Amblyopia is the most common cause of preventable blindness in children and young adults. Most of the amblyopic visual loss is reversible if detected and treated at appropriate time. It affects 1.0 to 5.0% of the general population. Various treatment modalities have been tried like refractive correction, patching (both full time and part time), penalization and pharmacological therapy. Refractive correction alone improves visual acuity in one third of patients with anisometropic amblyopia. Various drugs have also been tried of which carbidopa & levodopa have been popular. Most of these agents are still in experimental stage, though levodopa-carbidopa combination therapy has been widely studied in human amblyopes with good outcomes. Levodopa therapy may be considered in cases with residual amblyopia, although occlusion therapy remains the initial treatment choice. Regression of effect after stoppage of therapy remains a concern. Further studies are therefore needed to evaluate the full efficacy and side effect profile of these agents.

Central retinal vein occlusion (CRVO) can cause vision loss. The pathogenesis of CRVO involves a thrombus formation leading to increased retinal capillary pressure, increased vascular permeability, and possibly retinal neovascularization. Vision loss due to CRVO is commonly caused by macular edema. Multiple treatment modalities have been used to treat macular edema. Currently, the most common therapy used is intravitreal inhibition of vascular endothelial growth factor (VEGF). The three most widely used agents are aflibercept, bevacizumab, and ranibizumab and they are effective at blocking VEGF. In addition, intraocular steroids can be used to treat macular edema. This review will briefly cover the treatment options and discuss in greater detail the efficacy and safety of aflibercept.

With the rapid growth of the stem cell biology field, the prospect of regenerative medicine across multiple tissue types comes closer to reality. Several groundbreaking steps paved the way for applying stem cell biology to the several subfields within ophthalmology and oculoplastic surgery. These steps include the use of stem cell transplants as well as studies of various ophthalmologic pathologies at the molecular level. The necessity of stem cell transplant is readily apparent, having already been used for several studies such as artificial lacrimal gland design and eyelid reconstruction. Investigating the stem cell biology behind oncological diseases of the eye has also developed recently, such as with the identification of specific markers to label cancer stem cells in orbital adenoid cystic carcinoma. The advent of induced pluripotent stem cells led to a burst of productivity in the field of regenerative medicine, making it possible to take a patient's own cells, reprogram them, and use them to either study patient-specific pathology in vitro or use them for eventual patient specific therapeutics. Patient-specific adipose-derived stem cells (ASCs) have been used for a variety of treatments, such as wound healing and burn therapies. As the fields of stem cell biology and regenerative medicine continue to progress, its use will become a mainstay of patient-specific cell therapies in the future.

Purpose: To evaluate the efficacy, safety, predictability, and visual performance of excimer laser photorefractive keratectomy (PRK) for myopia greater than −8 diopters (D). Methods: Fifty-four patients (104 eyes) with myopia from −8D to −13D and cylinder up to −4D received surface ablation technique with the Allegretto wave version 1009-1 excimer laser to correct their refractive error. The patients were examined on days 1, 3, 7, and 14 and 1, 3, 6, and 12 months postoperatively. Visual acuity, manifest refraction, corneal haze, topography, intraocular pressure, contrast sensitivity, and wavefront aberration were evaluated. Results: Twelve months postoperatively, 95% of eyes were within 1D of the intended correction. In addition, 94% of eyes had attained uncorrected distance visual acuity of 20/25 or better, and 98% of eyes had improved or remained their corrected distance visual acuity. All eyes exhibited barely detectable corneal haze which peaked during the 1^st month with a gradual reduction in the 3^rd month. Ninety-five percent of patients had no or only mild degree of night glare. Conclusions: Excimer laser PRK is an effective and predictive treatment for high myopia greater than −8D with or without astigmatism up to −4D. The incidence of complication is low. All patients who are candidates for laser in situ keratomileusis can be candidates for surface ablation, especially those with preoperative thinner cornea or higher risk of corneal flap complications.

Purpose: Sickle cell disease (SCD) is the most common and serious form of an inherited blood disorder that lead to higher risk of early mortality. SCD patients are at high risk for developing multiorgan acute and chronic complications linked with significant morbidity and mortality. Some of the ophthalmological complications of SCD include retinal changes, refractive errors, vitreous hemorrhage, and abnormalities of the cornea. Materials and Methods: The present study includes 96 SCD patients. A dilated comprehensive eye examination was performed to know the status of retinopathy. Refractive errors were measured in all patients. In patients with >10 years of age, cycloplegia was not performed before autorefractometry. A subset of fifty patients' genotyping was done for NOS3 27-base pair (bp) variable number of tandem repeat (VNTR) and IL4 intron-3 VNTR polymorphisms using polymerase chain reaction-electrophoresis. Chi-square test was performed to test the association between the polymorphisms and refractive errors. Results: The results of the present study revealed that 63.5% of patients have myopia followed by 19.8% hyperopia. NOS3 27-bp VNTR genotypes significantly deviated from Hardy–Weinberg equilibrium (P < 0.0001). Although IL4 70-bp VNTR increased the risk of developing refractive errors, it is not statistically significant. However, NOS3 27-bp VNTR significantly reduced the risk of development of myopia. Conclusion: In summary, our study documents the prevalence of refractive errors along with some retinal changes in Indian SCD patients. Further, this study demonstrates that the NOS3 VNTR contributes to the susceptibility to development of myopia in SCD cases.

Purpose: This study was aimed to evaluate the difference in the ocular parameter changes following scleral buckling (SB) for rhegmatogenous retinal detachment (RRD) in different age group patients. Materials and Methods: This prospective study included 26 eyes of 26 patients who underwent SB for uncomplicated RRD. The patients were divided into three age groups: 16–30 years (Group I), 31–45 years (Group II), and 46–60 years (Group III). Axial length (AL), anterior chamber depth (ACD), and corneal curvatures were measured preoperatively and postoperatively at 1 week, 1 month, and 3-month. The postoperative change and progression of these parameters were evaluated and compared between three age groups using nonparametric Wilcoxon signed-rank test and Kruskal–Wallis test. Results: At 3-month follow-up, a statistically significant postoperative AL increase, ACD decrease, and surgically induced astigmatism (SIA) were observed in all groups (Group I - 0.75 ± 0.32 mm, 0.21 ± 0.21 mm, and 1.5 ± 0.48 D, respectively; Group II - 0.79 ± 0.41 mm, 0.14 ± 0.04 mm, and 2.07 ± 1.18 D, respectively; Group III - 0.86 ± 0.33 mm, 0.16 ± 0.05 mm, and 1.56 ± 1.19 D, respectively). However, surgery-induced change for any parameter was not significantly different between the groups (P for AL [0.7955]; ACD [0.8805]; and SIA [0.5485]). Progression in postoperative changes in AL and ACD was insignificant during three follow-up examinations in all the groups. However, SIA of Group I continued to change significantly up to 3 months but stopped to change at 1 month only in Group II and III. Conclusion: Age-related change in physical properties of ocular tissue does not have any major additional effect on the results of SB except that the postsurgical change in corneal curvature stops earlier in older patients compared to that in younger patients.

Purpose: To evaluate the surgical results of medial rectus (MR) muscle advancement with or without recession of the antagonist muscle for consecutive exotropia. Methods: Medical records of patients with consecutive exotropia (n = 27) were retrospectively reviewed. All patients received one-eye surgery with MR advancement, lateral rectus (LR) recession, or combined surgery. The pre- and post-operative angle of deviation was recorded. Characteristics were compared between groups. The follow-up period was at least 3 months. Results: The overall successful rate was 62.96%, with 50% in MR advancement group, 60% in LR recession group, and 71.4% in combined group. Patients in combined group had larger preoperative deviation. There were comparable surgical results between patients with inferior oblique (IO) muscle overaction receiving correction simultaneously and patients without IO muscle overaction. Conclusions: The overall surgical successful rate for consecutive exotropia in this study was 62.96%. Combined MR advancement and LR recession yielded better results than MR advancement or LR recession alone although it was not statistically significant.

A 50-year-old female presented with bilateral retinitis pigmentosa (RP) and acute angle closure (AAC) with fixed mid-dilated pupil and high intraocular pressure (IOP) in the left eye following left side periorbital botulinum toxin A injection for blepharospasm. Glaucomatous optic neuropathy and retinal nerve fiber layer defect were observed in the affected eye using optical coherence tomography although the IOP was maintained at <21 mmHg after the treatment. Botulinum toxin acts at the cholinergic synapse and inhibits acetylcholine release; hence, it can cause transient mydriasis and may lead to AAC in high-risk populations such as patients with RP. Patients should be explained about the possible development of mydriasis associated with botulinum toxin injection, and clinicians must evaluate the level of risk for AAC before administration of botulinum toxin around the eyelid. In cases showing side effects associated with botulinum toxin injection, early diagnosis and treatment is required to prevent blindness.

A 15-year-old boy presented with progressive myoclonic epilepsy and unbalance gaits for 4 years. Slit lamp examination showed a punctate cataract and funduscopic examination revealed bilateral macular cherry-red spots. Macular scan of spectral domain optical coherence tomography (SD-OCT) showed hyperreflectivity of the inner retinal layer and apparent hyperreflectivity of the photoreceptor layers in the foveal region. The clinical presentations were consistent with a Type I sialidosis which led to genetic analysis and revealed NEU1 mutation in this patient. He was under regular follow-up by ophthalmologist and neurologist. Sialidosis is a rare lysosomal storage disease resulting from a deficiency of alpha-N-acetyl neuraminidase caused by a mutation in the NEU1 gene. This results in abnormal intracellular accumulation of sialyloligosaccharides in brain neurons and ganglion cells of the retina. SD-OCT is a useful tool in detecting macular cherry-red spot and has a role in evaluating the extent of ganglion cell damage. It can aid in the differential diagnosis and long-term follow-up of the neurological metabolic disorders.