Eye & Contact Lens-Science and Clinical Practice最新文献

{"title":"Topical Anesthetics for Corneal Abrasions: Investigating Emergency Department Readmission Rates and Associated Risks.","authors":"Austin C Stewart, Mary Grace Hamlin, Richard Phan, Milan Patel, Bo DeVries, Pranav Gunturu, Thomas L Steinemann","doi":"10.1097/ICL.0000000000001291","DOIUrl":"10.1097/ICL.0000000000001291","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate whether prescribing topical ophthalmic anesthetics (TOAs) for corneal abrasions in the emergency department (ED) is associated with increased ED readmission and whether ophthalmology follow-up (OFU) modifies this risk.</p><p><strong>Methods: </strong>We performed a retrospective cohort study in the TriNetX US Collaborative Network (February 2023-February 2026). Adults with an ED diagnosis of corneal abrasion and a TOA prescription were compared with matched controls without TOA prescription. Patients with prior history of corneal disease were excluded. Propensity score matching controlled for demographics and socioeconomic status. Emergency department readmission at 3, 7, 14, and 30 days was the primary outcome; the association of OFU with 30-day readmission was secondary. Risk ratios (RRs) and risk differences (RDs) were calculated.</p><p><strong>Results: </strong>Among 23,152 eligible patients, 11,576 received TOAs. One-month ED readmission was higher with TOAs than controls (6.7% vs. 3.7%; RR 1.81; RD 2.99%). Ophthalmology follow-up within 30 days was associated with fewer readmissions in both groups (RR 0.82; RD -1.08%).</p><p><strong>Conclusions: </strong>Prescribing TOAs for corneal abrasions is associated with increased ED readmission, whereas timely OFU appears protective. These findings support ophthalmologists' concerns about TOA safety and highlight the need for joint emergency medicine-ophthalmology guidelines to optimize patient outcomes.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":"349-353"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of Ulcerative Keratitis in the United States With and Without Predisposing Diabetes Mellitus.","authors":"Silanur Inanoglu, Wuqaas M Munir","doi":"10.1097/ICL.0000000000001293","DOIUrl":"10.1097/ICL.0000000000001293","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the incidence of ulcerative keratitis (UK) in the United States between 2017 and 2024 and determine the risk of ulcerative keratitis development in patients with and without diabetes mellitus (DM).</p><p><strong>Methods: </strong>The TriNetX analysis platform was used to retrospectively analyze data from US health care organizations and run analyses to calculate incidence rates of UK. Subsequently, patients with and without DM were identified to determine risk of UK development after propensity score matching for baseline demographic characteristics.</p><p><strong>Results: </strong>The incidence rate of ulcerative keratitis fluctuated between 2017 to 2024, increasing to 30.06 cases per 100,000 person-years in 2024. Patients with DM exhibited increased risk of UK compared with those with no DM within one year of follow-up (RR, 1.601; 95% CI, 1.239-2.069). Among patients diagnosed with DM, those who had recorded hemoglobin A1c values greater than 8% exhibited increased risk of UK development compared with patients with hemoglobin A1c levels below 8% (RR, 1.14; 95% CI, 1.058-1.228).</p><p><strong>Conclusions: </strong>UK incidence was found to increase to a high of 30.06 cases per 100,000 person-years in 2024. Increased risk of UK was also found with DM, particularly at hemoglobin A1c levels above 8%, underscoring how pathophysiological mechanisms underlying DM can negatively affect corneal health.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":"354-361"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ivermectin in the Management of Demodex -associated Blepharitis: A Comprehensive Literature Review.","authors":"Matilde Buzzi, Pietro Sponga, Andrea Angheben, Alberto Carnicci, Fabrizio Giansanti, Rita Mencucci","doi":"10.1097/ICL.0000000000001299","DOIUrl":"10.1097/ICL.0000000000001299","url":null,"abstract":"<p><strong>Objectives: </strong>To review the role of Demodex infestation in blepharitis and summarize available evidence on the efficacy and safety of topical and oral ivermectin.</p><p><strong>Methods: </strong>This narrative review was conducted through collaboration between expert ophthalmologists and infectious diseases specialists with clinical experience in the use of ivermectin. A literature search was performed in PubMed and Embase from inception to November 2025.</p><p><strong>Results: </strong>Evidence from clinical trials, observational studies, and case series was reviewed and synthesized. Ivermectin, administered orally or topically, has been investigated as a potential treatment option for Demodex -associated blepharitis, either as monotherapy or in combination with other therapies. Across different treatment protocols and patient populations, ivermectin use was generally associated with reductions in Demodex mite density, improvement in cylindrical dandruff, ocular surface parameters, and patient-reported symptoms. Reported adverse events were infrequent and predominantly mild.</p><p><strong>Conclusions: </strong>Current evidence suggests that ivermectin may represent an effective and overall safe therapeutic option for Demodex -associated blepharitis. Further studies are needed to establish standardized treatment regimens and to assess long-term outcomes.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":"375-381"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recognizing Ocular Milker's Nodule: Diagnostic Clues and Clinical Course in Two Dairy Workers.","authors":"Laxmi Ahir, Nikhil Agrawal, Nidhi Paharia","doi":"10.1097/ICL.0000000000001301","DOIUrl":"10.1097/ICL.0000000000001301","url":null,"abstract":"<p><strong>Abstract: </strong>Milker's nodule is a zoonotic infection caused by the Parapoxvirus (genus Parapoxvirus , family Poxviridae ), typically affecting dairy workers through direct contact with infected cattle. Ocular involvement is rare and usually results from autoinoculation from hand lesions. We report two cases in dairy workers presenting with vesiculoulcerative eyelid lesions and corneal epithelial defects. One patient developed limbitis and stromal keratitis, which resolved completely with topical lubricants, and corticosteroids after reepithelialization. The second case healed spontaneously with conservative therapy. Ocular Milker's nodule closely mimics viral keratitis but follows a benign, self-limiting course. Recognition of characteristic hand lesions and occupational exposure is essential for accurate diagnosis and to avoid unnecessary antiviral therapy. Preventive measures include glove use, hand hygiene, and cattle vaccination.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":"387-389"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Ophthalmology Resident Knowledge of Contact Lens Science and Practice: Early Experience With a Structured Online Curriculum.","authors":"Minwoo Kwon, Khushali Shah, Sumayya Ahmad, Michelle K Rhee","doi":"10.1097/ICL.0000000000001298","DOIUrl":"https://doi.org/10.1097/ICL.0000000000001298","url":null,"abstract":"","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":"52 9","pages":"394"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Extremely Rare and Devastating Complication of Penetrating Keratoplasty: Postoperative Endophthalmitis Because of Carbapenem-Resistant Klebsiella pneumoniae.","authors":"Kubra Sincar, Oguz Reşat Sipahi, Mervenur Kanat, Sabire Sohret Aydemir, Canan Bor, Melis Palamar, Naim Ceylan, Banu Yaman, Mesut Arici, Ozlem Barut Selver","doi":"10.1097/ICL.0000000000001287","DOIUrl":"10.1097/ICL.0000000000001287","url":null,"abstract":"<p><strong>Abstract: </strong>To report the second case report in the literature of early-onset endophthalmitis caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) after penetrating keratoplasty (PK). The associated diagnostic and therapeutic challenges are highlighted, and the precautions that can be applied are emphasized. A 69-year-old woman with bullous keratopathy underwent elective PK. Within 24 hr postoperatively, stromal infiltration and partial separation at the superior quadrant of the graft and anterior chamber reaction were observed. Urgent rekeratoplasty was performed, and microbiologic culture of the donor tissue revealed extensively drug-resistant CRKP resistant to multiple antibiotics. Despite rapid surgical revision and intensive antimicrobial therapy (topical, intrastromal, intravitreal, and systemic), the infection progressed to orbital cellulitis and systemic involvement, ultimately requiring evisceration. Carbapenem-resistant Klebsiella pneumoniae was also isolated from the excised globe. Donor-derived contamination was strongly suspected because of the early clinical course but could not be confirmed microbiologically because the donor margin tissue was not preserved. Furthermore, retrospective medical data review of the donor did not reveal any similar microorganism and clinical follow-up of PK from the other corneal partner showed no infection. This case constitutes the second documented instance of CRKP-related endophthalmitis after PK in the literature. It emphasizes the importance of donor screening, continuous monitoring of the storage environment, preservation of donor margin tissue, and vigilant monitoring for systemic dissemination and severe postoperative complications.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":"382-386"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a Prostaglandin Analog-Based Eyelash Serum on Tear Film Stability and the Ocular Surface.","authors":"José-María Sánchez González, Margarita Gandullo-Asuar, Antonio Ballesteros Sánchez, María C Sánchez-González, Julia Hernández-Lucena, Raúl Capote-Puente, Concepción De-Hita-Cantalejo, Carlos Rocha-de-Lossada","doi":"10.1097/ICL.0000000000001300","DOIUrl":"10.1097/ICL.0000000000001300","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the short-term effect of a prostaglandin analog-based eyelash serum on the ocular surface.</p><p><strong>Methods: </strong>A prospective interventional study was conducted on 19 healthy women. Participants applied an eyelash serum containing dechloro dihydroxy difluoro ethylcloprostenolamide once daily to the upper eyelid margin for 6 weeks. Tear film parameters, meibomian glands analysis, and ocular surface inflammation and damage were assessed at baseline and posttreatment using the S390L slit lamp (Firefly WDR, MediWorks, Shanghai, China).</p><p><strong>Results: </strong>A significant reduction in tear film stability was observed, with decreases of 3.92±7.45 sec in first noninvasive break-up time ( P =0.003) and 3.97±6.25 sec in average noninvasive break-up time ( P <0.001). Tear volume was reduced, as shown by decreases of 0.01±0.04 mm in tear meniscus height ( P =0.049) and 0.27±0.66 mm 2 in tear meniscus area ( P =0.019). Ocular hyperemia increased, with temporal ciliary hyperemia rising by 1.68±3.45% ( P =0.006) and temporal conjunctival hyperemia by 2.41±4.14% ( P =0.001). No statistically significant changes were observed in meibomian gland morphology or ocular surface staining.</p><p><strong>Conclusions: </strong>Daily application of the prostaglandin analog-based eyelash serum induced tear film instability, reduced tear volume, and increased ocular hyperemia. These findings suggest that even short-term use may disrupt ocular surface homeostasis and cause mild inflammation. Further studies with longer follow-up are needed to assess its safety profile on the ocular surface.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":"368-374"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Agreement of Corvis ST Biomechanical IOP Measurements With Pachymetry-Based Correction Formulas in Patients With Keratoconus: A Comparative Analysis According to Disease Severity.","authors":"Fahri Onur Aydın, Ali Ceylan, Yusuf Berk Akbaş, İdil Çelen Arabacı, Serhat Ermiş, Burçin Kepez Yıldız","doi":"10.1097/ICL.0000000000001284","DOIUrl":"10.1097/ICL.0000000000001284","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the agreement of intraocular pressure (IOP) measurements obtained by Corvis ST using biomechanically corrected IOP (bIOP), noncontact tonometry (NCT), and pachymetry-based correction formulas (Ehlers, Shah, Dresden, Spoerl) across different keratoconus severity levels and in comparison with healthy control eyes.</p><p><strong>Methods: </strong>This prospective, cross-sectional study included 77 patients with keratoconus (77 eyes), categorized by severity using Pentacam-based Topographic Keratoconus Classification and 54 healthy control patients. Patients underwent corneal tomography, and IOP was measured with Corvis ST. Uncorrected NCT-IOP (IOPnct), biomechanically corrected IOP (bIOP), and pachymetry-based corrected IOP (Ehlers, Shah, Dresden, Spoerl) were compared. Agreement among methods was assessed using Bland-Altman analysis.</p><p><strong>Results: </strong>The mean patient age was 26.4±7.3 years (59.7% male). NCT consistently underestimated IOP compared with bIOP, while Ehlers (+2.6 mm Hg), Shah (+1.4 mm Hg), and Dresden (+0.7 mm Hg) formulas significantly overestimated ( P <0.001). The Spoerl formula (-0.9 mm Hg) showed no significant difference compared with bIOP ( P =0.209). Bland-Altman analysis confirmed that the Spoerl formula had the smallest bias and narrowest limits of agreement across all keratoconus stages. Differences between methods became more pronounced with increasing severity, particularly evident for Ehlers and Shah formulas. In healthy control eyes, the different IOP estimation methods showed relatively small bias relative to bIOP.</p><p><strong>Conclusions: </strong>Noncontact tonometry significantly underestimates, and common pachymetry-based corrections (Ehlers, Shah, Dresden) tend to overestimate IOP in keratoconic eyes. The Spoerl formula provides IOP values most closely aligned with the Corvis ST bIOP across all keratoconus stages and was the most consistent pachymetric correction method relative to this biomechanically corrected comparator. Agreement between methods was closer in healthy corneas than in keratoconic eyes, supporting the influence of altered corneal biomechanics on tonometric measurements.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":"362-367"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Endothelial Cell Loss After Ocular Chemical Injuries in Eyes with Resolved Corneal Edema: A Retrospective Paired-Eye Study.","authors":"Adi Porat Rein, Sharon Braudo, Elishai Assayag, Anna Lisitsky, Jonathan Solomon, David Zadok, Yishay Weill","doi":"10.1097/ICL.0000000000001307","DOIUrl":"https://doi.org/10.1097/ICL.0000000000001307","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate long-term effects of ocular chemical injuries on corneal-endothelial cells in eyes initially presenting with burn-induced corneal edema that resolved clinically.</p><p><strong>Methods: </strong>This retrospective paired-eye study included patients with unilateral chemical burns and corneal edema at presentation, treated between January 2020 and June 2024 at a tertiary ophthalmology center. Patients with bilateral injuries, prior ocular surgery, corneal dystrophies, or less than 3 months of follow-up were excluded. Endothelial parameters as endothelial cell density, coefficient of variation, hexagonality, average cell area, and central corneal thickness were assessed bilaterally using specular microscopy. Injured eyes were compared with contralateral, unaffected eyes.</p><p><strong>Results: </strong>Eight patients (16 eyes) were included (mean follow-up 25.9±17.1 months). Injuries were caused by alkaline (62.5%) or acidic (37.5%) agents. At final follow-up, the mean endothelial cell density was significantly lower in injured eyes compared with contralateral eyes (956.25±137.5 vs. 2740.25±266.94 cells/mm2, P<0.001), representing a 65.1% reduction. No differences were found between acid vs. alkali injuries or saline vs. Diphoterine irrigation. Central corneal thickness did not differ significantly. These analyses should be interpreted with caution due to the small sample size and limited statistical power.</p><p><strong>Conclusions: </strong>Ocular chemical injuries can cause substantial, persistent corneal endothelial cell loss, even after clinical resolution of corneal edema. Long-term endothelial monitoring and careful surgical planning are recommended in this population.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications of Poorly Fitted Scleral Lenses and Approaches to Continued Wear.","authors":"Cherie B Nau, Amy C Nau, Jennifer S Fogt, Ellen S Shorter, Jennifer S Harthan, Muriel M Schornack","doi":"10.1097/ICL.0000000000001306","DOIUrl":"https://doi.org/10.1097/ICL.0000000000001306","url":null,"abstract":"<p><strong>Abstract: </strong>Scleral lenses (SLs) are increasingly considered a mainstream option for optical correction in patients with corneal irregularity and for protection of the ocular surface in patients with ocular surface disease. However, there can be complications with SL if the fit and disease is not regularly monitored. This case series reviews complications from poorly fitted SLs. Changes in SL design may allow a patient to resume successful lens wear. Regardless, SL fit and underlying disease states should be assessed at regularly scheduled intervals for new concerns in all patients and for recurrence of problems despite modification of fit in those who suffer complications.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}