Background:Gel-based ocular phantom models provide a controlled platform to test the biomechanical factors and validate emerging diagnostic technologies. Despite the growing application in ophthalmic research, no comprehensive bibliometric analysis has been conducted to map their evolution and translational relevance in glaucoma diagnostics. Purpose:The study aimed to bridge this gap by identifying global research trends and highlighting the emerging role of gel-based ocular phantoms in intraocular pressure (IOP) assessment and glaucoma-related diagnostic applications. Materials and methods:A bibliometric analysis of open-access literature (2020-2025) was conducted using the Scopus database. Keyword co-occurrence and temporal overlay analysis were performed using VOSviewer to assess research trends, geographical contributions, and thematic evolution from general tissue-mimicking models to glaucoma-specific applications. Results:A total of 1,116 publications related to gel or tissue-mimicking phantoms were identified. The results showed a progressive narrowing of research focus from generic tissue-mimicking phantoms toward ocular biomechanical models for IOP assessment, with 62 publications specifically related to glaucoma, IOP, biomechanical modeling, sensor validation, or fluid dynamics. The United States and China emerged as leading contributors. The overlay visualization demonstrated a recent shift toward ocular biomechanics in glaucoma diagnostic simulation, reflecting growing clinical translation. Conclusion:Ocular gel phantoms are emerging as an integral experimental platform for addressing the biomechanical variability and enhancing safer preclinical validation of glaucoma diagnostic instruments. Clinical significance:The findings of this study highlight the importance of ocular biomechanics in glaucoma diagnostics and suggest the importance of gel phantom integration for preclinical validation of ocular biomechanics-related instruments to enhance accuracy.
Purpose:The aims are to study the prevalence, causes, and challenges of neuro-ophthalmic disorders being misdiagnosed as glaucoma in a tertiary care setting and to identify strategies for improving diagnostic skills in resource-constrained settings. Design:Single-center, retrospective, cross-sectional study over a period of 6 months, that is, July-December 2024, at a tertiary care hospital in Central India. Methodology:Medical records of 53 patients who presented to the glaucoma clinic during the study period were reviewed. All of them had already been diagnosed with glaucoma at other facilities. Seventeen such patients, who were later established to have nonglaucomatous (neuro-ophthalmic) conditions, were analyzed. Patients who were proven to have either primary or secondary glaucoma after comprehensive ophthalmic and neuroimaging evaluation were excluded. The demographic data, clinical findings, investigation results, and causes of misdiagnosis were analyzed. Results:The proportion of misdiagnosis was 32% (17/53). Compressive optic neuropathy was the most common mimicker, followed by demyelinating optic neuropathy at 23.5% and ischemic optic neuropathy at 17.6%. Major contributing factors to diagnostic error included falsely elevated intraocular pressure (IOP), optic disk cupping with pallor, family history of glaucoma, and lack of access to central corneal thickness assessment, visual field analysis, and neuroimaging. Visual field analysis and magnetic resonance imaging (MRI) were key investigations in diagnosis. Conclusion:Neuro-ophthalmic conditions mistaken for glaucoma lead to delayed and inappropriate management. The introduction of structured diagnostic algorithms, multimodal imaging, and clinician training, supported by telemedicine and artificial intelligence (AI)-assisted tools, may lead to a significant reduction in misdiagnosis and promote earlier diagnosis, especially in resource-constrained healthcare settings.
A middle-aged male patient with bilateral advanced glaucoma, who had undergone trabeculectomy, developed a suprachoroidal hemorrhage (SCH) on post-operative day 1. Ultrasound (USG) confirmed the presence of appositional choroidal mounds with clotted blood in the suprachoroidal space. The patient underwent recombinant tissue plasminogen activator (rtPA) injection into the suprachoroidal space in the first stage, followed by trocar-assisted drainage 5 hours later. This report aims to highlight the effectiveness of rtPA in aiding the lysis and subsequent drainage of clotted blood from the suprachoroidal space. This technique is especially useful when early drainage of SCH is being planned because of appositional/kissing choroidals or uncontrolled intraocular pressure (IOP), especially in one-eyed patients.
Background:Glaucoma is a leading cause of irreversible blindness worldwide, and environmental risk factors beyond intraocular pressure (IOP) are increasingly being investigated. Ambient air pollution, particularly fine particulate matter (PM₂.₅), may contribute to glaucomatous optic neuropathy through oxidative stress and vascular dysregulation; however, existing evidence remains fragmented. Objective:To systematically review and quantitatively synthesize the association between ambient air pollution exposure and glaucoma risk, IOP, and structural markers of glaucomatous optic neuropathy. Methods:This systematic review and meta-analysis followed PRISMA 2020 guidelines and was registered with PROSPERO. PubMed and Embase were searched from inception to 30th December 2025, for observational studies evaluating ambient air pollution exposure and glaucoma-related outcomes. Random-effects meta-analysis using generic inverse-variance methods was conducted for studies reporting associations between long-term PM₂.₅ exposure and glaucoma. Other pollutants were synthesized narratively. Results:Eighteen observational studies from diverse geographic regions were included, of which eight contributed to the PM₂.₅ meta-analysis. Higher long-term PM₂.₅ exposure was associated with an increased risk of glaucoma (pooled RR = 1.12; 95% CI, 1.06-1.18), with moderate heterogeneity (I² = 78.7%). Associations for NO₂, NOx, PM₁₀, and CO were directionally positive but heterogeneous. Structural changes, including RNFL and GCIPL thinning, and modest IOP elevations were also reported. Conclusion:Long-term PM₂.₅ exposure is associated with increased glaucoma risk, suggesting a potential environmental contribution; however, causality cannot be established from the available observational evidence. These findings highlight the need to integrate ocular outcomes into environmental health policy and to prioritize prospective studies capable of addressing confounding and temporality.
Prostaglandin analogs, including travoprost, are widely used to lower intraocular pressure in primary open-angle glaucoma. While generally safe, rare posterior segment changes have been reported. Retinal pigment epithelial detachment (RPED) associated with travoprost is uncommon and poorly documented. We report three patients who developed serous RPED shortly after initiating topical travoprost, none of whom had preexisting macular disease. Optical coherence tomography (OCT) confirmed the detachments, and complete anatomical and visual recovery occurred following discontinuation of travoprost and initiation of alternative glaucoma therapy. A clear temporal relationship was observed between drug initiation and RPED onset. The absence of clinical or OCT features suggestive of alternative diagnoses-such as central serous chorioretinopathy, age-related macular degeneration, or pachychoroid spectrum disorders-combined with consistent reversibility, suggests a possible association between travoprost and RPED. These findings emphasize the importance of early recognition and timely intervention, as RPED appears fully reversible when identified promptly, preventing potential persistent visual impairment.
