Search Results (11)

Background/Objectives: This study aimed to characterize eyelid speculum-induced intraocular pressure (IOP) elevation during cataract surgery and identify ocular biometric factors that stratify susceptibility to this pressure response. This study was conducted at Zengyo Suzuki Eye Clinic, Kanagawa, Japan. Methods: In this retrospective observational study, we analyzed 100 eyes that underwent routine cataract surgery. IOP was measured immediately before and within 10 s of speculum opening in the seated position using a rebound tonometer. The eyelid speculum was opened to a maximal opening position, and the opening width was recorded. Biometric parameters included axial length (AL), central corneal thickness, white-to-white distance, anterior chamber depth, and temporal angle-opening distance. Associations between IOP elevation and biometric factors were analyzed. IOP elevation rate was quantified as the percentage increase from baseline. The discriminatory performance of axial length was evaluated using receiver operating characteristic (ROC) analysis. Results: Overall, 100 patients (100 eyes) were included in the analysis. Mean IOP increased significantly from 15.75 ± 2.77 mmHg before speculum placement to 21.42 ± 5.54 mmHg after placement. The mean IOP elevation rate was 36.0 ± 27.4%. Shorter AL was consistently associated with a greater proportional IOP elevation. ROC analysis demonstrated consistent stratification of IOP elevation susceptibility by AL (area under the curve [AUC] = 0.645), with eyes shorter than 23.84 mm showing greater pressure elevation (sensitivity, 73.1%; specificity, 56.0%). Eyes in the upper quartile of the IOP elevation rate exhibited relatively greater pressure elevation. Conclusions: Eyelid speculum placement imposes a clinically meaningful IOP load during cataract surgery, with shorter ALs making eyes more biomechanically susceptible to IOP elevation. Full article

Objectives: To develop an effective learning method for using a smartphone-based slit-lamp microscope (SBSL) and to identify key points to emphasize when coaching individuals with no prior SBSL experience. Methods: This study included 60 orthoptic students: 40 second-year students (control group: 20, training group 1: 20) and 20 first-year students (training group 2). Subjects were instructed to record the anterior eye segment of a patient-role subject using the Smart Eye Camera. The control group was given paper instruction and was shown the demonstration of the SBSL beforehand. In addition, training groups 1 and 2 watched a tutorial video, practiced using the SBSL for 30 min, and received guidance from an expert. Four ophthalmologists evaluated the recordings based on the eyelid, conjunctiva, cornea, pupil including iris, lens, and anterior chamber depth. Results: ANOVAs showed significant differences among groups for all items. The control group had significantly lower scores than both training groups, while no significant differences were found between training groups 1 and 2. Principal component analysis of training groups 1 and 2 showed that the first principal component accounted for 74.36% of the variance. The second principal component accounted for 10.71%, with a wide range of loadings (anterior chamber depth of 0.7780 to conjunctiva of −0.5585), implying the existence of different favorite focusing depths within subjects. Conclusions: A coaching program consisting of tutorial video learning, a 30 min hands-on trial, and feedback is effective in helping individuals without an ophthalmological background acquire anterior segment imaging skills using SBSL. Comprehensive focusing across the entire anterior segment should also be emphasized. Full article

This study aimed to comprehensively review surgical interventions for ocular surface diseases (OSDs), including dry eye syndrome (DES), exposure keratopathy, Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and ocular graft versus host disease (oGVHD), and to highlight the indications, contraindications, outcomes, and complications of various oculoplastic procedures used in their management. A narrative review was performed based on expert-guided selection of relevant studies retrieved from PubMed, Scopus, and Web of Science. Relevant keywords included “ocular surface disease”, “dry eye syndrome”, “exposure keratopathy”, “thyroid eye disease (TED)”, “neurotrophic keratopathy (NK)”, “Stevens-Johnson syndrome”, “toxic epidermal necrolysis”, “punctal occlusion”, “tarsorrhaphy”, “botulinum toxin”, “eyelid loading”, “retractor weakening”, “corneal neurotization (CN)”, “amniotic membrane transplantation (AMT)”, “conjunctival flap”, “ocular graft versus host disease”, and “salivary gland transplantation (SGT)”. Studies addressing surgical approaches for OSDs were included. In conclusion, surgical options for OSDs offer significant benefits when non-invasive treatments fail. Surgical techniques such as punctal occlusion, eyelid fissure narrowing, AMT, and conjunctival flap procedures help stabilize the ocular surface and alleviate symptoms. Advanced methods like CN and SGT target the underlying pathology in refractory cases such as oGVHD. The outcomes vary depending on the disease severity and surgical approach. Each procedure carries specific risks and requires individualized patient selection. Therefore, a tailored approach based on clinical condition, anatomical involvement, and patient factors is essential to achieve optimal results. Ongoing innovations in reconstructive surgery and regenerative medicine are expected to further improve outcomes for patients with OSDs. Full article

Background: Incomplete eyelid closure and lagophthalmos due to facial nerve palsy are significant functional and aesthetic concerns often requiring surgical correction. The aim of this systematic review is to quantitatively assess the efficacy, safety, and patient satisfaction associated with gold or platinum weight implantation, autologous fat grafting (lipofilling), and müllerectomy. Methods: A systematic review was performed following PRISMA guidelines, searching PubMed, Embase, Cochrane Library, Web of Science, and Scopus up to March 2025. Studies included clinical data on surgical correction for incomplete eyelid closure in facial palsy, reporting functional, anatomical, and satisfaction outcomes. Quality was assessed using the Newcastle–Ottawa Scale (NOS) and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Results: Twenty-six studies including a total of 1205 patients were included. Gold/platinum weight implantation achieved complete or near-complete eyelid closure in 83–92% of cases, with a reduction in lagophthalmos to <1 mm. Complication rates ranged from 5–15% (mainly extrusion/migration), and patient satisfaction averaged 7.9/10. Lipofilling showed persistent benefit in 77% of cases, with 9–20% requiring repeat procedures and 10–12% experiencing minor complications. Müllerectomy yielded symptomatic improvement or resolution in 92% of cases, with a mean lagophthalmos reduction of 1.18 mm. Conclusions: Gold or platinum weight implantation provides the most reliable improvement for severe upper eyelid dysfunction in facial palsy. Lipofilling is a viable autologous alternative, while müllerectomy is effective in selected cases. Further prospective comparative trials are needed to refine surgical selection and optimize outcomes. Full article

The recommendations for the wear and hygiene of ocular prostheses can vary among practitioners, and it is still a controversial theme in the literature. This clinical trial evaluated the microbial load, tissue health of the socket, and the participants’ opinions before and after the use of two hygiene protocols. Thirty ocular prosthesis wearers used either a Daily Protocol (DPt: hygiene once a day) or Weekly Protocol (WPt: hygiene once a week) for 5 weeks with a washout of 7 days. The microbial load was quantified by the colony-forming unit count of the aerobic bacteria, Candida spp., Staphylococcus spp., and Gram-negative bacteria. The tissue health of the socket was evaluated by scores, and patients’ opinion of the protocols was evaluated using the analogic visual scale (VAS). Data were analyzed by ANOVA Repeated Measures, Friedman, Cochran’s Q Test, Wilcoxon, Fisher, and Pearson’s chi-square tests considering p < 0.05. There was no difference in the microbial load of the microorganisms (p > 0.05). Both protocols improved socket inflammation (p = 0.005) and discharge (p < 0.001); DPt improved edema (p = 0.021) and crusting (p = 0.020). There was no difference in patients’ rating responses (VAS) for all the questions of patients’ opinion (Q1: p = 1.0; Q2: p = 1.0; Q3: p = 1.0; Q4: p = 1.0; Q5: p = 1.0; Q6: p = 0.317; Q7: p = 1.0; Q8: p = 0.159). There was a correlation between eye drops/edema (p = 0.030), eye drops/pain (p = 0.016), microbial load with discharge, inflammation, eyelid edema, and pain. Inflammation was correlated with edema at baseline (p < 0.001) and after DPt (p = 0.018), and with crusting at baseline (p = 0.003); edema was correlated with crusting at baseline (p < 0.001); crusting was correlated with discharge after WPt (p < 0.001). The protocols showed no effects on the microbial load of the anophthalmic socket and ocular prosthesis. However, better tissue health and patient acceptance were observed after both regimens. Full article

Transport is a stressor that can cause physiological and metabolic imbalances in livestock, resulting in stress-induced hyperthermia. In water buffaloes, studies regarding the thermal state of animals during mobilization are scarce. Therefore, this study aimed to compare the thermal response of 1516 water buffaloes using infrared thermography (IRT) during 15 short trips (783 animals, 60,291 records, average duration = 50.33 min ± 5.48 min) and 14 long trips (733 animals, 56,441 records, average duration = 13.31 h ± 47.32 min). The surface temperature was assessed in 11 regions (periocular, lacrimal caruncle, nasal, lower eyelid, auricular, frontal-parietal, pelvic limb, torso, abdominal, lumbar, and thoracic) during seven phases from pasture to post-transport. It was found that the surface temperature of the periocular, lacrimal caruncle, nasal, auricular, frontal-parietal, pelvic limb, torso, abdominal, lumbar, and thoracic regions was significantly higher during SJs (+3 °C) when compared to LJs (p < 0.0001). In particular, the frontal-parietal region had a significant increase of 10 °C during the post-transport phase (p < 0.0001) in both groups, recording the highest temperatures during this phase. Likewise, a strong positive significant correlation between the different regions was found (r = 0.90, p < 0.0001). It is worth mentioning that the herding, loading, pre-, and post-transport phases were the ones where the greatest thermal response was recorded, possibly due to the influence of human interaction. Finally, a strong positive correlation (r above 0.9, p > 0.001) between the periocular, lacrimal caruncle, pinna, and pelvic limb was found. According to the results, SJ could be considered a stressful event that hinders thermal generation, contrarily to LJ. Full article

In response to the problem of high computational and parameter requirements of fatigued-driving detection models, as well as weak facial-feature keypoint extraction capability, this paper proposes a lightweight and real-time fatigued-driving detection model based on an improved YOLOv5s and Attention Mesh 3D keypoint extraction method. The main strategies are as follows: (1) Using Shufflenetv2_BD to reconstruct the Backbone network to reduce parameter complexity and computational load. (2) Introducing and improving the fusion method of the Cross-scale Aggregation Module (CAM) between the Backbone and Neck networks to reduce information loss in shallow features of closed-eyes and closed-mouth categories. (3) Building a lightweight Context Information Fusion Module by combining the Efficient Multi-Scale Module (EAM) and Depthwise Over-Parameterized Convolution (DoConv) to enhance the Neck network’s ability to extract facial features. (4) Redefining the loss function using Wise-IoU (WIoU) to accelerate model convergence. Finally, the fatigued-driving detection model is constructed by combining the classification detection results with the thresholds of continuous closed-eye frames, continuous yawning frames, and PERCLOS (Percentage of Eyelid Closure over the Pupil over Time) of eyes and mouth. Under the premise that the number of parameters and the size of the baseline model are reduced by 58% and 56.3%, respectively, and the floating point computation is only 5.9 GFLOPs, the average accuracy of the baseline model is increased by 1%, and the Fatigued-recognition rate is 96.3%, which proves that the proposed algorithm can achieve accurate and stable real-time detection while lightweight. It provides strong support for the lightweight deployment of vehicle terminals. Full article

The bat skin mites from the closely-related Demodecidae and Psorergatidae families occur synhospitally, populating the same host species and perhaps neighboring microhabitats. However, data on their occurrence and parasitism are fragmentary and dispersed. Thus far, 27 Demodecidae and 18 Psorergatidae species have been described, but the coexistence of mites from both families was only demonstrated in six species of bats. This article presents a description of Demodex pusillus sp. nov. from Nyctalus noctula, including a new host record (first observation of demodecid mites in Nyctalus) and a new record concerning the occurrence of Psorergatoides kerivoluae in Plecotus auritus. It also includes an updated global checklist of the occurrence of Demodecidae and Psorergatidae in Chiroptera, including data on their records/distribution and location in their hosts. In both studied families, the mites exhibit preferences, and even topographic specificity, colonizing different microhabitats in the host, including the eye region (e.g., Meibomian glands of the eyes, corneal surface and eyelid vault), wing membranes and hairy skin on the body. Such colonization of separate microhabitats enables different species to co-occur within the same host, while the total number of parasites determines the level of parasite load, with higher levels being associated with the incidence of disease symptoms. It is worth mentioning that Demodex pusillus sp. nov. is the smallest known representative of the Demodecidae family and one of the smallest animals (70–80 micrometers in length). Full article

Analyses of meibography may help in the diagnosis, prevention, and management of meibomian gland dysfunction (MGD). However, there is currently a paucity of data regarding meibography analyses in the young elderly populations in the Nordic countries. In the current study, meibography of the upper and lower eyelids of 117 65-year-old residents in Oslo, Norway, who did not fulfil the diagnosis of dry eye disease (DED) were analysed. Meibomian gland (MG) dropout and tarsal areas were measured semi-automatically using ImageJ software. The relationship between morphological features of the MGs and clinical dry eye tests was examined. The median percent MG dropout was 26.1% and 40.7% in the upper and lower eyelids, respectively. There was no significant difference between males and females. None of the MG morphological parameters demonstrated significant values in discriminating abnormal dry eye symptom loads or MGD diagnosis from the normal loads. We therefore concluded that moderate MG atrophy was common among the Norwegian population of 65-year-olds without DED and showed no sexual differences. Meibography alone cannot discriminate MGD from non-MGD; thus, both morphological and functional MG tests are necessary when screening for MGD. Full article

Implantation of gold weights into the upper eyelid is a proven method of treating lagophthalmos and exposure keratopathy in patients with unresolved facial nerve palsy. The aim of this study was to evaluate the factors affecting visual acuity and corneal complications in patients after upper eyelid gold weight lid loading. Material and methods: This prospective consecutive clinical study was conducted in years 2012–2018. In total, 59 people (40 women, 19 men aged 55.5 ± 17.4 years) meeting the inclusion criteria were treated with gold weights. The ordered multinomial logit model was used to analyze the factors affecting best-corrected visual acuity (BCVA) and degree of exposure keratopathy after surgery. The influence of the following variables was analyzed: patient age, etiology and duration of the facial nerve palsy, history of the previous eyelid surgery, degree of lagophthalmos in mm, presence of Bell’s phenomenon, and corneal sensation, Schirmer test results. Results: Implantation of gold weights into the upper eyelid effectively reduced lagophthalmos and exposure keratopathy in the study group (p < 0.001). BCVA was maintained or better in 95% of patients after surgery. Patient age, presence of the Bell’s phenomenon, and corneal sensation significantly affected the final BCVA (p < 0.1). The presence of Bell’s phenomenon and corneal sensation had a positive effect on the degree of keratopathy after surgery (p < 0.1). In turn, patient age and history of tarsorrhaphy were significant negative prognostic factors of exposure keratopathy and BCVA after surgery (p < 0.05). Etiology and duration of facial nerve palsy, degree of corneal exposure in mm, and results of the Schirmer test did not have a significant impact on the outcome after surgery (p > 0.1). Conclusions: The results of our study may help to answer the question of how to direct ophthalmologists and other specialists who refer to ophthalmologists for management advice in patients with facial nerve palsy. Elderly patients with a history of tarsorrhaphy who present with poor Bell’s phenomenon and/or a lack of corneal sensation should be the first candidates for immediate correction of lagophthalmos. Full article

Staphylococcus aureus is a major pathogen of the eye able to infect the tear duct, eyelid, conjunctiva, cornea, anterior and posterior chambers, and the vitreous chamber. Of these infections, those involving the cornea (keratitis) or the inner chambers of the eye (endophthalmitis) are the most threatening because of their potential to cause a loss in visual acuity or even blindness. Each of these ocular sites is protected by the constitutive expression of a variety of antimicrobial factors and these defenses are augmented by a protective host response to the organism. Such infections often involve a predisposing factor that weakens the defenses, such as the use of contact lenses prior to the development of bacterial keratitis or, for endophthalmitis, the trauma caused by cataract surgery or intravitreal injection. The structural carbohydrates of the bacterial surface induce an inflammatory response able to reduce the bacterial load, but contribute to the tissue damage. A variety of bacterial secreted proteins including alpha-toxin, beta-toxin, gamma-toxin, Panton-Valentine leukocidin and other two-component leukocidins mediate tissue damage and contribute to the induction of the inflammatory response. Quantitative animal models of keratitis and endophthalmitis have provided insights into the S. aureus virulence and host factors active in limiting such infections. Full article