Canadian journal of ophthalmology. Journal canadien d'ophtalmologie最新文献

{"title":"Bilateral optic nerve compression from suprasellar breast cancer metastasis.","authors":"Karanvir Gill, Colten Wendel, Briar Sexton","doi":"10.1016/j.jcjo.2025.04.006","DOIUrl":"10.1016/j.jcjo.2025.04.006","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977281","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":"Comparing the rate of cataract surgery complications between a hospital and an independent health facility.","authors":"Joshua Bierbrier, Stephanie Baxter, Davin Johnson","doi":"10.1016/j.jcjo.2025.04.002","DOIUrl":"10.1016/j.jcjo.2025.04.002","url":null,"abstract":"<p><strong>Objective: </strong>To compare the perioperative complication rates of cataract surgeries performed at a hospital and an independent health facility (IHF) in Ontario following governmental funding changes affecting for-profit private clinics.</p><p><strong>Design: </strong>Retrospective chart review.</p><p><strong>Participants: </strong>All patients receiving publicly funded elective cataract surgery in Kingston, Ontario, between January 1, 2023, and December 31, 2023.</p><p><strong>Methods: </strong>Electronic medical records were assessed for 3 cataract surgery complications: posterior capsular rupture (PCR), retinal tear/detachment, and endophthalmitis. Age, eye, lens type (spheric, aspheric, premium), intraoperative complication, and postoperative complications were recorded for each chart. Differences between clinical settings were evaluated using Fisher's Exact and χ² tests (p < 0.05).</p><p><strong>Results: </strong>A total of 3190 (hospital: 1741; IHF: 1449) charts were reviewed. The hospital had a significantly higher rate of PCRs (1.44% vs 0.21%; p < 0.01). Retinal tears/detachments occurred in 5 hospital cases (0.29%) and none at the IHF, while 2 endophthalmitis cases were reported at the IHF (0.14%) and none at the hospital (both p > 0.05). Lens use patterns significantly differed, with more premium and aspheric lenses used at the IHF and more spheric lenses at the hospital.</p><p><strong>Conclusions: </strong>Complication rates at both sites were similar and within expected ranges. Differences in PCR rates may be explained by a tendency to perform more complicated surgeries at the hospital. The findings suggest that cataract surgery at both clinical settings is safe.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977686","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":"Disparities in screening, diagnosis, treatment, and outcomes for diabetic retinopathy among people with lived experience of homelessness in Canada.","authors":"Ruchi Sharan, Kathryn Wiens, Li Bai, Paul E Ronksley, Gillian L Booth, Stephen W Hwang, Peter C Austin, Eldon Spackman, Anna Ells, Michael Fielden, David J T Campbell","doi":"10.1016/j.jcjo.2025.05.004","DOIUrl":"10.1016/j.jcjo.2025.05.004","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the rates of screening, diagnosis, treatment, and outcomes related to diabetic retinopathy among persons with diabetes who have experienced homelessness compared with a matched cohort of nonhomeless controls.</p><p><strong>Methods: </strong>A propensity score-matched cohort study was conducted using administrative health data from Ontario. Eligible persons required a diagnosis of diabetes and at least 1 hospital encounter between April 2006 and March 2019. Homeless status was determined using a validated algorithm that identified whether individuals were homeless at the time of any acute care encounter during the study period. Each person who experienced homelessness was matched to a nonhomeless control based on sociodemographic and clinical characteristics. Rate ratios (RR) and differences in proportions were calculated for screening, diagnosis, and treatment of diabetic retinopathy, as well as for the outcome of vision loss using generalized linear models with a negative binomial distribution and robust standard errors.</p><p><strong>Results: </strong>1,069,493 people met the inclusion criteria, of which, 6 944 had a history of homelessness. A suitable nonhomeless match was found for 5 712 individuals. The rate of diabetic retinopathy screening was lower in those with a history of homelessness when compared to controls (RR = 0.75; 95% CI: 0.72-0.78), while the rate of having billing codes representing diabetic retinopathy was higher (RR = 1.42; 95% CI: 1.02-1.97). There was no significant difference in rates of treatment or vision loss.</p><p><strong>Conclusions: </strong>The disparities in rates of screening and diagnosis of diabetic retinopathy in those with lived experience of homelessness presents an area for targeted interventions to improve health outcomes in this population.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141417","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":"Ethnic disparities in inherited retinal degenerations.","authors":"Kirk A J Stephenson, Shanil R Dhanji, Olubayo U Kolawole, Cheryl Y Gregory-Evans, Kevin Gregory-Evans","doi":"10.1016/j.jcjo.2025.04.007","DOIUrl":"10.1016/j.jcjo.2025.04.007","url":null,"abstract":"<p><strong>Objective: </strong>Inherited retinal degenerations (IRD) are clinically heterogeneous. There has been little study of the influence of ethnicity on IRD phenotypes. We aim to assess clinical and genetic variability between differing ethnic groups affected by IRD.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Participants: </strong>Patients with genetically resolved IRD (ABCA4, USH2A, RPGR) at a single centre (University of British Columbia).</p><p><strong>Methods: </strong>Clinical and genetic data were contrasted between ethnic groups (Caucasian, East Asian, South Asian, Indigenous, African) and between Caucasians and non-Caucasians.</p><p><strong>Results: </strong>143 patients met the inclusion criteria. Caucasians were over-represented (76%). For ABCA4, East Asians most commonly had bullseye maculopathy, while classic Stargardt disease predominated in other ethnicities; cataract was less prevalent in non-Caucasians (p = 0.001). For USH2A, most non-Caucasians had non-syndromic IRD, while Caucasians were 50% isolated and 50% Usher syndrome. Hyperautofluorescent rings were more common in non-Caucasians (p = 0.027). In RPGR, best-corrected visual acuity was worse for Caucasians (logMAR 0.76 ± 0.69) than non-Caucasians (0.49 ± 0.30; p = 0.047), and myopia was greatest in South Asians (-9.56 ± 0.27 D vs -3.82 ± 4.05 D; p < 0.001). Twenty-one novel genetic variants were identified, and only 3.3% (5/154) of genetic variants were shared between ethnic groups.</p><p><strong>Conclusions: </strong>Clinical and genetic differences are apparent between ethnic groups, even within \"common\" IRD genotypes. Awareness of these different retinal and extra-retinal (e.g., myopia, less favourable VA) features is critical to facilitate diagnostic accuracy and optimal clinical care, including access to novel therapies. Further work to expand the genetic reference databases for non-Caucasian ethnic groups is needed to facilitate equitable access to diagnosis and treatment for IRD.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967861","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":"Investigating drug-induced optic nerve hypoplasia and septo-optic dysplasia from the FDA adverse events database.","authors":"Ayesh Ali, Jamal O Azhari, Ryan Gise, Omar Solyman, Paul H Phillips, Abdelrahman M Elhusseiny","doi":"10.1016/j.jcjo.2025.05.005","DOIUrl":"10.1016/j.jcjo.2025.05.005","url":null,"abstract":"<p><strong>Objective: </strong>To identify potential teratogenic medication associated with optic nerve hypoplasia (ONH) and/or septo-optic dysplasia (SOD), by screening the Food and Drug Administration Adverse Events Reporting System (FAERS) database.</p><p><strong>Design: </strong>Retrospective pharmacovigilance study using disproportionality signal detection methods.</p><p><strong>Participants: </strong>Adverse event reports submitted to FAERS between Q1 2004 and Q3 2024. Reports were included if ONH or SOD was listed as an adverse event and drug exposure occurred in utero.</p><p><strong>Methods: </strong>A qualitative assessment evaluated patient demographics, and a disproportionality analysis covered pharmacovigilance signal detection and drug-event reporting frequencies. Pharmacovigilance algorithms that were applied to determine the statistical significance of signals included the proportional reporting ratio (PRR), chi-squared with Yates' correction (χ²), reporting odds ratio (ROR), empirical Bayes geometric mean (EBGM), and information component (IC).</p><p><strong>Results: </strong>A total of 103 adverse event reports for ONH and/or SOD were identified. The 75 cases reporting prenatal medication exposure were included. Twenty-three reports were of male patients, 13 reports of female patients, and 39 of unspecified gender. Thirty drugs were implicated as primary suspect drugs. Diazepam was the most reported primary suspect medication (n = 15; 20%) followed by methadone and citalopram (n = 8; 11%). The disproportionality analysis showed a positive signal with one medication: diazepam (n = 15; PRR = 82.24; χ² = 1008.66, ROR 95% CI: 102.55 [56.75-185.33], EBGM [EBGM05]: 48.45 [28.16], IC [IC05]: 4.46 [3.67]).</p><p><strong>Conclusions: </strong>A possible association was found between prenatal diazepam exposure and ONH/SOD. Further investigation is required to confirm this relationship and drug safety profiles.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141419","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":"True muscle transplantation for the management of third nerve palsy.","authors":"Ahmed Awadein, Christina S Farag, Sara Maher","doi":"10.1016/j.jcjo.2025.04.008","DOIUrl":"10.1016/j.jcjo.2025.04.008","url":null,"abstract":"<p><strong>Objective: </strong>To describe and report the results of 2 different techniques for true muscle transplantation for management of exotropia in patients with third nerve palsy.</p><p><strong>Methods: </strong>A retrospective chart review was conducted on patients with third nerve palsy in whom true muscle transplantation was performed. The resected segment of the medial rectus (MR) muscle was used to lengthen the lateral rectus (LR) muscle before recession. The transplantation was performed using either a free graft technique or a modified continuous graft technique. Ductions, versions, and angles of deviation were evaluated before and after surgery.</p><p><strong>Results: </strong>A total of 7 patients were identified (mean age: 32 ± 17 years). Two patients had prior LR recession. The mean preoperative angle of deviation was 53 ± 13 PD, and the mean preoperative limitation of adduction was -4. The free graft and the continuous graft techniques were used in 3 and 4 cases, respectively. The median amount of LR recession was 8 mm, and the amount of MR resection ranged from 6 to 8 mm. The mean follow-up was 6.0 ± 4.2 months. Postoperatively, 5 patients had residual exotropia <10 PD. The remaining 2 cases had residual exotropia 15 PD. The mean postoperative limitation of adduction improved to -2.3 ± 0.5. The postoperative limitation of abduction was -1 or less in 6 patients.</p><p><strong>Conclusions: </strong>True muscle transplantation can be used to correct large exotropia in partially recovered or recurrent third nerve palsy without causing significant limitation of abduction. Undercorrection is associated with smaller amounts of MR resection.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964333","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":"Short-term effects of tetracycline use in patients with diabetic retinopathy.","authors":"Ahmed M Alshaikhsalama, Amer F Alsoudi, Karen M Wai, Euna Koo, Prithvi Mruthyunjaya, Christina Y Weng, Ehsan Rahimy","doi":"10.1016/j.jcjo.2025.04.009","DOIUrl":"10.1016/j.jcjo.2025.04.009","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between tetracycline use and the development of short-term vision threatening complications (VTC) among patients with diabetic retinopathy (DR).</p><p><strong>Methods: </strong>Using a deidentified database, 4 596 patients with severe nonproliferative diabetic retinopathy (NPDR) or proliferative diabetic retinopathy (PDR) associated with tetracycline use versus 87,974 patients with NPDR or PDR but no tetracycline use, respectively, were included before propensity score matching (PSM). After PSM, 4 576 patients in each cohort were analyzed. Incidence of developing VTC, including diabetic macular edema (DME), vitreous hemorrhage (VH), tractional retinal detachment (TRD), neovascular glaucoma (NVG), and subsequent need for ocular interventions including intravitreal anti-vascular endothelial growth factor (VEGF) injections, panretinal photocoagulation (PRP), or pars plana vitrectomy (PPV).</p><p><strong>Results: </strong>Patients with DR and repeated tetracycline use had a reduced risk of developing DME (RR: 0.45, 95% CI: 0.28-0.72; p = 0.009) and VH (RR: 0.37, 95% CI: 0.20-0.69; p = 0.001) compared to the tetracycline-naive cohort at 6 months and 1 year. Further, there was a reduced risk of subsequent need for anti-VEGF (RR: 0.25, 95% CI: 0.13-0.47; p = 0.003) and PRP (RR: 0.40, 95% CI: 0.19-0.84; p = 0.012) in the tetracycline cohort compared to the tetracycline-naive group at 6 months and 1 year. There were no significant differences in the development of NVG, TRD, or the requirement for PPV between both cohorts.</p><p><strong>Conclusions: </strong>Repeated tetracycline use was associated with a potentially reduced short-term risk of developing DME, VH, and needing subsequent anti-VEGF or PRP therapy versus tetracycline naive patients.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970558","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":"Impact of neurotrophic keratopathy on quality of life: a utility analysis.","authors":"Suzan Sargsyan, Sammie E Fung, Tonya S Lee, Kathryn S Park, Brian M Fung, Erik Groessl, Daniel J Ozzello, Bobby S Korn, Don O Kikkawa, Natalie A Afshari, Catherine Y Liu","doi":"10.1016/j.jcjo.2025.04.011","DOIUrl":"10.1016/j.jcjo.2025.04.011","url":null,"abstract":"<p><strong>Objective: </strong>Neurotrophic keratopathy (NK) is a rare degenerative disease leading to impaired corneal sensation and function. In this study, we measured the utility values associated with NK to better understand the impact of this condition on patients.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Participants: </strong>Twenty-two patients with NK at a university-based outpatient ophthalmology clinic completed a survey.</p><p><strong>Methods: </strong>Patients were asked questions regarding their eye condition, overall health, and completed the Visual Function Questionnaire (VFQ-25). Health utility was calculated using the time trade-off (TTO) and standard gamble (SG) methods with anchor points of perfect eye function (pf) and perfect health (ph).</p><p><strong>Results: </strong>Four different utility values for NK were calculated, ranging from 0.69 to 0.86, depending on the measurement method (TTO or SG) and anchor point (pf or ph). Utility values were not significantly associated with age, gender, comorbidities, visual acuity, or severity of NK disease. Role difficulty and dependence (based on a subset of the VFQ-25) were associated with lower utility.</p><p><strong>Conclusion: </strong>Our study found that NK has a significant impact on quality of life, independent of vision loss. As treatment options for NK are expanding and increasing in efficacy, this study can provide a foundation for future cost-effectiveness analyses on the various treatments for NK.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954654","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":"Acute annular outer retinopathy: initial insights into clinical course variations with multimodal imaging.","authors":"Chunli Chen, Yizhe Cheng, Haiying Zhou, Yongpeng Zhang, Xiaoyan Peng","doi":"10.1016/j.jcjo.2025.05.011","DOIUrl":"10.1016/j.jcjo.2025.05.011","url":null,"abstract":"<p><strong>Objective: </strong>To describe the clinical course and provide initial imaging perspectives in acute annular outer retinopathy (AAOR) by reviewing multimodal imaging (MMI) findings.</p><p><strong>Design: </strong>Observational case series study.</p><p><strong>Participants: </strong>Nine patients (12 eyes) with AAOR.</p><p><strong>Methods: </strong>Review clinical charts and MMI findings.</p><p><strong>Main outcome measures: </strong>Clinical medical records and multimodal imaging features via fundus photographs, optical coherence tomography (OCT), fundus autofluorescence (AF) and OCT angiography (OCTA), as applicable.</p><p><strong>Results: </strong>Twelve eyes of nine patients (18-39 years) were identified. The clinical course was subdivided acutely progressive stage (APS), stationary stage (SS) and atrophic stage (AS) (1-3 weeks, 3 weeks to 3 months and >3 months, respectively). During APS, advancement of peripapillary annular band was noted in all eyes, accompanied by absent ellipsoid zone, increased choroidal thickness (ChT) and thinned outer nuclear layer (ONL) within the affected area. During SS, annular band disappeared on fundus photograph with improved ONL with improved ONL. During AS, affected area became depigmented with scattered pigmentation, exhibiting hyper-AF or mixed AF. Other manifestations included retinal atrophy and decreased ChT. OCTA revealed an enlarged foveal avascular zone in each stage, especially in AS. Seven eyes of 5 patients showed no macular involvement with best corrected visual acuity (BCVA) of 20/20, while 5 eyes of 5 patients showed macular involvement with poorer BCVA of HM-20/400 at the last visit.</p><p><strong>Conclusions: </strong>AAOR mostly occurs in young individuals with unilateral involvement, especially in those with mild to moderate myopia. The observed variations in the clinical course of AAOR, documented through MMI, aid in the prompt recognition and understanding of this rare entity.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186650","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":"Trends in medico-legal cases against Canadian ophthalmologists: a 10-year retrospective review (2013-2022).","authors":"Derek M Waldner, Gary Garber, Anne Steen, P J Finestone, Richard Liu, Donna Perron, Qian Yang, Anna MacIntyre, Natalie Gagné, Tricia Savoy, Kevin Warrian, Alex Ragan","doi":"10.1016/j.jcjo.2025.05.003","DOIUrl":"10.1016/j.jcjo.2025.05.003","url":null,"abstract":"<p><strong>Objective: </strong>To investigate trends in medico-legal complaints against Canadian ophthalmologists over a ten-year period (2013-2022).</p><p><strong>Methods: </strong>Retrospective review of closed legal, hospital, and regulatory cases involving ophthalmologists was conducted using data from the Canadian Medical Protective Association (CMPA). Cases were systematically coded by nurse analysts using the Canadian Classification of Health Interventions, ICD-10-CA, and a specific schema for contributing factors. Data analyses utilized SAS software (9.4) and Prism GraphPad (9.4.1).</p><p><strong>Results: </strong>A total of 970 closed cases with sufficient data for analysis were identified, including 584 college complaints, 340 legal complaints, and 46 hospital complaints. Complainants were predominantly female (55.4%) and mostly aged 30-64. Of the 1021 ophthalmologists named, 210 faced multiple complaints, with 82% of complaints against those with over ten years of practice. The most common clinical presentations generating complaints were disorders of the lens (37.1%), disorders of the choroid and retina (17.3%), and disorders of refraction (14.9%). The most common complications cited in complaints included visual disturbances (22.0%) and retinal complications (13.8%). Peer expert concerns were noted in 540 cases (55.7%), with common issues being inadequate documentation (31.5%), consent processes (25.9%), and communication (20.6%). Approximately 50.9% of cases had unfavorable outcomes for CMPA members, though the most frequent unfavourable college outcome was \"dismissed with concern\".</p><p><strong>Conclusion: </strong>This review highlights gaps in Canadian ophthalmic care, empowering ophthalmologists to address these concerns. Future work will focus on detailed assessments of cases with peer expert concerns and developing specific recommendations for clinical practice.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149281","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}