We aimed at searching in color art paintings through all art periods from Ancient Egyptian Art to Contemporary Art for sclerotic scatter (SS) and peripheral light focusing (PLF), using large-scale internet databases.These phenomena originate from the illuminated side of the eyeshell: limbal sclera for SS or cornea for PLF.They end at the darkness of the opposite limbal scleral side, where they are either scattered (SS) or concentrated (PLF) forming a clear arc or spot of light, respectively ("light through darkness").We found SS and PLF in 83 and 2 paintings respectively out of 113,962 paintings analyzed.These forms of objective chiaroscuro help to reconstruct a basic sense of eyeball modelling by bringing the limbus out of the shadows.Among the paintings with SS, most were painted during the following periods: Renaissance (44), Baroque (15), Rococo (11).Sixty-one of the paintings with SS have a dark background compatible with the fact that SS is more easily observed under low ambient light illuminance ("light through darkness").Acknowledgment of SS and PLF as subtle, rare characteristics of paintings should help see them in a new light, contribute to their proper treatment and restoration and is likely to enhance their economic value.

Figure S1: Complete set of paintings with a light orientation compatible with peripheral light focusing or sclerotic scatter; Figure S2: Complete set of paintings probably featuring peripheral light focusing or sclerotic scatter; Table S1: Detail about the 113,962 color paintings and pastels of 2311 painters analyzed in the present report. Painters having represented sclerotic scatter are displayed in bold characters.; Table S2: Details about the 909 paintings of 311 painters with light exposure of the eye compatible with the occurrence of sclerotic scatter. Painters having represented sclerotic scatter and paintings featuring sclerotic scatter are displayed in bold characters; Table S3: Details of the 83 paintings of 42 painters with probable sclerotic scatter representation; Tables S4: Details about the 5 paintings with a light exposure of the eye compatible with the occurrence of peripheral light focusing (PLF), among which 2 probably feature PLF. Painters having represented PLF are displayed in bold characters.

Purpose. - Lacking a standard technique, the surgical management of aphakia without capsular support remains to be optimized. The goal of this study is to analyze results for the Carlevale FIL-SSF intraocular lens and propose surgical recommendations. Patients and methods. - The P1.5 Collective performed a retrospective analysis, with a minimum follow-up of 6 months, of the records of 72 implantations of the Carlevale FIL-SSF intraocular lens, specifically designed for sutureless scleral fixation in the ciliary sulcus. Results. - The most common indication was exchange of a posterior chamber intraocular lens (70.8%). The surgery lasted a mean of 53.4 minutes due to the creation of scleral flaps. The implant was damaged in 12.5% of cases. Visual acuity was improved in 83.3% of cases. The postoperative spherical equivalent was -0.3 diopters, with no change in corneal astigmatism. The implant was centered and stable in all cases. Two cases (2.8%) of cystoid macular edema were observed and resolved over six months. Discussion. - A number of advantages of the Carlevale FIL-SSF intraocular lens make it a safe and effective solution for correction of aphakia in the absence of capsular support. It requires a longer than usual surgical procedure, and the implant must be handled with care. From their experience, the authors propose 7 recommendations to accelerate the learning curve. Conclusion. - In light of the results of this study, we propose the Carlevale FIL-SSF intraocular lens as the new standard for the correction of aphakia without capsular support, but other studies are necessary to determine its exact place within the heirarchy of other available techniques. (C) 2021 L'Auteur(s). Publie par Elsevier Masson SAS.

Purpose: To evaluate the different mechanisms of retinal detachment recurrence after retinectomy for rhegmatogenous retinal detachment (RD) complicated by proliferative vitreoretinopathy (PVR) and to study its outcome and prognosis. Methods: Retrospective, multicenter study conducted between January 2009 and November 2016. Retrospective review of 56 patients with recurrent RD (RRD) after a first relaxing retinectomy. Results: The secondary retinal attachment rate was 58.9% (33/56 cases). The various mechanisms of RRD were mainly related to PVR (52/56 cases: 93%). This PVR was anterior in 10 cases (21%), posterior in 31 cases (60%), and combined anterior and posterior in 11 cases (21%). The RRD mechanism was not PVR in 4 of the 56 cases. Some of the RRD mechanisms were specific to retinectomy: fibrosis of the edge of the retinectomy (26 cases: 46.4%), beyond-the-edge proliferation (8 cases: 14.3%), and severe inferior retinal folding (2 cases: 3.6%). In the 2 cases of severe inferior retinal folding, the retina could not be reattached. The anatomical outcome and the mechanism of RRD (anterior PVR, posterior PVR, or combined anterior and posterior PVR) were not correlated (P= 0.12). Visual acuity was significantly better only in patients with complete secondary success, that is, having an attached retina after silicone oil removal: mean preoperative visual acuity was 2.01 logarithm of the minimum angle of resolution versus 1.01 logarithm of the minimum angle of resolution postoperatively (P= 0.019). Conclusion: Proliferative vitreoretinopathy caused most of the recurrences, and the anatomical outcome did not depend on the type of PVR involved. Only complete secondary success (attached retina after silicone oil removal) was accompanied by visual acuity improvement.

Purpose: To compare the rate of posterior synechiae of the iris (PSI) occurrence after phacovitrectomy between a group with lens-in-the-bag (LIB) implantation, that is, implantation in the capsular bag, and a group with bag-in-the-lens (BIL) implantation. Setting: CHU de Caen, Department of Ophthalmology, Caen, France. Design: Comparative retrospective study. Methods: One hundred consecutive cases of phacovitrectomies conducted between May 2013 and July 2016 were included. A retrospective analysis of the occurrence rate of PSI in the LIB group and in the BIL group was performed, using multivariate analysis including multiple risk factors such as preoperative synechiae, proliferative diabetic retinopathy, use of 20-gauge vitrectomy, use of gas or silicone tamponade, and use of endophotocoagulation. Results: One hundred eyes of 92 patients were included in this study (55 eyes in the LIB group and 45 in the BIL group). The occurrence of PSI was significantly lower in the BIL group with 1 case (2%) versus 22 cases (40%) in the UB group (P < .001). Among the risk factors studied, preoperative synechiae and the use of retinal endophotocoagulation were almost significantly associated with the occurrence of PSI (P = .068 and P = .087, respectively). In the LIB group, these PSI led to 1 case of acute elevation of intraocular pressure by pupillary seclusion and the use of laser iridotomy in 8 cases. Conclusion: The use of BIL rather than LIB implantation in phacovitrectomy practically eliminates PSI. (C) 2019 ASCRS and ESCRS

Sclerotic scatter involves the scattering of incident light by the limbal sclera followed by entry of part of the scattered light into the cornea, where some of the light travels through total internal reflection to the other side, where it scatters a second time in the limbal sclera. It is then visible in the form of a limbal scleral arc of light. Sclerotic scatter has been used for decades to spot and delineate corneal opacities, which disrupt and scatter the light travelling through total internal reflection. To implement the technique, the slit beam and the binoculars of the slit lamp should be dissociated so that the limbal sclera is illuminated, while the binoculars are centered on the cornea. The technique does not provide any information as to the depth of corneal opacities and therefore needs to be complemented by direct illumination. The second sclerotic scatter may also be used clinically, for instance for diode cycloablation, the posterior part of the arc of light projecting 0.5mm behind the scleral spur. This article aims to describe the phenomenon of sclerotic scatter, explaining how the slit-lamp should be set to use this technique, describing its clinical applications (in the opacified cornea and in the normal sclera), showing that the limbal scleral arc of light of sclerotic scatter may be seen under certain circumstances in daily life with the naked eye and, finally, explaining how the arc of light differs from peripheral light focusing ("Coroneo effect").

Les primates hominoïdes (humain, Chimpanzé, Gorille, Orang-outang et Gibbons) possèdent des orbites convergentes qui favorisent la vision binoculaire et stéréoscopique (vision précise) mais limite le champ visuel latéral. Cependant, une étude récente montre que l’humain élargit son champ visuel de plus de 60° grâce aux mouvements oculaires (champs visuel dynamique). Nous cherchons à comprendre les bases anatomiques de cette performance et savoir si elles sont présentes chez les autres primates hominoïdes. Les orbites de 100 humains (47 hommes/36 femmes), 30 Chimpanzés, 30 Gorilles, 30 Orangs-outangs, et 30 Gibbons ont été analysées en mesurant leur angle de convergence et leur angle d’ouverture latérale ainsi que le rapport largeur/hauteur. Ces paramètres sont comparés selon les genres et modélisés pour évaluer le retentissement sur le champ visuel dynamique. Le genre humain possède une orbite significativement bien plus large (largeur/hauteur = 1,19) que les autres hominoïdes (p < 0,001). L’orbite humain et celui des Gibbon est aussi moins convergente que celui des autre hominoïdes (p < 0,001) ce qui favorise la vision latérale. Mais surtout, le bord latéral de l’orbite humaine présente un recul non retrouvé chez les autre hominoïdes (p < 0,001). Cette fenêtre latérale élargit le champ visuel de 21° lors de l’abduction de l’œil. La forme de l’orbite humaine se distingue des autres hominoïdes et permet à la fois une vision binoculaire précise et un champ visuel élargi lors des mouvements oculaires. Cette caractéristique pourrait résulter de l’évolution de l’homme dans un milieu ouvert où la détection des prédateurs est essentielle à la survie, tandis que l’orbite des hominoïdes arboricoles est plus fermée latéralement, protégeant mieux l’œil face aux traumatisme des branches.

INTRODUCTION:The prevalence and etiology of neovascular glaucoma (NVG) as a complication of central retinal artery occlusion (CRAO) is a debated issue. According to some authors, NVG associated with CRAO always involves underlying chronic ocular ischemic syndrome (COIS) as a primum movens for CRAO. However, we describe 5 cases of NVG following CRAO with no underlying COIS, confirmed by carotid Doppler studies and ultrasound color Doppler imaging (USCDI) of the ophthalmic artery (OA). MATERIAL AND METHODS:We conducted a single-center retrospective analysis of the medical records of 5 consecutive patients who developed NVG following non-arteritic CRAO between July 2010 and July 2014. RESULTS:Five patients were included. All 5 patients were examined at the emergency room. The 5 patients had normal intraocular pressure and no intraocular neovascularization upon initial examination. They had no hemodynamically significant internal carotid artery stenosis, and the ophthalmic artery USCDI was normal. These 5 patients developed NVG subsequently to the CRAO. CONCLUSIONS:In our patients, carotid Doppler studies and USCDI of the OA ruled out COIS. Thus, COIS did not cause the NVG. CRAO may therefore lead to neovascular glaucoma without underlying COIS.

The recommendation of having patients waiting 5 minutes between two eyedrops instillation is based on an experimental work conducted by Chrai et al. in 1974 on the albino rabbit. In this work, instillation of pilocarpine eyedrops was followed by instillation of saline eyedrops after 30 seconds and 2 minutes with as few as 4 rabbits and permitted a decreasing of the maximum difference in pupillary diameter respectively by 44% and 17.5%. The present study was undertaken to assess the validity of these findings in humans. Twenty-four healthy volunteers were enrolled from March 2016 to April 2017. Eyeballs were photographed in a completely dark room with an infrared camera at baseline, 40 minutes after instillation of 1% pilocarpine and 40 minutes after instillation of 1% pilocarpine eyedrops followed by the instillation of saline eyedrops immediately afterwards or 5 minutes later. Pupil to iris surface ratios were calculated and differences of ratios between baseline and 40 minutes (i.e. myosis gain) were compared with Wilcoxon test. The mean (SD) myosis gain was 0.176 (0.089) with 1% pilocarpine alone; 0.165 (0.086) with 1% pilocarpine immediately followed by saline eyedrops (p = 0.652) and 0.167 (0.087) with pilocarpine followed 5 minutes later by saline eyedrops (p = 0.731). Only some eye colours significantly influenced the myosis gain in multivariate analysis. Despite using pupil/iris surface ratios (more sensitive than diameter measurements), and more subjects (24 versus 4) our study fails to confirm the results found by Chrai et al.'s in the albino rabbits. While awaiting for the issue of the time interval between eyedrops in humans to be further investigated, one should be cautious with extrapolation of Chrai et al.'s conclusions in the albino rabbits to humans.

PURPOSE:Patients are usually advised to wait 5 minutes between eye drops. This delay supposedly allows the first drop not to be washed out by the second one, thereby increasing the combined effect. However, in the only experimental study conducted in humans on the concurrent administration of two different eye drops, the authors concluded that a 10-minute time interval between eye drops did not increase their combined effect. Our study was designed to address this puzzling observation.METHODS:Using digital photographs shot in photopic conditions in 40 eyes of 20 healthy volunteers, we compared relative pupil surface (i.e., pupil to iris surface area ratios) before and after the administration of one drop of 10% phenylephrine and one drop of 0.5% tropicamide either immediately or after a 5-minute time interval.RESULTS:Waiting 5 minutes yielded a 5.6% relative pupil surface gain (observer 1: P = .003, observer 2: P = .005) indicating an additional combined effect with a 5-minute time interval.CONCLUSIONS:These results show a detectable additive effect that is probably the result of methodological refinements including the challenging of the mydriasis by photopic conditions and the use of pupil and iris surface areas, which may show differences that would be undetectable in terms of diameter.

Background: The purpose of this study is to provide a report on scientific production during the period 2010–2014 in order to identify the major topics as well as the predominant actors (journals, countries, continents) involved in the field of eye disease. Methods: A PubMed search was carried out to extract articles related to eye diseases during the period 2010–2014. Data were downloaded and processed through developed PHP scripts for further analysis. Results: A total of 62,123 articles were retrieved. A total of 3,368 different journals were found, and 19 journals were identified as “core journals” according to Braford’s law. English was by far the predominant language. A total of 853,182 MeSH terms were found, representing an average of 13.73 (SD = 4.98) MeSH terms per article. Among these 853,182 MeSH terms, 14,689 different MeSH terms were identified. Vision Disorders, Glaucoma, Diabetic Retinopathy, Macular Degeneration, and Cataract were the most frequent five MeSH terms related to eye diseases. The analysis of the total number of publications showed that Europe and Asia were the most productive continents, and the USA and China the most productive countries. Interestingly, using the mean Five-Year Impact Factor, the two most productive continents were North America and Oceania. After adjustment for population, the overall ranking positions changed in favor of smaller countries (i.e. Iceland, Switzerland, Denmark, and New Zealand), while after adjustment for Gross Domestic Product (GDP), the overall ranking positions changed in favor of some developing countries (Malawi, Guatemala, Singapore). Conclusions: Due to the large number of articles included and the numerous parameters analyzed, this study provides a wide view of scientific productivity related to eye diseases during the period 2010–2014 and allows us to better understand this field.

PURPOSE:Bacterial keratitis is a sight threatening infection of the cornea which remains one of the most important potential complications of contact lens use. If the corneal ulcer is small, peripheral with no impending perforation present, intensive monotherapy with fluoroquinolones could be used. Therefore, a study was conducted with the objective to provide pharmacological data of the intra-ocular diffusion after administration of Ofloxacin using a scleral lens reservoir, as well as an evaluation of surface tolerability in rabbits.MATERIALS AND METHODS:Samples of corneas, aqueous humor and vitreous were collected to measure the drug levels of Ofloxacin using High Performance Liquid Chromatography. The corneas were examined by electron microscopy scanning and the eyeballs by light polarizing microscopy in order to evaluate surface tolerability.RESULTS:Ofloxacin levels found in the aqueous humor and cornea were higher than those previously reported. The mean Ofloxacin corneal levels exceeded the MIC (Minimum Inhibitory Concentration) for which 90% of isolates are indicated for all bacteria implicated in keratitis.CONCLUSION:To our knowledge, this is the first preclinical study assessing local tolerance and intra-ocular diffusion of Ofloxacin after administration using a scleral lens reservoir.

Comparison of the efficacy of tropicamide eyedrops to the combination of 0.5% tropicamide and 5% phenylephrine eyedrops in order to achieve a proper dilation in premature infants undergoing screening for retinopathy of prematurity.

L’œdème maculaire est la principale cause de baisse de l’acuité visuelle lors des uvéites et en conditionne le pronostic visuel. Nous avons procédé à une analyse rétrospective de la tolérance et de l’efficacité de l’implant intravitréen de dexaméthasone dans sa prise en charge. Vingt-cinq patients ont été inclus, de janvier 2012 à août 2014, tous ayant reçu un implant intraoculaire de dexaméthasone–Ozurdex® pour œdème maculaire cystoïde dans le cadre d’une uvéite. Nous avons évalué la récupération de l’acuité visuelle, l’épaisseur maculaire et l’évolution de la hyalite. Cinquante-deux injections ont été réalisées sur 32 yeux. La régression totale de l’œdème maculaire survenait dans 100 % des cas ainsi que la disparition de la hyalite. L’acuité visuelle s’améliorait chez 62 % des patients ; la diminution moyenne de l’épaisseur maculaire centrale était de 252 (± 171 μm) ; la durée moyenne entre les injections était de 6,7 (± 3,8) mois. Une hypertonie post-injection a été notée dans 33 % des cas. Aucune chirurgie n’a été nécessaire sur la totalité des patients, seule une trabéculoplastie au laser SLT était nécessaire. L’implant intraoculaire de dexaméthasone–Ozurdex® permet la régression totale et constante des œdèmes maculaires cystoïdes liés aux uvéites. Il permet d’évaluer le potentiel de récupération visuelle de l’œil traité. Sa durée d’action et sa tolérance en font un traitement de choix des patients non contrôlés malgré un traitement général optimal.Macular edema is the main cause of decreased visual acuity in uveitis and determines the visual prognosis. We retrospectively analyzed the tolerability and efficacy of the dexamethasone intravitreal implant in the management of uveitis. Twenty-five patients with uveitic cystoid macular edema were all treated with the Ozurdex® dexamethasone intravitreal implant from January 2012 to August 2014. The main outcome measures were visual acuity recovery, changes in macular thickness and resolution of the vitritis. Thirty-two eyes of 25 patients received 52 injections of Ozurdex®. Both complete regression of the macular edema and resolution of the vitritis occurred in 100 % patients. Visual acuity improved in 62 % of patients: the mean reduction in macular thickness was 252 (± 171 μm); the mean time between injections was 6.7 (± 3.8) months. Secondary ocular hypertension was seen in 33 % of patients. No patient required secondary surgery although a selective laser trabeculoplasty was required for one patient. The dexamethasone intravitreal implant Ozurdex® resulted in continuous and complete regression of uveitic cystoid macular edema. It allows evaluation of the potential visual recovery of treated eyes. The tolerability and duration of action provide a rationale for considering Ozurdex® as a first-line therapy for uveitis which remains uncontrolled despite optimal systemic treatment.

Purpose. Since 2006, French general practitioners have had to carry out an ophthalmological screening for children, using a methodology contained within the child's health record (carnet de sante). The purpose of this screening is to allow an early diagnosis of sight threatening as well as potentially life-threatening conditions (e.g., retinoblastoma). The aim of the present study was to evaluate the theoretical knowledge and the clinical skills of practitioners implementing the screening, with regards to two specific items of the health record screening schedule, by means of a questionnaire.Material and methods. From December 2013 to September 2014, 42 practitioners (16 general practitioners, 14 pediatricians, 12 resident physicians) from four distinct locations in Normandy, France, were questioned using a questionnaire on two ophthalmological items of the French health record: one on red reflex and one on eyeball size.Results. Only four of 42 practitioners provided correct answers on the red reflex color. Thirty of 42 practitioners reported difficulties performing the red reflex test, mostly because they did not know the normality criteria and the purpose served by this test. Thirty-three of 42 practitioners declared that they found it difficult to know whether or not eyeball sizes were normal, mostly because they were unaware of the normality criteria. None of the practitioners provided the correct (to within +/- 1 mm) mean horizontal cornea diameter in full-term new-borns and adults.Conclusion. This study demonstrates that there is poor theoretical knowledge and a low level of clinical skill for practitioners performing the ophthalmological screening based on the French health record schedule. This schedule therefore does not seem to meet its purpose. (C) 2015 Elsevier Masson SAS. All rights reserved.

Background:The purpose of this study is to provide a report on scientific production during the period 2010-2014 in order to identify the major topics as well as the predominant actors (journals, countries, continents) involved in the field of eye disease.Methods: A PubMed search was carried out to extract articles related to eye diseases during the period 2010-2014.Data were downloaded and processed through developed PHP scripts for further analysis.Results: 62 123 articles were retrieved.3 368 different journals were found, and 19 journals were identified as "core journals" according to Braford's law.English was by far the predominant language.853 182 MeSH terms were found, representing an average of 13.73 (SD=4.98)MeSH terms per article.Among these 853 182 MeSH terms, 14 689 different MeSH terms were identified.Vision Disorders, Glaucoma, Diabetic Retinopathy, Macular Degeneration, and Cataract were the most frequent five MeSH terms related to eye diseases.The analysis of the total number of publications showed that Europe and Asia were the most productive continents, and the USA and China the most productive countries.Interestingly, using the mean Five-Year Impact Factor, the two most productive continents were North America and Oceania.After adjustment for population, the overall ranking positions changed in favor of smaller countries (i.e.Iceland, Switzerland, Denmark, and New Zealand), while after adjustment for Gross Domestic Product (GDP), the overall ranking positions changed in favor of some developing countries (Malawi, Guatemala, Singapore).Conclusions : Due to the large number of articles included and the numerous parameters analyzed, this study provides a wide view of scientific productivity related to eye diseases during the period 2010-2014 and allows us to better understand this field.

Les membranes épimaculaires (MEM) idiopathiques se développent classiquement chez des patients âgés de plus de 50 ans. Le décollement postérieur du vitré jouerait un rôle dans leur formation. Les MEM idiopathiques sont rares chez le sujet jeune. Le traitement est chirurgical en cas de gêne fonctionnelle avérée.Nous rapportons une série de 3 cas ayant présenté un pelage spontané de membrane épimaculaire au cours du suivi, imagés par tomographie en cohérence optique.Tous les patients ont décrit une amélioration des signes fonctionnels au décours du pelage spontané de la membrane épimaculaire. La récupération anatomique avec réapparition d’une dépression fovéolaire était constatée en tomographie par cohérence optique.Une période d’observation plus longue pourrait être indiquée chez les patients jeunes présentant une membrane épimaculaire compte tenu d’un taux a priori plus élevé de pelage spontané.Idiopathic epiretinal membranes most commonly develop in patients over 50 years of age. Posterior vitreous detachment seems to play a role in their formation. Epiretinal membranes are uncommon in young subjects. Surgical intervention is indicated in eyes with true functional symptoms and loss of visual acuity.We report 3 cases with spontaneous separation of epiretinal membranes imaged by Optical Coherence Tomography.All patients reported improvement in functional symptoms after spontaneous separation of the epiretinal membrane. Anatomic recovery with reappearance of the foveolar depression was observed on Optical Coherence Tomography.A longer period of observation may be indicated in young patients with epiretinal membrane, due to the higher rate of spontaneous separation.