Cataracts are the world's leading cause of blindness. Cataract surgery is a highly effective and safe procedure for treating the condition, and - since it is widely considered a refractive intervention, particularly in the developed world - it often leads to excellent visual acuity and spectacle independence. Patients require detailed counselling about the various intraocular lens (IOL) designs and their potential, as well as potentially disturbing optical phenomena, which are more common with multifocal IOLs. There are two highly successful techniques: phacoemulsification and femtosecond laser cataract surgery. The latter offers greater precision and has produced remarkable results, even in complex cases such as advanced cataracts, corneal comorbidities and paediatric cataracts. Using a laser to fragment the lens significantly reduces the amount of ultrasound energy required for subsequent manual removal, or even eliminates the need for ultrasound energy altogether. The most feared complication is endophthalmitis, which requires immediate treatment, while the most common side effect, posterior capsule opacification (PCO), is generally harmless. In uncomplicated cases, the attending ophthalmologist normally recommends 3-4 postoperative check-ups.

The corneal endothelium is the innermost layer of the human cornea and it acts as a barrier between the aqueous humor and the corneal stroma, thus maintaining the hydration of the cornea. Both congenital dystrophies including (1) Fuchs' endothelial corneal dystrophy (FECD), (2) posterior polymorphous corneal dystrophy (PPCD), (3) congenital hereditary endothelial dystrophy (CHED), (4) X-linked endothelial corneal dystrophy (XECD) and age-related degenerations like (5) pseudoexfoliation-related (PEX) keratopathy, (6) pseudophakic bullous keratopathy (PBK), (7) iridocorneal endothelial (ICE) syndromes and endothelial graft rejection after keratoplasty can impair this function and are described in this review article.

Wherever consumer fireworks are used, incidents with eye injuries do occur. In Germany, their number has increased in the past nine years, a clear overrepresentation of minors and bystanders is documented. Eyes are affected by a very individual combination of thermal, chemical and mechanical impact, resulting in minor to most complex injuries to adnexes, eye surface, iris, lens, sclera and/or posterior segment. Diagnostics may be complicated and require a structured approach, that is proposed here. Open globe injuries and intraocular foreign bodies necessitate early surgical intervention. In thermal and chemical burns early rinsing and antiphlogistic therapy is major for prevention of scarring and secondary glaucoma. The need for early or late replacement of limbal stem cells may yet emerge. Consequences of blunt trauma can be traumatic cataract, phakic or pseudophakic lens luxation, ruptures to all structures of the eye with long-term effects such as retinal detachment, choroidal or retinal pigment epithelial rupture and formation of choroidal neovascular membranes (CNV). Medical and surgical strategies are discussed. Despite all proven and innovative care strategies of therapy, functional and cosmetic outcome of fire work induced eye injuries might be impaired. In cases of severe injuries, social security coverage and rehabilitation must be considered early on.

Congenital nasolacrimal duct obstruction (CNLDO) represents the most prevalent cause of epiphora in infancy, with a reported incidence of approximately 6-20% of newborns. In the majority of cases, a membranous occlusion at the valve of Hasner is responsible, with spontaneous resolution occurring in up to 96% within the first year of life.Clinical signs comprise persistent tearing, an elevated tear meniscus and recurrent mucopurulent discharge; digital pressure on the lacrimal sac may induce retrograde reflux. Ophthalmic examination is indispensable to exclude differential diagnoses such as congenital glaucoma, keratoconjunctivitis or eyelid malposition.Given the high probability of spontaneous resolution, conservative management is the treatment of choice during the first 6-12 months of life, including parental instructions, consistent lid hygiene, and lacrimal sac massage. Topical antibiotics should be restricted to short-term application in the presence of bacterial superinfection.In cases of persistent obstruction or complicated disease lacrimal probing is indicated, usually after 12 months of age in general anaesthesia. Silicone intubation is recommended for complex or recurrent obstructions, failed probing, or in older children, and associated with substantially improved success rates. Endoscopic techniques including transcanalicular dacryoendoscopy, ballon dacryoplasty, and endonasal endoscopy can be helpful in refractory and anatomically complex cases. Dacryocystorhinostomy serves as ultima ratio surgery in treatment-refractory or bony stenosis and should not be performed before the age of one year.A staged, evidence-based therapeutic management beginning with conservative measures and escalating to age- and anatomy-adapted interventions, is recommended to achieve favourable outcomes.

This comprehensive review evaluates the current evidence and expert opinion regarding the use of extended depth of focus (EDOF) intraocular lenses (IOLs) in patients with macular disease. A literature review and a survey of European Society of Cataract and Refractive Surgeons (ESCRS) committee members were conducted. The review found a growing body of evidence suggesting potential benefits of EDOF IOLs in selected patients with mild to moderate macular disease, although concerns remain. The survey found that while 59% of respondents considered EDOF IOL implantation in this population "worth trying", only 37% reported performing the procedure occasionally, and a minority did not consider it at all. Further research is needed to determine optimal patient selection criteria and long-term outcomes for EDOF IOLs in eyes with macular pathology.

Lasers are present in nearly every aspect of modern life - in daily activities, medicine, and industry. While this innovative technology offers great benefits to society, it can also be misused, whether intentionally or unintentionally. Globalisation has fostered rapid development and wider distribution of high-energy lasers, including illegal trade and unregulated use, and has resulted in a rising number of laser-related eye injuries in recent years. This review addresses these concerns and compiles current knowledge on the subject. It begins with an overview of laser basics and historical milestones, then examines the physical and biological fundamentals of laser-tissue interactions. We discuss the latest laser innovations and the challenges they pose in introducing new technologies. An up-to-date overview of relevant laws and DIN standards for ophthalmic laser applications is provided, followed by a clinical perspective on laser attacks in civilian and military contexts and strategies for eye protection. The aim is to raise awareness of the potential risks associated with everyday laser use and to highlight the importance of safety measures alongside the many uses of lasers.