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Opioids like fentanyl effectively prevent sneezing during propofol sedation for periocular injections, enhancing patient safety in ophthalmic procedures.

Using opioids to prevent sneezing and potential ocular tissue damage during sedation and periocular injections

assistant professor of ophthalmology at the Atrium Health Wake Forest Baptist School of Medicine

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Attending physician at the VA Boston Healthcare System, and assistant professor at Boston University.

Steven D. Ness, MD, discusses his research on vitamin D's role in reducing complications after retinal surgery at ASRS 2025.

Q&A: The potential impact of vitamin D on retinal surgery

From firsts to the future: A pioneer's perspective on ophthalmology

 celebrates its 50th anniversary, the moment serves as an opportunity to reflect on the innovations that have defined ophthalmology and to highlight the pivotal role women have played in shaping the field.

To commemorate the occasion, Sheryl Stevenson, executive editor, caught up with cornea and refractive surgeon Marguerite B. McDonald, MD, FACS, to discuss the evolution of the field. McDonald has achieved numerous historic firsts, including performing the world’s first laser vision correction procedure, the first excimer laser treatment for hyperopia, the first wavefront-guided laser surgeries in the United States, and the first Epi-LASIK procedure in North America.

In practice with the Ophthalmic Consultants of Long Island in New York, McDonald is also a clinical professor of ophthalmology at New York University in Manhattan and at Tulane University School of Medicine in New Orleans, Louisiana. She is a staff physician at Manhattan Eye, Ear and Throat Hospital; Island Eye Surgicenter in Westbury, New York; and Mercy Hospital in Rockville Centre, New York.

Note: Transcript edited for clarity and length.

What are the most significant changes you’ve seen in the field of ophthalmology, whether in technology, training, or patient care?

For sure, cataract surgery. It has undergone a radical change during my professional career and even during my training. I know I will sound like Methuselah here, but when I was a first-year resident, none of the staff doctors put in IOLs, the patients all had a huge incision with 8 to 12 sutures, and [they] stayed in bed postop for a week. Can you even imagine?

When I was a second-year resident, the young attending physicians who were just finished with their training [and] trying to make a name for themselves started putting in IOLs. By the time I was a third-year resident, all the patients got an IOL. Now, they weren’t very good IOLs in the beginning; they caused a lot of problems, but at least patients weren’t staying in bed for a week anymore. It was just during a 3-year period that all these advances happened. Then the revolution of phacoemulsification, given to us by [Charles] Kelman, [as well as] small-incision surgery [and] foldable IOLs—all of it is so astonishing. It is incredible how it has changed our patients’ lives.

People go in for surgery now, [are] out an hour and a half later, and go to dinner that night. They see distance, intermediate, and near, if they wish. It’s been a revolution with a capital R and such a joy to have participated in all of it and watched it. The pantheon of the gods certainly has Kelman in it, that’s for sure. He changed our lives forever.

Refractive surgery has certainly changed. When I started my education, there really wasn’t any. Dr [José Ignacio] Barraquer in Colombia was doing some innovative refractive surgery [keratophakia and keratomileusis], but almost nobody else was. Radial keratotomy became popular right after I finished my fellowship, and then the excimer laser, of course, with which I was intimately involved. Things have changed so much—LASIK, SMILE [small incision lenticule extraction], all the things we have now—with incredible safety and efficacy records. I like to say in ophthalmology, when you take a 1-week vacation and you come back, you have to catch up. You really do. That’s how fast it changes.

Pharmaceutically speaking, when I started, the only eye drops for glaucoma were pilocarpine, phospholine iodide, and eserine. They were all we had. Patients hated them. Some of them had to be taken 4 times a day. They didn’t work very well.

Look at what we have now, plus all the fantastic surgical solutions for glaucoma, like minimally invasive glaucoma surgery and filters. In addition, we didn’t have good antibiotics either. Patients with corneal ulcers were routinely admitted to the hospital. They were put in isolation with three 8-hour shifts of nurses putting drops in, like chloramphenicol, which was removed from the market because it caused aplastic anemia in a tiny percentage of patients. I cannot remember the last time I admitted somebody to the hospital for a corneal ulcer, because the drugs are so good now. In every single way, ophthalmology has changed. I’m not sure there’s another subspecialty in medicine that has changed as much as ours over the [past] few decades.

What early challenges did you face as an ophthalmologist and as a woman in ophthalmology, and how did you navigate them?

 When I started my career, there was tremendous resistance to change. I think we’ve gotten better at that as time [has gone] by. But back in the day, ophthalmologists did not like new things. I remember when most of the top professors in ophthalmology were against IOLs and putting plastic in a patient’s eye. They were certainly against the excimer laser. The pushback against laser vision correction was enormous; it was considered immoral to fire an industrial laser at the line of sight of a patient who just didn’t like [their] glasses. Editorials were written about it. [The research team was] castigated from the podium and in print. As the years have gone by, people are more open-minded. Now we’re getting used to thinking that something that was once impossible is now possible, so I don’t see as much pushback against new ideas anymore, which is a wonderful thing.

As far as being a woman, it has had its challenges, that’s for sure. I don’t think men swing their legs out of bed in the morning and say, “How can I oppress women today?” That’s certainly not what happens. Sometimes, especially in the past, assumptions were made about women in ophthalmology that may not necessarily be true—innocent assumptions like, “I can’t put Dr Mary Smith on this committee; she has 3 small children under the age of 10,” or another innocent assumption of what her life must be like.

I always give this advice to younger women ophthalmologists: speak up. You can say, “Dr Jones, I know you’re putting together your committee. If you have space for 1 more person, I’d love to contribute.” Then address the elephant in the room. In the next sentence, you say, “I have 3 children under 10, but I have a very supportive spouse, the best nanny in the world, and my children have 4 of the most active, young grandparents who help me tremendously, so I can make room for this in my schedule. Please think of me if you need someone.”

That’s my advice to young women—speak up. People aren’t mind readers. Men aren’t mind readers. If you want to be on that podium and give a talk, or if you want to be on a certain committee, speak up. You don’t have to be pushy; just let them know you’re available. You could even detail why you’re available, [and] that you have all these support systems in place that allow you to be available.

What do you believe are the most important things institutions and senior professionals can do to support and empower women entering the field today?

 I don’t think you have to change the criteria for women at all; just become cognizant of any assumptions you might be making. For instance…an innocent assumption [like], “She can’t possibly have the time for [or interest in] this.” Keep the playing field completely flat and reexamine your entry criteria for any position to make sure you’re not making assumptions about a woman that are not true.

What are you most excited about for ophthalmology and for women in ophthalmology?

Continued advancements in cataract surgery. Real accommodating IOLs are just around the corner. That is the Holy Grail—to give somebody the ability to see like they did when they were 16 [years old], at all distances [and] without any aberrations.

Women should realize that things are getting better every day. At the beginning of my career, there were no women on the podium, [and] there were almost no women in the audience. Most of the women in the audience were someone’s assistant or secretary, taking notes. And now look—half the people on the podium are [women, and] half the people in the audience are [women]. Nobody cares what you wear, as long as you’re clean, neat, and show up on time. Back in the early days of my career, everything was examined…. Now you can wear a formal suit [or] a cotton dress and cowboy boots; you can wear anything you want, as long as the content is good and relevant to your audience, which is great. In that regard, we’re like the men. Some men show up in a suit. Some men show up in khakis and a polo shirt. Nobody cares. It’s all about content now.

Is there anything else that you would like to add?

Stay excited about ophthalmology. It can be a drag sometimes with the changing reimbursement from the government. We get paid less and less for things that take more and more of our time, skill, and expertise. [With] the changes that accompany private equity and all the things that are impacting us now—you can get down and burned out. We shouldn’t be. We still have the best specialty in all of medicine…. We’re lucky. There’s very little cancer in ophthalmology. For the most part, we make people exceedingly happy and change their lives forever. You have to remember that when times get tough.

Landau E. Her vision: better, clearer sight. CNN. May 17, 2013. Accessed July 18, 2025. https://www.cnn.com/2013/05/17/health/lifeswork-mcdonald

McDonald MB. Celebrating a pivotal moment in laser vision correction history. 

. November 19, 2020. Accessed July 18, 2025. https://www.ophthalmologytimes.com/view/celebrating-pivotal-moment-laser-vision-correction-history

Ophthalmology has undergone significant advancements over the past decades, with cataract and refractive surgeries evolving dramatically. Marguerite B. McDonald, MD, FACS, a pioneer in laser vision correction, reflects on these changes and the increasing role of women in the field. She highlights the importance of speaking up for opportunities and the need for institutions to avoid assumptions about women's capabilities. McDonald is optimistic about future innovations, such as accommodating IOLs, and emphasizes the rewarding nature of ophthalmology despite challenges like changing reimbursements and private equity impacts.

Marguerite B. McDonald, MD, FACS, shares a front-row view of ophthalmology’s “revolution with a capital R."

Julia A. Haller, MD, will assume the role of chief executive officer (CEO) at Wills Eye Hospital, expanding her responsibilities beyond her current position as ophthalmologist-in-chief, a post she has held since 2007. She succeeds Joseph P. Bilson, who is retiring after more than 4 decades with the institution.

As CEO, Haller will oversee patient care, strategic planning, financial performance, and philanthropic efforts across Wills Eye Hospital’s regional network in Philadelphia, Pennsylvania, which serves more than 350,000 patients annually. She will continue in her role as ophthalmologist-in-chief.

“Julia is a trailblazing retina surgeon, internationally renowned ophthalmologist, and remarkable individual. The next era of Wills Eye is in excellent hands with her,” said Hon Michael A. Nutter, president of the Board of Directors of City Trusts, which administers the James Wills Trust that operates the hospital. “She brings a unique level of continuity and deep understanding of Wills Eye Hospital’s influence on global ophthalmology to this role.”

Haller emphasized her commitment to furthering the institution’s legacy: “After serving as ophthalmologist-in-chief for nearly 20 years, it is an honor to become yet more deeply embedded in this venerable institution,” she said. “I look forward to growing our impact locally, regionally, and internationally…and continuing to elevate the Wills Eye name as a relentless force for excellence and innovation.”

Bilson praised his successor: “I saw first-hand that she is an enormously talented professional who is uniquely prepared to take Wills to the next level. I know she’ll be great, and I wish her every success.”

Haller is also professor and chair of ophthalmology at Sidney Kimmel Medical College at Thomas Jefferson University and a consultant for Children’s Hospital of Philadelphia. She graduated from Princeton University in New Jersey; Harvard Medical School in Boston, Massachusetts; and Wilmer Eye Institute at The Johns Hopkins University School of Medicine in Baltimore, Maryland. Haller also serves as an officer of the Ophthalmology Foundation, a prominent nonprofit committed to improving eye care worldwide by supporting ophthalmic education and reaching underserved communities.

In light of this leadership transition, the 

 caught up with Haller to discuss her vision for Wills Eye Hospital, her strategic priorities as CEO, and what this new chapter means for the future of ophthalmology.

After nearly 20 years as Ophthalmologist-in-Chief, what does stepping into the CEO role mean to you personally and professionally?

This expansion of my role at Wills Eye Hospital is a tremendous honor for me, as well as an exciting opportunity to become even more deeply embedded in this remarkable, venerable institution. I am enthusiastic about bringing the perspective of a practicing surgeon to the CEO role, and working with our faculty, staff, and supporters to ensure that Wills Eye Hospital continues to deliver the best eye care in the world. Two decades of experience as Ophthalmologist-in-Chief allow me to approach the role of CEO with a well-informed understanding of clinical standards, research priorities, and physician needs. In partnership with our world-class team, expanding my oversight to include strategic planning, financial management, and fundraising has the advantage of allowing synergistic new cross-fertilization between all these critical elements of success.

What are your strategic priorities as you take the helm as CEO—particularly around patient care, innovation, and expansion?

My priorities all revolve around the North Star of excellence in patient care. That is the absolute 

of our strategic plan. In order to stay in the vanguard clinically, we also need to prioritize our other areas of famed strength, including education and mentorship for the next generation of the best and the brightest, building on our groundbreaking portfolio of innovations in the diagnosis and therapy of ocular disease, and finding ever new ways to ensure that our staff not only flourishes, but lives out their professional dreams.

What excites you most about the future of Wills Eye Hospital, and how do you plan to build on its legacy while adapting to the rapidly evolving landscape of healthcare and vision science?

The future of Wills Eye Hospital is one of unlimited potential, with our pre-eminent place in ophthalmology positioning us in leadership roles, even as tremendous advances in vision research and innovation continue to keep our specialty at the “tip of the spear” of medical breakthroughs. I look forward to deepening our impact locally, regionally, and internationally, serving as a champion for the hundreds of thousands of patients who walk through our doors each year, and continuing to elevate the Wills Eye name as a relentless force for excellence and innovation, shaping the future of ophthalmology across the globe.

Julia A. Haller, MD, named CEO of Wills Eye Hospital. News release. Wills Eye Hospital. July 17, 2025. Accessed July 28, 2025. https://www.willseye.org/press-release/julia-a-haller-md-named-ceo-of-wills-eye-hospital/

Ophthalmology Foundation elects new board members and officers to advance eye care worldwide. News release. Newswire.com. March 18, 2024. Accessed July 28, 2025. https://www.newswire.com/news/ophthalmology-foundation-elects-new-board-members-and-officers-to-22268350

Julia A. Haller, MD, has been appointed CEO of Wills Eye Hospital, succeeding Joseph P. Bilson. She will continue her role as ophthalmologist-in-chief, a position she has held since 2007. Haller will manage patient care, strategic planning, financial performance, and philanthropic efforts for the hospital's regional network. Her leadership is expected to enhance the institution's impact locally and globally. Haller is also a professor and chair of ophthalmology at Sidney Kimmel Medical College and a consultant for the Children’s Hospital of Philadelphia.

The Eye Care Network connected with Haller to hear her vision for Wills Eye Hospital, her priorities as CEO, and what lies ahead for the field of ophthalmology.

Wills Eye Hospital names Julia A. Haller, MD, as new chief executive officer

The 2025 Association for Research in Vision and Ophthalmology (ARVO) Annual Meeting will take place May 4-8, 2025, in Salt Lake City, Utah. Ahead of this exciting meeting, several companies have announced that data from clinical trials will be shared at this event.

As researchers prepare for their presentations, we are highlighting some of the scheduled sessions that will share important data and research from around the globe.

Note: The following list of presentations is in alphabetical order by company and will be updated as more information becomes available.

The company will share results from its clinical studies of investigational oral gildeuretinol for the treatment of Stargardt disease (TEASE) and geographic atrophy secondary to age-related macular degeneration (SAGA) at the 2025 ARVO annual meeting.

Safety and Efficacy of Oral Gildeuretinol for Stargardt Disease: TEASE-1 Trial

Presented by Benjamin Bakall, MD, PhD on Monday, May 5, 2025 at 4:30 PM to 4:45 PM MT

Oral Gildeuretinol Treatment in Geographic Atrophy Secondary to AMD in the SAGA Trial: Safety, Efficacy and Patient-reported Outcomes

Presented by David Boyer, MD, on Tuesday, May 6, 2025 at 4:45 PM to 5:00 PM MT

Jeff Cleland, PhD, CEO of Ashvattha Therapeutics, will present a poster entitled “Subcutaneous Migaldendranib Reduces Anti-VEGF Treatment Burden: A Unique Therapeutic Platform to Treat Retinal Vascular Disease” during the poster session on Wednesday, May 7, 2025, from 2:00-3:45pm MT.

This poster will highlight Phase 2 results for migaldendranib (MGB), Ashvattha’s investigational subcutaneous treatment for wet 

age-related macular degeneration (wet AMD)

. It was previously announced that the phase 2 clinical data demonstrated that MGB administration lowered production of subretinal fluid, reducing or eliminating the need for intravitreal anti-VEGF treatment in both the study eye and fellow eye in wet AMD and DME subjects with bilateral disease.

The company will have presentations that highlight its advancing ocular gene therapy, including the development of its proprietary VSaf AAV manufacturing platform and therapeutic candidate ABI-201, a single AAV vector carrying 3 functional genes to treat dry AMD.

A Fast and Robust VSaf AAV Platform Technology for Producing High Quality and Yield of AAV Vectors for Ocular Gene Therapy

Presented by Shengjiang Liu, PhD on Wednesday, May 7, 2025 from 2:15 PM to 2:30 PM MT.

Protective Efficacy of ABI-201 in a Sodium Iodate-Induced Retinal Damage Model of Dry AMD in Non-Human Primates

Presented by Sameera Peraramelli, PhD on Monday, May 5, 2025 from 3:00 PM to 4:45 PM MT

Advancing Retinal Disease Research: The Sodium Iodate NHP Model for Translational Therapeutic Evaluation

Presented on May 4, 2025 from 1:00 PM to 1:30 PM MT

At the meeting, Beacon Therapeutics is set to present 6-month interim safety and efficacy results from the Phase 2 DAWN trial of the Company's lead program, laru-zova (laruparetigene zovaparvovec), in patients with X-linked retinitis pigmentosa (XLRP). The presentation is titled, "Subretinal gene therapy laru-zova (AGTC-501) for X-linked retinitis pigmentosa (XLRP): Phase 2 DAWN preliminary month 6 results" and will be given by Mark Pennesi, MD, PhD, FARVO, on Tuesday, May 6, 2025.

Six abstracts related to Clearside’s suprachoroidal drug delivery platform have been accepted for presentation at the 2025 ARVO meeting.

Top Line Results from ODYSSEY: A Phase 2b Study of Suprachoroidally Administered CLS-AX in Participants with Neovascular Age-related Macular Degeneration

Presented by Robert Wang on Thursday, May 8, 2025, from 3:00 pm - 3:15 pm MT.

Suprachoroidal CLS-AX (Axitinib Injectable Suspension) Offers Durability, Safety, and Therapeutic Potential for Neovascular Age-Related Macular Degeneration (nAMD) Patients: Preclinical and Clinical Corroboration

Posterboard number A0125 presented by Viral Kansara, PhD on Wednesday, May 7, 2025, from 10:15 am - 12:00 pm MT

The Evolving Role of Suprachoroidal Drug Delivery in Macular Diseases: A Decade-Long Literature Review

Posterboard number B0517 presented by Victor Chong, MD, MBA on Monday, May 5, 2025, from 8:30 am - 10:15 am MT

Validation of Suprachoroidal Injection Training Program with a Synthetic Eye Model

Posterboard number B0415 presented by Chen-rei Wan on Thursday, May 8, 2025, from 8:00 am - 9:45 am MT

Dispensability Analysis of Suspension Formulations

Posterboard number B0515 presented by Darrin Rountree, MS on May 5, 2025, from 8:30 am - 10:15 am MT

Novel Deep Learning Algorithm for Suprachoroidal Space Segmentation and Measurement in Optical Coherence Tomography

Posterboard number A0229 presented by Oluwagbemisola Aderibigbe on May 4, 2025, from 1:00 pm - 2:45 pm MT

Doheny Eye Institute announced that more than 25 of its scientists and clinician-scientists will present their latest research at the 2025 ARVO Annual Meeting. In addition to a strong lineup of presenters, Doheny will also be well represented as SriniVas R. Sadda, MD, closes out his term as president of ARVO at the culmination of the 2025 meeting.

A complete list and schedule for all the Doheny Eye Institute and UCLA Stein Eye Institute research presentations is available 

Data from EyePoint has been accepted for presentation at the upcoming 2025 ARVO Annual Meeting. The company plans to showcase its clinical trial datasets for is phase 2 VERONA trial and phase 2 DAVIO 2 trial, which across multiple indications saw continued safety and efficacy, as well as the program’s de-risked study designs that reflect real-world patient populations.

Eyestem has recently shared that all patients across 3 cohorts in the company’s phase 1 trials of its investigational drug, Eyecyte-RPE, in patients with geographic atrophy (GA) secondary to dry age-related macular degeneration (AMD) were dosed without any serious adverse events. The first 6 patients showed an average 14.9-letter gain in ETDRS vision tests within 4–6 months, with early signs of disease reversal seen in some retinal scans. Data from this trial will be presented at the ARVO meeting.

The company will present new developments and updates on its lead candidate, ILYX-002, for immune-driven 

 from a recent Phase 2 clinical trial, ILYX-002-201. The presentation will take place during the Dry Eye: Clinical Aspects II session on May 8, 2025, 8:00 am – 9:45 am MST. Dr. Mark Hinds, principal investigator for the ILYX-002-201 trial, will be the presenter on the company’s behalf.

Luxa Biotechnology said it will present clinical results for its investigational dry age-related macular degeneration (AMD) cell therapy candidate, RPESC-RPE-4W, at the 2025 ARVO Annual Meeting. The data from cohort 1 of its phase 1/2a clinical trial evaluating RPESC-RPE-4W, a retinal pigment epithelium (RPE) cell therapy derived from adult retinal pigment epithelial stem cells (RPESCs).

The company is scheduled to participate at both the Eyecelerator and the 2025 ARVO annual meetings. Nanoscope's presentations will be centered around 126-week outcomes following treatment with its MCO-010 optogenetic therapy for retinitis pigmentosa (RP), the first and only therapy shown to restore vision in advanced RP patients via a one-time, standard intravitreal injection.

Ocular Therapeutix will present information at the meeting in Fort Lauderdale regarding the axitinib intravitreal hydrogel clinical trials, the use of its candidate OTX-TKI for diabetic retinopathy, and the HELIOS clinical trial for diabetic retinopathy.

Ocugen, Inc. will present on its modifier gene therapy platform, including OCU400 for the treatment of retinitis pigmentosa (Phase 3 LiMeliGhT clinical trial), OCU410ST for the treatment of Stargardt disease (Phase 2/3 pivotal confirmatory clinical trial), and OCU410 for the treatment of geographic atrophy (Phase 2 ArMaDa clinical trial) at the 2025 ARVO Annual Meeting.

Three abstracts on the company’s investigational gene therapy candidates have been accepted for presentation at the ARVO 2025 Meeting. The abstracts feature 12-month data from the first 3 adult patients in the ongoing Phase 1/2 trial of OPGx-LCA5, as well as preclinical results on OPGx-MERTK and OPGx-RDH12.

Evaluation of MERTK gene therapy in RCS rats following a single bilateral subretinal injection

Presented by Mayur Choudhary, PhD, on May 8, 2025, from 11:45 am to 1:30 pm MT.

Evaluation of ocular tolerability of OPGx-RDH12 by subretinal delivery in cynomolgus primates

Presented by Ash Jayagopal, PhD, on May 5, 2025, from 8:30 am to 10:15 am MT

LYNX-1 Phase 3 trial of the safety and efficacy of phentolamine ophthalmic solution for the treatment of reduced mesopic low contrast vision: A subset analysis of keratorefractive subjects

Presented by Kostas Charizanis, PhD on May 4, 2025 from 8:00 am to 9:45 am MT

The company's data will feature in several presentations at the ARVO annual meeting. These include new data on bevemipretide, the company's next-generation ocular topical investigational medicine, including protective effects observed in models of dry age-related macular degeneration (AMD) and glaucoma, and preclinical toxicology and exposure data informing the company's planned Phase 1 study.

TME Pharma N.V. and the Singapore Eye Research Institute (SERI) will present a poster highlighting data from preclinical studies performed with mNOX-E36 by SERI at the ARVO Annual Meeting. Preclinical data show that mNOX-E36 is as efficacious as standard-of-care mitomycin C (MMC) at attenuating postoperative inflammation and scarring (fibrosis) following glaucoma filtration surgery (GFS).

The 2025 ARVO Annual Meeting in Salt Lake City will feature presentations from various companies showcasing significant advancements in ophthalmology. Ashvattha Therapeutics will present Phase 2 results for migaldendranib, a treatment for retinal vascular diseases. Clearside Biomedical will discuss its suprachoroidal drug delivery platform. EyePoint Pharmaceuticals will share data from its Phase 2 trials. Eyestem Research will present promising results from its Eyecyte-RPE trial. Iolyx Therapeutics, Opus Genetics, and TMR Pharma N.V. will also present their latest research findings and developments in ophthalmic treatments.

The annual ARVO meeting will be held in Salt Lake City, Utah and feature presentation on clinical trials from around the globe. 

Steven D. Ness, MD

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