also demonstrated by the variations in zeta potential measured by the mucin‐eye drops mixture compared to mucin or product alone. The in vitro study on HCE cells demonstrated that Hyalistil SYNFO, compared to others formulation, was able to protect corneal epithelial cells from dehydration.Conclusions: The pseudoplastic profile and increased mucoadhesive strength, due to the presence of both SH and xanthan gum, may lead to an improved residence time of Hyalistil SYNFO on the corneal epithelium ensuring relief during the treatment of DED. Moreover, the effect against dehydration improves eye lubrication and corneal cell protection.

Familial Congenital Aniridia with Subluxated Lens and Glaucoma

Introduction: Congenital aniridia is a bilateral iris aplasia or hypoplasia associated with other ocular disorders. The purpose of this case report is to describe the clinical manifestation of congenital aniridia in two members of one family. Case Presentation: The first patient (mother) is a 43-year-old and the second patient (daughter) is a 12-year-old. Both patients complained of blurred vision since childhood. The visual acuity of the first patient was a positive light perception on the right eye (RE) and no light perception on the left eye (LE); the visual acuity of the second patient was 1/60 on the RE and 3/32 on the LE. Both patients had horizontal nystagmus and increased intraocular pressure (IOP) (N+1 palpation) in both eyes. Anterior segment abnormalities of both patients include aniridia with iris rudimentary and superiorly subluxated lens. The first patient also had LE corneal leukoma and RE cataract. The second patient also had right and left eye corneal conjunctivalization. Fundus examination showed no fundus reflex on the first patient and tigroid retina with foveal hypoplasia on the second patient. Eye ultrasounds of both patients showed vitreous opacity. Conclusions: Congenital aniridia primarily originates from a mutation in the paired box gene-6 (PAX6) and is associated with other ocular anomalies such as nystagmus, amblyopia, keratopathies, cataract, lens luxation, glaucoma, fovea, optic nerve hypoplasia. Patients in this case showed similar conditions between mother and daughter, however, the mother's condition was more advanced and more degenerated than the daughter's condition.