J. Clin. Transl. Ophthalmol., Volume 4, Issue 1 (March 2026) – 8 articles

Background: Given global population growth and aging, it is imperative to prioritize early eye disease detection and treatment. However, as patient volume increases, providers are facing a shortage of workforce capacity, particularly in areas where eye doctors are already scarce, making it important to consider alternative innovative solutions that could help increase eye screening capabilities. This study compared virtual reality (VR) platform of vision screening exams that are used to evaluate ocular health, such as 24-2 perimetry, Ishihara tiles, and the Amsler grid, against their in-clinic counterparts. Methods: A total of 86 subjects were recruited from Mount Sinai’s ophthalmology clinic (New York, USA) for a comparison trial that was internally controlled across healthy eyes and those with glaucoma and retinal diseases. VR and in-office tests were administered to the patients during their clinical visit, including 24-2 perimetry, Ishihara tiles, and the Amsler grid in a randomized order, and the results were compared for each test. Results: Perimetry results from Humphrey Visual Field Analyzer (HVFA) and VR suprathreshold testing demonstrated a good sensitivity both overall (80% OD, 84% OS) and across control (86% OD, 89% OS), glaucoma (69% OD, 78% OS), and retinal disease (76% OD, 80% OS) groups. A Garway-Heath anatomical map showed an overall 70–80% agreement. Ishihara plate tests did not show a significant difference between the two testing modalities (p = 0.12; Mann–Whitney U test), which remained true across all groups. Amsler grid testing differences were also non-significant within each subgroup (p = 0.81; Mann–Whitney U test). Patient time required to complete VR exams was significantly improved (p < 0.0001; Welch’s t-test) compared to the clinical standard tests. Conclusions: All VR-based exams tested in this study showed high sensitivity and percent agreement when compared to their in-office standards. Given the results of this study, VR has a promising potential in visual function screening, which, in addition to its portable design and easy use, could assist eye doctors in screening for prevalent diseases such as glaucoma and retinal conditions. Translational Relevance: VR-based vision exams that test vision fields, color vision and visual distortions provide comparable results in healthy patients, as well as those with glaucoma and retinal diseases, indicating its potential as a screening technology for different ocular pathologies. Given VR’s portable and low-profile features, it is important to consider leveraging VR to augment delivery of vision care. Full article

Background: Higher intake of omega-3 fatty acids from food sources is associated with a reduced risk of age-related macular degeneration (AMD), but there are no recommended parameters for omega-3 fatty acid supplementation. The purpose of our study was to investigate whether fish oil supplementation protects against development of AMD in the US Veteran Affairs (VA) Corporate Data Warehouse. Methods: Patients ≥ 55 years without an AMD diagnosis at the initial eye examination who also had a 5-year follow up eye examination were included in this retrospective cohort study. Patients receiving fish oil supplementation from the VA pharmacy were categorized into the fish oil exposure group and matched 1:1 to a non-exposure control group. All patients were assessed for AMD development at the 5-year follow up eye examination. Results: AMD developed in 772 of 16,172 patients (4.8%) with fish oil exposure and 635 of 16,093 (3.9%) without fish oil exposure (relative risk (RR) = 1.21, 95% confidence interval (CI) = 1.09–1.34, p = 0.0003). Compared to controls, AMD risk was similar in low-dose (RR = 0.91; 95% CI = 0.65–1.27) and moderate-dose (RR = 0.93; 95% CI = 0.79–1.10) fish oil supplementation but higher in high-dose fish oil supplementation (RR = 1.32; 95% CI = 1.19–1.47). Conclusions: Fish oil supplementation did not protect against AMD in a US veteran population. Full article

Background: The impact of cataract surgery on anterior segment structures in subjects affected by primary open-angle glaucoma (POAG) remains incompletely understood. The aim of this study was to characterize changes in anterior segment parameters after cataract surgery in POAG subjects compared with non-glaucoma subjects (control). Methods: A prospective comparative study was conducted, including patients scheduled for cataract surgery who underwent a comprehensive ophthalmic examination before and after surgery using anterior segment optical coherence tomography (OCT). Longitudinal changes and between-group comparisons were analyzed. Results: The results demonstrated a significant enlargement of the anterior chamber and iridocorneal angles after surgery in both groups (p < 0.05), with no significant differences between POAG and control eyes (p > 0.05). Several preoperative parameters, particularly angle-related metrics, were correlated with postoperative anatomical changes, suggesting their potential role as predictors of anterior segment variation (R > 0.50; p < 0.05). Conclusions: In conclusion, this study provides a detailed characterization of anterior segment changes in POAG subjects following cataract surgery, demonstrating anterior chamber enlargement comparable to that observed in non-glaucoma eyes, which may assist clinicians in the management of glaucoma. Full article

Purpose: This study evaluates the association between supervising attending surgeons’ post-residency experience and complication rates during resident-performed phacoemulsification (cataract extraction) surgeries, and to determine whether this relationship changes as the academic year progresses. Methods: A retrospective analysis of 1263 cataract surgeries performed by eight PGY-4 residents under 14 board-certified attendings was conducted at a New York City residency program over two years. Attendings were divided into four groups based on years of post-residency experience. Primary complications included posterior capsule (PC) tears, anterior vitrectomy (AV), capsulorrhexis extensions (CE), and inability to place a one-piece intraocular lens (IOL). Chi-square analyses compared complication rates between attending groups overall, and between the first and second halves of the academic year. Results: A total of 167 primary complications (13.2%) were identified. Attendings with the fewest years of experience (Group 1) supervised significantly more cases with PC tears (χ² = 8.173, p = 0.004), AV usage (χ² = 7.748, p = 0.005), and inability to place a one-piece IOL (χ² = 4.753, p = 0.029), particularly during the first half of the academic year. Notably, supervising attending experience was not correlated with resident complications in the second half of the academic year. Conclusions: Early in the academic year, less experienced attendings supervised cases with higher complication rates, underscoring the critical role of strategic case assignment and targeted mentorship during early surgical training. These findings suggest that aligning resident progression with appropriate supervision can enhance outcomes and support skill development, optimizing both education and patient safety. Full article

Objective: Assess visual acuity (VA) and strabismus changes in children after Baerveldt 350 (BV350) device placement. Methods and Analysis: Retrospective cohort study of children (<21 years of age) who had superotemporal BV350 placement (2011–2023) and >6-month follow-up. Ocular diagnoses, surgical details, and preoperative and final follow-up exam findings were collected. In bilateral cases, first eye implanted was included in analysis. Results: Ninety-seven patients underwent BV350 surgery with median age of 6.7 (interquartile (IQR) 3.1, 11.2) years and with a median of 4.2 (IQR 1.8, 6.8) years of follow-up. Most common glaucomas were secondary to non-acquired ocular anomaly (n = 31) or primary congenital glaucoma (n = 21). There was no difference in preoperative and final VA (p = 0.6583). Twenty-seven (28%) and twenty-five (26%) patients were orthophoric preoperatively and at final follow-up, respectively. Orthophoria at final follow-up was associated with preoperative (odds ratio (OR)1.8 [1.2, 2.9]) and final VA (OR1.5 [1.1, 2.3]). At final follow-up, 13 patients (13%) and 19 patients (20%) showed worsened or improved horizontal deviation (>10 prism diopter (PD) change), respectively. No patients reported postoperative diplopia. Only four patients, all with esotropia, underwent subsequent strabismus surgery. Conclusions: Children who underwent BV350 placement did not have significant change in VA, and a high percentage of patients had strabismus prior to (72%) and following (74%) glaucoma surgery. Orthophoria was associated with better VA. The majority of patients did not show worsening of strabismus postoperatively, and none reported diplopia. Full article

Background: We report an uncommon presentation of Lyme disease and highlight the importance of a detailed history in a patient with new-onset sixth nerve palsy. Methods: Case report and literature review. Results: A 46-year-old man receiving infliximab presented to the ophthalmology emergency department with horizontal binocular diplopia. History revealed a diffuse headache that had begun three weeks earlier. Ophthalmologic examination demonstrated a left sixth cranial nerve palsy. The workup showed positive Borrelia serum IgG, which was interpreted as a likely false-positive result given the limited specificity of serologic testing. At follow-up, the patient reported left-sided peripheral facial palsy, and worsening headache and diplopia. Further history revealed prior erythema migrans treated with doxycycline four months earlier. Considering these new findings, a lumbar puncture was performed and demonstrated intrathecal production of Borrelia antibodies. Neuroborreliosis, a neurologic involvement secondary to systemic infection by the spirochete Borrelia burgdorferi, was diagnosed. The patient was treated with oral doxycycline for 28 days with complete resolution of symptoms. Conclusions: Lyme disease may present with progressive neuro-ophthalmologic symptoms, underscoring the crucial role of ophthalmologists in its diagnosis. Moreover, immunosuppression may delay diagnosis and allow neurological progression, highlighting the need for careful history taking and close follow-up. Full article

Background: The recently defined pachychoroid disease spectrum (PDS), which includes central serous chorioretinopathy (CSCR), is a group of retinal disorders that share the common characteristic of a thick, dilated, hyperpermeable choroid. This study aimed to evaluate the efficacy of difluprednate and loratadine in the treatment of pachychoroid disease spectrum (PDS). Methods: A retrospective study of 27 eyes from 19 patients with macular edema secondary to chronic PDS were treated with topical difluprednate and oral loratadine at a tertiary medical center. Visual acuity and optical coherence tomography (OCT) images were analyzed at baseline, 1-, 2-, 3-, 6-, 12-month, and final follow-up. Baseline was defined as the initiation of topical difluprednate. Patients with neovascularization or who had other concurrent treatments for PDS were excluded. Subfoveal choroidal thickness was measured at each time point. Response was defined as eyes that showed a reduction in intra- or subretinal fluid. Results: All 27 eyes studied responded to treatment. Of these, 70.4% resolved by 4 months and 81.5% by 6 months, with 52.2% of these patients having recurrences related to cessation or tapering of topical steroids. Visual acuity remained stable (p > 0.05) while subfoveal choroidal thickness decreased compared to baseline (p < 0.001) across all time points. Eleven (40.7%) of the eyes developed increased intraocular pressure, for which seven (25.9%) required incisional surgery. Conclusions: Chronic PDS can be treated with a combination of topical difluprednate and oral antihistamines to reduce retinal edema and subfoveal choroidal thickness. The effectiveness of therapy could be linked to the regulation of mast cell degranulation, necessitating a well-powered prospective randomized clinical trial. Full article

Objective: The purpose of this study is to investigate the effect of low-dose atropine and dual-focus MiSight contact lenses on myopia control. Methods: This study included a retrospective review of patients (5–13 years old) started on MiSight contacts or 0.05% atropine with a ≥1-year follow-up. Outcomes included cycloplegic refraction, axial length measurement, and side effects. The right eyes were included in analyses. Results: One hundred children were treated with MiSight lenses (n = 55) or 0.05% atropine (n = 45) at an average age of 10.4 ± 2.1 years and 8.4 ± 2.5 years, respectively. At the 1-year follow-up, there was no difference from baseline in spherical equivalent or axial length in the MiSight group (p = 0.61, p = 0.98) or in the atropine group (p = 0.78, p = 0.97). Further, subgroup analysis based on age at treatment initiation (<9.5 years vs. ≥9.5 years) showed no age difference in baseline or final spherical equivalent and axial length in either the MiSight group or the atropine group. Linear regression analysis demonstrated no association between initial age and baseline spherical equivalent, baseline axial length, or the change in spherical equivalent in either the MiSight or atropine group. Conclusions: There was no significant difference in spherical equivalent or axial length after 1 year of treatment with either the MiSight contact lenses or 0.05% atropine eye drops. However, the limited sample size, the difference in age and ethnicity, and baseline refraction prevent a direct comparison between the two treatment groups. Full article