Novel application of multispectral refraction topography in the observation of myopic control effect by orthokeratology lens in adolescents

BACKGROUND Myopia,as one of the common ocular diseases,often occurs in adolescence.In addition to the harm from itself,it may also lead to serious complications.Thus,prevention and control of myopia are attracting more and more attention.Previous research revealed that single-focal glasses and orthokeratology lenses(OK lenses)played an important part in slowing down myopia and preventing high myopia.AIM To compare the clinical effects of OK lenses and frame glasses against the increase of diopter in adolescent myopia and further explore the mechanism of the OK lens.METHODS Changes in diopter and axial length were collected among 70 adolescent myopia patients(124 eyes)wearing OK lenses for 1 year(group A)and 59 adolescent myopia patients(113 eyes)wearing frame glasses(group B).Refractive states of their retina were inspected through multispectral refraction topography.The obtained hyperopic defocus was analyzed for the mechanism of OK lenses on slowing down the increase of myopic diopter by delaying the increase of ocular axis length and reducing the near hyperopia defocus.RESULTS Teenagers in groups A and B were divided into low myopia(0 D--3.00 D)and moderate myopia(-3.25 D--6.00 D),without statistical differences among gender and age.After 1-year treatment,the increase of diopter and axis length and changes of retinal hyperopic defocus amount of group A were significantly less than those of group B.According to the multiple linear analysis,the retinal defocus in the upper,lower,nasal,and temporal directions had almost the same effect on the total defocus.The amount of peripheral retinal defocus(15°-53°)in group A was significantly lower than that in group B.CONCLUSION Multispectral refraction topography is progressive and instructive in clinical prevention and control of myopia.

Analysis of postoperative ocular surface changes and intervention effect after pars plana vitrectomy in meibomian gland dysfunction dry eye patients

AIM:To observe ocular surface changes after phacovitrectomy in patients with mild to moderate meibomian gland dysfunction(MGD)-type dry eye and track clinical treatment response using a Keratograph 5M and a Lipi View interferometer.METHODS:Forty cases were randomized into control group A and treatment group B;the latter received meibomian gland treatment 3d before phacovitrectomy and sodium hyaluronate before and after surgery.The average non-invasive tear film break-up time(NITBUTav),first noninvasive tear film break-up time(NITBUTf),non-invasive measured tear meniscus height(NTMH),meibomian gland loss(MGL),lipid layer thickness(LLT)and partial blink rate(PBR)were measured preoperatively and 1wk,1 and 3mo postoperatively.RESULTS:The NITBUTav values of group A at 1wk(4.38±0.47),1mo(6.76±0.70),and 3mo(7.25±0.68)were significantly lower than those of group B(7.45±0.78,10.46±0.97,and 11.31±0.89;P=0.002,0.004,and 0.001,respectively).The NTMH values of group B at 1wk(0.20±0.01)and 1mo(0.22±0.01)were markedly higher than those of group A(0.15±0.01 and 0.15±0.01;P=0.008 and P<0.001,respectively);however,there was no difference at 3mo.The LLT of group B at 3mo[91.5(76.25-100.00)]significantly exceeded that of group A[65.00(54.50-91.25),P=0.017].No obvious intergroup difference was found in MGL or PBR(P>0.05).CONCLUSION:Mild to moderate MGD dry eye worsens in the short term after phacovitrectomy.Preoperative cleaning,hot compresses,and meibomian gland massage as well as preoperative and postoperative sodium hyaluronate promote the rapid recovery of tear film stability.

Ocular surface microbiota in patients with varying degrees of dry eye severity

AIM:To elucidate the profiles of commensal bacteria on the ocular surfaces of patients with varying severity of dry eye(DE).METHODS:The single-center,prospective,case-control,observational study categorized all participants into three distinct groups:1)control group(n=61),2)mild DE group(n=56),and 3)moderate-to-severe DE group(n=82).Schirmer’s tear secretion strips were used,and the bacterial microbiota was analyzed using 16S ribosomal ribonucleic acid gene sequencing.RESULTS:The three groups had significant differences in alpha diversity:the control group had the highest richness(Chao1,Faith’s phylogenetic diversity),the mild DE group showed the highest diversity(Shannon,Simpson),and the moderate-to-severe DE group had the lowest of the above-mentioned indices.DE severity was positively correlated with a reduction in beta diversity of the microbial community,with the moderate-to-severe DE group exhibiting the lowest beta diversity.Linear discriminant analysis effect size presented distinct dominant taxa that significantly differed between each.Furthermore,the exacerbation of DE corresponded with the enrichment of certain pathogenic bacteria,as determined by random forest analysis.CONCLUSION:As DE severity worsens,microbial community diversity tends to decrease.DE development corresponds with changes in microbial constituents,primarily characterized by reduced microbial diversity and a more homogenous species composition.

Ocular surface in patients with different degrees of myopia

AIM:To investigate the clinical features of the ocular surface in patients with different degrees of myopia.METHODS:A cross-sectional study was conducted involving 122 participants with myopia in Beijing Tongren Hospital from February to June,2023.After completing the Ocular Surface Disease Index(OSDI)score scale,measurements were taken for refraction,biometric parameters and ocular surface parameters.The prevalence,severity and related parameters of the dry eye among different groups based on axial length(AL)were compared.Correlation analysis was performed between ocular surface parameters and refraction/biometric measurement parameters.RESULTS:Statistically significant differences were observed in refractive error,corneal thickness,anterior chamber depth,and subfoveal choroidal thickness among the groups(all P<0.05).With the increase in AL,the incidence and severity of dry eye increased significantly(P<0.05).Moreover,the tear film break-up time(BUT)shortened(P<0.05),and the corneal fluorescein staining(CFS)points increased significantly(P<0.05).OSDI scores were positively correlated with AL and spherical equivalent(SE;both P<0.05);BUT was negatively correlated with AL,SE,and corneal astigmatism(AST;all P<0.05);Schirmer I test(SIT)results were negatively correlated with AL and SE(both P<0.05).CONCLUSION:AL elongation is a risk factor for dry eye onset in myopic participants.The longer the AL,the more severe the dry eye is,with the increased CFS spots and tear film instability.Additionally,SE and AST exhibit negative correlations with dry eye symptom scores and ocular surface parameters.

Intra-and interobserver reliability of ocular surface analyzer LacryDiag

AIM:To invastigate intra-and interobserver reliability of interferometry,tear meniscus height(TMH)measurement and meibography(MBG)of an ocular surface analyzer,LacryDiag(Quantel Medical,France).METHODS:Five consecutive measurements and subsequent analysis of interferometry,TMH,and MBG were recorded by two examiners using the LacryDiag.To assess intra-and interobserver reliability,we used Cohen’s kappa for categorical variables(interferometry),or intraclass correlation coefficient for continuous variables(TMH,MBG).RESULTS:Thirty eyes of 30 examinees were included.For both observers,there was excellent intraobserver reliability for MBG(0.955 and 0.970 for observer 1 and 2,respectively).Intraobserver reliability for observer 1 was substantial for interferometry(0.799),and excellent for TMH(0.863).Reliability for observer 2 was moderate for interferometry(0.535)and fair to good for TMH(0.431).Interobserver reliability was poor for interferometry(0.074)and fair to good for TMH(0.680)and MBG(0.414).CONCLUSION:LacryDiag ocular surface analyzer in our study proves to be a reliable noninvasive tool for the evaluation of TMH and MBG.As for interferometry,poor interobserver reliability,fair to good intraobserver reliability for observer 1,and moderate for observer 2,leave room for improvement.

Pattern of Eye Diseases among Tea Workers

Background: Bangladesh’s tea industry is essential to the country’s economic expansion. Since tea workers in Bangladesh are marginalized within our community, they have limited access to comprehensive eye care services. Productivity and well-being are cornerstones of comprehensive health care strategy. Ocular disorders are influenced by life expectancy, sociodemographic status, and the epidemiological transition. In this context, the state of ocular health and the many eye illnesses remain to be significantly addressed. Purpose: To evaluate the pattern of eye diseases among tea workers in a tea estate of Bangladesh. Methods: This cross-sectional observational study was carried out in Halda Valley Tea Estate, Nazirhat, Fatickchari, Chattogram, Bangladesh, under the supervision of the Department of Community Ophthalmology, BSMMU, following ethical clearance and approval by the IRB board of BSMMU. With informed written consent and approval from the authority of the tea estate, a total of 110 tea workers were recruited. Socio-demographic characteristics, ocular findings, and patterns of eye diseases were determined and recorded. Results: The mean age of the study participants was 39.60 ± 11.63 years. The maximum (58.1%) study participants were 31 - 50 years old, female (64.5%), illiterate (82.7%), and tribal (71.8%) indigenes. Eye diseases were found in 94.5% of workers. Presbyopia (28.2%), cataracts (27.3%), and refractive error (26.4%) were the most common. Tea workers with eye diseases were significantly older than those who did not have any eye diseases (40.20 ± 11.57 vs. 29.17 ± 7.31 years, p Conclusion: A significant number of tea workers had eye diseases, of which presbyopia, cataracts, and refractive error were the most common.

Bilateral Retinal Nerve Fiber Layer Loss and Recovery with Teprotumumab in Thyroid Eye Disease

Background: Thyroid Eye Disease (TED) is known to alter tissues of the orbital cavity, including the optic nerve. However, its effect on measured global Retinal Nerve Fiber Layer (gRNFL) is not well elucidated. This case evaluates the effect of teprotumumab on gRNFL in a patient with moderate TED. Observations: A 60-year-old female with controlled ocular hypertension and moderate TED received 8 standard IV teprotumumab infusions. Comprehensive ocular evaluations were performed pre-, during-, and post-treatment. Bilateral gRNFL thickness decreased (10 m OD;12 m OS) at 4 months post-treatment start, persisting at 8 months, but recovered at 20 months. Conclusions and Importance: Teprotumumab treatment in patients with TED led to a transient bilateral decrease in gRNFL thickness, which was restored to baseline levels with no adverse events reported. Monitoring gRNFL changes in teprotumumab-treated patients is crucial as gRNFL thinning indicates retinal ganglion cell damage. Teprotumumabs ability to dampen the IGF-IR inflammatory cascade may have reduced retinal inflammation, leading to recovery.

Ocular Trauma in a Rural Population of North China:The Handan Eye Study

Objective To determine the prevalence of ocular trauma and the proportion of blindness and visua impairment due to trauma in a rural population in northern China. Methods The Handan Eye Study is a population-based cross-sectional study that surveyed 6830 Chinese people aged 30＋ years from 13 randomly selected villages in Yongnian County, city of Handan, Hebei Province, in July, 2006. All participants underwent a standardized interview and extensive examinations. A structured questionnaire was used to collect information on ocular trauma. Results Of the 5837 participants who filled out the questionnaire, 124 subjects [2.1%; 95% confidence interval （CI）, 1.8%-2.5%] reported a history of ocular trauma in either eye, including 19 （0.3%） persons reporting trauma in both eyes. Men were more likely to have an eye injury than women [odds ratio （OR）, 3.3; 2.2-4.9]. In multiple logistic regression models, ocular trauma was significantly more frequent among normotensive participants when compared with hypertensive participants （hypertensive vs. normotensive＂ OR, 0.6; 0.4-0.9） and among participants who had a history of falls （OR, 2.4; 1.2-4.8）. The proportion of unilateral visual impairment and unilateral blindness due to trauma were 10.5% （13 subjects） and 21.0% （26 subjects）, respectively. Conclusion Our study reports the prevalence of severe ocular trauma among adults in rural China, revealing a high proportion of blindness and visual impairment due to trauma. These findings suggest the need for educational strategies to increase eye health awareness in this rural population with focus on providing at least appropriate first aid care to reduce blindness due to trauma.

Changes in ocular surface status and dry eye symptoms following femtosecond laser-assisted cataract surgery

AIM: To observe the changes in ocular surface and the dry eye symptoms following femtosecond laser-assisted cataract surgery(FLACS). METHODS: Patients with no eye signs or symptoms in Guangzhou Aier Eye Hospital between October 2017 and September 2018, who underwent FLACS and intraocular lens(IOL) implantation for age-related cataract were enrolled. Tear film stability assessed with OCULUS Keratograph 5 M, Schirmer’s I test(SIT), and corneal fluorescein staining(CFS) were evaluated before and after surgery at 1 d, 1 wk, 1, and 3 mo in order. Ocular Surface Disease Index scores(OSDI) and Subjective Symptom Questionnaires(SSQs) were recorded at the same time point.RESULTS: Thirty-eight eyes of 38 patients were enrolled. The noninvasive tear film break-up time(first break-up time and average break-up time) decreased in a peak at the 1 wk visit, and then increased to basic levels at 1 mo. The tear meniscus height(TMH) increased transiently at 1 d, and declined in the following 3 mo visits. The SIT had a transient increase at 1 d(P=0.357) and a decrease at 1 wk and 1 mo(both P<0.05) but returned to the preoperative levels at 3 mo after surgery(P=0.062). CFS scores were significantly improved compared with those before surgery, and had a statistical difference(P<0.05). OSDI scores and SSQs after surgery were obviously higher, and had a statistical difference(P<0.001) but didn’t return to the basic level by 3 mo. CONCLUSION: Dry eye signs and symptoms can occur immediately following FLACS and have a peak severity on day 7 postoperatively. Most signs of dry eye can return to preoperative basic levels within 3 mo postoperatively. However, all cases can not recover from CFS and dry eye symptoms at 3 mo postoperatively.

Ocular herpes:the pathophysiology,management and treatment of herpetic eye diseases

Herpesviruses are a prominent cause of human viral disease, second only to the cold and influenza viruses. Most herpesvirus infections are mild or asymptomatic. However, when the virus invades the eye, a number of pathologies can develop and its associated sequelae have become a considerable source of ocular morbidity. The most common culprits of herpetic eye disease are the herpes simplex virus(HSV), varicella zoster virus(VZV), and cytomegalovirus(CMV). While primary infection can produce ocular disease, the most destructive manifestations tend to arise from recurrent infection. These recurrent infections can wreck devastating effects and lead to irreversible vision loss accompanied by a decreased quality of life, increased healthcare usage, and significant cost burden. Unfortunately, no method currently exists to eradicate herpesviruses from the body after infection. Treatment and management of herpes-related eye conditions continue to revolve around antiviral drugs, although corticosteroids, interferons, and other newer therapies may also be appropriate depending on the disease presentation. Ultimately, the advent of effective vaccines will be crucial to preventing herpesvirus diseases altogether and cutting the incidence of ocular complications.

Eye reflux:an ocular extraesophageal manifestation of gastric reflux

AIM： To suspect laryngopharyngeal reflux（LPR） in patients with ocular surface disease（OSD）. METHODS： The present study evaluated a group of subjects with OSD assessing the Ocular Surface Disease Index（OSDI） and the Reflux Symptom Index（RSI） to detect patients with suspected LPR and define a possible relationship between tests.RESULTS： Two hundred and ninety subjects（175 females, mean age： 60.41±15.68y） were consecutively visited at ophthalmologist offices. One hundred and one（34%） patients had pathological RSI（〉13） and consequently a suspected LPR.CONCLUSION： The current study shows that suspected LPR may be common（34%） in patients with OSD and a suspected LPR may be considered in OSD patients when RSI score is 〉13 and OSDI score is 〉42.

Reliability of Chinese web-based ocular surface disease index questionnaire in dry eye patients:a randomized,crossover study

AIM:To assess the reliability of web-based version of ocular surface disease index in Chinese(C-OSDI)on clinically diagnosed dry eye disease(DE)patients.METHODS:A total of 254 Chinese participants(51%male,129/254;mean age:27.90±9.06 y)with DED completed paper-and web-based versions of C-OSDI questionnaires in a randomized crossover design.Ophthalmology examination and DED diagnosis were performed prior to the participants being invited to join the study.Participants were randomly designated to either group A(paper-based first and webbased second)or group B(web-based first and paper-based second).Final data analysis included participants that had successfully completed both versions of the C-OSDI.Demographic characteristics,test-retest reliability,and agreement of individual items,subscales,and total score were evaluated with intraclass correlation coefficients(ICC),Spearman rank correlation,Wilcoxon test and Rasch analysis.RESULTS:Reliability indexes were adequate,Pearson correlation was greater than 0.8 and ICCs range was 0.827 to 0.982;total C-OSDI score was not statistically different between the two versions.The values of mean-squares fit statistics were very low compared to 1,indicating that the responses to the items by the model had a high degree of predictability.While comparing the favorability 72%(182/254)of the participants preferred web-based assessment.CONCLUSION:Web-based C-OSDI is reliable in assessing DED and correlation with the paper-based version is significant in all subscales and overall total score.Webbased C-OSDI can be administered to assess individuals with DED as participants predominantly favored online assessment.

Human eye ocular component analysis for refractive state and refractive surgery

AIM： To analyze the clinical factors influencing the human vision corrections via the changing of ocular components of human eye in various applications; and to analyze refractive state via a new effective axial length.METHODS： An effective eye model was introduced by the ocular components of human eye including refractive indexes, surface radius（r1, r2, R1, R2） and thickness（t, T） of the cornea and lens, the anterior chamber depth（S1） and the vitreous length（S2）. Gaussian optics was used to calculate the change rate of refractive error per unit amount of ocular components of a human eye（the rate function M）. A new criterion of myopia was presented via an effective axial length.RESULTS： For typical corneal and lens power of 42 and 21.9 diopters, the rate function Mj（j=1 to 6） were calculated for a 1% change of r1, r2, R1, R2, t, T（in diopters） M1=＋0.485, M2=-0.063, M3=＋0.053, M4=＋0.091, M5=＋0.012, and M6=-0.021 diopters. For 1.0 mm increase of S1 and S2, the rate functions were M7=＋1.35, and M8=-2.67 diopter/mm, respectively. These rate functions were used to analyze the clinical outcomes in various applications including laser in situ keratomileusis surgery, corneal cross linking procedure, femtosecond laser surgery and scleral ablation for accommodation.CONCLUSION： Using Gaussian optics, analytic formulas are presented for the change of refractive power due to various ocular parameter changes. These formulas provide useful clinical guidance in refractive surgery and other related procedures.

Early changes to dry eye and ocular surface after smallincision lenticule extraction for myopia

AIM： To investigate the early changes in dry eye symptoms, tear function and ocular surface following small-incision lenticule extraction（SMILE） for myopia.·METHODS： Ninety-seven consecutive patients（193 eyes）who underwent SMILE for myopia were observed in this longitudinal and retrospective study. Parameters evaluated included： subjective dry eye symptoms（dryness, foreign body sensation and photophobia）, tear film breakup time（TBUT）, Schirmer Ⅰ test without anesthesia（S Ⅰ T）, tear meniscus height（TMH） and corneal fluorescein staining. Each parameter was evaluated before, and subsequently at 1d, 1wk, 1 and3 mo after surgery.·RESULTS： Compared with preoperative data, dryness was noted to be significantly increased at 1wk and 1mo postoperatively（P 〈0.01）. Symptoms of photophobia and foreign body sensation demonstrated significant differences at 1d and 1wk as compared with preoperative scores respectively（P 〈0.01）. These values were decreased at 1 and 3mo post-surgery（P 〉0.05）.Conversely the corneal staining scores were higher than the preoperative data at 1d, 1wk and 1mo（P 〈0.01）, but were close to the preoperative level at 3mo postoperatively. There was a significant decrease in TMH at 1wk and 1mo（P 〈0.01）, but the value was close to the preoperative level at 3mo postoperatively（P =0.16）. The examination outcomes of S Ⅰ T were significantly increased at 1d then reduced at 1wk after surgery（P 〈0.01）. Each value subsequently returned to the baseline value at 1 and 3mo（P 〉0.05）. TBUT was significantly decreased at all postoperative time points（P 〈0.01）.· CONCLUSION： SMILE resulted in mild dry eye symptoms, tear film instability and ocular surface damages; however, these complications can recover in a short period of time.

Efficacy of Isotonic Seawater Solution on Inflammation of the Ocular Surface in Matrix Metalloproteinase MMP-9-Positive Dry Eye Disease Patients

Purpose: Prospective study to evaluate the anti-inflammatory efficacy of isotonic seawater solution on metalloproteinase 9 (MMP-9) levels in the tears of patients with dry eye disease (DED). Methods: A total of 50 patients were included, with the following dry eye criteria in both eyes: InflammaDry? test initially positive, ocular surface disease index (OSDI) score ≥ 12 and <33, tear film breakup time (TBUT) ≤ 10 seconds, Shirmer I test result ≤ 10 mm/5 minutes, corneal staining ≥ 1. Additionally, all the patients selected corresponded to a dry eye type 2 - 3 severity degree - mild and moderate - Dry Eye Workshop Study (DEWS) classification. The InflammaDry test is used to measure levels of MMP9 at the beginning and the end of the study. All patients were treated exclusively with isotonic seawater solution 5 times a day for 3 weeks. Results: The InflammaDry test was positive in 100% of the patients (n = 50) and in 100% (n = 100) of the eyes before treatment. In 14 (28%) patients the test became negative in both eyes, and in 15 (30%) it was negative in one of the eyes. In 43% (n = 43) of the positive eyes, MMP-9 became undetectable in the tear fluid following treatment with isotonic seawater. This change was statistically significant (p < 0.001). Conclusions: The washes with ophthalmic isotonic seawater solution have a significant impact on inflammation of the ocular surface in dry eye disease, with an ability to make MMP-9 levels negative in 43% of cases.

Ocular Manifestations in Thyroid Eye Disorder: A Cross-Sectional Study from Nepal

Background: Thyroid eye disease represents an organ-specific autoimmune process that is usually associated with thyroid disease. Graves’ disease is the most common thyroid abnormality associated with thyroid eye disease. Aim: This study was conducted for the profile of ocular manifestation in Thyroid Eye Disease (TED). Methodology: A cross-sectional study of 117 cases of thyroid dysfunction was carried out at BP Koirala Institute of Health System, out of which 84 (71.79%) cases had ocular manifestation. They were evaluated and analyzed in detail and the characteristics documented included patient’s demography, ocular and systemic history and as well as ocular examination and some of the systemic and laboratory findings. Results: In this study, mean age of presentation of TED was 39.7 years. 59 patients were female and 25 were male. The maximum patients of both sexes were in the fourth decade of their lives. The common lid signs were lid retraction and lid lag. Proptosis was seen in 33.3% of cases out of which 68% had bilateral proptosis. Corneal ulcer was seen in 7.1% and optic neuropathy in 1.2% of cases. In 27.3% of cases there was elevation of IOP. Dry eye was seen in 61.9% of cases and POAG seen in 8.3% of cases. In the study population 75% were hyperthyroiditic, 16.7% were hypothyroiditic and 8.3% were in euthyroid state. Conclusion: Female was more commonly affected. The maximum number of patients of both sexes was in the fourth decade of their lives. Hyperthyroidism patient had greater chance of ocular manifestation.

Rabbit models of dry eye disease: comparative analysis

AIM:To report ocular changes in rabbits after the implementation of three different induction methods to create dry eye(DE)conditions and provides evidence of DErelated disease evolution.METHODS:Experimental methods were divided into 3 models.The first model used involved triple injection of complete Freund’s adjuvant,50µL each,also called the meibomian gland dysfunction(MGD)model.In the second model,DE conditions were created by the resection of nictitating membranes(NM),Harderian glands(HG),and main lacrimal glands(LG),also called the LGR model.The third model involved the topical administration of benzalkonium chloride(BAK)0.1%solution.The Schirmer test,ocular surface staining with fluorescein,and tear breakup time tests were implemented before and after excision.After euthanasia,the ocular tissues were dissected.Cornea,conjunctiva,and meibomian glands were treated with periodic acid–Schiff(PAS)staining and haematoxylin–eosin staining.RESULTS:The MGD model triggered inflammation of meibomian glands.It detected changes in the lipid layer of the tear film.The bilateral resection of NM,HG,and LG reduced the watering layer of the tear film.The topical administration of BAK of 0.1%solution impacted the mucosal layer of the tear film.CONCLUSION:Different changes are observed with different DE syndrome models.The composition of the tear film differ depending on which part of the eye is targeted.More studies need to be done to confirm whether an increased thickness of the cornea has any impact on the DE disease.

The Anatomical Dry Eye <br/>—A Different Form of Ocular Surface Disease Deserves Focus

Introduction: Dry eye disease is currently considered mainly tear film related ocular surface condition. This concept does, however, not respect ocular surface topography. The micro-anatomy of the corneal changes may lead to enhanced demands on the tear film and lead to significant complaints. However, they often remain undetected and hence untreated. It is suggested that the pathophysiology for an entire subgroup of dry eye disease patients is primarily of surface morphological nature. Methods: The tear film break up was observed and used to identify anatomical alterations in eyes of patients with dry eye complaints. The localization and pattern of TFBUT using fluorescein was compared between eye with normal surfaces and surface alterations. Results: Premature tear film rupture was localized at constantly same areas and did match changes on the ocular epitheliopathy in patients with diseases such as microcystic epithliopathy, MFD, and after excimer laser treatment. Disusssion: Whereas in normal surfaces TFBUT does occur within the floating tear film, the anatomical dry eye identifies itself with constant location of tear film break up and a constant spreading pattern. In contrast to the classic, tear film caused dry eye, the anatomical dry eye is accessible to treatment. This should catch our attention and intent to identify it. It is the ease of possible treatment that should make these ocular surface alterations prime target of dry eye disease diagnostic. It is hence suggested to introduce the anatomical dry eye as a subgroup in the large group of dry eye and ocular surface disease.

Ocular surface and tear film changes after eyelid surgery

Eyelid surgery is widely and extensively used in facial plastic and reconstructive surgeries.There are many categories of eyelid surgeries,the most common of which include blepharoplasty,ptosis surgery,and eyelid reconstruction.In many cases,these procedures are combined,and there are many different techniques for each type of operation.Upper eyelid blepharoplasty usually includes the excision of skin,preseptal orbicularis oculi muscle,and orbital fat.Common methods of lower eyelid blepharoplasty are the skin-muscle flap,the skin flap,and the transconjunctival.Ptosis surgery is mainly divided into three types:transcutaneous,transconjunctival,and sling surgery.Surgeons often used the Hughes or Cutler-Beard Bridge Flaps in eyelid reconstruction.Different types and methods of surgery have their own advantages and disadvantages,and postoperative complications may occur.Therefore,postoperative complications of eyelid surgeries,such as dry eye symptoms,should be taken into serious consideration.Relevant literature involving these complaints can be found in PubMed by searching the terms“dry eye”,“eyelid”,“surgery”,and other related keywords.Moreover,various ocular surface and tear film alterations may be detected using the Ocular Surface Disease Index(OSDI),tear film breakup time,Schirmer test,fluorescein staining,and lissamine green staining after various eyelid surgeries.As dry eye disease is prevalent in the general population,it is more urgent to figure out what we can learn from these complaints.Further exploration in this field may help surgeons to choose a better surgical method and give an accurate evaluation of the postoperative effect.

Spatial Correlation Module for Classification of Multi-Label Ocular Diseases Using Color Fundus Images

To prevent irreversible damage to one’s eyesight,ocular diseases(ODs)need to be recognized and treated immediately.Color fundus imaging(CFI)is a screening technology that is both effective and economical.According to CFIs,the early stages of the disease are characterized by a paucity of observable symptoms,which necessitates the prompt creation of automated and robust diagnostic algorithms.The traditional research focuses on image-level diagnostics that attend to the left and right eyes in isolation without making use of pertinent correlation data between the two sets of eyes.In addition,they usually only target one or a few different kinds of eye diseases at the same time.In this study,we design a patient-level multi-label OD(PLML_ODs)classification model that is based on a spatial correlation network(SCNet).This model takes into consideration the relevance of patient-level diagnosis combining bilateral eyes and multi-label ODs classification.PLML_ODs is made up of three parts:a backbone convolutional neural network(CNN)for feature extraction i.e.,DenseNet-169,a SCNet for feature correlation,and a classifier for the development of classification scores.The DenseNet-169 is responsible for retrieving two separate sets of attributes,one from each of the left and right CFI.After then,the SCNet will record the correlations between the two feature sets on a pixel-by-pixel basis.After the attributes have been analyzed,they are integrated to provide a representation at the patient level.Throughout the whole process of ODs categorization,the patient-level representation will be used.The efficacy of the PLML_ODs is examined using a soft margin loss on a dataset that is readily accessible to the public,and the results reveal that the classification performance is significantly improved when compared to several baseline approaches.