PURPOSE: This study aims to compare the effect of latanoprostene bunod and latanoprost on the vasculature of the posterior segment of the eye.
METHODS: The study included 34 eyes of 17 patients diagnosed with primary open-angle glaucoma or ocular hypertension. Of these, 14 eyes of 7 patients were administered latanoprost 0.005% (Latafree, VEM ilaç, Türkiye) once daily (defined as the LAT group), while 20 eyes of 10 patients were administered latanoprostene bunod 0.024% (Vyzulta, Bausch+Lomb, Rochester, NY, USA) once daily (defined as the VYZ group). Intraocular pressure (IOP), macular and optic disc vascular density (VD), as well as submacular and subfoveal choroidal vascular parameters, were assessed for changes within each group over time and compared between groups at all time points (at baseline, month 1, month 3, and month 6).
RESULTS: Latanoprost demonstrated superiority in reducing IOP compared to latanoprostene bunod (p<0.001). Nevertheless, a substantial decrease in IOP was observed in both agents by the conclusion of the 6th month, in comparison with the initial baseline level (all p<0.001). At the 6th month, peripapillary VD was observed to be higher in the VYZ group (p=0.001), whereas the majority of macular VD or choroidal vascular parameters exhibited higher values in the LAT group.
CONCLUSION: Latanoprostene bunod may protect the optic nerve head from hypoperfusion-related damage by improving peripapillary vascular perfusion. IOP-lowering effect may be more pronounced with latanoprost, but both drugs can effectively lower IOP. In addition, the utilization of latanoprost may increase macular and choroidal vasculature.

PURPOSE: To evaluate the effects of energy drink (ED) consumption on choroidal thickness (CT), central macular thickness (CMT), choroidal vascularity index (CVI), retinal microvasculature, pupil diameter (PD), intraocular pressure (IOP), central corneal thickness (CCT), and anterior chamber depth (ACD).
METHODS: Twenty-seven volunteers with no systemic or ocular diseases were enrolled in this prospective study. CT and CVI by optical coherence tomography (OCT), retinal vessel density (VD) by OCT-angiography, and PD by corneal topography were measured before the ED ingestion. Measurements were performed 1 h and 2 h after ED ingestion again. One week later, the measurements were repeated after the participants consumed 250 mL of water.

RESULTS: There was a significant decrease in temporal CT at 1 h after ED intake compared to baseline (p=0.005). Temporal CT was not significantly different from baseline 2 h after ED intake (p=0.763). There was a significant increase in temporal CT at both 1 and 2 h after water intake (0.039 and 0.022, respectively). Subfoveal CT was significantly lower at 1 h after ED intake compared to baseline (p=0.009), whereas no significant difference in subfoveal CT was found at the end of the 2nd h (p=0.076). Water consumption did not affect subfoveal CT (p=0.473). There was no statistically significant difference in IOP, CCT, ACD, PD, CMT, nasal CT, CVI, and retinal VD measured at 1 and 2 h after both ED and water consumption compared to baseline (p>0.05).
CONCLUSION: ED consumption resulted in a transient decrease in CT but did not cause significant alterations in other anterior or posterior ocular parameters, including IOP, PD, or retinal microvasculature. These findings suggest that moderate ED intake may induce short-term vascular changes in the choroid without affecting overall retinal or anterior segment structure in healthy individuals.

PURPOSE: Ocular trauma is a leading cause of monocular blindness worldwide, requiring forensic and medical evaluation. This study retrospectively examines forensic ophthalmology consultations, trauma types, and medicolegal implications.
METHODS: A retrospective analysis was conducted on ophthalmology consultation reports from the Forensic Medicine Clinic at Ordu University Training and Research Hospital (2017–2024). All statistical analyses were performed using IBM Statistical Package for the Social Sciences Statistics for Windows, Version 22.0 (IBM Corp., Armonk, NY, USA). The normality of the data was tested using the Shapiro–Wilk test. If the data were normally distributed, descriptive statistics were reported as mean±standard deviation. If the data were not normally distributed, the Mann–Whitney U test was used, and descriptive statistics were presented as Median (Min-Max). Categorical variables were expressed as frequency (n) and percentage (%). For group comparisons of categorical variables, the Fisher-Freeman-Halton exact test, Chi-square test, and Fisher’s exact test were used. Statistical significance was set at α=0.05.
RESULTS: A total of 123 eyes from 108 patients were included in the study. Among 108 cases, the mean age was 41.84±17.61 years, and 74.1% were male. Blunt trauma was most common (88.8%), while injuries caused by a sharp object were significantly more frequent in males (p<0.05). The mean duration from trauma to forensic evaluation was 3 (0–654) days, with longer delays in trauma from a sharp object cases (p<0.05). The presence of an intraocular foreign body was a key finding in a subset of open-globe injuries, which also showed a higher frequency of fundus pathologies (p<0.05). Post-traumatic severe visual impairment was recorded in 11.7% of right-eye cases and 4.16% of left-eye cases.
CONCLUSION: Forensic ocular trauma cases are predominantly associated with blunt injuries, with males being more frequently affected. In forensic medical reporting, assessing functional impairment and the forensic evaluation process with a multidisciplinary approach is of great importance.

PURPOSE: The objective of the study is to evaluate the effects of scleral contact lenses (ScL) wear on tear meniscus parameters and anterior segment changes in patients with keratoconus (KC).
METHODS: This prospective study included 37 eyes of 23 KC patients fitted with ScLs (ICD FlexFit scleral lens, ABB Optical Group, USA). Best-corrected visual acuity (BCVA) and lens fitting parameters were assessed. Tear meniscus depth (TMD), tear meniscus area (TMA) and tear meniscus height (TMH) were evaluated using anterior segment optical coherence tomography (AS-OCT) along with anterior chamber depth (ACD), anterior chamber angle (ACA), anterior chamber volume (ACV), pupil diameter, and central corneal thickness (CCT) were measured before lens application and after 4 h of wear using corneal topography.
RESULTS: According to the ABCD classification, 25 eyes were Stage 1, 9 eyes were Stage 2, and 3 eyes were Stage 3. The fitted ScLs had an average vault of 4369±453 μm, an average diameter of 16.1±0.37 mm, and a mean base curve of 7.64±0.71 mm. BCVA improved significantly after ScL from 0.25±0.11 to 0.018±0.05 logMAR. The mean tear reservoir thickness was 315±50 μm. Although no statistically significant changes were observed in parameters such as ACA, ACD, ACV, and CCT, a significant reduction in TMH, TMD, and TMA values was observed after lens wear (p<0.001).
CONCLUSION: ScLs are an effective treatment option to improve visual quality in patients with KC. Although scleral lenses have no direct contact with the cornea, TMH decreased within hours of wear. Changes in anterior segment parameters, as well as lens fitting, can be evaluated using AS-OCT and corneal topography.

PURPOSE: The objective of this study was to evaluate the vitreopapillary interface features in patients with acute and non-acute non-arteritic anterior ischemic optic neuropathy (NAION) compared with healthy controls.
METHODS: This is a retrospective cohort study and included 30 affected eyes (group 1) and 30 unaffected fellow eyes (group 2) from 30 NAION patients and 30 eyes from 30 age- and sex-matched healthy controls (group 3). Posterior vitreous detachment (PVD), peripapillary wrinkles (PPWs), and peripapillary superficial vessel protrusion (PSVP) at the vitreous-peripapillary interface were assessed from optical coherence tomography slices.
RESULTS: The average age of the patients was 60.7±10.7 years, and the average age of the controls was 57.4±9.5 years (p=0.213). The prevalence of complete PVD at the time of acute presentation was 23.3% in group 1, 0.0% in group 2, and 16.7% in group 3 (p=0.004). At the 3rd month, the prevalence of complete PVD increased to 30% in group 1 and remained unchanged in group 2. The number of PPWs was 5.33±2.96, 3.57±1.43, and 1.37±0.76 in groups 1, 2, and 3, respectively (p<0.001) at baseline. At the 3rd month, the PPW in group 1 was significantly greater than that in group 2 (p=0.011). The number of PSVPs was 8.4±3.47 in group 1, 10.7±1.82 in group 2, and 7.43±1.28 in group 3 at baseline (p<0.001). There was no significant difference in the number of PSVPs among the groups at the end of 3-month follow-up (p=0.96).
CONCLUSION: PVD was present in almost one-third of eyes that had suffered NAION, and the affected eyes had PVD significantly more frequently than the unaffected eyes. The increased PPW in the affected eyes of NAION patients may be related to optic nerve head edema. NAION patients had more superficial vessel protrusion in the subacute period regardless of ischemic episode.

PURPOSE: The purpose of this study was to evaluate the tear dynamics and ophthalmological findings in patients who underwent spontaneous granulation healing after eyelid tumor excision.
METHODS: Ten eyes of 10 patients with complaints of eyelid tumors were included in the study. Demographic information of the patients, presence of systemic diseases, pathological diagnosis, size of the lesion, size of the excised area, tear dynamics (Schirmer-I test, tear break-up time), and ocular findings of the lid left for secondary healing after excision were evaluated retrospectively.
RESULTS: Ten patients (five females and five males) with a mean age of 68±14.4 years were followed up with spontaneous granulation healing after eyelid excision. The healing time of the eyelids was 21.5±4.9 days. The mean value of the Schirmer-I test was 11.7±1.25 mm before the operation, and the mean Schirmer-I test was 7.42±2.14 mm at the 1st month after the operation (p<0.001). Tear break-up time was found to be 12.8±2.36 s preoperatively and 8 ± 2.51 s at the 1st month postoperatively (p=0.003). A positive correlation was found between age and the length of the eyelid healing time (r=0.685, p=0.045).
CONCLUSION: Spontaneous granulation healing after eyelid tumor excision may lead to a significant reduction in tear stability. Despite these changes in tear dynamics, the technique appears to be a feasible option for eyelid reconstruction, offering satisfactory healing without major complications.

PURPOSE: This study aimed to assess the impact of repeated 700 μg intravitreal dexamethasone implant (IDI) applications on corneal parameters in patients with macular edema (ME) secondary to retinal vein occlusion (RVO).
METHODS: This retrospective pilot study included 62 patients with RVO and 63 control subjects. RVO patients received two or more IDI treatments. Detailed eye examinations, including posterior segment evaluations, corneal topography, and endothelial parameters, were retrieved from the patients’ medical records.
RESULTS: The study involved 23 patients with central RVO (CRVO) and 39 with branch RVO (BRVO). Ischemic RVO was present in 52.2% of CRVO and 48.7% of BRVO patients. The mean age of RVO patients was 64.79±10.00 years; for the control group, it was 65.03±9.02 years (p=0.068). Patients received an average of 6.58±3.38 IDI injections. Eyes treated with IDI showed significantly worse best-corrected visual acuity and increased central macular thickness compared to fellow eyes and controls (p<0.001 and p=0.031, respectively). Central corneal thickness was significantly thinner in eyes that received IDI, and anterior corneal depth, anterior and posterior corneal curvature, total high-order corneal aberrations, trefoil, and spherical values were significantly higher (p<0.05). In addition, endothelial cell density was significantly lower, and the mean cell area, minimum cell area, and maximum cell area were higher in the eyes that received IDI (p<0.05).

CONCLUSION: Repeated IDI injections adversely affect corneal topographic and endothelial parameters in RVO-related ME. These changes were associated with the type and localization of RVO, ischemic status, number of IDI administrations, and lens status.

PURPOSE: This study aims to evaluate the readability of the Turkish Ophthalmology Association’s (TOA) glaucoma patient education brochure and to assess the capabilities of GPT-4.0, Gemini, and DeepSeek in generating Turkish patient education materials with respect to readability, accuracy, and comprehensiveness.
METHODS: The TOA’s patient education brochure on glaucoma was evaluated for readability using the Ateşman and Bezirci-Yilmaz formulae. The questions from the TOA booklets were presented independently to the GPT-4.0, Gemini, and DeepSeek models. The replies generated by these models were readability tested using the same formulas. In addition, qualified ophthalmologists evaluated the accuracy and comprehensiveness of the artificial intelligence (AI)-generated responses. AI-generated responses were converted to Q1 and Q2 formats to test text simplification. These versions were reevaluated for readability, accuracy, and comprehensiveness to see if simplification increased intelligibility without affecting medical accuracy.
RESULTS: The TOA brochure had a higher readability level than the recommended patient education standard. Bezirci-Yilmaz scores showed that Gemini and DeepSeek had significantly lower readability than the TOA brochure (p=0.007 and p=0.033, respectively), whereas GPT-4.0 showed no significant difference (p=0.077). Ateşman scores indicated no significant difference between TOA and AI-generated texts. Gemini showed significantly higher comprehensiveness than GPT-4.0 (p=0.042), whereas accuracy scores did not differ significantly among the models. Readability improved for Gemini following simplification (p=0.013 and p=0.005, respectively), whereas GPT 4.0 and DeepSeek remained unchanged. After simplification, the comprehensiveness score decreased for Gemini, whereas GPT-4.0 and DeepSeek maintained their comprehensiveness.
CONCLUSION: While large language models hold promise for use as glaucoma patient information materials, it is essential to rigorously evaluate the accuracy and comprehensiveness of the content they produce.

PURPOSE: To compare the long-term visual outcomes and corneal biomechanical properties following deep anterior lamellar keratoplasty (DALK) using either the big bubble (BB) technique or manual lamellar dissection (MLD) in patients with advanced keratoconus. In addition, to evaluate the relationship between residual stromal bed (RSB) thickness and post-operative visual and biomechanical parameters in MLD-DALK eyes, and to assess the reliability of intraocular pressure (IOP) measurements.
METHODS: A total of 78 eyes from patients with keratoconus who underwent DALK (43 BB-DALK, 35 MLD-DALK) and completed 18 months of post-operative follow-up were retrospectively analyzed. Corneal hysteresis (CH), corneal resistance factor (CRF), cornea-compensated IOP (IOPcc), Goldmann correlated IOP (IOPg), and best-corrected visual acuity (BCVA) were assessed. In the MLD group, RSB thickness was measured using anterior segment OCT. Biomechanical assessments were performed using the Ocular Response Analyzer.
RESULTS: At 18 months, CH and CRF were comparable between groups (p>0.05), as were BCVA and other topographic parameters. The mean RSB thickness in the MLD group was 75.8±27.7 μm, with no significant correlation between RSB and visual or biomechanical metrics. In both groups, IOPcc was significantly higher than IOPg (p<0.01), though IOP readings were not correlated with RSB thickness.
CONCLUSION: MLD-DALK offers similar visual acuity and biomechanical outcomes to BB-DALK and is a viable alternative when BB formation fails. Clinicians should consider using measurements IOPcc for accurate post-operative monitoring, as traditional methods may underestimate true IOP in DALK patients.s.

PURPOSE: The purpose of the study is to evaluate the clinical features, underlying etiology, and clinical outcomes of choroidal neovascularization (CNV) in the pediatric population.
METHODS: This is a retrospective, single-center, interventional case series. A total of 12 eyes of 12 consecutive pediatric patients with CNV with various etiologies were analyzed. The main clinical parameters included the underlying causes, best-corrected visual acuity before and after the treatment, characteristics of the CNV, and the treatment strategies.
RESULTS: There were four girls and eight boys with a median age of 12.3± 3 years (range: 7–17 years). Eight of 12 patients have completed the 6-month follow-up. The mean follow-up period was 32.8± 41 months (range: 6–132 months) in those 8 patients. Overall, five of them were treated. Four patients were treated with intravitreal anti-vascular endothelial growth factor (anti-VEGF) administration and the remaining patient with photodynamic therapy. Visual acuity improved from logMAR 0.54±0.2 (range: logMAR 0.8–0.2) to logMAR 0.26±0.18 (range: logMAR 0.5–0.1) at the last visit in the treated eyes. All anti-VEGF-treated patients required only a single injection.
CONCLUSION: CNV, a sight-threatening disease, is rarely seen in the pediatric age group. Families could be hesitant about the intravitreal treatment, but anti-VEGF injections seemed very helpful in our group of treated patients.

PURPOSE: This research examines the current status of nine ophthalmology journals in Türkiye by analyzing their editorial and advisory boards in terms of gender representation, geographical distributions, academic seniority, and subspecialty areas.
METHODS: This study examined the editorial and advisory boards of nine Turkish ophthalmology journals by analyzing demographic profiles and publication records obtained from institutional websites and bibliometric databases, National Institutes of Health iCite, and Dimensions.ai. Information regarding the subspecialties of Turkish academics was sourced from the Turkish Ophthalmological Association website. The iCite data provided metrics such as total publications, publications per year, total citations, citations per year, and relative citation ratio (RCR), while the dimensions database yielded complementary metrics, including total publications, total citations, mean citations per publication, field citation ratio, RCR, and percentage of cited publications.
RESULTS: Professors constituted the majority (75.66%) of the 393 editors and advisory board members, and 37.25% were women. Geographically, 87.25% of editors were based in Türkiye, with major concentrations in Ankara (31.61%), Istanbul (21.47%), and Izmir (13.12%). Institutional analysis demonstrated diverse affiliations, with independent and private practice physicians constituting 8.10% (n=40) of the members, followed by physicians affiliated with private hospitals at 6.48% (n=32). Performance metrics from the iCite and dimensions databases identified the Turkish Journal of Ophthalmology as the leading body, with 88.71±84.5 publications, 2108.92±3046.14 citations, and an RCR of 1.24±0.86.
CONCLUSION: Enhancing the global impact of Turkish ophthalmology journals involves increasing transparency in editorial selection, promoting gender-balanced representation, fostering international collaboration, and addressing regional disparities through strategic diversity initiatives.

Intravitreal dexamethasone (DEX) implant is a device that continuously releases DEX after injection into the vitreous. It is used for indications such as diabetic macular edema (DME), non-infectious posterior uveitis, and retinal vein occlusion. The most common complications include intraocular pressure elevation and cataract. We present the case of a 59-year-old female referred for cataract surgery 18 months after receiving a DEX implant for DME. Slit-lamp biomicroscopy revealed a Grade III nuclear cataract and an intralenticular DEX implant. The patient subsequently underwent phacoemulsification with intraocular lens (IOL) implantation. Hydrodissection was deliberately omitted, and excessive manipulations were avoided. The posterior capsule remained intact, and a three-piece IOL was implanted within the capsular bag without intraoperative complications. Conclusion: Intralenticular Ozurdex implantation is a rare but clinically relevant complication. Careful injection technique, patient cooperation, and meticulous surgical management are essential to prevent and successfully manage this event.
 

Anisocoria, defined as a ≥0.4 mm difference in pupil diameter, may result from physiological or pathological causes. While often benign, it can occasionally indicate serious neurological or ophthalmological conditions. Bilateral acute iris transillumination (BAIT) is a rare, recently defined entity characterized by iris pigment dispersion and sphincter paralysis. A 54-year-old female presented to the emergency department on noticing unequal pupil sizes. Neurological examination and cranio-cervical magnetic resonance ımaging were unremarkable. She was referred to ophthalmology for further evaluation. Slit-lamp examination revealed bilateral iris transillumination defects and pupillary mydriasis, more prominent in the left eye. No signs of uveitis, glaucoma, or optic nerve pathology were observed. On detailed anamnesis, she reported systemic moxifloxacin use 1 month earlier for an upper respiratory tract infection. Clinical findings and drug history supported a diagnosis of BAIT. BAIT should be considered in the differential diagnosis of anisocoria, especially when neurological imaging is normal. Early recognition may prevent unnecessary investigations and optimize patient care.

This review, inspired by prior reviews and based on fundamental and clinical literature on normal human eye histology, describes both basic and specialized ocular histology while presenting distinctive histological images. By encompassing this review, both clinical ophthalmic practitioners and investigators in the field of basic and experimental eye research can better understand human ocular histology and determine the pathogenesis of various eye disorders.