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This study reports the long-term outcomes of Descemet stripping endothelial keratoplasty (DSEK) in children with congenital hereditary endothelial dystrophy.

From brolucizumab to atropine for myopia, here's a look at the year's most-viewed clinical news stories and Editors' Choice coverage.

A, Inferior keratitis secondary to severe blepharitis. B, Fluorescein staining of keratitis (same patient as in part A).

Bilateral sclerocornea.

Chlamydial ophthalmia neonatorum.

Fundus photographs from a patient with Stargardt disease. The right eye (A) and left eye (B) demonstrate classic pisciform yellow-white flecks throughout the macula, with mottling of the central retinal pigment epithelium (RPE). Corresponding right (C) and left (D) fundus autofluorescence (FAF) images reveal mottled hypo- and hyperautofluorescence with hyperautofluorescent flecks (corresponding to the pisciform flecks) and a bull’s-eye maculopathy, greater in the left eye than in the right eye.

A, Superficial optic disc drusen, right eye. B, Appearance with autofluorescence. C, Optical coherence tomography image from a different child with drusen reveals the typical “lumpy bumpy” appearance.

The 3-step test. The cyclovertical muscles are represented in their fields of action. A, Step 1: Right eye higher than left suggests weakness in 1 of the 2 depressors of the right eye (RIR or RSO) or in 1 of the 2 elevators of the left eye (LIO or LSR). B, Step 2: If the deviation furthermore worsens on left gaze, this implicates either the RSO or the LSR. Note that at the end of step 2, 1 depressor and 1 elevator of opposite eyes will be identified as the possible weak muscle. C, Step 3: If the right eye is furthermore higher in right head tilt than left head tilt, there is weakness of the RSO: right head tilt induces intorsion of the right eye, which depends on activation of both the RSO (a depressor) and the RSR (an elevator), and extorsion of the left eye, from activation of both the LIO (an elevator) and the LIR (a depressor). This rules out the LSR (which was still a candidate at the end of Step 2), and identifies the RSO as the weak muscle. LIO = left inferior oblique; LIR = left inferior rectus; LSR = left superior rectus; RIR = right inferior rectus; RSO = right superior oblique; RSR = right superior rectus.

Corneal crystals in a girl with Schnyder corneal dystrophy.