Orbital fractures are common after craniofacial trauma. A rare but severe complication is retrobulbar hematoma (RBH), potentially causing increased intraorbital pressure, optic nerve compression, and irreversible vision loss. Prompt diagnosis and emergency decompression, typically via lateral canthotomy, are critical. Despite its low incidence, the relationship between fracture morphology and RBH remains insufficiently understood. This study investigates the association between orbital floor fracture characteristics and RBH occurrence. In this retrospective single-center study, we analyzed all patients who presented to our department between 2015 and 2025 with CT-confirmed RBH and elevated intraocular pressure (IOP) following orbital trauma. CT-based fracture morphology was assessed and classified by size, fragmentation, and wall involvement. Findings were correlated with clinical parameters, including IOP, initial and postoperative visual acuity, and the need for surgical intervention. Statistical analyses evaluated associations between fracture features and clinical severity. We analyzed 27 patients with RBH following orbital trauma, mainly involving the orbital floor, typically caused by falls or assault. Ipsilateral visual acuity was initially reduced (0.15 (0.00-0.80)), improving after decompression; IOP also decreased significantly. Functional outcomes were associated with fracture pattern and, to a lesser extent, anticoagulation. Several Association of the Study of Internal Fixation (AO) fracture types correlated with clinical outcomes. Receiver operating characteristic analysis showed that orbital floor displacement predicted preoperative visual acuity (AUC=0.75, cut-off 4.7mm), while medial wall displacement poorly predicted IOP or vision initially. Postoperatively, medial wall displacement showed excellent discrimination for IOP normalization (AUC=0.944); however, neither wall predicted visual outcome reliably. The extent and displacement of orbital fractures, along with intraocular pressure, strongly correlated with functional outcomes. Our findings highlight the prognostic value of CT-based fracture assessment in addition to urgent clinical evaluation and suggest that trauma mechanism and patient profile further influence risk and recovery.

To compare the Vitreous Floater Functional Questionnaire (VFFQ-23) to the NEI Visual Function Questionnaire (VFQ-25) in patients with vision degrading myodesopsia (VDM) from vitreous floaters. Composite scores for each questionnaire were compared in asymptomatic controls, patients who chose observation (OBS), and those electing vitrectomy. The impact of limited refractive vitrectomy (LRV) on the composite scores of each questionnaire was determined. A retrospective study comparing questionnaire correlations with management choice (OBS or LRV), and a prospective, non-randomized, interventional case series. 74 subjects were asymptomatic controls; 193 subjects had bilateral floaters: 139 chose OBS, 54 elected LRV surgery. Patients complaining of bilateral "floaters" completed the VFFQ-23 and VFQ-25 questionnaires and composite scores were correlated with visual acuity (VA), contrast sensitivity (CS), quantitative ultrasonography (QUS), and management choice (OBS or LRV). LRV was performed in 54 patients, and all tests were repeated at 6, 12, 24, and 36 months post-operatively. VFFQ-23 (0 to 100), NEI VFQ-25 (0 to 100), VA (Snellen), CS (Freiburg Acuity Contrast Test), QUS (AU), predictive value, Receiver Operator Characteristic areas under the curve (AUC), decision curve analysis (DCA). VFFQ-23 correlated with CS (R = -.619; P < .0001) and QUS (R = -.632; P < .0001). VFFQ-23 correctly identified 89% of patients who chose LRV with a positive predictive value of 73.8% for LRV and 95.3% for OBS, while VFQ-25 had a positive predictive value of only 60%; VFFQ-23 AUC = 0.923, VFQ-25 AUC = 0.570. DCA demonstrated a higher net benefit for VFFQ-23 than both "Treat All" and "Treat None" strategies. After LRV, VFFQ-23 improved 72.2% ± 3.2% (P < .001), while VFQ-25 only improved 7.4% ± 1.8%, (P < .001). The difference-in-differences before and after surgery between VFFQ-23 and VFQ-25 was 31.9 ± 12.0 (P < .001). In patients with vitreous floaters, the VFFQ-23 correlated with CS and QUS. VFFQ-23 was a better predictor of patient management choice (OBS or LRV) and was more sensitive to post-operative improvement than VFQ-25. VFFQ-23 superiority to VFQ-25 was confirmed by DCA. Thus, VFFQ-23 may be more useful in assessing the subjective impact of floaters on visual quality-of-life, in screening/triage, and as an outcome measure of current and future therapies for VDM.

Surgical outcomes of a novel non-diffractive, extended depth-of-focus intraocular lens - preliminary results from a phase 4 study.

Progression in X-Linked Retinoschisis: A Longitudinal Study Defining Quantitative Biomarkers and Their Implications for Gene Therapy.

To evaluate the long-term functional and anatomical outcomes of pars plana vitrectomy (PPV) combined with subretinal recombinant tissue plasminogen activator (tPA) injection and gas tamponade in patients with subretinal hemorrhage secondary to retinal arterial macroaneurysm (RAM) rupture. This retrospective multicenter study included 18 eyes of 18 patients who underwent PPV with subretinal tPA injection and gas tamponade for subfoveal hemorrhage because of RAM rupture. Baseline demographic and clinical features, pre- and postoperative best-corrected visual acuity (BCVA), central macular thickness (CMT), postoperative complications, and the relationship between symptom-to-surgery interval and visual outcomes were evaluated over a minimum follow-up period of 12 months. The mean preoperative BCVA was approximately 20/3,300 (2.22 ± 0.73 logMAR), improving to approximately 20/140 (0.85 ± 0.57 logMAR) at the 12-month visit ( P < 0.001). Earlier surgical intervention (≤14 days) was associated with greater improvement in BCVA. Subfoveal retinal pigment epithelium (RPE) atrophy developed in 38.9% of patients and was significantly associated with worse visual outcomes compared with extrafoveal atrophy ( P = 0.02). ILM peeling was performed in 44.4% of cases; although those patients tended to have greater BCVA gains, the difference was not statistically significant. RPE atrophy was observed in 77.8% of patients postoperatively, with varying progression patterns. PPV with subretinal tPA injection and gas tamponade appears to be an effective treatment for RAM-related subretinal hemorrhage, with significant improvements in visual acuity, particularly when performed within 2 weeks of symptom onset. The location of postoperative RPE atrophy is a critical prognostic factor for visual outcomes.

To report a case of late dehiscence of an EndoArt implant and its successful management 10 months after initial implantation. Case report. A 73-year-old man with a history of multiple failed Descemet membrane endothelial keratoplasty procedures on the right eye underwent EndoArt implantation for bullous keratopathy. The initial surgery was successful with improved visual acuity and a well-attached implant. However, 10 months after implantation, the patient experienced decreased visual acuity because of implant dehiscence in the superior quadrant. A rebubbling procedure using 20% Schwefelhexafluorid (SF6) gas without additional corneal sutures was performed, resulting in successful reattachment of the implant. Although EndoArt dehiscence typically occurs within the first 3 months after implantation, this case demonstrates that late dehiscence can occur even after prolonged implant attachment. Our report highlights the possibility of successful management through rebubbling without additional sutures and emphasizes the importance of extended follow-up for patients with this novel implant.

BackgroundOcular syphilis is a rare but potentially sight-threatening manifestation of Treponema pallidum. Despite increased awareness related to the global resurgence of syphilis and its association with HIV, data from Türkiye remain limited.MethodsThis case series included patients diagnosed with ocular syphilis at two tertiary centers in Türkiye. We evaluated their clinical, ophthalmologic, serologic, CSF, HIV-related data, treatment, and visual outcomes.ResultsTwenty-four patients (43 affected eyes) were included; 92% were male, with a median age of 46years (IQR, 31.0-52.8). Ocular involvement was the initial clinical manifestation of syphilis in 92% of patients, and 54% had no systemic symptoms at presentation. Bilateral disease was observed in 19 patients (79%). Among the 43 affected eyes, posterior uveitis and panuveitis were the most common anatomical patterns, each observed in 15 eyes (35%). Fifty-eight percent of patients were people living with HIV (PLWH), half of whom were newly diagnosed at presentation. PLWH were significantly younger than those without HIV (median 37.0 vs 52.0years; p = 0.012) and were more frequently men who have sex with men (64% vs 0%; p = 0.002). Lumbar puncture revealed at least one cerebrospinal fluid (CSF) abnormality in 71% of individuals; elevated CSF protein levels were more common among PLWH (85% vs 25%; p = 0.017). All individuals received neurosyphilis-equivalent therapy, resulting in significant improvement in visual acuity (median ΔlogMAR -0.56; p < 0.001).ConclusionsOcular syphilis frequently presents without systemic symptoms and is often associated with HIV. In patients presenting with posterior uveitis or panuveitis, routine syphilis and HIV testing is essential for accurate diagnosis and timely management.

Original article preliminary exploratory finding of anti-defocus (ADF) contact lenses on binocular vision.

To assess factors associated with retinal detachment (RD) in eyes presenting with endogenous endophthalmitis (EE). Multicenter retrospective study of individuals with an EE diagnosis from seven tertiary care centers. Demographics, medical history, ocular examination findings, microbial cultures (blood or intraocular), and management strategies were assessed relative to subsequent RD occurring within 6 months of EE diagnosis. Of note, this study did not distinguish between intraocular cultures without growth and eyes that were not sampled for an intraocular organism. A total of 201 eyes from 171 patients presented with EE. Of these, 22.4% (45/201) had a subsequent RD. Eyes that experienced a subsequent RD had worse presenting visual acuity ( P = 0.006) and lower intraocular pressure at presentation (RD: 13.7 ± 5.4 mmHg vs. No RD: 15.7 ± 6.5 mmHg, P = 0.04). Compared with other forms of bacteremia, S. aureus bacteremia was associated with increased odds of subsequent RD (OR: 6.10, CI: 1.82-20.41, P = 0.003). Eyes with a subsequent RD did not have significantly greater rates of therapeutic pars plana vitrectomy (RD: 11/48, 22.9% vs. No RD: 36/153, 23.5%). Eyes presenting with visual acuity ≤ light perception or S. aureus bacteremia had a higher risk of subsequent RD and may warrant closer surveillance. Although no therapeutic strategies were associated with reduced odds of subsequent RD, a pars plana vitrectomy was not associated with an increased risk of RD, suggesting that it may aid in eyes with lackluster responses to systemic and intravitreal pharmacotherapy.

Identification of immune cell subsets involved in retinal ganglion cell damage following blast exposure.

Efficacy and safety of acupuncture in slowing visual field loss in normal-tension glaucoma: A 24-week randomized controlled trial.

To evaluate outcomes of intravitreal faricimab in polypoidal choroidal vasculopathy (PCV) and pachychoroid neovasculopathy (PNV), focusing on subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI), compared with ranibizumab and aflibercept. This retrospective cohort study included 96 treatment-naive eyes with PCV or PNV, allocated by 1:1:1 propensity score matching to receive three consecutive monthly intravitreal injections of faricimab, ranibizumab, or aflibercept (n = 32 each). Best-corrected visual acuity (BCVA), central macular thickness (CMT), SFCT, and the CVI were evaluated at baseline and at Months 1 to 3. In addition, total choroidal area (TCA), luminal area (LA), and stromal area (SA) were quantified. Baseline characteristics were similar. Best-corrected visual acuity and CMT changes were not significantly different. Faricimab induced greater SFCT reduction than ranibizumab ( P < 0.001 at Months 1-3) and aflibercept ( P = 0.029, 0.005, 0.004 at Months 1-3). Choroidal vascularity index reduction was also greater with faricimab than ranibizumab ( P = 0.001, <0.001, 0.010 at Months 1-3) and aflibercept ( P = 0.032, 0.024 at Months 2-3). This was driven by larger LA reduction relative to TCA and SA (LA vs. TCA: P < 0.001 at Months 1-2, P = 0.006 at Month 3; LA vs. SA: P < 0.001 at Months 1-3). Ranibizumab and aflibercept showed proportional decreases without significant differences. Faricimab achieved greater SFCT and CVI reductions, suggesting enhanced vascular stabilization and reduced pachyvessel congestion. These results support the therapeutic potential of dual vascular endothelial growth factor-A/angiopoietin-2 inhibition in PCV and PNV.

Clinical outcomes of ray tracing-guided LASIK for myopic astigmatism correction.

Outer Retinal Erosion and Outer Retinal Pinching at the Origin of Subretinal Fluid in Central Serous Chorioretinopathy.

Astigmatism is one of the most common refractive conditions, with a large proportion of patients undergoing cataract surgery presenting with 1.0 D or more. Toric IOLs are the standard of care for astigmatism correction during cataract surgery. This overview of reviews synthesizes current evidence on the use of toric IOLs, focusing on clinical indications, surgical outcomes, and emerging technologies. Narrative review of reviews. The following databases were searched from inception to 2 June 2025: MEDLINE, Embase, the Cochrane Library (including CENTRAL and the Cochrane Database of Systematic Reviews), KSR Evidence, and the Trip Database. Keywords included astigmatism, toric intraocular lenses, cataract surgery, intraocular lens implantation, and postoperative outcomes. Included studies were systematic and narrative reviews, meta-analyses, and clinical guidelines related to the use of toric IOLs in cataract surgery. Eighty-five reviews were included. This overview summarizes key topics including the prevalence and impact of astigmatism, toric IOL technology, preoperative assessment, power calculation methods, surgical considerations, and postoperative outcomes such as rotational stability and surgically induced astigmatism. Reporting standards, patient-reported outcome measures, adverse events, and considerations in special populations are also discussed. Knowledge gaps and debated areas are highlighted. Toric IOLs improve uncorrected visual acuity and refractive outcomes in cataract patients with significant astigmatism. Advances in diagnostics, lens design, calculation formulas, and intraoperative tools continue to enhance accuracy and patient satisfaction. Further research is needed to address unresolved questions and support best practices in diverse clinical settings.

Injectable alginate hydrogels improve the effects of subretinal hiPSC-derived RPE cell therapy on retinal degeneration in rats.

Ocular complications of Mpox are relatively rare but can be devastating, particularly in immunocompromised individuals. We report a case of severe keratitis resulting in significant visual impairment in a 26-year-old male living with advanced HIV. The patient presented with a 2-month history of disseminated ulcerative lesions and a 1-month history of progressive vision loss in the right eye. He was newly diagnosed with HIV, and laboratory testing revealed a positive Mpox virus polymerase chain reaction (PCR) result alongside severe immunosuppression (CD4 + T-lymphocyte count: 35cells/μL). Ophthalmologic examination revealed corneal opacity, stromal edema, and neovascularization. Despite systemic antiviral and topical antibiotic/anti-inflammatory treatment, visual acuity remained poor due to permanent corneal scarring. This case highlights the potential for sight-threatening ocular complications in individuals with Mpox and severe immunodeficiency, underscoring the critical importance of early ophthalmologic assessment in this vulnerable population.

Visual fatigue and dry eye are prevalent pediatric ophthalmic conditions. Esculin-digitalis glycosides and sodium hyaluronate eye drops are widely used, yet their specific clinical value remains unclear. This study compared esculin and digitalis glycosides eye drops with sodium hyaluronate eye drops for pediatric digital screen-related visual fatigue and dry eye, assessing efficacy and tolerability. In the observational retrospective study, 126 patients were initially screened from December 2022 to December 2024 and 122 were enrolled after exclusions. They were divided into two groups according to the treatment plan: the sodium hyaluronate group (n=60) and the esculin-digitalis glycosides group (n=62). After propensity score matching (PSM), 50 patients were included in each group. The primary outcome measures included the Ocular Surface Disease Index (OSDI) score, Tear Film Breakup Time (TBUT), tear secretion volume and Corneal Fluorescein Staining (CFS) score. The secondary outcome measures included Functional Visual Acuity (FVA) accuracy rate, Tear Meniscus Height (TMH), Meibomian Gland Function Score (MGFS), incidence of adverse events and the Scale of Quality of Life for Diseases with Visual Impairment score (SQOL-DVI). After PSM, baseline data showed no significant between-group differences (all P > 0.05). Following 3 months of treatment, the esculin-digitalisglycosides group had greater reductions in OSDI, CFS and MGFS scores (all P < 0.001), longer TBUT, higher tear secretion, improved FVA accuracy and increased TMH than the sodium hyaluronate group (all P < 0.001). The esculin-digitalisglycosides group also had a higher SQOL-DVI total score. Adverse event rates were 4% (esculin-digitalisglycosides) and 8% (sodium hyaluronate), with no significant difference (P = 0.400) and no serious adverse events reported. Esculin and digitalis glycosides eye drops show superior efficacy to sodium hyaluronate eye drops in treating pediatric digital screen-related visual fatigue and dry eye, with good tolerability and clinical value.

Minor reduction in the back optical zone diameter of orthokeratology lenses delays axial elongation in children with myopia.

Longitudinal changes in retinal structure and visual function after mild methanol inhalation poisoning.