Their readability is mostly college level, the analysis—the first of its kind–shows. This isn’t recommended for content designed to be read by patients, say the researchers, who add that while communication quality may influence clinical outcomes, the dual purpose clinical letters serve makes improvement challenging.

Unlike many other health systems, there is a well established practice in the UK of sending letters to patients following an outpatient clinic appointment. These letters used to be copies of those sent to the patient’s family doctor (GP), but the emphasis has shifted to making them clearer and more patient centred, note the researchers.

Academy of Medical Royal Colleges (AoMRC) guidance in 2018 encouraged clinicians to write directly to patients rather than about them, and NHS England has since reinforced the importance of clear and timely communication with patients as essential for efficient and effective outpatient services, they add.

But it’s not clear to what extent clinical letters meet recommended readability standards. To find out and set a quality benchmark, the researchers focused on the highest volume outpatient specialty in UK healthcare—-ophthalmology.

They measured the readability and linguistic complexity of over 4.6 million outpatient clinic letters sent to 804,986 patients between 2013 and 2025 attending 17 subspecialty services at a UK hospital trust, specialising in various aspects of eye health.

Their analysis shows that the average readability score (Flesch Reading Ease) of the letters was 51.1, indicating college-level understanding. This means the correspondence was more complex and less accessible than recommended for content designed to be read by patients. Overall, 95% of the letters were less readable than recommended.

Readability varied across the 17 subspecialties, however, suggesting that communication quality may reflect service-level culture and documentation requirements, say the researchers.

The highest readability was observed for letters from paediatrics, optometry, and orthoptics services.

In children’s eye services, correspondence was often directed to parents or caregivers, which may encourage use of simpler language, suggest the researchers. And in optometry and orthoptics structured templates were often used, likely facilitating more consistent readability, they add.

There was a slight upward trend over the study period in the likelihood of letters being addressed directly to patients over the study period, but the proportion doing so remained very low, overall, at just over 2%, while use of the personal pronoun ‘you’ was also very low.

The researchers highlight several limitations to their findings, including the inability to assess variations in the readability of individual clinicians’ letters. The analysis also focused on readability and linguistic complexity rather than measuring which aspects of communication matter most to patients or had the greatest impact on healthcare outcomes.

The methods used to classify the intended audience may not fully reflect how correspondence is ultimately used or interpreted, while shifts in clinical practice, record keeping, or institutional policies may also have introduced effects not accounted for in the analysis, the researchers add.

But the study is the first long term population-scale evaluation of outpatient clinic letter readability over more than a decade, and exposes a gap between policy recommendations and routine practice, they point out.

“It demonstrates that poor readability is pervasive, has worsened over time, and varies
substantially between services, revealing system-level patterns that were previously unquantified,” they write.

Clinician letters must simultaneously work as a medical record and provide key information for other healthcare professionals as well as for patients, making it hard to simplify the linguistic content—a challenge that is further compounded by time pressures—they explain.

But they conclude: “These findings highlight a persistent gap between national recommendations and real-world practice, which underscores the need for targeted interventions and innovative approaches to support clear and patient-centred communication.”

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‘It’s very important that the problem is recognised and that we show that it can be measured by objective testing,’ says Prof Neil Lagali, professor of experimental ophthalmology at Linköping University, who led the study published in Nature Communications. ‘Patients don’t have access to that [testing] today. We’ve studied people in Sweden, but believe that many people around the world are experiencing these problems.’

The study originated with people seeking care for eye problems following a mild COVID-19 infection. They were experiencing a lot of discomfort, sensitivity to light and in many cases severe eye pain, difficulty reading and focusing their gaze.

The researchers examined 100 people with eye problems following COVID-19 who had not been hospitalised. They had suffered from eye problems for between three months and three years, and one in three were on full or part-time sick leave. The researchers compared the affected group with a control group of 32 people, who had also had mild COVID-19 but without eye problems.

‘We found that the problems experienced by those affected were not detectable by standard tests. We had to perform specialised examinations to detect deviations. The puzzle pieces then fell into place, and we found explanations for the symptoms,’ says Neil Lagali.

In their study, the researchers found long-term inflammation and deterioration of several eye functions controlled by the nerves in the brain.

One of the advanced tests involved proteomics, where a variety of proteins in the tear fluid are analysed. In those with eye problems, the researchers found an abnormal pattern of proteins regulating nerves and immune cells, so-called T cells. The findings were consistent with advanced eye microscopy that they used to measure the T cells and nerves in the eye. Strikingly, the same protein pattern has been found in blood and tissue in cases of severe and fatal COVID in other studies.

‘Our findings suggest that these people have suffered a severe reaction to COVID-19 manifested in the eyes, with long-term inflammation and an impact on the nerves that control multiple eye functions,’ says Dr Petros Moustardas, senior research associate at Linköping University and lead author of the study.

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The extent of these potentially blinding injuries prompts the report authors to call for clear manufacturer warnings amid the rising popularity of these devices and the absence of standardised guidelines on their use.

The young man in question had developed floaters (small dark specks in the field of vision) and occasional flashing lights (photopsia) over the preceding 6 days in his right eye, with no obvious cause, such as a blow to the head.

Close examination revealed multiple retinal tears and bruising (commotio retinae) in both eyes, and retinal dialysis in the right eye. Retinal dialysis is a specific type of tear, where the retina separates from its attachment, potentially causing permanent sight loss if left untreated.

When questioned further, the man admitted to using a percussive massage gun around and directly on both his eyes, for several minutes at a time, every week for 3 months, to relieve the feeling of tiredness.

Percussive massage guns deliver rapid, concentrated pulses of pressure to soft tissues, and are often used to boost muscle strength and relieve musculoskeletal pain, explain the report authors.

He was successfully treated with laser therapy, with no lasting detrimental impact on his sight—most likely because he sought prompt treatment once symptoms developed, the authors suggest.

This is just one case, and published reports of eye problems associated with massage gun use are rare, they highlight.

“However, cases of lens pathology, acute angle closure glaucoma, and retinal detachment have been described,” they note.

“There are two known cases of profound vision impairment associated with massage gun use, along with a further case of successfully treated isolated traumatic cataract without retinal injury or lasting visual compromise,” they add.

“Little is known regarding the safety profile of percussive massage guns. In this case, the massage gun was commercially purchased and used without professional guidance. The patient reported no awareness of any warnings in the operating instructions against ocular use,” they point out.

They conclude: “This rare presentation highlights the potential for significant retinal injury. It also underscores the need for cautious massage gun use, careful history taking in unexpected clinical scenarios, and clear manufacturer warnings against improper application.”

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The researchers say the drops led to small but significant reductions in myopia progression compared with placebo, and are “a worthwhile addition to currently available optical interventions for the treatment of myopia in children in the UK.”

Rates of myopia in children are increasing worldwide, and are linked to higher healthcare costs and long term eye-related complications

Atropine eye drops are used worldwide to treat myopia in children, but are not currently available in the NHS, so their effectiveness and safety in children in the UK is uncertain.

To address this knowledge gap, researchers recruited 289 children with myopia aged 6-12 years (average age 9.3 years; 72% reported white ethnicity; 56% were girls) from five NHS hospital eye services and academic institutions between June 2019 and February 2022. All children wore standard spectacles to correct myopia.

A total of 192 children received daily 0.01% atropine eye drops and 97 received placebo for two years, in addition to standard spectacles. Myopia progression, eye growth, safety, and tolerability were monitored every six months.

Final results were available for 230 children (151 in the atropine group and 79 in the placebo group).

After accounting for factors such as age, ethnicity, and history of myopia in at least one parent, children who used atropine eye drops experienced a small decrease in myopia progression and eye growth compared with those using placebo drops.

Specifically, atropine treatment led to an average reduction of 0.38 D (diopter) in refractive error and 0.14 mm in central axial length – two key measures of myopia – compared with placebo.

Pupil diameter was the only other outcome with a notable difference (0.36 mm greater in the atropine group). No differences were seen in the frequency of adverse events or in tolerability measures, such as sore eyes, blurry vision, itchiness, or difficulty reading and writing.

The researchers acknowledge several trial limitations, such as the generalisability of results outside of a clinical trial environment and the potential influence of the covid-19 pandemic, which occurred during the trial period.

Nevertheless, they conclude: “The findings suggest that a low concentration atropine eye drop product would be a worthwhile addition to currently available optical interventions for the treatment of myopia in children in the UK.”

These results will help inform policymakers in the UK, they add.

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“Glaucoma is a leading cause of blindness, and evidence has linked migraine with an increased risk of glaucoma, with both conditions affecting the capacity of the blood vessels in the brain to alter blood flow in response to stimuli,” said study author Chien-Hsiang Weng, MD, MPH, of Brown University in Providence, Rhode Island. “Since CGRP inhibitors help regulate blood vessel contraction and inflammation in the nervous system, there has been hope that these drugs could benefit eye health in people at risk of glaucoma.”

For this retrospective study investigators enrolled adults diagnosed with migraine who had, in 2018–2024, been treated with migraine preventive drugs known as calcitonin gene-related peptide (CGRP) inhibitors.

They matched 36,822 subjects who took (CGRP) inhibitors to an equal number of subjects who were treated with other types of migraine prevention drugs.

The drugs in the CGRP inhibitor group were erenumab, fremanezumab, galcanezumab, eptinezumab, atogepant and rimegepant. The drugs in the non-CRGP inhibitor group were valproate, topiramate, flunarizine, candesartan, lisinopril, metoprolol, propranolol, nadolol, amitriptyline and venlafaxine.

The subjects were followed for up to three years to see who developed glaucoma.

A total of 73,644 subjects were included in the final analysis.

During the study period, 153 subjects, (0.42%), in the CGRP inhibitor cohort developed glaucoma, compared to 223 subjects (0.61%) in the non-CGRP inhibitor cohort.

After adjusting the data for age, migraine frequency and history of high blood pressure, the investigators reported that subjects treated with CGRP inhibitors had achieved a 25% lower risk of developing glaucoma than those taking other migraine drugs.

Notably, the researchers also reported that the reduced risk of glaucoma only appeared in CGRP inhibitors using monoclonal antibodies– erenumab, fremanezumab, galcanezumab and eptinezumab. The reduced risk was not found with the CGRP receptor antagonists (or gepants), atogepant and rimegepant.

The authors concluded, “Among adults with migraine receiving preventive treatment, systemic use of CGRPi, particularly monoclonal antibody CGRPi, is associated with a reduced risk of glaucoma compared with the use of other migraine preventive medications.”

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Professor of Optometry Lisa Ostrin and postdoctoral researcher Barsha Lal are reporting that even one drop in the eye of low-dose atropine (0.01%–0.1%) produces clear changes in pupil size and focusing ability that persist for at least 24 hours. Importantly, they also found that the drop shows no short-term structural effects on the eye, with only temporary changes in blood flow inside the retina.

Ostrin’s latest research is published in the journal Eye and Vision. It adds to a growing body of vision research from David Berntsen, Golden-Golden Professor of Optometry at the University of Houston, who is co-leading a national $25 million NIH-funded clinical trial to delay the development of myopia in children by using the atropine drops.

Low concentration atropine is widely prescribed to slow myopia progression in children, yet its short-term retinal and choroidal effects remain incompletely understood. Ostrin’s new study evaluated short-term effects of a range of low atropine concentrations on the length of the eye, the blood vessels in the retina and the thickness of the retina and choroid, which sits just behind the retina. These are important measurements because longer eye length is associated with myopia and as it gets longer, the retina and choroid are stretched.

“These findings indicate that a single instillation of atropine does not alter axial length or retinal or choroidal thickness over 24 hours but may transiently affect superficial retinal perfusion in a time-dependent manner,” said Ostrin.

In the double-masked, randomized study, twenty healthy adults received a single instillation of either a placebo or atropine in the right eye during five separate sessions. Researchers then checked the eye structure, thickness, and length in the central retina both one-hour and 24-hours later.

“Characterizing these short-term effects is important for a better understanding of the physiological responses to atropine in clinical and research settings,” said Ostrin who previously published research results of a study investigating the short-term effects of a range of low-dose atropine concentrations on the pupils of young adults. In that study, she found similar results with a single drop of atropine inducing significant changes in the pupils.

Together, the studies indicate that atropine induces early functional and vascular effects in the eye, in the absence of structural change.

“By linking objective ocular responses with subjective visual experience, this work advances our understanding of how atropine works and supports more precise, evidence-based, and individualized approaches to myopia management,” said Ostrin.

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The use of autologous serum eye drops (ASED) was associated with promising real-world outcomes in patients with severe ocular surface diseases refractory to conventional treatment, according to a retrospective observational study conducted at Hospital General de Granollers, Spain.

ASED are derived from the patient’s own blood serum, producing a composition analogous to natural tears that promotes ocular surface healing and symptomatic relief. Despite growing clinical use, real-world evidence regarding their effectiveness, safety, and patient-reported outcomes has remained scarce.

This study enrolled 39 patients (mean age 66 ± 11.5 years) treated with ASED between August 2023 and August 2024. Diagnoses included severe dry eye (22), Sjögren’s syndrome (7), corneal injury (7), and other refractory ocular conditions (2). Symptom relief was reported by 28 patients, including improvements in dryness (10), foreign body sensation (6), itching (4), pain (4), irritation (3), and corneal ulceration (1). No adverse events were recorded.

Visual acuity data were available for 35 patients. Of these, 40% demonstrated improvement and 40% remained stable at six months, suggesting a favourable clinical trajectory even in the absence of statistically measurable acuity gains across the full cohort.

Patient-reported satisfaction, assessed using the validated Treatment Satisfaction Questionnaire for Medication (TSQM v1.4), indicated high scores across all domains: effectiveness 76.8 ± 24.3, side effects 100 ± 0.0, convenience 77.8 ± 16.4, and global satisfaction 84.9 ± 23.8. In total, 85.3% of patients rated global satisfaction at or above the positive threshold of 75.

The authors concluded that their findings support the use of ASED as a clinically relevant therapeutic option for patients with limited alternatives and highlight the value of incorporating patient-reported outcome measures into routine ophthalmic practice.

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The risk is almost 5 times higher with Wegovy than it is with Ozempic, and 3 times greater in men than it is in women, the analysis indicates.

Ischaemic optic neuropathy, or ION for short, is caused by inadequate/interrupted blood flow to the optic nerve, resulting in sudden vision loss in one or both eyes.

Although rare, ION has recently been linked to GLP-1 receptor agonists, particularly semaglutide, marketed as Wegovy, Ozempic, and Rybelsus, and variously used to treat obesity, diabetes, and to reduce cardiovascular disease risk, explain the researchers. 

To pinpoint whether the risks of ION might be associated with particular drugs, the researchers analysed alerts of unintentional and harmful side effects associated with medicines submitted to the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) between December 2017 and December 2024.

The researchers focused on ION associated with up to 2 mg of weekly injectable Ozempic for type 2 diabetes; up to 2.4 mg of weekly injectable Wegovy for obesity—the highest approved dose–and a daily tablet of Rybelsus for type 2 diabetes.  

They also included a once weekly injection of tirzepatide, a dual GLP-1/GIP agonist for the treatment of obesity and diabetes, which was analysed as a combined category and by indication: Mounjaro (for type 2 diabetes); Zepbound (for obesity).

Out of 30,668,520 unintentional and harmful side effect reports, 31,774 involved semaglutide; recipients had an average age of 56, and over half (54%) were female.

Of these reports, 3070 were attributed to Wegovy, originating from 6 countries in 3 continents, and 20,608 to Ozempic, originating from 11 countries in 4 continents.

Ozempic generated about 7 times more reports than Wegovy owing to its earlier approval in 2017; Wegovy was launched in 2021.

Yet despite this difference in volume, Wegovy was most strongly associated with ION (28 reports; higher odds of nearly 75), exceeding Ozempic (47 reports; higher odds of nearly 19) and generic forms of semaglutide (85 reports; higher odds of 21).

ION wasn’t reported in association with Rybelsus. And there was no signal—possible causal association between a medicine and an unintended side effect—with the comparator drugs.

When stratified by sex, the highest signal was for Wegovy in men (116 greater odds) and for Ozempic in women (nearly 27 greater odds).

And further analysis indicated that the odds of ION were nearly 5 times higher with Wegovy than with Ozempic, and more than 3 times higher in men than in women.

Injectables are faster acting than tablets, and differences in route, dose, and indication “may influence prescribing patterns and safety signals, with high-dose Wegovy probably driving the stronger association by predisposing to optic nerve hypoperfusion [low blood supply] through intravascular volume contraction, hypotension [low blood pressure] with nocturnal dips and autonomic instability, although no direct clinical link has been established,” point out the researchers.

“In contrast, the limited absorption and slower uptake of Rybelsus probably explain the absence of a detectable signal,” they add.

Media attention may have influenced reporting for Wegovy, they suggest, emphasising that the FDA reporting system precluded the ability to determine true incidence or assess whether reports clustered following regulatory recognition. And there was no information on co-existing conditions or disease severity either.

Nevertheless, “This study provides the first evidence of a formulation-and dose-dependent ION risk, with the strongest association observed for Wegovy,” write the researchers, concluding: “These findings highlight a potential dose-dependent safety concern that warrants urgent prospective evaluation to guide prescribing and regulatory policy.”

The authors of a linked commentary agree. “These findings add to an emerging body of growing literature reporting ocular complications with [anti-obesity medications] which warrants further scrutiny and urgent clarification for ophthalmologists,” they write.

The use of these drugs is set to grow, they suggest, highlighting that: “The UK has the highest level of obesity in Western Europe (29% of adults are obese, and 64% are overweight or obese).”

And research shows that anti-obesity medications “are also beneficial for cardiovascular diseases, such as stroke as well as dementia, which has led to [them] being considered first-line options for some of these conditions, further increasing their potential use,” they add. 

“To complicate matters further, the growing use of [anti-obesity medications] in children, typically over the age of 12, has caused considerable debate, likely increasing the risks of ocular complications in later life,” they suggest.

Recent clinical studies on these drugs “seem to offer new hope for some conditions, such as age related macular degeneration and uveitis,” they highlight, “but with potential risks of severe, though rare, ocular complications, such as ION, for others.”

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Uveitis

Uveitis is an umbrella term for inflammation affecting the uvea, the middle layer of the eye. Patients can present with pain, photophobia, blurred vision and floaters. Uveitis can be caused by infections but can also be associated with auto-immune inflammatory diseases such as rheumatoid arthritis, Crohn’s disease or Behcet’s disease. If untreated, uveitis can impair vision permanently; “There is potential for vision loss from this inflammation and the damage that it causes. It can induce macular oedema, which is leaky fluid in the eye and if that fluid accumulates at the macula, which is responsible for your central vision, then it can impact your vision temporarily, but if left untreated can lead to permanent vision loss”, explains Ms Goacher.

Treatment of uveitis

The primary goal of treatment is the control of inflammation to prevent damage such as macular oedema. The clinical approach to uveitis is determined by the anatomical site of the inflammation. Anterior uveitis, affecting the front of the eye, is typically managed with topical steroid or anti-inflammatory drops. However, topical treatments cannot penetrate deeply enough for intermediate, posterior, or panuveitis, and systemic steroids are the standard first-line treatment. “If we can’t control patients on systemic steroids or …. if you can’t get patients off the steroids without them flaring back up with their uveitis you would then move on to secondary immunosuppressive medications. So, commonly we’d use mycophenolate or azathioprine”, says Ms Goacher. The biological, adalimumab is available as a third-line treatment, she adds.  Immunosuppressive treatment is steroid-sparing and can enable patients to transition off systemic steroids and avoid long-term side effects. Despite these options, an unmet need persists for patients who do not tolerate immunosuppressants, those who require maximal treatment but still experience flares, or those for whom systemic steroids are contraindicated.  Fluocinolone acetonide intravitreal implants (Iluvien ®), which provide local treatment, can be useful in these situations.

Fluocinolone intravitreal implants

The fluocinolone acetonide implant is a miniature device, measuring only 3.5 mm in length and 0.37 mm in diameter—roughly the size of a grain of rice. It is designed to be injected into the vitreous (the jelly-like part of the eye), where it slowly elutes the medication over a period of up to three years.

The implantation is performed as an outpatient procedure.  After the administration of numbing drops, the device is injected; the process typically takes 10 to 20 minutes, followed by a course of antibiotic drops. Once implanted, the patient cannot feel the device, and the polymer shell remains in the eye after the drug has been fully eluted.

Real-world clinical outcomes

Ms Goacher conducted an evaluation of 45 eyes (34 patients) treated with fluocinolone implants since 2019. The study group included patients with associated systemic inflammatory diseases, such as rheumatoid arthritis or Crohn’s disease. The findings highlighted several key clinical benefits:

• Visual acuity: 58% of patients experienced an improvement in visual acuity.
• Macular oedema resolution: At the six-month mark, 80% of patients with macular oedema saw the condition resolve.
• Systemic treatment reduction: 84% of patients taking systemic immunosuppressive medication were able to reduce their dosage, and three patients were able to stop systemic treatment entirely.
• Topical treatment reduction: There was a 20% reduction in the need for topical drops among the study group.

While the implant is designed to last three years, the audit found the average time to treatment failure (defined as the need for rescue therapy, such as increased drops or additional implants) was approximately 15 months. However, not all the patients had reached the three-year time point, notes Ms Goacher. Nevertheless, one-third of the patients in the study did reach the three-year mark without requiring further intervention, she says.

Managing complications

The use of local steroids in the eye is associated with known complications, primarily cataract development and increased intraocular pressure (IOP). In this audit,16% of patients developed cataracts post-insertion, with the average time to surgery being 12 months. Furthermore, 11% of patients experienced an IOP rise at the three-month mark. While three patients required surgery to manage this pressure, most cases were manageable with glaucoma drops.

From a clinical perspective, these complications are often viewed as a necessary trade-off; as Ms Goacher notes, cataract surgery is a routine, “bread and butter” procedure, whereas uncontrolled inflammation can lead to permanent, irreversible blindness.

Conclusion and future directions

The real-world data suggests that fluocinolone implants offer a robust option for stabilising uveitis and reducing the systemic medication burden on patients. Current efforts are focused on refining this data by looking at long-term outcomes for patients who have had the implant for two or more years to provide further insights into treatment efficacy.

Ophthalmology specialist pharmacist

The role of the specialist pharmacist in ophthalmology is expanding. Although initially Ms Goacher’s role was concerned with oversight of high-cost drugs, it has since grown considerably. The ophthalmology team at the Sussex Eye Hospital was welcoming and supportive and she soon found that ophthalmology offered many opportunities for pharmacy input. “It may not be that obvious on the outset but as soon as you scratch the surface there’s a lot to do in ophthalmology for pharmacy”, she says. For pharmacists looking to specialise in this important field, Ms Goacher highlights the support available through the UK Ophthalmic Pharmacy Group (UK OPG), which provides a network for advice and collaboration.

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Why it matters

Millions of Americans lose vision to eye diseases that often go undetected until significant damage has occurred. Early identification of at-risk individuals could enable timely screening and preventive interventions before irreversible vision loss occurs. This study demonstrates that information already collected during routine doctor visits could help identify patients who would benefit from earlier eye exams, potentially preventing blindness in high-risk individuals. The findings offer a practical way to improve eye disease prevention without requiring additional testing or specialized equipment in primary care settings.

What the study did

Researchers analyzed electronic health records from 35,909 adults aged 40 to 79 years who participated in the All of Us Research Program between 2009 and 2015. They calculated each person’s Pooled Cohort Equations (PCE) cardiovascular risk score using standard health information including cholesterol levels, blood pressure, smoking status, and diabetes. Participants were categorized into four risk groups: Low (less than 5%), Borderline (5-7.4%), Intermediate (7.5-19.9%), and High (20% or greater). The research team then tracked who developed eye diseases over the following years, adjusting for factors not included in the cardiovascular score such as race (with extended subgroups not in PCE), body mass index, kidney disease, and education level.

What they found

Higher cardiovascular risk was strongly associated with increased likelihood of developing eye diseases. Adults in the High-risk group were 6.2 times more likely to develop age-related macular degeneration, 5.9 times more likely to develop diabetic retinopathy, 4.5 times more likely to develop hypertensive retinopathy, 3.4 times more likely to develop retinal vein occlusion, and 2.3 times more likely to develop glaucoma compared to those in the Low-risk group. The cardiovascular score performed particularly well at predicting diabetic retinopathy, hypertensive retinopathy, and age-related macular degeneration. These associations remained consistent across different follow-up periods ranging from five to seven years.

What’s next

The findings suggest that primary care physicians could use cardiovascular risk scores to identify patients who would benefit from referral to eye care specialists for comprehensive screening. Further research is needed to determine the optimal timing and frequency of eye exams for different risk groups, and whether earlier detection and interventions based on cardiovascular risk can actually help prevent vision loss. Implementation studies could help integrate this risk stratification approach into routine primary care workflows and electronic health record systems.

From the experts

“We found that a simple score already calculated in millions of doctor visits each year may meaningfully predict who will develop serious eye diseases,” said Dr. Anne L. Coleman, senior author of the study and chair of the Department of Ophthalmology at UCLA Health. “This gives us an opportunity to identify high-risk patients early, when preventive measures might still protect their vision. The beauty of this approach is that it requires no additional testing; the information is already there in the medical record.”

Article: Cardiovascular Risk and Eye Health: A Prospective Cohort Study of the Pooled Cohort Equations and Ocular Disease Incidence. Ophthalmology Dec 29, 2025. DOI: 10.1016/j.ophtha.2025.12.021

About the Research Team

Deyu Sun, PhD (David Geffen School of Medicine, UCLA) Victoria L. Tseng, MD, PhD (David Geffen School of Medicine and Stein and Doheny Eye Institutes, UCLA) Fei Yu, PhD (David Geffen School of Medicine, Stein and Doheny Eye Institutes, and Fielding School of Public Health, UCLA) Anne L. Coleman, MD, PhD (David Geffen School of Medicine, Stein and Doheny Eye Institutes, and Fielding School of Public Health, UCLA)

Funding and Disclosures

This research was supported by an Unrestricted Grant from Research to Prevent Blindness to the UCLA Department of Ophthalmology. Dr. Victoria L. Tseng has received the Research to Prevent Blindness Career Development Award and the American Academy of Ophthalmology Award for IRIS Registry Research. The sponsor or funding organization had no role in the design or conduct of this research. No conflicting relationship exists for any author.

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A drug-eluting implant has been shown to reverse cystoid macular oedema and reduce the need for systemic treatment in 80% of uveitis patients according to a real-world study presented by Ann-Marie Goacher (University Hospitals Sussex).

Uveitis is an inflammatory condition that affects the middle part of the eye (the uvea or uveal tract). It is often associated with systemic inflammatory (auto-immune) disease but many cases are idiopathic. Although uveitis is relatively rare it is important because it is a sight-threatening condition. Treatment involves the use of corticosteroids (first line) and immunosuppressant treatment (second line).

Iluvien (Alimera Sciences Ltd), a fluocinolone acetonide intravitreal implant has been developed to provide a continuous microdose of corticosteroid over an extended period.

The present study was undertaken to determine how these implants perform in a real-world setting.

Patient data for a five-year period were reviewed. This involved 45 eyes from 34 patients, 65% of whom were female.

Key findings included:

• The mean time to treatment failure (reactivation of disease) was 15 months.
• At 6 months, 80% of patients had a resolution of cystoid macular oedema.
• 84% of patients on systemic treatment were able to reduce their doses and 15% were able to stop all systemic treatment
• 58% of patients experienced improved vision.
• 14 eyes developed cataracts, a known complication of corticosteroid treatment; all had previously received dexamethasone implants.

The authors concluded that Iluvien offers significant benefits in managing inflammation and improving visual outcomes.

Goacher A-M, Ortiz G, Hughes E, Davidson C. Evaluating the use of Iluvien in uveitis patients in a real-world clinical setting. Poster presentation. Clinical Pharmacy Congress North, November 2025

Photo: Ann-Marie Goacher

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The INSIGHT Health Data Research Hub for Eye Health and Oculomics is benefiting from investment funding of £3.7 million awarded by UKRI Medical Research Council (MRC) and the National Institute for Health and Care Research (NIHR).

INSIGHT will expand from Moorfields Eye Hospital and create a blueprint for linking NHS sites across the country, supporting research, improving patient care, and fostering innovation in eye health.

As part of a four-year programme of work delivered through Moorfields Eye Hospital’s strategic partnership with the UCL Institute of Ophthalmology, INSIGHT will on-board NHS sites including Sunderland Eye Infirmary, one of the UK’s largest regional centres for ophthalmology, working in collaboration with South Tyneside and Sunderland NHS Foundation Trust and North East North Cumbria Secure Data Environment.

INSIGHT will also broaden national data linkages and integrate genetic data from the NIHR BioResource and UK Biobank to accelerate oculomics research, which uses biomarkers in the eye to detect systemic conditions such as dementia and cardiovascular disease.

Patient and public representatives will play a central role, working with project leads to embed standards for data access and governance, address risks of bias in artificial intelligence, and ensure equitable benefits for underserved communities.

The enhanced INSIGHT research data platform will grow from over 30 million images — currently more ophthalmic data than the top three centres in the US combined — to some 50 million images, consolidating the UK as the global leader in ophthalmology and oculomics research and innovation.

INSIGHT Director Professor Pearse Keane (UCL Institute of Ophthalmology and Moorfields Eye Hospital) said: “This funding allows us to expand INSIGHT from Moorfields Eye Hospital into a truly national resource, with significant benefits for clinical research and public health. Ophthalmology is the busiest NHS speciality, increasingly under pressure as patient need grows. By providing a comprehensive, interoperable research resource for ophthalmic data, we can help to accelerate research discoveries, bring new treatments to patients faster, and ultimately reduce the burden of sight-threatening disease in the UK and globally.”

Moorfields Eye Hospital CEO Peter Ridley commented: “The potential of NHS data to improve patient outcomes and tackle health inequalities is immense. We are proud that the INSIGHT Hub has led the way in harnessing routinely collected NHS eye imaging data for medical research, demonstrating how patient data can be optimised for research in a safe and secure way, involving patients and members of the public in decision-making. With this grant funding, we anticipate entering an exciting new phase in the Hub’s development, supporting the UK’s ambitions as a global leader in healthcare technology.”

The award is one of five announced by UKRI MRC and the NIHR to enhance biomedical and health-related data and digital platform resources in the UK, following a UKRI call published last year.

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