Superior Rectus (SR) palsy is a rare and often overlooked consequence of orbital trauma, particularly when associated with orbital roof fractures. The SR muscle plays a critical role in ocular elevation, and its dysfunction can lead to diplopia, ptosis, and significant visual impairment. While inferior and medial rectus entrapments are more commonly reported, SR involvement is exceedingly uncommon due to its protected anatomical location. Here, the authors report a rare case of a 20-year-old male who presented with persistent binocular diplopia and restricted upward gaze in the left eye, two months following a road traffic accident. Clinical examination revealed left upper eyelid ptosis and limited elevation, while imaging studies confirmed an orbital roof fracture with suspected entrapment of the SR muscle. Due to persistent symptoms and functional impairment, surgical intervention was undertaken via a sub-brow orbitotomy. Intraoperatively, a displaced bony fragment was identified and removed, relieving the muscle entrapment. Postoperative follow-up showed significant improvement in ocular alignment and resolution of diplopia. The present case highlights the importance of maintaining a high index of suspicion for extraocular muscle entrapment in orbital roof fractures and underscores the role of early imaging and timely surgical intervention in preventing long-term ocular morbidity.

Kidney transplantation remains the optimal treatment for children with end-stage renal disease (ESRD), 25%-40% of which are estimated to be caused by congenital malformations and genetic syndromes. Given the widespread nature of this surgical procedure, ocular complications may arise from the operation itself or from subsequent medical treatments. The aim of this study is to determine whether there are postoperative refractive changes in pediatric patients who have undergone kidney transplantation and to detect the presence of refractive changes that may cause amblyopia in patient follow-ups. The electronic medical records of 1144 patients who underwent kidney transplantation at the Akdeniz University Hospital Organ Transplant Center between January 2019 and January 2024 were reviewed retrospectively. Of these, 84 pediatric patients who had undergone a complete ophthalmologic examination at least 1 year after kidney transplantation and had no missing data were included in the study. For both eyes, all data were recorded, including Best Corrected Visual Acuity (BCVA), refractive error (measured with the KR-8900; Topcon, Tokyo, Japan), spherical equivalent refractions (SER), slit-lamp examination of the anterior segment, and a dilated fundus examination. The average age of patients who underwent kidney transplantation in the study is 13.01 ± 3.43 (6-18). The average follow-up period was 51.81 ± 33.5 (45-129) months. Thirty-five (41.7%) of the patients are female, and 49 (58.3%) are male. Cataracts were observed in 9 (10.7%) patients during follow-up after transplantation. Cataract development was observed on average in 5.6 years. Posterior subcapsular cataracts were observed in seven patients, cortical cataract in one patient, and anterior polar cataract in one patient. The mean preoperative visual acuity value in patients who developed cataracts after kidney transplantation was 0.00 logMAR, while it was measured as 0.19 logMAR in the postoperative period, and this decrease is statistically significant (p = 0.027). In patients who did not develop cataracts during the follow-up period, there was no statistically significant change in visual acuity in both eyes (p = 0.109). When all eyes are evaluated, the change in SER after kidney transplantation is not statistically significant compared with before (p = 0.689 for the right eye, p = 0.596 for the left eye). Although children receive longer-term immunosuppressive treatment, their cataract development rates are lower than those of adults. Despite intensive and prolonged immunosuppression therapy after kidney transplantation, cataract development and refractive changes in the pediatric age group are at an acceptable level. Especially in children who are too young to express themselves clearly, monitoring refractive changes is crucial to prevent permanent vision loss.

ABSTRACT 1. This study investigated the effects of different monochromatic light-emitting diode (LED) light colours on tear production, intraocular pressure and corneal thickness in broiler chickens, and to identify any correlations among these ocular parameters. 2. A total of 72 male broilers (144 eyes) were used. One-d-old chicks were randomly assigned to six experimental groups (white, blue, green, blue-green-blue, green-blue-green and white-blue-green LED light; n = 12). Lighting was provided using LED bulbs under identical environmental and management conditions. 3. At 42 d of age, 12 birds per group were randomly selected for ophthalmological examination, including the Schirmer tear test I (STT I), intraocular pressure measurement (IOP) and central corneal thickness assessment. At the animal level, without distinguishing between right and left eyes, a significant difference was observed in central corneal thickness between birds in the white LED group and the other treatments. 4. Monochromatic LED light colours affected only central corneal thickness, while tear production and intraocular pressure remained unaffected. The changes in corneal thickness observed under different light colours were within normal physiological limits, which indicated no adverse effect on ocular health in broiler chickens.

Background. Leber hereditary optic neuropathy (LHON) is a maternally inherited mitochondrial disorder that predominantly manifests as bilateral, painless vision loss in young males. While traditionally associated with the optic nerves, a subset of patients exhibits additional neurological symptoms, referred to as LHON-plus syndrome. Involvement of the spinal cord is uncommon, particularly among the pediatric population, and may result in diagnostic challenges, potentially leading to confusion regarding acquired demyelinating diseases. Case Presentation. We report a 6-year-old boy with near-complete vision loss in the right eye and blurred vision in the left eye. Demyelinating diseases were suspected in the case of acute bilateral optic neuropathy. Cranial and orbital magnetic resonance imaging (MRI) showed no demyelinating lesions, whereas spinal MRI revealed a T2-hyperintense lesion at the C3–C6 levels. Due to unresponsiveness to conventional treatment for demyelinating diseases, genetic testing confirmed the homoplasmic m.11778G>A variant in NADH dehydrogenase subunit 4 (MT-ND4), establishing an LHON diagnosis. Spinal cord involvement supported the LHON-plus syndrome classification. Idebenone therapy was initiated, and follow-up was scheduled. During the 1.5-year follow-up, right eye visual loss persisted, while the left eye showed gradual vision decline. A second spinal MRI performed at 6 months showed complete resolution of the previous lesion without new lesions. Conclusion. Since optic neuropathy and spinal cord involvement typically indicate demyelinating diseases, these should be prioritized in initial evaluation due to their frequency and need for early immunomodulatory treatment. However, spinal cord involvement can occur in mitochondrial diseases, as demonstrated in this case. The presence of a transient and asymptomatic spinal cord lesion in this patient expands the recognized spectrum of central nervous system involvement in LHON. Therefore, LHON-plus syndrome should be considered when spinal cord involvement accompanies optic neuropathy after excluding other demyelinating diseases.

Objective: To investigate the clinical, pathological and molecular genetic characteristics of conjunctival melanoma (CoM). Methods: A retrospective case series study was conducted. The clinical, imaging and pathological data of patients diagnosed with CoM from January 2004 to June 2025 at Shaanxi Eye Hospital of Xi'an People's Hospital (Xi'an Fourth Hospital) and Xi'an First Hospital were analyzed. Some patients were detected for the BRAF V600E mutation. The χ2 test or the χ2 correction test was used for statistical analysis. Results: A total of 70 patients (70 eyes) with CoM were enrolled, aged (60.8±10.6) years, including 40 males (57.1%) and 30 females (42.9%). There were 33 cases (47.1%) in the left eye and 37 cases (52.9%) in the right eye. The tumor was located at the bulbar conjunctiva in 37 cases (52.9%), at the vault conjunctiva in 24 cases (34.2%), and at the palpebral conjunctiva in 9 cases (12.9%), involving the orbit in 13 cases (18.6%), the eyeball in 3 cases (4.3%), and the lacrimal sac in 6 cases (8.6%). Most patients presented with black nodules or cauliflower-like masses in the conjunctival area. Some tumors were accompanied by superficial vascular hyperplasia and pigmentation of adjacent tissues, while some invaded the cornea or orbit, resulting in clinical manifestations such as visual field defects, exophthalmos and limited movement. Imaging showed irregular soft tissue density shadows at the conjunctival site. According to the criteria of the American Joint Committee on Cancer, the tumor was at the T1 stage in 10 cases (14.3%), T2 stage in 41 cases (58.6%), and T3 stage in 19 cases (27.1%), with superficial ulcers in 6 cases (8.6%). Histopathology results disclosed that 67 cases (95.7%) were of the nodular type, 3 cases (4.3%) were of the superficially diffuse type, 47 cases (67.1%) were of the epithelial cell type, and 23 cases (32.9%) were of the mixed cell type. Sixty-three cases (90.0%) were accompanied by melanin, 32 cases (45.7%) were accompanied by primary acquired melanosis, including 23 cases (32.9%) with atypical primary acquired melanosis and 2 cases (2.9%) with conjunctival nevus, and 48 cases (68.6%) had tumor infiltrating lymphocytes. Immunohistochemistry demonstrated positive melanin markers such as human melanoma-associated antigen 45, melanocyte antigen A, S-100 protein and sex-determining region Y-frame protein 10. Thirty cases (42.9%) completed the detection of BRAF V600E mutations, of which 11 had BRAF V600E point mutations, with a positive rate of 36.7%. Sixty-two patients (88.6%) were followed up, with a recurrence rate of 27.4% (17/62), a metastasis rate of 19.4% (12/62), and a case fatality rate of 54.8% (34/62). The recurrence rate was 4/5 among patients with ulcers, versus 22.8% (13/57) among patients without ulcers (χ2=4.96, P=0.026); it was 8/13 among patients with orbital invasion, versus 18.3% (9/49) among patients without orbital invasion (χ2=9.62, P=0.002). Thirty-four patients (48.5%) underwent complete resection of the ocular mass, 16 (22.9%) underwent partial resection, and 20 (28.6%) underwent ocular or intraorbital enucleation. Ten patients (14.3%) received BRAF inhibitor-targeted therapy. Seven patients had a significant reduction of the residual mass and no tumor progression, and 3 patients did not respond to the treatment and died from the disease progression. Conclusions: CoM mostly occurs in the unilateral eye of middle-aged and elderly patients, more common at the bulbar conjunctiva and fornix conjunctiva, and histopathological epithelial cell types are the main types, with a high recurrence and metastasis rate.

Objective: To evaluate the safety of trabeculotome tunnelling trabeculoplasty (3T) in treating primary open-angle glaucoma (POAG) by observing the changes in corneal endothelial cell quantity and morphology after surgery. Methods: This was a retrospective case series study. Patients diagnosed with POAG who underwent successful 3T surgery were recruited from the Department of Ophthalmology, Chengdu First People's Hospital between April 2023 and September 2025. Parameters such as the number of cells, corneal endothelial cell density, average size, hexagonal cell ratio of endothelial cells, and central corneal thickness were recorded preoperatively and at 6 months postoperatively. Data were analyzed using the t-test. Results: The cohort comprised 48 patients, involving 52 eyes (27 left eyes, 25 right eyes), of whom 36 (75%) were male and 12 (25%) were female. The mean age of the patients was (51.37±12.90) years, ranging from 18 to 72 years. The preoperative number of cells was (196±40) cells, which decreased to (170±56) cells at 6 months postoperatively (P<0.05). The preoperative endothelial cell density was (2 686±416) cells/mm², compared to (2 302±563) cells/mm² at 6 months postoperatively (P<0.05). The average size increased from (381±76) μm² preoperatively to (470±161) μm² at 6 months postoperatively (P<0.05). The hexagonal cell ratio was (52±9)% preoperatively and (50±8)% at 6 months postoperatively, with no significant difference (P>0.05). The central corneal thickness was (517±49) μm preoperatively and (514±39) μm at 6 months postoperatively, with no significant difference (P>0.05). Conclusions: Although the 3T surgery for POAG results in a slight reduction in corneal endothelial cell count, as well as changes in corneal endothelial cell morphology and size, it does not induce corneal endothelial decompensation during the 6-month follow-up period and shows favorable short-term safety.

Introduction: Basal cell carcinoma (BCC) is the most common skin cancer, with a rising incidence globally. We encountered a patient with the non-pigmented adenoid subtype of BCC. The non-pigmented subtype of BCC accounts for only a small percentage of cases of BCC in the Asian population, with the adenoid subtype of BCC also being rare in all human ethnicities. Case Presentation: An 82-year-old woman presented to us with a growth in the inner canthus of the left eye, which had been slowly evolving for about one year. The lesion had failed to respond to a variety of topical treatments. Physical examination revealed a reddish plaque in the inner canthus of the left eye that measured 10 × 6 mm in size. Dermoscopic evaluation showed blue-gray globules and arborizing telangiectasia. Histopathological examination confirmed the diagnosis of adenoid BCC. Conclusion: We analyzed the data of patients with the adenoid subtype of BCC in the Japanese population and found the possibility that this variant of BCC was often non-pigmented. Furthermore, we collected the dermoscopic findings of patients with the adenoid subtype of BCC, however, the data revealed no other noteworthy characteristics at present. We expect that further characterization of these two variants of BCC through accumulation of data from clinical cases will contribute to facilitating early diagnosis.

Paleolithic parietal art in the Dordogne, Southwestern France, was known to present representations solely made with mineral coloring matters. We found a significant number of carbon black-based figures in the galleries of the Font-de-Gaume cave in Les Eyzies, Dordogne, Southern France [I. Reiche, Y. Coquinot, A. Trosseau, A. Maigret, Sci. Rep. 13, 22235 (2023)]. Further reflectance imaging spectroscopy allowed a precise noninvasive discrimination between manganese- and carbon-based blacks. Consequently, in the Dordogne region, direct dating of drawn or painted lines was unlocked. Dating parietal representations can prove challenging because of the small amount of matter and the possible contaminations by other carbon sources. The sampling was conducted for radiocarbon dating on two selected figures identified as being made with carbon black: the Bison figure HB15 (named by Breuil, today GPCarG-006), located on the left at the level of the Carrefour in the public area of the cave, as well as on the Mask (human or animal face, GL3D-009) on the right of the remote sector 3 of the lateral gallery. Slightly more recent than expected, the obtained dates are of 13461-13162 calBP for the Bison, and of 8993-8590 calBP (left eye), 15981-15121 calBP (upper lip), and 15297-14246 calBP (lower lip) for the Mask. Except for one date, these results represent the experimental confirmation of the Paleolithic age of cave art in the Font-de-Gaume cave. This study opens numerous perspectives for a more systematic dating of the parietal representations of the cavern and motivates further research of carbon black-based Paleolithic parietal art in the Dordogne region.

Purpose Here, we aimed to obtain normative data for the retinal nerve fiber layer thickness in the peripapillary area (p-RNFL) using the spectral domain optical coherence tomography (SD-OCT) in healthy Caucasian children using the OCT Spectralis instrument. Methods Caucasian patients of our hospital 5–15 years with spherical equivalent refraction of ±2 diopters, physiological ocular findings, delivered at gestational age ≥38 weeks, whose legal guardians volunteered with their participation in this cross-sectional study and signed informed consent were included. Exclusion criteria were a personal history of toxoplasmosis and other diseases that could potentially affect p-RNFL thickness. Results of 3.5 mm circular p-RNFL scans with automatic calculation of the retinal nerve fiber layer thickness were prospectively collected. Both eyes were measured in each participant and values for the global diameter (G) and average thickness in six sectors (NS, N, NI, TI, T, TS) were determined and statistically evaluated. Results 154 patients were included, with a mean age of 11.03 years. We have acquired data for p-RNFL in healthy Caucasian children aged 5–15 years and used them to create a normative database for improving the quality of the interpretation of the p-RNFL results in children. No significant differences between the left and right eyes in the same individuals were detected. However, a negative association between age and p-RNFL thickness, in particular in the NI sector, was revealed. Conclusions We have created a high-quality normative database that will allow us to accurately interpret the results of p-RNFL measurements in the Caucasian pediatric population.

ALK-positive histiocytosis is a recently described histiocytic neoplasm characterized by ALK immunoreactivity in CD163-positive histiocytes and has been shown to respond favorably to ALK inhibitors. ALK-positive histiocytosis is a clonal neoplastic disorder that can manifest as single-system or multisystem disease, with frequent neurological involvement. Reported gene fusions include KIF5B-ALK, TPM3-ALK, and others, leading to constitutive activation of downstream signaling pathways such as MAPK and PI3K/AKT/mTOR. Although surgical resection and conventional chemotherapy have been used, ALK inhibitors offer a targeted and effective therapeutic option, particularly for intracranial disease. We report a case of a 17-month-old boy presenting with left eye deviation, ptosis, and visual loss. Magnetic resonance imaging revealed a lobulated, contrast-enhancing mass involving the orbital and canalicular segments of the left optic nerve, extending into the cavernous sinus, with additional enhancing foci in the left frontal and pineal regions. Given the atypical radiological features, surgical biopsy was performed and demonstrated ALK-positive histiocytosis with KIF5B-ALK gene fusion. Lorlatinib, a third-generation ALK tyrosine kinase inhibitor, was started which showed significant disease regression at 18-month follow-up. This report highlights the favorable response to targeted ALK inhibition in central nervous system ALK-positive histiocytosis.

ABSTRACT Case history An adult male wētāpunga (Deinacrida heteracantha), wild-caught under permit in May 2024 as part of a group collected for conservation breeding purposes, presented in mid-August 2024 with a month-long history of gradually worsening discolouration of the left eye and periocular region of the gena. Clinical findings The left eye was internally discoloured a blotchy yellow colour with a metallic bronze-gold sheen, while the periocular region was discoloured dark brown, radiating approximately 5 mm circumferentially from the eye. No samples from affected tissues were able to be taken ante-mortem for diagnostics. Fungal infection was suspected, and empirical treatment was started using once daily application of a topical ointment of povidone-iodine 10% w/w, equivalent to 1% w/w available iodine. Within 24 hours, discolouration of the eye, but not the periocular region, temporarily resolved during treatment and with no obvious adverse effects. The animal died 1 month after presentation, despite ongoing treatment. Gross necropsy showed focally extensive black discolouration of tissues deep to the left eye. Histopathology revealed extensive keratitis, rhabdomyositis and steatitis with multisystemic fungal infection. Fungal culture and phenotypic assessment were consistent with Metarhizium species, and genomic sequencing confirmed M. anisopliae as the causative agent. Retrospective evaluation of six previous cases of integumentary lesions in wētāpunga revealed some similarities in case presentation but key differences in the severity of infection. Diagnosis Multisystemic fungal infection due to Metarhizium anisopliae. Clinical relevance Metarhizium species are ubiquitous in the environment, and M. anisopliae is a known keratophilic pathogen of insects with application as a biologic pest control agent. While empirical topical treatment appeared to alleviate the external clinical signs of the ocular infection, the severity of infection was difficult to determine ante-mortem. Here, through retrospective analyses of this and similar cases at Auckland Zoo, we show that fungal integumentary and/or ophthalmic disease in wētāpunga may present as focal darkening of the exoskeleton and pallor of the affected eye(s). Given the limitations for ante-mortem diagnostics and treatment options in invertebrates, and the unknown capacity for these animals to perceive pain, subsequently making it more challenging to assess their welfare while diseased, euthanasia remains an important treatment option in invertebrate medicine.

Patient: Male, 32-year-oldFinal Diagnosis: Bilateral Eales’ disease with asymmetric proliferative courseSymptoms: Blurred vision • decreased visual acuity • floaters • hemorrhageClinical Procedure: Optical coherence tomography • pars plana vitrectomy • phacoemulsificationSpecialty: OphthalmologyObjective: Rare diseaseBackgroundEales’ disease – a rare idiopathic retinal vasculitis typically affecting young adult men – is characterized by periphlebitis, retinal ischemia, and neovascularization. Vitreous hemorrhage and tractional retinal detachment often occur; timely diagnosis and individualized management remain critical. This report describes bilateral Eales’ disease with an asymmetrical clinical course and complex treatment strategy incorporating vitrectomy, systemic immunosuppression, and targeted anti–vascular endothelial growth factor (anti-VEGF) therapy.Case ReportA 32-year-old White man without systemic illness, infectious exposure, or substance use exhibited left-eye vitreous hemorrhage. Best-corrected visual acuity (BCVA) was hand motion (≈2.3 logarithm of the minimum angle of resolution [logMAR]) in the left eye and 5/6 (≈0.08 logMAR) in the right eye. Ultrasonography and fluorescein angiography demonstrated vitreoretinal traction and peripheral retinal ischemia. After exclusion of infectious etiologies, the diagnosis was bilateral Eales’ disease. We performed left-eye vitrectomy with cataract extraction, panretinal photocoagulation (PRP), and systemic immunosuppression with azathioprine, followed by methotrexate. One year later, right-eye disease progression required intravenous methylprednisolone, PRP, and preoperative intravitreal faricimab, followed by vitrectomy. Faricimab-mediated inhibition of vascular endothelial growth factor A (VEGF-A) and angiopoietin-2 (Ang-2) enhanced vascular stabilization. At final follow-up – 18 months after left-eye vitrectomy and 12 months after right-eye vitrectomy – BCVA was 0.00 logMAR (5/5) in both eyes.ConclusionsEarly vitrectomy with systemic immunosuppression and adjunctive anti-VEGF therapy may achieve excellent long-term visual outcomes in bilateral Eales’ disease. Faricimab application highlights the utility of dual VEGF-A/Ang-2 pathway inhibition in surgical planning. Future studies will clarify anti-VEGF agent efficacies in this rare retinal vasculitis.

To investigate the opportunistic use of diagnostic focused computed tomography (CT) imaging for differentiating intraocular foreign body (FB) types.From 2020 to 2024, 49 eyes of 41 consecutive patients with a diagnosis of FB who underwent diagnostic focused CT were prospectively included in this study. CT studies of patients who had direct contact with a known FB and those who had indirect contact with an FB and then underwent surgery were examined. The volume and density (in HU) of the FBs were measured and statistically analyzed.The type of foreign body was determined by surgery in 34 patients with indirect injuries and by history in 7 patients with direct injuries. Metal was found in 21 eyes, rock in 8 eyes, bullet core in 10 eyes, wood in 2 eyes, glass in 7 eyes, and plastic in 1 eye. Industrial accidents were the cause in 20 patients, traffic accidents in 6 patients, gunshot injuries in 6 patients, and other types of injuries in 9 patients. 21 left eyes, 15 right eyes, and 5 bilateral eyes were affected. Statistical analyses revealed a significant difference in terms of density (HU) between metal and bullet core, rock-bullet core, wood-bullet core, and glass-bullet core (p<0.05).The majority of intraocular FBs were the result of an industrial accident and were found in the left eye. Bilateral eyes were primarily affected by gunshot injuries. Opportunistic use of CT measurements could accurately differentiate bullet core from metal, glass, stone, wood, or plastic. Left eye protection is particularly important in industrial labor. · Identification of the material in addition to the site is a significant concern for ophthalmologists.. · CT is the method of choice for the imaging of intraocular foreign bodies.. · Beam hardening artifacts accurately differentiate any metal objects and gunshot bullets from other intraocular foreign bodies with a hyperdense appearance.. · Opportunistic use of routine clinical care CT scans by measuring CT densities aids preoperative differentiation of gunshot bullets from other metal objects.. · Erdem Toslak İ, Erol MK, Karagol Aydinyurt G et al. Use of Opportunistic Computed Tomography for Differentiating Intraocular Foreign Bodies. Rofo 2026; DOI 10.1055/a-2781-9014.

To evaluate the relationship between baseline axial length (AL) and the rate of myopia progression in children and determine whether baseline AL alone predicts rapid myopia progression. This retrospective study included 1,458 patients (< 20 years old) who underwent cycloplegic refraction and biometry for at least two years between 2011 and 2024. Myopia progression rate was assessed using AL elongation (mm/year), spherical equivalent (SE) change (diopters/year), and AL/K radius (AL/corneal radius per year). Partial correlation analysis and multiple linear regression were performed to assess linearity between AL and myopia progression rate. A total of 2,916 eyes were analyzed. Baseline AL exhibited weak partial correlations with progression indicators. After adjusting for age, partial correlation coefficients for the right and left eyes were 0.297 and 0.305 for AL elongation, -0.267 and -0.278 for SE change, and 0.259 and 0.269 for AL/K radius rate, respectively. Multiple regression analyses, adjusting for age and K-rad effect revealed that the linear model for the right and left eyes accounted for only 2.4% and 2.0% for AL elongation, 10.0% and 10.5% of SE change, and 1.5% and 1.3% of AL/K radius rate, respectively. Analysis using generalized estimating equations to account for inter-eye correlation revealed that AL had a minimal impact on myopic progression rates. Progression rates decreased with baseline AL > 24 mm, suggesting a nonproportional relationship between AL and progression rate of myopia. Baseline AL was not a linear independent predictor of rapid myopia progression. Myopia progression tended to be slow in patients with an AL > 24 mm.

PurposeTo investigate the relationship between deviation control and accommodative load in patients with intermittent exotropia (IXT).MethodsA total of 35 patients with IXT aged 5-21 years (average, 10.46 4.42 years) with a best-corrected visual acuity of 20/20 or better were included in this study. All examinations, including binocular and monocular refraction, deviation angle, near stereoacuity, and deviation control, were done in patients with the best optical correction.ResultsOf the 35 patients, 16 (45.7%) were male and 19 (54.3%) were female. The results indicated a statistically significant difference in the average distance and near deviation angles between good, relatively good, and poor deviation control levels (P = 0.012). The results also showed that the likelihood of deterioration in deviation control increased significantly with deviation angle (P = 0.012). The accommodative load of the right and left eyes at distance and near fixation did not differ significantly across the three levels of deviation control. Based on the results of univariate logistic regression, no statistically significant relationship was observed between accommodative load (both the right and left eyes at distance and near) and deviation control level. However, there was a significant difference between the accommodative loads of the left and right eyes at near and distance (P 0.001).Conclusion In patients with IXT, deviation control decreased with deviation angle, and accommodative load increased in near fixation compared to distance fixation, but differences were not significant across the three deviation control groups (good, relatively good, and poor).

Purpose The eye dominance distribution in humans varies according to the assessment method. Although the correlation between refractive asymmetry and eye dominance has long been investigated, the results are inconsistent. Here, we analyzed the relationships between refractive asymmetry and eye dominance measured by fixation and sensory methods and assessed the concordance of the two methods. Methods One hundred and twelve subjects were enrolled to evaluate their refractive asymmetry and eye dominance. Refractive error was determined through objective and subjective refraction. The assessment of fixation eye dominance was conducted using the hole-in-card method, while the binocular orientation combination task was used to assess sensory dominance. Subgroups of anisometropia and non-anisometropia patients were established to evaluate the influence of the magnitude of refractive asymmetry. Results Among all subjects, the right eye exhibited greater fixation eye dominance than the left eye (p = 0.001), while sensory eye dominance was more even (p = 0.85). The concordance between these two methods was nonsignificant (p = 0.952). Only the spherical equivalent power difference in the non-anisometropia group was significant between the sensory dominant and nondominant eyes (p = 0.015). The right eye showed greater myopic spherical and spherical equivalent power (spherical power: p = 0.004, spherical equivalent power: p = 0.003). The absolute balance point was greater in individuals with anisometropia (p = 0.015). Moreover, a positive correlation was found between sensory eye imbalance and refractive asymmetry (r = 0.239, p = 0.011). Conclusion We assessed the difference between two assessments of eye dominance and determined that the sensory eye imbalance was greater in individuals with anisometropia. Additionally, a larger absolute balance point value indicated a greater refractive asymmetry.

We examined the choroid in both eyes from a donor with multifocal geographic atrophy (GA), enlarged choroidal vessels, and choroidal neovascularization (CNV) secondary to age-related macular degeneration, using histology and immunohistochemistry, and we correlated the findings with multimodal clinical imaging. A Caucasian woman with bilateral GA was followed clinically for 5 years, until 6 years prior to her death at age 93. To correlate clinical and histologic features, the right eyecup was photographed before dissecting the posterior pole. Choroidal blood vessels were labeled with Ulex europaeus agglutinin-1 (UEA-1) lectin following retinal pigment epithelium removal and imaged by confocal microscopy. Selected regions were embedded and sectioned for histologic staining. The left eye was used for ultrastructure analysis. The posterior pole exhibited areas of atrophy surrounded by mottled retinal pigment epithelium overlying calcified drusen. Confocal imaging of the UEA-1 lectin-labeled choroidal flatmounts showed limited visualization of the submacular vasculature, consistent with masking by basal laminar and lipid-rich deposits seen in histologic sections. In well-labeled regions of the posterior pole, the choriocapillaris was attenuated and widely separated by markedly thickened, hyalinized intercapillary pillars. Venules and veins appeared dilated, and arteries exhibited arteriosclerotic changes. A choroidal neovascular complex was observed superior to the optic nerve head near the atrophic border; the adjacent choriocapillaris was attenuated. In this single case of multifocal GA, choroidal thickening and large-caliber outer choroidal vessels coexisted with marked choriocapillaris degeneration and adjacent neovascularization. These observations suggest that structural choroidal enlargement does not preclude choriocapillaris failure and may be associated with ischemic and neovascular phenotypes.

To establish the central corneal thickness (CCT) and intraocular pressure (IOP) of normal Holstein cattle and any relationship with age. Age of 50 Holstein cattle was recorded in days. CCT was measured by ultrasonic pachymetry, and IOP values were recorded by rebound tonometry from a total of 100 eyes. CCT and IOP values were subsequently analyzed in relation to age. The animals were divided into the following two groups: calves (< 360 days old) and adults (≥ 360 days old). Mean CCT value of all animals was 723.1 ± 75.9 μm in the right eye, 714.5 ± 82.2 μm in the left eye. Mean IOP value of 100 eyes was 25.4 ± 8.07 mm/Hg in the right eye, 24 ± 7.89 mm/Hg in the left eye. Mean CCT and IOP values of the animals < 360 days old were 697.7 ± 8.28 μm and 21.6 ± 0.77 mm/Hg respectively. Mean CCT and IOP values of the animals ≥ 360 days old were 768.1 ± 14.4 μm and 31.9 ± 1.18 mm/Hg, respectively. A statistically significant difference was observed between the groups in terms of CCT and IOP values (p < 0.001). A positive correlation was identified between CCT and age (r = 0.57, p < 0.001) and between IOP and age (r = 0.488, p < 0.001). This study documents the age-related increase in both CCT and IOP values in cattle.

Pituitary apoplexy is a rare, life-threatening syndrome that commonly occurs in the adenomatous pituitary gland. It presents with a myriad of severe neuroendocrine and ophthalmological signs and symptoms. Early diagnosis and prompt treatment are vital in the management of pituitary apoplexy. This case report describes a 56-year-old woman who reported to the neurology clinic with 1 week's history of visual loss, and a severe headache, on the background of a 2-year history of pituitary adenoma with poor follow-up. The patient underwent transsphenoidal surgery. She regained vision in the right eye, but no perception of light in the left eye. Patients with headaches and impaired visual field should be screened for pituitary adenoma. Signs and symptoms may be reversible with early diagnosis and prompt treatment of pituitary apoplexy.

Bilateral thalamic gliomas are extremely rare tumours of the central nervous system. Although they are usually benign in nature, their outcome is poor because of the involvement of thalamic nuclei and inadequate surgical excision, making their excision extremely difficult. A 10-year-old girl presented with right-sided abnormal body movements for 2 months, fever for 10 days, followed by right-sided weakness, left facial palsy, and blurred vision in the left eye. Neurological examination showed right hemiparesis and left seventh nerve palsy. Magnetic Resonance Imaging (MRI) revealed bilateral thalamic lesions with a left-sided mass extending to the midbrain, and MR spectroscopy findings were suggestive of a bilateral low-grade glioma. She was started on antibiotics, and a stereotactic brain biopsy was planned. The present index case highlights the rarity of thalamic tumours in the paediatric population; wherein early diagnosis helps in prognosticating the family/caregivers of the child. However, the decision for further management is up to the parents, considering that the poor prognosis of the disease process and the associated morbidity and mortality is crucial. Management primarily includes tumor excision along with chemotherapy and radiotherapy, which entails a poor prognosis.