Journal of Ophthalmic and Optometric Sciences

Purpose:
To assess the efficacy of patching therapy in people with unilateral anisometropic amblyopia in adults.

Methods:
The research was conducted at Visifert Eye Clinic in Noida, India, from August 2023 to May 2024, involved 28 adults with unilateral anisometropic amblyopia. Those who were at least eighteen years old met the inclusion requirements, a spherical equivalent less than -3.00D, best habitual visual acuity between 0.3 logMAR and 1.0 logMAR in the amblyopic eye, and logMAR 0.2 or better in the fellow eye. Participants underwent cycloplegic refraction and were given corrective spectacles to wear for one month. If no improvement was observed, patching treatment commenced, involving 3 hours of daily occlusion for 8 weeks. Visual acuity was assessed at the start and end of the treatment.

Results:
Out of 28 subjects, vision improved in 26 (92.85%) and did not improve in 2 (7.14%) after 6 weeks of patching therapy. The 17-20 age group showed 100% improvement, 20-24 age group had 92.85% improvement, and the 25 and above age group had 50% improvement. The overall mean visual improvement was 1.03 ± 0.944 lines on the log MAR chart.

Conclusion:
The study demonstrates that patching therapy leads to significant visual acuity improvement in adults with unilateral anisometropic amblyopia in the 18-20 age group. The results demonstrate the possibility of patching therapy beyond childhood, despite the limited sample size, and reinforce the necessity for bigger sample sizes in future studies to corroborate these findings.

Purpose: This case series study reports the ophthalmic manifestations observed in multiple sclerosis (MS) patients and their diagnostic implications.
Patients and Methods: A cross-sectional case series included 15 MS patients from Negah Eye Hospital, Tehran, Iran. Each patient underwent a comprehensive ophthalmic evaluation, including best-corrected visual acuity (BCVA), pupillary response, ocular motility, slit-lamp biomicroscopy, fundoscopy, visual field testing, optical coherence tomography (OCT), and visual evoked potentials (VEP). Patient demographics, systemic conditions, and treatment history were also analyzed.
Results: Our study included 15 patients with MS (11 females, 4 males, aged 18–56 years). BCVA ranged from 20/20 to 20/100, with objective color vision impairment in 6 % of cases. Relative afferent pupillary defect was observed in 6 % of patients. Optic neuritis and visual disturbances were common findings. Optic nerve atrophy was observed in 20 % of patients.  Ocular motility disturbances, including internuclear ophthalmoplegia and diplopia, were present in 20 %. Visual field abnormalities were detected in 26 %, while VEP testing showed delayed latency in all tested eyes. OCT results were normal in 20 % of cases. Uveitis was noted in 6 %, and 13 % had concurrent COVID-19 infection.
Conclusion: This case series highlights the diverse ophthalmic manifestations of MS, with optic neuritis and ocular motility disturbances as key findings. VEP and OCT provide valuable diagnostic insights, especially for subclinical cases. A comprehensive ophthalmic assessment is crucial in MS management to improve diagnosis and prevent unnecessary treatments.

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.

Purpose: To classify ocular trauma in a rural region of southeast Iran, evaluate its impact on vision, and assess post-treatment visual outcomes.
Patients and Methods: The study was a hospital-based, prospective, observational study conducted over a one-year period including patients presenting with ocular trauma from rural areas of Sistan and Baluchestan province located in southeastern Iran. A total of 50 patients with ocular trauma were included. A detailed ocular history was obtained, followed by a comprehensive ophthalmic examination for each patient. Follow-up visits were scheduled one week after discharge, and subsequently at four weeks eight weeks and twelve weeks.
Results: Ocular injuries were more commonly seen in adults who were engaged in agricultural work. Males were more frequently affected (74 %). Closed-globe injuries (72 %) were more common than open-globe injuries (28 %). In both open- and closed-globe injuries, the most common object causing injury was a wooden stick. At presentation, only 29.2 % of patients had a visual acuity better than 1/10. However, after completing treatment and at the 3-month follow-up, 71.3 % had a best-corrected visual acuity better than 1/10.
Conclusion: Ocular trauma remains a major public health concern in rural areas, particularly among adult males involved in agricultural activities. Closed-globe injuries were more common than open-globe injuries, with wooden sticks identified as the primary cause of trauma. Further multi-center studies across multiple rural hospitals in Iran could provide a broader epidemiological picture of ocular trauma and its impact in these areas.

Cataract surgery is one of the most commonly performed eye surgeries worldwide, while dry eye disease (DED) is a multifactorial ocular surface disorder characterized by the loss of tear film homeostasis, accompanied by symptoms such as dryness, foreign body sensation, and inflammation. Although both conditions are more prevalent in older individuals, numerous reports confirm an increase in dry eye symptoms following cataract surgery. Additionally, tear film disorders can significantly affect preoperative biometric measurements. In such cases, cataract surgery outcomes may be compromised, and patient dissatisfaction due to the discomforting symptoms of DED may increase. This mini-review provides a brief overview of the key aspects of dry eye disease in patients undergoing cataract surgery.

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.

Case Report: A 30-year-old male presented with progressive blurred vision and a suspected family history of KCN. Clinical examination revealed high astigmatism, a scissor reflex on retinoscopy, and fine horizontal striae in the posterior stroma and Descemet’s membrane of both corneas, resembling Vogt’s striae. Pentacam imaging confirmed the diagnosis of KCN, demonstrating central corneal thinning, elevated front and back elevation maps, and high dioptric power points in the curvature map of both eyes. Due to intolerance to rigid gas permeable (RGP) lenses, deep anterior lamellar keratoplasty (DALK) was performed as the definitive treatment.
Conclusion: This case highlights a rare bilateral presentation of horizontal Vogt’s striae in KCN, an uncommon slit-lamp finding. The presence of these atypical stress lines may be attributed to mechanical stretching or corneal distortion induced by the cone. Recognizing such rare variations can enhance the understanding of KCN pathophysiology and aid in its clinical diagnosis and management.