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Proliferative vitreoretinopathy (PVR) is the most common cause for failure of rhegmatogenous retinal detachment repair and is characterized by the growth and contraction of cellular membranes within the vitreous cavity and on both sides of the retinal surface as well as intraretinal fibrosis. Currently, PVR is thought to be an abnormal wound healing response that is primarily driven by inflammatory, retinal, and RPE cells. At this time, surgery is the only management option for PVR as there is no proven pharmacologic agent for the treatment or prevention of PVR. Laboratory research to better understand PVR pathophysiology and clinical trials of various agents to prevent PVR formation are ongoing.

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BackgroundThe purpose of the current study was to analyze risk factors, clinical features, and treatment outcomes in patients with endogenous fungal endophthalmitis with yeast and mold infections. For this retrospective consecutive case series, microbiologic and clinical records were reviewed to identify all patients with intraocular culture-proven endogenous fungal endophthalmitis treated at a single institution between January 1, 1990 and December 31, 2011.ResultsSixty-seven eyes of 53 patients were identified; 51 eyes of 39 patients had positive cultures for yeast and 16 eyes of 14 patients had positive cultures for molds. Patients with molds as a causative organism had significantly shorter duration of symptoms prior to diagnosis (molds 3.8 days, yeast 21.0 days, p = 0.002), were more likely to be receiving iatrogenic immunosuppression (molds 57.1%, yeast 7.7%, p = 0.001), have a history of whole-organ transplantation (molds 35.7%, yeast 2.6%, p = 0.001), and were more likely to have hypopyon at the time of diagnosis (molds 37.5%, yeast 6.0%, p = 0.001). Patients with endogenous endophthalmitis caused by molds had significantly worse visual acuity at the time of diagnosis (logMAR visual acuity molds 1.80, yeast 1.15, p = 0.008) and at final visit (logMAR visual acuity molds 1.97, yeast 1.05, p = 0.005) compared to those patients with yeast as a causative organism. There was no significant difference in the rate of retinal detachment between the two groups (mold 12.5%, yeast 30.6%, p = 0.201). Patients with cultures positive for mold were significantly more likely to undergo enucleation (molds 25.0%, yeast 0%, p < 0.001).ConclusionsSystemic risk factors for patients with endogenous fungal endophthalmitis caused by molds were iatrogenic immunosuppression and a history of whole-organ transplantation. Shorter duration of symptoms before diagnosis and higher rates of hypopyon occurred in mold cases. While endogenous fungal endophthalmitis is generally associated with poor visual acuity outcomes, infection with mold species was associated with worse visual acuity on presentation and on final follow-up than infection with yeast species. Enucleation rates were much higher in mold cases.

undreds of individuals apply for ophthalmology residency positions each year using the Centralized Application Services (CAS), administered by San Francisco Residency and Fellowship Matching Services (SF Match). Although the match rate remains relatively stable at approximately 75%, the mean number of applications submitted has risen from 48 in 2008 to 75 in 2019. 1,2 In 2010, highly qualified applicants were advised to apply to between 10 and 20 residency programs, 3 but more recent studies suggested a target of 45 applications for these applicants and more than 80 for applicants with less competitive qualification. 2 The application process represents a considerable financial burden for applicants; in 2018-2019, the CAS application alone cost $685 to apply to 45 programs, which increased to $1910 for 80 pro-grams. These high costs are not unique to ophthalmology. In emergency medicine, the cost of securing a residency position was estimated at $8312 in 2016. 4 These trends also come with increasing administrative burden for residency programs tasked with reviewing rising numbers of applications. As a result, many programs have increasingly emphasized quantifiable cognitive measures, such as clinical grades and the US Medical Licensing Examination (USMLE) board scores. 3 The USMLE Step 1 scores and Alpha Omega Alpha Honors Medical Society membership are factors with statistically significant associations with matching into an ophthalmology residency. 5 Although USMLE Step 1 scores have been correlated with in-training examination scores and board-certification pass rates, they are not associated with IMPORTANCE The ophthalmology residency application process is critical for applicants and residency programs, and knowledge about the preferences of applicants would assist both groups in improving the process.OBJECTIVE To evaluate the experiences and preferences of ophthalmology residency applicants. DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional, nonvalidated survey was conducted online. All applicants to the Bascom Palmer Eye Institute ophthalmology residency program during the 2018-2019 application cycle were invited to complete the survey. Data collection occurred from April 1, 2019, to April 30, 2019.MAIN OUTCOMES AND MEASURES Applicant demographics, application submissions, interview experiences, financial considerations, match results, and suggestions for improvement of the application process. RESULTSResponses were received from 185 applicants (36.4%), including 77 women (41.6%). A successful match into an ophthalmology residency was achieved by 172 respondents (93.0%). There was a mean (SD) US Medical Licensing Examination Step 1 score of 245.8 (13.3) points. Respondents applied to a mean (SD) of 76.4 (23.5) ophthalmology residency programs, received 14.0 (9.0) invitations to interview, and attended 10.3 (4.4) interviews. Choices regarding applications and interviews were based mostly on program reputation, location, and advisor recommendation. A usual lead time of at least 3 weeks between the invit...

Purpose of review The aim of this article is to assess the current state of teleophthalmology given the sudden surge in telemedicine demand in response to the novel coronavirus 2019 (COVID-19). Recent findings Recommendations and policies from government and national health organizations, combined with social distancing, have led to exponential increases in telemedicine use. Teleophthalmology can be integrated into ophthalmic care delivery. In the emergency room, teleophthalmology can be utilized to triage patients and diagnose common ophthalmic eye diseases. Ophthalmology practices can utilize real-time medicine to conduct many parts of an in-person exam. In cases where more complex diagnostic tools are warranted, a model incorporating telemedicine and focused in-person visits may still be beneficial. Innovative technologies emerging in the market allow for increased remote monitoring, screening, and management of adult and pediatric patients for common eye diseases. Summary COVID-19 created a demand for healthcare delivery that limits in-person examination and potential viral exposure. Teleophthalmology allows ophthalmologists to continue caring for patients while keeping physicians and patients safe. Although challenges still exist, the pandemic has accelerated the adoption of teleophthalmology. As a result, teleophthalmology will play an integral role in providing high-quality efficient care in the near future.

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