Current Opinion In Ophthalmology[JOURNAL]
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200 papers
Evaluation of ophthalmic large language models: quantitative vs. qualitative methods.
Tan TF, Thirunavukarasu AJ, Quek C … +1 more , Ting DSW
Curr Opin Ophthalmol · 2025 Sep · PMID 40910897 · Publisher ↗
PURPOSE OF REVIEW: Alongside the development of large language models (LLMs) and generative artificial intelligence (AI) applications across a diverse range of clinical applications in Ophthalmology, this review highligh...
PURPOSE OF REVIEW: Alongside the development of large language models (LLMs) and generative artificial intelligence (AI) applications across a diverse range of clinical applications in Ophthalmology, this review highlights the importance of evaluation of LLM applications by discussing evaluation metrics commonly adopted. RECENT FINDINGS: Generative AI applications have demonstrated encouraging performance in clinical applications of Ophthalmology. Beyond accuracy, evaluation in the form of quantitative and qualitative metrics facilitate a more nuanced assessment of LLM output responses. Several challenges limit evaluation including the lack of consensus on standardized benchmarks, and limited availability of robust and curated clinical datasets. SUMMARY: This review outlines the spectrum of quantitative and qualitative evaluation metrics adopted in existing studies, highlights key challenges in LLM evaluation, to catalyze further work towards standardized and domain-specific evaluation. Robust evaluation to effectively validate clinical LLM applications is crucial in closing the gap towards clinical integration.
COVID-19: ocular manifestations and associations with corneal transplant rejection and uveitis reactivation.
Saban O, Doan T, Seitzman GD
Curr Opin Ophthalmol · 2025 Sep · PMID 40910884 · Publisher ↗
PURPOSE OF REVIEW: To highlight the ocular manifestations associated with COVID-19 and review the evidence surrounding proposed associations with corneal transplant rejection and uveitis reactivation. RECENT FINDINGS: SA...
PURPOSE OF REVIEW: To highlight the ocular manifestations associated with COVID-19 and review the evidence surrounding proposed associations with corneal transplant rejection and uveitis reactivation. RECENT FINDINGS: SARS-CoV-2 has been associated with various ocular manifestations, most commonly conjunctivitis. Less frequently, more severe complications such as uveitis, retinal vascular occlusions, and neuro-ophthalmic syndromes have been reported. These manifestations are theorized to occur secondary to both direct viral invasion as well as secondary systemic inflammation and immune dysregulation. While case reports suggest a possible link between COVID-19 infection and vaccination and corneal graft rejection, large cohort studies and meta-analyses have not confirmed an association. In contrast, retrospective data suggest a slight increase in uveitis recurrence following COVID-19 infection and vaccination in patients with prior uveitis. SUMMARY: Ocular involvement in COVID-19 ranges from mild conjunctivitis to rare, vision-threatening inflammatory and vascular complications. While case reports have suggested temporal links between COVID-19 infection or vaccination and corneal transplant rejection or uveitis reactivation, current evidence does not support an association with graft rejection, and only a slight increase in uveitis recurrence has been observed in certain high-risk populations. With longer follow-up and prospective analyses, a clearer understanding of underlying mechanisms and risk factors may emerge to better guide ophthalmic management during and beyond the pandemic.
Conjunctivitis secondary to novel systemic dermatologic agents: a growing concern.
Turner ML, Nguyen MT
Curr Opin Ophthalmol · 2025 Aug · PMID 40862508 · Publisher ↗
PURPOSE OF REVIEW: This review aims to summarize current knowledge on ocular surface side effects associated with novel systemic therapies for atopic dermatitis (AD) and psoriasis. RECENT FINDINGS: Interleukin inhibiting...
PURPOSE OF REVIEW: This review aims to summarize current knowledge on ocular surface side effects associated with novel systemic therapies for atopic dermatitis (AD) and psoriasis. RECENT FINDINGS: Interleukin inhibiting monoclonal antibodies such as dupilumab and tralokinumab, along with small molecule JAK-STAT inhibitors such as upadacitinib and abrocitibib, have revolutionized the treatment of AD and psoriasis. Despite their effectiveness in disease control, these agents have been increasingly associated with ocular adverse events, particularly conjunctivitis. While dupilumab-induced conjunctivitis is the most documented, emerging data highlights variable ocular safety profiles across different agents. Early recognition and grading of ocular inflammation through clinical examination allows for effective management with topical anti-inflammatory treatment. In severe or refractory cases, switching or discontinuing therapy may be necessary. SUMMARY: With the expanding use of novel systemic dermatologic therapies, ocular surface complications have become an important concern. Multidisciplinary collaboration and increased awareness are vital to prevent vision-threatening outcomes. Ongoing research is needed to elucidate pathophysiology and optimize therapeutic approaches that balance effective skin disease control with ocular health.
Ten years later: how is AI impacting retina care today?
Kuo D, Pajic M, Hadziahmetovic M
Curr Opin Ophthalmol · 2025 Aug · PMID 40862502 · Full text
PURPOSE OF REVIEW: Artificial intelligence (AI) is transforming retina care, with deep learning (DL) models shaping a new era of improved screening accessibility, diagnostic precision, and personalized disease monitoring...
PURPOSE OF REVIEW: Artificial intelligence (AI) is transforming retina care, with deep learning (DL) models shaping a new era of improved screening accessibility, diagnostic precision, and personalized disease monitoring. This review highlights recent AI-powered clinical applications in diabetic retinopathy (DR), and age-related macular degeneration (AMD) care. RECENT FINDINGS: Since the FDA's authorization of the first autonomous AI system for DR screening in 2018, multiple platforms have emerged, expanding access to diabetic eye care. Real-world studies have confirmed a significant improvement in screening adherence and diagnostic accuracy, illustrating AI's tangible impact on public health. Meanwhile, newly certified AI technologies that meet European regulatory standards are increasingly guiding clinical decision-making in the management of AMD and diabetic macular edema through automated analysis of optical coherence tomography (OCT) images. Most recently, FDA-authorized home OCT platforms are transforming AMD monitoring, enabling proactive and remote management of retinal fluid. SUMMARY: As AI increasingly empowers patients and providers, its widespread success still depends on ongoing work, including thorough validation, outcome-based metrics, and improved workflow integration. The next decade will reveal whether AI in retina care transitions from a promising innovation to an essential and indispensable tool in modern retina.
Considerations and surgical approach to vitreous, retinal, and chorioretinal biopsy.
Kasetty VM, Grewal DS
Curr Opin Ophthalmol · 2025 Aug · PMID 40862500 · Publisher ↗
PURPOSE OF REVIEW: This review summarizes the literature regarding vitreous and chorioretinal biopsy, with a focus on surgical techniques and methods to optimize diagnostic yield for the collected samples. RECENT FINDING...
PURPOSE OF REVIEW: This review summarizes the literature regarding vitreous and chorioretinal biopsy, with a focus on surgical techniques and methods to optimize diagnostic yield for the collected samples. RECENT FINDINGS: Various novel options for analyzing vitreous samples are being explored such as cell-free DNA analysis, single parameter flow cytometry, and mass spectrometry. These methods show promise in diagnosing primary intraocular lymphoma. SUMMARY: Vitreous and chorioretinal biopsies may be required in atypical cases of intraocular inflammation that do not respond to treatment or do not respond as anticipated. A thorough differential diagnosis is important, allowing the surgeon to order and prioritize the appropriate testing for an obtained sample. As these samples can be limited or challenging to collect, it is also crucial that vitreoretinal surgeons optimize their diagnostic yield by communicating with various labs that are involved with sample processing.
Update on autoimmune retinopathy: diagnosis and management.
Elbasiony E, Hu JCW, McKay KM … +1 more , Sobrin L
Curr Opin Ophthalmol · 2025 Aug · PMID 40862484 · Publisher ↗
PURPOSE OF REVIEW: Autoimmune retinopathy (AIR) is a rare but vision-threatening disorder characterized by retinal damage through humoral or cellular immune mechanisms. The purpose of this review is to summarize our curr...
PURPOSE OF REVIEW: Autoimmune retinopathy (AIR) is a rare but vision-threatening disorder characterized by retinal damage through humoral or cellular immune mechanisms. The purpose of this review is to summarize our current understanding on imaging, antibody testing, and immunosuppressive therapies for AIR. RECENT FINDINGS: AIR includes paraneoplastic forms - such as cancer-associated retinopathy (CAR) and melanoma-associated retinopathy (MAR) - as well as a nonparaneoplastic (np) variant (npAIR). Definitive diagnosis of AIR is challenging due the similar clinical findings between AIR and inherited retinal dystrophies and the lack of specific laboratory testing. Therefore, a multimodal diagnostic approach including electroretinography, fundus imaging, visual field testing, genetic testing, and serologic assays is necessary to support a diagnosis of AIR. Early diagnosis and treatment with systemic or local immunomodulators may preserve retinal function and lead to better visual outcomes. SUMMARY: This review highlights current diagnostic approach and treatment strategies in AIR. Advances in biomarkers and precision immunotherapy may improve diagnosis and outcomes.
Controversies in ophthalmology - challenges and crossroads in 2025.
Vakharia P, Sridhar J
Curr Opin Ophthalmol · 2025 Sep · PMID 40772314 · Publisher ↗
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Treatment of uveitic macular edema: a review.
Massenzio SS, Zafar S, Deaner JD
Curr Opin Ophthalmol · 2025 Aug · PMID 40747994 · Publisher ↗
PURPOSE OF REVIEW: To review the treatment modalities commonly available or under investigation for uveitic macular edema. RECENT FINDINGS: Corticosteroids are a mainstay of treatment and can be administered topically, p...
PURPOSE OF REVIEW: To review the treatment modalities commonly available or under investigation for uveitic macular edema. RECENT FINDINGS: Corticosteroids are a mainstay of treatment and can be administered topically, periocularly, intravitreally, suprachoroidally, and systemically. Advances in drug development aim to target delivery of corticosteroids to the posterior segment while sparing anterior segment structures to avoid intraocular pressure elevation and cataract formation. Nonsteroidal alternatives including intravitreal anti-VEGF, intravitreal methotrexate, intravitreal anti-IL6, systemic acetazolamide, systemic antimetabolites, systemic biologics, and interferons have all been studied as alternatives that would allow for potential reduction or discontinuation of corticosteroid use. Pars plana vitrectomy remains a controversial option for patients with uveitic macular edema refractory to other medical therapies. SUMMARY: Uveitic macular edema is a common complication of uveitis that can cause significant vision loss and persist even after the resolution of other signs of intraocular inflammation. Treatment modalities aim to reduce macular edema while limiting adverse effects.
Intravitreal antivascular endothelial growth factor therapy during pregnancy: an update and current perspective.
Zhang KX, Heisel CJ, Rahmani S
Curr Opin Ophthalmol · 2025 Sep · PMID 40600936 · Publisher ↗
PURPOSE OF REVIEW: Many ocular neovascular diseases, including diabetic retinopathy (DR) and diabetic macular edema (DME), are significant complications that can worsen during pregnancy, posing risks to vision. Antivascu...
PURPOSE OF REVIEW: Many ocular neovascular diseases, including diabetic retinopathy (DR) and diabetic macular edema (DME), are significant complications that can worsen during pregnancy, posing risks to vision. Antivascular endothelial growth factor (anti-VEGF) agents represent the mainstay of DR and DME treatment in nonpregnant populations. However, their use in pregnant populations remain controversial due to concerns over fetal safety. This review explores the available literature on anti-VEGF use during pregnancy, evaluating maternal and fetal outcomes, and incorporating lessons learned from their recent use in treating retinopathy of prematurity (ROP). RECENT FINDINGS: Although human data on the safety of anti-VEGF agents during pregnancy remain limited, available studies suggest that systemic absorption is minimal, and concerns regarding potential effects on fetal angiogenesis largely theoretical. Case reports and retrospective studies have not consistently demonstrated harm. Furthermore, several studies examining long-term systemic effects of anti-VEGF use in treating premature infants with ROP reveal no association with adverse neurodevelopmental outcomes when compared to untreated ROP or ROP treated with laser photocoagulation alone. SUMMARY: While the use of anti-VEGF agents in pregnancy remains controversial, recent evidence suggests they should not be categorically excluded as a treatment option. Until more causal studies emerge, treatment decisions should be individualized, balancing disease severity, maternal visual function, and fetal safety.
The clinical importance of retinal displacement in planning retinal detachment repair and evaluating outcomes.
Zaidi H, Vakharia PS
Curr Opin Ophthalmol · 2025 Sep · PMID 40539905 · Publisher ↗
PURPOSE OF REVIEW: Retinal displacement is an occasional yet underrecognized sequela of rhegmatogenous retinal detachment (RRD) repair that can cause postoperative visual distortions and anisekonia. While retinal surgeon...
PURPOSE OF REVIEW: Retinal displacement is an occasional yet underrecognized sequela of rhegmatogenous retinal detachment (RRD) repair that can cause postoperative visual distortions and anisekonia. While retinal surgeons strive to achieve single-surgery success, more emphasis and understanding should also be placed on optimizing visual outcomes following RRD repair, including minimizing retinal distortions. This review explores the pathophysiology, clinical manifestations, imaging modalities, risk factors, and preventive strategies associated with retinal displacement. RECENT FINDINGS: Retinal displacement is associated with significant visual disturbances - most notably metamorphopsia, aniseikonia, and spatial mislocalization - despite preserved visual acuity. Imaging advances, particularly optical coherence tomography (OCT) overlays and OCT homography, have improved detection over traditional fundus autofluorescence. Risk factors for displacement include macula-off detachments, extensive detachment area, use of a complete intraocular gas fill, and surgical modality, with pneumatic retinopexy and scleral buckling associated with lower displacement rates. Computer modeling has suggested biomechanical forces contributing to displacement. SUMMARY: Retinal displacement significantly affects postoperative visual quality following RRD repair. Although often missed on standard examination, improved imaging and surgical refinement offer opportunities for early detection and prevention. Continued research into the mechanisms and outcomes of displacement is critical for optimizing both anatomical and functional success in retinal detachment surgery.
Managing retinoblastoma in 2025.
Ramos-Dávila EM, Williams BK, Di Nicola M
Curr Opin Ophthalmol · 2025 Sep · PMID 40471757 · Publisher ↗
PURPOSE OF REVIEW: The management of retinoblastoma is an evolving field, with ongoing research focused on novel diagnostic techniques and therapeutic interventions. This review aims to summarize the current treatment op...
PURPOSE OF REVIEW: The management of retinoblastoma is an evolving field, with ongoing research focused on novel diagnostic techniques and therapeutic interventions. This review aims to summarize the current treatment options for retinoblastoma and explore future directions in the field. RECENT FINDINGS: Early diagnosis remains crucial for improving prognosis in retinoblastoma, as prompt identification significantly enhances treatment success. New diagnostic imaging strategies as well as prenatal testing are being developed to detect subclinical disease in high-risk patients, allowing for earlier intervention. Recurrent or refractory disease remains a challenge, but encouraging results have been observed with intravenous chemotherapy, intra-arterial chemotherapy, and intravitreal chemotherapy as salvage therapies. Other strategies, including anterior chamber chemotherapy, novel drug formulations, and advanced delivery methods like sustained release chemotherapy in the form of a chemoplaque, are being explored to address these persistent challenges. SUMMARY: Significant progress in retinoblastoma treatment has led to a dramatic improvement in globe salvage rates. Nevertheless, challenges remain. Delayed diagnosis, particularly in low-income and middle-income regions, continues to contribute to reduced survival rates. Additionally, the management of advanced disease, as well as recurrent or refractory tumors, remain critical issues. The development of new drugs and delivery methods as well as modified treatment strategies offer promise in overcoming these obstacles.
Optometry co-management of preoperative and postoperative cataract surgery patients.
Saigal K, Shah S, Ansari Z
Curr Opin Ophthalmol · 2025 Sep · PMID 40471754 · Publisher ↗
PURPOSE OF REVIEW: As the prevalence of cataracts continues to rise, the increasing demand for cataract surgery may surpass the availability of ophthalmologists. This review examines the role of optometry in the co-manag...
PURPOSE OF REVIEW: As the prevalence of cataracts continues to rise, the increasing demand for cataract surgery may surpass the availability of ophthalmologists. This review examines the role of optometry in the co-management of patients with cataracts, including preoperative and postoperative care, and discusses the implications of expanding optometric scope-of-practice laws. RECENT FINDINGS: Collaboration between optometrists and ophthalmologists occurs through two primary models: referral-based and integrated management. Studies indicate that direct referrals from optometrists to ophthalmologists improve surgical listing rates and streamline patient care. Integrated models enhance efficiency by incorporating optometrists into ophthalmology practices, allowing ophthalmologists to focus on surgical interventions. Postoperative care co-managed by optometrists has demonstrated mostly favorable visual outcomes, with 86% of patients achieving 20/40 vision or better and low postoperative complication rates. However, legislative changes expanding optometric surgical privileges remain controversial due to concerns about training adequacy and patient safety. Sharing clinical responsibilities can lead to a "slippery slope" phenomenon encroaching on the surgeon's role and threatening patient care. SUMMARY: Optometry-ophthalmology co-management can enhance surgical efficiency, improve patient access, and alleviate workforce shortages. While co-management may be effective for routine cases, the expansion of optometric surgical privileges raises debate regarding clinical competency and regulatory oversight. Future efforts should focus on creating best practice guidelines for standardizing training, shared ethical responsibility, and ensuring high-quality, patient-centered care.
Photobiomodulation: evidence and applications in ophthalmology.
Tan NRX, Chan KE, Lim BXH … +3 more , Giannaccare G, Najjar RP, Lim CHL
Curr Opin Ophthalmol · 2025 Sep · PMID 40471752 · Publisher ↗
PURPOSE OF REVIEW: Photobiomodulation (PBM) is a noninvasive therapy utilising low-level light energy to stimulate cellular processes, modulate inflammatory pathways, enhance mitochondrial activity, promote tissue regene...
PURPOSE OF REVIEW: Photobiomodulation (PBM) is a noninvasive therapy utilising low-level light energy to stimulate cellular processes, modulate inflammatory pathways, enhance mitochondrial activity, promote tissue regeneration. With growing interest in PBM as a potential treatment modality, this review synthesises current evidence and highlights challenges of implementing PBM across various ophthalmic conditions. RECENT FINDINGS: Current ophthalmic applications of PBM can be categorised into established and exploratory therapies, differentiated primarily by the attainment of regulatory approval. Established applications of PBM include the treatment of dry eye disease and nonexudative age-related macular degeneration, while the use of PBM is still largely exploratory in conditions such as diabetic macular oedema and retinopathy of prematurity. Regardless of the level of regulatory authorisation, the application of PBM in each ophthalmic condition presents with distinct challenges requiring further research for comprehensive validation. SUMMARY: While PBM holds promise as a novel therapeutic option, its long-term efficacy and safety remains to be fully established. Standardised treatment guidelines and larger randomised controlled trials are essential to optimise its use in future clinical practice.
Management of endophthalmitis: to culture or not to culture?
Samuelson AG, Patel SN, Garg SJ
Curr Opin Ophthalmol · 2025 Sep · PMID 40396379 · Publisher ↗
PURPOSE OF REVIEW: To review the role of microbial cultures in managing endophthalmitis following cataract surgery and intravitreal injections. RECENT FINDINGS: The endophthalmitis vitrectomy study (EVS) continues to gui...
PURPOSE OF REVIEW: To review the role of microbial cultures in managing endophthalmitis following cataract surgery and intravitreal injections. RECENT FINDINGS: The endophthalmitis vitrectomy study (EVS) continues to guide the management of endophthalmitis including its recommendation for intraocular vitreous sampling. Vitreous cultures have better diagnostic yield than aqueous cultures. Advances in culture techniques have improved the efficiency and sensitivity of pathogen identification. While culture results are useful for prognostication, microbiology data rarely changes management in endophthalmitis following cataract surgery or intravitreal injections. Endophthalmitis managed without microbial cultures had similar outcomes to eyes managed with microbial cultures. SUMMARY: Despite advances in culture techniques, most institutions still rely on gram stain and microbial cultures, often requiring several days for results. Initial administration of empiric antibiotics occurs before microbiology data becomes available, limiting the utility of cultures in clinical management. Despite concerns for antibiotic resistance, the large majority of postcataract surgery and postintravitreal injection endophthalmitis pathogens are susceptible to vancomycin and ceftazidime. Given this, obtaining intraocular specimens can be deferred if it poses a delay to prompt treatment with intravitreal antibiotics. Emerging culture techniques hold promise for more rapid and sensitive pathogen identification, which could change the landscape of culture guidelines and improve clinical usefulness.
Corneal complications of common vaccinations.
Gannamaneni K, Mian SI
Curr Opin Ophthalmol · 2025 Jul · PMID 40314667 · Publisher ↗
PURPOSE OF REVIEW: To summarize and evaluate the current literature concerning corneal complications associated with common vaccinations, particularly keratitis and corneal graft rejection following vaccination against S...
PURPOSE OF REVIEW: To summarize and evaluate the current literature concerning corneal complications associated with common vaccinations, particularly keratitis and corneal graft rejection following vaccination against SARS-CoV-2, Varicella-Zoster, and Influenza. RECENT FINDINGS: Small case series and reports have documented keratitis/herpesvirus reactivation and corneal graft rejection following vaccination, prompting concern from ophthalmologists regarding vaccination timing and management of patients. Recent population-based studies have reported higher risks of herpesvirus keratitis and herpes zoster ophthalmicus recurrence associated with the COVID-19 and varicella zoster vaccinations in rare cases, often in patients with identified risk factors. Similarly, corneal graft rejection rates appear to be stable following vaccination when compared with unvaccinated individuals, with the bulk of vaccine-associated rejection noted to occur with penetrating keratoplasties and in patients at a higher risk for rejection. SUMMARY: While the benefits of vaccination continue to outweigh the risks, clinicians must identify and balance patient-specific risk factors for corneal complications to inform individual management and counseling, potentially with heightened steroid use in the postvaccination period and more stringent follow up for signs of keratitis or graft rejection.
Medical and surgical management of neovascular glaucoma.
Yun JS, Santina A, Tseng VL
Curr Opin Ophthalmol · 2025 Sep · PMID 40314467 · Publisher ↗
PURPOSE OF REVIEW: Neovascular glaucoma (NVG) is a severe secondary glaucoma precipitated by ocular ischemia and abnormal neovascularization, resulting in elevated intraocular pressure (IOP) and vision loss if not prompt...
PURPOSE OF REVIEW: Neovascular glaucoma (NVG) is a severe secondary glaucoma precipitated by ocular ischemia and abnormal neovascularization, resulting in elevated intraocular pressure (IOP) and vision loss if not promptly addressed. This study evaluates recent advances in both medical and surgical management of NVG, focusing on strategies that integrate anti-vascular endothelial growth factor (VEGF) therapy, retinal ablation, and evolving surgical techniques. RECENT FINDINGS: Anti-VEGF agents remain central to NVG treatment, with newer agents and combination regimens showing sustained neovascular suppression, alongside panretinal photocoagulation as an additional cornerstone in reducing neovascular drive. Glaucoma drainage devices continue to have prominence for their ability to bypass fibrotic outflow pathways, while trabeculectomy augmented with mitomycin C continues to offer a viable option in select cases. Cyclodestructive procedures, including micropulse transscleral cyclophotocoagulation and endoscopic cyclophotocoagulation, provide alternative surgical avenues for refractory cases. Novel studies including lipidomic analyses present novel metabolic pathways that are potentially implicated in NVG pathogenesis, suggesting future targets beyond VEGF. SUMMARY: Timely recognition and comprehensive treatment - encompassing IOP control, ischemic drive reduction, and inflammation management - remain critical in the management of NVG. As research illuminates additional molecular targets and refines surgical interventions, the promise of a more personalized, biomarker-driven approach to NVG management continues to grow.
Advances in procedural management of dry eye disease.
Podd C, Fleifil S
Curr Opin Ophthalmol · 2025 Jul · PMID 40293212 · Publisher ↗
PURPOSE OF REVIEW: The purpose of this article is to provide a summary of in-office procedures available for dry eye treatment. Dry eye is a multifactorial condition of the ocular surface with increasing prevalence among...
PURPOSE OF REVIEW: The purpose of this article is to provide a summary of in-office procedures available for dry eye treatment. Dry eye is a multifactorial condition of the ocular surface with increasing prevalence among patients. There have been advances in nonpharmacological treatment options for patients in recent years. Most of these new treatments are geared towards evaporative dry eye due to meibomian gland deficiency. RECENT FINDINGS: Standard treatment of dry eye usually starts with topical treatments, such as artificial tears and inflammation modulators. However, options have now broadened to in-office procedural treatments. Most devices and procedures available for dry eye syndrome focus on the health of the lid structures involved in tear secretion, specifically the meibomian glands. There are fewer procedural options that address aqueous deficiency dry eye cases. The recent recall in over-the-counter eye drops may have caused patients to research nonpharmacological alternatives. SUMMARY: There are now numerous nonpharmacological options for dry eye therapy. A range of thermal devices are used for the purpose of assisting in meibomian gland expression. Intense pulsed light (IPL) is also a popular therapy option. In addition to thermal properties to melt the meibum, it also has the benefit of an anti-inflammatory effect. Radiofrequency can be used in combination with IPL. Meibomian gland probing is an option as a rejuvenator for improving meibomian gland function. Treating aqueous deficiency dry eye still favors topical treatments, but the surgical procedure of salivary gland transplantation is occasionally used.
Advancements in artificial intelligence for the diagnosis and management of anterior segment diseases.
Jin K, Grzybowski A
Curr Opin Ophthalmol · 2025 Jul · PMID 40279352 · Publisher ↗
PURPOSE OF REVIEW: The integration of artificial intelligence (AI) in the diagnosis and management of anterior segment diseases has rapidly expanded, demonstrating significant potential to revolutionize clinical practice...
PURPOSE OF REVIEW: The integration of artificial intelligence (AI) in the diagnosis and management of anterior segment diseases has rapidly expanded, demonstrating significant potential to revolutionize clinical practice. RECENT FINDINGS: AI technologies, including machine learning and deep learning models, are increasingly applied in the detection and management of a variety of conditions, such as corneal diseases, refractive surgery, cataract, conjunctival disorders (e.g., pterygium), trachoma, and dry eye disease. By analyzing large-scale imaging data and clinical information, AI enhances diagnostic accuracy, predicts treatment outcomes, and supports personalized patient care. SUMMARY: As AI models continue to evolve, particularly with the use of large models and generative AI techniques, they will further refine diagnosis and treatment planning. While challenges remain, including issues related to data diversity and model interpretability, AI's integration into ophthalmology promises to improve healthcare outcomes, making it a cornerstone of data-driven medical practice. The continued development and application of AI will undoubtedly transform the future of anterior segment ophthalmology, leading to more efficient, accurate, and individualized care.
Scleral lenses for correction of irregular astigmatism: advances and limitations.
Gindina S, Kang JJ, Jacobs DS
Curr Opin Ophthalmol · 2025 Jul · PMID 40279320 · Publisher ↗
PURPOSE OF REVIEW: In this review, we will address advances and limitations in the field of scleral lenses pertaining to the correction of irregular astigmatism. RECENT FINDINGS: There are reports on the benefits of scle...
PURPOSE OF REVIEW: In this review, we will address advances and limitations in the field of scleral lenses pertaining to the correction of irregular astigmatism. RECENT FINDINGS: There are reports on the benefits of scleral lenses for eyes with irregular astigmatism, particularly regarding improvement of visual acuity and the reduction of higher-order aberrations. Innovations such as wavefront-optimized and wavefront-guided optics can improve vision in keratoconus. Customized haptics, topographic and profilometric-based fitting, and impression-based design can achieve fit in problematic eyes with ectasia, after penetrating keratoplasty, and with corneal scarring. Challenges persist, including resource requirements for practitioners, patient difficulty with insertion and removal, and limitations to lens wear, including midday fogging and corneal edema. Risks such as graft failure persist. SUMMARY: Scleral lenses have emerged as a useful tool in the management of irregular astigmatism, reducing the need for penetrating keratoplasty. By vaulting the cornea and resting on the sclera, scleral lenses neutralize corneal astigmatism, while providing a stable and comfortable surface for advanced optics. Over the past two decades, the use of scleral lenses has increased, reflecting advances in fitting systems, expanded access, greater adoption by clinicians, broader patient eligibility, and improved clinical outcomes.
Comparing femtosecond LASIK and small-incision lenticule extraction (SMILE).
Ahluwalia A, Manche EE
Curr Opin Ophthalmol · 2025 Jul · PMID 40279261 · Publisher ↗
PURPOSE OF REVIEW: This review compares two refractive surgery modalities, femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and small-incision lenticule extraction (SMILE), focusing on their efficacy, safety,...
PURPOSE OF REVIEW: This review compares two refractive surgery modalities, femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and small-incision lenticule extraction (SMILE), focusing on their efficacy, safety, postoperative recovery, and patient-reported outcomes. The aim is to provide an updated review of recent findings and identify areas for additional research to further optimize surgical outcomes and patient selection. RECENT FINDINGS: FS-LASIK and SMILE show excellent, comparable visual outcomes for the correction of myopia and astigmatism. SMILE may have a lower risk of dry eye and has no flap-related complications, while FS-LASIK provides quicker visual recovery. SMILE may offer superior long-term visual outcomes, particularly for high myopia. However, customized FS-LASIK (wavefront- and topography-guided) outperform SMILE in some visual metrics, including uncorrected visual acuity and reduction in higher-order aberrations. SUMMARY: FS-LASIK remains the gold standard refractive procedure due to its rapid recovery and predictable results, but SMILE offers advantages in preserving corneal biomechanical stability and potentially minimizing dry eye symptoms. SMILE may also offer improved long-term stability for patients at risk of myopic regression. However, a growing body of evidence suggests that wavefront- and topography-guided LASIK yield superior visual outcomes compared to SMILE. Additional long-term comparative studies are needed for different refractive treatment requirements.
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