Objective: To assess the influence of the COVID-19 pandemic on the medication adherence and follow-up of glaucoma patients in the Nile Delta region. Setting: A tertiary care center in the Nile Delta region, Egypt. Study Design: An observational, cross-sectional study. Participants: Patients' records (2019-2020; group A) and (2020-2021; group B) were assessed for missed follow-up visits, medication adherence, number of trabeculectomies performed, and uncontrolled patients. In addition, a telephone-based questionnaire involving randomly chosen 200 patients from B.G.U. was carried out to clarify the potential causes of poor patients' compliance. Results: There was a marked decline in the number of newly diagnosed patients and patients on regular follow-up with incidence rates 0.208 and 0.088 in group (A) and group (B), respectively (P-value < 0.0001). The number of compliant patients in group B decreased with an incidence rate difference of 0.312. The number of trabeculectomies declined in group (B) with an incidence rate in group (A) 0.131 compared to 0.081 in group (B). On the other hand, the number of uncontrolled glaucoma patients increased in group B with an incidence rate difference −0.231 between the two groups. 21.5% of patients who participated in the questionnaire identified financial issues as the leading cause of non-compliance. Comorbidities (19.5%), lockdown and transportation difficulties were also highlighted. Conclusion: COVID-19 had greatly hampered glaucoma care in the Nile Delta region. As a result, we need to implement new technologies like telemedicine and improve patients' awareness of glaucoma care. Training orthoptists and using mobile glaucoma care services would also be helpful ways of managing glaucoma during that pandemic.

To assess the effect of peribulbar anesthesia on retinal microvasculature in primary open-angle glaucoma (POAG) patients undergoing cataract surgery using OCT Angiography. Participants: Forty-nine patients undergoing cataract surgery were divided into two groups. Group I included patients with no history of glaucoma, while group II included patients previously diagnosed as POAG with controlled IOP. Each participant received 6 mL of peribulbar anesthetic injection of 4 mL lidocaine 2% containing 150 IU hyaluronidase and 2 mL bupivacaine 0.5%. They were scanned with the OCT-A 10 minutes before and 10 minutes after injection for foveal deep (DCP), superficial (SCP) capillary plexuses density and total vessel density, foveal avascular zone (FAZ) diameter, optic disc total vessel density, and radial peripapillary capillary (RPC) network density. In addition, IOP was checked before and 10 minutes after injection. Results: Median percent change in DCP post-injection was significantly greater in group II (−43%) than in group I (−2.5%) (P < 0.001). Also, DCP total density median percent change post-injection was significantly higher in group II (−21%) than in group I (−0.9%) (P < 0.001). Foveal SCP vessel density and total vessel density median percent change post-injection were −62.6% and −16.2%, respectively, in group II and were −2.6% and −1.1%, respectively, in group I, which are statistically significant (P < 0.001). The FAZ diameter median percentage change postinjection was higher in group II (40.6%) than in group I (2.5%) (P < 0.001). Optic disc total vessel density and radial peripapillary capillary (RPC) network density post-injection median percent change were significantly higher in group II (−13.6%) and (−13.1%) respectively than in group I (−1.1%) and (−1.25%) respectively (P < 0.001). Conclusion: Peribulbar anesthesia harbors a deleterious ischemic effect on the retinal vascular tree of glaucoma patients, which could harmfully affect the vision and the visual field in those vulnerable patients.

Background: Ocular allergy is a heterogeneous disorder in which allergic inflammation plays a major role. its manifestation may be seasonal or a perennial with a yearround moderate to severe symptoms like in perennial allergic conjunctivitis (PAC) or Atopic keratoconjunctivitis (AKC). Objectives: Our goal is to determine sensitization prevalence of inhalant allergens in ocular allergy. Patients and Methods: a cross sectional study conducted from November 2022 to March 2023 on 21 year-round ocular allergic patients with perennial allergic conjunctivitis or atopic keratoconjunctivitis was conducted. Total Ocular Symptoms Score (TOSS) score was used to measure the severity of ocular allergy. Skin Prick test with 7 inhalant allergens, negative and positive control were applied. Participants were recruited from Benha University Hospitals, Egypt after gaining ethical committee approval. Results: 80.9 % (17/21) had positive Skin Prick Test of our 21 participants. Only cockroach and dust mites' allergens were significantly associated with ocular allergy severity. Conclusion: to our knowledge it is the first study to state that cockroach sensitivity in year-round ocular allergy has higher prevalence especially in atopic keratoconjunctivitis and is more commonly found in severe ocular allergy patients. So, we enrich the research in this area which could secure an adjuvant treatment that might help in controlling patients' symptoms.