J. Clin. Transl. Ophthalmol., Volume 4, Issue 2 (June 2026) – 8 articles

Introduction: Conjunctival and eyelid lesions encompass a broad spectrum of conditions, ranging from benign entities to malignant neoplasms, and may significantly impact ocular health and quality of life. Their occurrence is influenced by environmental exposure, demographic characteristics, and access to healthcare services. In public health settings, delayed diagnosis and limited access to specialized care may contribute to disease progression. Objective: To characterize the clinical and epidemiological profile of conjunctival and eyelid lesions in patients treated at a referral ophthalmology service within the Brazilian Unified Health System (SUS). Methods: This retrospective observational study reviewed medical records of patients diagnosed with conjunctival and/or eyelid lesions during ophthalmologic screening campaigns. Clinical and demographic variables were analyzed using descriptive statistics to assess prevalence and distribution patterns. Results: A total of 66 patients were included. Conjunctival involvement predominated (78.8%), with the nasal region being the most frequently affected location (62.1%). Pterygium was the most prevalent diagnosis (31.8%), followed by racial melanosis (15.2%) and melanocytic nevus (12.1%). No statistically significant differences were observed according to sex or lesion laterality. However, a significant association was identified between lesion type and anatomical location. Conclusions: Conjunctival and eyelid lesions in this population were predominantly benign and associated with demographic and environmental factors. These findings highlight the importance of structured screening strategies and early diagnosis to improve clinical outcomes and support public health policies aimed at reducing the burden of ocular disease within the SUS. Full article

Background: Population-level predictors of intraocular pressure (IOP)-lowering surgery for neovascular glaucoma (NVG) are understudied. This study examines factors associated with IOP-lowering surgery in California (CA) Medicare beneficiaries with NVG. Methods: The study population included all 2019 CA Medicare beneficiaries with NVG. Covariates included age, sex, race/ethnicity, history of treatments for retinal ischemia, dual Medicare/Medicaid eligibility, Social Vulnerability Index score, and Charlson Comorbidity Index (CCI) score. Outcomes included incidence of trabeculectomy, tube shunt, minimally invasive glaucoma surgery, cyclophotocoagulation (CPC), or any IOP-lowering surgery. Results: Of 1843 beneficiaries, 264 (14.3%) had IOP-lowering surgeries. In multivariable logistic regression including all covariates, CCI ≥ 5 versus 0 was associated with lower odds of any IOP-lowering surgery and of each type of surgery except CPC (adjusted odds ratio [aOR] = 0.47, 95% confidence interval [CI] = 0.29, 0.75 for any versus no surgery; aOR = 1.35, CI = 0.51, 3.60 for CPC). Compared to Non-Hispanic White, racial and ethnic minorities had increased odds of trabeculectomy (aOR = 3.77, CI = 1.05, 13.57 for Black; aOR = 2.69, CI = 1.04, 6.92 for Hispanic) and tube shunt (aOR = 2.62, CI = 1.27, 5.41 for Other/Unknown). Beneficiaries 75–79 versus 65–69 years old had decreased odds of trabeculectomy (aOR = 0.21, CI = 0.05, 0.98). Conclusions: Among CA Medicare beneficiaries, higher systemic disease burden was associated with a decreased likelihood of surgery for NVG, while racial and ethnic minorities were more likely to undergo certain procedures. These findings suggest surgical risk stratification and treatment pattern disparities for individuals with NVG. Full article

Purpose: We sought to evaluate the surgical outcomes of unilateral lateral rectus (LR) resection among patients with age-related distance esotropia (ARDE). Methods: We conducted a retrospective review of 39 patients who underwent unilateral LR resection for ARDE between January 2019 and November 2024 performed by a single surgeon at a tertiary eye centre in Brisbane, Queensland. The inclusion criteria included symptomatic horizontal diplopia at distance, comitant esotropia that was at least 25% greater at a distance than nearby, and absence of an abduction deficit or neurologic abnormality. In all but one procedure, an adjustable-suture technique was used. The amount of LR resection was based on a 1 mm per 4 prism dioptre (PD) personal surgical table. Pre- and postoperative measurements of deviation close up at near (33 cm) and at a distance (6 m) were obtained using prism and alternate cover testing. Results: The mean (±SD) patient age was 68.1 ± 9.7 years (range: 44–91). The mean preoperative esotropia measured 14.3 ± 2.7 PD at a distance and 4.7 ± 3.3 PD nearby. The mean LR resection was 3.8 ± 0.7 mm (range: 3.0–6.0 mm), with a mean follow-up of 18 months (range: 9–26). Diplopia was resolved in 97% (38/39) of the patients. At the final follow-up, 85% (33/39) were orthophoric at a distance, and all were orthophoric nearby. Five patients (13%) required postoperative adjustment, four of whom achieved orthophoria. Three patients had minimal residual esotropia (<5 PD). Conclusions: Unilateral LR resection with adjustable sutures provides a safe, effective, and targeted surgical option for ARDE, achieving high rates of distance orthophoria and diplopia resolution without compromising near alignment. Prospective long-term studies are warranted to confirm durability and refine surgical dosing. Full article

Recreational (“party”) drug use is prevalent in social environments and is increasingly relevant in ophthalmic care. While the neurological and cardiovascular consequences of these subokstances are well documented, their ocular and visual effects may not be fully recognized or consistently reported in clinical practice. This invited narrative review summarizes clinical observations and translational mechanisms underlying ophthalmic manifestations associated with commonly used recreational substances, including sympathomimetic stimulants (cocaine, amphetamines), empathogens (3,4-methylenedioxymethamphetamine (MDMA), inhalants (alkyl nitrites, “poppers”), and cannabinoids (cannabis/Δ9-tetrahydrocannabinol (THC)). Particular focus is placed on vascular dysregulation, altered ocular perfusion pressure, venous outflow impairment, oxidative stress, and neuro-ophthalmic dysfunction. Characteristic presentations, diagnostic pitfalls, and management considerations are discussed. Improved awareness of drug-related ocular effects may facilitate earlier recognition of such conditions and help reduce the risk of visual complications. Other recreational substances, including hallucinogens and emerging psychoactive compounds, may also have ocular effects, although current evidence remains limited. Full article

Early eye loss, congenital microphthalmia, and anophthalmia can significantly disrupt facial and psychological development in children. Timely intervention with conformers and ocular prostheses is essential for stimulating orbital growth and supporting healthy psychosocial development. This review presents evidence-based guidelines for ocularists, physicians, and allied professionals on fitting conformers and prostheses in young children, emphasizing the need for individualized treatment based on anatomical severity and age. Recommendations include initial conformer fitting within the first month of life for congenital cases or 4–6 weeks post-surgery in acquired cases, with frequent early replacements. For microphthalmia, moderate-to-severe cases require treatment similar to congenital anophthalmia cases; mild-to-moderate cases treatment within months; and mild cases are usually managed individually without urgency. A cosmetic prosthesis is advised the latest after the first year, as growth slows and self-awareness develops. Regular follow-up and adjustments support functional and psychosocial outcomes. We advocate for standardized care protocols to ensure equitable access and consistent long-term results across healthcare systems. Full article

Background: A novel titanium scleral buckle implant (TSBI) was developed for the treatment of posterior pole retinal detachments, analytically modeled and structurally tested as part of preclinical approval studies. The strength and stiffness requirements to apply pressure for retinal reattachment also suggested potential benefits for correcting high myopia greater than 8 diopters. Methods: Laboratory load testing and analytical calculations were complemented by nonlinear finite element modeling (FEM), applied for the first time to capture the interaction between the highly deformed myopic eye and the TSBI. Simulations were used to visualize posterior pole indentation and force distribution across anatomical regions. Seven TSBI units were tested in the transverse direction and six in the longitudinal direction. Results: The simulations confirmed that stable indentation is maintained even in areas distant from the sutures. The TSBI’s minimum midspan bending capacity was 40 N at yield and 60 N at ultimate. These values, together with FEM predictions, demonstrated a very large safety margin and showed that the implant deforms insignificantly under high intraocular pressure changes. Conclusions: The TSBI withstands ocular forces, cushions the sclera safely, and retains its geometry, a behavior that may differ from softer buckle materials, which can exhibit time-dependent deformation under sustained loading. Early controlled clinical applications outside the USA, followed for over three years, further validate its safety and potential effectiveness. Full article

Background: Graft-versus-host disease is the most common complication after allogeneic hematopoietic stem cell transplantation. While ocular graft-versus-host disease typically manifests as dry eye syndrome and anterior segment involvement, posterior segment complications are rare. Previously reported posterior segment complications in graft-versus-host disease have been limited to acute presentations with significant functional visual impairment. Methods: A 41-year-old man developed progressive retinal nerve fiber layer and ganglion cell layer loss four years after allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia. The patient had established chronic graft-versus-host disease with cutaneous involvement and ocular surface disease. Results: Despite preserved visual acuity and visual fields, and only subtle functional involvement on visual evoked potentials, optical coherence tomography revealed significant reduction in retinal nerve fiber layer thickness and ganglion cell layer. Magnetic resonance imaging showed no optic nerve or brain abnormalities. Conclusions: This case describes an uncommon presentation of chronic, subclinical posterior segment involvement in chronic GVHD and suggests that optical coherence tomography may detect progressive structural retinal changes in the absence of clinically evident visual impairment, supporting its potential role in longitudinal monitoring. Full article

Background: Accurate evaluation of the Near Point of Convergence (NPC) is essential for diagnosing and managing convergence insufficiency (CI). Conventional assessment relies on the patient’s verbal feedback and the examiner’s visual observation, making it subjective and examiner-dependent. The AI-based MobileS platform, previously validated for both diagnosis and home-based therapy of CI, enables smartphone-based measurement and visualisation of NPC through eye tracking, without the need for verbal responses or additional equipment. This study, the third stage of our research programme, examined how ophthalmologists interpret NPC data when presented as videos versus AI-derived graphs. Methods: Twenty-two ophthalmologists completed an online questionnaire with 20 NPC test cases from the validated MobileS database, presented as both silent videos and AI-derived graphs. Accuracy was analysed using mixed-effects logistic regression, and continuous error was assessed using clustered bootstrap. Results: Graph-based interpretation showed higher odds of accurate NPC identification than video-based interpretation at the primary ±5 mm threshold (OR = 19.7, 95% CI: 13.50–28.74; p < 0.0001). Absolute error was lower for graphs than videos (Graphs − Videos: −22.73 mm; 95% CI: −26.88 to −18.59; p < 0.0001). “Uncertain” responses occurred in 28.2% of video-based assessments and 0% of graph-based assessments. Off-target errors decreased from 50.2% (videos) to 3.6% (graphs). Conclusions: AI-derived graphs of eye-movement data were associated with improved NPC estimation, suggesting a potential role in supporting clinical and tele-ophthalmology workflows. Full article