Purpose: To report the case of a patient with multiple food allergies comorbid with multiple chemical sensitivity (MCS) who was misdiagnosed on various occasions, resulting in a negative impact on the patient’s personal and social life. Case Report: We present the case of a 43-year-old Colombian women with multiple food allergies concomitant with MCS. Symptoms started with a mild reaction to insecticides, car exhaust smoke, and perfumes and gradually evolved into a severe reaction to her environment. She also presented recurrent episodes of clinical reactivity to foods and persistent elevated IgE levels, as well as several life-threatening anaphylactic reactions. Alternative and allopathic therapies were applied, but her symptoms persisted. Various diagnoses were made before the definitive diagnosis. Conclusion: MCS is an unusual entity of unknown pathophysiology that can, on rare occasions, coexist with food allergies. Early recognition and multidisciplinary treatment are required as these entities have a major impact on the patient’s quality of life. We present the first Latin American case regarding the association of the two diseases.

Background and Objectives: Mobile Eye Units (MEUs) have emerged as practical innovations to overcome geographic, financial, and systemic obstacles to eye care. Although numerous programs operate across the United States and Canada, a narrative review describing their structure, implementation and services, remain limited. This narrative review examines various MEUs models in the United States and Canada, using real-world examples to highlight each model’s structure, services, populations served, and key benefits and limitations. Methods: We performed a narrative review of peer-reviewed and gray literature published from 1990 to August 2025, identifying mobile eye units in the United States and Canada. Programs were grouped into four operational models based on services, equipment, and implementation characteristics. Ophthalmology residency program websites in the United States were also reviewed to assess academic involvement in mobile outreach. Results: We identified four operational MEU models: Fully Equipped Mobile Units (FEMUs), Semi-Mobile Outreach Units (SMOUs), School-Based Vision Mobile Units (SBVMUs), and Hybrid Teleophthalmology Units (HTOUs). FEMUs provide comprehensive on-site diagnostic capabilities but require substantial financial and logistical resources. SMOUs are lower-cost and flexible but offer more limited diagnostics. SBVMUs facilitate early detection in children and reduce school-based access barriers but depend on school coordination. HTOUs expand specialist interpretation through remote imaging, although their success relies on reliable digital infrastructure. Across all models, follow-up and continuity of care remain major implementation challenges. Approximately 21% of U.S. ophthalmology residency programs publicly report involvement in mobile outreach. Conclusions: MEUs play a critical role in reducing geographic and structural barriers to eye care for underserved populations across United States and Canada. However, limited outcome reporting, particularly regarding follow-up rates and continuity of care, hinders broader assessment of their effectiveness. Strengthening the integration of MEUs with patient navigators, integrated electronic health record, insurance support and support of local health networks is essential for improving long-term sustainability and impact.

Purpose: To describe structural and systemic barriers to ophthalmic care experienced by underserved patients, particularly those facing language obstacles, immigration-related constraints, limited insurance coverage, financial hardship, and navigation challenges in an urban setting, and to examine these barriers through a complexity-informed lens. Methods: We conducted a narrative literature review focused on healthcare disparities, patient navigation, complexity in care delivery, and time-sensitive prioritization frameworks in ophthalmology. Findings were integrated with case vignettes drawn from Eyes on Wheels (EOW), a mobile eye care initiative that provides no-cost examinations at Federally Qualified Health Centers (FQHCs) and free clinics. Cases were identified through routine clinical documentation and used to illustrate how structural barriers described in the literature manifest in real-world care pathways. Results: Three recurring system-level issues were identified across EOW encounters: (A) misclassification of medically necessary, time-sensitive ophthalmic care as “non-urgent”; (B) patient disengagement driven by cumulative structural and logistical barriers; and (C) failures that arise when the healthcare system, functioning as a complex adaptive system (CAS), is unable to adapt to patients’ and systems’ changing circumstances. A review of the literature confirmed that these patterns reflect widely documented challenges faced by underserved urban populations. Three EOW case vignettes, selected from seven patients identified in 2024, are presented as illustrative examples of these systemic patterns. Conclusions: Addressing inequities in eye care requires an approach that recognizes how many parts of the healthcare system interact and affect a patient’s ability to receive timely treatment. Vision loss is often the preventable result of systems that are rigid, fragmented, or unable to adapt to a patient’s circumstances. Improving outcomes will require flexible care models, such as mobile clinics, paired with strong institutional support, patient-centered navigation, and consistent assessment of social needs and barriers to care. Sustained progress will depend on collaboration across organizations, adaptable leadership, and policies that respond to the real-world situations in which patients live.

Purpose: This study aims to evaluate the ocular surface characteristics in children diagnosed with uveitis and explore the association between uveitis and dry eye disease (DED). Methods: We included 84 children, 42 with uveitis and 42 healthy children. We performed the OSDI questionnaire and several ocular surface tests, including osmolarity, NITBUT, Schirmer test, and vital staining. We used Fisher's exact test and Mann-Whitney to compare variables and a binomial logistic regression to determine the factors associated with DED. Results: The difference in the prevalence of DED between uveitis (54.8%) and healthy (31%) groups was statistically significant (p < 0.05). Most patients with uveitis had mixed DED, and none of the healthy subjects had a severe form of the disease. There were no statistically significant differences in most of the tear film tests. However, all parameters tended to worsen in the uveitis group, and lipid layer thickness was thinner (p < 0.036). The uveitis group exhibited significantly more symptoms (p < 0.05). In the multivariate logistic regression, uveitis was associated with an odds ratio (OR) of 3.0 (95% CI: 1.07-8.42, p < 0.05) for DED. Conclusions: Our findings demonstrate a significantly higher prevalence of DED in children with uveitis compared to their healthy counterparts. Furthermore, our analysis indicates that the risk of DED in pediatric patients with uveitis is threefold higher than in healthy children. Therefore, it is crucial for clinicians to vigilantly monitor the development of DED in pediatric patients with uveitis and consider the implementation of preventive treatments.