Purpose The aim of this study was to investigate the clinical characteristics, refractive error profile, and management approaches in Iraqi patients diagnosed with keratoconus (KC), emphasizing the disease severity, sex distribution, and visual outcomes. Patients and methods A retrospective study was conducted on 405 eyes of 405 patients diagnosed with KC at Ibn Al-Haytham Teaching Eye Hospital, Baghdad, Iraq, between January 2022 and January 2025. The collected data included age, sex, KC severity (classified by keratometry), refractive error type and axis orientation, treatment modality (optical or surgical), and uncorrected and best-corrected visual acuity. Results Most patients (57.28%) were females and aged 21–30 years (43.46%). Mild and moderate KC accounted for 38.77 and 32.35% of the cases, respectively. Oblique compound myopic astigmatism was the most prevalent refractive error (42.47%), followed by with-the-rule compound myopic astigmatism (26.67%). Rigid gas-permeable and scleral lenses were the most common treatments used (34.57 and 32.10%, respectively), while 24.69% of the patients underwent corneal collagen cross-linking and 18.52% required surgical intervention. The visual acuity improved significantly after treatment, with 40.99% of the eyes achieving 6/6 best-corrected visual acuity and fewer than 10% remained below 6/18. Conclusion KC in this Iraqi cohort demonstrated a female predominance and a high frequency of oblique compound astigmatism, particularly in early disease. Stage-specific treatment strategies effectively restored the visual function, including early contact lens fitting and collagen cross-linking. These findings support the need for early detection and access to tailored interventions in low-resource settings.
Background Posterior blepharitis, primarily involving meibomian gland dysfunction, is a chronic inflammatory condition requiring multimodal management. Azithromycin offers both antimicrobial and anti-inflammatory properties, yet the optimal route of administration remains undetermined. Purpose The aim of this study was to compare the clinical efficacy of topical, systemic, and combined Azithromycin regimens in posterior blepharitis treatment. Patients and methods This is a prospective, randomized clinical trial that enrolled 45 adult patients diagnosed with posterior blepharitis at Suez Canal University Hospital, Ismailia, Egypt. The patients were equally allocated into three arms (each of 15 patients): group A received topical Azithromycin ophthalmic solution, group B received oral Azithromycin, and group C received combined topical and systemic regimen. The patients were evaluated at baseline, and at 1- and 5-weeks following treatment by the tear film break-up time, Schirmer’s test, conjunctival hyperemia, eyelid debris, and ocular surface disease index (OSDI). Results The baseline demographic and study parameters were comparable between the three groups. By 5 weeks, group A and C patients showed significant improvement in the tear film break-up time ( P =0.004 and 0.0001 respectively), hyperemia grade ( P =0.0009 and 0.002, respectively), and OSDI ( P <0.0001 and 0.02, respectively), while group B showed better Schirmer’s test values ( P =0.009) as well as lid debris grades ( P =0.002). The intergroup analysis for each follow-up revealed a significantly faster improvement in the OSDI after 1 week, favoring the topical Azithromycin route ( P =0.047). Otherwise, there were no significant differences in all other parameters among the different groups at each single visit. Conclusion Topical Azithromycin achieved comparable long-term efficacy in treatment of posterior blepharitis compared with systemic or combined forms, with the advantage of providing earlier symptomatic relief while avoiding the systemic adverse events.
Selective laser trabeculoplasty (SLT) offers a noninvasive therapeutic option to various types of glaucoma and ocular hypertension, yet its specific efficacy and safety in steroid-induced cases require a comprehensive evaluation. This systematic review assessed the SLT effectiveness in reducing the intraocular pressure (IOP) and medication dependence, alongside its safety profile in steroid-induced glaucoma (SIG) and steroid-induced ocular hypertension (SIOHT) patients. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance and registered in PROSPERO (CRD420251126072). PubMed, Google Scholar, ProQuest, EBSCO, Wiley Online Library, and ScienceDirect were searched from each database inception to July 13, 2025. The eligible studies included adults with SIOHT or SIG treated with SLT and reporting at least one of the following outcomes: IOP, use of IOP-lowering medication, treatment success, or adverse events. The risk of bias was assessed with the Joanna Briggs Institute checklist for case series and Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I) for nonrandomized interventional studies. The study included seven studies comprising 154 eyes. The follow-up duration ranged from 6 to 24 months. SLT consistently lowered the IOP, with mean reductions ranging from 30 to 52% from baseline. A significant decrease in antiglaucoma medication use was also observed. The success rates varied considerably (46-91.7%). SLT was generally safe, showing minimal, transient complications. High heterogeneity in SLT protocols (pretreatment, laser devices, energy, and postoperative management) was noted, contributing to the outcome variability. The current evidence suggests that SLT may reduce the IOP and medication burden in selected patients with SIOHT or SIG. However, confidence in these findings is limited by the small sample sizes, retrospective designs, inconsistent treatment protocols, and substantial risk of bias. Larger prospective studies with standardized outcome definitions are needed to better define the role of SLT in this setting.
Background Epiphora is a common symptom resulting from nasolacrimal duct obstruction (NLDO). Dacryocystorhinostomy (DCR) remains the surgical treatment of choice for NLDO. Mitomycin-C (MMC) is an antiproliferative agent which is hypothesized to improve the postoperative success rate by reducing fibrosis at the osteotomy site. Purpose The aim of this study was to compare the outcome of endoscopic endonasal DCR with and without postoperative MMC application. Patients and methods This is a prospective interventional comparative study that was conducted on 40 patients with acquired NLDO. The patients were randomly assigned into two groups: group A ( n =20) who underwent endoscopic DCR with postoperative 0.05% MMC application for 48 h, while group B ( n =20) underwent endoscopic DCR without MMC application. The preoperative and postoperative evaluations included the clinical presentation, regurgitation test, fluorescein dye disappearance test, and syringing. The follow up was done at 48 h, 2 weeks, 1, 3, and 6 months, postoperatively. The surgical success was defined anatomically by patent irrigation and functionally by resolution of epiphora. Results The overall success rate was 100% in group A and 85% in group B, with no statistically significant difference ( P =0.231). In group A, the postoperative complications included mucopurulent discharge in two (10%) patients, epiphora in one (5%) patient, bleeding in one (5%) patient, and periorbital swelling in four (20%) patients, while in 12 (60%) patients no postoperative complications were reported. In group B, there was mucopurulent discharge in two (10%) patients, epiphora in one (5%) patient, bleeding in two (10%) patients, and periorbital swelling in one (5%) patient, while in 14 (70%) patients no postoperative complications were detected, with no statistically significant difference between the two groups ( P =0.683). The postoperative causes of failure, in group B, were nasal crustation (33.3%), intranasal adhesions (33.3%), and punctal obstruction (33.3%). The functional improvement was better in group A. No serious adverse effects were recorded in either group. Conclusion The postoperative use of MMC during endoscopic DCR enhanced the surgical success (though not statistically significant) by reducing the postoperative fibrosis and restenosis without adding further complications.
Purpose The aim of this study was to evaluate the correlation between the subjective symptoms of dry eye disease (DED) and the objective ocular surface parameters measured by the Idra device. Patients and methods This prospective cross-sectional study included a total of 150 patients (mean age 41.69±13.5 years; 68% males) who presented with DED either symptomatic or accidentally discovered during routine slit lamp examination. The subjective symptoms were assessed using the Dry Eye Questionnaire-5 (DEQ-5), while the objective signs were measured with the Idra device, including the lipid layer thickness (LLT), noninvasive tear break-up time (NIBUT), tear meniscus height (TMH), and meibomian gland dropout score (MIBO). The correlations were analyzed using the Spearman’s rank correlation. Results The DEQ-5 scores showed a highly significant negative correlation with the LLT ( r =−0.758, P <0.001) and a highly significant positive correlation with the MIBO ( r =0.470, P <0.001). No significant correlations were found between the DEQ-5 and the NIBUT ( r =−0.109, P =0.184) or the TMH ( r =−0.025, P =0.758). A highly significant negative correlation was found between the LLT and the MIBO ( r =−0.464, P <0.001). In addition, the MIBO was also significantly correlated with age ( r =0.207, P =0.011). The female pa r ticipants reported significantly higher DEQ-5 scores than the males (9.56±2.41 vs. 8.76±2.86, P =0.009). Conclusion The LLT and the MIBO were significantly correlated with dry eye symptoms, whereas the TMH and the NIBUT showed no significant correlations with the DED symptoms.
