What does it mean to save the ocular surface?
Depending on who you ask, and indeed how the question is asked and in what context, it is a question likely to garner a wide array of responses. And so, when we set out to judge the second annual OSD Saves Photo contest, the results of which are presented in the following publication, we had to think about what criteria we would use to select the winners. We wondered whether we should be looking for extraordinary pathology? Whether we should base our decision on how unexpected the final outcome was? Or should we think more closely about the word “save” and look for cases where a patient was spared a seemingly inevitable negative outcome?
We can share with readers that the art of judging a photo contest is highly subjective, and this year, our task was made difficult by the quality of the submissions. It was no easy task to select a few to highlight. Nevertheless, after we had sorted through all the entries, we found four remarkable examples of cases in which the clinician used his or her judgement to arrive at a solution for a complex problem.
The beauty of the criteria we ultimately used for judging, of course, is that we got to define “complex problem” from different vantage points. One case in the following demonstrates the use of a novel therapy for neurotrophic keratitis (NK) in a pediatric patient affected by glioblastoma; the etiology of the NK was certainly complicated by an underlying medical issue. Another case describes the use of an amniotic membrane to facilitate treatment of filamentary keratitis; while this is a clinical entity on the more common side of the spectrum, the particulars of the case underscore the complexity in treating it with the array of options available for use in the clinic. Yet the linkage between these cases and the others in this series is that in the end, the patient was “saved” from irreversible loss of vision, from damage to the ocular structures, or from the life-altering symptoms associated with ocular surface disease.
No matter how you define it, we all know a good “save” when we experience one in the clinic. That is because, thanks to advancements in treatments for clinical entities like NK and other ocular surface disease, the outcomes we used to think were extraordinary are becoming more commonplace. And it is also because clinicians around the world are using those tools in new and creative ways to redefine treatment paradigms in common clinical entities—and we think readers will agree, that much is evident from the cases highlighted in this series.
