P

A disease in which new blood vessels form beneath the retinal pigment epithelium against a background of choroidal thickening. It accounts for about half of exudative age-related macular degeneration in Japan, and anti-VEGF therapy and PDT are the mainstays of treatment.

A group of diseases characterized by abnormally dilated choroidal vessels (pachyvessels). This concept encompasses central serous chorioretinopathy, polypoidal choroidal vasculopathy, and retinal pigment epithelial detachment.

Bilateral optic disc swelling secondary to increased intracranial pressure. It is a warning sign of brain tumors, cerebral venous thrombosis, idiopathic intracranial hypertension (IIH), and other conditions. If untreated, it can lead to optic atrophy and irreversible vision loss.

A comprehensive explanation of bilateral optic disc swelling (papilledema) secondary to increased intracranial pressure and its most common cause, idiopathic intracranial hypertension (IIH), including definition, epidemiology, diagnosis, Frisén classification, treatment, fulminant type, and management during pregnancy.

A group of inherited macular degenerations characterized by lipofuscin accumulation in the retinal pigment epithelium (RPE). Mainly caused by PRPH2 gene mutations, leading to mild visual impairment in middle age and later.

Pattern strabismus (A-V pattern strabismus) is a condition in which the horizontal deviation differs between upward and downward gaze. This article explains the classification into V, A, Y, X, and λ patterns, etiology, diagnosis, and surgical treatment.

Explains the structure, features, surgical technique, and clinical outcomes of the Paul Glaucoma Implant. Covers comparisons with Ahmed and Baerveldt, outcomes in adult and pediatric glaucoma, and complications.

Full-thickness corneal transplantation performed in patients under 18 years of age. Main indications include congenital corneal opacities and acquired corneal diseases. However, graft failure rates are higher compared to adults, and multidisciplinary collaboration including amblyopia management is essential.

Pediatric vision screening aimed at early detection of amblyopia, strabismus, and refractive errors. This article explains the selection of examination methods according to age and the screening system centered on Japan's 3-year-old health checkup.

Explains visual acuity testing methods for infants to preschool children by age. Introduces the characteristics and procedures of each test, such as preferential looking, Teller acuity cards, LEA symbols, and Landolt C rings.

A collective term for surgical treatments of vitreoretinal diseases occurring in childhood, such as retinopathy of prematurity (ROP), familial exudative vitreoretinopathy (FEVR), persistent fetal vasculature (PFV), and Coats disease. It requires a specialized approach considering anatomical and physiological characteristics different from adults.

A complement C3/C3b inhibitor approved by the FDA in 2023 for geographic atrophy (GA). It is a first-in-class treatment that slows the expansion of GA lesions with monthly or every-other-month intravitreal injections.

A transplant surgery that replaces the full thickness of the cornea with donor cornea. Main indications include bullous keratopathy, keratoconus, corneal leukoma, and corneal dystrophy. The three major complications are rejection, glaucoma, and infection. In recent years, indications have been changing due to the spread of lamellar keratoplasty.

A group of diseases presenting with crescent-shaped destructive inflammation in the peripheral cornea. It is strongly associated with systemic autoimmune diseases such as rheumatoid arthritis, and can lead to corneal perforation if left untreated. Early systemic immunosuppressive therapy and multidisciplinary collaboration are important.

Persistent pupillary membrane (PPM) is a congenital anomaly resulting from the persistence of the anterior tunica vasculosa lentis. This article details its epidemiology, classification, clinical findings, diagnosis, and treatment (mydriatics, laser, surgery).

Fluid dynamics and physical principles of ultrasonic energy in phacoemulsification (PEA). Explains the parameters and mechanisms that surgeons should control for safe and efficient cataract surgery.

Phakic intraocular lens (ICL) is a refractive surgery that corrects myopia and astigmatism by inserting a collamer lens into the posterior chamber while preserving the natural crystalline lens. It is mainly indicated for myopia of 6D or more, does not involve corneal ablation, and offers excellent reversibility. The central hole design of the EVO ICL eliminates the need for iridotomy, further improving safety.

This article explains the classification, indications, preoperative evaluation, surgical techniques, and complication management of phakic intraocular lenses (phakic IOLs). Focusing on ICL (EVO ICL), it details criteria based on the Japanese Ophthalmological Society guidelines, including age range 21-45 years and correction amount of 6 diopters or more.

Phakic posterior chamber lens (ICL) is a refractive surgery that corrects myopia and astigmatism by inserting a Collamer lens into the eye. It does not involve corneal ablation, is reversible, and can treat a wide range from moderate to high myopia.

Pharmacologic mydriasis is pupillary dilation caused by drugs such as anticholinergics or adrenergic agonists. It is important to differentiate it from life-threatening oculomotor nerve palsy, and a stepwise diagnosis using the pilocarpine test is required.

Pharyngoconjunctival fever (PCF, pool fever) is an adenovirus infection characterized by the three main symptoms of fever, pharyngitis, and conjunctivitis. It commonly occurs in children and spreads during the summer. Under the School Health and Safety Act, it is classified as a Type 2 infectious disease requiring school exclusion for 2 days after the resolution of major symptoms. Diagnosis, treatment, and infection control are explained based on the Viral Conjunctivitis Clinical Practice Guidelines 2025 edition.

A disease characterized by nodular inflammation of the cornea or conjunctiva due to a type IV (delayed-type) hypersensitivity reaction to exogenous antigens. Currently, Cutibacterium acnes (formerly Propionibacterium acnes) and Staphylococcus aureus are the main causes. In Japan, it is understood as a subtype of meibomian gland-associated keratoconjunctival epitheliopathy (MRKC). In tuberculosis-endemic regions, Mycobacterium tuberculosis remains an important cause.

A treatment for retinal and choroidal diseases combining the photosensitizer verteporfin with a 689 nm laser. Used for age-related macular degeneration, central serous chorioretinopathy, polypoidal choroidal vasculopathy, and others.

Photoscreening is a vision screening method that uses a camera to capture and analyze the red reflex in children, detecting refractive errors and strabismus that are risk factors for amblyopia.

A treatment that uses an excimer laser (193 nm) to remove corneal surface opacities and irregularities. Indications include corneal dystrophy, band keratopathy, and recurrent corneal erosion. FDA approved in 1995.

This article explains the definition, pathophysiology, triad, risk factors, diagnosis, and treatment of pigmentary glaucoma (PG) and pigment dispersion syndrome (PDS). It covers the mechanism of pigment dispersion due to reverse pupillary block, Krukenberg spindle, trabecular meshwork pigmentation, precautions for laser treatment, and the latest cases of iatrogenic pigmentary glaucoma.

A yellowish-white raised lesion on the bulbar conjunctiva in the interpalpebral fissure. Ultraviolet exposure and aging are the main causes, and it is found in most people over 50 years of age. Usually asymptomatic, but when inflamed it becomes pingueculitis, which is treated with low-concentration steroid eye drops.

A tumor arising from the glandular cells of the anterior pituitary. It can cause bitemporal hemianopsia due to compression of the optic chiasm and may be accompanied by systemic symptoms due to hormone hypersecretion.

Pathophysiology, diagnosis, and treatment of plateau iris syndrome (PIS) are explained based on the Japan Glaucoma Treatment Guidelines 5th edition and the International PPP 2026. It covers UBM findings of anterior rotation of the ciliary body, double hump sign, and stepwise treatment including ALPI after LPI, pilocarpine, and lens extraction.

A disease characterized by polyp-like vascular dilations arising from an abnormal branching vascular network in the choroid. It is common in exudative age-related macular degeneration among Asians and Japanese, and definitive diagnosis by ICGA along with anti-VEGF therapy and PDT are important.

A refillable ranibizumab sustained-release device permanently implanted in the sclera. It significantly reduces the injection burden of anti-VEGF therapy for wet age-related macular degeneration, maintaining continuous drug concentration with refills every 24 weeks.

This article explains the definition, epidemiology, symptoms, diagnosis, differential diagnosis, treatment, CMV association, and pathophysiology of Posner-Schlossman syndrome (PSS). It covers acute management with steroids and intraocular pressure-lowering drugs based on the Uveitis Clinical Practice Guidelines, the 5th Edition of the Glaucoma Clinical Practice Guidelines, and TITAN Report 2, as well as ganciclovir and valganciclovir treatment for CMV-positive cases, and surgical indications.

A condition characterized by acute, unilateral, recurrent elevation of intraocular pressure with mild anterior chamber inflammation. First reported by Posner and Schlossman in 1948. Strongly associated with CMV infection, and recurrent attacks increase the risk of secondary glaucoma.

This article organizes the causes of distorted vision (metamorphopsia) and visual field defects using a differential diagnosis table, and explains self-check methods using the Amsler grid, urgency of consultation, and treatment overview.

This article explains the definition, mechanism (corneal nerve transection), risk comparison by surgical technique, diagnosis, and treatment (TFOD/TFOT, punctal plugs, IPL) of dry eye that occurs after refractive surgeries such as LASIK, PRK, and SMILE. It also covers preoperative screening. The latest information is based on the Dry Eye Clinical Practice Guidelines (Journal of Japanese Ophthalmological Society 2019) and TFOS DEWS III (2025).

The most common postoperative complication after cataract surgery, caused by proliferation and migration of residual lens epithelial cells leading to opacification of the posterior capsule. It can be effectively treated with Nd:YAG laser posterior capsulotomy.

A disease causing acute vision loss due to ischemia of the optic nerve posterior to the lamina cribrosa. There are three types: arteritic, non-arteritic, and perioperative; the perioperative type often leads to severe and irreversible visual impairment.

An autosomal dominant corneal dystrophy affecting the corneal endothelium and Descemet's membrane. It presents with vesicular changes, band-like lesions, and diffuse opacities. Four genetic loci (OVOL2, COL8A2, ZEB1, GRHL2) have been identified, and abnormal epithelial-mesenchymal transition (EMT) is central to the pathogenesis.

A brain edema syndrome triggered by hypertension, immunosuppressants, eclampsia, etc. It presents with headache, seizures, and visual disturbances. It is often reversible, but about 10–20% of cases leave permanent neurological sequelae.

A physiological, age-related change in which the posterior vitreous cortex separates from the internal limiting membrane of the retina. It is the most common cause of floaters and photopsia, and differentiation from retinal tear and retinal detachment is important.

A review of postoperative endophthalmitis occurring after cataract surgery. It covers both acute-onset (within 1 week post-surgery) and delayed-onset (after 1 month, typically caused by Cutibacterium acnes) forms. Topics include epidemiology, causative organisms, clinical features, diagnosis, stepwise treatment, EVS recommendations, and prevention strategies.

Explains eye changes and diseases associated with pregnancy. Includes visual impairment due to preeclampsia, risk of worsening diabetic retinopathy, and safety of eye drops during pregnancy.

Acute infectious inflammation of the eyelids and periorbital soft tissues anterior to the orbital septum. Unlike orbital cellulitis, it does not involve proptosis or ophthalmoplegia. Main causes include sinusitis, trauma, and insect bites, and it commonly occurs in children. Mild cases can be managed with oral antibiotics on an outpatient basis, but progression to orbital cellulitis must be monitored.

Explains the structure, material, surgical technique, and clinical outcomes of the PreserFlo MicroShunt (Ab-Externo MicroShunt). Covers the characteristics of the SIBS material, comparison with XEN and trabeculectomy, and complication management.

Primary acquired melanosis (PAM) is an acquired flat pigmented conjunctival lesion caused by abnormal proliferation of melanocytes. PAM with atypia is a major precursor of conjunctival malignant melanoma, and biopsy for atypia assessment and regular follow-up are essential.

Explains the staging, diagnosis, and treatment of primary angle closure glaucoma (PACG), primary angle closure (PAC), and primary angle closure suspect (PACS). Covers the 5th edition of the Glaucoma Clinical Practice Guidelines, the EAGLE study, laser iridotomy, lens extraction, and management of plateau iris.

A rare congenital glaucoma in which intraocular pressure rises due to impaired aqueous humor outflow caused by developmental abnormalities of the anterior chamber angle. Surgery is the first-line treatment, and early diagnosis and treatment determine visual prognosis.

This article explains the definition, risk factors, diagnosis, treatment, and pathophysiology of primary open-angle glaucoma (POAG). It covers evidence based on the 5th edition of the Japanese Glaucoma Guideline, the Tajimi Study, AAO PPP, and the 6th edition of EGS, including 6-year results of the LiGHT Trial, surgical strategies for MIGS and refractory POAG, and the latest research on optic disc hemorrhage.

Explains the differentiation, pathophysiology, and treatment of primary angle-closure glaucoma (PACG) and secondary angle-closure glaucoma. Covers mechanisms of pupillary block and plateau iris, topiramate-induced ACG, cases with retinitis pigmentosa, and acetazolamide idiosyncratic reactions.

An abnormal proliferative disease that occurs as a complication of retinal detachment. Fibrous membranes form on the retina, causing traction and making surgery difficult.

A specialist explains the symptoms, causes, diagnosis, and treatment of Pseudomonas aeruginosa keratitis. Detailed coverage includes contact lens-related risks, characteristics of ring abscess, fluoroquinolone treatment, and pathophysiology of liquefactive necrosis.

Cystoid macular edema (CME) occurring after cataract surgery. The main mechanism is disruption of the blood-retinal barrier mediated by prostaglandins and VEGF, and it is one of the common causes of postoperative visual acuity loss.

A condition in which the eyes appear misaligned despite the absence of true deviation of the visual axes. It is most commonly pseudoesotropia due to facial morphological features such as epicanthal folds or an abnormal angle kappa.

This article describes the clinical features, diagnosis, and treatment of uveitis associated with psoriasis and psoriatic arthritis. Anterior uveitis is predominant, and caution is needed regarding new onset or exacerbation risk when using IL-17 inhibitors.

A chronic disease in which fibrovascular tissue of the conjunctiva extends onto the cornea in a wing-like shape. Ultraviolet exposure is the greatest risk factor, and surgical excision with conjunctival autograft is the mainstay of treatment.

A comprehensive explanation of the definition, classification by cause (congenital, aponeurotic, neurogenic, myogenic, pseudoptosis), diagnosis, surgical technique selection, and conservative treatment (oxymetazoline eye drops) of blepharoptosis.

A condition that causes epiphora due to narrowing or occlusion of the punctum, the tear drainage opening. It is classified into congenital punctal agenesis and acquired types (inflammatory, drug-induced, age-related, traumatic). Main acquired causes include Stevens-Johnson syndrome, ocular cicatricial pemphigoid, anticancer drug S-1, and glaucoma eye drops. First-line treatment is punctal dilation or incision; for recurrent occlusion, silicone tube intubation is performed.

An idiopathic inflammatory choroidal disease that predominantly affects young myopic women. It presents with small yellowish-white lesions in the posterior pole and is frequently complicated by choroidal neovascularization (CNV).

A comprehensive review article covering the causes, differential diagnosis, and diagnosis of miosis (small pupil) and mydriasis, including management of small pupils during cataract surgery. It organizes the differential diagnosis and treatment of Horner syndrome, Adie pupil, oculomotor nerve palsy, IFIS, and others.

Explanation of techniques and devices for securing the pupil using iris retractors, pupil expansion rings, and mechanical stretching in cataract surgery for small pupils and intraoperative floppy iris syndrome (IFIS).

A complication after cataract surgery where the optic part of the intraocular lens prolapses in front of the iris. It is more likely to occur after sutured IOL or intrascleral fixation IOL, with an incidence of about 3.6% for scleral-sutured IOL. Characterized by glare and photophobia, and attention should be paid to recurrence due to reverse pupillary block.

Pupillary function testing evaluates pupil size, light reflex, and near reflex. In particular, detection of relative afferent pupillary defect (RAPD) using the swinging flashlight test is essential for diagnosing optic nerve disorders. This article explains the anatomy of the light reflex, examination procedure, differential diagnosis of anisocoria, and pharmacological pupillary testing.

Pupillography is a test method that combines an infrared video camera and computer software to quantitatively record and measure pupillary responses. It objectively evaluates parameters such as the pupillary light reflex, dilation dynamics, and PIRP, and is clinically applied in a wide range of fields including ophthalmology, neurology, and pharmacology.

An occlusive retinal microvasculopathy characterized by cotton-wool spots, retinal hemorrhages, and Purtscher flecken in the posterior pole, associated with trauma or systemic diseases (e.g., acute pancreatitis, renal failure). Approximately 60% of cases are bilateral, and observation is the basic management strategy.

A vision-threatening keratitis caused by the aquatic oomycete Pythium insidiosum. It closely resembles fungal keratitis but antifungal drugs are ineffective; early accurate diagnosis and antibacterial treatment determine the prognosis.