Diabetes mellites (DM) is one of the most common systemic disorders in Saudi Arabia and worldwide. Diabetic retinopathy (DR) is a potentially blinding ophthalmic consequence of uncontrolled DM. The early detection of DR leads to an earlier intervention, which might be sight-saving. Our aim in this cross-sectional study is to assess patients’ knowledge and practices regarding DR, and to detect the barriers for eye screening and receiving a check-up from an ophthalmologist. The study included 386 diabetic patients. One hundred and thirty-one patients (33.9%) had T1DM and 188 (48.7%) had T2DM. Most of the diabetic patients (73.3%) know that they must have an eye check-up regardless of their blood sugar level. DM was agreed to affect the retina in 80.3% of the patients, 56% of patients agree that DM complications are always symptomatic, and 84.5% know that DM could affect their eyes. The fact that blindness is a complication of diabetic retinopathy was known by 65% of the diabetic patients. A better knowledge was detected among patients older than 50 years of age (54.9%) compared to those aged less than 35 years (40.9%), which was statistically significant (p = 0.030). Additionally, 61.2% of diabetic patients who were university graduates had a significantly better knowledge in comparison to 33.3% of illiterate patients (p = 0.006). Considering the barriers to not getting one’s eyes screened earlier, a lack of knowledge was reported by 38.3% of the patients, followed by lack of access to eye care (24.4%). In conclusion, there is a remarkable increase in the awareness of DR among the Saudi population. This awareness might lead to an earlier detection and management of DR.

Amblyopia is a reduced best-corrected visual acuity of one or both eyes that cannot be attributed to a structural abnormality; it is a functional reduction in the vision of an eye caused by disuse during a critical period of visual development. It is considered the leading cause of visual defects in children. With early diagnosis and treatment, children with amblyopia can significantly improve their vision. However, if it is neglected and not treated during childhood, unfortunately, it permanently decreases vision. Therefore, prevention, detection, and treatment largely depend on parents. This article explores parents’ perspectives on amblyopia and routine examination of their children’s eyes. A cross-sectional study used an electronic questionnaire consisting of five main sections to assess the level of awareness of amblyopia among parents. As a result, a total of 325 participants were included in our analysis. 209 (64.3%) were mothers, and 116 (35/7%) were fathers. The age groups were 35–50 years of age (61.5%), 20–34 years (23.4%), and older than 50 years (15%). Participants with a history of amblyopia numbered 23 (7.1%), and 39 had an amblyopic child (12%). A good awareness level of amblyopia among parents was found in only 10 (3%) participants, a fair awareness level in 202 (62%), and 113 (35%) participants were classified as having a poor awareness level of amblyopia. Only 13.8% of the parents took their children for yearly routine eye exams, while the majority (72%) took their children only if they had a complaint, and 14.2% took them for eye checkups only before school entry. In conclusion, parents’ awareness of amblyopia in Tabuk City, KSA, was low. In addition, a limited proportion of parents reported consistently taking their children for routine eye exams. Therefore, raising awareness should be considered in public education regarding the disease.

Background/Objectives: Brolucizumab is a humanized single-chain antibody fragment with a molecular weight of approximately 26 kilodaltons (scFv, ~26 kDa) targeting all VEGF-A isoforms. Intravitreal brolucizumab (6 mg) is FDA-approved for neovascular age-related macular degeneration (nAMD) (2019) and diabetic macular edema (DME) (2022). We systematically review the literature on brolucizumab for nAMD and DME, focusing on efficacy, safety, pharmacokinetics, real-world outcomes, and cost-effectiveness in adult and pediatric patients. Methods: Our method involves a comprehensive literature search of PubMed, Embase, Scopus, Cochrane, and related databases (through late 2024) using terms including “brolucizumab,” “Beovu,” “neovascular AMD,” “diabetic macular edema,” “safety,” “pharmacokinetics,” and “pediatric.” High-quality clinical trials, meta-analyses, regulatory documents, and real-world studies were prioritized. Results: In pivotal Phase III trials (HAWK/HARRIER for nAMD), brolucizumab 6 mg demonstrated non-inferior visual acuity (VA) gains to aflibercept, with >50% of eyes maintained on 12-week dosing and greater retinal fluid reduction. In DME trials (KESTREL/KITE), brolucizumab was similarly non-inferior to aflibercept for VA and showed superior anatomic drying, with 33–48% of eyes maintained on ≥12-week intervals. However, brolucizumab use has been associated with intraocular inflammation (IOI), retinal vasculitis, and vascular occlusion: clinical trials and post hoc analyses reported higher rates of these events than comparator agents. Real-world cohorts found IOI in ~4–10% of treated eyes, often occurring early (within 3 months) after initiation. Conclusions: In conclusion, Brolucizumab is an effective anti-VEGF option for nAMD and DME, providing durable anatomic control with fewer injections. Non-inferior vision outcomes and superior fluid resolution have been demonstrated. However, it carries a distinct risk of IOI and occlusive vasculitis, necessitating careful patient selection, dosing, and monitoring.

Gene therapy has emerged as a promising treatment for several eye diseases since it may restore vision and stop blindness. Many eye diseases, including retinitis pigmentosa and macular degeneration, have historically been rather difficult to treat and usually cause permanent vision loss. However, thanks to advances in gene therapy, many disorders can now be effectively targeted and genetically changed, providing a safer, more direct, maybe even curative approach. By introducing, altering, or repairing specific genes inside the eye, gene therapy seeks to fix the defective genes causing these disorders, thereby improving general eye health and visual ability. Voretigene neparvovec is one FDA- and EMA-approved treatment for RPE65 mutations. Retinitis pigmentosa, age-related macular degeneration, X-linked retinoschisis, choroideremia, and Stargardt disease are among the several eye disorders still under clinical trials, and experimental treatment is in progress. As research on gene therapy develops, it opens the path for groundbreaking treatments that could fundamentally change the ophthalmic care scene.

Introduction: The hydrogel Scleral Buckle is a soft and pliable subtype of buckles which has been used to repair retinal breaks and detachments externally. This case represents an unusual late orbital complication of the implant. Case report: A 70 years old male patient presented with drooping right upper lid and eye misalignment, associated with foreign body sensation and discomfort. The patient underwent scleral buckle surgery for a rhegmatogenous retinal detachment 32 years before his presentation using a hydrogel MIRAgel® explant. Orbital imaging showed a large cystic lesion in the superolateral quadrant of the orbit indicating a fluid-filled explant. Discussion: In patients who were treated with hydrogel MIRAgel® explant for retinal breaks or detachments, detailed ophthalmic history, particular past eye surgery history, and examination, orbital imaging, and good clinical documentation. Serious orbital and neurological conditions need to be ruled out carefully. Conclusion: Late orbital complications of hydrogel MIRAgel® explant might develop late after surgery and might represent a diagnostic challenge for ophthalmologists. Highlights:

Autosomal recessive types of both syndromic and non-syndromic inherited myopia are common in Saudi Arabia (SA) because many people marry their relatives. The prevalence of syndromic myopathies in SA, like Stickler syndrome (SS), Knobloch syndrome (KS), and Marfan syndrome (MFS), further complicates the disease spectrum. The causative genes linked to the Knobloch, Marfan, and Pierson syndromes are COL18A1, FBN1, and LAMB2, respectively. Additionally, we found recessive types of non-syndromic high myopia that have a high chance of causing retinal detachment, like those linked to LRPAP1 and LEPREL1. In these cases, regular evaluation and early intervention, including prophylactic laser photocoagulation and pars plana vitrectomy, may improve the outcome. Advancements in genetic testing for diagnosis and prevention accelerate detection, facilitate early interventions, and provide genetic counseling. The utilization of artificial intelligence (AI), machine learning (ML), and the advancement of gene therapy offer promising avenues for personalized care. We place a high value on using genetic knowledge to create a national screening program and patient registry aimed at understanding the national burden of myopia, knowing that we have a high rate of consanguinity, which reflects pathogenic homozygous alleles and founder mutations. This initiative will incorporate genetic counseling and leverage innovative technologies, which are crucial for disease management, early identification, and prevention in Saudi Arabia’s healthcare system.