Search Results (124)

Dry eye disease (DED) is a complex, multifactorial, progressive disease that has consequences both for individuals and society. Symptoms reported by patients include discomfort in the eye and periodic blurred vision, while in the broader perspective, the disease is associated with economic burdens and challenges for healthcare systems. Globally, dry eye disease remains a growing problem observed in many countries. It is estimated that symptoms of dry eye syndrome occur in approximately 10 to 20 per cent of people over the age of 40. This prevalence is on the rise, which is associated with both the aging population and increased incidence among younger adults. In this group, factors such as contact lens wear and prolonged use of digital devices are considered to be contributing factors. Further epidemiological studies, conducted in different regions of the world, covering diverse populations and a wide range of age groups, with a particular focus on younger cohorts, may contribute to a more accurate understanding of the prevalence of dry eye disease. There are more and more methods of diagnosing DED. In addition to well-known procedures like the Schirmer test or tear break-up time, there are also methods that focus on the evaluation of the tear film or imaging of the ocular surface. Moreover, usage of artificial intelligence is also playing a significant role in it. However, the key issue in individual cases is introducing the most effective treatment based on combining available substances, including corticosteroids, antibiotics and supplements, which leads to a reduction in inflammation and improvement in visual comfort. Full article

Background/Objectives: Hemangioblastomas are rare, benign, highly vascular tumors of the central nervous system, frequently associated with von Hippel–Lindau (vHL) disease. Case Presentation: We report a 16-year-old female with vHL presenting with recurrent headaches, abdominal distension, and ocular discomfort. Imaging revealed hemangioblastomas in the fourth ventricle and retrobulbar space, alongside multiple pancreatic cysts. The patient underwent three sessions of Gamma Knife Surgery (GKS) with initial tumor regression and symptom relief. However, long-term follow-up demonstrated progressive disease, with new lesions in the cerebellum, spinal cord, and orbit, including cystic transformation. Histopathology confirmed the reticular variant of hemangioblastoma. Despite further radiosurgical and surgical recommendations, the patient and family opted for conservative management, with lesions remaining radiographically stable over nine years. Conclusions: This case demonstrates that Gamma Knife Surgery may provide temporary local disease control for selected solid hemangioblastomas in von Hippel–Lindau disease but does not alter the underlying disease course. Long-term radiographic stability should be interpreted cautiously, as hemangioblastomas exhibit saltatory growth patterns that make it difficult to distinguish treatment effect from natural tumor quiescence. These findings emphasize that radiosurgery should be regarded as a disease-control strategy rather than curative therapy, underscoring the importance of individualized management, multidisciplinary decision-making, and prolonged surveillance. Full article

Background: Chronic work-related stress, including exposure to mobbing, is associated with a wide range of psychological and somatic consequences. However, its potential impact on visual function, particularly in the absence of structural ocular damage, remains underexplored. This narrative review critically examines the evidence linking chronic stress, autonomic nervous system (ANS) dysregulation, and functional visual disorders, focusing on accommodative function and asthenopia. Methods: A qualitative narrative review of the literature published between 2000 and 2025 was conducted using major biomedical databases. Studies addressing chronic stress, ANS activity, accommodative function, digital eye strain, and functional ocular symptoms were identified and integrated into a coherent pathophysiological framework. Results: The ocular system, being richly innervated by the ANS, may represent a peripheral target of prolonged stress-related autonomic alterations. Available evidence suggests that chronic stress is associated with asthenopia, accommodative inefficiency, and ocular discomfort even in the absence of overt ocular pathology. In particular, altered parasympathetic control of the ciliary muscle emerges as a plausible mediating mechanism. Conclusions: Functional visual disorders may represent peripheral manifestations of stress-related ANS dysregulation. Although causality cannot be established conclusively, the proposed framework supports the need for multidisciplinary research to clarify the clinical and medico-legal relevance of stress-related visual dysfunction. Full article

Presbyopia-correcting IOLs have revolutionized cataract surgery by enabling functional vision across multiple focal distances, thereby reducing dependence on spectacles. These lenses—ranging from multifocal to extended depth-of-focus (EDOF) and hybrid designs—incorporate advanced optical technologies to address the limitations of traditional monofocal IOLs. Despite their clinical promise, patient satisfaction remains variable, with a substantial subset experiencing postoperative visual discomfort. This review provides a comprehensive overview of presbyopia-correcting IOL technologies, detailing their optical principles, design evolution, and clinical performance. It further analyzes the multifactorial causes of postoperative dissatisfaction, which include optical phenomena such as glare, halos, and reduced contrast sensitivity; ocular comorbidities like dry eye disease, corneal irregular astigmatism, glaucoma, and macular pathology; and surgical variables including IOL centration, pupil size, and biometry accuracy. Additionally, non-physiological factors—such as patient expectations, lifestyle demands, and psychological disposition—play a critical role in perceived outcomes. To address these challenges, the review explores evidence-based strategies for improving satisfaction. These include rigorous preoperative screening for ocular surface disease and aberrations, personalized lens selection based on anatomical and functional criteria, and thorough patient counseling to align expectations with achievable results. Emerging IOL designs that blend multifocal and EDOF features offer promising avenues for minimizing visual disturbances while preserving range of vision. By integrating optical innovation with individualized clinical care, ophthalmologists can enhance postoperative outcomes and optimize real-world satisfaction with presbyopia-correcting IOLs. Full article

The aim of this study was to evaluate the performance and safety of T2769 (Thealoz^® Total), a preservative-free eye drop combining 0.15% sodium hyaluronate, 3% trehalose, and 2.45% N-acetylaspartyl-glutamate (NAAGA), in contact lens wearers with dry eye symptoms and discomfort. This prospective, single-arm investigation enrolled 34 adult contact lens wearers with Ocular Surface Disease Index (OSDI) scores ≥ 18 and Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8) scores ≥ 12. Patients instilled one drop of T2769 three to six times daily for 36 days. Performance assessments included CLDEQ-8, ocular discomfort and symptoms, OSDI, soothing sensation, and ocular signs. Safety assessments included adverse events (AEs), far BCVA, and ocular tolerance. CLDEQ-8 improved from the baseline at Day 36 (−12.6 ± 5.0; p < 0.001) and as early as D15, with similar improvements in ocular discomfort, OSDI, and total symptom score. Soothing sensation was judged important by 79.4% of patients at D36. Ocular surface staining, tear break-up time, and the Schirmer test improved at D15 and D36, while conjunctival hyperaemia improved in 82.4% of patients at D36. Two non-serious treatment-related AEs (photophobia and blurred vision) occurred in one patient. BCVA was unchanged, and tolerance was rated very satisfactory/satisfactory. In conclusion, T2769 was safe and effective for reducing contact lens-associated dry eyes and discomfort. Full article

Background/Objectives: Poor adherence remains a key challenge in glaucoma management, often due to difficulties with accurate self-administration and discomfort associated with conventional eye drop bottles. MistGo^® is a novel dispensing device that delivers precise micro-doses of medication as a fine mist, allowing dosing with a neutral head position. With its ergonomic design, eye rest, and dose release button, MistGo^® aims to improve comfort and ease of use. This study compared the user-friendliness, comfort, and administration confidence of MistGo^® versus conventional eye drop dispensers in patients using topical ocular hypotensive medications. Methods: Twenty-two patients with glaucoma or ocular hypertension who had used conventional eye drop dispensers for ≥3 months were enrolled. Participants used the MistGo^® device for 14 days and subsequently rated comfort, user-friendliness, and administration confidence on 0–10 scales for both their conventional dispensers and the MistGo^® device. Results: MistGo^® was rated significantly higher than conventional eye drop dispensers in terms of comfort (p < 0.0001), caused less discomfort from excess fluid (p < 0.001), and was perceived as more user-friendly (p < 0.001). There was no significant difference in the perceived accuracy of administration (p = 0.5); however, participants reported a significantly lower likelihood of medication being applied outside the eye when using MistGo^® (p < 0.001). Overall, 20 out of 22 patients preferred MistGo^®. Conclusions: Patients with glaucoma or ocular hypertension preferred MistGo^® over conventional eye drop dispensers as they found it more comfortable and user-friendly. These findings suggest that MistGo^® has the potential to reduce barriers to adherence in glaucoma care. Further studies are warranted to evaluate its long-term efficacy and broader applicability. Full article

When an orthokeratology (ortho-k) lens contacts the ocular surface, tear film components such as lipids and proteins rapidly adsorb onto the lens, which may increase friction and contribute to discomfort if not properly removed. Polysaccharides have been reported to reduce protein deposition and improve lubrication, prompting the investigation of alginate acid and lambda-carrageenan in modulating the tribological properties of ortho-k lenses. An in vitro tribological property analysis of ortho-k lenses and protein adsorption and desorption analyses were carried out to investigate the lubricating ability of alginate acid and carrageenan. Zeta potential and turbidity analyses were further conducted to examine potential interactions between polysaccharides and tear film proteins. Tear film proteins significantly increased the friction coefficient of the ortho-k lens, whereas the addition of alginate acid and carrageenan markedly reduced friction. Electrostatic interaction and polysaccharide–protein complex formation were identified as possible mechanisms underlying these effects. These results demonstrate that alginate acid and carrageenan can modify the tribological and interfacial behavior of ortho-k lenses in protein-rich environments, suggesting their potential application in reducing friction-related complications in ortho-k lens wearers. Full article

Gulf War Illness (GWI) is a chronic multi-symptom condition affecting veterans of the 1990–1991 Gulf War, with ocular discomfort increasingly recognized among its manifestations. This pilot study evaluated whether lipid alterations in tears and plasma could serve as potential biomarkers of GWI. Participants included Gulf War-era veterans seen in the Miami Veterans Affairs Hospital eye clinic from 2018–2022. Cases met GWI criteria, while controls were non-deployed, age- and gender-matched veterans without GWI. Participants completed systemic and ocular symptom questionnaires, and lipidomic profiling of tears and plasma quantified sphingolipids and eicosanoids. Compared to controls (n = 21), GWI cases (n = 19) reported greater ocular symptom burden, while ocular signs were similar between groups. Lipidomic analyses revealed increased tear eicosanoids ((±)14(15)-EET and (±)8(9)-EET), elevated plasma sphingomyelins (SM C16:0 DH, SM C20:0, SM C22:0), and reduced plasma monohexosylceramide (MHC C16:0) and sphingomyelin (SM C14:0) in cases. Logistic regression and random forest models identified plasma SM C16:0 DH and SM C20:0 as top predictors distinguishing GWI cases from controls, with an area under the receiver operating characteristic curve (AUC) of 0.89. These findings suggest lipid dysregulation in ocular and systemic compartments and support further investigation of tears as a minimally invasive source for biomarker discovery. Full article

Background: Type 2 diabetes mellitus (T2DM) is increasingly recognized as affecting not only the retina but also the ocular surface. Chronic hyperglycemia can disrupt meibomian gland function, reduce tear secretion, and impair corneal sensitivity, leading to tear film instability and symptoms of dry eye disease. However, previous studies have reported variable findings, and the extent of these alterations remains uncertain. Methods: Following PRISMA guidelines, this systematic review and meta-analysis evaluated observational studies that compared tear film parameters between adults with T2DM and non-diabetic controls. Eligible studies assessed one or more of the following: invasive or non-invasive tear break-up time, Schirmer test, tear meniscus height, or Ocular Surface Disease Index (OSDI). Results: Twenty-four studies involving approximately 3500 eyes were included. Most reported significantly reduced tear stability and secretion in diabetic participants compared with controls. Tear break-up times were consistently shorter in T2DM, indicating a less stable tear film. Schirmer test results demonstrated lower tear production correlated with diabetes duration and poor glycemic control. Tear meniscus height was modestly reduced in T2DM, reflecting decreased tear reservoir volume. Subjective symptoms, as measured by OSDI, were generally higher among patients with T2DM, suggesting greater ocular surface discomfort. Conclusions: T2DM is strongly associated with tear film instability, reduced tear secretion, and increased dry eye symptoms. These findings suggest that diabetic care should include routine ocular surface assessment and highlight the need for standardized, longitudinal investigations. Full article

Hyaluronic acid (HA) fillers represent the most frequently performed minimally invasive procedures for facial rejuvenation, yet their overall safety profile is critically influenced by the cross-linking technology employed. Polyethylene glycol diglycidyl ether (PEGDE) has recently been introduced as an alternative to 1,4-butanediol diglycidyl ether (BDDE). The present prospective observational study was undertaken to evaluate the safety of a PEGDE-crosslinked HA filler for the correction of severe nasolabial folds. A total of 60 patients received bilateral injections of 1 mL per side and were monitored over a six-month period. Safety assessment included systematic documentation of adverse events and non-invasive biophysical and imaging techniques, specifically corneometry, sebumetry, and high-frequency ultrasound (HFUS). The treatment was well tolerated: 15% of patients reported only mild and transient adverse events, such as pain, swelling, bruising, or discomfort, while no serious adverse events, vascular compromise, or ocular complications were observed. Corneometry demonstrated a statistically significant increase in cutaneous hydration, sebumetry confirmed stability of sebaceous activity, and HFUS documented correct placement, homogeneous distribution, and progressive integration of the filler without nodules or granulomatous reactions. These findings support the favorable short-term safety and local tolerance of PEGDE-crosslinked HA fillers in the treatment of severe nasolabial folds. Full article

Background: The purpose of this study was to assess differences in clinical symptoms and signs of DED in non-adherent to treatment patients to describe long-term disease progression. Methods: 120 patients previously diagnosed with Dry Eye Disease (DED) were contacted to undergo a second eye examination. The final included participants were classified into three groups based on when the second examination was scheduled: 4 years (Group 1; n = 33), 6 years (Group 2; n = 18) or 8 years (Group 3; n = 37) since the diagnostic visit. All included participants were classified as ‘non-adherent to DED treatment’, defined as patients who reported not following their prescribed DED therapy. In both examinations, Ocular Surface Disease Index (OSDI) questionnaire, tear film osmolarity, inter-eye osmolarity (osmolarity |OD-OS|), Fluorescein Break-Up Time (FBUT), Maximum Blink Interval (MBI) and corneal staining were evaluated. Results: OSDI score improved after 4 years of DED diagnosis (Group 1, mean difference close to 12 points, p < 0.001) and after 8 years (Group 3, mean difference of 9 points, p < 0.001), but remained stable after 6 years (Group 2, p = 0.328). Osmolarity worsened only after 6 years of DED diagnosis (Group 2, mean difference of 13.2 mOsm/L, p = 0.011), while osmolarity |OD–OS| showed no change (all p ≥ 0.231). FBUT values were stable across all groups (all p ≥ 0.265). MBI increased after 4 and 8 years of DED diagnosis (Groups 1 and 3, p ≤ 0.003), but not after 6 years (Group 2, p = 0.391). Corneal staining worsened after 8 years of DED diagnosis (Group 3, 0.55 points, p = 0.011), with no changes at 4 or 6 years (Groups 1 and 2, both p ≥ 0.318). Conclusions: In non-adherent DED patients, osmolarity |OD-OS| and tear film stability remain stable during the natural course of the disease, while ocular surface damage increases. However, the subjective symptomatology and the nociceptive blink reflex due to ocular discomfort decreased since the diagnostic visit. Full article

Objective: To evaluate the efficacy of lid wipes and tear substitutes, in addition to standard postoperative treatment, in alleviating signs and symptoms of ocular surface disease (OSD) following cataract surgery. Methods: Retrospective study on patients who underwent cataract surgery and received either standard postoperative treatment (topical antibiotics, corticosteroids, and nonsteroidal anti-inflammatory drugs) or the same regimen supplemented with lid wipes and tear substitutes. Preoperatively and one month postoperatively, symptoms were evaluated using the 5-item Dry Eye Questionnaire (DEQ-5) and the Ocular Surface Disease Index (OSDI), while noninvasive keratograph break-up time (NIKBUT), tear meniscus height (TMH), conjunctival hyperemia, and infrared meibography were measured by the Oculus Keratograph. Results: A total of 63 patients (mean age 75.1 ± 6.3 years) were analyzed. Patients receiving standard treatment showed no significant changes in OSDI (+2 ± 32.7; p = 0.859) or DEQ-5 scores (+1.7 ± 5.4; p = 0.204). Conversely, those receiving the adjunct of lid wipes and tear substitutes demonstrated significant improvement in OSDI scores (−19.4 ± 15.9; p < 0.0001), a trend toward improvement in DEQ-5 scores (−1.9 ± 5.5; p = 0.059), and a reduction in the meibography score of the inferior eyelid (−0.24 ± 0.60; p = 0.023). Intergroup comparisons showed significantly greater improvements in both OSDI and DEQ-5 scores in patients receiving treatment for the ocular surface. Multivariate regression analysis confirmed the association between the use of wipes and tear substitutes and improvements in OSDI (p = 0.010) and DEQ-5 scores (p = 0.015). No significant postoperative changes in objective OSD parameters were observed in either group. Conclusions: The addition of lid wipes and tear substitutes to the standard postoperative regimen significantly improved patient-reported symptoms of ocular discomfort after cataract surgery, while no significant changes were observed in objective signs of ocular surface disease. These findings support the routine use of lid wipes and tear substitutes as an effective strategy for managing postoperative ocular surface discomfort. Full article

Background: Dry eye disease is a multifactorial ocular surface disorder characterized by tear film instability, inflammation, and neurosensory abnormalities that can lead to corneal pain and discomfort. In this study, we evaluated the effects of specific eye drops for dry eyes on neuronal pain receptors to gain insight into the mechanisms underlying corneal nerve pain in patients with dry eyes using a primary cell culture model of murine trigeminal ganglion cells. Methods: Trigeminal ganglia were obtained from wild-type postnatal day 7–10 mice. Primary cultures were prepared using the cell suspension method. After culturing for one week, the cells were stained with neuron-specific anti-neuronal nuclei, polymodal nociceptor, and transient receptor potential vanilloid 1 (TRPV1) antibodies. The calcium ion probe Fura2-AM^® was added to cultured cells after 2 weeks of incubation. The effects of capsaicin alone, in combination with the TRPV1 antagonist AMG9810, and in the presence of components of commercially available eye drops (cyclosporine, diquafosol tetrasodium, or rebamipide) were evaluated by monitoring calcium signals. Results: Neural excitation and capsaicin-induced increase in fluorescence intensity ratio were suppressed by AMG9810, cyclosporine, and diquafosol tetrasodium, but not by rebamipide. Conclusions: Inhibition of cellular excitation by cyclosporine and diquafosol tetrasodium may underlie their clinical pain suppressive effects. The primary culture model described here may serve as a useful tool for future studies on corneal perception. Full article

Visual quality in the human eye depends on the integrity of ocular structures. Soft contact lenses interact directly with these structures and can also serve as an external source of straylight. The purpose of this study was to quantify changes in optical quality among habitual wearers of monthly disposable silicone hydrogel soft contact lenses (SCLs) by comparing retinal straylight with new versus month-old lenses. Retinal straylight was measured using a C-Quant straylight meter in 33 young adults (22.0 ± 1.4 years) wearing either comfilcon A (n = 17) or lotrafilcon B (n = 16) lenses. Measurements were first performed with month-old SCLs that had been worn for ≤4 h that day; after lens replacement and a 15 min adaptation period, measurements were repeated with new SCLs. The mean decimal logarithm of the straylight parameter, log(s), was significantly higher with month-old SCLs (0.97 ± 0.17) than with new SCLs (0.86 ± 0.15; paired t-test, p < 0.001), yielding an average increase of Δlog(s) = 0.11 ± 0.08. No significant difference was found between materials. Thirty-six percent of participants reported end-of-cycle visual discomfort. These findings indicate that monthly SCLs at the end of the replacement period can measurably increase retinal straylight. Full article