J. Clin. Transl. Ophthalmol., Volume 1, Issue 1 (March 2023) – 5 articles

Background: Traumatic brain injury (TBI) can cause visual dysfunction affecting binocularity, spatial orientation, posture, and balance. Currently, there are several options for treating manifested visual disturbances; vision therapy is one of the possible treatment options. Methods: A 14-year-old female fainted and sustained trauma to the upper-temporal part of her right eyebrow. The patient presented with eye pain, a decreased visual field, and blurred vision and she exhibited great difficulties when reading. Both neurological tests and exploration of the anterior and posterior ocular segments showed results within normal limits. The patient was diagnosed with fusional vergence dysfunction, associated with accommodative infacility and oculomotor dysfunction. To eliminate her symptoms, a visual rehabilitation program was implemented; it consisted of accommodative, anti-suppressive, vergential, motility, hand–eye coordination, and peripheral vision exercises. Results: The symptoms manifested by the patient gradually dissipated throughout the course of therapy. However, not all optometric parameters reached normal values after visual therapy, which could indicate a traumatic injury that limited the achievement of normal optometric ranges. Conclusions: After a mild traumatic brain injury (mTBI), it is necessary to carry out a complete examination of the patient’s visual function. This visual examination must include an analysis of vergences, ocular motility, and the accommodative system to obtain an accurate diagnosis. The outcomes of the present clinical case imply that visual therapy should be considered as a treatment in cases of mTBIs. Full article

(1) Background: After filtering surgery, bleb morphology is an indicator of the factors that may determine the final intraocular pressure (IOP). The present study aimed to evaluate and compare filtering bleb characteristics after combined cataract and glaucoma surgery. (2) Methods: We conducted a prospective multi-center randomized trial. Eyes with glaucoma and cataract were randomly assigned to either phacoemulsification and filtration surgery with an EX-PRESS implant (Alcon) or non-penetrating deep sclerectomy (NPDS) with an ESNOPER implant (AJL). The bleb characteristics were assessed with the Moorfields bleb grading system at months 1 and 12 of follow-up, and the relationship with IOP was analyzed. (3) Results: There were significant changes in bleb appearance between the assessments at month 1 and month 12. The changes in bleb appearance were more evident in the EX-PRESS group. The central area in the EX-PRESS group decreased from 2.9 at month 1 to 2.4 at month 12 (p = 0.014). Bleb height in the EX-PRESS group decreased from 2.3 at month 1 to 1.8 at month 12 (p = 0.034). The vascularity of the central area in the NPDS group decreased from 1.8 at month 1 to 1.3 at month 12 (p = 0.02). The maximal bleb area was inversely related (r = −0.39; p = 0.03) to the IOP in the NPDS group at month 1. Vascularity in the central area was directly related (r = 0.39; p = 0.01) to a higher IOP in the EX-PRESS group at month 1. Vascularity in the central area (r = 0.56; p < 0.001) and maximal area (r = 0.37; p = 0.012) at month 1 was directly related to a higher IOP in the EX-PRESS group at month 12. (4) Conclusions: More intense vascularity at month 1 was related to a higher final IOP in the EX-PRESS group. Larger blebs were associated with a lower IOP in the NPDS group. Full article

Here, we present a case of floppy iris leading to positional pupillary capture by a sutureless, scleral-fixated intraocular lens (IOL) causing recurrent uveitis-glaucoma-hyphema (UGH) syndrome. The patient developed recurrent episodes of UGH syndrome after dislocated IOL removal and the placement of sutureless, scleral-fixated IOL. Gravitationally dependent pupillary capture was noted with the superior iris moving in front of and behind the IOL, depending on head positioning. Ultrasonography showed a floppy iris that moved with shifting gaze. The lack of the capsular bag may have contributed to extreme iris movements. This finding may be secondary to a combination of a lack of zonular support and capsular bag support as well as the lack of vitreous support following vitrectomy. When possible, secondary IOL placement behind a peripherally preserved capsular bag may reduce the risk of UGH. Full article

Endophthalmitis is a serious ophthalmologic condition involving purulent inflammation of the intraocular spaces. Fungal endophthalmitis is a highly sight-threatening condition that can be complicated by difficulties in diagnosis and therapeutic delay. We report herein a rare case of bilateral endogenous Candida albicans endophthalmitis with favorable outcome. High suspicion of fungal origin is essential since the diagnosis for fungal endophthalmitis is usually based on the ophthalmological exhibition in combination with the presence of fungemia or predisposing factors. Only prompt initiation of systemic, intravitreal and surgical treatment may reduce ocular morbidity or even mortality. Full article