Presbyopia, a common age-related condition affecting near vision, impacts over a billion people worldwide. The aim of this paper is to review the main reports and results of clinical trials, comparing the newest pharmacological treatment options for presbyopia, their mechanisms of action, and possible side effects. Pharmacological approaches, involving eye drops that target the underlying mechanisms of presbyopia, have gained growing interest. Two key pharmacological agents in this field are miotics and lens softeners. Miotics enhance near vision temporarily by creating a pinhole effect, though they may cause side effects and are under further investigation for long-term use with ongoing research also exploring the potential benefits of combining them with other drugs to improve outcomes and reduce adverse reactions. Lens softeners, on the other hand, aim to restore the flexibility of the lens, addressing one of the primary causes of presbyopia. Despite early trials, further development of lens softeners has been suspended. A notable advancement in this field is the recent FDA approval of 1.25% and 0.4% pilocarpine, a miotic agent, for presbyopia treatment. This milestone highlights the growing interest in pharmacological solutions for presbyopia, with several new drugs and their combinations currently being investigated for potential FDA approval. pharmacological treatments, particularly miotics like pilocarpine, represent a promising alternative to conventional methods for managing presbyopia. Continued research into these treatments, especially combinations of drugs, may offer more effective and convenient options for presbyopia patients in the future.
Background and Objectives: Myopia is the most widespread ocular disorder globally and its prevalence has been increasing over the past decades. Atropine eye drops stand out as the only pharmacological intervention used in clinical practice to control myopia progression. The aim of this study was to explore the effect of 0.01% atropine eye drops on myopia progression. Patients and Methods: Healthy children aged 6–12 years with cycloplegic spherical equivalent (SE) from −0.5 D to −5.0 D and astigmatism ≤1.5 D were included. Myopia progression was assessed by changes in SE and axial length (AL) over 1 year and SE changes 1 year before the study enrollment and during the 1-year follow-up. Adverse events were evaluated based on complaints reported by either parents or the children themselves during follow-up visits. Results: The analysis involved 55 patients in the 0.01% atropine eye drops group and 66 in the control group. After the 1-year follow-up, the change in SE was −0.50 (−2.25–0.50) D in the control group compared to −0.50 (−1.50–0.50) D in the 0.01% atropine group (p = 0.935); AL change was 0.31 (0.18) mm in the control group and 0.29 (0.18) mm in the 0.01% atropine group (p = 0.480). The change in SE was −0.68 (−2.0–−0.25) D/year before the study and remained similar −0.50 (−2.25–0.25) D over the 1-year follow-up in the control group (p = 0.111); SE change was reduced from −1.01 (−2.0–−0.25) D/year before the study to −0.50 (−1.5–0.5) D over the 1-year follow-up in the 0.01% atropine group (p < 0.001). In the 0.01% atropine group, ten (16.4%) children experienced mild adverse events, including blurred near vision, ocular discomfort, photophobia, dry eyes, and anisocoria. Conclusions: Compared to the control group, the administration of 0.01% atropine eye drops demonstrated no significant effect on changes in SE and AL over a 1-year follow-up. However, children in the 0.01% atropine group initially experienced higher myopia progression, which decreased with treatment over the course of 1 year. Future studies should explore the long-term effects, rebound effects, potential genetic associations, and efficacy of higher doses of atropine in managing myopia progression.
Neurological disorders significantly affect ocular surface homeostasis, influencing parameters such as blink rate (BR), tear production, corneal nerve density, and sensitivity. This review summarizes recent findings on ocular surface alterations associated with neurological diseases, including Alzheimer’s disease (AD), Parkinson’s disease (PD), Guillain-Barré syndrome (GBS), trigeminal neuralgia (TN), multiple sclerosis (MS), and Charcot–Marie–Tooth disease (CMT). Notably, ocular manifestations such as reduced BR, decreased tear break-up time (TBUT), impaired tear secretion, and corneal nerve fiber loss are consistently reported. In AD, elevated tear amyloid-beta and tau proteins emerge as promising biomarkers for early disease detection. PD patients frequently experience dry eye symptoms attributed to reduced BR and tear film instability. GBS is linked to lagophthalmos and corneal nerve impairment, potentially leading to severe ocular surface damage. TN demonstrates bilateral ocular surface dysfunction despite unilateral neuropathic symptoms. MS is associated with significant ocular surface alterations, reflecting broader neuroinflammatory and autonomic disturbances. Similarly, CMT patients show reduced corneal sensitivity and tear production, underscoring the systemic nature of neurological impacts. Awareness of these ocular manifestations is essential for improving patient care and guiding future research into ocular biomarkers and targeted therapies.
The global incidence of cutaneous melanoma (CM) is rising, necessitating early detection and identification of risk factors across different populations. A case–control study with 180 patients with primary diagnosed CM and 182 healthy controls was conducted. Participants underwent ophthalmic and skin examinations, where the identification and counting of common melanocytic nevi (CMN) and atypical melanocytic nevi (AMN) was performed. During ophthalmic examination, high-resolution slit lamp iris images were taken. Images were categorized according to iris periphery, collaret, and freckles. There was no difference in iris periphery and collaret color between groups. However, blue/grey iris periphery and blue collaret with or without freckles were the most common patterns. The presence of pigmented iris lesions and 2–5 mm and ≥5 mm in diameter CMNs was strongly associated with CM risk. The evidence from this study indicates that blue or grey periphery and blue collaret iris pattern with iris freckles are 2.74 times higher in the CM group than controls. Further research is needed to explore iris patterns’ association with CM risk in diverse populations.
Background/Objectives: Sun exposure and ultraviolet (UV) radiation significantly affect human health, especially concerning skin and eye conditions. Sun exposure is a risk factor for both cutaneous melanoma (CM) and cataract. To investigate the association between CM, cataract and the number of common melanocytic nevi (CMNs) in the Lithuanian population. Methods: A case–control study with 180 primary diagnosed CM subjects and 182 healthy controls was conducted. Participants underwent ophthalmic and dermatological examination, where a counting of the common melanocytic nevi (CMNs) on the face, outer surfaces of the upper arms, lower arms and hands was performed. A detailed ophthalmic slit lamp examination was conducted; additionally, lens status and cataract formation were evaluated according to the Lens Opacities Classification System III (LOCS III). Results: Subjects with an LOCS III grade of nuclear opalescence (NO) ≥3 had a 1.82 times higher risk of CM, and patients with a nuclear color (NC) grade ≥3 had a 2.02 times higher risk of CM. LOCS III evaluations of cortical (C) and of posterior subcapsular (P) cataract showed a 5.24 and 6.34 times increased risk of CM, respectively. The CMN number on the face increased CM risk by 1.25 times; on the outer surface of the upper and lower arms, correspondingly 1.05 and 1.04 times; and on outer surface of hands—1.29 times. Conclusions: All types of cataracts were found more often in patients with CM than in healthy subjects. The number of CMNs on the face and outer surfaces of arms and hands could be an indicator of higher risk for CM.
Background and Objectives: This study aimed to translate and validate the Lithuanian version of the 5-Item Dry Eye Questionnaire (DEQ-5). Materials and Methods: The original English DEQ-5 was translated and adapted into Lithuanian according to guidlines. A total of 40 Lithuanian-speaking adults without diagnosed ocular or systemic disease completed the questionnaire twice, with a 2–3-day interval. Internal consistency was evaluated using Cronbach’s alpha and corrected item–total correlations. Test–retest reliability was assessed using the intraclass correlation coefficient (ICC), and convergent validity was evaluated by correlating DEQ-5 scores with the Lithuanian version of the Ocular Surface Disease Index (OSDI). Results: The Lithuanian DEQ-5 demonstrated good internal consistency (Cronbach’s α = 0.843). Corrected item–total correlations ranged from 0.160 to 0.829, with Item 3 showing the weakest correlation. Test–retest reliability was good (ICC (A, 1) = 0.868; 95% CI: 0.764–0.928; p < 0.001). Bland–Altman analysis showed a mean difference (bias) of 0.075 points, with 95% limits of agreement ranging from −4.73 to 4.88 points. DEQ-5 scores showed a strong positive correlation with OSDI scores (Spearman’s ρ = 0.796; 95% CI: 0.55–0.92, p < 0.001), providing evidence of convergent validity in the OSDI subgroup. Conclusions: The Lithuanian version of the DEQ-5 demonstrated good internal consistency and test–retest reliability, while evidence of convergent validity was observed among participants who completed the OSDI.