Journal of Ophthalmic and Optometric Sciences

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.

Purpose: This study aimed to evaluate changes in tear volume and dry eye symptoms in cancer patients following first time systemic chemotherapy.
Patients and Methods: In this cross-sectional study, cancer patients undergoing chemotherapy for the first time with different drug regimens were evaluated before and after treatment. Assessments included the Schirmer’s test, the Ocular Surface Disease Index questionnaire, and a comprehensive eye examination for all patients.
Results: A total of 60 patients (120 eyes) with a mean age of 52.07 ± 13.047(range: 18-80 years) were examined. Of these patients 53.3% (n = 32) were female. The mean Schirmer’s test score was 9.17 ± 8.65 mm before chemotherapy and 10.02 ± 9.82 mm after chemotherapy; showing no statistically significant difference (P = 0.865). The only group showing a significant increase in mean Schirmer’s test score was patients older than 40 years old (P < 0.01).

Conclusion: Although changes in mean tear volume following systemic chemotherapy were not significant - except among patients over 40 years old - further studies with larger sample sizes and longer follow-up periods are warranted.

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.

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.

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.

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.

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.