Air composition influences Dry Eye (DE) symptoms as demonstrated by studies that have linked the outdoor environment to DE. However, there is insufficient data on the effect of short-term exposure to indoor environments on DE symptoms. We conducted a prospective experimental research, in which an older building served as an experimental site, and a newer building served as the control site. Indoor air quality was monitored in both buildings. One-hundred-and-ninety-four randomly selected individuals were interviewed in the afternoon exiting the buildings and de-identified responses were recorded. Self-reported DE symptoms were modeled with respect to experimental and control buildings, adjusting for potential confounders. The experimental site had 2-fold higher concentration of airborne particulate matter (24,436 vs. 12,213 ≥ 0.5 µm/ft³) and microbial colonies (1066 vs. 400/m³), as compared to the control building. DE symptoms were reported by 37.5% of individuals exiting the experimental and 28.4% exiting the control building. In the univariate analysis, subjects exiting the experimental building were 2.21× more likely to report worsening of DE symptoms since morning compared to the control building (p < 0.05). When adjusting for confounders, including a history of eye allergy, subjects from the experimental building were 13.3× more likely to report worsening of their DE symptoms (p < 0.05). Our findings suggest that short-term exposure to adverse indoor environmental conditions, specifically air pollution and bioaerosols, has an acutely negative impact on DE symptoms.

Case: After an unremarkable arthroscopic evaluation for foot and ankle pain after a minor injury, an 18-year-old athlete had persistent pain and developed a flatfoot deformity. Magnetic resonance imaging revealed an osteochondral lesion of the calcaneocuboid joint and spring ligament failure. Arthroscopy confirmed the lesion and retrograde drilling provided safe access. Simultaneously, a comprehensive flatfoot reconstruction was performed, including gastrocnemius recession, spring ligament repair, and minimally invasive calcaneal osteotomy. Conclusion: A hybrid surgical approach—combining arthroscopic, open, and minimally invasive techniques—allowed for simultaneous correction of intra-articular pathology and extra-articular deformity in a single staged procedure, with resolved pathology at the 5-year follow-up.

Introduction: The current, mainstay surgical prophylaxis for neuropathic and phantom limb pain post amputation, namely targeted muscle reinnervation (TMR), presents complexities in the setting of digit amputation, given the sparsity of distal motor nerve targets. In this case series, we describe a novel approach of direct skin neurotization on distal sensory targets post amputation. This technique draws upon the principles of targeted sensory reinnervation (TSR) and targeted nipple reinnervation (TNR) as alternatives to limit the onset of neuropathic and phantom limb pain postoperatively. Methods: We performed a retrospective analysis of clinical outcomes over a 5-year period (2020–2024). This series includes two patients: a 66-year-old male treated for lentiginous melanoma of the left thumb in 2020 and a 57-year-old male treated for squamous cell carcinoma (SCC) of the left index finger in 2022, with a subsequent recurrent SCC in the left small digit in 2024. Clinical data were reviewed to evaluate surgical results and pain outcomes, specifically the onset and resolution of neuropathic pain. Results: The first patient underwent amputation of the left thumb at the interphalangeal joint with direct skin neurotization. Postoperatively, he demonstrated improved digit sensation and reported minimal neuropathic pain. The second patient initially underwent amputation of the left index finger at the DIP joint with direct skin neurotization in 2022; later, in 2024, he required amputation of the left small digit for recurrent SCC, which was performed with standard traction neurectomy. Notably, this patient reported minimal neuropathic pain 3 months following the initial neurotization procedure. Conversely, following the subsequent traction neurectomy, he experienced significant neuropathic pain and minimal sensory improvement. Conclusion: The use of direct skin neurotization, an adaptation of the principles of TSR and TNR, may improve skin sensation and prevent or reduce neuropathic pain in distal digital amputations where motor targets for TMR are unavailable.