Journal of Ophthalmic and Optometric Sciences
The "Journal of Ophthalmic and Optometric Sciences (JOOS)" is a quarterly open-access, peer-reviewed scientific journal. It is published by the Basir Eye Health Research Center in collaboration with Shahid Beheshti University of Medical Sciences in Tehran, Iran. The primary goal of JOOS is to advance the field of ophthalmologic and optometric research and foster collaboration between Iranian researchers and scientists worldwide. JOOS publishes both print and online versions of the journal and accepts high-quality manuscripts that cover various aspects of ophthalmic and optometric disorders. These include topics such as diagnosis, treatment, epidemiology, etiology, biology, molecular aspects, and clinical genetics of these diseases. Manuscripts focusing on the history of modern ophthalmology and optometry in Iran, the contributions of notable scientists to its progress, and the advancements in the ophthalmic care system over the past decades are particularly valued by JOOS. By publishing such articles, the journal aims to document and celebrate the development of ophthalmology and optometry in Iran. As an open-access journal, JOOS ensures that its content is freely accessible to readers worldwide, which facilitates the dissemination of research findings and promotes the advancement of knowledge in the field of ophthalmic and optometric sciences.
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Accidental Exposure of a Worker’s Eyes to Hydrochloric Acid Leading to Total Binocular Blindness
A 62 years old male patient was referred to Basir eye clinic for visual evoked potential measurement. The result was flat VEP, P100 latency and amplitude in both of his eyes. He was an installation worker who was exposed to hydrochloric acid (HCl) in both of his eyes. He went corneal transplantation, but the result was negative. We performed VEP which indicated visual pathway involvement.
Copyright (c) 2026 Journal of Ophthalmic and Optometric Sciences
Why Iran’s Medical Databases Fall Short: A Call for Reform in Iranian Ophthalmology
Reliable, well-structured medical databases underpin evidence-based practice, clinical research, and health policy. International platforms such as PubMed, Scopus, and Web of Science enable efficient data synthesis, systematic reviews, and trend analysis. In Iran, national databases including SID (Scientific Information Database), Magiran, and IranMedex were established to index domestic scientific output. Despite initial promise, these platforms currently lack the efficiency, accuracy, and interoperability needed for high-quality ophthalmic research1. Iranian ophthalmologists have made notable contributions in areas such as refractive surgery, glaucoma, and corneal disorders. However, deficiencies in national databases limit the visibility, reproducibility, and clinical translation of local studies. This editorial highlights key structural issues and proposes targeted reforms.
Long-Term Anterior Segment Biometric Changes after Posterior Chamber Phakic Intraocular Lens Implantation: Conventional Versus Aquaport Implantable Collamer Lens
Purpose: To compare biometric changes after implantation of posterior chamber phakic collamer lenses (PCLs) in conventional and Aquaport ICL models. Patients and Methods: Records of myopic patients who underwent ICL implantation between March 2012 and April 2015 were reviewed. Demographics, manifest and cycloplegic refraction, BCVA, and preoperative IOP were documented. All patients underwent ultrasonic biomicroscopy to determine sulcus-to-sulcus distance and angle parameters under dim illumination (STS, Quantel Biomedical, France), along with topography and keratometric measurements. Patients were recalled postoperatively for repeat ultrasonic biomicroscopy under identical settings. Keratometric values were also obtained using the Galilei Dual Scheimpflug Tomography Analyzer (Ziemer, Switzerland). Results: Fifty-eight eyes of 30 myopic patients were included; 28 eyes of 15 patients were assigned to the V4b group and 30 eyes of 15 patients to the V4c group. Mean follow-up time was 27.7 ± 9.3 months in the V4b group and 26.6 ± 8.8 months in the V4c group. No significant differences in postoperative refraction or intraocular pressure were observed between groups at 1 and 3 months. All preoperative biometric parameters changed after surgery in both groups. Nasal angle parameters (TIA-nasal and AOD500-N) differed significantly between V4b and V4c lenses, while other biometric indices and lens densitometry showed no significant differences. Conclusion: The central-hole design of the V4c ICL appears as effective as peripheral iridotomy in V4b lenses in preventing deterioration of anterior-segment biometric parameters and may promote a more uniform aqueous humor outflow at the anterior chamber angle.
Validity and Reliability Assessment of the Persian ASQ-17 Questionnaire
Purpose: To evaluate the reliability, content validity, and cultural appropriateness of the Persian translation of the Asthenopia Questionnaire (ASQ-17) among Persian-speaking adults. Materials and Methods: Thirty adults aged 20–54 years completed the Persian ASQ-17. Translation followed a forward–backward protocol. Internal consistency was assessed using Cronbach’s alpha for the total scale and its subscales. Content validity was evaluated by 20 experts using the Content Validity Index (CVI). Face validity was assessed through structured cognitive interviews. Results: The overall scale demonstrated strong internal consistency (α = 0.888). Subscale coefficients ranged from 0.618 to 0.841. All items achieved CVI values between 0.80 and 1.00. Interview feedback confirmed clarity, comprehensibility, and cultural suitability of all items. Conclusion: The Persian ASQ-17 shows strong reliability, content validity, and face validity, supporting its use for assessing asthenopia symptoms in Persian-speaking adults.
Visual Pathway Dysfunction in Myasthenia Gravis Assessed by Pattern Reversal Visual Evoked Potentials: A Case–Control Study
Purpose: To evaluate visual pathway function in individuals with myasthenia gravis using pattern-reversal visual evoked potentials (VEP) and to compare P100 latency and amplitude between affected individuals and healthy controls. Patients and Methods: A case–control design was used, including 10 individuals with myasthenia gravis (20 eyes) and 10 age-matched healthy controls (20 eyes). Pattern-reversal VEP was recorded monocularly under standardized conditions. P100 latency and amplitudes were measured and statistically compared between groups. Results: Eyes from the myasthenia gravis group demonstrated significantly prolonged P100 latency (113.1 ± 5.74 ms) compared with controls (98.1 ± 3.33 ms; P < 0.001). P100 amplitude was markedly reduced in the myasthenia gravis group (2.65 ± 1.22 µV) relative to controls (9.00 ± 2.20 µV; P < 0.001). Conclusion: The results of this study suggest that myasthenia gravis is associated with functional disturbance of the visual pathway, reflected by significant abnormalities in pattern-reversal VEP. Although not diagnostic, VEP may serve as a complementary tool for assessing visual involvement in this condition.
Comparison of the Effect of Autologous Serum versus Preservative-Free Artificial Tears after Photorefractive Keratectomy: A Contralateral-Eye Clinical Trial
Purpose: To compare 20 % autologous serum (AS) with preservative-free artificial tears (PFAT) for epithelial healing and early outcomes after photorefractive keratectomy (PRK). Patients and Methods: Prospective, contralateral-eye clinical trial including 60 myopic patients (120 eyes). In each patient, one randomly assigned eye received 20 % AS and the fellow eye PFAT post-PRK. Primary outcome was time to complete epithelial closure. Secondary outcomes included day-by-day postoperative pain (Days 1–3), epithelial defect (ED) size (Days 1–2), corneal haze, and uncorrected visual acuity (UCVA) at 12 weeks. Standardized PRK technique and identical bandage contact lenses were used. Paired-eye statistics were applied (paired t-test or Wilcoxon as appropriate; χ² for categorical data; α=0.05). Results: Epithelial closure time did not differ between groups (AS 3.00 ± 0.33 vs. PFAT 3.03 ± 0.21 days; P=0.655). Mean Day-1 pain was numerically lower with AS overall (AS 3.28 ± 1.75 vs. PFAT 3.60 ± 1.83), and significantly lower among women (AS 3.39 ± 1.96 vs. PFAT 4.11 ± 2.05; P = 0.003). Pain declined to near-zero by Day-2 in both groups (AS 0.07 ± 0.31 vs. PFAT 0.08 ± 0.38). ED size was similar on Day-1 (AS 5.50 ± 0.73 vs. PFAT 5.56 ± 0.73) and Day-2 (AS 3.33 ± 0.60 vs. PFAT 3.47 ± 0.79). No eye developed haze. Conclusions: After PRK, 20 % AS and PFAT yield comparable epithelial closure (~3 days) and 12-week visual outcomes. AS may reduce early postoperative pain, particularly in women, warranting larger paired-eye trials to confirm this signal.
Iran’s Health Transformation Plan and the COVID-19 Response: A Systematic Review of Strengths, Failures, and Lessons
Purpose: To examine how Iran’s Health Transformation Plan (HTP), introduced in 2014 to expand coverage and reduce out-of-pocket costs, shaped the country’s COVID-19 response and to identify lessons for future health crises. Materials and Methods: A systematic review of studies published between 2014 and 2023 was conducted in line with PRISMA standards. Sources included international databases, national policy documents, and institutional reports. Twenty-five studies met inclusion criteria. Data were synthesized thematically and interpreted using Kingdon’s Multiple Streams Framework. Results: The HTP improved access to health services but provided limited resilience during COVID-19. Lockdowns were partial and delayed; digital tools were mostly informational hotlines rather than case-based tracing; laboratory and testing capacity expanded slowly; and social protection programs largely excluded informal workers. Vaccine rollout was delayed by early restrictions on Western imports but accelerated later through domestic production and alternative imports. Across domains, the absence of interoperable data systems, particularly a National Vulnerability Database, restricted targeted interventions. Conclusion: The HTP enhanced visibility but lacked adaptability in crisis. Durable resilience requires interoperable data governance, inclusive social protection, and decentralized preparedness. The findings provide transferable lessons for health reforms under fiscal and geopolitical constraints.
Copyright (c) 2025 Journal of Ophthalmic and Optometric Sciences
Misdiagnosis of Amblyopia for a Refractive Surgery Candidate
Purpose: To highlight the importance of comprehensive dilated examination in refractive surgery candidates and to demonstrate how early detection of lenticonus can prevent misdiagnosis and suboptimal management. Case Report: Lenticonus is a rare ocular anomaly characterized by protrusion of the anterior or posterior surface of the crystalline lens due to thinning of the lens capsule, resulting in reduced visual acuity and irregular astigmatism that is often not adequately correctable with spectacles or contact lenses. A 29-year-old female presented to our refractive surgery center with compound myopic astigmatism and a high astigmatic component. Conclusion: Comprehensive dilated examination of the fundus and lens should be routinely performed in all refractive surgery candidates to prevent misdiagnosis and facilitate early detection of conditions such as lenticonus, allowing appropriate management.
Determinants of Myopia among School-Going Children: A Questionnaire-Based Assessment of Risk Factors in North India
Purpose: To assess risk factors associated with high myopia among school-going children in Moradabad, Uttar Pradesh, attending a tertiary eye care hospital. Patients and Methods: A cross-sectional questionnaire-based study was conducted among 386 patients younger than 18 years diagnosed with myopia. A pre-validated questionnaire was administered through interviews; for children under 6 years, responses were obtained from parents. Information was collected on demographics, duration of spectacle use, study hours at school and home, near-work activities, and daily outdoor activity. Logistic regression was used to analyze potential risk factors, and results were reported as odds ratios with 95% confidence intervals. A p-value ≤ 0.05 was considered statistically significant. Results: High myopia was present in 10.9% (n = 42) of participants. Most children with high myopia (69.04%) attended private schools. A positive parental history of spectacle use was significantly associated with high myopia (p = 0.03). Studying or reading for more than 4 hours per day (p = 0.01) and playing video or mobile games for more than 2 hours daily (p = 0.001) were positively associated with high myopia. Outdoor activity for more than 2 hours per day showed an inverse association, with fewer children with high myopia engaging in extended outdoor play. Conclusion: Our results indicate statistical associations between behavioral patterns, environmental exposures, and high myopia in school-going children. These associations should be interpreted with caution given the hospital-based, cross-sectional design. Identifying potentially modifiable behaviors may inform preventive strategies, though longitudinal studies are required to establish temporal or causal relationships.
Factors Associated with Out-of-Pocket Payments for Refractive Surgery in Tehran, Iran
Purpose: Out-of-pocket (OOP) expenses are a major factor influencing patients’ decisions to undergo refractive eye surgery. This study aimed to identify the factors associated with OOP payments for refractive surgery in selected medical centers in Tehran, Iran. Patients and Methods: In this cross-sectional study, 200 adults undergoing refractive surgery (LASIK, LASEK, or PRK) were recruited through cluster sampling from state and private hospitals in Tehran Surgery Centers in 2025. Data were collected using a contingent valuation questionnaire to estimate patients’ maximum OOP payments. Factors influencing OOP costs were analyzed using ANOVA and independent t-tests. Results: The mean OOP payments were 9,826,531 Rials (US$106) in state teaching hospitals, 26,387,097 Rials (US$284) in state non-teaching hospitals, and 74,380,282 Rials (US$800) in private hospitals. OOP costs were significantly associated with hospital type, age, marital status, length of hospitalization, type of insurance and supplementary insurance (P < 0.05). Conclusion: OOP expenses for refractive surgery were substantially lower in governmental hospitals compared to private hospitals. Introducing multi-tiered insurance packages tailored to patient characteristics could improve access and reduce the financial burden of refractive surgery.
Vision Therapy for Presbyopia: A Systematic Review
Purpose: To systematically review the available evidence on the role of vision therapy in presbyopia management. Materials and Methods: A systematic search was conducted in PubMed, Google Scholar, Cochrane Library, and Wiley for studies published between 1990 and 2024. Eligible studies assessed the effects of vision therapy, accommodative training, orthoptic exercises, or perceptual learning on presbyopic patients. Data on visual acuity, accommodative amplitude and facility, pupil size, patient satisfaction with near vision, and outcomes of eye exercises were extracted. Results: From 87,404 initial records, 325 articles were screened, and 7 studies met inclusion criteria. These studies demonstrated that vision therapy may improve accommodative amplitude, near visual acuity, accommodative facility, and patient satisfaction. However, the evidence is limited by small sample sizes, heterogeneous methodologies, and short follow-up periods, which restrict generalizability. Conclusion: Vision therapy shows potential as a non-invasive adjunct for presbyopia management, but current evidence is insufficient for definitive recommendations. Well-designed randomized controlled trials with standardized protocols are needed to establish its clinical efficacy and long-term outcomes.
Controlling Childhood Myopia Progression: A Systematic Review of Interventions
Purpose: To synthesize evidence on risk factors and interventions for slowing myopia progression in children and adolescents. Methods: PubMed, Scopus, Embase, and Web of Science were searched through December 2023. Eligible studies included randomized and observational designs evaluating environmental factors, specialized spectacle lenses (defocus incorporated multiple segments [DIMS], highly aspherical lens [HAL], slightly aspherical lens [SAL]), multifocal or dual-focus soft contact lenses, orthokeratology, low-dose atropine, and repeated low-level red-light therapy. Two reviewers independently screened and extracted data. Risk of bias was assessed with Cochrane RoB 2 for randomized trials and the Newcastle–Ottawa Scale for observational studies. Outcomes were annual change in spherical equivalent refraction (diopters/year) and axial length (millimeters/year). Results: Increased outdoor time was consistently associated with reduced incidence and slower progression. Specialized spectacle lenses (DIMS, HAL, SAL) and dual-focus/multifocal soft contact lenses slowed refractive change and axial elongation compared with single-vision controls. Orthokeratology effectively reduced axial elongation in appropriately selected eyes. Low-dose atropine produced dose-dependent benefits, with 0.05% generally more effective than 0.01%; rebound varied with dose, treatment duration, and tapering. Emerging evidence for red-light therapy suggested short-term efficacy, but long-term safety and rebound remain uncertain. Combination strategies, such as atropine plus optical interventions, showed additive effects, though data are limited. Conclusions: Outdoor exposure, low-dose atropine (≈0.05%), DIMS/HAL/SAL spectacle lenses, multifocal or dual-focus soft contact lenses, and orthokeratology show the strongest evidence for slowing childhood myopia. Combination therapy may enhance outcomes, while red-light therapy remains promising but investigational, with long-term safety and rebound still uncertain.
Binocular Anomaly, Color Vision Deficiency and Dry Eye in Patients with Cancer
Objective: To determine the prevalence of color vision disorders and dry eye in patients with cancer. Patients and Methods: This cross-sectional study was conducted in 2019 at Imam Hossein Hospital, Tehran, Iran, and included 307 eyes from 165 patients with cancer before initiation of systemic chemotherapy. All participants underwent Schirmer I testing, binocular vision and ocular motility assessment, and color vision evaluation with Ishihara plates and the Farnsworth D15 panel. Posterior and anterior segment examinations were also performed. Results: Data from 307 eyes of 165 patients were analyzed. The mean age was 54.26 ± 13.39 years (range, 18–86). Overall, 74.6 % of eyes showed some degree of dry eye. The mean Schirmer value was 8.65 ± 8.69 mm. Abnormal color vision was detected in 6.74 % of eyes by Ishihara and in 17.28 % by the D15 test. Exophoria was present in 58.8 % of patients and esophoria in 29.1 %, while 2.1 % demonstrated abnormal ocular motility. Conclusion: Dry eye, color vision deficiency and heterophoria were more frequent among patients with cancer than in the general population, underscoring the need for routine ophthalmic screening and follow-up in oncologic care.
Optic Neuritis Visual Loss after Intragastric Botulinum Toxin A Injection: A Case Report
Intragastric botulinum toxin A is increasingly used as an endoscopic adjunct for weight reduction, and although generally safe, rare neurological and ophthalmic adverse effects have been reported. We describe the case of a 37-year-old woman who developed dimming of vision in the left eye twelve days after intragastric botulinum toxin A injection. Visual evoked potential revealed delayed P100 latency in the affected eye, while the contralateral eye was normal, and magnetic resonance imaging demonstrated inflammation of the left optic nerve. Demyelinating disease was excluded through appropriate investigations. The close temporal relationship between botulinum toxin exposure and symptom onset, along with the absence of alternative etiologies, supported a diagnosis of toxin-related optic neuritis. This case highlights that intragastric botulinum toxin A may rarely precipitate optic nerve involvement and emphasizes the importance of patient counseling and prompt ophthalmologic assessment when visual symptoms occur.
Association between Central Retinal Vein Occlusion and Mental Health Disorders
Purpose: To investigate the association between central retinal vein occlusion (CRVO) and the presence of mental health disorders. Patients and Methods: This observational study included 120 patients with CRVO, aged 48–82 years. Psychiatric assessment was performed using standardized tools, including the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI), to evaluate the prevalence of depression, anxiety, and related mental health disorders. Results: Of the 120 patients, 71 (59.16 %) were diagnosed with mental health disorders, most commonly depression and anxiety. The findings indicate that more than half of patients with CRVO experience significant psychiatric comorbidities. Conclusion: Mental health disorders, particularly depression and anxiety, are highly prevalent in patients with CRVO. These results underscore the need for routine psychiatric evaluation and integrated care strategies to improve overall outcomes in affected individuals.
Comparing the Clinical Outcome of Transepithelial and Conventional Photorefractive Keratectomy in Correction of Moderate Myopia
Purpose: To compare the clinical outcomes of one-step transepithelial photorefractive keratectomy (tPRK) with those of conventional photorefractive keratectomy (PRK) in correction of moderate myopia. Patients and Methods: In this prospective, randomized case-control study consecutive patients with moderate myopia were randomly assigned to undergo either one-step tPRK or conventional PRK using the Schwind Amaris excimer laser system at Vanak Eye Surgery Center, Tehran, Iran, from May to December 2020. Outcome measures included one and three months post-surgical uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), sphere, cylinder, spherical equivalent (SE), intraocular pressure, haze, and levels of pain and discomfort. Results: One hundred and twenty eyes from 60 consecutive patients were evaluated. No statistically significant differences were observed in mean UCVA, BCVA, or SE at one and three months postoperatively. One month postoperatively, the mean haze was significantly lower in the tPRK group compared to the PRK group (P < 0.001), but this difference was not observed at three months. Patients undergoing tPRK experienced significantly less pain (P = 0.027) and discomfort (P < 0.001) one day postoperatively. No differences between the two groups regarding postoperative intraocular pressure were observed. Conclusion: The findings of the present study suggest that the tPRK method is associated with reduced early postoperative pain and discomfort at day one as well as less corneal haze at one month postoperatively, compared to the conventional PRK method. There were no significant differences between the two methods in terms of postoperative intraocular pressure, UCVA, BCVA, or SE.
Total Binocular Blindness Resulting from an Untreated Seizure: A Case Report
Cortical blindness is a rare but serious complication of seizure disorders, typically associated with occipital lobe involvement. We report a case of a 32-year-old female with a history of hydrocephalus who developed acute, irreversible bilateral blindness following an untreated generalized tonic-clonic seizure episode. Flash visual evoked potential (VEP) testing revealed cortical dysfunction, consistent with seizure-related occipital damage. This case suggests that untreated seizures may lead to permanent vision loss through cortical visual pathway disruption. It underscores the potential neurological risks of delayed seizure intervention and highlights the importance of timely management to mitigate such outcomes. The report is contextualized with a review of relevant literature on seizure-induced cortical visual impairment.
Prevalence and Risk Factors of Keratoconus in Iran: A Narrative Review
Purpose: Keratoconus (KCN) is a progressive ectatic disorder of the cornea with variable prevalence across populations. This narrative review synthesizes evidence on the prevalence and risk factors of KCN in Iran, highlighting regional and genetic heterogeneity. Materials and Methods: A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, SID, and MagIran for studies published between 1990 and 2025. Eligible studies included population-based surveys and case-control analyses reporting on KCN prevalence and risk factors in Iranian populations. Results: Prevalence estimates in Iran range from 0.76 % in Shahroud to 4.0 % in rural regions, with localized values reaching 3.3 % in Tehran. Significant geographic and ethnic variation was observed, including higher prevalence among non-Persian ethnic groups. Major risk factors include family history, consanguinity, eye rubbing, vernal keratoconjunctivitis, and low socioeconomic status. Genetic studies identified associations with polymorphisms in COL4A4, TIMP-1, KIF26B, and LOX, while VSX1 and MIR184 showed no pathogenic involvement. Environmental factors such as ultraviolet radiation, arid climate, and low humidity also contribute. Behavioral and inflammatory mechanisms, particularly eye rubbing and allergic symptoms were consistently linked to disease onset and progression. Conclusion: KCN in Iran exhibits substantial regional, ethnic, and genetic diversity. Gene–environment interactions appear central to disease risk. National-level surveillance, standardized diagnostics, and multicenter genetic studies are needed to improve early detection and guide tailored interventions. The scarcity of available studies underscores the urgent need for expanded epidemiological and genetic research to address regional disparities and refine preventive strategies.
Effectiveness of Intravitreal Bevacizumab for Diabetic Macular Edema in Eyes with Preserved Visual Acuity: A Prospective Clinical Trial
Purpose: To assess the effectiveness of intravitreal Bevacizumab injections in reducing central macular thickness and preserving visual acuity in diabetic patients with center-involving macular edema and good baseline vision. Patients and Methods: This prospective clinical trial was conducted over 18 months starting in April 2017. Patients with non-proliferative diabetic retinopathy, visual acuity ≥20/25, and central macular thickness > 300 µm on OCT were included. Participants were assigned to two groups: one received intravitreal Bevacizumab (1.2 mg), and the other was monitored without treatment. Central macular thickness and best-corrected visual acuity were measured at baseline and six months postoperatively. Results: Twenty-two eyes completed the study (12 treated, 10 control). In the treatment group, the mean macular thickness decreased from 319 µm to 301 µm (P = 0.031). In the control group, it increased from 318 µm to 328 µm. However, the intergroup difference at six months was not statistically significant (P = 0.581). Visual acuity declined slightly in both groups: from 9.05/10 to 8.7/10 in the treated group and from 9.3/10 to 9.2/10 in controls, with no significant difference between groups (P = 0.373). No adverse events were reported. Conclusion: Bevacizumab injections led to a modest reduction in macular thickness but did not significantly improve or preserve visual acuity in diabetic patients with good baseline vision. These findings suggest that factors beyond vascular endothelial growth factor may play a role in early-stage diabetic macular edema. Further studies with a higher sample size are suggested to confirm our findings.
Visual Disturbance in Multiple Sclerosis: The Effect of Tinted Spectacle Lenses
This case report investigates the impact of tinted spectacle lenses on visual disturbances in a patient with multiple sclerosis (MS). A 42-year-old woman with preclinical-stage MS presented with severe photophobia and visual discomfort, despite normal visual acuity and the absence of ocular pathology. Conventional spectacles had failed to alleviate her symptoms. The patient reported marked improvement in visual comfort, reduced photophobia, and better tolerance to daily visual environments one month after being prescribed yellow-tinted lenses with medium density (category B). This case supports the potential utility of tinted lenses as a non-invasive, optical intervention for managing visual symptoms in MS. Further studies are warranted to assess the efficacy of various lens colors and densities across a broader spectrum of neurological disorders with visual complaints.
Visual Outcomes after Cataract Surgery in an Adult Patient with Presumed Amblyopia and Anisomyopia
Cataract surgery in adults with amblyopia can lead to improved visual acuity in the amblyopic eye, with several studies reporting a significant correlation between pre- and postoperative corrected distance visual acuity (CDVA). While some amblyopic eyes may experience a slight deterioration in visual acuity, many show stability or improvement after surgery. The extent of improvement varies, with some patients achieving 6/12 or better uncorrected visual acuity (UCVA) and nearly all achieving 6/12 or better best-corrected visual acuity (BCVA).
Juvenile Open-Angle Glaucoma: Demographic and Clinical Profile from a Tertiary Eye Care Center in Northern India
Purpose: To evaluate the demographic and clinical characteristics of juvenile open-angle glaucoma (JOAG) patients presenting to a tertiary eye care center in northern India. Patients and Methods: We conducted a retrospective review of medical records of patients aged 5–35 years diagnosed with JOAG. Data collected included age, sex, family history, refractive error, best-corrected visual acuity, intraocular pressure (IOP), cup-to-disc ratio, optic disc changes, retinal nerve fiber layer findings, and visual field indices. Treatment status, prior surgeries, and associations with systemic illness were also analyzed. Results: A total of 79 patients (158 eyes) were included. The majority was male, and most cases were bilateral. Myopia was the predominant refractive error. At presentation, many patients had advanced optic disc cupping and significant visual field loss, often despite ongoing anti-glaucoma medication. Mean IOP was markedly elevated, and several eyes had undergone prior trabeculectomy. Family history of glaucoma was noted in a subset of patients. Systemic comorbidities were infrequent. Conclusion: JOAG in this cohort predominantly affected young males and was strongly associated with myopia and advanced disease at presentation. The findings highlight the aggressive nature of JOAG and the need for early diagnosis, vigilant screening of at-risk individuals, and timely surgical intervention to prevent irreversible visual disability.
A Brief of Review of Amblyopia and its Management
Amblyopia, or "lazy eye," is the leading cause of unilateral vision impairment in children worldwide, with a prevalence of 3.7%. This condition results from early visual deprivation or improper light focus in one eye, leading to an imbalance in visual input to the brain’s visual cortex. Consequently, vision in the affected eye declines, disrupting binocular coordination. When one eye sends unclear signals, the brain suppresses its input. Beyond visual coordination, amblyopia can impact tasks such as hand-eye coordination, reading, and self-perception. Various treatments have been developed for amblyopia in both children and adults. However, both traditional and modern treatments have limitations regarding effectiveness and patient comfort, affecting individuals and their families. A more practical approach may involve simultaneous stimulation of both eyes to enhance vision in the weaker eye, reduce suppression, and strengthen binocular vision. This review aims to provide a concise, evidence-based overview of amblyopia, covering its pathogenesis, classification, diagnosis, and treatment. By highlighting sensory adaptations and advancements in therapy, we emphasize the importance of early intervention and emerging neuroplasticity-based treatments to improve clinical outcomes.
Pediatric Ocular Trauma in Iranshahr, Iran
Purpose: The aim of this article was to evaluate the characteristics, causes, and severity of pediatric ocular trauma in Iranshahr, Iran. Patients and Methods: This retrospective observational study analyzed pediatric ocular trauma (age < 12 years) cases presenting to pediatric and ophthalmology emergency units in Iranshahr, Sistan and Baluchestan Province, Iran, between April 2019 and September 2022. Data were collected on age, sex, circumstances of trauma, injury type, location and mechanism of trauma, associated injuries, hospitalization rate and length of stay, treatment, and trauma sequelae (visual impairment). Ocular traumas were classified according to the Birmingham Eye Trauma Terminology (BETT) system and the Ocular Trauma Score (OTS). Results: A total of 79 children (56 males, 23 females) were included. The mean age was 6.4 ± 2.1 years (range: 6 months to 11.5 years). Blunt objects (25 %) and direct trauma (8 %) were the primary mechanisms of injury. According to BETT classification, 24% of ocular traumas were open-globe traumas. By the end of ophthalmic follow-up, 19 patients (9.4%) had persistent sequelae. Compared with female patients, male patients were older (P < 0.001) and more frequently injured by projectiles (P = 0.026). The majority of injuries occurred at home (49 %), followed by public areas (18%). Conclusion: Our findings indicate that male gender and home setting are risk factors for childhood eye trauma. Increasing public awareness, strengthening safety awareness at home, and improving ophthalmic emergency care are crucial steps in reducing the burden of pediatric ocular injuries in our setting and beyond.
Effect of Bevacizumab on Pterygium: A Case Series Study
Purpose: to study evaluate the effectiveness of a single subconjunctival injection of bevacizumab (Avastin), an anti-vascular endothelial growth factor (VEGF) agent, in reducing pterygium size and vascularization among patients with primary pterygium. Patients and Methods: Seventeen patients with primary pterygium were enrolled in this case series study. Each patient received a single subconjunctival injection of 1.25 mg bevacizumab. Follow-up evaluations were conducted at one week, one month, and three months post-injection. The primary outcomes included changes in symptoms such as itching, redness, tearing, and burning, as well as pterygium size and vascularization. Statistical analysis was performed using Repeated Measures ANOVA and Paired T-tests. Results: Itching significantly decreased within the first week and remained stable at three months. Pterygium vascularization was also reduced. However, changes in pterygium size, astigmatism, and refraction were not statistically significant. No serious adverse effects were reported. Conclusion: A single dose injection of subconjunctival bevacizumab significantly reduces vascularization and itching in pterygium. However, its impact on pterygium size remains unclear. While surgical excision remains the gold standard, subconjunctival bevacizumab offers an alternative treatment approach for patients seeking a minimally invasive alternative. Further studies are needed to determine optimal dosing strategies and long-term effects.
Unilateral Optic Disc Pseudo-duplication with Contralateral Chorioretinal Coloboma: A Case Report
Optic disc pseudo-duplication (ODPD) is a rare condition presumed to be a form of retinal coloboma. In this report, we present the case of a child with ODPD in one eye and diffuse chorioretinal coloboma, along with microcornea in the fellow eye. This case supports the hypothesis that ODPD may be linked to the colobomatous nature of the condition.
Myopia Induced after Systemic Chemotherapy with Docetaxel
Transient myopia is an unreported toxicity of docetaxel. We report an unexpected development of myopia following systemic chemotherapy with docetaxel. A 38-year-old woman undergoing chemotherapy for breast cancer received docetaxel every two weeks. Prior to chemotherapy, she had no visual impairments, ocular disorders, or other comorbidities. After seven cycles of systemic chemotherapy, she began experiencing visual impairment. Her spherical equivalent refractive errors were -2.00 D in the right eye and -1.63 D in the left eye. Uncorrected visual acuity was 0.42 logMAR in the right eye and 0.3 logMAR in the left eye, both correctable to 0 logMAR. At a 4-week follow-up after cessation of chemotherapy, her vision gradually recovered. To our knowledge this is the first reported case of docetaxel induced myopia in a patient undergoing cancer treatment in the English literature, underscoring the need for clinicians to be aware of this potential ocular toxicity.
Epidemiological Assessment of Keratoconus at an Eye Clinic in Tehran, Iran
Purpose: To characterize the demographic, biometric, and clinical features of keratoconus (KC) at an eye clinic in Tehran, Iran, and to identify key risk factors associated with disease severity. Patients and Methods: This cross-sectional study included 426 KC patients referred to Basir Eye Center, Tehran, Iran between April 2019 and May 2021. All cases were confirmed using Scheimpflug-based tomography (SIRIUS). Variables included age, sex, nationality, refractive error, topographic parameters (Kmax, TCT, and pachymetry), treatment modality, and clinical history. Results: The mean patients age was 28.7 ± 5.2 years, with 62% aged 15-25. Males comprised 60.3% of the cohort. Iranian patients accounted for 86.38% of the sample, followed by Iraqi nationals (12.44%). A first-degree family history was present in 16.9% and second-degree history in 10.04% of patients. Consanguinity was reported in 40% of familial cases. Kmax > 48 D and pachymetry < 450 µm were strongly associated with increased disease severity (P < 0.01 for both). We also observed a strong association between male sex, age < 25 years, and need for surgical intervention (P < 0.01 for both). Eye rubbing was strongly associated with disease progression (OR = 3.2; P = 0.003). Conclusion: Keratoconus in this population exhibited early onset, male predominance, and strong associations with eye rubbing, Kmax, pachymetry, male sex, and age. Severity classification based on biometric parameters revealed a high proportion of patients eligible for early therapeutic intervention. These findings highlight the potential value of incorporating biometric risk profiling into clinical evaluation to guide timely treatment.
Visual Evoked Potential Findings in a Vitiligo Patient
A 45-year-old man was referred to the Basir Eye Clinic in Tehran, Iran, for a visual evoked potential (VEP) assessment due to complaints of blurred vision in his left eye. His condition remained untreated because of his corticosteroid phobia, despite medical recommendations. VEP results revealed a delay of VEP P100 peak in both eyes, indicating optic nerve involvement, a finding observed in some patients with this condition.
Refractive Errors, Corneal Power, and Far and Near Visual Acuity in Cancer Patients
Purpose: To determine visual acuity, central and peripheral corneal power, and the prevalence of refractive errors in cancer patients from Imam Hossein Medical Center, Tehran, Iran. Patients and Methods: In this cross-sectional, population-based study, cancer patients were examined for far and near visual acuity (VA), refractive errors, central and peripheral corneal power, and near addition. Data analysis was performed using SPSS version 22 software. Results: Data were collected from 330 eyes of 165 patients. The mean age was 54.26 ± 13.39 years (range: 18-86 years). The prevalence of hyperopia, myopia, and astigmatism was 30.3 % (95 % confidence interval [CI]: 25.5-35.5 %), 27 % (95 % CI: 22.1-31.8 %), and 80.3 % (95 % CI: 76.1-84.5 %), respectively. The mean uncorrected and corrected distance visual acuity (VA) was 0.29 ± 0.36 logMAR (95 % CI: 0.25-0.33) and 0.07 ± 0.21 logMAR (95 % CI: 0.05-0.09), respectively. The mean uncorrected and corrected near VA was 0.51 ± 0.32 logMAR (95 % CI: 0.47-0.54) and 0.04 ± 0.19 logMAR (95 % CI: 0.017-0.06), respectively. The mean near addition was 1.73 ± 0.93 D (95 % CI: 1.63-1.84). The mean central and peripheral keratometry values were 44.20 ± 1.54 D (95 % CI: 44.03-44.37) and 44.17 ± 1.50 D (95 % CI: 44.00–44.34). Conclusion: The prevalence of refractive errors in this study was higher than in most previous reports and increased significantly with age. Based on our results astigmatism was the most common refractive error in cancer patients, followed by hyperopia and myopia.