Background: Benign essential blepharospasm (BEB), aberrant facial nerve degeneration and hemifacial spasm (HFS) are all examples dystonia which, though not life-threatening, can have a significant impact on patient quality of life. The need for reliable self-rating surveys to monitor functional disability is fundamental. The Blepharospasm Disability Index (BSDI) is already a widely utilised and validated self-rating score for blepharospasm whilst the functional disability score (FDS) requires further validation. The principle aim of this study is to repeat validation of the FDS against the BSDI, which has been validated by several groups since its original description but only in patients with BEB.

Methods: A randomised blinded prospective cohort study was conducted at a single unit on 38 patients with BEB, aberrant facial nerve degeneration and HFS. Patients were blinded to complete the FDS followed by the BSDI or the BSDI followed by the FDS with a 30-minute interval.

Results: Both the FDS and BSDI were found to be reliable with high internal consistency and test-retest reliability. Both scales were also found to be moderately correlated with the Jankovic disease severity score.

Conclusions: This study is the first to use the FDS as a rating scale in patients with HFS and aberrant facial nerve degeneration. It is also the first study to formally validate the FDS as an acceptable rating scale for patients with dystonia and in particular it provides validation for its use in patients with HFS and aberrant facial nerve degeneration.

A young female patient developed sudden bilateral dark shadows in front of her eyes after being infected with the SARS-CoV-2. She was initially diagnosed with "macular disease" at the local hospital and received oral prednisone treatment, but her eye symptoms did not improve. At our hospital, further examinations were performed. Optical coherence tomography showed obvious thinning of the outer nuclear layer at typical lesions in both eyes, as well as missing ellipsoid zone and cone interdigitation with retinal pigment epithelium. The patient was diagnosed with acute macular neuroretinopathy (AMN). Treatment with corticosteroids, improvement of microcirculation, and neurotrophic agents resulted in improvement of the patient's condition. This case report is helpful for ophthalmologists to understand and diagnose this disease quickly and accurately, as AMN can occur as a result of SARS-CoV-2 infection.

Background and Objective: Ocular surface disease (OSD) is a common yet often overlooked consideration in the management of patients with glaucoma. Although there have been several review articles summarizing the relationship between glaucoma medications and OSD, there is a relative absence of such articles on the effects of glaucoma surgical treatments. Here, we present a comprehensive review of the literature regarding the relationship of glaucoma management and OSD, with an emphasis on surgical considerations.

Methods: PubMed, Google Scholar, and Cochrane Review searches were performed using the following search terms: ocular surface, dry eye, minimally invasive glaucoma surgeries (MIGS), trabeculectomy,glaucoma medications. The titles and abstracts from those searches were screened for relevance to our review topics. Publications were included if the subjects included glaucoma patients, and if ocular surface outcomes were described. Non-English papers were excluded.
Key Content and Findings: Topical glaucoma medications frequently cause adverse effects on the ocular surface, both through direct action of the medications themselves as well as through toxicity from their associated preservatives. Optimization of the ocular surface may improve medication compliance rates.Traditional surgical treatments for glaucoma, such as trabeculectomy, can exacerbate OSD by disrupting the ocular surface but can also reduce the need for chronic medications. Optimization of ocular surface health is imperative in reducing trabeculectomy complication rates, while also potentially reducing the need for trabeculectomy in patients that are able to achieve intraocular pressure control through improved drop tolerability. The introduction of MIGS represents a promising alternative to existing therapies and has been shown to alleviate the overall medication burden. It would be reasonable to assume that decreasing the medication burden could reduce OSD prevalence and severity. However, more research is needed to directly assess the extent of improvement seen after MIGS.

Conclusions: A comprehensive understanding of the importance of OSD in medical and surgical management of glaucoma is essential in optimizing patient care and improving outcomes.

Background and Objective: Limbal stem cell deficiency (LSCD) describes the clinical condition when there is dysfunction of the corneal epithelial stem/progenitor cells and the inability to sustain the normal homeostasis of the corneal epithelium. The limbal stem cells are located in a specialized area of the eye called the palisades of Vogt (POV). There have been significant advances in the diagnosis and management of LSCD over the past decade and this review focuses on the pathophysiology of LSCD, its clinical manifestations, diagnosis, and causes.

Methods: Papers regarding LSCD were searched using PubMed to identify the current state of diagnosis and causes of LSCD published through to June 2022. 
Key Content and Findings: LSCD is clinically demonstrated by a whorl-epitheliopathy, loss of the POV, and conjunctivalization of the cornea. The diagnosis of this condition is based on clinical examination and aided by the use of impression cytology, in vivo confocal microscopy, and anterior segment optical coherence tomography (asOCT). There are many causes of LSCD, but those which are most common include chemical injuries, aniridia, contact lens wear, and Stevens-Johnson syndrome (SJS).

Conclusions: While this condition is most commonly encountered by corneal specialists, it is important that other ophthalmologists recognize the possibility of LSCD as it may arise in other co-morbid eye conditions.

Objective To evaluate the efficacy and safety of intravitreal injection of Conbercept combined with oral administration of Maizhiling tablets in patients with macular edema secondary to retinal vein occlusion. Methods The data of 40 patients with retinal vein occlusion and macular edema who received intravitreal injection of Conbercept combined with oral administration of Maizhiling tablets were retrospectively analyzed. All patients underwent comprehensive ophthalmologic examination, optical coherence tomography, and fundus fluorescein angiography or/and multifocal ERG. Repeat injections were performed for those with no improvement in visual acuity after injection, no significant improvement in macular leakage or repeated injections. The primary outcome came from observational follow-up of changes in best-corrected visual acuity (BCVA), central foveal thickness (CFT), and macular volume (TMV). Repeated intraocular injections were performed for those with no improvement in vision after injection or no significant improvement in macular leakage or repeated disease. All cases completed at least 12 months of observational follow-up. Results Among the 40 patients (40 eyes), there were 19 males and 21 females, with an average age of 52 years. The mean logarithmic BCVA, CFT and TMV of patients before treatment were 0.27±0.19, 304.85±128.12μm, 7.43±0.95 mm3, respectively. After a mean follow-up of 12 months, the improvement of BCVA (logMAR, 0.60±0.33; p=0.003), CFT (192.20±54.49; p=0.005) and TMV (6.72±0.69; p=0.004) was statistically different from that before treatment . No serious ocular and systemic adverse reactions occurred. The patients in this group received a total of 78 intravitreal injections, with an average injection frequency of 1.95 times/eye, and 68.3% of the patients could improve their visual acuity by two or more lines after 1 month after re-injection. Conclusion Intravitreal injection of Conbercept combined with oral administration of Maizhiling Tablets in the treatment of retinal vein occlusion and macular edema showed significant improvement in BCVA, CFT and TMV after an average follow-up of 12 months, with high safety.

Central retinal artery occlusion (CRAO) is an eye disease that seriously impairs vision. CRAO develops rapidly and its risk factors are complex.CRAO may be related to cardiovascular disease, or secondary to other systemic or local factors. This case report in a patient with older women, because of her left eye vision loss 1 weeks in hospital. Through an eye test preliminary diagnosis of diabetic retinopathy with cataract. Vitrectomy combined with phacoemulsification was performed after admission. During the operation, the patient was found to have fundus manifestations related to central retinal artery occlusion. The fundus fluorescein angiography showed central retinal artery occlusion on the third day after the operation, and the patient did not receive relevant treatment.

The prevalence of diabetic retinopathy (DR) continues to increase in pregnant females; these individuals are also at a higher risk of disease progression. The lack of evidence regarding the safety and efficacy of current treatment options in pregnancy makes disease management particularly challenging.All pregnant women with diabetes should have a prenatal DR screening, as well as receive counseling regarding the progression and management of DR during pregnancy. Optimal blood glucose and blood pressure control should be encouraged. For patients with proliferative diabetic retinopathy (PDR) in the absence of visually significant diabetic macular edema (DME), panretinal photocoagulation (PRP) remains a safe and effective treatment option. Visually significant DME can be treated with focal laser if areas of focal leakage are identified in the macula on fluorescein angiogram, intravitreal steroids or anti-vascular endothelial growth factor (VEGF) agents, The theoretical risk of anti-VEGF agents to the fetus should be considered and the patients should be extensively counselled regarding the risks and benefits of initiating anti-VEGF therapy before initiating treatment. When the decision is made to treat with anti-VEGF agents, Ranibizumab should be the agent of choice. In conclusion, ophthalmologists should make treatment decisions in pregnant patients with DR on a case-by-case basis taking into consideration disease severity, risk of permanent threat to vision, gestational age, and patient preferences.

Acute primary angle-closure glaucoma refers to the sharp increase of intraocular pressure caused by sudden angle closure. If not treated in time, it will lead to irreversible injury of optic nerve and even blindness. Laser peripheral iridoplasty can open the angle of the chamber and reduce the adhesion by burning and contracting the iris with laser, thus reducing the intraocular pressure. With the deeper exploration of diseases and operations, this article mainly reviews the curative effect, complications and factors affecting the postoperative effect of laser peripheral iridoplasty for acute primary angle-closure glaucoma in recent years.

Background and Objective: Nearly 30 years have passed since limbal stem cell deficiency (LSCD) was first identified by pioneers and given clinical attention. LSCD remains a difficult disease to treat. It can potentially lead to blinding. At present, understanding of limbal stem cells (LSCs) has deepened and various treatment options for LSCD have been devised. The objective of this review is to summarize basic knowledge of LSCD and current treatment strategies.

Methods: PubMed search was performed to find studies published in English on LSCs and LSCD including original reports and reviews. Literatures published from 1989 to 2022 were reviewed.
Key Content and Findings: LSCs are enigmatic stem cells for which no specific marker has been discovered yet. Although LSCD is not difficult to diagnose, it is still challenging to treat. An important advancement in the treatment of LSCD is the provision of guidelines for selecting systematic surgical treatment according to the patient’s condition. It is also encouraging that stem cell technologies are being actively investigated for their potential usefulness in the treatment of LSCD.

Conclusions: Although various treatment options for LSCD have been developed, it should be kept in mind that the best chance of treatment for LSCD is in the early stage of the disease. Every effort should be made to preserve as many LSCs as possible in the early treatment of LSCD.

Corneal disease is one of the most important causes of blindness worldwide. The current primary treatment for corneal blindness is corneal transplantation. However, corneal transplants often fail for patients with high-risk indications, and the primary source of corneal transplants is donation, which falls far short of the demand. In the past decades, 3D bioprinting technology, which enables the precise design of complex geometries to reconstitute tissues and organs, has shown great potential and promise in the field of regenerative medicine. This technology can precisely control the structure and curvature of the cornea, which can perfectly show the refractive properties of the cornea. This advantage of the controlled structure and refractive properties makes this technology irreplaceable in corneal regeneration and makes personalized corneal implantation and single or multi-layer corneal isotropic implantation possible, providing a new tool to solve the major problems of corneal personalization and donor shortage. This article presents a review of recent research advances in 3D bioprinted artificial corneas. Mainly dealing with 3D printed corneal replaceable biomaterials and 3D printing technology, we summarize the advantages of 3D printing as a future corneal regeneration and present its challenges and limitations to provide a reference for further corneal transplant donor selection.