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  1. Arun Singh,
  2. Harminder Dua, Editors-in-Chief

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Paediatric and adolescent elevated conjunctival lesions in the plica

Beykin et al report clinical, histopathological and molecular features of ‘salmon patch’-like conjunctival lesions in 11 patients (aged 6–21 years). Nine patients underwent an excisional biopsy that histopathologically disclosed extranodal marginal zone B cell lymphoma in two cases and reactive lymphoid hyperplasia (RLH) in seven cases. Molecular diagnosis showed polyclonal B cells in six patients, monoclonal B cells in two patients, and a questionable status in one patient. The authors conclude that it is clinically difficult to differentiate between conjunctival RLH and EMZL in the paediatric and adolescent population. Molecular analysis of excised lesions does not always correlate with histopathology.

Impact of dry eye on reading

van Landingham et al determined if dry eye was associated with measurable reading deficits in a cross-sectional study of 1981 elderly participants. Dry eye symptoms were identified by questionnaire and clinically significant dry eye was defined by examination. Spoken reading speed was measured. Subjects self-reported difficulty in reading newsprint. Whilst 14% of subjects had dry eye symptoms only 3% had clinically significant dry eye. Presence of dry eye did not affect reading speed but was associated with self-reported reading difficulty and avoidance of newspaper reading.

The collagen matrix of the human trabecular meshwork

Dua et al examined the peripheral part of pre-Descemet's layer (PDL) in relation to the origin of the trabecular meshwork (TM) located at the angle of the anterior chamber in 19 human donor eyes and one exenterated sample by light and electron microscopy (EM) for tissue architecture and by immunohistology for matricellular proteins and collagen types. EM revealed that beams of collagen emerged from the periphery of PDL on the anterior surface of the Descemet's membrane and divided to continue as the beams of the TM suggesting that collagen core of the TM is an extension of the PDL of the cornea.

Secondary iris-claw anterior chamber IOL

Güell et al evaluated secondary iris-claw intraocular lens (IOL, Artisan, Ophtec BV) implantation in 128 consecutive aphakic eyes without capsular support. One year postoperatively, mean logarithm of the minimum angle of resolution best-spectacle corrected visual acuity improved to 0.52 and remained stable up to 5 years. Mean SE progressively decreased during the 1st year, and remained stable thereafter. Mean preoperative central endothelial cell count of 2237 cells/mm2 showed a slight decrease over the years. Complications such as pupillary block, transient increase in intraocular pressure, and cystoid macular oedema were rare. Iris-claw IOL implantation in aphakic eyes is an effective, predictable and safe procedure in the first 5 years of follow-up.

Screening for convergence insufficiency in young adults

Horwood, Toor, and Riddell conducted a Convergence Insufficiency Symptom Survey (CISS) and assessed orthoptic findings in 167 University students who considered themselves to have normal eyesight apart from need for spectacles.

A CISS score of ≥21 was used to define ‘significant’ symptoms. The group mean CISS score was 15.4. In all, 17 (10%) of the participants were diagnosed with convergence insufficiency (CI), but 11 (65%) of these did not have significant symptoms. 41 (25%) participants returned a ‘high’ CISS score of ≥21 but only 6 (15%) of these had CI. Sensitivity and specificity of the CISS to detect CI was 38% and 77%, respectively. This study suggests that visual symptoms' are common in young adults, but often not related to any detectable clinical defect, while true CI may be asymptomatic.

Ocular haemodynamics in type 2 diabetes and coronary artery disease

Krasnicki et al evaluated the relationship between ocular blood flow parameters and diabetic retinopathy and coronary artery disease in diabetic patients. Colour Doppler imaging was used to assess the peak systolic and end-diastolic blood velocities as well as resistivity index in the ophthalmic, central retinal and posterior ciliary arteries. As compared to controls (14), the peak systolic and end-diastolic blood velocities in all three evaluated vessels were significantly lower in the case of diabetic patients with coronary artery disease (29). Diabetic patients without coronary artery disease (13) showed only decreased end-diastolic velocity values in the ophthalmic artery compared with the controls.

Ocular Trauma Scores in paediatric open globe injuries

Schörkhuber et al assessed the predictive value and the applicability of Ocular Trauma Score (OTS) for paediatric injuries in a retrospective analysis of 71 open globe injuries. The variables of the OTS, the Paediatric Penetrating OTS (POTS), lens injuries and anterior versus posterior segment injuries were analysed for their predictive values (visual outcome). The application of OTS proved difficult, as the presence of a mild degree of a relative afferent pupillary defect (RAPD) could not accurately be evaluated in all patients. OTS without RAPD rendered it easily applicable for the initial examinations while remaining significantly prognostic. Several POTS variables (ie, iris prolapse, age, organic injuries and delay of surgery >48 h) had only limited impact on visual outcome.