PURPOSE: This investigation aimed to assess structural alterations in the retina and choroid among individuals with multiple sclerosis (MS), both with and without prior optic neuritis (ON), using spectral domain-optical coherence tomography (SD-OCT) and enhanced depth imaging-optical coherence tomography (EDI-OCT).
METHODS: In this cross-sectional analysis, participants included patients with relapsing-remitting MS and matched healthy individuals. MS subjects were stratified into ON and non-ON categories. Measurements of retinal nerve fiber layer (RNFL) thickness, macular volume (MV), and choroidal thickness (CT) were conducted and examined in relation to Expanded Disability Status Scale (EDSS) scores and the duration of disease.
RESULTS: Data from 80 individuals (40 MS, 40 controls) were analyzed. RNFL thickness was significantly reduced in the MS group, particularly in the temporal and superior regions (p<0.001 and p=0.004, respectively), with ON patients showing more marked thinning temporally (p=0.01). No notable differences were observed in MV or CT at any location (subfoveal, nasal, and temporal) (p>0.05). A significant inverse association existed between EDSS and RNFL thickness in superior (r=−0.768), temporal (r=−0.501), and nasal (r=−0.276) quadrants. Duration of illness showed a negative correlation with inferior RNFL (r=−0.631) and nasal/temporal CT (r=−0.351; r=−0.271).
CONCLUSION: Thinning of the RNFL – especially in the temporal and superior regions – was a consistent finding and was linked to both disease severity and chronicity. Conversely, MV and CT parameters did not show substantial variation, implying RNFL thickness could serve as a more sensitive biomarker for MS-related neurodegeneration.

PURPOSE: The purpose of the study is to evaluate the effect of oral paracetamol on the intraocular pressure (IOP) and the anterior segment parameters and axial length (AL) in participants without glaucoma.
METHODS: The study involved and evaluated two groups of participants: Group 1, which received oral paracetamol (1 g/day) for 14 days, and Group 2, which received topical brinzolamide (1%, bid) for the same duration. The IOP was measured with a Goldmann applanation tonometer. The central corneal thickness (CCT) and anterior chamber angle (ACA) measurements were performed using a Scheimpflug camera–Placido disc device (Sirius, CSO, Italy). The anterior chamber depth (ACD) and AL measurements were performed using the IOL Master 500 (Carl Zeiss Meditec, Jena, Germany). Measurements were taken before the beginning of oral paracetamol and topical brinzolamide therapy, and 7 and 14 days after the beginning of therapy.
RESULTS: A significant decrease in IOP was observed in both groups at the end of the 1st week (3.5±0.44 mmHg and 3.5±0.39 mmHg in groups 1 and 2, respectively), and no significant difference was found between the groups (p=0.798). The decrease in IOP persisted in the 2nd week, but the reduction was significantly greater in Group 2 (p<0.001). While Group 1 demonstrated a significant decrease in ACD at the end of the 1st week (p=0.005), no significant difference was found at the 2nd week (p=0.101). The AL, ACA, and CCT measurements did not show any significant changes from baseline in both groups (p>0.05, for all comparisons).
CONCLUSION: The findings of this study suggest that paracetamol treatment may have a lowering effect on IOP, although its efficacy may diminish over the weeks. However, further research enrolling glaucoma patients and employing a prolonged treatment period is necessary to delineate the potential role of paracetamol in glaucoma management.

PURPOSE: To present the demographic and clinical characteristics and treatment management of patients who were followed with the diagnosis of juvenile idiopathic arthritis-associated uveitis (JIA-U).
METHODS: Data from 66 eyes of 33 patients with JIA-U who were followed in our clinic between 2018 and 2024 were retrospectively reviewed. Demographic findings, best-corrected visual acuity (BCVA) according to the Snellen chart at the first and last visit, ocular complications, applied treatment regimens, side effects of drugs, and need for ocular surgery were retrospectively analyzed. In addition, the age, age at the time of first diagnosis, BCVA values, ocular complications, and surgical needs of patients diagnosed with uveitis before their first visit to our clinic (Group 1) and patients diagnosed with uveitis for the first time by us (Group 2) were compared.
RESULTS: Twenty-seven of the patients were female, six were male, and the mean age was 8.8±3.9 years. All patients had chronic anterior uveitis, and the involvement was bilateral in 30 of them. The most common type was oligoarticular type JIA (84.8%). MTX was the first choice for systemic treatment in all patients. Biological treatment was started in 23 patients. The most common ocular complication was posterior synechiae (49.2%). Posterior synechiae, band keratopathy, and cataract rates were higher in Group 1 (p=0.001, p=0.012, and p=0.026, respectively). The mean initial BCVA value in Group 1 was statistically significantly lower than Group 2 (p<0.05).
CONCLUSION: With a timely and appropriate treatment regimen in JIA-U, the rates of sight-threatening ocular complications can be significantly reduced.

PURPOSE: This study aims to evaluate lymphocyte-mediated systemic inflammation by analyzing the level of lymphocyte-to-monocyte ratio (LMR) and other hematological parameters in patients who underwent pterygium surgery.
METHODS: A retrospective, cross-sectional comparative study. Thirty-five patients underwent pterygium surgery, and 37 age- and sex-matched healthy controls were included. Pre-operative complete blood count parameters of all participants were analyzed. LMR, neutrophil-to-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) levels were compared.
RESULTS: The mean age was 56.03±12.11 years in the patient group and 59.84±6.83 years in the control group. The lymphocyte count (LY) (p=0.009) and LMR were significantly higher in the pterygium group (p<0.001). No statistically significant differences were observed in the other hematological parameters between the groups (p>0.05). The ROC curve analysis demonstrated that LMR was a more reliable indicator of pterygium than NLR and SII. The AUC was 0.781 for LMR (95% CI, 0.673–0.888; p<0.001), was 0.424 (95% CI, 0.291–0.557; p=0.267), and 0.443 (95% CI, 0.309–0.577; p=0.408) for NLR and SII, respectively. The optimal cutoff value of LMR to predict pterygium patients was >4.04, with 80.4% sensitivity and 70.3% specificity.
CONCLUSION: The LY and the LMR were found to be significantly elevated in the pterygium group. However, LMR demonstrated relatively lower sensitivity and specificity. Elevated LMR may be a new systemic factor that deserves further evaluation in order to clarify the role of lymphocyte-mediated systemic inflammation in the occurrence of pterygium.

PURPOSE: To compare the efficacy of green tea extract (epigallocatechin gallate – EGCG) and resveratrol with autologous serum (AS) in a chemical eye injury.
METHODS: A total of 17 New Zealand rabbits were divided into 5 groups (3 treatment groups, 1 sham, and 1 control group). A membrane filter paper impregnated with 10% potassium hydroxide was placed over the right eyes of the rabbits under sedation for 30 seconds to induce a chemical burn. Next, the ocular surfaces were washed with 0.9% saline for 10 minutes. EGCG solution was applied to the rabbits in Group 1, resveratrol solution to Group 2, and 20% AS to Group 3 for 3 weeks. In all groups, 0.9% saline was applied to the left eyes for 3 weeks (sham). Two corneas were left untreated after the chemical burn as a control. All groups were photographed daily for 3 weeks. Afterwards, the rabbits were sacrificed, the corneas were excised, and examined histopathologically with Hematoxylin & Eosin, Masson Trichrome, PAS staining, and immunohistochemically for GFAP, Ki-67, NF-kB, and IL-17 expression.
RESULTS: Clinically: AS was the only agent that clinically decreased the epithelial defect compared to the pre-treatment status. Histologically: Neuronal regeneration was higher in Group 2. Innate immune and inflammatory responses, as well as regeneration, were superior in Group 1.
CONCLUSION: EGCG and AS, but not resveratrol, could stimulate corneal healing in chemical eye injuries. More studies are needed to determine the optimal dose of EGCG and obtain a clinical response.

PURPOSE: Amniotic membrane transplantation (AMT) has become a widely used therapeutic approach in ophthalmology, particularly for managing ocular surface disorders. Despite its clinical significance, no comprehensive bibliometric analysis has been conducted to evaluate the research landscape of AMT in ophthalmology. This study aims to analyze publication trends, identify influential contributors, and highlight emerging research directions.
METHODS: A bibliometric analysis was conducted using the Web of Science (WoS) Core Collection. A comprehensive search was performed on February 1, 2025, using the keywords “amniotic membrane” in the title or “amniotic membrane” OR “AMT” in the author keywords. Data were extracted from the “Analyze Results” and “Citation Reports” sections of WoS to assess publication trends, author productivity, institutional and country contributions, highly cited publications, and journal-level output. Bibliometric mapping was performed using VOSviewer to examine research focus areas, as well as co-authorship and country collaboration networks.
RESULTS: A total of 1012 AMT-related publications in ophthalmology were identified, spanning 1995–2025. The United States emerged as the most productive country. Tseng SCG was identified as the most prolific author, with 102 publications and an H-index of 54. Highly cited publications primarily focused on ocular surface reconstruction, limbal stem cell deficiency, and pterygium surgery, whereas emerging research areas included glaucoma surgery, retinal disorders, and bioengineering applications.
CONCLUSION: AMT research in ophthalmology has evolved over time, with shifts in focus from anterior segment applications to emerging uses in glaucoma and retinal disorders. The increasing attention to bioengineering approaches, regenerative medicine, and minimally invasive techniques suggests promising directions for future investigations.

PURPOSE: The study aims to evaluate the effects of anti-vascular endothelial growth factor (anti-VEGF) treatment on corneal nerve morphology and ocular surface health in patients with unilateral wet age-related macular degeneration (AMD).
METHODS: The study included 48 patients who received at least three unilateral intravitreal anti-VEGF injections for wet AMD and 25 subjects who were healthy. Corneal nerve morphology was assessed using in vivo confocal microscopy, and ocular surface health by tear film parameters and ocular surface disease index scores. The effects of different anti-VEGF agents (bevacizumab, ranibizumab, and aflibercept) were also compared.
RESULTS: The results showed a marked decline in corneal nerve fiber width (CNFW) in anti-VEGF-treated eyes compared to untreated eyes and healthy control eyes. However, no notable discrepancies in other corneal nerve parameters, tear film parameters, and corneal sensitivity were found between treated, untreated eyes, and healthy control eyes. Furthermore, no statistically significant change was noted between the effects of different anti-VEGF agents on corneal nerves.
CONCLUSION: Anti-VEGF treatment may affect corneal nerve structure, as indicated by a decrease in CNFW, but does not necessarily lead to changes in corneal sensitivity and tear film parameters. The results of the study suggest that anti-VEGF treatment appears to be safe in terms of its effects on corneal nerves, but further research, especially longitudinal studies, are required to validate these findings.

PURPOSE: It has been reported that there is a decrease in lamina cribrosa thickness (LCT) in neurodegenerative diseases. However, patients with schizophrenia have not been evaluated before. In the current study, we aimed to assess the LCT and lamina cribrosa curvature index (LCCI) in patients with schizophrenia.
METHODS: The study included 20 eyes of 20 patients with schizophrenia and 20 eyes of 20 healthy controls. After routine ophthalmological examination, the optic nerve head area was scanned using swept-source optical coherence tomography (OCT) (DRI OCT Triton, Topcon Inc., Tokyo, Japan) to examine the lamina cribrosa curvature depth (LCCD) and LCT. To determine the degree of the posterior bending of the lamina cribrosa, LCCI was calculated using the formula, lamina cribrosa curvature depth/curvature width × 100.
RESULTS: The mean age of the patients was 35.4±8.2 years, and there were 18 males. The LCT values were 205.86±21.38 µm in the schizophrenia group and 229.72±25.84 µm in the control group and were found to be statistically significantly lower in the schizophrenia group (p=0.003). The LCCI value in the schizophrenia group was found to be 3.07±0.70 and was similar to the healthy control group (p=0.923). Furthermore, there was no significant difference between the two groups regarding the LCCD or lamina cribrosa curvature width (p=0.396 and 0.362).
CONCLUSION: OCT revealed that the lamina cribrosa was thinner in patients with schizophrenia. LCT can also be used to determine early damage to nerve fibers in these patients.

PURPOSE: The aim of the study is to explore intraoperative challenges and complications during cataract surgery in patients with an intravitreal injection (IVI) history.
METHODS: This retrospective study included 119 eyes of patients who underwent cataract surgery following a history of IVIs at a tertiary center between January 2015 and October 2022. Data on demographics, number and type of injections, surgical technique, and intraoperative challenges and complications were collected. Surgeries were performed by either experienced surgeons or ophthalmology residents, and outcomes were compared accordingly.
RESULTS: Experienced surgeons exhibited lower complication rates compared to resident surgeons (odds ratio [OR], 5.68 p=0.06), highlighting the role of surgical expertise in minimizing complications during cataract surgery in patients with an IVI history. A moderate correlation was observed between the total number of prior IVIs and the complications during cataract surgery, suggesting a cumulative effect with multiple injections (> 10 IVIs, OR, 1.81). Dexamethasone injections were associated with higher rate of intraoperative difficulties (OR, 1.29, p=0.033). Posterior capsule rupture occurred in 9.2% of cases, with a higher incidence in cases performed by resident surgeons.
CONCLUSION: Cataract surgery in patients with a history of IVIs may present specific challenges, emphasizing the importance of surgical experience and individualized preoperative assessment. This study provides valuable insights for surgical decision-making and patient management in this specific population. Larger cohorts and further research are recommended to validate and extend these observations.

PURPOSE: The purpose of the study is to present the histopathological evaluation of the excised pterygium tissues and to investigate accompanying ocular surface pathologies.
METHODS: The histopathologic data of the patients who underwent pterygium excision between 2013 and 2024 were retrospectively evaluated. The demographic data, pterygium location, and whether the pterygium was primary or recurrent were also noted.
RESULTS: A total of 190 eyes of 190 patients were included. Mean age was 56.36±13.2 (range, 21–90) years, and the female-to-male ratio was 84/106. Pterygium was located in the nasal quadrant in all eyes (100%) and was recurrent in 20 (10.5%) of 190 eyes. The histopathological evaluation of the excised materials revealed that they were compatible with pterygium in 188 of the cases (98.9%). At pterygium materials histopathologically, epithelial hyperplasia, goblet cell hyperplasia, solar degeneration, squamous metaplasia, stromal inflammation, and proliferation in fibrovascular tissue were seen. In one case (0.5%) of 188 patients with pterygium, additionally epithelial dysplasia was seen histopathologically. The other two cases with clinically consistent with pterygium were diagnosed as limbal dermoid (0.5%) and as intramucosal nevus (0.5%) histopathologically.
CONCLUSION: Pterygium is a common lesion on the ocular surface which is triggered by ultraviolet light exposure. Although the risk of malignant transformation is very low, its relationship with sunlight exposure indicates the risk of other malignancies. As pterygium location is similar and the appearance might mimic ocular surface squamous neoplasia, histopathological examination is important to achieve a proper diagnosis.

PURPOSE: The aim of the study is to evaluate the accuracy and legibility of the answers given by 3 different large language models (LLMs) to common patient questions about cataract surgery.
METHODS: Three distinct LLMs (ChatGPT, Microsoft Copilot, and Google Gemini) were queried on 30 common inquiries about cataract surgery. The accuracy of the responses was evaluated using a Likert scale, based on the consensus opinion of two specialists. The readability of the responses was evaluated using three distinct readability indices: Flesch-Kincaid Grade Level, Coleman-Liau, and Flesch Reading Ease.
RESULTS: None of the responses from LLMs received a score of 1 for any question. All responses generated by ChatGPT were rated four or higher. For comparison, 90% of Gemini’s responses and 27% of Copilot’s responses achieved scores of four or above. In consideration of legibility, it was observed that all three LLMs were challenging to read. However, Copilot exhibited slightly superior readability, followed by Gemini and ChatGPT, respectively.
CONCLUSION: While the responses provided by ChatGPT exhibited a slightly lower level of readability, they nonetheless proved to be the most proficient in answering cataract surgery-related questions. LLMs may support patient education, but their readability must be improved to ensure effective communication. Future work should focus on making AI-generated responses clearer and more accessible.

PURPOSE: The objective of the study is to evaluate ocular biometric measurements, retinal and choroidal characteristics in individuals aged six years and older with unilateral anisometropic amblyopia.
METHODS: Fifty-eight participants were selected and assigned to two groups: Myopic anisometropic and hyperopic anisometropic amblyopia. All participants received a standardized ophthalmic work-up comprising visual-acuity testing, refraction, ocular biometry, and multimodal retinal imaging with optical coherence tomography (OCT) and OCT angiography (OCTA).
RESULTS: he mean age was 31.12±2.49 years (range: 6–60 years). Visual acuity, spherical and cylindrical refractive error, and spherical equivalent differed significantly between the amblyopic and fellow eyes in both myopic and hyperopic groups (p<0.001 for all). Axial length and vitreous length differed significantly between the hyperopic (p=0.008 and p=0.003, respectively) and myopic amblyopic (p<0.001 for both) eyes compared to their fellow eyes. Retinal thickness measurements revealed that the myopic anisometropic amblyopic eyes had significantly thinner superior temporal, inferior temporal, and global peripapillary retinal nerve fiber layer thickness values compared to hyperopic anisometropic amblyopic eyes (p=0.022, p=0.002, and p=0.007, respectively). Evaluation of the microvascular features in the macular and peripapillary regions using OCTA revealed that the myopic amblyopic eyes had significantly lower mean superior peripapillary vessel density values in both the superficial capillary plexus (p=0.041) and choriocapillaris (p=0.033) segments compared to fellow eyes.
CONCLUSION: A holistic evaluation of the anatomical characteristics and microvascular structures of ocular tissues may be valuable in elucidating the mechanisms of amblyopia in anisometropic amblyopic eyes.

PURPOSE: Good visual health is important in children for healthy growth and good educational performance. Ocular diseases are regular causes of hospital consultations with varying types of diseases in different localities. This study aimed to determine the pattern of childhood eye diseases and provide baseline data in our hospital.
METHODS: This is a retrospective review of all patients aged between 0 and 17 years old who presented to the eye clinic of our hospital to our clinic between January 2021 and December 2022. Diagnoses were made by the consultants and follow-up of the patients was done by the ophthalmology residents. Data on age at presentation, sex, and diagnosis were collected and analyzed using SPSS. P<0.05 was considered statistically significant.
RESULTS: A total of 639 pediatric cases presented to the clinic during the study period with a male-to-female ratio of 1: 1.1. This represents 24.62% of all the cases (adults and children) that presented to the eye clinic within the study period. Children aged 11–17 years made up the largest group (p=0.013). Refractive errors (37.9%), allergic and vernal conjunctivitis (32.7%), ocular trauma (7.0%), and infective conjunctivitis (3.8%) were the most common conditions. Refractive error was more common in females (p=0.002).
CONCLUSION: The knowledge of common childhood diseases can aid planning, allocation of resources and increase awareness to prevent these potentially blinding conditions.

PURPOSE: To analyse the 6-month clinical results of latanoprostene bunod (LBN) and to compare the efficacy of LBN in the treatment of open-angle glaucoma (OAG) with other prostaglandin analogues (PGAs), latanoprost and bimatoprost.
METHODS: This retrospective study included 193 patients with OAG. There were 63 patients in the LBN group, 57 in the bimatoprost group, and 73 in the latanoprost group. We examined the intraocular pressure (IOP) changes, retinal nerve fibre layer (RNFL) analyses, and visual field (VF) changes of each group during the 6-month treatment period. Baseline and 6-month data of the LBN group were compared. The 6-month changes of the LBN group were statistically compared with the 6-month changes of the bimatoprost and latanoprost groups.
RESULTS: After six months of LBN use, there was a significant decrease in IOP compared to baseline (p=0.022). No difference was found in terms of other parameters (p>0.05 for each). In other parameters, LBN was similar to bimatoprost and latanoprost (p>0.05 for each).
CONCLUSION: LBN provides a significant decrease in IOP. However, 6-month clinical effects were similar to bimatoprost and latanoprost.

We report a case of periorbital and orbital cellulitis following trauma, resulting in left upper eyelid necrosis. The infection was treated with broad-spectrum systemic antibiotics, debridement, and drainage of the abscess. Early treatment can prevent complications such as blindness, aesthetic problems, and systemic involvement.

Astrocytic hamartomas are benign glial tumors originating from the retinal nerve fiber layer. While commonly associated with tuberous sclerosis and neurofibromatosis, they can also coexist with retinitis pigmentosa (RP).
A 48-year-old RP patient presented for a routine examination with no systemic complaints. Best-corrected visual acuity was 0.8 bilaterally. Fundus examination revealed bone spicules, vascular attenuation, and elevated, nodular, cream-colored masses over both optic discs. Fundus autofluorescence showed hyperautofluorescent masses, while B-scan ultrasonography revealed hyperechogenicity with posterior shadowing. Optical coherence tomography angiography demonstrated a mass with moth-eaten cavities. Neurology and nephrology evaluations found no systemic pathology. Based on these findings, the lesions were suspected to be astrocytic hamartomas. No changes were observed over one year of follow-up.
The coexistence of RP and astrocytic hamartomas is rare. When optic disc masses are detected in RP patients, this possibility should be considered, and differential diagnoses should include optic disc drusen, meningioma, hemangioma, and papilledema.

Sympathetic ophthalmia (SO) is a rare bilateral granulomatous uveitis that typically appears weeks to months after penetrating ocular trauma; presentations decades later are exceptional. A 40-year-old man developed blurred vision in his left eye thirty-six years after childhood penetrating ocular trauma to the right eye. Best-corrected visual acuity was no light perception in the right eye and counting fingers at two meters in the left eye. Multimodal imaging revealed diffuse choroidal thickening as well as subfoveal serous detachment. Laboratory work-up excluded infectious and malignant etiologies. High-dose intravenous methylprednisolone, followed by oral prednisone and azathioprine, led to the resolution of subretinal fluid and improvement to 20/20 at 6 months, sustained over 18 months. This case underscores the lifelong risk of SO after ocular injury and illustrates the diagnostic value of multimodal imaging in detecting choroidal inflammation, guiding treatment response monitoring, and long-term management.

Upper and lower eyelid blepharoplasty is one of the most commonly performed oculoplastic surgeries worldwide, serving both aesthetic enhancement and functional purposes. While blepharoplasty enhances facial aesthetics and expands the visual field effectively, it carries significant ocular surface complication risks. These operations may impact ocular surface health by changing eyelid structure, influencing blinking behavior, and affecting tear film homeostasis, predisposing patients to or aggravating preexisting dry eye disease (DED). Therefore, a meticulous preoperative assessment for dry eye, cautious surgical approaches, and diligent postoperative care are necessary to prevent surgery-induced or aggravated DED and achieve optimal patient satisfaction and surgical success. This narrative review evaluates recent evidence and TFOS DEWS II and III consensus data to define causative mechanisms, recognize predisposing factors, and present management strategies to improve surgical safety and patient outcomes.

Dry eye disease (DED) is a multifactorial ocular surface disorder driven by tear film instability, hyperosmolar stress, and immune-mediated inflammation, ultimately leading to visual disturbance and reduced quality of life. This review integrates current evidence-based recommendations consistent with the Tear Film and Ocular Surface Society Dry Eye Workshop III (TFOS DEWS III) Diagnostic Methodology and aligns therapeutic interventions with prevalent DED phenotypes to facilitate precision-based management. The proposed stepwise algorithm advances from environmental and behavioral modification, tear supplementation, and ocular surface lubrication to targeted eyelid therapies, anti-inflammatory and immunomodulatory treatments, device-assisted modalities, ocular surface rehabilitation, nutritional supplementation, and perioperative prophylaxis. Given the heterogeneity of disease mechanisms and the variable strength of supporting evidence, DED management must be tailored to individual phenotypic expression and disease severity, with systematic re-evaluation of symptoms, objective clinical parameters, and therapeutic safety.