OphthaTherapy. Therapies in Ophthalmology

Corneal higher order aberrations in beta-thalassemia major

Maryam Firdous — 2025-06-18

Purpose: This study aimed at evaluating the corneal higher order aberrations in beta-thalassemia major cases and comparing it to the healthy individuals.
Material and methods: It was a comparative cross-sectional study conducted on 56 beta-thalassemia major cases and 64 healthy controls from December 2023 to June 2024. All the participants received a standard ophthalmological examination subsequently followed by measurement of corneal higher order aberrations using Corneal Topography Galilei G5.
Results: The mean age of the cases and controls was comparable (P = 0.190). All the corneal higher order aberrations were significantly different among cases and controls (P <0.05), except for total coma, horizontal come, and spherical aberrations (P >0.05). Only fifth order aberrations were weakly positively correlated to thalassemia duration (r = 0.28, P = 0.033). The fourth order and spherical aberrations were weakly negatively correlated to hemoglobin levels (P = 0.029, P = 0.012 respectively). The fifth and sixth order aberrations were significantly different among the patients undergoing monotherapy and combined therapy (P = 0.006, P = 0.022 respectively).
Conclusions: Corneal higher order aberrations are greater in beta-thalassemia major cases potentially due to disease and its treatment-related factors. The findings of the study focuses the need for regular ocular monitoring in these patients to lessen potential visual disturbances and improve ocular health.

Optically induced hyperopic defocus: axial length changes in emmetropes from mobile screen exposure

Saif Ullah — 2025-08-06

Background: The rapid increase in smartphone screens led to eye problems. The study measured transient axial length variations during mobile screen exposure before and after hyperopic defocus.

Methods: A quasi-experimental study on students utilizing non-probability sampling was conducted at Al-Shifa Trust Eye Hospital. LogMAR measured visual acuity, and retinoscopy measured refractive status of right eye only. Samsung Galaxy A7 provided full-blue screen exposure. -3.00 DS lens in trial frame caused hyperopic defocus. IOL Master Zeiss 700 measured axial length and ocular biometrics. The online web program Data tab was entered, and data was analyzed.

Results: A total of 30 subjects, which includes 6 (20%) males and 24 (80%) females, with a mean age of 20.67 (±0.96) years. Mean visual acuity and Spherical Equivalent Refraction were 0.00 (±0.00) and 0.10 (±0.01). Comparing the median interquartile range (Median-IQR) pre-defocus axial length (PDAXL) and after defocus axial length (ADAXL), pre-defocus lens thickness (PDLT) and after defocus lens thickness (ADLT) following 1 h exposure to mobile screen a statistically significant difference were observed respectively – 23.2 (±0.93), 23.14 (±0.92), p value = 0.003 and 3.61 (±0.28), 3.61 (±0.22), p value = 0.001. Other ocular parameter like pre-defocus anterior chamber depth (PDACD) and after-defocus anterior chamber depth (ADACD), pre-defocus central corneal thickness (PDCCT) and after-defocus central corneal thickness (ADCCT) no statistically significant were observed respectively – 3.45 (±0.29), 3.44 (±0.26), p value = 0.861 and 528 (±31.50), 525.17 (±24.75), p value = 0.139.

Conclusion: Exposure to mobile screens in blue mode, along with hyperopic defocus, was found to cause axial length shortening, offering potential implications for managing myopia progression.

The impact of multiple sclerosis on vision and ocular motility. The role of ophthalmologists, orthoptists, and optometrists in patient management and treatment

Ewa Witowska-Jeleń — 2025-06-11

Multiple sclerosis has numerous adverse effects on vision and can lead to significant visual impairment. Beyond the well-known symptom of optic neuritis, multiple sclerosis can cause various eye movement disorders, with bilateral internuclear ophthalmoplegia being the most common. This paper explores the range of visual disorders associated with multiple sclerosis, emphasizing ocular motility issues and the crucial role of eye care professionals in managing these patients.

The impact of latanoprost glaucoma eyedrops with and without preservatives on the ocular surface parameters – a case series report

Jaromir Wasyluk — 2025-06-30

Background: Preservatives and additives commonly found in ophthalmic solutions can aggravate the symptoms of dry eye disease, a condition that already affects a large percentage of the global population. These additives are also frequently present in topical medications for glaucoma, another widespread disorder impacting several millions of individuals worldwide being on a persistent anti-glaucoma therapy. With the continued aging of populations, the prevalence of both diseases is expected to rise.

Methods: Four patients diagnosed with glaucoma, who were on topical latanoprost monotherapy were switched from the preservative prescription to a preservative-free analogue. Lubricating eye drops were withdrawn 4 weeks prior and restrained from use during the 3 months observation period. Tear break-up time, interferometry, conjunctival redness, tear film osmometry, along with a dry eye disease questionnaire were performed at each timepoint to assess changes on the ocular surface condition. Standard ophthalmic examination was also performed.

Results: Conjunctival redness remained constant at all timepoints. Tear film osmolarity decreased in all patients and so did the Ocular Surface Disease Index. As for the tear break-up time and interferometry, tendencies of the results were inconclusive. Best corrected visual acuity and intraocular pressure remained stable throughout the study.

Conclusions: Preservative-free topical glaucoma therapies appear to be better tolerated and impose less burden on the ocular surface. Such formulations should be prioritized for glaucoma patients, who often require life-long treatment. Given the chronic nature of dry eye disease and the absence of regenerative options for the lacrimal and meibomian glands, preventive strategies are of critical importance.

The impact of phosphates in eye drops on the ocular surface

Dominika Wróbel-Dudzińska — 2025-07-31

The ocular surface plays a key role in maintaining corneal transparency and protecting the visual organ from external factors. One of the threats to its integrity is the use of topical ophthalmic preparations containing phosphates, which – when the epithelium is damaged – can lead to the formation of calcium phosphate deposits and the development of band keratopathy. The aim of this article is to present the role of phosphates as excipients in eye drops, their mechanism of action, potential toxicity, and the risks associated with their long-term use. Special attention is given to the conditions that promote corneal calcification and the negative impact of phosphates on epithelial healing and regeneration processes. The article emphasizes the need to raise awareness among physicians and patients about the potential adverse effects of phosphates and the necessity for caution in their use, particularly in individuals with a compromised ocular surface.

Komentarz

Marta Misiuk-Hojło — 2025-07-31

None

Anisometropia and myopia progression – patient management guidelines

Joanna Przeździecka-Dołyk — 2025-08-31

Anisometropia, or a diff erence in refraction between the eyes, can lead to aniseikonia – a difference in the size or shape of retinal images. Th e main symptoms include asthenopia and disturbances in stereopsis and spatial perception, including disturbances in movement patterns. Incorrectly applied correction can result in fusion disorders, headaches, diplopia, or amblyopia. Treatment requires appropriately selected spectacle or contact correction, taking into account the degree of aniseikonia, binocular balance, and visual rehabilitation. Pharmacological (e.g., atropine) and optical methods (DIMS glasses, MFSCL lenses, orthokeratology) are used to manage myopia progression. Th eir goal is to control myopic defocus at the periphery of the retina and slow down the growth of the eyeball, ideally with early implementation of therapy and lifestyle modifi cations (time outdoors, breaks from close-up work). Eff ective care requires cooperation between an ophthalmologist, optometrist, and in children, a pediatrician and educator to ensure proper visual development and functioning in the school environment.

To the Editor: on paper "Negative dysphotopsia after cataract surgery – a problem that exists"

Samuel Masket — 2025-07-23

Answer to dr Samuel Masket: on paper "Negative dysphotopsia after cataract surgery – a problem that exists"

Marcin Jezierski — 2025-07-23

The evolution of intraocular lenses: from monovision to spiral optics

Bogumił Wowra — 2025-07-31

Cataracts remain one of the leading causes of blindness worldwide, and their surgical treatment, which involves the removal of the cloudy lens and the implantation of an artificial intraocular lens (IOL), is highly effective and safe. Advances in technology have significantly expanded the range of lens options, allowing not only the restoration of visual acuity but also the correction of co-existing refractive errors and presbyopia. This review article presents current standards for the use of intraocular lenses and discusses various types of implants: from classic monofocal lenses and monovision strategies, through improved monofocal plus lenses, to advanced multifocal designs, EDOF, and innovative spiral lenses. Particular attention is paid to the optical properties of each type of IOL, their advantages, limitations, and impact on patients’ quality of life after surgery. The aim of this article is to help physicians and patients make informed choices about the most appropriate type of lens, tailored to their individual visual needs and expectations.

Retinal detachment as a late complication of ocular trauma with posterior segment intraocular foreign body

Adam Chmiel — 2025-08-12

The paper presents a case report of retinal detachment as a late complication in a 43-year-old patient, initially hospitalized in 2013 due to a penetrating injury to the right eye with the presence of an intraocular foreign body. The paper summarizes complications of posterior segment intraocular foreign body injuries, their diagnostics and discusses their potential clinical significance.

Presbyopia – epidemiological background, pathophysiology, and treatment methods, including laser refractive surgery

Grzegorz Jasina — 2025-08-06

Presbyopia is the inability to see small things up close, usually occurring after the age of 40, associated with loss of accommodation, which results in dependance on glasses when working up close. There are many different methods of correcting presbyopia, but it is still difficult to restore the status from before disease onset. The article describes the epidemiology, pathophysiology and non-surgical and surgical methods of treating presbyopia, with particular emphasis on corneal, scleral and intraocular refractive methods related to lens replacement.

Post-pandemic health debt in cataract treatment and the costs of its mitigation. Population study of Northwestern region in Poland

Arnold Maciejewski — 2025-08-12

Regulating access to medical services via institutional means, but also as a result of unforeseeable events, may generate social costs. This may be especially relevant for indications where treatment results in full recovery. One of such indications is cataract, which, if untreated, is the leading cause of blindness. This paper is the first attempt at empirically estimating the existing medical and financial needs associated with cataract treatment among patients aged 41 and older in Poland, taking into consideration the limitations imposed by the system regulators and the impact of the unpredictable event that was the SARS-CoV-2 pandemic. The needs and the costs of fulfilling them were estimated on the basis of three scenarios of treatment eligibility. The first one assumed the system being fully open to every patient diagnosed with crystalline lens opacities. The second one assumed a systemic limitation of the treatment access on the basis of visual acuity as an eligibility criterion. In the third scenario, crystalline lens clouding could only be qualified for surgical treatment if it caused difficulties in performing activities of daily livings.