This case report highlights a possible association between netarsudil use and crystalline keratopathy. Presented here is the case of a 72-year-old woman with primary open-angle glaucoma (POAG) who developed corneal crystalline keratopathy after taking netarsudil for 24 months. The patient's medical history was significant for dry eye syndrome, bilateral ptosis with surgical repair, and atopy (including asthma and various ocular and systemic allergies). The patient had previously undergone surgical repair for bilateral ptosis as well. During the interval between two routine visits, this patient experienced worsening vision with associated eye irritation. Further examination revealed crystal deposits on the anterior corneal surface in the left eye, the only eye undergoing netarsudil treatment. Long-term netarsudil use may be associated with crystalline keratopathy in the anterior stroma, with the potential to cause sight-threatening vision loss if located in the visual axis.

Aicardi syndrome is a neurodevelopmental disorder characterized by a triad of partial or complete agenesis of the corpus callosum, infantile spasms, and pathognomonic chorioretinal lacunae.Examinat...

Bardet-Biedl Syndrome (BBS) is a rare autosomal recessive ciliopathy. Within corneal development, primary cilia serve a critical role. We sought to investigate the association of BBS with corneal astigmatism among a cohort of patients with BBS. This was a cross-sectional, retrospective study performed at a pediatric ophthalmology department of a tertiary hospital. The study enrolled 45 patients with genetically confirmed Bardet-Biedl syndrome, encompassing a total of 90 eyes observed from February 2011 to August 2021. Spherical and cylindrical refractive errors and keratometry outcome measures, including diopter (D) values at the flattest and steepest axes, were recorded. Corneal astigmatism of greater than 3D is considered extreme corneal astigmatism based on previously published data. Among 45 patients (M:26; F:19), the mean age was 16.4 ± 8.2 years, and the mean best-corrected visual acuity was 20/60. The most common molecular diagnosis was BBS1, seen in 24 of 45 (53.3%). Among all the patients, the mean spherical refractive error was -2.9 ± 3.8D. The mean cylindrical refractive error was 2.6 ± 1.5D. The mean keratometry values at the flattest axis was 43.5 ± 5.3D (39.4-75.0) and at the steepest axis was 47.2 ± 7.3D(41.5-84.0). Among all the patients with BBS, the mean corneal astigmatism was 3.7 ± 1.0D(0.5-7.1), which is considered extreme. A cohort of individuals with BBS demonstrated high corneal astigmatism. These results suggest an association between corneal astigmatism and primary ciliary dysfunction and may assist in clinical management and future therapeutic targets among BBS and other corneal disorders.

Epidermolysis bullosa (EB) is a rare inherited genetic disorder associated with severe ocular surface complications and progressive corneal scarring. This case series aimed to structurally characterize and quantitatively analyze central corneal subbasal nerve plexus loss using in vivo confocal microscopy (IVCM) in pediatric patients with recessive dystrophic epidermolysis bullosa (RDEB). This retrospective case series included five pediatric patients with RDEB presenting with ocular and systemic manifestations. In vivo confocal microscopy (IVCM) imaging showed severe central subbasal corneal nerve plexus loss in 85% of eyes, with a median total nerve density of 0 μm/mm² (IQR: 0–5150.67), main nerve trunk density of 0 μm/mm² (IQR: 0–2720.56), and branch nerve density of 0 μm/mm² (IQR: 0–2769.22). Dendritiform reflective structures were qualitatively observed in multiple scans of eyes demonstrating marked central subbasal nerve loss.No immunophenotyping was performed. Corneal sensation testing was not performed due to severe ocular surface fragility and photophobia; therefore, no clinical diagnosis or staging of NK was inferred or concluded from this cohort. This series identifies profound structural corneal denervation of the central subbasal plexus on IVCM in pediatric RDEB-associated ocular surface disease. The findings support future prospective studies investigating corneal nerve-regeneration and epithelial-stabilization frameworks to preserve long-term visual outcomes in children with RDEB.

Introduction: Phakic intraocular lenses (pIOLs) are well recognized for effectively correcting high refractive errors; however, rare complications such as iris cysts may significantly compromise outcomes. To the authors' knowledge, this case is unique because it is the first documented instance of a recurrent iridociliary cyst associated with an iris-claw pIOL, adding important insights into the potential for such complications and emphasizing the need for meticulous postoperative monitoring. Patient and Clinical Findings: A 54-year-old woman with a longstanding iris-claw pIOL presented with fluctuating visual acuity. Clinical evaluation revealed a recurrent iridociliary cyst that had progressively displaced the implant, resulting in intermittent vision loss and mechanical distortion of the pIOL. Diagnosis, Intervention, and Outcomes: The primary diagnosis was a recurrent iridociliary cyst causing displacement of the iris-claw pIOL. Initial management with cyst drainage and ablation provided only temporary relief, as the lesion recurred. Definitive surgical intervention, including complete cyst excision, repositioning of the pIOL, and subsequent cataract extraction, was required. These interventions stabilized the patient's visual acuity, with no recurrence of the cyst at final follow-up. Conclusions: This case underscores the critical importance of early detection, vigilant postoperative assessment, and timely surgical intervention in managing iris cysts associated with iris-claw pIOLs to preserve long-term visual function.