Background: Refractive errors, including myopia, hyperopia, and astigmatism, are a leading cause of visual impairment among children worldwide. In Saudi Arabia, the prevalence of these conditions among school-age children and adolescents remains poorly understood, with significant variations reported across studies. This systematic review and meta-analysis aimed to provide a comprehensive estimate of the pooled prevalence of refractive errors in this population and explored factors influencing their distribution. Methods: A systematic search of PubMed, Scopus, Web of Science, and ScienceDirect was conducted in accordance with PRISMA 2020 guidelines. Observational studies reporting the prevalence of refractive errors among Saudi school-aged children and adolescents were included. Data extraction and quality assessment were conducted using the Newcastle-Ottawa Scale. Pooled prevalence estimates with 95% confidence intervals (CIs) were calculated using a random-effects model, and heterogeneity was assessed with the I² statistic. Results: Nine studies including over 15,000 participants were analyzed. The pooled prevalence of myopia was 6.7% (95% CI: 3.0% to 14.2%), hyperopia was 3.6% (95% CI: 1.3% to 9.8%), and astigmatism was 7.7% (95% CI: 2.5% to 20.9%). Subgroup analysis revealed regional disparities, with the highest myopia prevalence reported in Taif (33.3%) and Bisha (22.5%), and the lowest in Medina (1.6%). Studies conducted after 2018 showed a significantly higher pooled myopia prevalence (16.4%, 95% CI: 8% to 30.5%) compared to those published before 2018 (3.3%, 95% CI: 1.4% to 7.5%) (p < 0.001). While studies using cycloplegic refraction reported a slightly higher myopia prevalence (7.2%, 95% CI: 4.7% to 11%) than those using non-cycloplegic methods (6.7%, 95% CI: 2.4% to 17.5%), the difference was not statistically significant (p = 0.9). No significant difference was observed between studies with smaller or larger sample sizes, although high heterogeneity persisted across all subgroups. Conclusion: Refractive errors, particularly astigmatism, represent a significant and growing public health issue among Saudi school-aged children and adolescents. The findings underscore the urgent need for standardized diagnostic protocols, including the use of cycloplegic refraction, and the implementation of school-based vision screening programs.

The intragastric balloon (IGB) is a relatively recent non-surgical weight loss technique that is now widely used in the world to treat obesity. However, IGB causes a wide range of adverse effects that range from minor ones, such as nausea, stomach pain and gastroesophageal reflux, to serious ones, such as ulceration, perforation, intestinal blockage and compression of adjusting structures. A 22-year-old Saudi woman presented to the emergency department (ED) with a history of upper abdominal pain that started 1 day before admission. The patient’s surgical background was unremarkable, and no other obvious pancreatitis risk factors were present. The patient underwent a minimally invasive treatment after being diagnosed with obesity (class 1), in which an IGB was inserted one and a half months prior to her ED presentation. She consequently began to lose weight (around 3 kg). The hypothesis states that pancreatitis following IGB insertion can be caused either by stomach distention and pancreatic compression at the tail or body or by ampulla obstruction due to balloon catheter migration at the duodenum. Heavy meal consumption, which may cause an increase in pancreatic compression, is another potential cause of pancreatitis in such patients. We believe that the IGB-induced compression of the pancreas at its tail or body was the likely cause of pancreatitis in our case. This case was reported because it is the first one from our city as far as we know. A few cases from Saudi Arabia have also been reported, and reporting them will help to improve doctors’ awareness of this complication, which can cause pancreatitis symptoms to be mistaken for something else because of the balloon-related effects on gastric distention.

Endophthalmitis is a severe intraocular infection that can cause substantial visual impairment or blindness. Although it is an uncommon post-cataract surgery complication. In this case series, we present a group of patients who underwent surgery on the same day by the same surgeon. Our goal is to investigate the causes of this outbreak, explore the management strategies employed, and derive lessons learned to prevent future occurrences. This case series presents five immunocompetent patients who underwent uncomplicated cataract surgery at a single center and developed acute postoperative endophthalmitis. All patients presented with severe eye pain and decreased vision on the 2nd day post-surgery; one patient presented 15 days later. Following their surgeries, they were prescribed prednisone acetate and moxifloxacin, both to be taken every 2 h. Their visual acuity at presentation was light perception. Immediate vitreous tap and administration of intravitreal antibiotics. Despite these urgent interventions, the outcomes varied among the patients. In the short term, no significant improvement in visual acuity was noted; all patients continued to experience severely limited vision. The long-term consequences were grave: three of the five patients eventually underwent evisceration due to the severity of the infection and persistent inflammation. This underscores the aggressive nature of the infection and the challenges in managing such severe cases of endophthalmitis. This case series underscores the critical need for rigorous infection control protocols. By meticulously addressing these challenges, healthcare providers can enhance patient outcomes and significantly reduce the risk of future outbreaks in ophthalmic surgical settings.

Background: Low vision (LV) is a significant public health challenge with profound effects on patients and their families. In Saudi Arabia, studies indicate a high prevalence of LV, yet low vision services (LVS) remain limited, with gaps in optometrist knowledge, training, and service accessibility. This study evaluates the current state of LV services, documents optometrist involvement, and identifies barriers to delivering LVS. Methods: A nationwide, cross-sectional study surveyed 275 optometrists using a validated, self-administered electronic questionnaire. Awareness, clinical practices, referral patterns, and perceived barriers were assessed. Multivariate logistic regression analyzed awareness levels and barriers, with statistical significance set at p< 0.05. Results: Moderate awareness of the WHO definition of LV was observed (70.1%), significantly higher among those with formal training (90.1%, p< 0.001). Only 36.4% provided LV services, primarily in the central region. Low vision cases constituted 1% of patient loads for most participants (44.4%). Key barriers included device unavailability (68.4%), insufficient training (65.8%), and high costs (50.9%). Diabetic retinopathy (70.9%), glaucoma (63.3%), and hereditary conditions (46.5%) were leading causes of LV. Conclusion: Critical gaps in LV care include insufficient awareness, uneven service distribution, and financial/training-related barriers. Enhancing education, improving affordability, and fostering multidisciplinary care are essential. Region-specific interventions are urgently needed to ensure equitable access to LVS across Saudi Arabia.

Venous air embolism (VAE) is a rare but potentially lethal condition. It has numerous clinical and physiological causes. We present a case report of a 72-year-old Saudi male, known case of diabetes mellitus (DM), hypertension, and ischemic heart disease. The patient came to the emergency room (ER) complaining of the heaviness of the tongue that resolved spontaneously within a few hours. He underwent percutaneous coronary angiography three months ago. The patient with the previously mentioned neurological symptoms, who had been misdiagnosed as having transient cerebral ischemia, was, after a computerized tomography (CT) scan result, diagnosed with venous air embolism. Venous air embolism can occur in situations other than those in which patients are traditionally thought to be at risk, making diagnosis difficult. Any sudden change in mental status and hemodynamic alterations during minimally invasive procedures should raise the physician's suspicion of VAE. Because VAE is an uncommon complication, few cases have been recorded in Saudi Arabia.

The demand for vitreoretinal surgery (VRS) specialists is increasing globally due to the rising prevalence of retinal diseases such as diabetic retinopathy and age-related macular degeneration. In Saudi Arabia, the burden of retinal diseases is particularly high, with diabetic retinopathy affecting about one-third of diabetic patients. Despite this, factors influencing ophthalmology trainees’ decisions to pursue VRS fellowship remain underexplored. This study aimed to identify the key factors shaping career decisions among ophthalmology trainees in Saudi Arabia. A cross-sectional study was conducted between July and December 2024, targeting senior ophthalmology residents and vitreoretinal surgery fellows across Saudi Arabia. A purposive sampling method was used, and data were collected via an online survey adapted from a validated tool and assessed for content validity. The survey explored exposure to VRS, research opportunities, mentorship, and career motivations using a 5-point Likert scale. Descriptive statistics and nonparametric Mann-Whitney U tests were applied. A total of 61 trainees participated, of whom 35 (57.4%) reported pursuing a VRS fellowship. Male trainees were significantly more likely to pursue VRS than females (88.6% vs. 46.2%, p < 0.001). Most VRS pursuers reported deciding during residency years R2–R3, and 40% had performed over 100 cataract procedures. Major motivators included strong interest in complex surgeries (74.3%), advanced technology (51.4%), and the perceived prestige of VRS (54.3%). Exposure to VRS, research opportunities, and program match success were significantly associated with career choice, while mentorship and work–life balance played a lesser role. The decision to pursue vitreoretinal surgery among ophthalmology trainees in Saudi Arabia is primarily influenced by early exposure, surgical complexity, and perceived prestige. Gender disparities remain evident, with male trainees more likely to enter VRS, partly due to limited female mentorship. Enhancing mentorship opportunities and fostering early exposure may help address these disparities and sustain interest in the subspecialty.