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Lacrimal occlusion with punctal or canalicular plugs have been used to treat dry eye disease for more than 40 years. Indeed, punctal plugs constitute a safe and effective tool to retain the natural tear film and prolong the effect of tear substitutes. A wide variety of plugs is available, differing in their design, location (punctal versus canalicular) and their resorbability. There indications have increasingly broadened, and they are now one of the treatment options for numerous ocular surface diseases. Current research focuses on using punctal plugs for extended delivery of drugs to the ocular surface. This review addresses physiology of lacrimal drainage, available models of punctal plugs, their indications, practical details of prescribing and placing punctal and canalicular plugs, and possible complications., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Lacrimal occlusion with punctal or canalicular plugs have been used to treat dry eye disease for more than 40 years. Indeed, punctal plugs constitute a safe and effective tool to retain the natural tear film and prolong the effect of tear substitutes. A wide variety of plugs is available, differing in their design, location (punctal versus canalicular) and their resorbability. There indications have increasingly broadened, and they are now one of the treatment options for numerous ocular surface diseases. Current research focuses on using punctal plugs for extended delivery of drugs to the ocular surface. This review addresses physiology of lacrimal drainage, available models of punctal plugs, their indications, practical details of prescribing and placing punctal and canalicular plugs, and possible complications., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

All the components of the ocular surface and the lacrimal system are affected by aging. Aging induces lacrimal gland fibrosis, Meibomian gland dysfunction, loss of corneal sensitivity, decreased corneal cell density, impairment of immune defences, increased local inflammation associated with hormonal changes, conjunctivochalasis, lid abnormalities, etc. Furthermore, homeostasis of the ocular surface may be altered by various age-related systemic comorbidities and iatrogenic interventions. Altogether, aging is considered the most predominant risk factor for dry eye disease. The increasing knowledge of the pathophysiology of aging of the ocular surface allows for refinement of the management of ocular surface disease in the elderly., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Familial amyloid polyneuropathy (FAP) or transthyretin (TTR) amyloid polyneuropathy is a progressive sensorimotor and autonomic neuropathy of adult onset, which is transmitted as an autosomal dominant trait. In addition to neurologic symptoms, FAP may be associated with weight loss, cardiac and renal failure and ocular complications. FAP is a devastating disease, causing death within 10years after the first symptoms. The TTR Val30Met mutation is the most common of more than 100 amyloidogenic mutations identified worldwide. Liver transplantation (LT) is currently the only treatment for preventing synthesis of the amyloidogenic variants of TTR. LT can halt progression of the neuropathy in up to 70% of cases and doubles the overall median survival of young Val30Met patients. Oral administration of tafamidis, which prevents deposition of mutated TTR, is now available to delay neurologic complications in early stages of the disease. Ocular manifestations of FAP are frequent and mainly include keratoconjunctivitis sicca, secondary glaucoma, vitreous deposits and pupillary abnormalities. Retinal and choroidal vascular abnormalities are more rare. Since ocular TTR is synthesized, at least in part, in the retinal pigment epithelium, LT does not influence the course of ocular involvement. The effects of tafamidis on the latter are still unknown. Because LT and symptomatic treatments greatly improve life expectancy of patients with FAP, ocular involvement is becoming a more frequent challenge to address. This review summarizes the pathophysiology, clinical findings and possible treatments of ocular manifestations of FAP., (Copyright © 2013. Published by Elsevier Masson SAS.)

Measles is a disease due to morbillivirus, which belongs to the paramyxoviridae subfamily. It affects mostly young patients, and evolves through four phases: incubation, invasion, eruption and desquamation. Ophthalmic manifestations may occur during the invasive and eruptive phases. Conjunctivitis is the most common ophthalmologic manifestation and is often asymptomatic. Measles keratitis is the most concerning manifestation, with possible corneal ulcer, bacterial superinfection and corneal perforation. We report two cases of acute keratitis occurring during the eruptive phase of measles in two unvaccinated young adults. The involvement was central and strictly epithelial in both patients. The outcome was favorable with symptomatic treatment., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

Neurotrophic keratopathy is a potential consequence of herpes simplex virus (HSV) or varicella zoster virus (VZV) infection. The treatment is based on artificial tears and the withdrawal of preserved eye drops or other types of epitheliotoxic topical medicines. Autologous serum or amniotic membrane transplantation may also be used in severe cases, but their cost and safety are still under debate. We report a case of a patient with a history of herpes zoster ophthalmicus, who developed a persistent epithelial ulcer after cataract surgery, with no improvement despite 3 weeks of artificial tears (eight drops per day). A new ophthalmologic solution based on a regenerating agent (RGTA, Cacicol20(®)) was then used, with a dosage of two eye drops per week for 6 weeks. Improvement was observed 1 week later, and complete healing was obtained in less than 3 weeks, with no side effects. This heparin mimetic, which may stimulate extracellular matrix healing, may be a possible alternative therapy to autologous serum or amniotic membrane transplantation in severe neurotrophic ulcer. However, randomized studies are necessary to validate this observation., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)