Objective Patients suffering from corneal neuropathy may present with photoallodynia; i.e., increased light sensitivity, frequently with a normal slit-lamp examination. This study aimed to evaluate the efficacy of autologous serum tears (AST) for treatment of severe photoallodynia in corneal neuropathy and correlate with corneal subbasal nerve alterations by in vivo confocal microscopy (IVCM). Methods Retrospective case control study with 16 patients with neuropathy-induced severe photoallodynia compared to 16 normal controls. Symptom severity, clinical examination and bilateral corneal IVCM scans were recorded. Results All patients suffered from extreme photoallodynia (8.8±1.1) with no concurrent ocular surface disease. Subbasal nerves were significantly decreased at baseline in patients compared to controls; total nerve length (9208 ±1264 vs 24714 ±1056 μm/mm2; p<.0001) and total nerve number (9.6±1.4 vs 28.6±2.0; p<.0001), respectively. Morphologically, significantly increased reflectivity (2.9±0.2 vs 1.8±0.1; p<.0001), beading (in 93.7%), and neuromas (in 62.5%) were seen. AST (3.6±2.1 months) resulted in significantly decreased symptom severity (1.6±1.7; p=.02). IVCM demonstrated significantly improved nerve parameters (p< .005), total nerve length (15451±1595 μm/mm2), number (13.9±2.1), and reflectivity (1.9±0.1). Beading and neuromas were seen in only 56.2% and 7.6% of patients. Conclusion Patients with corneal neuropathy-induced photoallodynia show profound alterations in corneal nerves. AST restores nerve topography through nerve regeneration, and this correlated with improvement in patient-reported photoallodynia. The data support the notion that corneal nerve damage results in alterations in afferent trigeminal pathways to produce photoallodynia.

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Light and electron microscopical studles allow a descriptive account to be given of the preadult development of the ovary of Drosophila melanogaster. The lineage of the cell groups which contribute to the tissues of the adult ovary has been determined. The earliest morphologically detectable event in the differentiation of each ovariole is the formation during the larval period of its terminal filament. Oogonia play no role in the induction of terminal filaments. The developmental events which transform a spherical mass of ovarian cells into a collection of multicellular cylinders is described. The importance in morphogenesis of acellular membranes secreted at the interface separating cells of different prospective significances is stressed. Such membranes may serve to regulate the future migration of cell populations or as sites of attachment for monolayers of cells which later fuse to form multinucleated muscle sheaths. The transformation of oogonia to cystoblasts coincides with and presumably depends upon the same hormonal stimulus which causes metamorphosis. The first oocytes to undergo crossing over do so between 24 and 36 hours after puparium formation.

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Suspension of elective surgical care during COVID-19 will result in a large backlog of cataract surgeries in Medicare beneficiaries. It is necessary to start planning proactively to reduce the backlog.

Objective: Corneal nerve damage may result in neuropathic corneal pain (NCP). Autologous serum tears (AST) have been shown to results in nerve regeneration and may help alleviate corneal pain. This study aimed to evaluate the efficacy of AST in the treatment of NCP.Methods: This was a retrospective case-control study. Sixteen patients suffering from severe NCP and no current ocular surface disease were compared to 12 controls. In vivo confocal microscopy (IVCM) (HRT3/RCM; Heidelberg, Germany) of the central corneas was performed bilaterally. Change in pain severity (scale of 0-10), corneal nerve density, tortuosity, reflectivity and presence of beading and microneuromas before and after treatment were recorded.Results: All patients had severe pain of 9.1 ± 0.2 (range 8-10). Before treatment, subbasal nerves were significantly decreased compared to controls, including total nerve length (10,935.5 ±1,264.3 vs. 24,714.4 ±1,056.2 μm/mm 2 ; p<0.0001) and total number of nerves (10.5±1.4 vs. 28.6±2.0; p<0.0001), respectively. Morphologically, significantly increased reflectivity (2.9±0.2 vs. 1.2±0.1; p=0.00008) and tortuosity (2.4±0.2 vs. 1.7±0.1; p=0.001), both graded on a scale of 0-4, were noted. After 3.8 ±0.5 months (range 1-8 months) of AST treatment, pain severity decreased to 3.1 ± 0.3 (range 0-4), (p<0.0001). Further, IVCM demonstrated a significant improvement (p<0.005)