Purpose: To evaluate current diagnostic and therapeutic practices among South Korean oculoplastic surgeons, with particular focus on adherence to guidelines and perspectives on emerging therapies such as teprotumumab. Methods: A nationwide, anonymized online survey was conducted in May 2025 among members of the Korean Society of Ophthalmic Plastic and Reconstructive Surgery (KSOPRS). The questionnaire collected data on physician demographics, diagnostic and monitoring approaches, therapeutic strategies for mild and moderate-to-severe thyroid eye disease (TED), management of dysthyroid optic neuropathy, and perspectives on teprotumumab treatment. Results: Thirty-two physicians participated in the study, most of whom practiced at tertiary centers. Most respondents (n = 28, 87.5%) utilized the Clinical Activity Score and the European Group on Graves’ Orbitopathy severity classification. Intravenous (IV) glucocorticoid (GC) therapy was the predominant treatment for moderate-to-severe TED (n = 31, 96.9%), with adjunctive use of oral GCs, immunosuppressants (n = 13, 40.6%), and orbital radiotherapy (n = 29, 90.6%). In managing dysthyroid optic neuropathy, 19 respondents (59.4%) employed IV GC with radiotherapy, and 29 (90.6%) recommended decompression for refractory cases. Teprotumumab was considered primarily for GC-refractory cases, although its use was limited owing to cost and limited clinical experience. Functional assessments, including visual acuity and relative afferent pupillary defect, were prioritized over structural imaging in evaluating treatment response. Conclusions South Korean oculoplastic surgeons generally follow international TED guidelines, favoring IV GC and conventional therapies over biologics due to access and cost barriers. As biologics like teprotumumab become more accessible, region-specific guidelines integrating global evidence and local healthcare constraints will be critical for optimized patient care.

Pediatric optic neuritis is a demyelinating optic nerve inflammation in children, characterized by acute vision loss and visual field defects, often accompanied by eye movement pain, color vision abnormalities, and relative afferent pupillary defects. It can manifest as an isolated episode or as part of broader demyelinating disorders such as multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease. Its incidence varies globally, with recent studies defining it as optic neuritis in individuals aged <16 years.Current Concepts: Pediatric optic neuritis has distinct clinical features compared to its adult counterpart, particularly in presentation patterns and associated systemic diseases. Children often experience greater visual acuity deficits and are more likely to develop bilateral eye involvement, severe optic disc swelling, and accompanying encephalopathic features than adults. Epidemiological studies have shown that it is relatively rare, with varying incidence rates across different regions. Diagnostic criteria are primarily based on clinical assessment, magnetic resonance imaging findings, and serological tests, including antibodies against specific biomarkers such as anti-MOG and anti-aquaporin-4 antibodies. Treatment strategies for pediatric optic neuritis involve high-dose corticosteroids followed by tapering and, in severe cases, plasma exchange or intravenous immunoglobulins. Long-term management may require immunosuppressants or biological agents, particularly in cases progressing to MS or NMOSD.Discussion and Conclusion: Understanding the unique aspects of pediatric optic neuritis is crucial for appropriate management and improving outcomes. Further studies are needed to refine diagnostic and therapeutic approaches for this condition.

Purpose: To evaluate the clinical reliability of the Topolyzer Vario (Wavelight-Alcon, Erlangen, Germany), we compared threedifferent corneal topographers in terms of corneal refractive power. Methods: The medical records of patients who visited Severance Hospital for corneal refractive surgery were retrospectivelyreviewed. Keratometric data of patients who underwent evaluations using the Pentacam HR (Oculus, Wetzlar, Germany),ORBscan II (Bausch & Lomb, Rochester, NY, USA), and Topolyzer Vario instruments on the same day were obtained. Flat keratometry(Kf), steep keratometry (Ks), mean keratometry (Km), astigmatism keratometry (Kastig), Cartesian astigmatism (J0), andoblique astigmatism (J45) values were calculated. The measurement values of the three devices were subjected to Pearson’scorrelation analysis and repeated measures analysis of variance (with Bonferroni correction); a Bland-Altman plot was alsocreated. Results: The keratometric data of 80 eyes were included in the analysis and all of the keratometric measurements obtained bythe three devices showed significant correlations, i.e., good agreement. The Kf and Km measurements of the Pentacam HR wereflatter than those of the ORBscan II, and the Kf, Km, Ks, and J45 measurements were flatter than those of the Topolyzer Vario.However, there was no significant difference in keratometric values between the ORBscan II and Topolyzer Vario. Furthermore,the difference in corneal refractive power between the Pentacam HR and Topolyzer Vario was not clinically significant. Conclusions When measuring the corneal refractive power of patients without any history of corneal disorder or ocular surgery,the Topolyzer Vario is a clinically reliable device that shows similar performance to the ORBscan II and Pentacam HR.