The number of people affected by myopia worldwide is estimated to reach two billion and to further grow. Therefore, numerous treatment approaches (pharmacological, behavioral, environmental, and optical) have been put forth to slow the progression of myopia, especially in children. Among these, spectacle lenses represent a straightforward and less intrusive therapeutic approach for children and their parents. For this reason, in recent years, several spectacle lenses with different technologies have been developed to slow myopia progression and enhance the quality of life for myopic children, thus trying to reduce the related health care burden. According to the published scientific literature, three different types of spectacle lenses are currently the most validated optical options for myopia management: (i) Defocus Incorporated Multiple Segments lenses (DIMS), (ii) Highly Aspherical Lenslet Target lenses (HALT) and (iii) Cylindrical Annular Refractive Elements (CARE) lenses. The aim of this narrative review is to exclusively discuss the scientific evidence of these three different spectacles lenses, and to point out the potential benefits and drawbacks in their use for myopia control and management.

To compare the efficacy and safety of topical insulin and amniotic membrane extract eye drops (AMEED) in promoting healing of corneal persistent epithelial defects (PEDs) refractory to conventional therapy. This retrospective comparative study included 27 eyes of 24 patients (mean age 61.0 ± 16.6 years) with PEDs treated with either topical insulin (1 IU/mL) or AMEED four times daily. Clinical outcomes included complete epithelial closure, rate of epithelialization, change in best-corrected visual acuity (BCVA), and occurrence of adverse events. Of 27 eyes, 18 received topical insulin and 9 received AMEED. The mean interval from diagnosis to treatment initiation was 93.4 ± 111.7 days in the AMEED group and 72.5 ± 56.1 days in the insulin group. Complete healing occurred in all eyes (100%) in the insulin group versus 44.4% in the AMEED group. The daily reduction in epithelial defect area during the first two weeks was significantly greater with insulin (P = 0.04). At final follow-up, BCVA improved significantly only in the insulin group (P = 0.006). No adverse reactions were observed in either group; one AMEED-treated eye required amniotic membrane transplantation. Topical insulin and AMEED are both safe and effective for refractory PEDs, but insulin showed superior epithelial healing and visual recovery. Given its availability, low cost, and favorable safety profile, topical insulin may represent a practical alternative in the management of persistent epithelial defects.

Photoallodynia is a rare but disabling condition in which mild non-painful light triggers pain. Novel reliable diagnostic tools and effective treatments are desirable. A 68-year-old female patient with dry eye owing to Sjogren syndrome reported severe photoallodynia not controlled by a wide armamentarium of topical treatments (eyelid hygiene, lubricants, corticosteroids, cyclosporine, and autologous serum). Patient symptoms were evaluated using visual analogue scale (VAS). Light discomfort thresholds under different lighting conditions (continuous warm, continuous cold and flashing warm) were measured using the Lumiz 100 device (Essilor International, Paris, France). All the evaluations were performed at presentation (T0), after proparacaine test (T1), and after 1 month of therapy with naltrexone 0.01 % eye drops instilled 4 times/day (T2). At T0, VAS score was 10; light discomfort thresholds were 1.83 log10[lux] for continuous warm, 1.79 log10[lux] for continuous cold, and 1.87 log10[lux] for flashing warm. At T1, a partial improvement of symptoms was reported and VAS score decreased to 8; light sensitivity thresholds slightly increased to 2.06 log10[lux] for continuous warm, 2.02 log10[lux] for continuous cold, and 2.18 log10[lux] for flashing warm. At T2, patient experienced a clinically meaningful improvement of symptoms and VAS score decreased to 4; in parallel, light discomfort thresholds increased to 2.78 log10[lux] for continuous warm, 2.82 log10[lux] for continuous cold, and 2.66 log10[lux] for flashing warm. Naltrexone 0.01 % eye drops successfully controlled a severe case of photoallodynia refractory to all previous treatments. This improvement was quantitatively detected by the increase of light discomfort thresholds under all lighting conditions.

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and newer dual-incretin therapies have become central to the treatment of diabetes mellitus and obesity, with benefits extending beyond glycemic control. Their expanding use has prompted growing interest in their potential ocular effects. Experimental data support plausible protective mechanisms, including reduction in oxidative stress and neuroprotective effects on retinal and optic nerve tissues. Clinical evidence, however, remains heterogeneous. In diabetic retinopathy, the main concern appears to be transient early worsening associated with rapid glycemic improvement rather than direct retinal toxicity. A potential semaglutide-associated signal for non-arteritic anterior ischemic optic neuropathy has raised concern, although the absolute risk appears low and causality remains unproven. Emerging studies also suggest possible beneficial associations with glaucoma, ocular surface diseases, and certain retinal vascular outcomes, whereas the evidence regarding age-related macular degeneration and cataract remains conflicting or preliminary. Overall, ocular outcomes associated with incretin-based therapies seem to reflect a complex interplay among drug-specific pharmacology, systemic metabolic changes, and individual patient susceptibility rather than a class effect. Baseline ophthalmic assessment and individualized follow-up may be advisable in selected high-risk patients. Further prospective ophthalmology-focused studies are needed to clarify long-term safety and identify the patients most likely to benefit or develop adverse events.

Purpose: To evaluate the differences between two distinct patient postoperative positions following rhegmatogenous macula-off retinal detachment surgery. Methods: In this consecutive clinical study, 26 patients were placed in either the face-up or face-down postoperative position group. Postoperative follow-ups were conducted at 1, 3, and 6 months using type 1 M-CHARTS, best-corrected visual acuity (BCVA), intraocular pressure, and optical coherence tomography imaging to evaluate the functional and anatomical outcomes after surgery. Results: The average vision recovery at 6 months was 0.35159 +/- 0.30945 logarithm of the minimum angle of resolution (logMAR) for the face-up group and 0.81521+/- 0.46662 logMAR for the face-down group. At 6 months, the average horizontal type 1 M-CHARTS for the face-up group was 0.1615 +/- 0.1710 and 0.2846 +/- 0.2828 for the face-down group; and the average vertical type 1 M-CHARTS was 0.1615 +/- 0.1557 for the face-up group and 0.2846 +/- 0.1725 for the face-down group. Conclusion: The face-up position demonstrated significant improvement in both metamorphopsia and BCVA, suggesting that slow reattachment of photoreceptors on the retinal pigment epithelium layer can result in better quality of sight recovery. Further studies with larger sample sizes are warranted to confirm these results. The study adhered to the guidelines of the Declaration of Helsinki.

Background: Dry eye disease (DED) is among the most common complications experienced after femtosecond laser-assisted in situ keratomileusis (Femto-LASIK), often affecting visual recovery, as well as patient satisfaction. Low-level light therapy (LLLT) has shown benefits in various ocular surface diseases, but its role in refractive surgery remains underexplored. This study aimed at evaluating the efficacy of perioperative LLLT in preserving tear film parameters and reducing ocular discomfort symptoms after Femto-LASIK. Methods: In this prospective multicentric, randomized, double-masked, sham-controlled clinical study, adult patients undergoing Femto-LASIK were randomized (1:1) to receive periocular LLLT (633 ± 10 nm, 15 min/session) or sham treatment 7 ± 2 days before and after surgery. Ocular surface evaluation was performed at baseline (T0), and 1 week (T1), 1 month (T2), and 3 months (T3) postoperatively. Outcomes were tear meniscus height (TMH), Schirmer test values, and Dry Eye Questionnaire-5 (DEQ-5) scores, noninvasive tear break-up time (NIBUT), and interferometry. Results: Forty eyes of 40 patients (mean age: 34.58 ± 5.67 years) were analyzed. In the LLLT group, tear film parameters and subjective symptoms remained stable throughout follow-up, with no statistically significant changes over time. Conversely, the control group showed a significant decline in TMH (0.27 ± 0.05 mm to 0.20 ± 0.05 mm; p < 0.001), Schirmer test (20.39 ± 10.84 mm/5’ to 15.65 ± 9.02 mm/5’; p = 0.022), and a significant worsening in DEQ-5 scores (3.53 ± 4.10 to 5.94 ± 2.79; p = 0.005). Between-group comparisons demonstrated in the LLLT group significantly higher TMH at T2 ( p = 0.034) and T3 ( p = 0.016), higher Schirmer values at T2 ( p = 0.048) and T3 ( p = 0.018), and lower DEQ-5 scores at T1 ( p = 0.041), T2 ( p = 0.029), and T3 ( p = 0.018). NIBUT and interferometry showed no significant between-group differences at any time point. No treatment-related adverse events were observed. Conclusion: Perioperative LLLT appears to be a safe and well-tolerated adjunctive treatment that may help preserve tear volume and support postoperative comfort after Femto-LASIK. These findings suggest a potential role for LLLT in perioperative refractive surgery care, although further studies are warranted to confirm its clinical benefit.