Epidemiology of Product-Related Ocular Injuries in the United States From 2001 to 2020.

BACKGROUND: Although ocular injuries are a major cause of ocular morbidity, ocular trauma secondary to consumer-related products is often preventable, and epidemiologic data can highlight potential avenues for intervention. OBJECTIVE: Our aim was to characterize epidemiologic trends in product-related ocular injuries presenting to the emergency department (ED) from 2001 to 2020 based on the National Electronic Injury Surveillance System (NEISS) database. METHODS: The NEISS database was reviewed for all ED visits for ocular injuries between 2001 and 2020. Trends in incidences were determined by calculating average annual percent change. RESULTS: There were 106,533 ocular injuries reported to the NEISS database, which represented an estimated 4 million national cases. Most injuries occurred during the summer in men (69.2% of cases) younger than 40 years (66.2%). The incidence rates decreased for patients younger than 60 years, but remained steady in those 60 years and older. Although the most common overall cause was home workshop equipment-related products (23.5%), patients younger than 20 years were most likely injured from sports (27.2%), and those 80 years and older experienced injuries due to furniture (24.0%). CONCLUSIONS: Although the overall incidence of product-related ocular injuries has decreased over the past 2 decades, not all age groups are affected equally. The data showed that the trends in frequency and cause of eye-related ED visits differ depending on the age of the patient and indicated avenues for age-specific interventions.

Changes in choroidal thickness and choroidal vascularity index in thyroid eye disease: a systematic review.

PURPOSE: To evaluate the evidence for changes in choroidal thickness and choroidal vascularity index (CVI) in people with thyroid eye disease (TED), stratified by severity, as measured by optical coherence tomography (OCT). METHODS: Systematic review, including quality assessment, of published studies investigating choroidal thickness in TED. Outcomes of interest included CVI, subfoveal choroidal thickness, mean choroidal thickness, and peripheral choroidal thickness in four quadrants (superior, inferior, medial, lateral). RESULTS: Nineteen studies were included which contained measurements from 1067 eyes in 798 patients with TED. Most studies found an increased CVI and increased choroidal thickness in patients with TED compared to normal controls, especially in the subfoveal region. In addition, several studies reported an increased thickness in patients with active vs. inactive TED, although the results are equivocal. Finally, many studies reported associations between increased choroidal thickness and worsened clinical measurements of disease activity, such as Clinical Activity Score (CAS). CONCLUSIONS: This systematic review provided evidence for an association between increased CVI/choroidal thickness and TED, suggesting a potential for OCT-measured CVI/choroidal thickness as an objective clinical marker. Given heterogeneity, future studies are needed to assess the role of measuring the choroidal changes in diagnosis and management of TED.

Correction: Compensation for Blur Requires Increase in Field of View and Viewing Time.

[This corrects the article DOI: 10.1371/journal.pone.0162711.].

Predictors of Success of Endonasal Septal Perforation Repair: A 10-Year Experience.

Background: There is no consensus on optimal repair technique for nasal septal perforations (NSPs). Objective: To measure success rate and evaluate predictors of success for NSP repair. Methods: Medical records of patients who underwent NSP repair from 2010 to 2020 were reviewed. Included patients had at least 60 days of postsurgical follow-up. Surgical technique involves an endonasal approach; subperichondrial dissection with local flap mobilization; and multilayer closure using cartilage interposition graft, fascia graft, and mucoperichondrial flaps. A chi-squared test or Fisher exact test was used for statistical analysis. Results: Eighty-one repairs were performed with a closure rate of 86%. The median patient age was 46 years (range 13-77); 34.6% of perforations were ≥2 cm. Conchal (77.8%), rib (7.4%), or septal (7.4%) cartilage was used as graft material. A complication rate of 8.6% was reported. Perforation size or graft material had no impact on successful closure rate. Of patients with failed repairs, 55% had perioperative complications or conditions associated with poor healing. Conclusion: An endonasal approach for NSP repair showed a high success rate across diverse presentations; however, NSP repair was significantly more likely to be successful in patients without perioperative complications or pre-existing conditions associated with poor wound healing.

Pharmacotherapeutic candidates for myopia: A review.

This review provides insights into the mechanism underlying the pathogenesis of myopia and potential targets for clinical intervention. Although the etiology of myopia involves both environmental and genetic factors, recent evidence has suggested that the prevalence and severity of myopia appears to be affected more by environmental factors. Current pharmacotherapeutics are aimed at inhibiting environmentally induced changes in visual input and subsequent changes in signaling pathways during myopia pathogenesis and progression. Recent studies on animal models of myopia have revealed specific molecules potentially involved in the regulation of eye development. Among them, the dopamine receptor plays a critical role in controlling myopia. Subsequent studies have reported pharmacotherapeutic treatments to control myopia progression. In particular, atropine treatment yielded favorable outcomes and has been extensively used; however, current studies are aimed at optimizing its efficacy and confirming its safety. Furthermore, future studies are required to assess the efficacy of combinatorial use of low-dose atropine and contact lenses or orthokeratology.

Higher Contrast Requirement for Letter Recognition and Macular RGC+ Layer Thinning in Glaucoma Patients and Older Adults.

Purpose: Growing evidence suggests the involvement of the macula even in early stages of glaucoma. However, little is known about the impact of glaucomatous macular damage on central pattern vision. Here we examine the contrast requirement for letter recognition and its relationship with retinal thickness in the macular region. Methods: A total of 40 participants were recruited: 13 patients with glaucoma (mean age = 65.6 ± 6.6 years), 14 age-similar normally sighted adults (59.1 ± 9.1 years), and 13 young normally sighted adults (21.0 ± 2.0 years). For each participant, letter-recognition contrast thresholds were obtained using a letter recognition task in which participants identified English letters presented at varying retinal locations across the central 12° visual field, including the fovea. The macular retinal ganglion cell plus inner plexiform (RGC+) layer thickness was also evaluated using spectral-domain optical coherence tomography (SD-OCT). Results: Compared to age-similar normal controls, glaucoma patients exhibited a significant increase in letter-recognition contrast thresholds (by 236%, P < 0.001) and a significant decrease in RGC+ layer thickness (by 17%, P < 0.001) even after controlling for age, pupil diameter, and visual acuity. Compared to normal young adults, older adults showed a significant increase in letter-recognition contrast thresholds and a significant decrease in RGC+ layer thickness. Across all subjects, the thickness of macular RGC+ layer was significantly correlated with letter-recognition contrast thresholds, even after correcting for pupil diameter and visual acuity (r = -0.65, P < 0.001). Conclusions: Our results show that both glaucoma and normal aging likely bring about a thinning of the macular RGC+ layer; the macular RGC+ layer thickness appears to be associated with the contrast requirements for letter recognition in central vision.

Compensation for Blur Requires Increase in Field of View and Viewing Time.

Spatial resolution is an important factor for human pattern recognition. In particular, low resolution (blur) is a defining characteristic of low vision. Here, we examined spatial (field of view) and temporal (stimulus duration) requirements for blurry object recognition. The spatial resolution of an image such as letter or face, was manipulated with a low-pass filter. In experiment 1, studying spatial requirement, observers viewed a fixed-size object through a window of varying sizes, which was repositioned until object identification (moving window paradigm). Field of view requirement, quantified as the number of "views" (window repositions) for correct recognition, was obtained for three blur levels, including no blur. In experiment 2, studying temporal requirement, we determined threshold viewing time, the stimulus duration yielding criterion recognition accuracy, at six blur levels, including no blur. For letter and face recognition, we found blur significantly increased the number of views, suggesting a larger field of view is required to recognize blurry objects. We also found blur significantly increased threshold viewing time, suggesting longer temporal integration is necessary to recognize blurry objects. The temporal integration reflects the tradeoff between stimulus intensity and time. While humans excel at recognizing blurry objects, our findings suggest compensating for blur requires increased field of view and viewing time. The need for larger spatial and longer temporal integration for recognizing blurry objects may further challenge object recognition in low vision. Thus, interactions between blur and field of view should be considered for developing low vision rehabilitation or assistive aids.