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The nature of the Fermi surface observed in the recently discovered family of unconventional insulators starting with SmB6 is a subject of intense inquiry. Here we shed light on this question by accessing quantum oscillations in the high magnetic field-induced metallic regime above ≈47 T in YbB12, which we compare with the unconventional insulating regime. In the field-induced metallic regime, we find prominent quantum oscillations in the electrical resistivity characterised by multiple frequencies and heavy effective masses. The close similarity in Lifshitz-Kosevich low-temperature growth of quantum oscillation amplitude in insulating YbB12 to field-induced metallic YbB12, points to an origin of quantum oscillations in insulating YbB12 from in-gap neutral low energy excitations. Higher frequency Fermi surface sheets of heavy quasiparticle effective mass emerge in the field-induced metallic regime of YbB12 in addition to multiple heavy Fermi surface sheets observed in both insulating and metallic regimes. f-electron hybridisation is thus observed to persist from the unconventional insulating to the field-induced metallic regime of YbB12, in contrast to the unhybridised conduction electron Fermi surface observed in unconventional insulating SmB6. Our findings thus require an alternative model for YbB12, of neutral in-gap low energy excitations, wherein the f-electron hybridisation is retained. [ABSTRACT FROM AUTHOR]

A case of haemorrhagic pulmonary oedema after successful pulmonary embolectomy is presented. The relevant literature is reviewed. Thirteen cases are analysed as well as the four survivors. The aetiology appears to be ischaemic damage of the capillary bed. This had previously been called incomplete infarction by Castleman. The incidence is low after acute pulmonary embolectomies but appears to be much higher after chronic endarterectomies, especially with severe pulmonary hypertension. Therapy is outlined. [ABSTRACT FROM PUBLISHER]

Purpose: This study aimed to compare the effectiveness of 3 artificial intelligence language models-GPT-3.5, GPT-4o, and Gemini, in delivering patient-centered information about thyroid eye disease (TED). We evaluated their performance based on the accuracy and comprehensiveness of their responses to common patient inquiries regarding TED. The study did not assess the repeatability of artificial intelligence responses, focusing on single-session evaluations per model., Methods: Five experienced oculoplastic surgeons assessed the responses generated by the artificial intelligence models to 12 key questions frequently asked by TED patients. These questions addressed TED pathophysiology, risk factors, clinical presentation, diagnostic testing, and treatment options. Each response was rated for correctness and reliability on a 7-point Likert scale, where 1 indicated incorrect or unreliable information and 7 indicated highly accurate and reliable information. Correctness referred to factual accuracy, while reliability assessed trustworthiness for patient use. The evaluations were anonymized, and the final scores were averaged across the surgeons to facilitate model comparisons., Results: GPT-3.5 emerged as the top performer, achieving an average correctness score of 5.75 and a reliability score of 5.68, excelling in delivering detailed information on complex topics such as TED treatment and surgical interventions. GPT-4o followed with scores of 5.32 for correctness and 5.25 for reliability, generally providing accurate but less detailed information. Gemini trailed with scores of 5.10 for correctness and 4.70 for reliability, often providing sufficient responses for simpler questions but lacking detail in complex areas like second-line immunosuppressive treatments. Statistical analysis using the Friedman test showed significant differences between models (p < 0.05) for key topics, with GPT-3.5 consistently leading., Conclusions: GPT-3.5 was the most effective model for delivering reliable and comprehensive patient information, particularly for complex treatment and surgical topics. GPT-4o provided reliable general information but lacked the necessary depth for specialized topics, while Gemini was suitable for addressing basic patient inquiries but insufficient for detailed medical information. This study highlights the role of artificial intelligence in patient education, suggesting that models like GPT-3.5 can be valuable tools for clinicians in enhancing patient understanding of TED., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.)

Purpose: To assess the influence of Botulinum neurotoxin A (BoNT-A) injection on meibomian gland function and dry eye in patients diagnosed with Blepharospasm (BPS) and Hemifacial spam (HFS)., Methods: Adult patients aged 18 years or older who suffer from periocular dystonia, and were treated with BoNT-A injections, were recruited in this interventional prospective study between 2023 and 2024. Each patient was followed up for a period of three months. The following parameters were compared at baseline, 14 and 90 days post BoNT-A injections: Visual acuity, meibography, tear break up time (TBUT), Schirmer test, meibum expression, tear meniscus height, fluorescein corneal staining, meibomian gland dysfunction (MGD) grading, and ocular surface disease index (OSDI). In addition, patients underwent subjective quality of life questionnaire for BPS and HFS., Results: Thirty-six eyes of twenty-six patients were included in this study. The mean age ±SD was 59 ± 17.33 years. There was a significant statistical difference in vascular changes on the lid margin, TBUT, corneal and conjunctival fluorescein staining and meibum expression (P < 0.001 in all). The differences were statistically significant when compared to baseline vs visit 2, and visit 2 vs visit 3 (p-value<0.05). Jankovic rating scale and HFS score improved significantly between the time periods (P < 0.001 in both). There was no significant difference in meibomian gland loss, tear meniscus height, Schirmer test, and OSDI., Conclusion: BoNT-A injection is an effective treatment for periocular dystonia, but it worsens ocular surface and dry eye disease. Moreover, it affects the meibomian glands by disturbing their secretion., Competing Interests: Declarations of interest None., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Competing Interests: The authors have no financial or conflicts of interest to disclose.

The ionization potential of molecular chains is well-known to be a tunable nanoscale property that exhibits clear quantum confinement effects. State-of-the-art methods can accurately predict the ionization potential in the small molecule limit and in the solid-state limit, but for intermediate, nanosized systems prediction of the evolution of the electronic structure between the two limits is more difficult. Recently, optimal tuning of range-separated hybrid functionals has emerged as a highly accurate method for predicting ionization potentials. This was first achieved for molecules using the ionization potential theorem (IPT) and more recently extended to solid-state systems, based on an ansatz that generalizes the IPT to the removal of charge from a localized Wannier function. Here, we study one-dimensional molecular chains of increasing size, from the monomer limit to the infinite polymer limit using this approach. By comparing our results with other localization-based methods and where available with experiment, we demonstrate that Wannier-localization-based optimal tuning is highly accurate in predicting ionization potentials for any chain length, including the nanoscale regime.

Polymorphism is a well-known property of molecular crystals, which allows the same molecule to form solids with several crystalline structures that can differ significantly in physical properties. Polymorphs that possess different optical absorption properties in the visible range may exhibit different perceived colors, a phenomenon known as color polymorphism. One striking example of color polymorphism is given by 5-methyl-2-[(2-nitrophenyl)amino]-3-thiophenecarbonitrile, known as ROY for its red-orange-yellow colors. First-principles prediction of color polymorphism may help in polymorph assignment and design but has proven to be challenging. Here, we predict the absorption spectra and simulate the colors of 12 ROY polymorphs using the general, nonempirical method of time-dependent (TD) optimally tuned screened range-separated hybrid (OT-SRSH) functional. For 5 ROY polymorphs with known experimental absorption spectra, we show that the TD-OT-SRSH approach predicts absorption spectra in quantitative agreement with experiment. For all polymorphs, we show that an accurate simulation of the colors is obtained, paving the way to a fully predictive, low-cost calculation of color polymorphism.

Purpose: To investigate the effect of ptosis surgery on dry eye disease as measured by dry eye parameters and meibomian gland function., Methods: This prospective, case series study included patients with involutional ptosis with no prior history of dry eye disease who were scheduled for a levator aponeurosis advancement procedure. Dry eye evaluation included the ocular surface disease index (OSDI) questionnaire as well as objective measurements, which included meibomian gland loss measured by meibography, meibomian gland disease grading, tear breakup time (TBUT), corneal and conjunctival fluorescein staining, tear meniscus height, and Schirmer testing. All dry eye measurements were recorded preoperatively and repeated 21-28 days postoperatively., Results: A total of 30 eyes were included with a mean age of 65.6 ± 11.9 years. There was a significant improvement in margin reflex distance1 (MRD1) postoperatively ( p < 0.001) and a significant decrease in upper lid margin thickening ( p = 0.022). There were no significant differences between the pre- and postoperative measurements in meibomian gland loss, TBUT, corneal and conjunctival fluorescein staining, tear meniscus height, and the Schirmer test. OSDI was increased nonsignificantly postoperatively (16.094 vs. 24.296, respectively, p = 0.107)., Conclusion: The levator aponeurosis advancement procedure does not affect the eyelid meibomian glands, nor does it cause an increase in dry eye signs and symptoms, according to the measured parameters., Competing Interests: The authors have no financial or conflicts of interest to disclose., (Copyright © 2023 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.)

To describe the reach, implementation, and sustainability of COVID-19 vaccination programs delivered by social service community organizations. Five academic institutions in the Chicagoland CEAL (Community Engagement Alliance) program partnered with 17 community organizations from September 2021-April 2022. Interviews, community organizations program implementation tracking documents, and health department vaccination data were used to conduct the evaluation. A total of 269 events were held and 5,432 COVID-19 vaccines delivered from May 2021-April 2022. Strategies that worked best included offering vaccinations in community settings with flexible and reliable hours; pairing vaccinations with ongoing social services; giving community organizations flexibility to adjust programs; offering incentives; and vaccinating staff first. These strategies and partnership structures supported vaccine uptake, community organization alignment with their missions and communities' needs, and trust. Community organizations delivering social services are local community experts and trusted messengers. Pairing social service delivery with COVID-19 vaccination built individual and community agency. Giving COs creative control over program implementation enhanced trust and vaccine delivery. When given appropriate resources and control, community organizations can quickly deliver urgently needed health services in a public health crisis., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

To illuminate the forces of structural racism influencing COVID-19 vaccine receipt, we developed a conceptual model that recontextualizes trust and presents potential pathways to address structural racism. Our model emerged from Chicagoland CEAL, a partnership of community and academic experts collaborating to encourage COVID-19 vaccine uptake for communities of color. We concluded that systemic factors influenced by racism contribute to an overall lack of trustworthiness in vaccine-affiliated institutions. We highlight the need to recenter discussions of COVID-19 vaccination on our system's trustworthiness rather than mistrust and suggest using the model to test pathways to close racial gaps in COVID-19 vaccination., Competing Interests: No competing financial interests exist., (© Monique Jindal et al., 2023; Published by Mary Ann Liebert, Inc.)

Competing Interests: The authors declare that they have no conflicts of interest to disclose.

Purpose: To assess the success rate and complications of Lacrijet monocanalicular stent (FCI S.A.S, Paris, France) intubation in children treated for congenital nasolacrimal duct obstruction (CNLDO)., Methods: Retrospective review study which included children with CNLDO that were intubated with Lacrijet monocanalucilar silicone tube.The Lacrijet tube remained in place for 11-15 weeks post operatively and was removed in the clinic with topical anesthesia. Operative time was recorded for each case. All children were evaluated using the following parameters preoperatively and postoperatively: tear meniscus height, Fluorescein dye disappearance test (FDDT), and MUNK score., Results: The study included 20 eyes with mean age of 26.25 ± 11.25 months. 17 eyes (85%) had undergone probing previously. Mean operation time of Lacrijet intubation was 8.5 min (95% CI 7.04-9.95). Mean follow-up period was 204.65 ± 105.27 days. Lacrijet intubation resulted in statistically significant improvements in tear meniscus height ( P  < .001), FDDT ( P  < 0.001), and MUNK score ( P  < 0.001) in all children. Two different sizes of Lacrijet intubations were used. Complete success was obtained in all cases. No complications were observed., Conclusions: Lacrijet lacrimal intubation has a high rate of success, shortens surgical time and has a low rate of complications in children with CNLDO.

Purpose: To evaluate the use of meibography as an objective measure of the effects of incision & curettage (I&C) chalazion surgery on meibomian gland loss and morphology as well as dry eye syndrome., Methods: This prospective, interventional clinical study included adult patients with a primary chalazion which persisted despite conservative treatment. All patients underwent I&C surgery. The following parameters were compared both preoperatively and 21 days postoperatively: meibography, tear breakup time (TBUT), Schirmer test, meibum expression, tear meniscus height, meibomian gland dysfunction (MGD) grading, and the Ocular Surface Disease Index (OSDI)., Results: Thirty eyelids were enrolled in the study. The mean age ± SD was 40.56 ± 13.94 years. Meibography demonstrated a significant decrease in meibomian gland loss (P = 0.00) and improvement in morphology. The most common meibomian gland pathology preoperatively noted was morphological signs of atrophy that included fluffy areas and tortuous glands. Both of these findings improved postoperatively (P = 0.04 and P = 0.02, respectively). There were a significant change in MGD grading and a significant decrease in meibum expression score postoperatively (P = 0.00). TBUT and tear meniscus height also improved significantly (P = 0.00 and P = 0.003, respectively). The OSDI score improved significantly as well (P = 0.00)., Conclusion: While incision and drainage surgery is a time-honored, standard treatment for chalazion, meibography now demonstrates a global improvement in the meibomian glands, not just the ones involved with the chalazion. In addition to the improvements in the clinical and dry eye syndrome parameters improvements, meibography findings demonstrate that early I&C surgery restores the meibomian glands architecture significantly., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: Retrospective cohort study evaluating long term keratoconus progression amongst cross-linking (CXL) treated pediatric patients in the treated and the fellow untreated eyes., Methods: Data on 60 eyes of 30 patients, 18 years old or younger, who underwent CXL in at least one eye was collected and analyzed. Follow-up measurements taken from the treated and untreated eye up to 7 years after CXL treatment, were compared to baseline measurements. Parameters included uncorrected distance visual acuity (UCDVA), best-corrected spectacle visual acuity (BCSVA), manifest refraction, pachymetry, corneal tomography, and topography., Results: Mean age of patients was 16 ± 2.1 years. For the treated eyes, during follow-up period mean UCDVA had improved (from 0.78 ± 0.22 at baseline to 0.58 ± 0.26 logMAR at 7 years; p  = 0.13), as well as mean BCSVA (from 0.23 ± 0.107 at baseline to 0.172 ± 0.05 logMAR at 7 years; p  = 0.37). The mean average keratometry showed a significant flattening (from 49.95 ± 4.04 to 47.94 ± 3.3 diopters (D); p  < 0.001), However there was no change in the mean maximal keratometry. The mean minimal corneal thickness (MCT) showed a significant mild reduction of 26 µm ( p  = 0.006). Although statistically insignificant, the mean manifest cylinder was also reduced to 2D ( p  = 0.15). During the follow-up period, eight untreated eyes (26.6%) deteriorated and underwent CXL, while only one treated eye (3.33%) required an additional CXL., Conclusion: CXL is a safe and efficient procedure in halting keratoconus progression in the pediatric population, the fellow eye needs to be carefully monitored but only a 25% of the patients will require CXL in that eye during a period of 7 years.

We study the optimal tuning of the free parameters in range-separated double hybrid functionals, based on enforcing the exact conditions of piecewise linearity and spin constancy. We find that introducing the range separation in both the exchange and the correlation terms allows for the minimization of both fractional charge and fractional spin errors for singlet atoms. The optimal set of parameters is system specific, underlining the importance of the tuning procedure. We test the performance of the resulting optimally tuned functionals for the dissociation curves of diatomic molecules. We find that they recover the correct dissociation curve for the one-electron system, H 2 + , and improve the dissociation curves of many-electron molecules such as H 2 and Li 2 , but they also yield a nonphysical maximum and only converge to the correct dissociation limit at very large distances.

Background: During, shortly after, and sometimes for years after hematopoietic stem cell transplant, a large proportion of hematological cancer patients undergoing transplant report significant physical and psychological symptoms and reduced health-related quality of life. To address these survivorship problems, we developed a low-burden, brief psychological intervention called expressive helping that includes two theory- and evidence-based components designed to work together synergistically: emotionally expressive writing and peer support writing. Building on evidence from a prior randomized control trial showing reductions in physical symptoms and distress in long-term transplant survivors with persistent survivorship problems, the Writing for Insight, Strength, and Ease (WISE) trial will evaluate the efficacy of expressive helping when used during transplant and in the early post-transplant period, when symptoms peak, and when intervention could prevent development of persistent symptoms., Methods: WISE is a multi-site, two-arm randomized controlled efficacy trial. Adult hematological cancer patients scheduled for a hematopoietic stem cell transplant will complete baseline measures and then, after hospitalization but prior to transplant, they will be randomized to complete either expressive helping or a time and attention "neutral writing" task. Both expressive helping and neutral writing involve four brief writing sessions, beginning immediately after randomization and ending approximately 4 weeks after hospital discharge. Measures of symptom burden (primary outcome), distress, health-related quality of life, and fatigue (secondary outcomes) will be administered in seven assessments coinciding with medically relevant time points from baseline and to a year post-intervention., Discussion: The steady and continuing increase in use of stem cell transplantation has created growing need for efficacious, accessible interventions to reduce the short- and long-term negative physical and psychosocial effects of this challenging but potentially life-saving treatment. Expressive helping is a psychological intervention that was designed to fill this gap. It has been shown to be efficacious in long-term transplant survivors but could have even greater impact if it is capable of reducing symptoms during and soon after transplant. The WISE study will evaluate these benefits in a rigorous randomized controlled trial., Trial Registration: Clinicaltrial.gov NCT03800758 . Registered January 11, 2019., (© 2021. The Author(s).)

Background: Dermal filler injections continue to grow in popularity as a method of facial rejuvenation. This increase in the number of injections performed has resulted in an increasing number of types of filler-related complications., Objectives: We report a series of cases where dermal filler injected in the face migrated to the orbit. Treatment methods and possible mechanisms of this newly reported complication are discussed., Methods: A retrospective, multicenter analysis was performed on patients with dermal filler migration to the orbit after facial filler injections., Results: Seven patients (6 females, 1 male; age range, 42-67 years) presented with orbital symptoms after filler injection and were subsequently found to have dermal filler in the orbit. Four out of 7 patients underwent orbitotomy surgery, 1 patient underwent lacrimal surgery, 1 patient had strabismus surgery, and 1 patient was treated with hyalurodinase injections. All patients have remained stable postoperatively., Conclusions: Orbital complications secondary to migrated filler may occur long after the initial procedure. Because the site of the complication is distant from the injection site, patients and physicians may not immediately make the connection. Furthermore, this may lead to unnecessary examinations and a delay in diagnosis while looking for standard orbital masses. Dermal fillers should therefore be considered in the differential diagnosis of patients presenting with new-onset orbital masses., (© 2020 The Aesthetic Society. Reprints and permission: journals.permissions@oup.com.)

A central question in the underdoped cuprates pertains to the nature of the pseudogap ground state. A conventional metallic ground state of the pseudogap region has been argued to host quantum oscillations upon destruction of the superconducting order parameter by modest magnetic fields. Here, we use low applied measurement currents and millikelvin temperatures on ultrapure single crystals of underdoped [Formula: see text] to unearth an unconventional quantum vortex matter ground state characterized by vanishing electrical resistivity, magnetic hysteresis, and nonohmic electrical transport characteristics beyond the highest laboratory-accessible static fields. A model of the pseudogap ground state is now required to explain quantum oscillations that are hosted by the bulk quantum vortex matter state without experiencing sizable additional damping in the presence of a large maximum superconducting gap; possibilities include a pair density wave., Competing Interests: The authors declare no competing interest.

The finding of bulk quantum oscillations in the Kondo insulator SmB 6 proved a considerable surprise. Subsequent measurements of bulk quantum oscillations in other correlated insulators including YbB 12 lent support to our discovery of a class of bulk unconventional insulators that host bulk quantum oscillations. Here we perform a series of experiments to examine evidence for the intrinsic character of bulk quantum oscillations in floating zone-grown single crystals of SmB 6 that have been the subject of our quantum oscillation studies. We present results of thermodynamic, transport, and composition analysis experiments on pristine floating zone-grown single crystals of SmB 6 and compare quantum oscillations with metallic LaB 6 and elemental aluminum. These results establish the intrinsic origin of quantum oscillations from the insulating bulk of floating zone-grown SmB 6 . The similarity of the Fermi surface in insulating SmB 6 with the conduction-electron Fermi surface in metallic hexaborides is at the heart of a theoretical mystery., Competing Interests: The authors declare no competing interests., (© 2020 The Authors.)

Background: Chronic, long-lasting edema accompanied by the Tyndall effect as a delayed reaction to hyaluronic acid (HA) filler injection seems to occur exclusively in the eyelids., Objectives: The authors sought to present a treatment algorithm for management of patients with chronic lower eyelid edema as a delayed complication of HA filler injection., Methods: Retrospective study including 61 patients with delayed-onset chronic periocular edema following uneventful HA filler injection in the lower eyelids or cheeks. All patients underwent hyaluronidase enzyme dissolution followed by secondary treatment. Three retreatment options were presented: (1) observation, (2) secondary treatment with HA filler, and (3) lower eyelid blepharoplasty., Results: All patients underwent filler dissolution using hyaluronidase. The mean age was 48 years and 97% of the patients were female. Single treatment was effective in 92% of patients with 8% requiring another hyaluronidase injection to completely eradicate residual edema. Six patients (10%) were satisfied after hyaluronidase only and 6 patients (10%) underwent lower eyelid blepharoplasty. Secondary treatment with HA filler was performed in 48 patients (80%). All were satisfied with final results without further edema in the follow-up period., Conclusions: Delayed-onset chronic lower eyelid edema is a frequent HA-related complication and cause of concern when considering periocular HA treatment. Previous treatment has been limited to either hyaluronidase only or blepharoplasty as a secondary solution after hyaluronidase, with only a minority of patients satisfied. Hyaluronidase, shortly followed by HA filler retreatment, is a safe and effective solution., (© 2019 The Aesthetic Society. Reprints and permission: journals.permissions@oup.com.)

Purpose: To describe a previously unreported phenomenon of idiopathic edematous punctal stenosis (IEPS) with chronic epiphora, presenting almost exclusively in young female patients., Methods: A review of patients who presented with chronic epiphora and edematous punctal stenosis of unknown cause (IEPS) at the outpatient clinic of Soroka Medical Center between August 2011 and August 2015. Associated findings from clinical examination were recorded., Results: A total of 32 patients with IEPS were documented. There were 30 female and 2 male patients. Average age at diagnosis was 37.6 ± 13.4 years, range 19-63 years, median 35 years. Temporary alleviation of symptoms was reported in subjects treated with topical steroids (43.8%), tacrolimus ointment (15.6%), and matrix metalloproteinase inhibitors (3.1%). No improvement in symptoms was reported in 37.5% of patients. Symptoms were bilateral in 78.1% of the patients. Spontaneous resolution was achieved in only 6.3% (2/32)., Conclusions: IEPS accompanied by chronic epiphora has not been characterized to date. Our data show a clear predominance of females, most of them in their fertile years.

We report magnetic quantum oscillations measured using torque magnetisation in the Kondo insulator YbB 12 and discuss the potential origin of the underlying Fermi surface. Observed quantum oscillations as well as complementary quantities such as a finite linear specific heat capacity in YbB 12 exhibit similarities with the Kondo insulator SmB 6 , yet also crucial differences. Small heavy Fermi sections are observed in YbB 12 with similarities to the neighbouring heavy fermion semimetallic Fermi surface, in contrast to large light Fermi surface sections in SmB 6 which are more similar to the conduction electron Fermi surface. A rich spectrum of theoretical models is suggested to explain the origin across different Kondo insulating families of a bulk Fermi surface potentially from novel itinerant quasiparticles that couple to magnetic fields, yet do not couple to weak DC electric fields.

Importance: Antibiotic stewardship is important in controlling resistance, adverse reactions, and cost. The literature regarding antibiotic use for eyelid surgery is lacking., Objectives: To determine standard care and assess factors influencing antibiotic prescribing practices for eyelid surgery., Design, Setting, and Participants: A survey study was conducted from February 2, 2014, to March 24, 2014. The survey was distributed to 2397 oculoplastic surgeons in private and academic oculoplastic surgery practices in 43 countries. All surgeons were members of ophthalmic plastic and reconstructive surgery societies. Data were analyzed by geographic location. Linear regression was performed to quantify contributions to rates of prescribing postoperative antibiotics for routine eyelid surgical procedures., Main Outcomes and Measures: Rates of prescribing prophylactic intravenous, oral, and topical antibiotics as well as factors that influence surgeons' prescribing practices., Results: A total of 782 responses were received from 2397 surgeons (average response rate, 36.7%; 2.5% margin of error) from 43 countries. Topical antibiotic use was common in all regions (85.2%). Perioperative intravenous antibiotic use was uncommon in all regions (13.5%). Geographic location was the greatest predictor of antibiotic prescribing practices (range, 2.9% in the United Kingdom to 86.7% in India; mean, 24%). Within Europe, Italy had the highest rate of antibiotic prescriptions for eyelid surgery (41.7%) and the United Kingdom had the lowest rate (2.9%.) In South America, Venezuela had the highest rate of antibiotic prescriptions for eyelid surgery (83.3%) and Chile had the lowest rate (0%). The practice locations that were associated with routinely prescribing postoperative oral antibiotics were India (odds ratio [OR], 15.83; 95% CI, 4.85-51.68; P < .001), Venezuela (OR, 13.47; 95% CI, 1.43-127.19; P = .02), and Southeast Asia (OR, 2.80; 95% CI, 1.15-6.84; P = .02). Conversely, practice location in the United Kingdom (OR, 0.048; 95% CI, 0.0063-0.37; P = .004), Australia and New Zealand (OR, 0.15; 95% CI, 0.033-0.67; P = .01), and the United States and Canada (OR, 0.41; 95% CI, 0.23-0.72; P = .002) were associated with decreased rates of postoperative oral antibiotic use. Surgeons' concern for allergic reactions was associated with decreased rates of prescribing antibiotics (OR, 0.34; 95% CI, 0.23-0.49; P < .001), while surgeons' concern for infection was associated with increased rates of prescribing antibiotics (OR 1.80; 95% CI, 1.45-2.23; P < .001)., Conclusions and Relevance: These results from members of ophthalmic plastic and reconstructive surgery societies confirm that antibiotic prescribing practices for routine eyelid surgical procedures vary widely throughout the world. No standard of care has been established that would require the routine use of postoperative prophylactic antibiotics following eyelid surgery.

Purpose: To report the diagnosis and management of a patient with chronic ophthalmic topical anesthetic abuse and floppy eyelid syndrome., Methods: We describe the case of a 47-year-old man suffering from persistent bilateral ocular irritation and chronic corneal erosions., Results: The patient was hospitalized in our ophthalmology department and underwent thorough ophthalmic, systemic, and psychiatric evaluation. Chronic topical anesthetic abuse was discovered. Removal of abused drops and copious lubricating treatment lead to partial improvement further permitting diagnosis of floppy eyelid syndrome. Definitive surgical treatment by horizontal eyelid tightening combined with continuous lubrication resulted in remission of symptoms., Conclusions: Uncommon conditions may coexist in 1 patient. In this case, floppy eyelid syndrome resulted in topical anesthetic abuse. Ophthalmologists should keep both these conditions in mind when treating patients with otherwise unexplained chronic persistent corneal erosions.

Purpose:  Fatigue due to sleep deprivation is one of the main causes of accidents. An objective and efficient method for determining whether the person is tired could provide a valuable tool in accident prevention. In this study, we evaluated whether oculomotor responses related to pupillary light reflex and saccadic velocity can identify subjects with sleep deprivation and whether these objective values correlate with subjective feeling of sleepiness., Methods:  Thirteen normal subjects (5 male, 8 female) participated in a 4-day study. During the first two days following a full night's (8 hr in bed) sleep, they underwent baseline automated oculomotor testing using the FIT-2500-Fatigue-Analyzer. Following a third full night's sleep, participants were then sleep-deprived for 28 hr. Ten measurements of automated oculomotor tests were performed during the sleep deprivation period. Visually-guided saccadic velocity (SV), initial pupil diameter (PD), pupillary constriction latency (CL), and amplitude of pupil constriction (CA) were assessed using the FIT-2500-Fatigue-Analyzer. The FIT-index, which expresses the deviation of the ocular parameters from the baseline measurements, was calculated. Correlation of oculomotor parameters with the subjective Stanford Sleepiness Scale (SSS) was performed., Results:  We found that oculomotor measures showed a significant increase in CL (298.6 to 308.4 msec, P < 0.05) and calculated FIT index (3.4 to 16.8, P < 0.05) and a significant decrease in SV (64.8 to 59.6 deg/sec) during sleep deprivation. The SSS was found to significantly increase over the sleep deprivation period (2.05 to 5.05, P < 0.05) and was significantly correlated with the FIT-index (r > 0.66, P < 0.02)., Conclusion:  Evaluation of oculomotor responses, particularly CL and SV together with the FIT-index, might have practical applications for the assessment of an individual's state of alertness or fatigue. Correlation of the FIT-index to the SSS provides evidence for the potential usefulness of oculomotor function measurements in the detection of subjective sleepiness.