Anecdotal evidence suggests that eyelid disorders are common, although estimates of prevalence vary. The current study determined the prevalence of eyelid disorders, meibomian gland dysfunction (MGD) and related diseases (specifically ocular surface disease) in a population of patients presenting for routine ophthalmologic consultations. This cross-sectional epidemiologic survey evaluated patients presenting for routine ophthalmic visits. During the consultation, an ophthalmologist completed a questionnaire, and each patient underwent an ophthalmic examination and completed a quality of life questionnaire.

A total of 349 ophthalmologists, recruited from 11 countries, provided data on 6,525 patients. Patients were predominantly females (61.6%). The mean age of the study population was 57.0 ± 17.6 years. Eyelid disorders were diagnosed in 5,109 (78.3%) patients and were statistically associated with: atopic dermatitis, seborrheic dermatitis, dry eye, age-related macular degeneration, diabetes, cataract, allergy and MGD. Eyelid abnormalities were identified in 59.6% of patients; conjunctival or corneal abnormalities were observed in 64.9% and 28.1% of patients, respectively. MGD was diagnosed in 54.3% patients and was statistically significantly associated with the presence of eyelid disorders and eyelid margin abnormalities. Dry eye was diagnosed in 61.8% of patients. Concurrent dry eye and MGD were present in 67.6% of patients. Most patients reported some degree of impaired vision and daily/work activities related to dry eye. Impact on contact lens usage, emotions and quality of sleep was also reported. The effects on daily life were associated with the presence of MGD.

In conclusion, eyelid disorders were highly prevalent in this “real-world” population of patients from ophthalmology clinics. Routine ophthalmologic consultation provides an opportunity to improve patient quality of life and to modify topical therapy in patients who may be predisposed to eyelid disorders.

These researchers examined intraocular pressure (IOP) measurement disagreement between technicians and physicians, and the impact of an educational intervention on the short and long-term disagreement in IOP measurement using Goldmann applanation tonometry. This study was conducted at a glaucoma clinic at a university hospital with six technicians and two physicians. An educational intervention was implemented for the technicians to try to improve IOP measurement agreement with physicians. Frequency of IOP measurement disagreement between physicians and technicians, defined as a difference in IOP of >2 or >3 mmHg and assessed at baseline, immediately and six months post-intervention were evaluated.

IOP was evaluated for a total of 529 eyes (physician measured mean IOP=16.4 mmHg [SD=5.9]), 30 per technician-physician pair for each data collection period: baseline, immediately post-intervention and six months post-intervention. At baseline, physicians disagreed 17% and 7% of the time when measuring IOP using >2 and >3 mmHg to define disagreement, respectively, while the average disagreement between technicians and physicians was 25% and 13%. Disagreement was greater at IOPs over 20 mmHg. No significant changes were noted in the frequency of disagreement between technicians and physicians immediately or six months post-intervention.

Two physicians measuring the same patient in the same room disagreed by >2 mmHg in 17% of patients' eyes, and this amount of disagreement was even higher when comparing physicians to certified technicians. An educational intervention did not improve agreement in IOP measurements between technicians and physicians. This highlighted an important limitation of Goldmann tonometry.

Researchers wrote that posterior capsular opacification (PCO) is the most common complication after cataract surgery. They aimed to assess the relationship between intraocular lens (IOL) diopter and formation of PCO among a consecutive real-world registry. Included were 14,264 consecutive cases of uncomplicated cataract surgery performed from 2014 to 2018 in Helsinki University Hospital in Finland. Nd:YAG capsulotomies were used as an estimate of clinically significant PCO. A single eye of each patient and a single type of IOL were included.

Mean age was 73.2 ± 9.9 years and 61.8% were female. Mean follow-up time was 25.4 ± 16.8 months. Overall PCO rates were 1.1% at one year, 3.0% at two years, 7.1% at three years and 10.2% at four years. Patients with IOL diopters (D) in the lower quartile (≤ 20.0D) had significantly higher rates of PCO (1.3% at one year, 4.4% at two years, 9.4% at three years and 14.2% at four years). A logistic regression model showed increased risk for PCO formation with lower diopter IOLs; for ≤20.0D: OR 1.343 (95% CI: 1.132 to 1.593), for ≤10.0D: OR 2.409 (95% CI: 1.203 to 4.287), p<0.001 for all comparisons. In a multivariant regression accounting for possible confounders, results remained consistent.

Among a cohort of patients undergoing cataract surgery, use of lower diopter IOLs was associated with increased incidence of clinically significant PCO. Researchers suggested that research into IOL biomechanics to decrease PCO may be warranted especially in lower diopter IOLs.