Obstructive sleep apnea (OSA) is a disease of obstructed airways during sleep that significantly impacts the quality of life and increases the risk of various systemic diseases.

The authors wrote that OSA has been studied as a risk factor for a number of neuro-ophthalmic conditions and a strong relationship has been established with non-arteritic anterior ischemic optic neuropathy (NAION). The incidence of glaucoma and stroke have also been significantly associated with OSA and are conditions that may also be seen by neuro-ophthalmologists, they added. Patients with NAION have a significantly higher incidence of OSA, and OSA diagnosis significantly increases the risk for NAION development, they also noted. Non-compliance with continuous positive airway pressure (CPAP) in OSA patients has also been found to be a risk factor for fellow-eye involvement. and there is increasing evidence to suggest that every patient with NAION should be formally evaluated with polysomnography, the authors continued. The relationship between OSA and idiopathic intracranial hypertension (IIH) has also been studied, but the relationship between these two conditions is less clear.

The authors reported that there is insufficient evidence to recommend routine eye examinations in OSA patients for papilledema, and conducting a sleep study for a newly diagnosed IIH patient should be left to the discretion of the clinician based on other symptoms and risk factors of OSA.

Students ages four to 16 in 41 Baltimore City schools were screened using distance visual acuity (VA) and photoscreening to compare the vision needs of children wearing and not wearing eyeglasses who failed school-based vision screening. Students failing screening underwent school-based, non-cycloplegic examination. They compared students who were wearing eyeglasses at failed screening with those not wearing eyeglasses with respect to age, sex, right-eye refractive error, right-eye presenting and best-corrected VA (BCVA).

A total of 2,176 students failed screening and completed the examination; 94 (4.3%) failed while wearing eyeglasses. Students wearing eyeglasses were older (mean age 10.2 vs. 8.8 years). Myopia (72.3% vs 46.0%), severe myopia, ≥6.00 spherical equivalent diopters (D) (9.6% vs. 1.8%), astigmatism (66.4% vs. 50.8%) and severe astigmatism, and ≥3.00D of cylinder (14.9% vs. 7.0%) were more common in students wearing eyeglasses. The prescription rate was higher for students wearing eyeglasses at failed screening compared with those not (95.7% vs. 80.4%). About 4% of the children in both groups required referral to community providers for non-refractive pathology, such as strabismus or amblyopia.

Researchers wrote that children who failed vision screening while wearing eyeglasses nearly always needed an updated prescription and had more severe refractive errors than those not wearing eyeglasses. However, they added, the community referral rate was the same for both groups. Researchers concluded that school-based programs can support children currently wearing eyeglasses that may be incorrect or outdated.

The coronavirus disease 2019 (COVID-19) represents a global concern of public health, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Its clinical manifestations are characterized by a heterogeneous group of symptoms and pictures (ranging from asymptomatic to lethal courses). The prevalence of conjunctivitis in patients with COVID-19 is at present controversial. Although it has been reported that only 0.9% developed signs of conjunctivitis, other report indicates that up to 31.6% of hospitalized patients had conjunctivitis. Considering the widespread use of topical ophthalmic medications (e.g., eye drops) by the general population, for various reasons (e.g., artificial tears, anti-glaucoma medications, topical antibiotics, etc.), the authors wrote that the existence of their side effects as antiviral action should be investigated in-depth because it could possibly explain the aforementioned controversial data and represent a potential antiviral treatment for SARS-CoV-2 replication/diffusion on the ocular surface.

The authors discussed the antiviral side effect of a number of eye drops and ophthalmic ointments commonly used for others purposes, thus showing that these secondary effects (not to be confused with the “adverse effects”) might be of primary importance in a number of viral infections (e.g., those for which there is no validated treatment protocol), according to a drug repurposing approach.

Some active ingredients or excipients described have activity against other types of viruses, thus suggesting potential broad-spectrum applications.