So Many Injections, So Much Waste: Understanding the Environmental Impact of Intravitreal Injections.

To understand the environmental burden associated with intravitreal injections (IVIs) and propose actionable solutions to mitigate this impact. An analysis of current IVI practices was conducted, focusing on packaging waste, energy consumption, the carbon footprint, and disposal processes. Data on the environmental footprint of IVIs were collected from the literature and industry reports.

Rho Kinase Inhibitors: Strategies in Glaucoma Treatment in Older Adults.

Glaucoma is a leading cause of irreversible blindness which preferentially affects older individuals. No medications or therapies which are currently in our arsenal actually treat glaucoma itself. We know that intraocular pressure (IOP) is currently the only modifiable risk factor for glaucoma.

Outcome of combined trabeculectomy with cataract surgery in patients on prostaglandin analogs and aqueous suppressants.

Purpose: To compare the effect of prostaglandin analogs (PGA) against other glaucoma medications (non-PGA) on the intraocular pressure (IOP) outcomes of combined trabeculectomy with phacoemulsification, and the conjunctival cell profile in persons with primary open-angle (POAG) and pseudoexfoliation glaucoma (PXFG).

Methods: A prospective cohort study was conducted among 116 patients with POAG or PXFG on glaucoma medications for a minimum of 3 months undergoing glaucoma triple procedure. Patients were divided into two groups (PGA and non-PGA) based on preoperative exposure to PGA.

Reducing ophthalmic surgical waste through electronic instructions for use: a multisociety position paper.

Every ophthalmic surgical supply, including intraocular lenses (IOLs), IOL cartridges, and ophthalmic viscosurgical device syringes, is packaged with instructions for use (IFU). These pamphlets are printed in multiple languages and, in the case of an IOL, significantly increase the size and weight of the packaging. To eliminate this significant and unnecessary source of waste, we recommend that manufacturers move to Quick Response codes that link to online electronic IFU (e-IFU) as a sensible alternative.

Comparison of Ophthalmologist and Large Language Model Chatbot Responses to Online Patient Eye Care Questions.

Importance: Large language models (LLMs) like ChatGPT appear capable of performing a variety of tasks, including answering patient eye care questions, but have not yet been evaluated in direct comparison with ophthalmologists. It remains unclear whether LLM-generated advice is accurate, appropriate, and safe for eye patients.

Objective: To evaluate the quality of ophthalmology advice generated by an LLM chatbot in comparison with ophthalmologist-written advice.

Validation of a portable, non-mydriatic fundus camera compared to gold standard dilated fundus examination using slit lamp biomicroscopy for assessing the optic disc for glaucoma.

Purpose: To evaluate the sensitivity and specificity of a portable non-mydriatic fundus camera to assess the optic disc for glaucoma.

Methods: We conducted a single-site, cross-sectional, observational, instrument validation study. Non-mydriatic fundus photographs centred at the optic disc were obtained from 276 eyes of 68 glaucoma and 70 normal patients, using a portable fundus camera (Smartscope, Optomed, Oulu, Finland).

Detection of Posterior Segment Eye Disease in Rural Eye Camps in South India: A Nonrandomized Cluster Trial.

Purpose: Rural screening camps in India historically have focused on detection of cataract and uncorrected refractive error. This study aimed to increase detection, referral, and follow-up for posterior segment diseases (PSDs) in rural eye camps using a novel technology-driven eye camp model.

Design: A clustered nonrandomized trial in the catchment area of Aravind Eye Care System (AECS) Pondicherry, to compare 2 eye camp models: the traditional AECS eye camp model and the novel, technology-driven, eye camp model.

The Aravind Pseudoexfoliation Study: 5-Year Postoperative Results. The Effect of Intraocular Lens Choice and Capsular Tension Rings.

Purpose: We compared rates of intraocular lens (IOL) decentration, neodymium-doped yttrium aluminum garnet capsulotomy for posterior capsule opacification (PCO), and visual acuity (VA) in eyes with and without pseudoexfoliation (PEX) 5 years after undergoing cataract surgery.

Design: Prospective comparative interventional study.

Methods: This multicenter study population included 1 eye of both 930 cataract patients with and 470 cataract patients without uncomplicated PEX (no small pupils or phacodonesis) all undergoing phacoemulsification by experienced Aravind Eye Care System surgeons.

Rho-Associated Kinase Inhibitors: Evolving Strategies in Glaucoma Treatment.

Glaucoma, a group of progressive optic neuropathies with similar patterns of tissue loss, is primarily treated with medical therapy, followed by laser therapy and, later, incisional surgery. Aside from the introduction of prostaglandin analogs, topical carbonic anhydrase inhibitors, and topical alpha-agonists in the 1990s, no new pharmaceutical agents to lower intraocular pressure (IOP) have been introduced for approximately 20 years. The Rho kinase inhibitors represent a new class of glaucoma medications that inhibit the downstream pathway of the Rho family of small G-proteins to increase outflow from the conventional (trabecular) outflow pathway in the eye.

Cataract surgery and environmental sustainability: Waste and lifecycle assessment of phacoemulsification at a private healthcare facility.

Purpose: To measure the waste generation and lifecycle environmental emissions from cataract surgery via phacoemulsification in a recognized resource-efficient setting.

Setting: Two tertiary care centers of the Aravind Eye Care System in southern India.

Design: Observational case series.

New pharmacotherapy for the treatment of glaucoma.

Glaucoma is the second leading cause of blindness in the world and current pharmacotherapies for glaucoma have remained relatively unchanged (with the exception of fixed combinations of previously available medications) since the mid-1990s with the development of prostaglandin analogues. Now, with both new formulations and new classes of medications with novel mechanisms of action, the medical therapy of glaucoma may be heralding a new dawn in medical management. Areas covered: This review outlines new topical therapies for intraocular pressure (IOP) lowering treatment, in addition to new formulations, preservative-free options, and advances in glaucoma medical therapy delivery.

Nonmedical Out-of-Pocket Patient and Companion Expenditures Associated With Glaucoma Care.

Purpose: Nonmedical out-of-pocket cost to both patients and their companions of office visits for routine glaucoma care has not been extensively studied in the United States. We evaluate potential key predictors of patient expenditures that are critical to assessing the cost-effectiveness of glaucoma health care delivery.

Materials And Methods: In total, 300 patients responded to the survey in 3 clinics in 2 clinical practice settings.

Microinvasive Glaucoma Surgery: An Evidence-Based Assessment.

Introduction: The advent of Microinvasive Glaucoma Surgery (MIGS) offers a novel approach in the treatment of glaucoma with the number of procedures developing at an exciting pace.

Areas Covered: MIGS procedures aim to lower intraocular pressure (IOP) via four mechanisms: (1) increasing trabecular outflow, (2) increasing outflow via suprachoroidal shunts, (3) reducing aqueous production, and (4) subconjunctival filtration. A comprehensive search for published studies for each Microinvasive Glaucoma Surgery (MIGS) device or procedure was undertaken using the electronic database PubMed.

New classes of glaucoma medications.

Purpose Of Review: To discuss recent advances in the medical management of glaucoma and to highlight future medical therapies currently in development.

Recent Findings: In 1996, latanoprost (Xalatan) was approved in the United States as a new chemical entity and new class (prostaglandin analogs) for the topical treatment of ocular hypertension and glaucoma. In the period from the late 1990s-2010s, while there were additional new chemical entities, fixed dose combinations, and formulation improvements, there were no new classes of ocular hypotensive medications approved worldwide.