Incidence and severity of asymptomatic ocular injury in adult and pediatric orbital fractures.

PURPOSE: To evaluate the incidence of severe ocular injury requiring emergent ophthalmic evaluation in visually asymptomatic patients presenting with orbital fractures. METHODS: We performed a retrospective chart review of all adult and pediatric orbital fractures between 2012-2022 at a level 1 trauma center. Ocular injuries were categorized into severe, moderate, and mild. We evaluated symptoms, mechanism of injury, visual acuity (VA), and severity of injuries using the Cochran-Armitage and linear-by-linear tests. RESULTS: Of the 2495 cases, 1534 had ophthalmology evaluation. The mean ± standard deviation age was 40.4 ± 20.4 years. Most patients were male (73.1%) and Caucasian (75.9%). The mean time to evaluation was 0.6 ± 2.5 days. 486 (31.7%) were visually symptomatic, 760 (49.5%) were asymptomatic, and 288 (18.8%) were unknown. Of the symptomatic, 135 (27.8%) had severe injuries, 108 (22.2%) had moderate injuries, 216 (44.4%) had mild injuries, and 27 (5.6%) had no injuries. Of the asymptomatic, 67 (8.8%) had severe injuries, 183 (24.1%) had moderate injuries, 468 (61.6%) had mild injuries, and 42 (5.5%) had no injuries. Symptoms correlated with injury severity (p-value <.001). The most common mechanism of injury were falls (24.0%), assaults (22.2%), and motor vehicle accidents (14.8%). CONCLUSIONS: Visually asymptomatic orbital fractures were less likely to have severe ocular injuries; however, many patients were unable to express symptoms. Emergent ophthalmology evaluation should be considered in all patients presenting with orbital fractures, especially patients with visual symptoms or are unable to report symptoms.

Ipilimumab-related orbitopathy: a case report.

Ipilimumab, an immune checkpoint inhibitor used in the treatment of metastatic melanoma, can cause immune-related adverse events including rare ocular-related inflammation. This is a case of a 54-year-old man with metastatic melanoma and bilateral orbital inflammation associated with ipilimumab that occurred after drug rechallenge 6 years after initial orbital inflammation with ipilimumab use. Imaging revealed tendon-involving myositis. He was managed with intravenous corticosteroid and intravenous immunoglobulin therapy with improvement in his orbital inflammation. This case demonstrates the potential ocular effects of ipilimumab use, differentiation of ipilimumab-associated orbital inflammation from thyroid orbitopathy and management considerations to effectively reduce orbital inflammation.

Gender Representation Among Presenters in Ophthalmology Subspecialties in 2019: A Retrospective Review.

PURPOSE: To describe gender representation at 8 national ophthalmology conferences, stratified by role, session category, and subspecialty. DESIGN: Retrospective cross-sectional study. METHODS: Data were examined on 3817 presenters at the 2019 American Academy of Ophthalmology subspecialty days, American Society of Cataract and Refractive Surgery, American Glaucoma Society, American Society of Retina Specialists, American Society of Ophthalmic Plastic and Reconstructive Surgery, American Association for Pediatric Ophthalmology and Strabismus, North American Neuro-Ophthalmology Society, and American Uveitis Society meetings. The main outcome measure was the gender of presenters in 7 subspecialties, stratified by category and role. RESULTS: The proportion of female presenters was less than the American Board of Ophthalmology (ABO)-estimated proportion of women in their respective fields in glaucoma (28.0% vs 39.8%), neuro-ophthalmology (35.3% vs 45.3%), and pediatrics (42.1% vs 53.3%) and greater than expected in retina (24.6% vs 19.8%). Overall, the proportion of female presenters exceeded the ABO-estimated proportion of women in ophthalmology (24.5%) for clinical (mean = 38.5%, 95% CI [35.8%, 41.4%]) and scientific (39.4% [30.3%, 49.2%]) sessions. For clinical subspecialty sessions, the proportion of female leaders exceeded the overall proportion of female leaders in the respective subspecialty in cornea (35.1% [30.4%, 40.1%] vs 24.6% all sessions). Females represented fewer than the expected number of surgical session leaders in cornea (22.0% [19.9%, 24.3%]), glaucoma (18.0% [13.2%, 24.1%]), pediatrics (22.0% [14.4%, 32.1%]), and retina (18.6% [14.2%, 24.1%]). CONCLUSIONS: Gender representation varied, with fewer than expected female presenters in glaucoma, neuro-ophthalmology, and pediatrics. Women led relatively more clinical sessions but were underrepresented in surgical sessions in most subspecialties.

Ophthalmology Residency Virtual Interviews in the Setting of the COVID-19 Pandemic: Perspectives of Applicants, Selection Committee Members, and Current Residents.

Background In the setting of the COVID-19 pandemic, residency programs implemented videoconferencing "virtual" interviews for the 2020 to 2021 match cycle. There is limited published information on virtual ophthalmology residency interviews. Objective The study aimed (1) to assess applicant, selection committee member, and resident opinions of technical quality, communication quality, and ability to assess applicant or program "fit" during virtual interviews; (2) to determine which interview format-in-person or virtual-each party would prefer in the future; and (3) to survey which residency resources applicants found helpful. Design Surveys were sent to applicants, selection committee members, and residents to assess the above objectives for the 2020 to 2021 match cycle virtual interviews at the Moran Eye Center, University of Utah. Setting This study was conducted in a single residency program interview season from 2020 to 2021. Participants Forty applicants, eight committee members, and seven residents who participated in the virtual interview process were surveyed. Intervention or Exposure Prior to interviews, various avenues were implemented to connect with applicants. A videoconferencing software was utilized for interviews. Applicants and selection committee members met in one-on-one or small group interviews. Residents communicated with applicants in a large group setting between interviews. Main Outcome and Measure The study aims to survey the participants as stated in the objectives. There was no planned outcome for this quality improvement study. Results Survey response rate was 98.2% (54/55). All parties rated the technical components as good or very good. Applicants and selection committee members rated communication as overall good or very good, although residents thought communication was very poor. A total of 92.3% applicants, 75% selection committee members, and 0% residents were reported that they were able to appropriately assess fit of the program with the applicant. However, 46.3% respondents preferred in-person interviews in the future. Popular applicant resources were resident-produced videos (82.1%), conversations with residents (46.2%), and a gift bag (43.6%). Conclusion and Relevance Overall, the technical components of the interview were successful. Small, structured group interactions led to better communication and assessment of fit. There were variable opinions regarding future interview format preference between in-person, virtual, or choice. Amid the COVID-19 pandemic, connecting with applicants via various means can optimize the match process.