Purpose: Since the beginning of the COVID-19 pandemic, news related to the pandemic has created a feeling of fear, particularly among high-risk groups including elderly patients. This study aimed to assess the fear associated with COVID-19 and to evaluate the fear of vision decrease related to the delay of treatment in neovascular age-related macular degeneration patients (nAMD) during the pandemic. Patients and Methods: This is a prospective cross-sectional study of 160 actively treated patients with nAMD enrolled between September and November 2020 at a tertiary hospital in Québec, Canada. For each participant, demographic and clinical data were collected. The anxiety was rated in a questionnaire composed of two sections: the Fear of COVID-19 Scale (FCV-19S) and eight additional questions to assess ophthalmology-related COVID-19 statements. Results: The mean ± standard deviation level of FCV-19S was 17.05± 4.38. In the multivariable analysis, it was significantly higher in women (p< 0.001) and lower in patients with a high school education vs elementary school (p=0.009). In the ophthalmology-related statements, 16% feared vision loss because of difficulties in maintaining regular follow-ups during the pandemic. The female gender was significantly associated with a higher tendency to postpone their appointment (p=0.03). No association was found between the patients’ underlying disease characteristics and higher fear of vision loss. Conclusion: Despite the massive impact of the pandemic, anxiety related to COVID-19 and delaying ophthalmology treatments remained relatively low in nAMD patients. Greater explanations to address this fear may reduce anxiety level, especially among female patients and those with an elementary school education.

Androgens given for gender affirmation have been implicated in the pathophysiology of idiopathic intracranial hypertension (IIH) in transgender patients. 10 cases of transgender adults with IIH have been published but this association has not been described in younger patients. Herein we describe the first case of IIH in an adolescent transgender patient. A 17-year-old non-obese female-to-male transgender patient on subcutaneous testosterone since age 13 presented with a two-month history of transient visual obscuration and frontal headaches. Ophthalmological examination revealed Frisen grade 2 papilledema with preserved visual function. Lumbar puncture confirmed elevated opening pressure. Papilledema resolved with oral acetazolamide and reduction of testosterone therapy. The use of cross-sex hormone therapy (CSH) for gender affirmation may increase the risk of IIH. Awareness of this association is important as the number of younger transgender patients seeking CSH is increasing significantly.

Purpose . To identify predictive factors for visual outcomes of patients presenting with a posterior segment intraocular foreign body (IOFB). Methods . A retrospective chart review was performed for all consecutive patients operated for posterior segment IOFB removal between January 2009 and December 2018. Data were collected for patient demographics, clinical characteristics at presentation, IOFB characteristics, surgical procedures, and postoperative outcomes. A multiple logistic regression model was built for poor final visual acuity (VA) as an outcome (defined as final VA 50 letters or worse [Snellen equivalent: 20/100]). Results . Fifty‐four patients were included in our study. Ninety‐three percent of patients were men, with a mean age of 40.4 ± 12.6 years. Metallic IOFB comprised 88% of cases with a mean ± standard deviation (SD) size of 5.31 ± 4.62 mm. VA improved in 70% of patients after IOFB removal. Predictive factors for poor VA outcome included poor baseline VA, larger IOFB size, high number of additional diagnoses, an anterior chamber extraction, a second intervention, the use of C3F8 or silicone tamponade, and the presence of vitreous hemorrhage, hyphema, and iris damage. Predictive factors for a better visual outcome included first intention intraocular lens (IOL) implantation and the use of air tamponade. In the multiple logistic regression model, both baseline VA ( p = 0.009) and number of additional complications ( p = 0.01) were independent risk factors for a poor final VA. Conclusions . A high number of concomitant complications and poor baseline VA following posterior segment IOFB were significant predictive factors of poor visual outcome.

(max. 250) Purpose: To evaluate the safety and outcomes of immediately sequential bilateral cataract surgery (ISBCS) at a Canadian academic teaching center. Setting: Tertiary university teaching hospital of Laval University, Quebec City, Canada. Design: Retrospective cohort study of 2003 consecutive patients (4006 eyes) who underwent ISBCS under topical anesthesia from January 2019 to December 2019. Methods: All charts were retrospectively reviewed. Outcome measures included intraoperative and postoperative complications, postoperative uncorrected (UCVA) and pinhole (PHVA) visual acuities, and autorefraction measurements. Results: 1218 (60.8%) female and 785 (39.2%) male patients with a mean age of 74 ± 8 years old had a mean preoperative visual acuity of 0.503 LogMAR (Snellen 20/63). The mean axial length was 23.53 ± 1.37 mm. The majority of eyes had monofocal intraocular lenses (IOL) implanted (n=3738, 93.3%) followed by toric (n=226, 5.6%), multifocal (n=25, 0.6%), and multifocal toric (n=17, 0.4%) IOLs. Intraoperative complications included 14 (0.3%) posterior capsule ruptures with 5 (0.1%) requiring sulcus IOL placement, and 7 (0.2%) partial zonulysis, with 3 requiring capsular tension rings (0.07%). There were no cases of endophthalmitis or toxic anterior segment syndrome. Mean 5-week postoperative UCVA was 0.223 (Snellen 20/33), PHVA was 0.153 (Snellen 20/28) with a mean spherical equivalent of -0.21 diopters. Conclusions: ISBCS performed following iSBCS recommended guidelines is a safe procedure. This cohort of 4006 eyes had very few complications, with none attributable to the surgery being done bilaterally. The UCVA, PHVA and refractive outcomes were good.