CRISPR-Cas9 gene editing has emerged as one of the most promising strategies in precision medicine applied to ophthalmology. Although its initial development focused on inherited retinal diseases, recent advances have increasingly targeted anterior segment disorders, including herpetic keratitis, hereditary corneal dystrophies, and genetically associated glaucoma. The ability to modify specific DNA or RNA sequences enables direct intervention in molecular pathways involved in inflammatory, degenerative, and infectious disease progression. This review summarizes the biological basis of CRISPR-Cas systems and discusses the main preclinical and translational findings related to corneal and glaucomatous diseases. Current limitations, including off-target effects, immunogenicity, and challenges associated with molecular delivery into ocular tissues, are also addressed. Available evidence suggests that CRISPR-Cas9 may significantly transform the future management of multiple anterior segment diseases.

This review aims to evaluate the factors affecting the accuracy of intraocular lens (IOL) power calculation and the strategies to optimize refractive predictability in eyes with atypical anatomy, prior refractive surgery, or phakic intraocular lenses. A narrative review of studies was conducted using PubMed, Scopus, and Web of Science up to March 2026, following PRISMA methodology. Articles were independently screened and reviewed by two authors. Studies on IOL calculation in normal and non-standard eyes, post-corneal refractive surgery, phakic IOLs, and refractive lens exchange were included. In axial myopia, new-generation formulas or third-generation formulas with Wang-Koch adjustment can compensate for the historical tendency toward hyperopic errors in these eyes. In short eyes, new-generation formulas outperform third-generation formulas, particularly in cases with shallow anterior chambers. The use of toric IOL calculators that adjust implant toricity at the corneal plane based on the effective lens position and account for posterior corneal astigmatism appears to improve outcomes. In eyes with high or non-vertical posterior corneal astigmatism, it may be beneficial to use IOL calculation methods that consider the effect of implant position. After myopic refractive surgery, the ASCRS calculator average or post-refractive versions of modern formulas may be valid options. In patients with phakic IOLs, it is recommended to ensure correct crystalline lens identification or to use formulas that do not rely on anterior chamber depth if measurement errors are significant. In conclusion, refractive predictability depends on ocular anatomy, prior surgery, and IOL characteristics. New-generation formulas generally outperform third-generation formulas in non-standard eyes, although the optimal choice varies by cohort. Selecting an appropriate calculation formula and carefully verifying biometric data are essential to improving refractive accuracy in refractive lens exchange.

The involvement of both the central and peripheral nervous systems in Mycoplasma pneumoniae infection is rare. We report a patient who developed bilateral optic neuritis and Guillain-Barré syndrome (GBS) following a Mycoplasma pneumoniae infection. A 32-year-old man presented with progressive weakness, ataxia, and dysphagia after a recent respiratory infection. Clinical, cerebrospinal fluid, and neurophysiological findings were consistent with GBS, and treatment with intravenous immunoglobulin was initiated. Two days later, the patient developed visual loss, and post-infectious autoimmune optic neuritis was diagnosed. Treatment with methylprednisolone and plasmapheresis led to significant neurological and visual recovery. At one-year follow-up, the patient had full neurological recovery and maintained 20/20 visual acuity in both eyes. This case illustrates the rare coexistence of GBS and optic neuritis and highlights that, despite severe presentation, timely diagnosis and immunotherapy can result in excellent long-term outcomes.

This case describes a delayed bilateral posterior pole inflammation with secondary choroidal neovascularization (CNV) occurring after discontinuation of dual immune checkpoint inhibition (ICI) for metastatic cutaneous melanoma. A 53-year-old man presented with sudden visual loss five months after his last ICI infusion. Although symptoms were initially unilateral, fundus examination and multimodal imaging revealed bilateral posterior pole involvement, with an active CNV and retinal pigment epithelium (RPE) disturbances in both eyes. Intravitreal anti-vascular endothelial growth factor (anti-VEGF) monotherapy in one eye and corticosteroid monotherapy in the other provided limited benefit. Combined therapy achieved partial anatomical improvement but limited functional visual recovery, particularly in the initially symptomatic eye. In conclusion, this case highlights that ICI-associated inflammatory chorioretinopathy with VKH-like features may present late and progress despite treatment discontinuation, underscoring the role of multimodal imaging in guiding targeted management.

Ocular bee stings are uncommon injuries that may cause a wide spectrum of clinical manifestations depending on the affected structure. We report a case of conjunctival bee sting with successful complete removal of the stinger, followed by a favorable clinical outcome. Clinical images illustrating the stinger in situ and after removal are presented. Current literature suggests that although immediate removal is recommended, retained stingers may occasionally be well tolerated.

Human Dirofilaria infection is increasingly reported in Europe, driven by rising temperatures and the expansion of ecological niches suitable for its mosquito vectors. We report the case of a 20-year-old woman with ocular involvement after volunteering during the clean-up following the October 2024 DANA (Isolated High-Level Depression) floods in Valencia, Spain. The nematode was initially observed in the upper eyelid, later migrating to the subconjunctival space and ultimately forming an infrapalpebral subcutaneous nodule. We highlight the diagnostic challenge posed by the parasite's continuous migration, which hindered its visualization during examinations and therefore delayed its isolation and definitive identification.

Orbital spindle cell tumors with neural differentiation represent an uncommon and diagnostically challenging entity in clinical practice. We report the case of an 82-year-old man with a history of treated rectal adenocarcinoma, who presented with progressive orbital pain and right-sided proptosis. Computed tomography revealed a soft tissue mass located at the orbital apex, without evidence of bone erosion. Orbital exenteration was performed, and histopathological examination demonstrated an infiltrative high-grade spindle cell neoplasm with a fascicular growth pattern, moderate pleomorphism, and increased mitotic activity. Immunohistochemical analysis showed diffuse positivity for S100 and SOX10, with negative staining for melanocytic, muscular, epithelial, and vascular markers. The Ki-67 proliferative index was elevated (approximately 50%). H3K27me3 immunostaining was not available. Overall, the morphological and immunophenotypic findings were consistent with a spindle cell neoplasm with neural differentiation, suggestive of a malignant peripheral nerve sheath tumor (MPNST, malignant peripheral nerve sheath tumor). This case highlights the diagnostic limitations of these neoplasms in the absence of molecular confirmation and underscores the importance of clinicoradiologic-pathologic correlation in anatomically complex locations such as the orbit. This case emphasizes that, in the absence of molecular confirmation, the diagnosis of MPNST should be considered as an integrative hypothesis based on multidisciplinary correlation. From a surgical standpoint, this case underscores the role of radical procedures such as orbital exenteration in infiltrative orbital apex tumors with suspected high-grade malignancy and extensive involvement of deep orbital structures and neurovascular compromise.

The aim of this study was to evaluate the safety and efficacy of the intracameral antibiotics vancomycin, cefuroxime, and moxifloxacin, as well as the need for topical antibiotics preoperatively, postoperatively, or both. A systematic review and meta-analysis were conducted using PubMed to compare their efficacy in cataract surgery performed by phacoemulsification. We also assessed the additional benefit of topical antibiotics in preventing endophthalmitis when intracameral antibiotics and povidone-iodine were used. All included studies supported the use of intracameral antibiotics at the end of surgery. The results were more favourable for moxifloxacin and vancomycin than for cefuroxime, although no statistically significant differences were found. In addition, the secondary analysis showed no additional benefit from the perioperative use of topical antibiotics. Intracameral antibiotic injection is a safe and effective measure for the prevention of endophthalmitis following phacoemulsification. The use of vancomycin remains controversial. Furthermore, postoperative topical antibiotics do not appear to provide any additional benefit when intracameral antibiotics are administered.

This narrative review aimed to explore the evidence on photic phenomena (PP) and positive dysphotopsia (PD) associated with simultaneous vision intraocular lenses (SVIOLs), with particular emphasis on refractive lens exchange (RLE) and the functional classification framework. A structured PubMed search identified systematic reviews and meta-analyses reporting PP/PD outcomes, and these findings were integrated with stratified analyses from the IOLEvidence database, restricted to standard, non-toric IOL studies in populations without comorbidities. Evidence syntheses consistently indicate lower rates of halos and dysphotopsia with monofocal and enhanced monofocal IOLs and higher frequencies with Full-DOFi designs, although heterogeneity and inconsistent PP/PD definitions limit pooled inferences. Category-based analyses suggest that Narrowed and Enhanced lenses show lower halo frequency than Full-DOFi lenses, while Extended designs demonstrate intermediate outcomes with substantial overlap. Within-category variability, particularly in the Extended group, indicates that optical design (refractive versus diffractive) may influence PP/PD more strongly than the achieved DOFi. Stratified analyses using IOLEvidence enable earlier, model-specific comparisons that anticipate clinically relevant differences before conventional meta-analyses detect them. In RLE, where preoperative lens clarity and patient expectations differ from cataract populations, preoperative symptom assessment and objective optical-quality metrics might be critical to manage postoperative dysphotopsia patient expectations.

Nutrition plays a crucial role in the prevention and management of dry eye disease (DED. Polyunsaturated fatty acids ω-3 and ω-6, known for their anti-inflammatory properties, improve ocular surface health. Similarly, antioxidants found in diets like the Mediterranean diet stabilize the tear film and reduce oxidative stress (OXs); however, food additives can negatively impact both general health and DED. The gut microbiome and the gut-eye axis play a critical role, as gut dysbiosis amplifies systemic inflammation, disrupts immune balance, and diminishes the production of protective metabolites such as short-chain fatty acids. The ocular microbiome further supports homeostasis and immunity by safeguarding against external pathogens. Factors such as diet, aging, and antibiotic use negatively impact microbial diversity. Probiotics, prebiotics, and fecal microbiota transplantation are emerging microbiota-targeted strategies for dry eye disease. However, current evidence remains limited and is largely based on preclinical and preliminary clinical studies, highlighting the need for further controlled investigations to better define their therapeutic role and clinical applicability.