State University of New York College of Optometry

This review describes the evidence related to the burden of myopia and the status of access to myopia care, including detection, treatment, and management, in the United States. It examines the societal impact of myopia, vision screening guidelines from professional organizations, and state mandates on vision screening. Using the Anderson-Newman framework, the review evaluates access to and utilization of myopia care. It identifies knowledge gaps and barriers, offering strategies to improve access to myopia care and management. Improving access to comprehensive myopia management will require collaboration among stakeholders to address research gaps and develop policies that promote equitable access to the detection, treatment, and management of myopia, particularly for populations at high risk of adverse outcomes.

The loss of Dicer in Müller glia (MG) results in severe photoreceptor degeneration, as it occurs in retinitis pigmentosa or age-related macular degeneration; however, the sequence of events leading to this severe degenerative state is unknown. The aim of this study was to conduct a chronological functional and structural characterization of the pathological events in MG-specific Dicer-conditional knockout (cKO) mice in vivo and histologically.

To delete Dicer and mature microRNAs (miRNAs) in MG, two conditional Dicer1 knockout mouse strains (Rlbp-CreER:tdTomato:Dicer-cKOMG and Glast-CreER:tdTomato:Dicer-cKOMG) were created. Optical coherence tomography (OCT), electroretinograms (ERGs), and histological analyses were conducted to investigate structural and functional changes up to 6 months after Dicer deletion.

Dicer/miRNA loss in MG leads to (1) impairments of the area spanning from the external limiting membrane (ELM) to the retinal pigment epithelium (RPE), (2) cone photoreceptor dysfunction, and (3) retinal remodeling and functional loss of the inner retina at 1, 3, and 6 months after Dicer loss, respectively, in both of the knockout mouse strains. Furthermore, in the Rlbp-CreER:tdTomato:Dicer-cKOMG strain, rod photoreceptor impairment was found 4 months after Dicer depletion (4) accompanied by alteration of RPE integrity (5).

MG Dicer loss in the adult mouse retina impacts cone function prior to any measurable changes in rod function, suggesting a pivotal role for MG Dicer and miRNAs in supporting cone health. A partially impaired RPE, however, seems to accelerate rod degeneration and overall degenerative events.

This case report highlights an atypical clinical presentation featuring ipsilateral head, neck, shoulder, and eye pain with erythema, edema of the right eyelid and conjunctiva, alongside classic signs of dorsolateral medullary syndrome, also known as Wallenberg Syndrome, characterized by ipsilateral Horner's syndrome and contralateral loss of body pain and temperature in a 37-year-old female. The correct diagnosis of Wallenberg syndrome was achieved through the collaborative effort of eye care professionals, primary care, emergency, and neurology specialties in medicine.