Ophthalmology Commons^™

Implementation Of Artificial Intelligence In Retinoblastoma Diagnosis, Zana Moldavsky

inSIGHT

The retina is essential for vision. It is composed of 10 distinct layers and contains specialized photoreceptor cells, rods, and cones that are responsible for converting photons of light into electrical signals through a process called phototransduction.¹ These electrical signals are transmitted to the brain via the optic nerve where they are interpreted as a visual picture.¹

Retinoblastoma is a rare but aggressive malignant tumor of the retina and represents the most common intraocular malignancy in the pediatric populabon.² The disease follows Knudson's two-hit hypothesis and occurs due to biallelic inactivation of the RB1 tumor suppressor gene …

Home-Use Oct For Neovascular Age-Related Macular Degeneration: A Rapid Review, Sneh S. Shah

inSIGHT

Neovascular age-related macular degeneration (nAMD) requires frequent monitoring to identify recurrent exudation and guide treatment with anti-vascular endothelial growth factor (VEGF) therapy.1 Clinic-based optical coherence tomography (OCT) plays a central role in management but provides only intermittent assessments of a disease that changes over time. Home-use OCT technologies have recently been developed as a possible solution, allowing patients to perform self-imaging with remote clinician review and artificial intelligence (AI)-assisted analysis. This rapid review summarizes current evidence on home-use OCT for nAMD, including feasibility, diagnostic performance, clinical usefulness, and challenges related to implementation. Findings from feasibility studies, AI validation analyses, observational …

Glp-1 Receptor Agonists And Ocular Risk, Saharsh Satheesh

inSIGHT

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have moved from second-line diabetes medications toward the frontline of type 2 diabetes, obesity, and cardiometabolic care.¹ A meta-analysis of 10 randomized cardiovascular outcomes trials (n = 71,351) demonstrated that longacting GLP-1 RAs reduce major adverse cardiovascular events by 14%, all-cause mortality by 12%, and composite kidney outcomes by 17%.² With GLP-1 RAs usage increasing, ophthalmology is also increasingly encountering patients who have recently started GLP-1 RAs therapy, often alongside substantial improvements in glycemic control.

In the context of GLP-1 RAs ocular complications, two specific topics currently dominate conversations: (1) worsening diabetic …

Dichoptic Therapy Versus Patching – State Of Literature Review, Eve Miller

inSIGHT

Amblyopia is the most common cause of vision loss in children. A meta-analysis performed by Hu et al. 2022 estimated the global prevalence of amblyopia to be 1.36%.¹ Amblyopia is defined as a reduction in best-corrected visual acuity (BCVA) of one or both eyes caused by abnormal neurologic development in the critical period of visual development. Amblyopia may result from unequal refractive error, strabismus or ocular pathology.² Despite treatment of these inciting factors, suppression of one eye remains, resulting in unequal vision. The clinical consequences of untreated amblyopia include permanent reduction in vision in the affected eye and …

Novel Advancements In Glaucoma Surgery, Eshani Ragam

inSIGHT

Glaucoma is a degenerative ocular condition characterized by irreversible vision loss from damage to the optic nerve. This is usually secondary to increased aqueous production or impaired aqueous outflow, resulting in increased intraocular pressure (IOP). Aqueous outflow is managed by the trabecular meshwork and Schlemm’s canal, although secondary pathways may also be involved.¹ Injury to the nerve is permanent, and interventions are primarily aimed at slowing the rate of progression. While eye drops and laser procedures are first-line measures to lower IOP, more persistent or severe etiologies require surgical treatment to preserve sight.² In recent years, advancements in …

Novel Treatments For Keratoconus, Caroline Paik

inSIGHT

Keratoconus is a progressive condition in which the cornea gradually thins and bulges outward, causing it to become steep and irregular. This leads to irregular astigmatism and worsening vision, most often beginning in adolescence or early adulthood.¹ The management of keratoconus has evolved significantly over the past two decades, with novel therapeutic approaches emerging across three critical domains: halting disease progression, improving visual function, and providing surgical alternatives when conservative measures fail. This review examines the latest advances in keratoconus treatment, focusing on innovative approaches that are reshaping clinical practice.

Insight, Volume 6, Issue 1, 2026

inSIGHT

Contents

7 - Novel Treatments for Keratoconus
By Caroline Paik

12 - Novel Advancements in Glaucoma Surgery
By Eshani Ragam

16 - Dichoptic Therapy versus Patching – State of Literature Review
By Eve Miller

24 - GLP-1 Receptor Agonists and Ocular Risk
By Saharsh Satheesh

33 - Home-use OCT for Neovascular Age- Related Macular Degeneration
By Sneh Shah

40 - Implementation of Artificial Intelligence in Retinoblastoma Diagnosis
By Zana Moldavsky

Retinopathy Of Prematurity: History, Diagnosis, And Treatment, Henry Nguyen, Bs, Ayra Khan, Bs, Flavius Beca, Md, Yoshihiro Yonekawa, Md

inSIGHT

Abstract
Retinopathy of prematurity (ROP) is a vasoproliferative disorder that remains a leading cause of preventable childhood blindness worldwide. This review examines the current understanding of ROP's pathophysiology, prevention, diagnosis, and treatment. ROP develops in two distinct phases: an initial hyperoxic phase, denoted by decreased levels of vascular endothelial growth factor (VEGF), followed by a hypoxic phase, where increasing levels of VEGF trigger pathological neovascularization. Currently, the most effective therapeutics for management are laser photocoagulation and anti-VEGF therapies. The current paradigm in ROP management is shifting toward earlier identification, better risk stratification, and integration of digital screening technologies and standardizing …

Genetic Counseling In Ophthalmology: An Interview, Emmanuel Worede-Kal, Bs

inSIGHT

Ms. Procopio has been practicing as a genetic counselor for seven years, and in the Department of Ocular Genetics at Wills Eye Hospital for the past four years. She provides patients with information necessary to understand the role of genetic testing and the impact of results on their care as well as potential implications for family members. Given the rapidly changing field of ophthalmic genetics, Ms. Procopio is an important member of the multidisciplinary care team of patients with rare genetic conditions.

Comparing Approaches To Refractive Laser Eye Surgery, Tejal Patel, Ba

inSIGHT

Laser eye surgery is one of the most common outpatient ophthalmic procedures performed in the United States. Most patients choose laser eye surgery because they want to decrease the need for daily glasses or contact lens wear. In the past 10 years, over 700,00 eyes have been treated with some type of laser surgery (1).¹ While colloquially known as “LASIK,” there are three major types of laser eye surgeries: Photorefractive Keratectomy (PRK), Laser in Situ Keratomileusis (LASIK), and Small Incision Lenticule Extraction (SMILE). These surgeries all fundamentally rely on the same concept of using a laser to reshape the …

A Day In The Life Of An Orbital And Oculoplastic Surgeon, Alexis Duffy, Ba

inSIGHT

Have you ever heard of an oculoplastic surgeon before? And if so, ever wonder what they do or how they differ from plastic surgeons? Treating the periocular region requires an in-depth understanding not only of the eye, but also its complex interplay with adjacent orbital, sinus, and craniofacial anatomy; there is much more than meets the eye! The most common pathway to become an oculoplastic surgeon includes completion of a four-year ophthalmology residency, followed by one to two years of subspecialized oculoplastic fellowship. Oculoplastic fellowships provide surgical and medical experience managing pathology of the eyelid and orbit, and different programs …

Idiopathic Intracranial Hypertension: A Comprehensive Review Of Diagnosis And Management, Sriya Sadhu, Bs

inSIGHT

Idiopathic intracranial hypertension (IIH) is a critical vision-threatening disease that has been on the rise over the past 10 years.¹ IIH is a condition involving an increase in intracranial pressure due to an unknown (idiopathic), nonspecific cause. The previous alternative name of IIH, "pseudotumor cerebri" (false brain tumor), was given because IIH can present with symptoms similar to those that are seen in several brain tumors - severe headaches, seizures, nausea, and vision deterioration. IIH has a primarily female predominance and a strong association with obesity. As the rates of obesity increase, the prevalence of IIH is similarly expected …

Recent Trends In The Ophthalmology Match, Michael Pratt, Ma

inSIGHT

Ophthalmology remains a competitive field to match for residency, with applications far outnumbering available positions. The criteria for a successful match are unclear owing to differences in data reporting from the SF Match system as compared to the National Residency Match Program, a relatively low volume of scholarly research about the ophthalmology match, and the transition of the USMLE Step 1 exam to pass/fail grading in 2022. This narrative review, while not intended as a guide to become a competitive applicant for residency, will summarize the 2024 ophthalmology match cycle results, report the specific match rate for Sidney Kimmel Medical …

Vascular, Immunological, And Mechanical Factors In Normal Tension Glaucoma: A Multidimensional Approach To Pathogenesis, Rachel E. Cain

inSIGHT

Glaucoma is characterized by progressive degeneration of retinal ganglion cells leading to optic neuropathy and visual field loss.

The major risk factor for glaucoma is elevated intra-ocular pressure (IOP) (Fig. 1). However, 30-40% of patients with glaucoma have normal IOP, leading to the classification of normal-tension glaucoma (NTG) (Fig. 1 C, E).^1,2 The prevalence of NTG varies between populations, with Asians having the highest prevalence (77- 92%), followed by Africans (57%), and Caucasians (30-39%).³ In a landmark study, the collaborative normal tension glaucoma study group (CNTGS) showed that a 30% reduction in IOP in NTG patients slowed the …

Giving More Than Vision: The Evolution And Impact Of Give Kids Sight Day, Leah Prischak, Bs

inSIGHT

Current literature strongly suggests that quality of life is diminished in children with visual impairments.¹ In many situations, visual impairment (VI) can be a serious barrier in obtaining the typical experiences and accomplishments of childhood. Evidence suggests an association between visual acuity, refractive error, and child academic performance.² VI is also associated with the prevalence of more intangible, psychological obstacles in areas such as independence and autonomy, concerns about the future, social relationships, participation, and acceptance.³

Retina In 10 Years—Exciting Developments, Amer Ahmed

inSIGHT

Significant advancements in the field of retina are expected over the next decade.

Wet AMD: Emerging Therapies
Wet age-related macular degeneration (AMD) is a chronic eye condition and a leading cause of vision loss in older adults. It occurs when abnormal blood vessels grow beneath the macula. These vessels are fragile and prone to leaking blood or fluid, which damages the retina and leads to rapid central vision loss.¹

Insight, Volume 5, Issue 1, 2025

inSIGHT

Contents

8 - Retina in 10 Years—Exciting Developments
By Amer Ahmed

12 - Giving More than Vision: The Evolution and Impact of Give Kids Sight Day
By Leah Prischak

15 - Vascular, Immunological, and Mechanical Factors in Normal Tension Glaucoma: A Multidimensional Approach to Pathogenesis
By Rachel Cain

22 - Recent Trends in the Ophthalmology Match
By Michael Pratt

25 - Idiopathic Intracranial Hypertension: A Comprehensive Review of Diagnosis and Management
By Sriya Sadhu

31 - Day in the Life of an Orbital and Oculoplastic Surgeon
By Alexis Duffy

35 - Idiopathic Intracranial Hypertension
By Tejal Patel

42 - Genetic …

Cavernous Wonders: Delving Into Cavernous Sinus Syndrome In Neuro-Ophthalmology, Anza Rizvi, Ba

inSIGHT

Cavernous sinus syndrome (CSS) is any disease process that affects the cavernous sinus. This syndrome is marked by a complex interplay of neurovascular symptoms, primarily due to the compression or dysfunction of the cranial nerves that traverse the cavernous sinus. Understanding the intricate details of this syndrome is critical to providing optimal care and improving patient outcomes.

Seeing Clearly: A Bright Future With Light Adjustable Intraocular Lenses For Presbyopia, Shady Mina, Bs

inSIGHT

Presbyopia, or the age-related decline in the ability to focus on near objects, is a common vision disorder that affects 1.8 billion people globally, with this number expected to increase to 2.1 billion by 2030.^1-4 A diminished accommodation response is the primary cause of presbyopia.¹ The eye has a very complex accommodation mechanism that permits people to distinctly see objects from various distances.^1,3 Even though the precise mechanism of accommodation is yet to be determined, the current evidence strongly supports Helmholtz’s theory, which claims that the thickness and curvature of the eye’s lens increase while its diameter …

Medical Missions, Ethical Considerations And The Future For Healthcare Delivery In Ophthalmology, Robert Medina, Ba

inSIGHT

Beginning hundreds of years ago, priests from Europe embarked on ‘medical missions’ with the goals of delivering care to the body, mind, and soul. Hundreds of years later, members of the United States healthcare system set out on humanitarian medical missions to provide medical assistance to communities in developing countries.¹ The concept of providing care internationally as a product of global social responsibility has become engrained in the United States healthcare system, and is popular among providers, trainees, and pre-medical students. In 2023, 21.8% (n = 3264) of matriculating medical students reported participating in international volunteer work, while 7.0% …

Chronic Progressive External Ophthalmoplegia, Bahram Pashaee, Mph, Bs

inSIGHT

Chronic progressive external ophthalmoplegia is an inherited or sporadic form of dystrophy that preferentially affects the extraocular muscles of the eye. While this dystrophy can manifest systemically, the extraocular muscles are commonly involved due to their constant metabolic demands and vulnerability to oxidative stress.¹ This preferential involvement of the eyelid levator muscle and extraocular muscles makes CPEO an important condition to consider in a differential diagnosis for eyelid asymmetry and double vision among other conditions such as myasthenia gravis, thyroid-associated ophthalmoplegia, and other mitochondrial myopathies.² This dystrophy tends to occur in the third or fourth decade of life. …

Macular Holes: Diagnosis, Treatment, And Complications, Ayra Khan, Bs

inSIGHT

Macular hole is a condition that affects the central visual field of the eye. Without prompt diagnosis and intervention, macular holes can progressively worsen, significantly impacting both vision and overall quality of life.

Cmv Retinitis: An Expert’S Perspective, Caitlyn Kwun, Ba

inSIGHT

Uveitis is a rare inflammatory disease with a prevalence of around 38 per 100,000 people and is the overall 5th leading cause of blindness in the developed world.^1,2 Uveitis is most commonly found in patients younger than 40 years of age, but it can occur in any age group with an etiology that varies within each age demographic.^1,3 While the etiology of certain forms of uveitis are not fully understood, there are some that are autoimmune in nature and others that are associated with systemic diseases such as sarcoidosis.⁴ Uveitis may be inflammatory or infectious. It may …

Bridging The Global Gap Of Blindness Through Artificial Intelligence - Exploring The Tools Of Ai To Address The Top Causes Of Blindness In Under-Resourced Communities Worldwide, Nathan Delacth, Bs

inSIGHT

Technological advancements have allowed us to submerge in a sea of innovation and excellence in medicine. Electronic health records transformed the healthcare landscape, improving portability of patient information while streamlining communication and fostering collaboration.¹ Imaging technologies, such as magnetic resonance imaging (MRI) and Optical computed tomography (OCT), granted us the ability to view internal structures using non-invasive methods. In a similar vein, artificial intelligence (AI) has emerged as an impactful force in various fields of medicine, and its influence on ophthalmology is no exception.

Evolution Of Lamellar Keratoplasty, Ishan Kasat, Bs

inSIGHT

Overview of Keratoplasty The evolution of corneal transplantation, or keratoplasty, has seen a paradigm shift from traditional penetrating keratoplasty (PKP) to the refined precision of lamellar keratoplasty (LK). Penetrating, or full thickness, keratoplasty is a replacement of all corneal layers: epithelium, Bowman's layer, stroma, Descemet's membrane, and endothelium.¹ Lamellar, or partial thickness, keratoplasty involves replacement of either epithelium and stroma (anterior lamellar) or Descemet’s membrane and endothelium (posterior lamellar).² From 1985 to 2004, over 95% of graft tissues were used for PKP. However, from 2005 to 2014, the percentage of PKP procedures decreased from 95% to 42%, while …

The Myopia Epidemic: Exploring The Pathology And Management Of The World’S Most Common Eye Disorder, Gabriella Baldassarre, Bs

inSIGHT

Myopia is the most common eye disorder in the world and an increasing cause of vision impairment in children.¹ Myopia is an imbalance in the refractive components of the eye and its length, leading to inaccurate focusing of light rays in front of the retina tissue instead of on it. There is a spectrum of severity of myopia, from mild nearsightedness to a more severe form known as high or degenerative myopia, which has the potential to cause vision loss and blindness. There is evidence of a developing myopia epidemic, with an estimated one-third of the world population affected …

Insight, Volume 4, Issue 1, 2024

inSIGHT

Contents

8 - The Myopia Epidemic: Exploring the Pathology and Management of the World’s Most Common Eye Disorder
By Gabriella Baldassare

15 - Evolution of Lamellar Keratoplasty
By Ishan Kasat

19 - Bridging the Global Gap of Blindness Through Artificial Intelligence
By Nathan Delacth

24 - CMV Retinitis: An Expert’s Perspective
By Caitlyn Kwun

29 - Macular Holes: Diagnosis, Treatment, and Complications
By Ayra Khan

36 - Chronic Progressive External Ophthalmoplegia
By Bahram Pashaee

39 - Medical Missions, Ethical Considerations, and the Future for Healthcare Delivery in Ophthalmology
By Robert Medina

43 - Shaping the Future of Vision: The Rise …

Current Barriers To Eye Care, Annika Samuelson, Bs

inSIGHT

Barriers to care penetrate all aspects within our healthcare system and ophthalmology is no exception. The World Health Organization (WHO) estimates 2.2 billion people worldwide have vision impairment, half of which are due to preventable causes and/or remain untreated. In the United States, 6 million people are reported to have visual impairment and over one million people are blind.² The leading causes of blindness within the United States are macular degeneration, cataract, glaucoma, and diabetic retinopathy.³ Management of these diseases require access to early detection, therapeutic intervention, and follow up care at regular intervals; for example, nearly half …

Thyroid Eye Disease: Overview And Treatment, Michelle Omega, Ms

inSIGHT

Your immune system consists of a guided molecular army of antibodies equipped to recognize millions of foreign enemy antigens. However, in autoimmune conditions, antibodies are produced which target the cells of your own body. This is how many autoimmune diseases begin, including thyroid eye disease.

Ophthalminute Highlight: A Look Into The Popular, Educational One-Minute Videos, Anza Rizvi, Bs

inSIGHT

Ophthalminute is a series of one-minute videos designed to provide information on different, essential topics in ophthalmology. What separates the Ophthalminute videos from many of the other videos currently available is their unique ability to effectively and succinctly present information into a one-minute video to help viewers learn and better understand the fundamentals of ophthalmology. The videos showcase witty banter, enthusiastic energy, and stimulating visuals. Across YouTube, Twitter, and Instagram, Ophthalminute has received an astonishing over 2000 followers or subscribers and over 20,000 views!