J. Clin. Transl. Ophthalmol., Volume 4, Issue 3 (September 2026) – 6 articles

Despite a growing range of effective monotherapies for childhood myopia control, a subset of children continues to show suboptimal control, prompting interest in combination therapy. This narrative mini-review summarises recent evidence on combining pharmacological, optical, and device-based treatments to slow myopia progression, with emphasis on axial length (AL) as the benchmark of efficacy. The most studied combination is low-dose atropine plus orthokeratology (OK), with multiple studies and meta-analyses reporting greater slowing of AL elongation than OK alone, particularly in younger children and faster progressors. Emerging evidence supports combining low-dose atropine with other refractive interventions, such as defocus-incorporated multisegment (DIMS) and highly aspherical lenslets (HALs), and dual-focus soft contact lenses, although findings vary by study design, atropine dose, and cohort characteristics. Repeated low-level red light (RLRL) therapy combined with OK or DIMS spectacles has also shown improved AL outcomes in some studies, but retinal safety signals and rebound after cessation require careful monitoring. Combination therapy may be most appropriate for fast progressors, notably those with greater than 0.2 mm over 12 months or for inadequate responders to monotherapy, with stepwise escalation guided by AL response, safety, and adherence. Further long-term, randomised trials with standardised endpoints and responder definitions are needed. Full article

Peripheral exudative hemorrhagic chorioretinopathy (PEHCR) is an uncommon but likely underrecognized degenerative retinal disorder characterized by peripheral subretinal and sub-retinal pigment epithelium hemorrhagic and exudative lesions, predominantly affecting elderly individuals. The condition frequently mimics choroidal melanoma and other peripheral retinal diseases, often resulting in diagnostic uncertainty and occasionally unnecessary invasive procedures. Recent advances in multimodal imaging have substantially improved the recognition and characterization of PEHCR, suggesting possible associations with polypoidal choroidal vasculopathy and the pachychoroid disease spectrum. A narrative literature review was performed using PubMed/MEDLINE, Scopus, Embase, and Web of Science. Original studies, retrospective case series, multimodal imaging reports, and relevant review articles published in English were included according to their relevance to PEHCR epidemiology, imaging, pathogenesis, differential diagnosis, and treatment. Particular attention was devoted to recent developments in ultra-widefield imaging, optical coherence tomography, indocyanine green angiography, and optical coherence tomography angiography. PEHCR typically presents with peripheral subretinal hemorrhage, exudation, pigment epithelial detachments, and occasionally vitreous hemorrhage. Multimodal imaging, particularly ultra-widefield imaging and ICGA, has substantially improved the diagnosis of PEHCR and supports its relationship with the pachychoroid-PCV spectrum. Although many patients can be managed conservatively, individualized treatment based on lesion activity remains essential, while prospective studies are needed to establish evidence-based management strategies. Full article

Background/Aims: This study set out to compare patient experiences and attitudes toward virtual reality (VR) versus in-office ophthalmic functional testing, as well as their eye exam visit preferences. Methods: A total of 64 patients undergoing a comparative clinical trial including VR and in-office versions of 24-2 visual field perimetry, Pelli–Robson contrast sensitivity, ETDRS visual acuity, Ishihara plates, and Amsler Grid tests were given a survey that included Likert-scaled questions regarding overall experience, speed, and comfort of broad VR testing versus in-office tests, as well as binary modality preference, like or dislike of various exam modality aspects, ease of understanding each test, distance traveled to their appointment, visit frequency, and remote care preferences. Results: In terms of overall experience, 59 (93.7%) participants rated VR as “Liked” or “Very Much Liked” compared to 38 (60.3%) for in-office tests (χ² p < 0.0001). Regarding comfort, 59 (93.7%) and 38 (60.3%) participants at least “Liked” VR and in-office tests, respectively (χ² p < 0.0001). For speed, 60 (95.2%) and 36 (57.1%) participants at least “Liked” VR and in-office tests, respectively (χ² p < 0.0001). Accordingly, 11 (17.5%) patients liked all aspects of in-office tests, while 54 (85.7%) patients said the same for VR (χ² p < 0.0001). Overall, 33 (52.4%) patients disliked something about in-office tests, while 20 (31.7%) said the same for VR (χ² p < 0.0001). There were no differences in ability to understand tests between the two modalities. We noted a variable distribution of distance traveled and visits per year in our population, yet there was also a strong preference for implementing more remote eye testing options. Conclusions: Development and implementation of virtual reality analogs to in-office, functional ophthalmic exams can improve patient experience and facilitate remote care delivery. Full article

Background: Potential vision rehabilitation in patients with hypotony and pre-phthisis remains one of the most challenging issues of ophthalmology. Boston type I keratoprosthesis (KPro) combined with pars plana vitrectomy (PPV) and silicone oil injection (SOI) represents a potential approach to this problem in patients believed to have recoverable vision. This study presents a case series of three patients who underwent Boston type I KPro implantation with simultaneous silicone oil tamponade at our center. Methods: We retrospectively reviewed medical records of three patients with prephthisical changes who underwent Boston type I KPro and PPV/SOI. Preoperative and postoperative visual acuity (VA), anatomical stability, and postoperative complications were assessed over a follow-up period. Three eyes of three patients were included. All eyes had severe corneal pathology with sufficient wet surface. Two of three eyes had corneal decompensation secondary to intraocular inflammation, one eye had penetrating trauma-related corneal scarring. All three eyes underwent simultaneous KPro implantation with combined PPV/SOI. Results: Postoperatively, all eyes demonstrated improvement in best-corrected visual acuity (BCVA) from hand motion (HM) to 20/1000, with final BCVA ranging from counting fingers at 2 feet (CF2) to 20/150 and no evidence of progressive phthisical changes over a follow-up period of 23–66 months. Conclusions: Boston type I KPro implantation combined with PPV/SOI can be a viable approach for preserving anatomical integrity and improving visual function in patients with prephthisical eyes and perceived recoverable-vision potential. Full article

Background: Lateral eye movements are part of natural ocular motility, and their effect on tear film behavior is largely unknown because they are usually not evaluated during tear film examinations, where patients are required to look straight ahead. This study aimed to determine what happens to the tear film during lateral eye movements in the absence of blinking. Methods: Tear film dynamics during a sequence of open-eye lateral gaze maneuvers were recorded using an infrared camera system (TearView). Results: The study included 15 healthy participants (5 female; median age 26) who had no ocular surface-related complaints. It was observed that lateral eye movements exposed new ocular surface areas not previously covered by the tear film. The tear film margins reacted to lateral eye movements by spreading towards the newly uncovered ocular surface areas, thereby recoating them. This response was asymmetrical, with a tear reservoir in the lacus lacrimalis of the medial canthus providing additional tear film spread only during ocular abduction. Conclusions: These findings expand our understanding of tear film physiology beyond static gaze. They might also bear implications for dry eye disease and oculoplastic surgical techniques affecting the medial canthus. Full article

Background: Faricimab is one of the most potent anti-vascular endothelial growth factors used in the management of diabetic macular edema (DME). However, real-world benefits regarding its timing and efficacy are still being explored. Methods: This retrospective non-randomized pilot study aimed to evaluate the efficacy of intravitreal faricimab in the treatment of DME. Eyes initially treatment-naïve for DME with a follow-up of 1 year were grouped as: group 1, where faricimab was introduced within the first six months after the start of treatment; group 2, where it was initiated six or more months after treatment with other drugs. Study parameters included changes in best corrected visual acuity (BCVA) and optical coherence tomography based structural parameters within the 6 × 6 mm optical coherence tomography (OCT) scan regions. Results: Forty-two eyes from 26 patients were analyzed. No statistically significant differences were observed between the groups in cluster-weighted proportions of intra- or sub-retinal fluid, retinal thickness or volume parameters, although group 1 showed modest numerical benefits. SRF showed a trend towards qualitative reduction in group 1, although IRF showed persistence in both groups. Adjusted linear mixed-effects modeling demonstrated no significant impact of early faricimab initiation on functional and anatomical outcomes, which appeared to be influenced by the baseline BCVA, glycemic control, and the number of injections, nullifying the benefits. Conclusions: Faricimab demonstrated modest anatomical improvements with earlier treatment in eyes initially treatment-naïve for DME. Further prospective studies are indicated to assess the treatment strategy and the timing of introduction with faricimab in such eyes. Full article