Explore the vast range of titles available.

Purpose of Review This paper aims to provide an overview of the currents aspects involving 27-gauge vitrectomy published on the PubMed directory. Recent Findings Almost 15 years have passed since the microincision vitrectomy system was introduced. The idea of removing vitreous through a smaller aperture has become a reality and is widely adopted among surgeons. Although not completely accepted, the use of 27-gauge systems has shown encouraging results. Newer vitrectomy platforms and cutter designs have tried to associate high-performance, smaller instruments with better outcomes. Consequently, the indications for 27-gauge vitrectomy have broadened during the last few years. Summary Twenty-seven-gauge vitrectomy seems to be safe and feasible in a variety of vitreoretinal scenarios.

Purpose Chemical injuries of the eye remain a serious cause of visual disability. The current literature is reviewed, with a focus on recent studies that inform evidence-based treatment decisions. Recent Findings Prevention continues to be a primary goal. In addition to conventional therapy (urgent irrigation, topical corticosteroids and antibiotics, oral vitamin C, possibly doxycycline and topical antioxidants), there is evidence that amniotic membrane, umbilical cord serum, or platelet-rich plasma may improve epithelial healing rates in moderate to severe burns. Reconstruction of the ocular surface continues to evolve; for unilateral disease, simple limbal epithelial transplant (SLET) is gaining momentum. For bilateral total limbal stem cell deficiency, treatment options include allogeneic keratolimbal allograft, ex vivo expansion of cultured epithelial sheets, and keratoprosthesis; each intervention represents a unique balance of risks and benefits. Summary SLET appears to be simple and effective for unilateral limbal stem cell deficiency secondary to chemical injuries. The treatment of bilateral injuries requires additional studies to define the preferred practice patterns, as there is no clear consensus regarding the preferred intervention.

Background Although uncommon, uveitis and other ocular inflammatory disorders may pose a serious threat to a patient’s vision and quality of life. Purpose The purpose of this review is to evaluate the indications for immunosuppressive therapy in the treatment of uveitis and to appraise the data regarding their usage, including efficacy and potential side effects. Recent Findings While some agents such as antimetabolites have been used to treat uveitis for decades, there are now newer medications such as biologics that have recently met with great success. Adalimumab is the first biologic therapy FDA approved for the treatment of uveitis. Summary There are multiple immunosuppressive therapies available for the treatment of uveitis that allow for sustained control of ocular inflammation and limitation of systemic corticosteroid exposure. Additional research will be necessary to characterize the efficacy of newer agents to determine if they may be superior and tolerated as older therapies.

Purpose of Review The aim of this review is to summarize history, treatment outcomes, indications, complications, and current controversies of both intra-arterial (IAC) and intravitreal (IViTC) chemotherapy in the management of retinoblastoma (RB). Recent Findings Over the years, the ability of IAC to provide excellent tumor control while limiting systemic toxicity has extended its indications from globe-sparing salvage therapy to the first-line therapy for unilateral disease. The establishment of safe IVitC techniques, on the other hand, has changed treatment philosophies from avoiding intraocular drug delivery at all costs to improve the control of vitreous seeds, which has been an important cause of failure of IAC. The use of both techniques has actually not only managed to reduce the enucleation rate but also to eliminate the need for external beam radiotherapy, at least as the first-line or second-line treatment. Summary During the past decade, IAC and IVitC have completely transformed the management of RB with a considerable improvement in ocular survival without affecting patient survival despite the lack of randomized controlled trials. Long-term prognosis, recurrence rates, and incidence of metastases after IAC and IVitC remain to be determined. Future challenges include studies of drug-induced retinal toxicity and optimization of treatment protocols in order to preserve vision.

Purpose of Review Age-related macular degeneration is among the leading causes of blindness in the USA, and the prevalence is increasing. Although anti-vascular endothelial growth factor (VEGF) therapy has dramatically improved the treatment outcome for patients with wet age-related macular degeneration (AMD), repeated intravitreal injections can be a challenge for patients and physicians. The following provides a review of several innovative approaches to wet AMD therapy currently under investigation. Recent Findings Novel anti-VEGF delivery routes, platelet-derived growth factor (PDGF) receptor antagonism, immunomodulatory therapy, and new imaging technology are all poised to possibly expand the current clinical options available for wet AMD patients. Summary There are a number of exciting new treatment modalities for wet AMD currently being researched. As clinical trials of these new therapies continue, we can hope that improved visual outcomes and patient satisfaction are on the horizon.

Purpose of the Review The purpose of the present article is to describe the evaluation and treatment processes for glaucoma patients with functional challenges related to their vision. Recent Findings Studies of glaucoma patients demonstrate a decline in the ability to perform vision-related activities. Low vision therapy has proven to have a positive impact for many of these patients. We review the most recent literature in this area and also report on the characteristics of glaucoma patients enrolled in low vision services. Summary Glaucoma is a significant cause of visual impairment and blindness. Low vision rehabilitation complements traditional medical and surgical care by working with patients to identify losses in and improve functionality. A battery of testing to assess visual acuity, contrast sensitivity, visual field, psychological well-being, and ambulation is performed in order to categorize deficits in vision-related tasks. Training and education on the use of visual aids have helped many patients improve independent function.

Purpose of Review Conventional filtering surgeries such as trabeculectomy and tube-shunt surgery have traditionally been considered the gold standard for management of glaucoma. However, they have a significant complication profile due to the invasive nature of the surgery, and have a relatively high risk of failure such as exuberant fibrotic responses leading to obstruction of the created outflow system. Due to these limitations of traditional incisional surgeries, new surgical techniques for management of glaucoma are of particular interest, especially in the setting of increasing prevalence of glaucoma with an aging population. These new procedures target either inflow or outflow system of the eye in order to manage the intraocular pressure (IOP). The recent innovative techniques share a common goal of effective intraocular pressure control while decreasing the complication profile and minimizing failure rate. This article reviews the primary challenges of developing a successful glaucoma surgery and the recent advancements in glaucoma laser and surgeries. Recent Findings Recent surgical modalities have been designed to target eye inflow or outflow system. The advancements in their designs are based on detailed knowledge about eye fluidic system. These new developments have been associated with higher success rate and lower complications. More detailed investigations are currently being conducted regarding the long-term safety and repeatability of these interventions. Summary Advanced surgical modalities have shown promising results in modulating IOP, minimizing the complications, lessening the exaggerated inflammatory-fibrotic response, and reducing the number of post-surgical medications.

Purpose of Review The ocular surface is a potential site of ocular involvement by SARS-CoV-2 infection. We performed a review of the literature to understand the pathogenesis of SARS-CoV-2 disease manifestations on the ocular surface as well as to elucidate emerging treatment patterns and practice changes during the COVID-19 pandemic. Recent Findings The ocular manifestations of SARS-CoV-2 are likely limited to a mild and transient conjunctivitis. Other manifestations have not been validated in larger cohorts. Ocular surface tissue should be considered potentially infectious due to the presence of host receptors on surface tissues. The availability of donor tissue in lower-middle income countries has been greatly impacted by the pandemic and would benefit from further investigation into transmissibility through donor tissue. Summary Transmission of SARS-CoV-2 through the ocular surface has yet to be confirmed. The most common ocular manifestation is a mild conjunctivitis. Ocular surface surgeons face specific challenges in the use of donor tissues and aerosolizing procedures and have adapted practice patterns accordingly.

Traumatic endophthalmitis remains an uncommon but potentially blinding complication of penetrating eye trauma. It comprises of 25–30% of endophthalmitis cases. Bacillus cereus is an organism that is not frequently implicated in endophthalmitis. Early suspicion and detection of this organism are often overlooked in favor of more common organisms such as Streptococcus or Klebsiella species. We report a rare case of Bacillus cereus endophthalmitis following trauma to the eye with a wire. A 43-year-old male with no known medical illness presented to the eye casualty with left eye pain and counting finger vision after being poked with a wire which immediately dislodged, while doing gardening. He had sustained a self-sealing laceration wound of the cornea which was Seidel’s negative. He was started on IV ciprofloxacin and underwent corneal cleaning and suturing with vitreous tap and intravitreal antibiotics. However, on the next day, he developed signs of fulminant endophthalmitis with no perception of light in the eye. The left eye was eviscerated which resulted in improvement in infection. He completed a 1-week course of ciprofloxacin along with topical moxifloxacin. Follow-up at 1-week post evisceration showed the left adnexa remaining quiet. Vitreous tap yielded florid growth of Bacillus cereus . We reviewed all other cases of Bacillus cereus –related ocular infections reported previously in the literature and analyzed their outcomes. A high index of suspicion following the mechanism of injury to the eye along with timely and appropriate choice of antibiotics can lead to a better visual outcome in cases of ocular trauma patients.

While ocular syphilis is not a new phenomenon, recent increased rates of new diagnoses, especially in human immunodeficiency virus (HIV)-infected persons and men who have sex with men, have sparked a new interest in an old disease. This article will review the clinical presentation, diagnosis, and treatment of ocular syphilis, and provide guidance on management.