No momento em que escrevo este editorial, estamos impactados por tudo o que ocorre no mundo, especialmente na Ucrânia, em Israel e no Brasil, onde uma guerra urbana ocorre em vários locais quase diariamente. Poderia comentar os artigos publicados nesta edição da Revista Brasileira de Oftalmologia ou abordar avanços na oftalmologia, ou algum tópico referente ao que vi ou fiz nestes últimos 50 anos em que presenciei tantos fatos acontecendo na medicina. […]

HISTORY Richard Banister (1622) was the first to associate the loss of vision by glaucoma with high levels of IOP.() Adolph Weber (1855) was the first to establish the concept of glaucoma as an optic neuropathy.() In 1864, eserine and physostigmine (miotics) were introduced as the first drugs extracted from a plant used to treat the progression of glaucoma.() It is well known that elevated or uncontrolled IOP cause the excavation of the optic disc (glaucomatous excavation) and visual field […]

STATUS REFRACIONAL: DEFINIÇÃO E APLICAÇÃO CONCEITUAL Apesar de tradicionalmente limitado ao sinônimo de refração manifesta e acuidade visual (com e sem correção),(,) o termo “status refracional” se estende à maneira como a ametropia do paciente e sua correção óptica em uso se relacionam com as atividades do dia a dia, englobando correções refracionais suplementares, como lentes de contato. Em outras palavras, status refracional se refere à compreensão detalhada da forma em que a correção óptica atual do paciente se aplica […]

ABSTRACT Objective: To describe the clinical features and outcomes of patients with uveitis associated with juvenile idiopathic arthritis (JIA) and idiopathic uveitis. Methods: This was an observational, retrospective study, conducted in a tertiary center. Patients under 18 years old who experienced at least one episode of uveitis and followed between 2000 and 2019 were included. Results: A total of 82 patients were included, of whom 43 had idiopathic uveitis and 39 had uveitis associated with JIA. Anterior uveitis was the […]

ABSTRACT Introduction: To obtain fundoscopy images through portable and low-cost equipment using artificial intelligence to assess the presence of DR. Methods: Fundus images of diabetic patients’ eyes were obtained by using a smartphone coupled to a device with a 20D lens. By using artificial intelligence (AI), the presence of DR was classified by a binary algorithm. Results: 97 ocular fundoscopy images were evaluated (45 normal and 52 with DR). Through AI diagnostic accuracy around was 70% to 100% in the […]

ABSTRACT Objective: To describe the clinical and epidemiological characteristics, surgical techniques, and results of the canalicular laceration treatment at our service. Methods: A retrospective study was carried out from January 2012 to June 2020, considering canalicular injuries operated at a reference center. Demographic data, lesion characteristics, surgical details, and treatment outcomes were obtained from electronic medical records and were statistically analyzed. Results: Twenty-six cases of people with canalicular lesions aged between 2 to 71 years old were included, of whom […]

ABSTRACT Objective: To evaluate the effect of 0.2% brimonidine eye drops in reducing hyperemia and ocular bleeding during strabismus surgeries, in comparison with 0.025% naphazoline + 0.3% pheniramine eye drops. Methods: Fourteen patients with strabismus and indication for bilateral surgical correction were evaluated. Before the procedure, the eye drops were instilled randomly in each eye of the evaluated patients. The subjective analysis of conjunctival hyperemia and perioperative bleeding was performed in a double-blind manner, by 02 surgeons. The objective assessment […]

ABSTRACT Objective: To analyze the morphological and functional long-term outcomes of amniotic membrane transplantation after ocular surface chemical burns. Methods: This prospective study analyzed 7 patients who suffered from severe ocular surface burn and underwent amniotic membrane transplantation from 2015 to 2020 in Hospital de Clínicas – Universidade Federal do Paraná. Results: Out of the seven patients, six (85.7%) suffered unilateral burn and one (14.3%) suffered bilateral burn. Five of them had alkali burns (71.4%), one had acid burn (14.3%) […]

ABSTRACT Objective: To assess the accuracy of general practitioners in recognizing diabetic retinopathy through color retinal retinography, with a two-hour training course, by comparing the capacity of screening and classifying diabetic retinopathy. Methods: In the first arm of the study, of 142 diabetic patients included, 274 eyes were evaluated, and these patients were examined with an indirect binocular ophthalmoscope and classified according to the degree of diabetic retinopathy. In the second arm of the study, 14 physicians who are not […]

ABSTRACT Introduction: Vision is one of the senses that most integrates the individual with the environment, since it captures most of the sensory stimuli to which the human being is exposed, and it is precisely this integration that allows the creation of memories and the formation of the knowledge. Low vision in childhood impairs learning, socialization, and also determines visual quality in adulthood. Objective: to identify the visual acuity of school children using the Snellen Test and refer and carry […]

ABSTRACT Purpose To evaluate the efficacy of grafting a preseptal strip of orbicularis muscle to treat deep static glabellar wrinkles. Methods This was a prospective, interventional, case series study that included patients aged between 21 and 80, who underwent upper and lower blepharoplasty, and who presented varying degrees of deep static glabellar rhytids. After marking the glabellar rhytid, a subcision was made with 40 x 12mm needle along the entire length of the glabellar wrinkle. The orbicularis muscle graft was […]

ABSTRACT Objective: To describe the clinical features and outcomes of patients with uveitis associated with juvenile idiopathic arthritis (JIA) and idiopathic uveitis. Methods: This was an observational, retrospective study, conducted in a tertiary center. Patients under 18 years old who experienced at least one episode of uveitis and followed between 2000 and 2019 were included. Results: A total of 82 patients were included, of whom 43 had idiopathic uveitis and 39 had uveitis associated with JIA. Anterior uveitis was the […]

ABSTRACT Objective: To assess the performance of a portable autorefractor as refractor and screening tool for refractive errors in schoolchildren. Methods: Cross-sectional observational study. Refractometric measurements of children between 5 and 10 years old were obtained through four methods: 2WIN under non-cycloplegic conditions, and 2WIN, conventional autorefractor, and retinoscopy, under cycloplegic conditions. Correlations and agreement between the methods and accuracy of the portable autorefractor to define whether to prescribe glasses were assessed. Results: The mean age ± standard deviation was […]

ABSTRACT Objective: To assess myopia prevalence in children from public schools of the metropolitan region of Porto Alegre, in Rio Grande do Sul. Methods: It is a prospective cross-sectional study with a sample of 330 children from public schools of the metropolitan region of Porto Alegre, from 5 to 20 years old. The students were submitted to an ophthalmological evaluation including auto-refractor measurements, best corrected and uncorrected visual acuity, subjective refraction under cycloplegia and axial length. The outcomes were prevalence […]

ABSTRACT Objective To evaluate the preliminary medium-term results (up to 6 months) of the stand-alone use of XEN® Gel Stent implantation or in combination with cataract surgery in the Brazilian population. Methods A retrospective longitudinal study was carried out on eyes with primary open-angle glaucoma consecutively submitted to XEN® Gel Stent implantation surgery alone (XEN® Group) or in combination with cataract surgery (Phaco-XEN® Group) in the same center between April and December 2023. The ability to reduce intraocular pressure and […]

ABSTRACT Objective: To compare the hypotensive effect of SLT vs the use of latanoprost in the initial management of patients with suspected glaucoma and diagnosis of glaucoma. To evaluate the patients’ quality of life using the Glaucoma Quality of Life questionnaire. Methods: Randomized controlled clinical trial conducted in the city of Cartagena, Colombia, between October 2021 to June 2023. Assignment to the SLT or latanoprost group with follow-up at days 7, 30, 90, 180, and 365 in patients diagnosed with […]

ABSTRACT Objective: To assess the clinical-epidemiological profile of patients with eyelid trauma associated with lacrimal canaliculus laceration, factors related to trauma and surgical intervention, and to evaluate post-surgical anatomical and functional success. Methods: A retrospective and longitudinal analytical study was conducted, in which chart analysis was performed for patients with eyelid trauma and associated canalicular injury, who were operated on from January 1, 2015, to July 31, 2022. Patients were selected and contacted for in-person evaluation and tests to analyze […]

ABSTRACT Objective: To determine the prevalence of ocular alterations in patients diagnosed with dengue, admitted to a reference center for infectious and parasitic diseases in Manaus (AM), Brazil. Methods: This was an observational, analytical, and prospective case series study with 33 patients admitted to the hospital with positive clinical pathology tests during a 90-day period of a dengue epidemic in 2011. The investigations included measurement of visual acuity, macular assessment with Amsler grid test, fundus biomicroscopy, retinography and optical coherence […]

ABSTRACT Objective: To evaluate the epidemiological, clinical, and imaging profile of lesions that mimic choroidal melanoma. Methods: Retrospective study of medical records of suspected choroidal melanoma lesions referred to the Ocular Oncology Service from the Universidade Federal de São Paulo, from 2014 to 2020. Demographic data, clinical history, and exams were evaluated. Results: A total of 104 patients (mean age: 65.57 ± 13.18; 49.04% female) were referred to our service with suspected choroidal melanoma. Of these, 32 (30.77%) were classified […]

ABSTRACT Objective: To study vertex-optical distance variation and estimate its impact on manifest refraction. Methods: Prospective study in a private clinic using the Vision-S™ 700 with five forehead positions. Forehead on the third position showed the closest vertex-optical distance of 12mm. Results: Analysis of 52 eyes from 26 patients revealed mean differences in vertex-optical distance of 12.25mm (right eye) and 11.75mm (left eye). A 2mm change in vertex-optical distance resulted in a 0.05D change for a 5D spherical equivalent and […]

ABSTRACT Objective: To evaluate the tear film and dry eye symptoms before and after phacoemulsification. Methods: Fifty-one patients diagnosed with cataracts participated in this clinical study (55% female; 78% white; 71.2 ± 6.5 years old; without the use of lubricating eye drops) and underwent phacoemulsification at a hospital in Aparecida (SP). Tear film analysis was performed by the tear film break-up test and dry eye symptoms were assessed by the Ocular Surface Disease Index, both before surgery and 30 and […]

ABSTRACT Objective: To characterize the effectiveness of anti-vascular endothelial growth factor drugs in exudative age-related macular degeneration. Methods: Retrospective longitudinal study of 54 patients with age-related macular degeneration receiving bevacizumab or aflibercept. Demographic data, visual acuity, and central retinal thickness measurements were collected. Improvement/stability of visual acuity and reduction in retinal thickness configured satisfactory responses. Results: Among the 60 eyes studied, there was no difference (p = 0.262) in satisfactory response when using bevacizumab (48.5%) or aflibercept (63.0%). Snellen’s visual […]

ABSTRACT Objective: To verify whether there are pathological dysfunctions in the cornea of patients with endometriosis. Methods: Case-control research with a quantitative approach that compared topographic and tomographic examinations of the cornea of patients with a laparoscopic diagnosis of endometriosis, without the use of hormonal medications, to the control group. Results: We analyzed 78 eyes, 34 from the endometriosis group and 44 from the control group. The loss of orthogonality between the axes of the corneal curvatures was more frequent […]

ABSTRACT Objective: To evaluate the long-term safety and efficacy of repeated corneal cross-linking in eyes of children and adolescents with progressive keratoconus. Methods: This retrospective study included nine eyes of nine consecutive patients with progressive keratoconus who underwent repeated corneal cross-linking 3.9 (range of 1.6 to 5.6) years after a primary one. All patients were followed for a mean period of 9.11 (range of 6 to 11) years after first treatment and 5.44 (range of 4 to 9) years, after […]

ABSTRACT Objective To evaluate intraocular lens power calculation and postoperative refractive errors in patients with high myopia undergoing cataract surgery, comparing predicted target refraction and actual postoperative refraction measured 30 days after surgery with SRK/T formula. Methods This retrospective analysis comprised 39 eyes of 31 patients undergoing cataract surgery through phacoemulsification with in-the-bag IOL implantation. Axial length was measured by partial coherence interferometry or immersion ultrasound biometry, with measurements greater than 26 mm and preoperative myopia greater than -6.0 D […]

ABSTRACT Objective: To assess the impact of the COVID-19 pandemic on corneal donations and the operation of the eye bank in the Zona da Mata Mineira Region. Methods: Retrospective analysis of medical records of all donations obtained by the Banco de Olhos Hospital Regional Dr. João Penido/FHEMIG, Juiz de Fora – MG between 2017 and 2022, comparing pre (January/2017 – March 11/2020) and post-pandemic (12/March/2020 – December/2022) periods. Results: There was a reduction in cornea donations and the number of […]

ABSTRACT Objective: To evaluate patients’ clinical-epidemiological profile and causative agents of infectious keratitis on patients submitted to culture obtained from corneal smears in an ophthalmological emergency in a reference hospital. Methods: Retrospective analysis of medical records and corneal culture examination results. The data were collected after the approval of the Human Research Ethics Committee. Results: Most patients were male, with an average age of 47.6 years old, Caucasian ethnicity, low level of education, and from the Greater Florianópolis area. Ocular […]

ABSTRACT Objective: To outline the epidemiological profile of a reference ophthalmological emergency department, with no appointment scheduled, at a tertiary hospital in Southern Brazil. Methods: A cross-sectional historical study was conducted at Hospital Regional de São José, Santa Catarina, covering all visits to the ophthalmological emergency department over 46 days in 2019 (n = 1,728). Data were entered in a spreadsheet and analyzed using Statistical Package for Social Sciences, version 21.0.0.0), with frequencies and chi-square tests for categorical data (p […]

ABSTRACT Purpose: To evaluate the visual, topographic, and refractive outcomes of the implantation of asymmetric segments (AS) of the ICRS intracorneal ring in eyes with keratoconus and irregular/asymmetric astigmatism (phenotypes type 2 Duck and 3 Snowman by morphological classification of Fernandez-Vega/Alfonso Keratoconus). Methods: Prospective clinical study including 60 patients (60 eyes) with keratoconus who underwent implantation of the Kearing ICRS selected and implanted according to the Mediphacos nomogram () with femtosecond laser. Preoperative and postoperative evaluations included uncorrected visual acuity, […]

ABSTRACT Objective: To know the profile of trabeculectomy, in addition to the success rate in controlling intraocular pressure in patients with glaucoma. Methods: A retrospective, observational study, with medical records of patients with glaucoma, followed up at an ophthalmological reference center, who underwent trabeculectomy from January 1, 2016 to May 31, 2017, by a single experienced surgeon. The success rate was considered with an intraocular pressure < 21 mmHg, for high intraocular pressure glaucoma, and a reduction of at least [...]

ABSTRACT Objective: To present a novel, low-cost, and accessible methodology for capturing high-quality stereoscopic images and streaming it in real time to a standard three-dimensional television in a surgical setting, utilizing readily available smartphones. Methods: Two smartphones were attached to each eyepiece of the surgical microscope using a custom-made adapter. The smartphones recorded the surgical procedure and streamed the video via HDMI cables to a dual-input multi-viewer, which combined the feeds into a single image displayed on a conventional 3D […]

ABSTRACT Objective: To validate visual acuity measurements using a cross-platform system in an ophthalmological setting. Methods: Visual acuity was assessed at a distance of 5m using two different modalities: printed and digital optotypes. The devices included Android, LG WebOS and Samsung Tizen smart TVs. Optotypes were presented in the logMAR scale. Two modalities, a single row and a block of symbols, presented Sloan letters and Tumbling E symbols. Results: Visual acuity measurements of 190 participants aged 12 to 60 years […]

ABSTRACT Objective To determine the incidence of the congenital nasolacrimal duct obstruction in Down Syndrome children and its treatment. Methods Retrospective study with medical records of 33 patients with Down Syndrome treated at the Peri-Peri Health Center from July 7, 2004 to October 14, 2009. Results Of the 33 Down syndrome children, 9 (27,27%) had congenital nasolacrimal duct obstruction, 5 were female and 4 were male and 6 (66,66%) had bilateral obstruction. The resolution rate with conservative treatment was in […]

ABSTRACT Objective: To evaluate the long-term clinical and refractive results of surgical correction of presbyopia in patients with cataracts and initial to moderate open-angle glaucoma through combined phacoemulsification surgery with multifocal intraocular lens implantation and angular surgery with trabecular implant. Methods: This is a real-world retrospective longitudinal study of a series of cases undergoing combined cataract surgery and anti-glaucoma surgery with a second-generation trabecular implant, iStent inject® (Glaukos Inc., California, USA). A statistical analysis of the entire study population was […]

ABSTRACT Objective: To evaluate the real-world long-term effectiveness and safety of the standalone use or in combination with cataract surgery of the second-generation trabecular implant, iStent inject®. Methods: A retrospective longitudinal study was carried out on a series of cases that underwent iStent inject® trabecular implantation alone and associated with cataract surgery. In addition to sociodemographic data, the parameters evaluated included intraocular pressure, number of medications, visual acuity, and possible complications from surgical interventions throughout follow-up. The effectiveness of the […]

ABSTRACT Objective: Ophthalmology is the medical area dedicated to taking care of the eye health of individuals and is present in all means of health care. Its correct understanding is essential for the correct management of ocular and visual disorders. The objective of the study was to analyze the level of general ophthalmological knowledge of medical students who have already attended the course of ophthalmology at a university in the South of Santa Catarina. Methods: This is a cross-sectional study. […]

ABSTRACT Objective: To know the prevalence of visual impairment in children from pre-selected public schools, as well as to analyze and intervene in it. Methods: The study was conducted in four stages. During the first and second ones, school professionals and medical students were trained in visual screening to perform the visual acuity of children in the first years of Elementary School. Children with altered acuity received ophthalmologic referral for diagnosis and intervention. Results: Of the 450 children screened, 64 […]

ABSTRACT Objective: To assess the impact of the Covid-19 pandemic on the number of medical appointments, exams and procedures performed in a public ophthalmic teaching hospital in Brazil. Methods: The total number of consultations, outpatient procedures and surgeries performed between March 2018 and March 2021 were reviewed and compared. Number of surgeries per resident was also reviewed. Results: There was a drop of 31.6% of care provided in the 2020 period compared to the average of the last two pre-pandemic […]

ABSTRACT Objective: To identify the characteristics of cornea transplant after transplantation. Methods: Cross-sectional, retrospective study with quantitative approach. Research was conducted at Banco de Olhos do Ceará and at three other private transplant centers in Fortaleza. Medical records of transplant patients from October 2020 to September 2022 were analyzed within one year of the procedure. Results: 300 medical records of patients undergoing corneal transplantation were collected, of which 289 (96.3%) corneas demonstrated good transparency. Regarding visual acuity, 62 transplants (20.7%) […]

ABSTRACT Objective: To delineate the epidemiological profile of patients with rhegmatogenous retinal detachment at a reference hospital in the state of Santa Catarina, Brazil. Methods: A retrospective observational study of 381 eyes, with secondary data collection and a quali-quantitative approach during one year. Patient characteristics and details of the provided care were collected. Results: The majority of cases involved males (70.34%), aged between 50 and 69 years old, referred from external medical services. The time for ophthalmic care ranged from […]

ABSTRACT Objective: To analyze the performance of the Color and Snellen Tests in Brazil. Methods: This descriptive and retrospective epidemiological study employs a quantitative approach to analyze data obtained via TABNET regarding the “Color Vision Test” and the “Visual Acuity Potential Assessment” over the last five years, focusing on school-aged children. Results: 26,374 tests were conducted, predominantly in the southern region of Brazil, although some states did not present data. There is a triple frequency in the use of the […]

ABSTRACT Cavernous sinus thrombosis is a rare, capricious condition, associated with the extension of infectious processes, which may originate from the middle third of the face, such as sinusitis that affects the paranasal sinuses of the face. Namely, the primary sites of infection are commonly the face, orbits and ethmoid, and sphenoid sinuses. The typical clinical presentation includes fever and periorbital edema followed by headache, ptosis and extraocular muscle paralysis. The diagnosis is eminently clinical and difficult to make. It […]

ABSTRACT The purpose of this study was to report the ocular changes observed after a bee sting with a stinger retained in the cornea. We show the treatment and outcome of an unusual corneal injury and its pathogenesis. This is a case report and literature review of ocular injuries caused by bee stings. A 63-year-old female patient sought emergency ophthalmic care because of a bee sting on the cornea of her right eye six days before. She complained of blurred […]

ABSTRACT This report was aimed at presenting a case of neurotrophic keratitis and concomitant SARS-CoV-2 infection in a patient who has recently undergone a corneal DALK transplant. One month after corneal transplantation with adequate corneal epithelialization, the patient presented neurotrophic keratitis with a torpid course of the corneal transplant coinciding with a SARS-CoV-2 infection, with an excessive host immune response. In addition, the patient presented a re-positivization of nasopharyngeal polymerase chain reaction of SARS-CoV-2 with past disease after starting treatment […]

ABSTRACT Pigment dispersion syndrome is associated with clinical features such as Krukenberg’s spindles, trabecular pigmentation, Scheie’s stripe and Zentmayer’s ring. Another less common feature of this syndrome is retrolental pigment deposits due to anterior hyaloid detachment or a defect in the Wieger’s ligament. We present two cases of pigment deposits on the posterior lens capsule. In both cases, there is bilateral dispersion of pigment throughout the anterior segment. The retrolental deposits are unilateral in the first case and bilateral in […]

ABSTRACT Acute disseminated encephalomyelitis is a rare, acute, inflammatory, and demyelinating disease of the central nervous system. Presumably associated in more than three quarters of cases by infections (viral, bacterial, or nonspecific) and immunizations or without any identifiable antecedent. It usually presents a monophasic course with onset of nonspecific symptoms in the prodromal phase and may evolve with multifocal neurological changes and even visual acuity loss. We describe a case of a 9-year-old boy with an initial picture of papillary […]

ABSTRACT A 36-year-old black male presented with a progressive loss of visual acuity in both eyes for 7 years. He had a history of tractional retinal detachment in the right eye and vitreous hemorrhage followed by retinal detachment in the left eye. He denied any systemic illness, trauma, or drug abuse. After clinical investigation, he was diagnosed with SC hemoglobinopathy and proliferative sickle cell retinopathy stage V in both eyes.

ABSTRACT We present an interesting case of a 62-year-old black female, presented to the ophthalmological hospital with a little “nevus” on the left eye previously visualized at the mirror, with one month of development. Physical examination with slit lamp (biomicroscopy) showed a group of painless veins, with vascular redness, and a mass nodular aspect in the mid temporal bulbar conjunctiva, of approximately 2mmx4mm.

ABSTRACT A 41 year-old man presented with unilateral vision loss for a week and constitutional symptoms for 3 months. Ophthalmic evaluation revealed cotton wool spots on the right eye and widespread retinal necrosis and hemorrhage on the left eye, suggestive of cytomegalovirus uveitis and HIV infection and retinopathy, and confirmed by serology. The patient was treated with ganciclovir and highly active antiretroviral therapy and preserved contralateral vision. Clinicians should be aware of uveitis and retinopathies to prevent irreversible vision loss […]

ABSTRACT The aim of this study was to report a rare case of neovascular glaucoma in a patient with type 1 diabetes mellitus that progressed to necrotizing scleritis with inflammation. A 22-year-old male with poorly controlled type 1 diabetes mellitus experienced sudden painful vision loss on the right eye. Visual acuity on the right eye was no light perception, while it was 20/80 in the left eye. Intraocular pressure was measured at 35 mmHg, and the examination was consistent with […]