INTERESTING EYE NEWS & CLINICAL PEARLS

 A study from China found that higher magnesium intake may help lower the risk of cataracts , especially in people who smoke, drink alcohol, or have other health risks like obesity and high blood pressure. Researchers analyzed data from over 8,000 adults in the U.S. and found that those who ate more magnesium were less likely to have had cataract surgery . Magnesium may protect the eyes by reducing oxidative stress , which increases with age and contributes to cataract formation. This effect was strongest in non-Hispanic white individuals and those with moderate income levels, and in people without heart disease. While the results suggest magnesium could help prevent cataracts, more research is needed to confirm this link.

 A Chinese clinical trial compared low-dose (0.01%) and mid-dose (0.04%) atropine eye drops with orthokeratology (ortho-K) to manage myopia in children. Over two years, 0.04% atropine was the most effective at slowing eye growth (axial elongation), which drives myopia progression. It outperformed both 0.01% atropine and ortho-K. However, 0.04% caused more light sensitivity (photophobia), though this declined over time. Critics of the study pointed out that subgroup sizes were small and behavior during the COVID-19 lockdowns (like time spent indoors) wasn’t accounted for, which could have skewed results. They also questioned conclusions about age-specific effectiveness due to limited data. Still, the overall finding stands: 0.01% atropine is not enough for effective myopia control, and higher doses like 0.04% may offer better results.

 Hydroxychloroquine (HCQ) and chloroquine are commonly used to treat lupus but may cause serious eye problems over time. A new study from China looked at data from the FDA's Adverse Event Reporting System (2004–2024) and found that these drugs are linked to several vision-related side effects, including cataracts, macular degeneration, glaucoma, retinal degeneration, cystoid macular edema (CME), and optic atrophy. Researchers found that eye issues were more common in women and middle-aged patients. Cataracts showed up the fastest (about 4 months after starting the drug), while retinal degeneration took the longest (over 2.5 years). The drugs are believed to build up in eye tissues, especially in the retina, possibly causing long-term damage. The study suggests these medications carry a real risk of vision problems, and further research is needed to understand exactly how the damage occurs and how to prevent it.

A study in the American Journal of Ophthalmology found that people who regularly take oral nitrates (like nitroglycerin) for heart disease had a lower risk of developing open-angle glaucoma (OAG) after three and five years, though not after just one year. They also needed glaucoma medications less often during that time. Researchers looked at data from over 30,000 patients with heart disease. Those taking nitrates had slightly lower rates of glaucoma compared to those who didn’t. However, nitrate use didn’t seem to affect the risk of ocular hypertension (OHT), a related condition. The study suggests nitrates might help protect the optic nerve by improving blood flow and reducing stress on nerve cells. But since it’s an observational study, more research is needed to prove if nitrates actually prevent glaucoma or slow its progress.

  A recent study explored how diet and sleep habits influence the development and progression of different types of glaucoma, a disease that damages the optic nerve and can lead to blindness. Researchers found that high-fat, high-calorie diets may raise glaucoma risk through inflammation and metabolic dysfunction. In contrast, antioxidant-rich fruits, vegetables, and fiber-heavy grains may help protect the eyes by reducing oxidative stress. The study used genetic data and health records to examine over 1,700 factors, including diet, sleep, amino acids, and inflammatory markers. Certain foods like cheese, chocolate, and meat were linked to higher risk of specific glaucoma types, while foods like grapes, avocados, and cereals showed protective effects. The benefits or risks often depended on portion size and nutrient balance. Sleep also played a key role. Short naps and good sleep quality were associated with lower glaucoma risk, possibly by helping regulate stress and inflammation i...

  A  study from China  analyzed U.S. survey data to examine the link between diet-based antioxidant levels and glaucoma risk. Using a measure called the Dietary Oxidative Balance Score (DOBS), which reflects the balance of antioxidants and pro-oxidants in a person's diet, researchers found that higher DOBS—indicating more antioxidants—was associated with a lower risk of glaucoma. Specifically, each point increase in DOBS reduced the risk by 4%, with the highest antioxidant group showing the lowest glaucoma rates. While the findings suggest a protective role of antioxidants, the study had limitations. It relied on self-reported glaucoma diagnoses, only included adults, and couldn’t prove a direct cause-and-effect link. The authors emphasized the importance of maintaining oxidative balance and called for more research into how nutrition affects glaucoma development and treatment.

  In a recent  study , researchers aimed to assess associations between long-term BPV and the risk of age-related macular degeneration (AMD) and found that a 5mm Hg increase in diastolic BPV was associated with a 54% higher risk of advanced AMD, suggesting that one of the mechanisms is choroidal ischemia and inflammation leading to choroidal thinning and ultimately to AMD onset.  In their paper, the researchers speculated that blood pressure variability affects choroidal thickness.  “It has been observed that, in the presence of continuous fluctuations in systemic BP, the choriocapillaris sympathetic system is overstimulated by, among others, local oxidative stress. This has been shown to induce vasoconstriction of the choriocapillaris, which can lead to ischemia and thinning of the choroid,” the authors explained in their article. One study observed a thinning of the choroid in hypertensive patients compared to a control group, particularly in the subfoveal region. ...

  Lacrimal gland injections can be a good option for patients who experience excessive tearing. In  this study  i t was found that Schirmer test scores decreased at three months as well as having decreased at six months. Adverse event overall incidence was 22%, with the most common being ptosis and diplopia.  Other than the objective measurement of Schirmer scores, subjective patient-reported outcomes also displayed significant improvement, reflective of high patient-reported satisfaction. Therapeutically, the effect of Botox is achieved via inhibition of acetylcholine at the neuromuscular junction within the lacrimal gland. In general they believe botulinum toxin injection “stands as a promising option for select patients, offering a balance of efficacy, reversibility and low invasiveness in managing chronic epiphora.”

   Two emerging treatments for dry eye disease (DED) associated with meibomian gland dysfunction (MGD) are intense pulsed light therapy (IPL)—thought to lead to the breakdown of aberrant or telangiectatic blood vessels and decrease inflammation—and low-level light therapy (LLLT)—a more recent development intended to aid tissue repair and neural recovery. When performed alone, the latter procedure has been shown to alleviate clinical signs and symptoms better than IPL, prompting the authors of a  new study  to investigate whether LLLT is more effective for MGD-related DED on its own or in combination with IPL. Their findings revealed that while both approaches improved symptom frequency and severity, combined therapy held an advantage in boosting cellular energy levels. The results revealed significant improvements in symptomatology across both treatment modalities.  Furthermore, meibum expressibility saw improvements in both groups after treatment.  The stu...

  Copper, found in foods typical of the Mediterranean diet, plays a critical role in various biological processes, including antioxidant defense and extracellular matrix biosynthesis. In a recent  study,  researchers investigated the relationship between the intake of copper, as well as iron, zinc, selenium in diet and late AMD, and found that out of all of these elements, increased copper consumption is associated with a reduced risk of late AMD, especially in those between the ages of 70 and 85. The Age-Related Eye Disease Study (AREDS) 1 and AREDS 2 study demonstrated similar results, indicating that copper consumption was linked to reduced late-stage AMD risk. The authors suggest that more research into the mechanism linking copper and late AMD development is warranted.

  Tryptyr (pronounced  trip-tir ), released by Alcon activates trigeminal nerve signaling, leading to increased basal tear production. The recommended dosing of Tryptyr is twice per day.  Roughly half of subjects receiving the test drug met the primary outcome of at least a 10mm increase in Schirmer score at day 14, up to a fourfold increase over controls treated with the vehicle only,  The Alcon press release also states that some subjects treated with Tryptyr demonstrated statistically significant natural tear production as early as day 1. The company anticipates a US launch in the third quarter of 2025. Tryptyr will be supplied in preservative-free, single-use vials.