The February 2025 CJO is now available online. Here are some of the highlights: 

Resident Perspectives + visual abstract: Our talented team of residents have summarized 4 articles from this issue with a focus on what’s most relevant to ophthalmology learners here in Canada and around the globe. And our February visual abstract provides a visual summary of an article on the Morphometric analysis of bony nasolacrimal canal and sinonasal anatomical variations in primary acquired nasolacrimal duct obstruction.

Reviews and Original Research Articles:

• The state of eyecare and health among Indigenous Peoples in Canada
• Trends in immediate sequential bilateral cataract surgery in Ontario
• Cardiovascular risk in anti-VEGF treatment of neovascular age-related macular degeneration
• Visual impairment, employment status, and reduction in income: the Canadian Longitudinal Study on Aging
• Pars plana vitrectomy and scleral-fixated intraocular lenses: comparison of Gore-Tex suture and flanged intrascleral haptic fixation techniques
• ChatGPT and retinal disease: a cross-sectional study on AI comprehension of clinical guidelines

Research Letters, Photo Essays, Case Reports, and more:

• Appointment patterns and patient perspectives in corneal telemedicine
• Attitudes of Canadian ophthalmology residents on rural and Indigenous ophthalmology education 
• Impact of a slit lamp program on medical student competence, confidence, and career interests  
• Illuminated depressor enhanced fundus photography  
• Frontal periosteum flap: an approach for improved vascular supply for buccal membrane graft
• Isolated case of noninfectious and nontraumatic panophthalmitis
• F. Y. EYE Column

Follow the CJO on social media:

BlueSky: @cjo-jco.bsky.social

Facebook: CanJOphth

Instagram: @cjo_jco

LinkedIn: CJO – JCO

The following CJO Highlight summarizes key findings from the journal article “Acute Angle-Closure Glaucoma Risk: A Comparative Study of Escitalopram and Antidepressants.”¹

Acute angle-closure glaucoma (AACG) is an ophthalmic emergency that has been linked to selective serotonin reuptake inhibitors (SSRIs) due to their mild anticholinergic effect and possibility of mydriasis. Escitalopram, one of the most prescribed SSRIs, has been implicated in the risk of AACG in case reports. However, prior to this CJO study by Khan et al., it remained unclear whether AACG secondary to escitalopram is a class effect or carries a higher risk than other SSRIs. The highlighted study investigated whether escitalopram poses a greater risk of AACG compared to other SSRIs or non-SSRI antidepressants. A total of 865,546 subjects were included to assess the incidence of AACG among new users of citalopram, escitalopram, sertraline, and venlafaxine. Results indicated trends toward a lower AACG risk in users of citalopram, escitalopram, and venlafaxine compared with sertraline, though none of these differences reached statistical significance. Findings suggest that escitalopram may be associated with a reduced risk of AACG, but further research with larger cohorts is needed. Clinicians should remain cautious when prescribing antidepressants, particularly for patients at risk of glaucoma.

To access the full article, please follow the link below:

Download Full Article PDF

Reference:

1. Khan HM, Schendel S, Mikelberg FS, Etminan M. Acute angle-closure glaucoma risk: a comparative study of escitalopram and antidepressants. Can J Ophthalmol. 2025 Jan 24:S0008-4182(25)00004-3. doi: 10.1016/j.jcjo.2025.01.004. Epub ahead of print. PMID: 39870359.

Submitted by: Audrey-Anne Lapierre
Reviewed and Approved by: Anne Xuan-Lan Nguyen, MD

The October 2024 CJO is now available online. Here are some of the highlights: 

Resident Perspectives + visual abstract: Our talented team of residents have summarized 3 articles from this issue with a focus on what’s most relevant to ophthalmology learners here in Canada and around the globe. In addition, our October visual abstract provides a visual summary of an article on the Long-term effect of fluid volumes during the maintenance phase in neovascular age-related macular degeneration: results from Fight Retinal Blindness!

Reviews and Original Research Articles:

• Advancements in the diagnosis, prognosis, and treatment of retinoblastoma

• Evaluating smartphone fundoscopy as a pedagogical tool in medical education: a narrative review

• Routine history and physical examinations prior to cataract surgery are not beneficial

• Outcomes and risk factors for Kahook Dual Blade excisional goniotomy with concomitant phacoemulsification: a multicentre Canadian study

• Breaking bad news in ophthalmology: a pilot skills workshop for residents

• Ophthalmic diseases in meningitis within the pediatric population

Research Letters, Photo Essays, Case Reports, and more:

• Patient knowledge of pentosan polysulfate maculopathy in Alberta: a population wide survey-based study 

• Massive ciliochoroidal melanoma masquerading as conjunctival melanoma  

• Ocular Jarisch-Herxheimer reaction causing a transient sub-foveal lesion in ocular syphilis  

• Advanced intraocular retinoblastoma: evolving criteria for group E disease

• Exudative retinal detachment following laser photocoagulation for retinopathy of prematurity

• Diagnosis of a uveal melanoma arising from the choroid beneath a congenital hypertrophy of the retinal pigment epithelium: the value of microvascular flow imaging

• F. Y. Eye Column — October 2024

Follow the CJO on social media:

Facebook: CanJOphth

Instagram: @cjo_jco

LinkedIn: CJO – JCO

Twitter: @CanJOphth

The August 2024 CJO is now available online. Here are some of the highlights: 

Resident Perspectives + visual abstract: Our talented team of residents have summarized 3 articles from this issue with a focus on what’s most relevant to ophthalmology learners here in Canada and around the globe. In addition, our August visual abstract provides a visual summary of an article on the Epidemiology of ocular emergencies in a large Canadian eye centre.

Reviews and Original Research Articles:

• Advances in conjunctival melanoma: clinical features, diagnostic modalities, staging, genetic markers, and management
• Advances in multimodal imaging for diagnosis of pigmented ocular fundus lesions
• Research productivity of first-year Canadian ophthalmology residents: a 12-year trend
• Visualization of preretinal membranes using trypan blue in patients with traction retinal detachments
• Artificial intelligence chatbot performance in triage of ophthalmic conditions
• Retinal and choroidal microvascular changes during pregnancy detected with OCTA

Research Letters, Photo Essays and Case Reports:

• Performance of three artificial intelligence chatbots on Ophthalmic Knowledge Assessment Program materials
• Scleral patch graft for emergency open-sky repair
• Cavitary ciliary body melanoma with extensive pigment dispersion
• Acute macular neuroretinopathy following uncomplicated epiretinal membrane removal
• Bilateral circumscribed choroidal hemangiomas in 2 patients: a rare finding
• 532-nm laser for sub-internal limiting membrane hemorrhage associated with retinal macroaneurysms
• Syndromic PRD: case report of McArdle retinopathy and review of literature

Follow the CJO on social media:

Facebook: CanJOphth

Instagram: @cjo_jco

LinkedIn: CJO – JCO

Twitter: @CanJOphth

The second issue of the Video Journal of Cataract, Refractive, & Glaucoma Surgery is live!  The program is entitled: The Essential Partnership with Industry. 

Dick Lindstrom and David Chang give a great introduction detailing the synergy between ophthalmologists and industry that results in innovative products which address unmet needs.  For the first time in our 40 year history, we are publishing videos submitted from industry showcasing new products and company philosophies. To view more, please visit: http://www.vjcrgs.com/ and view the table of contents below!

The June 2024 CJO is now available online. Here are some of the highlights: 

Resident Perspectives + visual abstract: Our talented team of residents have summarized 4 articles with a focus on what’s most relevant to ophthalmology learners here in Canada and around the globe. In addition, our April visual abstract provides a visual summary of an article on Comparison of pain perception in patients undergoing manual cataract surgery versus refractive laser-assisted cataract surgery

Original research articles:

• Retinal vein occlusion in patients with primary angle closure: a prospective case-control study
• Effectiveness of the Eyesi Surgical Simulator for ophthalmology trainees: systematic review and meta-analysis
• Incidence of ophthalmologic pathology and associated risk factors in orbital fractures at a level 1 trauma centre
• Herpes zoster ophthalmicus: frequency and risk factors for developing uncommon ocular manifestations
• Burnishing of exposed porous polyethylene orbital implant: is it useful?
• Diabetic retinopathy screening integrated in multidisciplinary diabetes eye care clinic: a pilot project

Photo essays and case reports:

• Scleromalacia after extrusion of a senile calcific plaque [photo essay]
• Bacillary layer detachment due to retinal arterial macroaneurysm [photo essay]
• Early ophthalmic findings in Hermansky-Pudlak syndrome type 9 [photo essay]
• Corneal ulcer as the presenting sign of prolonged contact lens retention over 25 years [case report]
• Monocular Charles Bonnet syndrome secondary optic neuritis and the utilization of artificial intelligence to illustrate visual hallucinations [case report]
• Rhegmatogenous retinal detachment associated with an epibulbar tumour [case report]
• Beyond the norm: unusual orbital manifestation of hairy cell leukemia [case report]

Follow the CJO on social media:

Facebook: CanJOphth

Instagram: @cjo_jco

LinkedIn: CJO – JCO

Twitter: @CanJOphth

The April 2024 CJO is now available online. Here are some of the highlights: 

Resident Perspectives + visual abstract: Our talented team of residents have summarized 4 articles with a focus on what’s most relevant to ophthalmology learners here in Canada and around the globe. In addition, our April visual abstract provides a visual summary of an article on OCT outcomes as biomarkers for disease status, visual function, and prognosis in diabetic macular edema.

Original research articles:

·        Development and validation of the first Canadian Aboriginal syllabics visual acuity chart

·        Zonular dialysis and cataract surgery: results from a UK tertiary eye care referral centre

·        Development of a standardized Canadian undergraduate medical education ophthalmology curriculum

·        Incidence of ocular surface squamous neoplasia in pterygium specimens

·        Effect of race and ethnicity on surgical outcomes for rhegmatogenous retinal detachments

• Characterization of pentosan polysulfate patients for development of an alert and screening system for ophthalmic monitoring

Photo essays, correspondence, and case reports:

·        Bilateral conjunctival melanosis in diffuse melanosis cutis and metastatic melanoma

·        Unilateral acute idiopathic maculopathy in hand, foot, and mouth disease

·        Laser pointer-induced maculopathy with secondary macular neovascularization

·        A virtual Canadian Ophthalmology Mentorship Program (COMP) for medical students

·        Surgical technique enhancements for successful subretinal gene therapy delivery

·        Ocular syphilis with coincident Bartonella infection

·         Unveiling ocular surface squamous neoplasia within a conjunctival epithelial inclusion cyst

Follow the CJO on social media:

Facebook: CanJOphth

Instagram: @cjo_jco

LinkedIn: CJO – JCO

Twitter: @CanJOphth

UPDATE (2024-04-17): We are collecting case reports on solar retinopathy following the recent solar eclipse. If a patient you’ve seen experienced vision impairment or related symptoms after viewing the eclipse, please fill out the following form to contribute to our research efforts. Your participation is crucial in helping us gather valuable data to better understand and mitigate the effects of solar retinopathy. You can access the form by clicking HERE.

Looking directly at the sun without proper protection can cause significant damage to your eye leading to a condition called solar retinopathy. During unshielded observation of a solar eclipse, the lens of the eye acts just like a magnifying glass, focusing the sun’s rays onto the retina at the back of the eye. This concentrated energy can result in permanent burns of the retina, and even irreversible blind spots.

The retina has no pain receptors. Therefore, it can take time before someone realizes that retinal damage may have occurred. You should be attentive to signs such as a blurry vision, visual distortion, and decreased colour vision and if you have looked at the solar eclipse without eye protection.

Let’s delve into some commonly asked questions about solar retinopathy and solar eclipse safety, and expert answers to equip both patients and providers with valuable insight during this event.

Commonly asked questions and answers

Q: What is the best primary prevention?

A: Refraining from viewing the solar eclipse is the best primary prevention to solar retinopathy. You can safely view the event indirectly, by TV or web.

Q: Which glasses are unsafe?

A: Sunglasses, glasses with transition lenses, glasses with polarizing filters, exposed film, x-ray film, and neutral density filters, do not provide enough safety to view the eclipse.

It is equally unsafe to view the eclipse from your telescope, camera, binoculars without the appropriate special filter, or through a window without the correct eye protection.

Q: Can one take pictures of the eclipse with a smartphone?

A: You can take pictures of the eclipse with your smartphone or tablet device, but make sure that you are not viewing the eclipse without the proper eye protection while aligning the device for the photo. Please keep in mind that some manufacturers state that prolonged pointing of the smartphone/camera to the sun may affect its sensors.

Q: What is the right filter to have when viewing the eclipse?

A: ISO 12312-2 certified. Upon receiving your glasses, please take the time to inspect as the glasses should not be scratched or torn. If the glasses are being worn by children, ensure that they are supervised at all times.

Q: What is the maximum duration of time that we can view the solar eclipse without permanent damage? What if I glance at the eclipse, look away, and then back again?

A: There is no duration of time that you can view the eclipse without permanent damage! The effects of the damage by the sun are cumulative, so looking at the eclipse multiple times would do more damage than looking at it once. It is advised that you do not look directly at the sun at all.

Please keep in mind that if on the totality path, to use great caution and under expert supervision to indicate the time that you may securely remove and put back on the certified glasses.

Q: Can animals suffer from solar retinopathy as well?

A: In theory, yes, if they are looking at the sun during the eclipse.

Q: Can someone with a previous history of ocular disease view the eclipse?

A: Yes, but only with precaution and the correct eye protection. If unsure, they can enjoy the solar eclipse by viewing it indirectly (such as through a livestream or broadcast on TV).

Resources

The authors of this Q&A on solar eclipse eye safety have compiled a comprehensive set of resources tailored to both patients and ophthalmologists, ensuring that everyone can access reliable information and guidance.

For the general public

Government of Canada – Stay safe while watching the solar eclipse

American Astronomical Society – Viewing the solar eclipse safely

Exploratorium – View the eclipse safely through livestream

Association des médecins ophthalmologistes du Québec – Éclipse solaire du 8 avril (French only)

Canadian Ophthalmological Society – Protect your vision

The Dose – How can I watch a solar eclipse and keep my eyes safe?

For the ophthalmologist

American Academy of Ophthalmology EyeWiki – Solar retinopathy

The Astronomical Journal – Physical and visual evaluation of filters for direct observation of the sun and the international standard ISO

Queen’s University – Grand Rounds Presentation: Total solar eclipse and eye health

Ophthalmology Times – Protecting vision during solar eclipses: Insights for ophthalmologists

Thank you to Dr. Marie-Josée Aubin and Dr. Cynthia Qian for creating this helpful resource!

The latest issue of Canadian Eye Care Today is now available! This publication features clinical perspectives and practical information on topics in eye care relevant to today’s clinician. Its peer-reviewed articles focus on the treatment and management of eye disease from a Canadian perspective.

The content of this issue includes:

• Gene Therapy Updates for Inherited Retinal Dystrophies
  • Melissa Lu, MD; Daniel Milad, MD; Cynthia X. Qian, MD, FRCSC.
• Recent Advances in the Evaluation and Treatment of Primary Angle Closure Disease
  • Alanna James, MD; Benjamin Y. Xu, MD, PhD.
• Corneal Lumps and Bumps
  • Mohammad Al-Fayyadh, MD; Mona Koaik, MD.
• Retinal Artery Occlusion and Neurovascular Risk
  • Jesia Hasan, MD, FRCSC.
• Approach to Infectious Keratitis: Clinical Pearls While on Call
  • Sonia N. Yeung, MD, PhD, FRCSC, FACS; Alfonso Iovieno, MD, PhD, FRCSC, FACS; Barbara Burgos-Blasco, MD, PhD.

To access the latest issue, click on the picture below!