Purpose: To review current eyedrop instillation techniques, common difficulties faced by patients instilling eyedrops, available eyedrop assistive devices, and patient education regarding eyedrop instillation. Methods: PubMed, Embase, and Google Scholar were searched from conception until June 2022 for articles on eyedrop instillation difficulties, techniques, tools, and patient education. Results: Instillation involves pulling down the lower eyelids and placing drops on the corneal surface or conjunctival fornix, followed by closing of the eyelids for about 1 min. Examples of techniques include eyelid closure and nasolacrimal obstruction techniques. Patients encounter many difficulties when administering eyedrops, including but not limited to poor visibility, squeezing the dropper bottle, aiming the bottle, and accidentally blinking. However, devices are available that assist with aim and dropper compression-force reduction in eyedrop instillation. These can be particularly useful in patient demographics with diminished manual dexterity or the ability to generate force from their fingers. Furthermore, despite patient education in eyedrop instillation not being a common practice, it has been found that adequate patient education can lead to significant improvement in eyedrop instillation technique. Conclusions: While many factors are associated with poor eyedrop instillation technique, there are many solutions available including assistive devices and proper instillation education.

Purpose: To compare the efficacy of diclofenac sodium 0.1% and betamethasone 0.1% and combination therapy with both drugs in controlling postcataract surgery inflammation. Methods: In this randomized-clinical trial, 78 patients who had undergone ECCE-PCIOL surgery were randomized to receive diclofenac sodium 0.1% eye drop, betamethasone 0.1% eye drop and combination therapy with both drugs. The patients were examined on days 3,7 and 28 postoperatively. Severity of anterior chamber reaction (A/C reaction) and conjunctival injection were evaluated and compared. Results: Severity of A/C reaction and conjuctival injection were not statistically different among the three groups. No significant complication was observed in either groups. Also no significant change in intraocular pressure occurred in any group. Conclusion: Diclofenac sodium 0.1% eye drop is as effective as betamethasone 0.1% eye drop in controlling post cataract surgery inflammation. Although combination therapy with both drops is more effective than monotherapy with either drop but this difference is not statistically significant.    

Background: Umbilical cord blood (UCB) is a novel treatment of resistant corneal ulcers owing to the unique anti-inflammatory molecules and growth factors it contains. Platelet lysates are a potential future alternative. The aim of the present study was to assess the role of human UCB platelet lysate in treating resistant corneal ulcers. Methods: This was prospective, non-comparative, interventional case series involving 40 eyes of patients aged 6 –,65 years with persistent corneal ulcers from the Mansoura Ophthalmic Center and Mansoura Research Center for Cord Stem Cells. Patients were classified according to the cause of persistent corneal ulcer into four groups: group I, including 14 eyes with dry eye disease,group II, including six eyes post-keratoplasty,group III, including four eyes with corneal chemical burn,and group IV, including 16 eyes with persistent corneal ulcer from other causes. All participants underwent detailed ophthalmic examinations, and baseline and final bestcorrected distance visual acuity (BCDVA) were recorded. Eye drops were prepared from UCB platelet lysate and administered to all patients along with detailed meticulous instructions for the method of use. Clinical progression of wound healing was continuously observed. The treatment response was identified as complete healing, improvement, or treatment failure. Results: BCDVA improved significantly in all studied groups (all P < 0. 05). In group I, complete healing, improvement, and treatment failure occurred in 71%, 29%, and 0% of cases. In group II, complete healing, improvement, and treatment failure occurred in 67%, 33%, and 0% of cases. In group III, complete healing, improvement, and treatment failure occurred in 50%, 50%, and 0% of cases. In group IV, complete healing, improvement, and treatment failure occurred in 63%, 12%, and 25% of cases. No adverse events associated with the treatment were observed or subjectively self-reports in the study period. Conclusions: Eye drops from UCB platelet lysate were a novel therapeutic blood component with unique growth factors and anti-inflammatory compounds that could be an effective and safe treatment option in managing persistent corneal ulcers of different causes. A future randomized clinical trial with a large sample size and a longer follow-up is required to confirm these preliminary outcomes.

In this study, pathogenesis of co-infection of (A/Chicken/Iran/ m.1/2010) H9N2 virus and (ORT -R87-7/1387) Ornithobacterium rhinotracheale bacteria, and tissue tropism and dissemination of this co-infection throughout the body of SPF chickens were investigated. The clinical signs and gross lesions of the infected chicks were also monitored. Forty, 21-day-old SPF chicks were divided randomly into two groups (20 chicks in the experimental and 20 chicks in the control group). At the age of three weeks, the chicks in the experimental group were inoculated by eyedrop with the virus of 106 EID50 and intratracheally with the bacteria of 1×1010 CFU. The samples from various tissues were collected at 2, 4, 6, 8, 10, 12 and 14 days post-inoculation (DPI). We used culture on blood agar for detection of the bacteria and isolation assay in embryonated chicken eggs (SPF) to evaluate virus dissemination. Experimental group chickens exhibited depression, reduced appetite, ruffled feathers, more severe respiratory signs and 15% mortality. The most remarkable clinical signs appeared on day 3 PI. H9N2 was detected in the lungs and trachea on days 2 and 4 PI. The virus was also found in the Bursa of fabricius on days 2 and 6 PI. The H9N2 virus was observed only on day 2 PI in Thymus and Liver, and only on day 8 PI in Kidneys. We could not trace the virus in the spleen, cecal tonsils and cloaca during study. ORT was isolated in the swabs of trachea on days 2 and 4 PI. The bacteria was also found in the lungs on day 4 PI.But ORT was not detected in swab samples taken from heart and liver during study. The Results of this study indicated that H9N2 virus and ORT bacteria was not detected from days 6 and 10 PI, respectively and also concurrent infectious with H9N2 virus and ORT bacteria could exacerbates clinical signs and gross lesions in infected chickens.