A novel training session: mixed reality evisceration surgery webinar.

Background: Evisceration surgery is an important part of an ophthalmologist's skillset but is an uncommon procedure. Therefore, it is important for training ophthalmologists to have adequate knowledge and confidence in this procedure to maximise learning opportunities. Mixed reality involves the intertwining of real and virtual environments and has been used successfully in surgical training.

Digital Exclusion, Social Deprivation, and Clinical Outcomes of Patients Undergoing Hyperacuity Home Monitoring.

Introduction: Digital exclusion is a growing challenge when deploying digital patient care pathways and a potential barrier to widespread implementation, especially in the field of smartphone-based self-monitoring of vision. This retrospective case series seeks to examine the characteristics of individuals who adhere to a smartphone home monitoring programme using the Alleye app for retinal disease, with a focus on digital exclusion, social deprivation and clinical outcomes.

Methods: We conducted a retrospective analysis of 89 patients with retinal pathologies including diabetic retinopathy and retinal vein occlusions at Moorfields Eye Hospital participating in an Alleye home monitoring programme between April 2020 and November 2022.

Teleophthalmology and retina: a review of current tools, pathways and services.

Telemedicine, the use of telecommunication and information technology to deliver healthcare remotely, has evolved beyond recognition since its inception in the 1970s. Advances in telecommunication infrastructure, the advent of the Internet, exponential growth in computing power and associated computer-aided diagnosis, and medical imaging developments have created an environment where telemedicine is more accessible and capable than ever before, particularly in the field of ophthalmology. Ever-increasing global demand for ophthalmic services due to population growth and ageing together with insufficient supply of ophthalmologists requires new models of healthcare provision integrating telemedicine to meet present day challenges, with the recent COVID-19 pandemic providing the catalyst for the widespread adoption and acceptance of teleophthalmology.

The Outcomes of Involutional Ptosis Surgeries in a Single Tertiary Center.

Purpose: To report the surgical outcome of anterior approach primary ptosis surgery in a tertiary center and to compare redo surgical rates between different grades of surgeons.

Methods: This is a Retrospective review of series of annual audits. All involutional/aponeurosis-disinsertion ptosis surgeries performed at Moorfields Eye-hospital (MEH) between January 01, 2016 and December 31, 2019 were included.

Determinants of non-attendance at face-to-face and telemedicine ophthalmic consultations.

Background/aims: Evaluation of telemedicine care models has highlighted its potential for exacerbating healthcare inequalities. This study seeks to identify and characterise factors associated with non-attendance across face-to-face and telemedicine outpatient appointments.

Methods: A retrospective cohort study at a tertiary-level ophthalmic institution in the UK, between 1 January 2019 and 31 October 2021.

Automated extraction of clinical measures from videos of oculofacial disorders using machine learning: feasibility, validity and reliability.

Objectives: To determine the feasibility, validity and reliability of automatically extracting clinically meaningful eyelid measurements from consumer-grade videos of individuals with oculofacial disorders.

Methods: A custom computer program was designed to automatically extract clinical measures from consumer-grade videos. This program was applied to publicly available videos of individuals with oculofacial disorders, and age-matched controls.

Introducing the 'Benign Eyelid Lesion Pathway': 1 year experience of synchronous tele-oculoplastics in a tertiary hospital.

Background: Patients with benign eyelid lesions make up a large proportion of referrals to the oculoplastic service and lend themselves well to telemedicine with assessments heavily reliant on history, observation-based examination and photographs to enable management decision-making. Our tertiary unit set up tele-oculoplastics clinics for all new patients referred for benign eyelid lesions comprising tele-consultation with antecedent patient photograph: Benign Eyelid Lesion Pathway (BELP). One year on, we describe a retrospective analysis of 974 patients looking at distinct parameters of effectiveness.

Rituximab for thyroid-associated ophthalmopathy.

Background: Thyroid-associated ophthalmopathy (TAO) is the most frequent extrathyroidal manifestation of Graves' disease, affecting up to 50% of patients. It has a great impact on quality of life. Rituximab (RTX) is a human/murine chimeric monoclonal antibody that targets the CD20 receptor on B-lymphocytes.

Digital Transformation in Ophthalmic Clinical Care During the COVID-19 Pandemic.

COVID-19 has placed unprecedented pressure on health systems globally, whereas simultaneously stimulating unprecedented levels of transformation. Here, we review digital adoption that has taken place during the pandemic to drive improvements in ophthalmic clinical care, with a specific focus on out-of-hospital triage and services, clinical assessment, patient management, and use of electronic health records. We show that although there have been some successes, shortcomings in technology infrastructure prepandemic became only more apparent and consequential as COVID-19 progressed.

Impact and Challenges of Integrating Artificial Intelligence and Telemedicine into Clinical Ophthalmology.

Aging populations and worsening burden of chronic, treatable disease is increasingly creating a global shortfall in ophthalmic care provision. Remote and automated systems carry the promise to expand the scale and potential of health care interventions, and reduce strain on health care services through safe, personalized, efficient, and cost-effective services. However, significant challenges remain.

Telemedicine in oculoplastic and adnexal surgery: clinicians' perspectives in the UK.

Background/aims: The COVID-19 has facilitated a paradigm shift in the sphere of ophthalmic telemedicine: its utility is no longer limited to providing care to remote regions, rather it is expeditiously being adopted as the new standard of care. The aim of our paper is to explore the current attitudes of oculoplastic surgeons towards telemedicine and its utility in the present landscape and its prospects in the future.

Methods: A 39-item questionnaire was distributed to consultant oculoplastic surgeons practising across the UK and anonymised responses were collected and analysed.

Recurrent epiphora after dacryocystorhinostomy surgery: Structural abnormalities identified with dacryocystography and long term outcomes of revision surgery : Success rates of further surgery following failed dacryocystorhinostomy surgery.

Background: To investigate the aetiopathology of recurrent epiphora or stickiness after dacryocystorhinostomy (DCR) surgery, identifiable on dacryocystography (DCG), and to assess the success rates of secondary corrective surgeries.

Methods: Consecutive post-DCR DCG images from patients with recurrent symptoms were reviewed between 2012 and 2015.

Results: One hundred fifty-nine eyes of 137 patients were evaluated.

Accuracy of periocular lesion assessment using telemedicine.

Objectives: To assess the agreement in diagnosis and management plans reached between clinicians reviewing eyelid lesions remotely and in face-to-face clinics.

Methods: In this single-centre observational case series, data were prospectively collected on 50 consecutive adults referred with eyelid lesions suitable to be seen by a nurse. A proforma was completed to gather salient information.

An Artificial Intelligence Approach to the Assessment of Abnormal Lid Position.

New artificial intelligence (AI) approaches to facial analysis show promise in the clinical evaluation of abnormal lid position. This could allow more naturalistic, quantitative, and automated assessment of lid position. The aim of this article was to determine whether OpenFace, an AI approach to real-time facial landmarking and analysis, can extract clinically useful measurements from images of patients before and after ptosis correction.

Eye clinic liaison officers service in the United Kingdom.

Background: To investigate the role of eye clinic liaison officers (ECLOs) in the United Kingdom and analyse patients' demographics and services provided.

Methods: This is a retrospective observational study. Data were collected from the Royal National Institute of Blind People for ECLOs in Wales, Scotland, Northern Ireland and England for the first quarter of 2015.

Ocular amyloid: adnexal and systemic involvement.

: To investigate the natural history of ocular adnexal and orbital amyloidosis.: In a retrospective, non-comparative case series, the clinical records of patients with biopsy-proven ocular, adnexal, and orbital amyloidosis managed at our institution between 1980 and 2016 were evaluated.: Forty-one patients (29 female; 71%) were identified.

Tocilizumab for thyroid eye disease.

Background: Thyroid eye disease (TED) is an autoimmune disorder that constitutes a major clinical and therapeutic challenge. Current treatment options for moderate-to-severe TED include immunotherapy, orbital radiotherapy and decompression surgery. Limited drugs of proven efficacy are available for the treatment of people with TED.

Calculated plasma volume status and prognosis in chronic heart failure.

Aims: Plasma volume (PV) expansion hallmarks worsening chronic heart failure (CHF) but no non-invasive means of quantifying volume status exists. Because weight and haematocrit are related to PV, they can be used to calculate relative PV status (PVS). We tested the validity and prognostic utility of calculated PVS in CHF patients.

Expansion of the red cell distribution width and evolving iron deficiency as predictors of poor outcome in chronic heart failure.

Background: An elevated red cell distribution width (RDW) and iron deficiency (ID) at baseline predict enhanced mortality in chronic heart failure (CHF), but little is known about the prognostic implications of their temporal trends. We sought to determine the survival implications of temporal changes in RDW and evolving ID in patients with CHF.

Methods: The relation between red cell indices on first consultation and over time with mortality in 274 stable patients with systolic CHF was analysed.

Tuberculosis and anti-TNF treatment: experience of a central London hospital.

Reactivation of latent tuberculosis (TB) is an established risk of anti-tumour necrosis factor α (anti-TNF) therapy. We report five cases of active TB occurring in 703 patients treated with anti-TNF therapy over a 10-year period in a central London hospital and review our screening practices for identifying latent TB prior to anti-TNF treatment. Four patients were receiving adalimumab and one patient etanercept at the time of TB diagnosis.

Structural rearrangements in RNA on the binding of an antisense oligonucleotide: implications for the study of intra-molecular RNA interactions and the design of cooperatively acting antisense reagents with enhanced efficacy.

We show that binding of an antisense oligonucleotide can lead to considerable changes in the target mRNA structure. The approaches described here are not only useful in the study of intra-molecular interactions in RNAs but can also be used to design oligonucleotides that facilitate binding of other antisense reagents. Such "cooperatively acting" antisense reagents have the potential to overcome several problems faced in their use, for example, low efficacy and non-specificity.