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Simultaneously occurring bilateral herpetic keratitis is a rare clinical manifestation of ocular herpes. Immunocompromised patients are more susceptible to develop bilateral disease. The purpose of this study is to review recent literature on the topic and to highlight latest updates, regarding risk factors and possible correlations to the disease, as well as new therapeutic options.

Background and Objectives: Amblyopia is a neurodevelopmental disorder caused by interocular suppression of visual input, affecting visual acuity, stereopsis, contrast sensitivity, and other visual functions. Conventional treatment comprises occlusion of the sound eye. In recent years, novel therapies that deploy perceptual learning (PL) principles have been introduced. The purpose of this study is to assess the latest scientific data on this topic. Materials and Methods: For this purpose, we conducted a literature search for relevant studies published during the previous 4 years (2020–2023). Results: A plethora of visual perceptual learning protocols have been recently developed. Dichoptic video games, contrast rebalanced movies, and online perceptual training platforms are the main formats. Perceptual learning activates neuroplasticity, overcomes interocular suppression, and improves the visual impairments induced by amblyopia. Conclusions: This novel treatment is effective in both children and adults, as well as in patients non-responding to patching.

A 74-year-old female patient visited our department reporting unilateral painless vision reduction in her left eye noticed a few months ago. Clinical examination revealed decreased visual acuity in the left eye. Fundoscopy showed bilateral retinal venous stasis with cystoid macular edema in the affected eye, also confirmed by optical coherence tomography (OCT) imaging. OCT angiography showed no evidence of ischemia. Bilateral findings raised suspicion for a systemic underlying cause. Laboratory tests showed elevated homocysteine plasma levels. Brain MRI showed ischemic encephalopathy. Hyperhomocysteinemia creates a hypercoagulable state and therefore it is a risk factor for vascular thrombosis and retinal vein occlusion. Our patient was considered to suffer from an impending retinal vein occlusion due to venous stasis, causing a persistent macular edema, and, therefore, was treated with anti-vascular endothelial growth factor (VEGF) injections. She was also prescribed oral folic acid for life. Her visual acuity showed improvement and remained stable for a long period of time. When macular edema reoccurred she was treated with another intravitreal injection.

A teenage female patient visited the ophthalmology emergency department reporting blunt ocular trauma from a stretched elastic band, accompanied by blurred vision. At presentation, uncorrected visual acuity (VA) was 6/60 in the affected eye, improving to 6/7.5 with pinhole. A slit lamp examination showed a mild anterior chamber reaction and iridoplegia with pupil shape irregularity. Gonioscopy revealed partial cyclodialysis with angle recession. Fundoscopy revealed focal commotio retinae with blot hemorrhages. B-scan ultrasonography yielded no pathology. Follow-up examination, the day after the injury, included detailed refraction, which showed a myopic shift in the affected eye. Uncorrected VA improved to 6/15 and the patient achieved 6/7.5 with correction. Clinical findings indicated myopia, which resolved within one week from the incident, and refractive error rapidly decreased to prior emmetropic values.

According to findings, the volume of visits in OED has been hugely decreased possibly because of patient's concern about the pandemic and also due to minimized external activities which conceivably resulted to fewer cases of traumas. A dedicated phone line could attribute to a significant improvement of ophthalmic services by avoiding an unnecessary workload and subsequently, condense hospital visits.Availability of data and material All data support published claims and comply with field standards.Authors' contributions All authors whose names appear on the submission: 1)made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; or the creation of new software used in the work; 2)drafted the work or revised it critically for important intellectual content; 3)approved the version to be published; and 4)agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The Human Investigation Committee (IRB) of Volos General Hospital approved this study (No. 01/25-01-2021).Funding No funding was received to assist with the preparation of this manuscript.Declaration of Competing Interest All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Simultaneously occurring bilateral herpetic keratitis is a rare clinical manifestation of ocular herpes. Immunocompromised patients are more susceptible to develop bilateral disease. The purpose of this study is to review recent literature on the topic and to highlight latest updates, regarding risk factors and possible correlations to the disease, as well as new therapeutic options.