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Chemosis is a common, though typically temporary complication of both upper and lower blepharoplasty surgery, though it is much more common after the latter. It occurs due to extravasation of fluid into the subconjunctival space precipitated by desiccation, inflammation, and manipulation of the conjunctiva and associated lymphatic drainage. Intraoperatively, minimizing surgical exposure and manipulation as well as maintaining a moist ocular surface can reduce the risks. Postoperatively, we propose a stepwise approach, starting with lubricants and escalating to increasingly potent anti-inflammatories with compression bandaging and surgery reserved for persistent cases. [ABSTRACT FROM AUTHOR]

This document is a reply to a survey conducted by the European Board of Ophthalmology on cataract surgical training in Europe. The authors, from various institutions in Australia, provide their perspective on the topic. The document includes contact information for the corresponding author and discloses that the authors have no financial or proprietary interests in the subject matter. The document was published in the Journal of Cataract & Refractive Surgery in August 2024. [Extracted from the article]

Purpose Methods Results Conclusions To report national practices and recent progress in competency‐based medical education (CBME) implementation in ophthalmology across European countries.A 30‐question online survey was emailed to European Union of Medical Specialists (UEMS) ophthalmology section delegates, European Board of Ophthalmology Diploma (EBOD) examiners and presidents of ophthalmology societies affiliated with UEMS/EBO.A total of 230 ophthalmologists with an average age of 54.7 years [30–77] and from 28 countries completed the survey. Half of them had been involved as medical educators for more than 10 years. The majority (74%) exercised their educational role in a University Hospital. Ninety six percent of them dedicated less than 50% of their activity to teaching. A third dedicated more than a half of their activity to patient care. The teaching of skills reported (medical, surgical, research, attitudinal and theoretical knowledge) was significantly better applied than their assessment. While 91% of the respondents found it necessary to harmonize European Training Requirements (ETR) in ophthalmology, competency‐based education concepts were rarely implemented in their country (for instance, 8% for CBME; 6% for entrustable professional activities (EPAs) and 3% for ETR).Despite considerable diversity in European residency programmes, post‐graduate medical education leaders in ophthalmology agree on the need to find a platform for equivalence in the content of the basic training requirements that constitute the professional identity of a practicing ophthalmologist. [ABSTRACT FROM AUTHOR]

Purpose: There is currently no consensus on which keratoconus need cross-linking nor on how to establish progression. This study assessed the performance of diverse progression criteria and compared them with our clinical knowledge of keratoconus evolution., Methods: This was a retrospective, longitudinal, observational study. Habitual progression criteria, based on (combinations of) keratometry (K MAX ), front astigmatism (A F ), pachymetry (P MIN ), or ABCD progression display, from 906 keratoconus patients were analyzed. For each criterion and cutoff, we calculated %eyes flagged progressive at some point (R PROG ), individual consistency C IND (%examinations after progression detection still considered progressive), and population consistency C POP (% eyes with CIND >66%). Finally, other monotonic and consistent variables, such as front steep keratometry (K 2F ), mean radius of the back surface (R mB ), and the like, were evaluated for the overall sample and subgroups., Results: Using a single criterion (e.g., ∆K MAX >1D) led to high values of R PROG . When combining two, (K MAX and A F ) led to worse C POP and higher variability than (K MAX and P MIN ); alternative criteria such as (K 2F and R mB ) obtained the best C POP and the lowest variability ( P <0.0001). ABC, as defined by its authors, obtained R PROG of 74.2%. Using wider 95% confidence intervals (95% CIs) and requiring two parameters over 95CI reduced R PROG to 27.9%., Conclusion: Previous clinical studies suggest that 20% to 30% of keratoconus cases are progressive. This clinical R PROG value should be considered when defining KC progression to avoid overtreatment. Using combinations of variables or wider margins for ABC brings R PROG closer to these clinical observations while obtaining better population consistency than current definitions., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2023 Contact Lens Association of Ophthalmologists.)