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American Academy Ophthalmology

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The world’s largest association of eye physicians and surgeons. We protect sight and empower lives by ensuring the highest-quality eye care.

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“Mogging” has been named as word of the year by the Collins English Dictionary. It means to outshine, outperform or upstage someone or something.

We think this case report in Ophthalmology fits the definition. It upstages your typical case of corneal neovascularization.

The condition pictured here is what’s called persistent fetal vasculature. When a baby is growing in the womb, its eyes have a temporary set of blood vessels inside them. These vessels are thought to nourish the developing lens of the eye before the eye starts making its own fluid. It normally disappears at around 28 to 30 weeks of pregnancy. When those fetal blood vessels don’t fully go away, you get persistent fetal vasculature.
Babies show a range of signs depending on where in the eye the leftover vessels are located. Some leftovers are minor. For instance, a small spot called a Mittendorf dot is a mild form of this condition, and treatment for it is rarely needed. Another leftover near the optic nerve, called a Bergmeister papilla, usually causes no symptoms and is often found by chance.

In more serious cases, it can significantly affect a child’s sight. It remains an important cause of amblyopia (often called “lazy eye”) and other vision problems in children. The condition itself doesn’t get worse over time, but as the eye grows, the leftover tissue can pull on structures inside it. This can lead to complications such as glaucoma, cataracts, bleeding inside the eye, and retinal detachment.

This 13-year-old boy had experienced poor vision in his right eye since he was aged 3. His right eye also turned inward towards his nose, but it was not abnormally small, with an axial length of 25.90 mm. Anterior-segment photography revealed tree-like vessels in the corneal stroma. In the second image, corneal fluorescein angiography shows the filling of these vessels beginning approximately 15 seconds after intravenous injection of fluorescein sodium, without leakage.

📸 Yaling Liu, PhD, Jiannan Tang, PhD, Guoming Zhang, PhD, of Shenzhen Eye Hospital. Pictures & Perspectives, September 2026 issue of Ophthalmology by @aaoeye

Last year, the Academy led a coalition of more than 60 physician & patient groups to pressure the federal government’s health watchdog, the HHS Office of Inspector General, to investigate step therapy in Medicare Advantage plans.

Today, the Academy’s seasoned advocacy team – Michael X. Repka, MD, MBA, medical director for Governmental Affairs, John McAllister, MD, secretary for Federal Affairs, and George Williams, MD, senior secretary for Advocacy – is meeting with the Office of Inspector General (OIG) as it sets out to evaluate whether Medicare Advantage plans are using step therapy tools appropriately.

Step therapy, sometimes called “fail first,” means an insurance plan makes patients try the plan’s preferred drug, and sometimes two or three of them, before it will cover the drug their doctor prescribed. Medicare banned this for doctor-administered drugs (like eye injections) until 2019, when the rules changed to allow it. Since then, its use has grown sharply: 84% of surveyed doctors report seeing more of it, and 94% say it keeps them from prescribing what’s best for their patients.

Today, our advocacy team is telling the OIG what step therapy looks like in practice. They’ll tell the story of the Tennessee patient who was blinded by step therapy. They’ll tell them plans are forcing patients who are already doing well on a drug to switch, requiring drugs that aren’t approved for the condition being treated, and pushing medications favored for financial reasons rather than medical ones. The consequences can be permanent: people with cancer or vision-threatening eye conditions losing critical time.

It’s Important to Know:

✅ The OIG makes recommendations; it’s up to the Centers for Medicare & Medicaid Services (CMS) or Congress to act to implement any policy changes.

✅ The OIG’s objective is to evaluate whether Medicare Advantage plans are using step therapy appropriately, not whether it should exist at all.

How You Can Help:

✅ Share with the Academy stories of patient harm from overutilizing of step therapy or prior authorization. Link in bio

✅ When the Academy puts out the call to contact Congress, heed it. by @aaoeye

If you give or get injections for macular degeneration, diabetic eye disease, or retinal vein occlusion, this is worth knowing.

A new study in Ophthalmology looked at more than 930,000 Medicare patients and nearly 13 million anti-VEGF eye injections from 2017 to 2022. It compared people with Medicare Advantage (MA) to people with traditional Medicare (Fee-For-Service). Link in bio.

What they found:

👁️ 60% of MA patients mostly received bevacizumab, the lower-cost option, compared with 47% on traditional Medicare.

👁️ MA patients were less likely to receive newer, higher-cost drugs like aflibercept (Eylea), ranibizumab (Lucentis), and faricimab (Vabysmo).

👁️ The researchers point to prior authorization and “step therapy” as likely reasons. Many MA plans require patients to try a cheaper drug first before they can get another one.

Why this matters to YOU:

Bevacizumab works well for many patients. But the right drug depends on your condition and how your eyes respond, and that choice should be made by you and your ophthalmologist. Many people don’t realize their plan’s rules can affect their treatment options.

✅ What you can do:

• Ask your ophthalmologist which medication they recommend for you and why.

• Ask whether your plan requires prior authorization or step therapy for eye injections.

• Find out what your out-of-pocket costs are for doctor-administered drugs.

• Medicare Open Enrollment runs Oct 15 to Dec 7, so now is the time to compare plans with your eye care in mind.

📖 Chan J, et al. Ophthalmology. 2026;133:1363–1369.

📸 Courtesy of Paul Griggs, MD. by @aaoeye

Thank you for joining us in New Orleans, where the force of the best meeting in ophthalmology diverted an entire hurricane!
#aao2026
See you in Las Vegas! by @aaoeye

What does it take to bring an optogenetic therapy toward clinical application?

At Eyecelerator, Samuel B. Barone, MD, of Nanoscope Therapeutics shares his perspective on the transformative potential of optogenetics and what gathering with fellow pioneers gives him to keep pushing forward.

A closer look at an innovative approach to retinal disease, and the people working to bring it to patients.

Learn more at https://www.eyecelerator.com/

This content is intended exclusively for healthcare professionals and eye care practitioners. It is not intended for the general public. Products or therapies discussed may not be registered or approved in all jurisdictions, including Singapore.

#Eyecelerator #Optogenetics #NanoscopeTherapeutics #GeneTherapy #Ophthalmology #EyeCare #MediaMICE #AAO2026 by @aaoeye

So, it’s not as good as being here in New Orleans, but you can still sign up for the virtual meeting until January 31. Link in bio for more information.
We’re going home inspired and energized.
See you in Las Vegas!
#ophthalmology #aao2026 #BestSpecialtyinMedicine by @aaoeye

A new position statement from the American Glaucoma Society and the American Academy of Ophthalmology says yes.

Right now, Goldmann applanation tonometers fall under the “semi-critical” category of the Spaulding classification, the same bucket as endoscopes and bronchoscopes. That means high-level disinfection (HLD) is required. But that framework was never built with the ocular surface in mind.

Here’s what the authors found⬇️

🔬 Decades of clinical experience haven’t shown higher infection rates with low-level disinfection, even though most ophthalmologists already use alcohol wipes.

⚠️ HLD can backfire. Harsh chemicals can dissolve the glue holding the tip together, causing swelling and cracking. That can injure corneas and throw off IOP readings.

♻️ Disposable tips aren’t the answer either. With roughly 102 million tonometry exams indicated each year in the US, switching entirely to single-use tips would cost an estimated $150M annually and create mountains of plastic waste.

The recommendation: reclassify tonometers as non-critical items.

For most patients, thorough physical cleaning plus an isopropyl alcohol wipe is enough.

Patients with signs of ocular infection (redness, discharge, irritation) or chronic viral disease should get single-use tips, HLD-cleaned tips, or another tonometry method.

The goal is accurate IOP measurement, safe patients, and a more sustainable practice.

Link in bio for the statement

📸 “Encounter of the semicircles (Goldmann Tonometry)” by Celso de Souza Dias Júnior, MD by @aaoeye

New injectables and a retinal implant that could be the first treatment to restore lost sight in people with geographic atrophy. That’s just a few of the late-breaking, late-stage clinical trial results discussed at Retina Subspecialty Day at #aao2026

We learned at last year’s annual meeting that a retinal implant called PRIMA could restore some lost vision in patients with geographic atrophy, an advanced form of age-related macular degeneration. New data presented yesterday showed that the vision these patients gained persisted through three years.

PRIMA received the CE mark in July, which allows it to be sold in Europe. It has not yet been approved in the United States.

Merck’s remigromig, an investigational tri-specific antibody designed to activate the Wingless-related integration site pathway, showed promise for the treatment of diabetic macular edema, meeting its primary non-inferiority endpoint against ranibizumab at 1 year in a phase 2b/3 study.

Two investigational intravitreal agents from Kodiak Sciences met the primary end point of the phase 3 DAYBREAK trial in treatment-naive neovascular age-related macular degeneration. Tarcocimab tedromer and the bispecific tabirafusp alfa tedromer each achieved best-corrected visual acuity BCVA gains noninferior to aflibercept at 1 year.

It is the first positive wet AMD readout for tarcocimab on an extended, individualized regimen. #ophthalmology #eyedoctor #retina by @aaoeye

Seven years ago, I was scheduled to speak on a panel at the American Academy of Ophthalmology meeting. My husband, who is also an eye surgeon, was tied up in a wet lab learning a new corneal transplant technique. We had unexpected gaps in our schedule, so I brought them with me.

They sat quietly in the back of the room during my panel, following along with the itinerary. They took some zany photos in the Young Ophthalmologist’s Lounge. They crashed the exhibit hall, played with the surgical VR headsets, and my son even played pinball while eating fro-yo. My daughter found the official YO Program Participants roster and decorated it, drawing hearts all over her favorite speaker (shoutout to Dr. Janice Law!).

That year was the very first time the AAO created a childcare program. It was a huge step forward in supporting parents and an acknowledgment that we don’t have to hide our motherhood (or fatherhood) to be taken seriously. We can be both dedicated parents and eye surgeons.

I recognize that having the autonomy to walk into a national medical conference with three kids in tow is a massive privilege. It is a flexibility that comes from being a practice owner and an attending physician, a leverage I absolutely did not have as a medical student or a resident.

But it is also a reminder that we can give a national lecture, and we can also make sure our kids are fed, safe, and having fun. We can change the way things are done.

These pics popped up on my photos feed since hubby and I are at another AAO conference today and I just had to share.

What’s the wildest way you combined work and parenthood? by @aaoeye

What does it take for a pitch to win the room?

At Eyecelerator @ AAO 2026, The Winning Pitch Challenge brought promising ideas in front of people who can help move them forward. Dr. Vance Thompson and Dr. Julie Schallhorn introduce this year's winner, Chris Horvath of EyeX Solutions, and the SoftLase™ picosecond laser.

Watch the full video.

Learn more at https://www.eyecelerator.com/

This content is intended exclusively for healthcare professionals and eye care practitioners. It is not intended for the general public. Products or therapies discussed may not be registered or approved in all jurisdictions, including Singapore.

@aaoeye
#Eyecelerator #Eyecelerator2026 #TheWinningPitchChallenge #Innovation #EyeCare #MedicalInnovation #HealthTech #MedTech #EyeCare #MediaMICE #AAO2026 by @aaoeye

After almost 5 years of submitting proposals that have gotten rejected for AAO‘s annual meeting, my first course on ocular nutrition supplementation is finally happening!

You can check it out: Course 800V available on demand called:

Nutrition and Supplements in Ophthalmology: What the Evidence Really Supports—and What It Does Not.

Let me know if you’re planning to participate!

Also DM me if you’re attending AAO in New Orleans this weekend– would love to meet you and take a selfie together!

#ophthalmology #eyedoctor #ocularnutrition #eyenutrition #aao2026 by @aaoeye

As Fat Bear Week ends today, we have a late entry. This is our favorite chonky bear.

This image was taken in the wildlands known as Wills Eye Hospital by the legendary ophthalmologist, Carol L. Shields, MD, and her team, Megan Ruben, BA, Antonio Yaghy, MD, and Sandor R. Ferenczy, CRA.

Dr. Shields has documented and published extensively on these distinct retinal lesions called “bear tracks”.

While bear tracks sound menacing, these lesions resembling the footprint of a bear aren’t harmful. However, when a person has many lesions in both eyes, it can be a sign of a genetic condition called Gardner’s syndrome. People affected by Gardner’s syndrome have a high risk of developing colorectal cancer at an early age.

Congenital hypertrophy of the retinal pigment epithelium (CHRPE) occurs in 3 variant forms: solitary (unifocal), grouped (multifocal) and atypical. The atypical variant is associated with a high risk of cancer. This patient has multifocal CHRPE. Link in bio to our EyeWiki page on CHRPE.

For the uninitiated, Fat Bear Week is an annual online competition at Katmai National Park, Alaska. They invite the world to vote for the brown bear most successful at gaining weight for winter hibernation. Live webcams allow virtual visitors a front-row seat to watch these magnificent animals feasting on salmon (and the occasional Philadelphia Eagle😉) in preparation for the lean winter months.

🐻Fat bears = healthy bears

🐻 Regular eye exams = healthy eyes

We’re big fans of both

#nationalparks #fatbearweek #retina #ophthalmologist #eyedoctor by @aaoeye