University of Calgary Visual Sciences & Ophthalmology Research Day 2026

Purpose: Digital periocular measurements commonly use corneal white-to-white (WTW) distance to calibrate photographic measurements such as MRD1 and MRD2; however, this approach may introduce error because of natural inter-individual variation in WTW. We compared two methods for scale standardisation in digital periocular photography: a 10 mm forehead reference sticker and optical biometer-derived WTW.

Methods: In this retrospective method-comparison study, 100 patients seen in an oculoplastics clinic underwent bilateral WTW measurement using an optical biometer (Zeiss IOLMaster) and digital photography incorporating a blue 10 mm forehead sticker. Agreement between methods was assessed in Python using correlation analysis and Bland-Altman plots.

Results: Mean right-eye WTW was 11.98 ± 0.45 mm with optical biometry and 11.25 ± 0.53 mm with the sticker method. Mean left-eye WTW was 11.90 ± 0.48 mm and 11.31 ± 0.56 mm, respectively. Measurements were strongly correlated between methods (p < 0.0001). Bland-Altman analysis showed a consistent positive bias, with optical biometer measurements exceeding sticker-derived measurements by a mean of 0.73 mm in right eyes and 0.59 mm in left eyes. Conclusions: A 10 mm forehead reference sticker is a practical, low-cost method for standardising digital periocular measurements. Compared with reliance on WTW-based scaling, it may better account for anatomical variability and reduce systematic calibration error in derived periocular measurements.

Purpose: To characterize the epidemiology of pediatric retinal injuries presenting to United States emergency departments (EDs).

Methods: A retrospective analysis of pediatric ocular trauma (ages 0–17) was conducted using the National Electronic Injury Surveillance System (NEISS) from 2005 to 2024. Cases were confirmed through a narrative review to isolate retinal pathologies. National incidence was estimated using complex survey weighting. Developmental transitions in injury mechanism were evaluated using Rao-Scott chi-square testing and multivariable logistic regression.

Results: Among 171 confirmed cases, an estimated 3,060 ED visits occurred nationwide over 20 years. Injuries predominantly affected males (72.8%), with a mean age of 12.5 ± 3.2 years. Early adolescents (10–14) represented the largest cohort (45.6%). Commotio retinae (26.2%) and retinal detachment (14.9%) were the most frequent diagnoses. Soccer was the most common activity (33.3%), followed by basketball (8.1%), football (7.3%), and baseball (6.3%). A developmental shift in injury mechanisms was observed (P=0.008): injuries in children aged 0-4 were exclusively related to household objects and domestic accidents, whereas soccer predominated among adolescents aged 15–17 (54.9%). Soccer was not associated with an increased risk of retinal detachment compared with other mechanisms (aOR 0.44; 95% CI: 0.09–2.19; P=0.30). Annual incidence did not significantly change over time (ρ=0.30; P=0.20).

Conclusions: Pediatric retinal injuries presenting to EDs are largely sports-related, with soccer as the leading mechanism in adolescents. A clear developmental shift from domestic to athletic injuries suggests that prevention strategies should be age-specific, emphasizing home safety in young children and protective eyewear in youth sports.

Purpose: Central retinal artery occlusion (CRAO) is a vision-threatening emergency with rapidly declining treatment efficacy after symptom onset. Optical coherence tomography (OCT) can detect retinal changes, often before fundus signs become apparent. This study systematically reviewed OCT retinal thickness as a diagnostic and prognostic biomarker in CRAO.

Methods: We searched Ovid MEDLINE, Embase, CENTRAL, and Web of Science through February 3, 2026, for studies reporting quantitative OCT measurements of CRAO. Primary outcomes were CRAO-fellow eye thickness differences, diagnostic accuracy for classifying onset <4.5 hours, and associations between baseline thickness and final best-corrected visual acuity (BCVA). Random-effects meta-analyses pooled differences and correlations. Results: Twenty-three studies including 1,036 CRAO eyes were included. Within 0–7 days, CRAO eyes showed greater thickness than fellow eyes. Central foveal thickness (CFT) was higher by 61.9 µm (95% CI, 39.0–84.8; I2=67.9%; k=7), while central macular thickness (CMT) showed an imprecise increase of 62.8 µm (95% CI, −25.7 to 151.3; I2=63.4%; k=3). Greater baseline thickness correlated with poorer final vision: r=0.39 for CFT and r=0.42 for CMT. Two studies evaluated onset <4.5 hours, with sensitivity of 96.2% and specificity of 91.5%. Conclusions: OCT shows foveal thickening in acute CRAO and moderate, unadjusted associations between baseline thickness and worse visual outcomes. Evidence for thickness-based early-onset classification is promising but limited. Retinal thickness should be interpreted as an adjunctive marker of ischemic injury rather than a stand-alone diagnostic tool.

Purpose: Gender disparities persist in ophthalmology, with women underrepresented in leadership and academia due to multifactorial barriers. Mentorship is an important contributor to professional development, yet female trainees and early-career ophthalmologists may have limited access to meaningful mentorship. This study explored mentorship experiences among Canadian female-identifying ophthalmologists and residents and assessed interest in a national mentorship program.

Methods: An online cross-sectional survey was distributed to female-identifying ophthalmologists and trainees across Canada from October 2025 to January 2026. Survey questions assessed interest in a formal mentorship program, preferences for matching and program format, and priority areas for mentees and mentors. Quantitative data were analyzed using descriptive statistics and Mann-Whitney U tests. Free-text responses were analyzed using thematic coding.

Results: A total of 68 participants provided consent, including 26 trainees and 42 practicing ophthalmologists. Most respondents were from Western Canada (57%; British Columbia, Alberta, Saskatchewan, or Manitoba). Interest in mentorship pairing was high, with 69% of participants responding “yes.” Participants preferred cross-province pairing (74%), check-ins every 2–3 months (45%), and remote or virtual formats (57%). Mentees and mentors reported similar levels of agreement regarding the need for a pan-Canadian mentorship program (p=0.136). However, there was a significant difference between groups regarding ease of accessing meaningful female mentorship (p=0.02).

Conclusions: Canadian women in ophthalmology expressed strong interest in a national mentorship program with flexible matching, virtual meetings, and cross-province pairings. These findings may inform future mentorship initiatives supporting career development, transitions, and work-life integration.

Purpose: To compare the induction of corneal higher-order aberrations (HOAs) after photorefractive keratectomy (PRK) versus laser-assisted in situ keratomileusis (LASIK) for myopia and examine the influence of ablation profile and excimer laser platform.

Methods: MEDLINE, Embase, CENTRAL, Web of Science, CINAHL, and PubMed were searched from inception to 2 September 2025 for comparative PRK versus LASIK studies reporting corneal HOA outcomes. Two reviewers independently screened studies, extracted data, and assessed risk of bias using ROBINS-I. Random-effects meta-analyses were performed for total corneal HOA root-mean-square (RMS) and corneal spherical aberration, with prespecified subgroup and leave-one-out sensitivity analyses.

Results: Ten studies met the inclusion criteria. Eight studies (751 PRK eyes and 608 LASIK eyes) contributed to the pooled analysis of induced total corneal HOA RMS, showing a small but significant effect favouring PRK (mean difference [MD] −0.04 μm, 95% CI −0.06 to −0.02; I² = 79%). The effect remained directionally consistent for wavefront-optimized (MD −0.05 μm, 95% CI −0.08 to −0.02) and aspheric/aberration-free profiles (MD −0.09 μm, 95% CI −0.17 to −0.02). Corneal spherical aberration did not differ overall (MD 0.00 μm, 95% CI −0.03 to 0.03; I² = 59%), although excluding outlying Russo 2021 data yielded a small effect favouring LASIK. Vertical coma generally increased more after LASIK.

Conclusions: PRK is associated with a small reduction in induced total corneal HOAs compared with LASIK, although the magnitude of the difference is modest and its clinical significance is uncertain. Spherical aberration appears similar between procedures, while vertical coma may increase after LASIK.

Purpose: To synthesize evidence on ophthalmic health disparities among newcomers to Canada, including barriers to care, screening uptake, disease burden, and care outcomes.

Methods: Following PRISMA guidelines (PROSPERO CRD42024572584), eight databases were searched from inception to March 2026 for Canadian studies on newcomer populations and ophthalmic care disparities, disease burden, and outcomes. Two reviewers independently screened studies and extracted data, with disagreements resolved by a third reviewer. Risk of bias was assessed using ROBINS-I V2, the Critical Appraisal Skills Program checklist, or the Joanna Briggs Institute Checklist. Qualitative and mixed-methods findings on barriers were thematically synthesized. Screening uptake data were pooled using a random-effects Mantel-Haenszel model; heterogeneity was assessed using I² and τ².

Results: Of 3,800 records, 19 studies met the inclusion criteria, and five contributed to the meta-analysis. Most focused on immigrants and were conducted in Ontario. Access to care was the dominant outcome domain. Key barriers included language and communication challenges, limited health literacy and navigation, financial constraints, and transportation- or time-related barriers. Immigrants were less likely than non-immigrants to undergo vision screening (odds ratio 0.69, 95% confidence interval 0.61 to 0.77). Evidence on ocular disease burden was limited and heterogeneous, though several studies reported unmet eye-care needs and elevated visual impairment among refugee and immigrant populations.

Conclusions: Newcomers face linguistic, financial, and systems-level barriers to ophthalmic care in Canada. Lower screening uptake among immigrants highlights persistent inequities in access. Targeted, culturally informed interventions, including outreach, navigation support, and equitable coverage of vision services, are needed to improve access and outcomes.

Purpose: To evaluate whether selective serotonin reuptake inhibitor (SSRI) use is associated with retinal vein occlusion (RVO) and its major subtypes, branch RVO (BRVO) and central RVO (CRVO).

Methods: A retrospective cohort study was conducted using the All of Us Research Program database. Adults aged ≥40 years with antidepressant exposure were included: 28,397 SSRI users and 10,520 non-SSRI comparator patients. SSRI exposure required ≥2 distinct prescriptions. Multivariable logistic regression adjusted for age, sex, smoking, hypertension, diabetes mellitus, hyperlipidemia, and glaucoma.

Results: Among 38,917 participants, 216 RVO events occurred: 58 BRVO, 103 CRVO, and 55 unspecified/other RVO diagnoses. RVO occurred in 160 SSRI users (0.56%) and 56 comparators (0.53%). SSRI use was not independently associated with overall RVO (OR 1.12, 95% CI 0.83–1.53, p=0.46). Increasing age (OR 1.07/year, p<0.001), smoking history (OR 1.62, p=0.003), and hyperlipidemia (OR 1.72, p=0.005) were independently associated with RVO. SSRI use was associated with higher odds of CRVO (OR 1.67, 95% CI 1.02–2.72, p=0.041), but not BRVO (OR 1.11, p=0.73). Hypertension was independently associated with BRVO, while smoking, hyperlipidemia, and glaucoma were independently associated with CRVO. Conclusions: SSRI use was not independently associated with overall RVO in this active-comparator cohort. Exploratory subtype analyses suggested a possible association with CRVO, but not BRVO, indicating differing associations across RVO subtypes.

Purpose: To evaluate the real-world baseline characteristics, 12-month efficacy, and safety profile of intravitreal pegcetacoplan and avacincaptad pegol for geographic atrophy (GA) secondary to age-related macular degeneration (AMD).

Methods: This study was prospectively registered (CRD420251174114). MEDLINE, Embase, and Cochrane CENTRAL were searched from inception to January 14, 2026, to identify observational studies reporting on real-world use of pegcetacoplan and avacincaptad pegol. Random-effects meta-analyses were conducted to estimate pooled proportions, mean differences in continuous outcomes for 12-month efficacy, and annualized incidence rates, alongside ROBINS-I and GRADE bias and evidence appraisals.

Results: Eight observational studies (1,879 patients; 2,488 treated eyes) were included. Real-world cohorts demonstrated high baseline disease burden, yielding pooled rates of subfoveal involvement [42.5%, 95% CI (20.1–68.4%); I²: 96.3%], multifocal morphology [55.2%, 95% CI (48.7–61.5%); I²: 0.0%], and concurrent fellow-eye neovascular AMD [43.1%, 95% CI (36.9–49.6%); I²: 0.0%]. At 12 months, pooled absolute GA lesion growth was 0.91 mm² [95% CI (0.60–1.21), I²: 85.7%] and visual acuity declined by 0.07 logMAR [95% CI (-0.096 to -0.044), I²: 28.7%]. Annualized conversion to neovascular AMD was 12.02 events per 100 eye-years [95% CI (10.02–14.44), I²: 18.4%]. Intraocular inflammation risk was 0.32% [95% CI (0.16–0.64%), I²: 0.0%], contributing to an all-cause discontinuation rate of 2.42% [95% CI (1.09–5.30%), I²: 67.5%].

Conclusions: Low-to-very-low-certainty evidence estimates the pooled baseline characteristics, 12-month efficacy, and safety of real-world pegcetacoplan and avacincaptad pegol use. These results may assist ophthalmologists in counseling patients about anticipated outcomes before initiating therapy.

Purpose: To evaluate the effectiveness of selective laser trabeculoplasty (SLT) as primary treatment in reducing intraocular pressure (IOP) in treatment-naïve patients in a community ophthalmology practice, and to identify predictors of treatment failure.

Methods: A retrospective chart review was conducted on 411 treatment-naïve eyes undergoing SLT between 2020 and 2023 in a single community practice in Saskatchewan. Eligible patients had newly diagnosed, untreated primary open-angle glaucoma, ocular hypertension (OHT), glaucoma suspect, or other open-angle glaucoma subtypes. Patients received up to two rounds of 180-degree SLT; data following escalation to additional treatment were excluded. Target IOP was determined per Canadian Target IOP workshop guidelines based on disease severity. Eyes were stratified into success (target reached after one or two SLT sessions), failure after one SLT without retreatment, and failure after two SLTs. ANOVA, chi-square, t-tests, and multivariable logistic regression were used.

Results: SLT achieved target IOP in 245 eyes (59.6%); 126 (30.7%) failed a single session without retreatment, and 40 (9.7%) failed two. Success was associated with younger age (62.7 vs 66.1 years, p=0.016), higher baseline IOP (25.6 vs 22.3 mmHg, p<0.001), OHT, and early disease (both p<0.001). On multivariable regression, moderate (OR 6.15, p=0.001) and advanced glaucoma (OR 8.25, p<0.001), lower baseline IOP (OR 0.82, p<0.001), and greater central corneal thickness (OR 1.007, p=0.026) independently predicted failure. Conclusions: SLT is an effective primary therapy for treatment-naïve glaucoma patients in community practice, particularly those with early disease, OHT, and higher baseline IOP. Advanced severity and lower baseline IOP predict failure.

Purpose: Uveal melanoma (UM) is the most common primary intraocular malignancy and is commonly treated surgically. Although tumour control is high, patients may experience postoperative visual impairment, psychological distress, and treatment-related symptoms. Preoperative rehabilitation aims to improve surgical tolerance and recovery. Enhanced Recovery After Surgery (ERAS) pathways have improved outcomes in other surgical specialties, but no UM-specific ERAS guidelines exist. This review synthesized UM guideline recommendations on preoperative optimization and appraised the supporting evidence.

Methods: Medline, Embase, and Cochrane were systematically searched from inception to August 2025 for UM clinical guidelines published within the past seven years, supplemented by targeted searching. Eligible guidelines were reviewed for preoperative recommendations. Guidance was categorized by intervention type and graded using SIGN Grading System (1999–2012).

Results: Eight guidelines (2019-2025) met inclusion criteria. Most emphasized non-recovery-focused preoperative management: six (75%) addressed prognostication, and four (50%) addressed cancer staging. These recommendations were deemed Grade A, reflecting directly applicable and overall consistent evidence. Six (75%) guidelines provided no recommendations on interventions intended to enhance recovery. Two (25%) discussed preoperative patient education, psychosocial support, and care coordination, while one (12.5%) also addressed symptom management and nutrition. Recovery-related recommendations were graded as Good Practice Points or Grade D, likely reflecting clinical experience, patient surveys, or limited cited evidence.

Conclusions: Current UM guidelines emphasize survival-focused preoperative management, with limited recovery-focused guidance. Many preoperative care recommendations reflect general best practices across the disease course rather than interventions timed before surgery, warranting research on UM-specific ERAS strategies to improve patient outcomes.

Purpose: Femtosecond laser-assisted cataract surgery (FLACS) automates capsulotomy, lens fragmentation, and corneal incisions, theoretically improving IOL centration and reducing higher-order aberrations (HOAs). Whether these advantages translate into measurable optical benefits over conventional phacoemulsification remains uncertain. We conducted a systematic review and meta-analysis to compare postoperative HOAs between FLACS and phacoemulsification.

Methods: MEDLINE, Embase, ProQuest, WebofScience, CENTRAL, CINAHL, and Scopus were searched without language or date restrictions for comparative studies reporting wavefront-derived HOA outcomes. Mean differences (MD) with 95% confidence intervals were pooled using a random-effects model. Sensitivity analyses assessed the influence of outlying studies on heterogeneity.

Results: Eleven studies were included. FLACS yielded significantly lower corneal HOAs (MD = -0.11µm; 95% CI: −0.19 to −0.03; P=0.01; I²=42%) and internal HOAs (MD = −0.15µm; 95% CI: -0.26 to -0.03; P=0.01; I²=72%) compared to conventional phacoemulsification. Total ocular HOAs did not differ significantly in the primary analysis (MD = −0.07µm; P=0.11; I²=58%); however, sensitivity analysis excluding a high-leverage outlier yielded a significant reduction with FLACS (MD = -0.09µm; P=0.03). Ocular trefoil was also significantly lower (MD = -0.05µm; P=0.001). Coma and spherical aberration showed no significant differences.

Conclusions: FLACS is associated with a modest reduction in corneal and internal HOAs compared to conventional phacoemulsification; however, these differences do not consistently translate into reduced total ocular aberrations. Modest effect sizes and substantial heterogeneity suggest limited optical advantage for most patients, though benefits may be clinically relevant with premium IOL implantation.

Purpose: To evaluate provider card accessibility through quantitative typographic analysis and qualitative exploration of patient experience.

Methods: Provider card dimensions, font size, leading, and contrast ratios were measured. Anonymized surveys captured patient demographics, visual acuity, and Ishihara colour vision testing. Readability and importance to physician-patient relationship were rated on a visual analog scale. Qualitative responses were analyzed using Braun and Clarke’s thematic analysis.

Results: Forty-one cards were analyzed (mean width 91.43 mm; height 57.46 mm). Mean font size was 2.70 mm (7.68 pt), below the 20/50 Snellen equivalent threshold. The font-to-leading ratio averaged 80%, and mean contrast ratio was 7.51:1, with 37% of cards failing minimum contrast standards. Among 113 respondents, 74% were over 45 and 65% were female, predominantly from glaucoma and neuro-ophthalmology clinics. Mean near visual acuity was 0.14 logMAR (20/30), and 25% scored at test plate or below on Ishihara testing. Mean readability was 8.0/10, though 9% rated cards at 3.0/10 or below. Importance to the doctor-patient relationship averaged 7.6/10, and reliance on cards for follow-up was 6.6/10. Key readability barriers included small font (79%), small card size (49%), and cluttered design (49%). Physician name (94%) and phone number (92%) were identified as the most essential content elements. Qualitative themes emphasized larger font, higher contrast, and minimalist design.

Conclusions: Provider cards are integral to clinical communication and follow-up compliance, yet typographic and design deficiencies limit accessibility. Patient perspectives support foldable, large-font, high-contrast cards with essential information only. Adopting accessible design standards may improve continuity of ophthalmic care.

Objective: To assess the association between prophylactic L-arginine supplementation and ROP at discharge, and visual outcomes to the age of 3 years, in preterm infants born before 29 weeks gestational age (GA).

Methods: Premature infants admitted to NICU between 1999-2007 and followed at the Neonatal Follow-up Clinic were included. Two groups were compared: the pre-supplementation group (1999-2003) and the post-supplementation group (2003-2007) with a six-month washout period. The primary outcome was any stage of ROP, and visual impairment (visual acuity <20/60, unilateral blindness, or refractive errors requiring glasses) and/or blindness (bilateral blindness, visual acuity <20/200 in the better eye, or light perception or less) at the last assessment. Logistic regression analysis was used to adjust for potential confounding variables. Results: Of 676 eligible infants, 306 were in the pre‑supplementation group (mean birth weight [BW] 839 g; range 410–1380; GA; 26 weeks [range 22–28]) and 370 were in the post‑supplementation group (mean BW 903 g; range 440–1560; GA 26 weeks [range 23–28]) (p < 0.001). The incidence of ROP decreased from 75% to 64% (aOR 0.49, 95% CI 0.29–0.83). At 3 years, the risk of visual impairment and/or blindness decreased from 12% to 7% (aOR 0.58, 95% CI 0.29–1.15) after adjusting for various confounders. Conclusions: In preterm infants born <29 weeks GA, L-arginine supplementation was associated with a significant reduction in ROP but not severe ROP. However, at 3 years, the composite risk of visual impairment and/or blindness did not differ between the groups.[/et_pb_accordion_item][et_pb_accordion_item title="Preoperative Corneal Densitometry and Adjustment Burden After Light-Adjustable Lens Implantation in Post-Refractive Eyes - Alizada A, Sadek K, Maddigan A, Bhamra J" _builder_version="4.8.2" _module_preset="default" custom_margin="||1px||false|false" open="off"]Purpose: To evaluate whether preoperative corneal densitometry is associated with visual outcomes, higher-order aberrations (HOAs), or light-delivery device (LDD) treatment burden in post-refractive eyes undergoing light-adjustable lens (LAL) implantation.

Methods: We retrospectively reviewed 28 eyes with prior LASIK or PRK that underwent cataract surgery with LAL implantation at Vector Eye Centre. Preoperative Pentacam densitometry was analyzed by layer and zone, emphasizing total and anterior densitometry in the central 0–2 mm and 2–6 mm zones. Outcomes included uncorrected visual acuity (UCVA), total HOA, coma, spherical aberration, trefoil, and number of LDD treatments at 2 weeks, after final adjustment, and after lock-in. Exploratory Spearman correlations were performed for all, dominant, and non-dominant eyes.

Results: Final dominant-eye outcomes were excellent, with 13/14 achieving 20/20 or better UCVA at lock-in, creating a ceiling effect for final UCVA success. Densitometry was not meaningfully associated with final UCVA. Across all eyes, higher anterior central densitometry correlated with greater LDD treatment burden (anterior 0–2 mm vs number of LDDs: rho=0.389, p=0.041). Exploratory optical-quality signals were observed, including anterior 2–6 mm densitometry correlating with final trefoil (rho=0.375, p=0.049). High total densitometry was also associated with higher trefoil (median 0.101 vs 0.056, p=0.029).

Conclusions: In post-refractive LAL eyes, preoperative densitometry did not predict final visual failure but was associated with adjustment complexity. Future studies should evaluate densitometry-based qualification metrics for LAL and multifocal IOL selection.

Purpose: To describe two complementary digital platforms developed to support ophthalmology medical education: OCTcases 2.0, a collaborative case-based resource for optical coherence tomography (OCT) interpretation, and Fluxmi, an adaptive review platform for longitudinal reinforcement of ophthalmic knowledge.

Methods: OCTcases 2.0 was developed through a multi-contributor educational model involving ophthalmology faculty, trainees, and medical students, with a 2026 redesign emphasising accessibility, visual clarity, and learner engagement through a refined website and mobile app. The platform curates real clinical cases, atlas content, and concise teaching resources to support pattern recognition and clinical reasoning. Fluxmi was developed as a complementary self-directed learning tool to reinforce high-yield ophthalmology concepts through structured repeated review of board examination material. Together, the platforms were designed to support resident and medical student education through both image-based interpretation and durable knowledge retention.

Results: As of March 2026, OCTcases contains 171 indexed clinical cases, 151 atlas entries, and 6 foundational OCT articles organised by pathology and learning objective. The redesigned platform expands access across devices and improves learner experience through a modern, intuitive interface. Fluxmi is a new iPhone application for repetition-guided self-study and ongoing review, providing a practical framework for longitudinal reinforcement of board review knowledge. Collectively, these tools address complementary educational needs across undergraduate, postgraduate, and continuing ophthalmic education.

Conclusions: OCTcases 2.0 and Fluxmi represent scalable, learner-centred innovations in ophthalmology education that support self-directed learning, curricular supplementation, and future study of digital strategies to improve knowledge acquisition, image interpretation, and retention among medical students and ophthalmology residents.

Purpose: Retinal vascular occlusion is an ophthalmic emergency associated with irreversible vision loss. A pathophysiological link between systemic hormonal therapy and retinal vascular occlusion exists; however, this relationship remains largely understudied. This review aims to synthesize the available evidence and characterize this association.

Methods: A comprehensive search was conducted across eight databases from inception to November 2025. Eligible studies investigated women exposed to systemic hormonal therapies, including oral contraceptives, hormone replacement therapy, and selective estrogen receptor modulators or aromatase inhibitors. Risk of bias was assessed using the Newcastle-Ottawa Scale. Random-effects meta-analyses were performed to quantify associations using hazard ratios (HRs) and risk ratios (RRs), analyzed separately.

Results: Seven studies (n≈5.5 million patients, as reported) were included. Pooled estimates found no statistically significant association between oral contraceptive use and retinal artery occlusion (HR 0.99, 95% CI: 0.10-9.52), retinal vein occlusion (HR 1.05, 95% CI: 0.82-1.34), or combined retinal vascular occlusion (RR 1.35, 95% CI: 0.61-2.99) with negligible statistical heterogeneity. However, the largest and most contemporary study (Niazi et al., 2025) reported a significant dose-dependent association between current hormonal contraceptive use and retinal vessel occlusion (AIRR 1.4, 95% CI: 1.1-1.8). Most studies were designated to have a low risk of bias.

Conclusions: These findings reflect a sparse, underpowered, and methodologically heterogeneous evidence base rather than a true absence of association. The dose-dependent relationship identified in the most rigorous available study, situated alongside the recognized prothrombotic mechanisms of exogenous estrogen, supports the need for large, prospective studies with pre-specified outcomes and sex-stratified analyses.

Purpose: To describe the clinical characteristics, potential associations, and surgical outcomes of macular holes developing after prior rhegmatogenous retinal detachment repair using pars plana vitrectomy, with or without scleral buckle.

Methods: A retrospective, consecutive case series was conducted including patients diagnosed with macular hole after retinal detachment surgery between January 2016 and July 2024.

Results: Thirty-two patients were included. The mean interval between retinal detachment repair and macular hole diagnosis was 93 weeks (range: 1–439 months). Several potential associations were identified: epiretinal membrane in 53% (17/32), previous macula-off retinal detachment in 75% (24/32), recurrent retinal detachment in 37% (12/32), and high myopia in 34% (11/32). Primary surgery achieved macular hole closure in 21 of 32 patients, while 11 patients required more than one procedure. Overall anatomical closure was obtained in 87.5% (28/32). Visual outcomes were modest; an improvement of at least two Snellen lines was observed in 43% (14/32) of cases.

Conclusions: Macular hole formation after retinal detachment repair appears to be associated with epiretinal membrane, prior macula-off detachment, recurrent detachment, and high myopia. Although high rates of anatomical closure can be achieved with surgery, functional visual improvement is frequently limited. These findings suggest that mechanisms beyond simple vitreofoveal traction may contribute to macular hole development in previously vitrectomized eyes.

Purpose: To compare IOLMaster 700 and Pentacam AXL biometric measurements and Barrett recommended IOL outputs, including IOL power, lens category, and toric selection.

Methods: Retrospective paired eye-level analysis of cataract surgery evaluations from March–November 2025. Biometric comparisons included K1, K2, axial length, anterior chamber depth (ACD), white-to-white (WTW), and pupil diameter. Mean paired differences used patient-clustered standard errors and Bland-Altman limits of agreement. Barrett Universal/Toric outputs were compared for IOL power, category, residual astigmatism, and toric model.

Results: Sixty-three eyes (34 patients; mean age 69.2 years) were included; 5 eyes had prior refractive surgery. Keratometry was similar, with no significant K1 or K2 differences. IOLMaster measured longer axial length by 0.036 mm (p<0.001), lower ACD by 0.012 mm (p=0.010), higher WTW by 0.346 mm (p<0.001), and larger pupil diameter by 1.478 mm (p<0.001). In non–post-refractive eyes, Barrett IOL power was similar. Exact IOL power agreement was 38.1%, within 0.50 D was 78.6%, and within 1.00 D was 90.5%. IOL category agreement was high (95.6%, kappa=0.91; n=45). Exact toric model agreement was 62.2%; within-one-step agreement was 92.3%, suggesting most disagreements reflected adjacent cylinder steps rather than different lens families. Conclusions: IOLMaster 700 and Pentacam AXL produced similar Barrett IOL recommendations overall, despite biometric differences. Toric selection was the main discrepancy, likely reflecting small astigmatism-related input differences. Larger studies are warranted.

Purpose: Uveal melanoma (UM) is a rare cancer, comprising ~5% of primary melanomas. Its rarity poses unique challenges for researchers conducting statistically robust studies. Therefore, the purpose of this study is to detail the development of the Alberta Ocular Brachytherapy Program (AOBP) clinical registry and biorepository to collect UM clinical data and samples. This registry will establish standards for structured UM data to develop a minimum viable dataset, facilitating future meta-analyses and multicenter collaborations.

Methods: The AOBP registry and biorepository was developed to provide clinical insights for quality improvement with enough rigor to support scientific research. The goal was to capture patients’ medical history, tumor and genetic profiles, clinical care, and outcomes from referral to death, with some of this data collected via spreadsheets, ad hoc, or not at all. These were consolidated under an approved protocol by the Health Research Ethics Board of Alberta – Cancer Care using University of Alberta’s REDCap (Research Electronic Data Capture) server.

Results: To-date, the AOBP registry has enrolled 932 UM patients. Medical history and clinical care data was extracted for all of those patients; 422 (45%) have had their next-generation genetic sequencing data added; and 444 (48%) have completed at least one patient-reported outcome measure. We recorded 97 (10%) metastatic progressions and 96 (10%) deaths from NetCare.

Conclusions: We developed the AOBP clinical registry and biorepository, capturing comprehensive, standardized data across the patient care continuum while establishing open standards for UM clinical registries, promoting multi-site data collection in the future.

Purpose: To estimate the prevalence of vitamin A deficiency after bariatric surgery and characterize associated ocular manifestations.

Methods: MEDLINE, Embase, CENTRAL, Scopus, and Web of Science for studies reporting postoperative vitamin A status or ocular manifestations after bariatric surgery. Primary meta-analysis was restricted to nonpregnant surveillance cohorts with systematic retinol testing and defined thresholds. Pregnancy cohorts and referral-based ocular reports were analyzed separately.

Results: Twenty-seven reports were included. Nine nonpregnant surveillance cohorts (455 participants) contributed to the primary analysis. Pooled vitamin A deficiency prevalence, defined by study-specified low serum or plasma retinol, was 26.1% (95% CI, 18.5–35.4; 95% prediction interval, 10.0–52.8; I² = 71%). Pregnancy cohorts following Roux-en-Y gastric bypass cohorts showed a higher prevalence (61.0%; 95% CI, 51.5–69.8). Night blindness was reported in 60.0% of participants (95% CI, 43.5–74.5; I² = 88%), though assessment was largely symptom-based. Reported ocular manifestations included ocular surface disease, impaired dark adaptation, electroretinographic abnormalities, outer retinal changes, and neuro-ophthalmic findings. Visual dysfunction generally improved following vitamin A repletion (20/23 cases).

Conclusions: Vitamin A deficiency is common after bariatric surgery and may result in a spectrum of ocular complications, particularly night-vision impairment. Risk appears higher in pregnancy and after malabsorptive or revisional procedures. Standardized retinol thresholds and objective assessment of visual function are needed to better define ocular risk and treatment response.

Background: Standard automated perimetry (SAP), commonly performed using the Humphrey Visual Field Analyzer, is the gold standard for visual field assessment but is limited in pediatric populations due to cost, accessibility, and challenges with patient cooperation. Virtual reality (VR)-based perimetry has emerged as a potential alternative, offering portability and improved engagement.

Methods: A systematic review was conducted across Embase, Medline, Scopus, Web of Science, and PubMed to identify studies evaluating VR-based perimetry in children (<18 years). Included studies reported on diagnostic accuracy, reliability, or patient experience. Data extracted included sensitivity, specificity, agreement with SAP, test completion rates, and patient preference. Mixed-population studies were included when pediatric-specific data were limited. Results: Nine studies met inclusion criteria, encompassing predominantly pediatric populations with glaucoma, neuro-ophthalmic disease, or normal vision. VR perimetry demonstrated high feasibility, with completion rates up to 94.9%, consistently outperforming SAP in patient preference and tolerability. Agreement with SAP was moderate to high across studies (e.g., correlation coefficients up to r=0.78), particularly for larger visual field defects. Only one study reported formal diagnostic accuracy, demonstrating high sensitivity (~88.6%) but low specificity (~33.5%). Evidence for reproducibility was limited, with only one study reporting moderate test–retest reliability (ICC ~0.70). Significant heterogeneity existed in VR devices and testing algorithms, contributing to variability in outcomes.

Conclusions: VR perimetry is a feasible and well-tolerated modality for pediatric visual field testing, with moderate agreement with SAP. However, evidence for diagnostic accuracy and reliability remains limited. Further standardized, large-scale studies are required to establish its role in clinical practice.

The eyes and pineal complex arise from a shared developmental origin during early embryogenesis. While they both contain light-sensitive photoreceptors cells, their function and structural complexity diverge markedly. The retina of the eye exhibits a highly cellular organized and defined neural structure consisting of three distinct nuclear layers with specialized cell types. Unlike the retina, the adult non-mammalian pineal complex comprised of the frontal organ and secretory pineal organ, has a less specified structure, which these compartments are not divided at the Xenopus laevis embryonic stages completely. Pineal complex primarily involved in non-visual process like circadian cycle regulation. While, the pineal photoreceptors are homologous to retinal rods and cones, we find they also operate as neurosecretory cells, integrating photoreception with endocrine output.

Current knowledge of the cellular architect of the pineal complex is limited, a gap that this project aims to address. We used Xenopus laevis larvae at a developmental stage where their pineal complex is functional. We compared and analyzed the eye and pineal complex photosensitive systems that work independently of one another. In this study, we utilized fluorescent in-situ hybridization (FISH), immunohistochemistry (IHC), and advanced 3D analysis via IMARIS, to characterize photosensitive structure. Using established retinal cell-type markers as a reference, we performed a comparative analysis between the eye and the pineal complex. Ultimately, this project will characterize the developing pineal complex structure and define the various pineal cell types and transcriptional relationships with potential retinal homologs.

Purpose: To characterize a retinal ganglion cell (RGC)-specific injury model in zebrafish and determine how individual Müller glia (MG) contribute to RGC regeneration.

Methods: I will use a transgenic zebrafish nitroreductase/metronidazole (NTR/MTZ) to selectively injure RGCs. The timing, extent, and functional consequences of RGC loss will be assessed across developmental stages using histological and functional assays. Next, I will quantify the regenerative capacity of a single MG through lineage-tracing using a photoconvertible reporter Kaede combined with in vivo imaging to track progenitor output following injury.

Results: I have obtained all plasmids required to generate the transgenic RGC-specific injury line. In addition, successful in vivo photoconversion of individual MG using Kaede has been achieved, establishing feasibility for single-cell lineage tracing. Data collection and characterization of RGC ablation and MG-derived regeneration are ongoing.

Conclusions: These preliminary results establish the feasibility of the experimental approach to generate and analyze an RGC-specific injury model and to track MG-derived regeneration at single-cell resolution. Completion of this work will define the characteristics of this injury paradigm and clarify how individual MG contribute to RGC regeneration. These findings will advance understanding for uncovering mechanisms that may be leveraged to therapeutically induce endogenous neurogenesis from human MG to treat neurodegenerative disease.

Purpose: To discuss and evaluate migration of silicone oil (SiO) into the vitreous from intravitreal drug injections (IVI) of anti-vascular endothelial growth factor (VEGF) for the treatment of various retinal diseases.

Methods: A representative vitrectomy case presentation for numerous silicone micro droplets from repeated anti-VEGF injectables will be shared. Literature review and summarized recommendations will be discussed to assist vitreoretinal specialists to minimize these risks for their injectable patients.

Results: Majority of commercially available syringes used to administer these IVI are not develop specifically for ophthalmic use, with the syringe inner surface coated with SiO. Factors leading to migration of SiO into the vitreous may include syringe design, needle used, agitation of siliconized syringes and storage. Side effects from SiO migration into the vitreous includes floaters, visual disturbances, inflammatory/immunological responses and elevated intraocular pressure.

Conclusions: Chronic intravitreal anti-VEGF injections may lead to clinically significant accumulation of SiO microdroplets in the vitreous. A SiO free system from vial to eye is imperative to minimize patient morbidity.

Purpose: Delirium is a prevalent and serious neuropsychiatric syndrome associated with adverse clinical outcomes. This systematic review and meta-analysis aimed to evaluate the association between visual impairment and delirium across various clinical settings.

Methods: MEDLINE, Embase, and CENTRAL were systematically searched from inception to September 2025. Title/Abstract/full-text screening, and data extraction were performed by two independent reviewers. Eligible studies included those reporting both visual impairment and delirium. Random-effects meta-analyses were performed to pool odds ratios (ORs). Risk of bias was assessed using the Joanna Briggs Institute (JBI) tools, and the certainty of the evidence was evaluated using the GRADE approach. This review was prospectively registered (PROSPERO; CRD420251269018).

Results: A total of 44 studies involving 26,230 participants were included. Overall, visual impairment was associated with significantly increased odds of delirium (OR 2.40, 95% CI 1.81-3.18; I² = 89.8%). In analyses restricted to studies reporting multivariable-adjusted estimates, this association remained significant (OR 2.02, 95% CI 1.29–3.16; I² = 82.8%). Setting-specific analyses revealed stronger associations in stroke, surgical, orthopedic, and intensive care inpatients, while associations in general medicine and emergency settings were weaker and less precise.

Conclusion: Visual impairment is consistently associated with increased odds of delirium across diverse adult populations and care settings. Identification and management of visual impairment may represent an important component of delirium prevention, including adapting re-orientation approaches to better meet the needs of visually impaired patients. Future studies should evaluate the effectiveness of delirium prevention strategies specifically tailored to individuals with visual impairment.

Purpose: Tele-ophthalmology improved access to care in various subspecialties. Yet, its role in oculoplastic care remains underexplored. This study aimed to examine the result of tele-orbit virtual assessments and how it alters traditional pathways of orbit care.

Methods: 123 patients referred for orbital pathologies were virtually assessed between April 2020 – February 2025. Patient demographics, diagnostic category and the clinical actions taken following virtual assessment were assessed. Patient satisfaction was measured using a Telemedicine Satisfaction Questionnaire (TeSS).

Results: The most common diagnosis was thyroid eye disease (TED) (68 patients, 55.3%). Orbital lesions (OL) (18 patients, 14.6%), meningiomas (5 patients, 4.1%), and a diverse “Other” group of 32 patients (26.0%) consisted of vascular malformations, ocular edema and other inflammatory or structural conditions. Stratified by diagnosis, the mean referral-to-diagnosis time was 60 days for TED, 82 days for OL, 99 days for meningioma, and 34 days for the ‘Other’ group. Across all patients, 59 (46.1%) received CT or MRI from the virtual visit. A high satisfaction rate (89.8%) was shown across all TeSS domains. Most patients (89.8%) felt the tele-orbit model improved their access to specialist care, and 84.7% were satisfied without an in-person physician encounter. 94.9% found the flexible scheduling of telemedicine more convenient than in-person visits.

Conclusion: This tele-orbit program enabled high-yield clinical decision-making and virtual monitoring for orbit patients. This is the first Canadian program to implement structured virtual follow-up for these patients. This program ensures that those with visual consequences are identified early allowing care to be accelerated.

Purpose: To report long-term outcomes of corneal neurotization surgery using sural or medial antebrachial cutaneous nerve autograft in patients with neurotrophic keratopathy.
Study Design: Prospective Consecutive Case Series

Methods: All patients over a 10-year period 2015-2025 with stage 2–3 NK undergoing sural or medial antebrachial cutaneous nerve autograft CN at a single center were included. Outcomes included corneal sensation, epithelial integrity, visual acuity, and postoperative complications. Data was extracted at standardized postoperative (PO) intervals: POD1, POM1, POM3, POM9, POM12, and most recent follow up. Results were interpreted alongside recent systematic reviews and meta-analyses.

Results: Patients demonstrated improved corneal sensation (19/19), stabilization of epithelial defects (16/19), and visual gains (13/19) where scarring and comorbidity permitted. Vision remained unchanged in (3/19) patients. Our post-operative follow up period ranged from 9-113 months (mean: 42 months; SD: 30 months). Surface healing typically began by 3–6 months postoperatively, consistent with published in vivo confocal microscopy data. No significant differences in outcome were found in the following subgroups: pediatric (2/19), median-antebrachial donor nerve (2/19). Donor-site morbidity was mild. Findings aligned with recent meta-analytic evidence confirming significant improvements in sensation, NK stage, and visual acuity after CN.

Conclusions: Our large, long-term outcomes from a single Canadian center show nerve autograft for CN provides durable reinnervation, with outcomes varying by etiology and timing. Outcomes highlight the overall efficacy, safety and utility of this procedure. CN should be considered a definitive surgical option in patients failing maximal medical therapy or with profound sensory loss.