In light of the close contact between patient and clinician during ophthalmic examinations and the multiple opportunities for pathogen transmission, we identified and evaluated potential pathogen transmission routes through high-touch surfaces in an outpatient ophthalmology clinic. A circuit simulation was performed to replicate a patient’s journey through an ophthalmology clinic with various stations. Fluorescent oil and powder were applied to the hands of Simulated Patient A who went through the circuit. Routine disinfection of surfaces in the slit lamp environment and hand hygiene by the ophthalmologist were conducted prior to Simulated Patient B going through the same circuit with untagged hands. Ultraviolet black light was used to identify fluorescent marker contamination after Simulated Patient B completed the circuit. Fluorescent marker contamination was found on the hands of all the simulated patients and staff, various items of the simulated patients, multiple equipment surfaces—particularly the ophthalmologist’s working table and slit lamp environment—and miscellaneous objects like appointment cards and files. Fluorescent marker contamination on Simulated Patient B’s untagged hands despite proper hand hygiene being performed prior suggests suboptimal surface disinfection following Simulated Patient A’s circuit. Through this pilot study, we recognised the key role that ophthalmic high-touch surfaces play in fomite transmission and that thorough disinfection of high-touch surfaces is essential on top of proper hand hygiene. With the contact sequences delineated in this pilot study, specific cues for hand hygiene and surface disinfection may be implemented at suitable intervals during contact with high-touch surfaces. Environmental decontamination adjuncts could also be considered to reinforce surface disinfection.

With the growing aging population, cataract surgeries are becoming increasingly common, placing significant pressure on hospital eye services to manage postoperative care. Co-management between ophthalmologists and optometrists offers a potential solution to enhance efficiency and care quality. This study evaluates the feasibility and safety of co-management models between ophthalmologists and optometrists for post-cataract surgery patients in different countries. A comprehensive search was conducted across PubMed, Scopus, Web of Science, and bibliographies, up to November 26, 2024. Search terms included "shared care scheme" and "post-operative cataract surgery". Papers involving optometrists in post-cataract surgery monitoring and reporting related management outcomes were included. The ten selected studies, conducted in the United States of America (USA), England, Scotland, Ireland, and the Netherlands, showed that post-cataract co-management is feasible and safe. The results demonstrated uncompromised patient safety, positive patient satisfaction outcomes, and optometrist competency. Successful implementation was dependent on clear referrals and workflow guidelines, rigorous optometrists training, strong ophthalmologists and optometrists collaboration, and regular patients feedback. However, study heterogeneity and limited geographic scope hindered comparability and generalisability of the findings to other countries with different healthcare systems and optometric training levels. Co-management of post-cataract surgery patients between ophthalmologists and optometrists has demonstrated feasibility and patient safety in some countries. However, tailoring the guidelines and adapting models to each country's specific demands and capabilities is essential for a successful implementation. Further research is needed to explore the feasibility and effectiveness of such models in different countries and healthcare systems.

There is growing interest in the application of Rho-associated protein kinase (ROCK) inhibitors (ROCKI) to the treatment of corneal diseases. ROCK is a key regulator of several cellular processes in the cornea, including cytoskeletal organization, cell proliferation, migration, inflammation, and wound healing. ROCKI, such as ripasudil and netarsudil, enhances endothelial cell migration, and promotes repair in conditions characterized by endothelial dysfunction. These agents also exert anti-inflammatory, anti-angiogenic, and anti-fibrotic effects for wound healing. As such, ROCKI demonstrate promise as therapeutic options for conditions such as Fuchs’ endothelial corneal dystrophy, pseudophakic bullous keratopathy, and iridocorneal endothelial syndrome. Emerging data further supports ROCKI’s potential in managing corneal neovascularization and supporting recovery following cataract surgery and keratoplasty, reducing the need for donor tissue. This narrative review provides a comprehensive evaluation of ROCKI’s mechanism of action, pharmacological properties, safety profile, applications in corneal disease management, emerging clinical trials, and novel approaches. We emphasize both preclinical and clinical findings, highlight existing evidence gaps, and outline future research priorities.