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A 61-year-old man presented with a superior visu- al field defect on his right eye (RE), for 3 months, but he delayed coming to the emergency department for fear of coronavirus. His best-corrected visual acuity of the RE was 1.25/10 and biomicroscopy generated unremarkable findings. A large, dome-shaped, pigmented, and peripheral lesion with an adjacent exsudative retinal detachment was seen on ophthalmoscopy and documented by an ultra-wide field pseudocolor photograph captured using Optos (Fig. 1). B-scan ultrasonography confirms a low-moderate internally reflective dome-shaped choroidal lesion, sized 13x12 mm, with adjacent retinal detachment. The optical coherence tomography of the macula showed subretinal fluid reaching the fovea. Patients are avoiding medical care due to fear of coronavirus.1 Regarding choroidal melanoma, patients will present with more advanced disease with lost opportunities for conserving vision and the eye.2 We want to alert to this new reality that we have been facing and the need to provide health literacy, avoiding unnecessary costs for patients, and conserve healthcare resources., Revista Sociedade Portuguesa de Oftalmologia, Vol. 46 N.º 2 (2022)

A 61-year-old man presented with a superior visu- al field defect on his right eye (RE), for 3 months, but he delayed coming to the emergency department for fear of coronavirus. His best-corrected visual acuity of the RE was 1.25/10 and biomicroscopy generated unremarkable findings. A large, dome-shaped, pigmented, and peripheral lesion with an adjacent exsudative retinal detachment was seen on ophthalmoscopy and documented by an ultra-wide field pseudocolor photograph captured using Optos (Fig. 1). B-scan ultrasonography confirms a low-moderate internally reflective dome-shaped choroidal lesion, sized 13x12 mm, with adjacent retinal detachment. The optical coherence tomography of the macula showed subretinal fluid reaching the fovea. Patients are avoiding medical care due to fear of coronavirus.1 Regarding choroidal melanoma, patients will present with more advanced disease with lost opportunities for conserving vision and the eye.2 We want to alert to this new reality that we have been facing and the need to provide health literacy, avoiding unnecessary costs for patients, and conserve healthcare resources.

Supplemental material, sj-pdf-3-ejo-10.1177_11206721221099777 for Photoscreening for amblyopia risk factors assessment in young children: A systematic review with meta-analysis by André Ferreira, Rita Vieira, Sofia Maia, Vasco Miranda, Ricardo Parreira and Pedro Menéres in European Journal of Ophthalmology

Supplemental material, sj-docx-1-ejo-10.1177_11206721221099777 for Photoscreening for amblyopia risk factors assessment in young children: A systematic review with meta-analysis by André Ferreira, Rita Vieira, Sofia Maia, Vasco Miranda, Ricardo Parreira and Pedro Menéres in European Journal of Ophthalmology

Supplemental material, sj-docx-2-ejo-10.1177_11206721221099777 for Photoscreening for amblyopia risk factors assessment in young children: A systematic review with meta-analysis by André Ferreira, Rita Vieira, Sofia Maia, Vasco Miranda, Ricardo Parreira and Pedro Menéres in European Journal of Ophthalmology

Supplemental material, sj-pdf-4-ejo-10.1177_11206721221099777 for Photoscreening for amblyopia risk factors assessment in young children: A systematic review with meta-analysis by André Ferreira, Rita Vieira, Sofia Maia, Vasco Miranda, Ricardo Parreira and Pedro Menéres in European Journal of Ophthalmology

Supplemental material, sj-docx-5-ejo-10.1177_11206721221099777 for Photoscreening for amblyopia risk factors assessment in young children: A systematic review with meta-analysis by André Ferreira, Rita Vieira, Sofia Maia, Vasco Miranda, Ricardo Parreira and Pedro Menéres in European Journal of Ophthalmology

Supplemental material, sj-docx-6-ejo-10.1177_11206721221099777 for Photoscreening for amblyopia risk factors assessment in young children: A systematic review with meta-analysis by André Ferreira, Rita Vieira, Sofia Maia, Vasco Miranda, Ricardo Parreira and Pedro Menéres in European Journal of Ophthalmology

Introdu����o: Nosso objetivo �� relatar um caso de paralisia traum��tica grave do VI par bilateral. Descrevemos um caso cl��nico documentado com fotografias em diferentes posi����es do olhar; gr��ficos do ecr�� de Hess e testes de campo visual de Goldmann durente o per��odo de seguimento. Relato de caso: Um homem de 42 anos envolveu-se num acidente de carro de alta energia (240 km/h). Nove dias depois, quando foi transferido para nosso hospital, apresentou quadro de paralisia grave do sexto nervo bilateral, com limita����o na abdu����o do olho direito e esquerdo, sem cruzar a linha m��dia. Ele foi submetido a 3 inje����es de toxina botul��nica do reto medial (BTX). O primeiro feito 1 m��s e as ��ltimas 6 meses ap��s o acidente. O doente obteve bons resultados sem diplopia e sem limita����es de abdu����o. Conclus��o: Embora o envolvimento bilateral e a gravidade do d��ficit de abdu����o na paralisia do VI par estejam independentemente associados a um mau progn��stico, o caso cl��nico apresentado obteve um bom desfecho com recupera����o total e definitiva da paralisia bilateral grave ap��s inje����es de BTX no reto medial iniciadas na fase aguda., Revista Sociedade Portuguesa de Oftalmologia, Vol. 45 N.�� 4 (2021)

Introduction: Our purpose was to report a case of severe traumatic bilateral sixth nerve palsy. We describe a clinical case documented with photographs on different gazes; Hess screen charts and Goldmann visual field tests over time. Case Report: A 42-year-old male was involved in a high-energy car crash (240 km/h). Nine days after, when transferred to our hospital, he presented with severe bilateral sixth nerve palsy, with limitation in the abduction of right and left eye, without crossing the midline. He was submitted to 3 rounds of medial rectus botulinum toxin (BTX) injections. The first done 1 month and the last 6 months after the accident. He achieved good results with no diplopia and no abduction limitations. Conclusion: Although the bilateral involvement and the severity of the abduction deficit in sixth nerve palsy are independently associated with a poor outcome, our clinical case had a good outcome with total and definitive recuperation of severe bilateral palsy after medial rectus BTX injections started in the acute phase., Introdução: Nosso objetivo é relatar um caso de paralisia traumática grave do VI par bilateral. Descrevemos um caso clínico documentado com fotografias em diferentes posições do olhar; gráficos do ecrã de Hess e testes de campo visual de Goldmann durente o período de seguimento.Relato de caso: Um homem de 42 anos envolveu-se num acidente de carro de alta energia (240 km/h). Nove dias depois, quando foi transferido para nosso hospital, apresentou quadro de paralisia grave do sexto nervo bilateral, com limitação na abdução do olho direito e esquerdo, sem cruzar a linha média. Ele foi submetido a 3 injeções de toxina botulínica do reto medial (BTX). O primeiro feito 1 mês e as últimas 6 meses após o acidente. O doente obteve bons resultados sem diplopia e sem limitações de abdução.Conclusão: Embora o envolvimento bilateral e a gravidade do déficit de abdução na paralisia do VI par estejam independentemente associados a um mau prognóstico, o caso clínico apresentado obteve um bom desfecho com recuperação total e definitiva da paralisia bilateral grave após injeções de BTX no reto medial iniciadas na fase aguda.

Book of abstracts of the Science Conference of the Arctic Science Summit Week 2021, held online from 23 to 26 March 2021. Website: http://www.assw2021.pt

INTRODUCTION: The screening and treatment of retinopathy of prematurity (ROP) may vary significantly between providers. The aim of the study is to determine preferred practices in screening, diagnosis and treatment of ROP. MATERIAL AND METHODS: Portuguese ophthalmologists that perform ROP screening were invited to complete an electronic anonymous questionnaire regarding screening, treatment and the use of telemedicine (n=26). RESULTS:In 76.9% of the responders, ROP screening is made if ≤ 32 weeks of gestational age or ≤ 1500 g of birth weight or if > 32 weeks / > 1500 g with an unstable clinical state, starting at 4 weeks’ chronologic age or at a corrected gestational age of 31 weeks in 65.4%, using topical 2.5% phenylephrine + 0.5% tropicamide and binocular indirect ophthalmoscopy in 84.6%. After the diagnosis of type 1 ROP, 46.2% performed the treatment. The initial treatment for type 1 ROP was anti-VEGF intravitreal injection if ROP in zone I and laser photocoagulation if ROP zone II in 65.2%. No complications were reported in 72.2% of laser treatments and in 73.3% of anti-VEGF injections. The use of telemedicine for ROP screening is considered to be helpful by 88.5%. CONCLUSION:Most Portuguese ophthalmologists use a more inclusive criteria of gestational age to screen ROP and mostly perform it with a binocular indirect ophthalmoscope. The treatment of choice for type 1 ROP is mostly dependent on the zone of ROP. Screening of ROP with teleme-dicine seems a reliable option for most ophthalmologists., OBJETIVOS: O rastreio e tratamento da retinopatia da prematuridade (ROP) varia significa-tivamente entre unidades hospitalares. O objetivo deste estudo é sintetizar as práticas atuais no rastreio, diagnóstico e tratamento da ROP em Portugal, MATERIAL E MÉTODOS: Os oftalmologistas portugueses com prática no rastreio de ROP foram con-vidados a preencher um questionário online anónimo relacionado com o rastreio, tratamento e aplicação da telemedicina (n=26). RESULTADOS:A maioria dos participantes rastreia ROP se ≤ 32 semanas de idade gestacional ou ≤ 1500 g de peso ao nascimento ou um estado clínico instável, iniciando às 4 semanas de idade cronológica ou 31 semanas de idade gestacional, utilizando fenilefrina a 2,5% + tropicamida a 0,5% e com oftalmoscopia indire-ta. Após o diagnóstico de ROP tipo 1, o tratamento é realizado pelo próprio inquirido em 46,2% dos casos. O tratamento inicial para ROP tipo 1 é injeção intravítrea de anti-VEGF se ROP zona I ou fotocoagulação laser se ROP zona II em 65,2%. A maioria não reportou complicações secundárias ao laser ou à injeção de anti-VEGF. A maioria reconhece a utilidade da telemedicina no rastreio da ROP, com a aplicação de um sistema ocular digital, realizado por oftalmologistas e revisto num centro especializado. CONCLUSÃO:A maioria dos oftalmologistas inquiridos utilizam um critério mais inclusivo de idade gestacional para rastrear ROP, utilizando mais frequentemente oftalmoscopia binocular indireta. O tipo de tratamento da ROP tipo 1 está dependente da zona de ROP na maioria dos casos. O rastreio por telemedicina é uma opção viável para a maioria dos inquiridos.