Multiple Evanescent White Dot Syndrome Developing Three Days following Administration of mRNA-1273 Booster Vaccine: Case Report.

Little is known about the potential ocular adverse events following mRNA-1273 vaccine. We aimed to report a case of multiple evanescent white dot syndrome (MEWDS) developing 3 days following the administration of mRNA-1273 vaccine booster. A 71-year-old white myopic female presented with complaints of seeing "pulsating light" and scotoma with her left eye that started about 3 days following mRNA-1273 vaccine booster administration. The patient was found to have multiple scattered white-yellow outer retinal lesions on dilated fundus exam of the left eye. Visual symptoms and exam findings continued to improve without any intervention confirming a short-lived and self-limiting disease course. Clinical presentation was consistent with a clinical diagnosis of MEWDS. Ophthalmologists need to take detailed vaccination history in patients presenting with MEWDS.

Ocular Trematodiasis Caused by the Avian Eye Fluke Philophthalmus in Southern Texas.

A trematode identified as a Philophthalmus sp was extracted from the bulbar conjunctiva of a patient in southern Texas with short-distance travel to Mexico. This parasite is very rarely reported from humans, and species identification is challenging. Aspects of diagnosis, zoonotic transmission, and unresolved questions about Philophthalmus spp are discussed.

Selective laser trabeculoplasty vs micropulse laser trabeculoplasty in open-angle glaucoma.

AIM: The aim of this study was to prospectively compare the efficacy, safety, and tolerability of selective laser trabeculoplasty (SLT) vs micropulse laser trabeculoplasty (MLT) in reducing intraocular pressure (IOP) in open-angle glaucoma patients. PATIENTS AND METHODS: In all, 38 patients were randomized to 360° MLT and 31 patients were randomized to 360° SLT. IOP was measured at intervals of 1 hour and 1, 1-6, 6-12, 6-24, 24-36, and 36-52 weeks. Patients completed a survey 1 week after the procedure. Patients with end-stage, neovascular, uveitic, or angle-closure glaucoma were excluded. Treatment response was defined as an IOP reduction of ≥20.0% or ≥3 mmHg from baseline. RESULTS: IOP was lowered to ≥3 mmHg from baseline among 37.0% of the micropulse patients and 36.0% of patients in the selective laser group at 24-52 weeks. Similarly, 29.6% of the micropulse patients and 36.0% of the selective laser patients experienced a 20.0% IOP decrease from baseline during the 24-52-week interval (P=0.77). Both groups revealed similar reductions in IOP as absolute values and percentage decreases from baseline at all intervals up to 52 weeks post treatment. There were more treatment failures in the micropulse group up to 52 weeks post laser treatment; however, this was not statistically significant. The micropulse group reported less pain both during and after the procedure (P=0.005). CONCLUSION: Micropulse trabeculoplasty has demonstrated similar efficacy to SLT over a 52-week follow-up period with less discomfort experienced both during and after the procedure.

Association between oral fluoroquinolone use and lateral canthal tendon rupture: case report.

It is well established and documented that fluoroquinolone use is associated with the development of tendinopathy. However, little is known about the possible effects of this class of antibiotics on the orbit. We present a case of lateral canthal tendon rupture that presented with an acute right lower eyelid ectropion in a young, renal compromised patient in the setting of recent fluoroquinolone use for pneumonia. Eye care clinicians need to be aware of the possible effects of fluoroquinolones on the eyelids.

Marijuana Use Among Patients With Glaucoma in a City With Legalized Medical Marijuana Use.

IMPORTANCE: Previous research has shown several limitations associated with the use of marijuana as a treatment for glaucoma. However, little is known regarding patients' perceptions toward using marijuana for glaucoma and their intentions to use this therapeutic alternative. OBJECTIVE: To identify factors among patients with glaucoma that could lead to intentions to use marijuana for treatment. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional survey study of 204 patients with glaucoma or suspected to have glaucoma was conducted at an academic-based glaucoma clinic in Washington, DC, between February 1 and July 31, 2013. Patients completed a self-administered survey assessing demographics, perceived severity of glaucoma, prior knowledge about marijuana use in glaucoma, past marijuana use, perceptions toward marijuana use (legality, systemic adverse effects, safety and effectiveness, and false beliefs), satisfaction with current glaucoma management, relevance of treatment costs, and intentions to use marijuana for glaucoma. Medical records were reviewed for disease severity. Data analysis was conducted from September 1, 2013, to September 30, 2015. MAIN OUTCOMES AND MEASURES: The main outcome was patients' intentions to use marijuana for glaucoma. Multiple linear regression analysis was conducted to identify factors associated with patients' intentions to use marijuana for glaucoma. RESULTS: Of the 334 patients who were invited to participate in the study, 204 (61.1%) completed the survey. About half the participants were women (104 [51.0]%), and 82 (40.2%) were white. Regression analysis of 204 respondents indicated that perceptions of legality of marijuana use (ß, 0.378; 95% CI, 0.205 to 0.444; P < .001), false beliefs regarding marijuana (ß, 0.323; 95% CI, 0.236 to 0.504; P < .001), satisfaction with current glaucoma care (ß, -0.222; 95% CI, -0.362 to -0.128; P < .001), and relevance of marijuana and glaucoma treatment costs (ß, 0.127; 95% CI, 0.008 to 0.210; P = .04) were significantly associated with intentions to use marijuana for glaucoma treatment after controlling for demographic variables, disease severity, and previous marijuana use. CONCLUSIONS AND RELEVANCE: This study's findings suggest a need for more education on this topic for ophthalmologists to be able to protect patients with glaucoma against the increased acceptability among the public of using marijuana based on false perceptions of its therapeutic value in glaucoma therapy. Considering the strong influence of perceptions of the legality of marijuana use on intentions to use this substance as a treatment for glaucoma, patient education might be particularly relevant in states in which marijuana use for glaucoma is legal, as in the case of the current study's setting.

Utility of Heidelberg retinal tomography as a screening tool for analyzing retinal nerve fiber layer defects.

CONTEXT: Although Heidelberg retinal tomography (HRT)-generated topographic images have been studied extensively for the detection of retinal nerve fiber layer (RNFL) defects, little is known about the role of HRT-generated surface reflectivity images in the detection of RNFL defects in either patients with glaucoma or glaucoma suspects. AIMS: To evaluate the effectiveness of HRT version II (HRT II) optic nerve reflectivity images in uncovering RNFL defects in an outpatient population evaluated for glaucoma. STUDY DESIGN/MATERIALS AND METHODS: In 102 consecutive eyes from 60 patients evaluated for glaucoma in an academic-based practice, HRT II optic nerve images were prospectively imaged and compared with clinical optic nerve exam techniques to see if HRT II was able to detect RNFL defects overlooked in clinical practice. RESULTS: Nine eyes (8.8%) were found to have RNFL defects recognized by screening with HRT II. Of these nine eyes, eight (88.9%) were recognized to demonstrate RNFL defects by conventional examination techniques. One additional eye had an RNFL defect seen on physical exam that was not detected by HRT. CONCLUSION: In academic practice, HRT II may be helpful in complementing conventional exam techniques in the recognition and documentation of acquired RNFL loss.