Introduction: Since the appearance of COVID-19 pandemic by the end of 2019 and beginning of 2020 conferences, and events are canceled targeting the social distance to limit the spread and decrease the danger of the newly emerging virus webinars instead spread all over the world as an educational tool with no risk of communications. Purpose: to evaluate the effi cacy of webinars in increasing the clinical and surgical skills of Egyptian ophthalmologists during the time of obligatory social distancing of COVID-19. Results: most of ophthalmologists in this survey consider the webinars is a good educational tool and hoping to progress after COVID-19 Pandemic. Most of them followed their topics of interest rather than the speaker or the organizing company and interested till the end due to the more comfortable situations. Conclusion: Webinars are readily available technology inexpensive, benefi cial experience added to the clinical and surgical skills of Egyptian ophthalmologists who are hoping to be continued even after the COVID-19 pandemic time.

Background/AimsTo assess the safety and efficacy of argon laser photocoagulation as a new modality for the treatment of presumed trematode-induced granulomatous anterior uveitis (PTGAU) in children.MethodsForty-eight eyes of 48 children with PTGAU with pearl-like nodule(s) in the anterior chamber were included in this prospective non-randomised controlled clinical trial. The patients were divided into two groups: those in Group A (23 eyes) were treated with one session of argon laser applied to the anterior chamber nodules and those in Group B (25 eyes) received medical treatment in the form of topical steroid and cycloplegic eye drops with trans-septal triamcinolone injections. All cases were followed up for 3 months with measurement of visual acuity (VA), assessment of the anterior chamber reaction and measurement of the pearl-like nodule size.ResultsIn Group A, 22 eyes (95.65%) showed regression of the pearl-like nodules with resolution of the anterior chamber reaction (flare and cells) and improvement in visual acuity from 0.52±0.12 to 0.06±0.08 logMAR (p<0.001). Such improvement was maintained within the 3-month follow-up period. In Group B, 23 eyes (92%) showed initial regression of the granulomas, which was maintained in only 14 eyes (56%),with nine eyes experiencing recurrence after 3 months of follow-up.ConclusionArgon laser photocoagulation is a safe and effective novel treatment for PTGAU with pearl-like nodules in the anterior chamber in children. Larger studies with longer follow-up periods are needed to confirm these results.

Purpose. To evaluate the role of medical treatment and assessing its effect on resolving epiphora and improving punctum size by high resolution AS-OCT imaging comparing punctal parameters in patients before and after treatment with topical combined antibiotic and steroid treatment in cases of inflammatory punctual stenosis. Patients and Methods. Double-blinded controlled randomized study which was conducted on two groups of patients who had acquired punctal stenosis and epiphora presented to Ophthalmology Clinics of Sohag University Hospitals in the period between Jan 2021 and April 2021. The study included 44 eyes of 50 subjects complaining of epiphora. They were divided into two groups, the epiphora group one (EG1) received eye drops containing combination of antibiotics and steroids (orchadexoline eye drops, each ml contains 5 mg chloramphenicol, 1 mg dexamethasone sodium phosphate, 0.25 mg tetryzoline hydrochloride, 2 mg hydroxypropyl methyl cellulose, 10 mg α-tocopherol acetate (vitamin E), and 8 mg macrogol 400), 5 times daily for the first week, three times daily for the next two weeks, and one time daily for another one week. The second epiphora group (EG2) received preservative-free artificial tears (sodium hyaluronate-, polyethylene-, and propylene glycol-based), three times daily for four weeks. The patients were examined before treatment, one week, one month, and one and half months later. Results. Both groups were comparable regarding mean age (49 ± 13 vs 53 ± 11 years, P value = 0.2) and sex (males were 38.6% vs 31.8%, female were 61.4% vs 68.2%, P value = 0.6), respectively, with no statistically significant difference between both groups. Both groups were comparable regarding outer punctual diameter and length between the puncti before treatment. Outer punctal diameters were (EG1 228 ± 113 um, EG2 241 ± 115 um, P value = 0.5). Length between the puncti were (EG1 129 ± 73 um, EG2 137 ± 72 um, P value = 0.6). There was marked improvement of the outer punctual diameter (EG1 373 um ± 92 um, EG2 240 ± 109 um, ( P value < 0.0001) and length between the puncti (EG1 217 ± 109 um, 136 ± 71 um ( P value < 0.0002)) during the follow-up period. EG1 showed more improvement than EG2 when compared during the follow-up period. Conclusions. Topical combined antibiotic and steroid treatment was an effective method in treating cases of inflammatory punctual stenosis as found by monitoring of punctal parameter changes by AS-OCT. AS-OCT was found to be a useful method for evaluation of the lacrimal punctal parameters especially with different treatment modalities in epiphora cases.

PURPOSE: To evaluate specular microscopic changes of corneal endothelial cell (CEC) count and morphology in correlation to retinal nerve fiber layer RNFL changes detected by OCT in early and advanced primary open-angle glaucoma (POAG).METHODS: A cross-sectional study was conducted on patients with POAG versus non-glaucomatous patients of the same age group. Specular microscopy, VF test, OCT scans of RNFL, and macular ganglion cell complex (GCC) were performed. Glaucoma group was further subdivided into early and advanced stages.RESULTS: The study included 130 eyes of 130 subjects, 70 were eyes with POAG (early glaucoma 40 eyes, advanced glaucoma 30 eyes), 60 were healthy eyes (control group). Both groups were comparable regarding mean age and sex.In the early glaucoma group, a significant negative correlation was found between the coefficient of variation (CV%) and superior RNFL thickness (r=-0.5, p-value=0.018). A significant negative correlation was also found between percentage of cellular hexagonality (HEX%) and vertical cup/disc (C/D) ratio (r=-0.43, p-value= 0.035). A significant positive correlation was found between HEX% and (superior, inferior) RNFL thickness (r=0.53, 0.5 and p-value= 0.008, 0.015) respectively.Mean CEC count was significantly lower in the advanced glaucoma group than in the control group (2958.7±371.2 vs 3085±172.5, p value=0.043). CONCLUSIONS: CEC is affected by chronic intraocular pressure (IOP) elevation just like the RNFL and macular GCC. CEC morphology is insulted in the early stages of POAG while the count can withstand chronic IOP elevation till advanced stages where both are affected.

Background: Corneal endothelial cell (CEC) loss in glaucoma can be attributed to the direct compressive effect of elevated intraocular pressure. Herein, we aimed to evaluate specular microscopic changes in CEC count and morphology in correlation to retinal nerve fiber layer (RNFL) changes detected by spectral-domain optical coherence tomography (SD-OCT) in early and advanced primary open-angle glaucoma (POAG). Methods: This descriptive-analytical study involved patients with medically controlled POAG versus non-glaucomatous patients of the same age group. Specular microscopy, visual field testing, and SD-OCT of the RNFL and macular ganglion cell complex (GCC) were performed. Eyes with POAG were further subcategorized into early and advanced stages. Results: The study included 130 eyes of 130 participants; 70 were eyes with POAG (40 eyes with early-stage POAG, 30 eyes with advanced-stage POAG), and 60 were healthy eyes. The groups were comparable regarding mean age and sex. No significant difference was found in corneal parameters between healthy eyes, eyes with early POAG, and eyes with advanced POAG (all P > 0.05). In eyes with early-stage POAG, a significant negative correlation was found between the coefficient of variation (CV) and superior RNFL thickness (r = - 0.5; P = 0.018), and between the percentage of hexagonal cells (hexagonality) and vertical cup-to-disc ratio (r = - 0.43; P = 0.035). A significant positive correlation was found between hexagonality and superior as well as inferior RNFL thickness (r = + 0.53; P = 0.008 and r = + 0.50; P = 0.015, respectively). However, in the advanced glaucomatous eyes, no significant correlation was found between RNFL thickness and CEC parameters. Conclusions: CEC parameters were not affected in eyes with early or advanced POAG compared with healthy eyes, despite a significant thinning of RNFL and macular GCC. In eyes with early-stage POAG, a significant correlation was found between morphological characteristics of CECs, such as CV and hexagonality, with superior and inferior RNFL thickness in the optic nerve head on SD-OCT images. Future longitudinal studies with larger sample sizes are needed to verify our results.