Journal of Ophthalmic and Optometric Sciences

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.

Purpose: This study aimed to evaluate the profile of myopic patients suffering from convergence insufficiency (CI) at an eye care center in northern India.
Patients and Methods: A total of 172 myopic patients aged 5 to 39 years who attended Tamojyoti Netralaya eye clinic, Gurugram, India, from December 2023 to December 2024 were included. All patients underwent comprehensive ophthalmic evaluations, including visual acuity, subjective refraction, and assessments of near point of convergence (NPC), accommodative functions, positive fusional vergence (PFV) and negative fusional vergence (NFV).
Results: CI was prevalent among myopic patients, and patients with compound myopic astigmatism showed a higher rate of CI. The degree of CI increased with age and the severity of myopia. Notably, even low degrees of myopia (0.5 D and above) were associated with CI.
Conclusion: Our study results indicate that CI is commonly associated with myopia. CI was more prevalent in patients with compound myopic astigmatism, especially among adults aged 20–24 years. Therefore, regular eye examinations are essential to reduce asthenopic symptoms in these patients.

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.

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.

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.

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.