Reactive orbital energy theory (ROET), an orbital-energy-based electronic-structure framework, elucidates the electron motions that drive pericyclic reactions and helps clarify the orbital-energy basis of WH-type stereoselectivity. For WH-allowed electrocyclic reactions, symmetry-conserving pathways are favored because the occupied reactive orbital (ORO) is strongly stabilized in the vicinity of the transition state, thereby lowering the barrier. This stabilization is correlated with symmetry-allowed occupied-occupied crossings between nearby occupied orbitals of different symmetry, which preserve the character of the ORO and facilitate the dominant occupied-virtual response. By contrast, in WH-forbidden pathways, a HOMO-LUMO crossing near the transition state is associated with an electrostatic force opposite to the reaction direction, thereby increasing the barrier. For the non-electrocyclic reactions examined here, ROET reveals that cycloadditions are driven by electron transfer from diene π orbitals. On the other hand, for the propylene-ethylene ene reaction, ROET shows that hydrogen migration is accompanied by redistribution of the ethylene-derived π component of the ORO into the developing σ-bonding framework. For many of the reactions examined here, the pericyclic step can be rationalized in terms of constructive orbital overlap within the ORO, whereas the sigmatropic rearrangements, including the Claisen rearrangement and hydrogen shifts, require consideration of additional occupied orbitals that exert large reaction-driving electrostatic forces near the TS. ROET thus provides an energetically grounded perspective that clarifies the origin of WH-type stereoselectivity in the electrocyclic reactions examined here and offers a common interpretive framework for the other pericyclic classes analyzed in this study.
Orbital hypertelorism is observed in a wide spectrum of congenital disorders, such as in case of frontonasoethmoidal tumors or encephaloceles, craniofrontonasal dysplasia, craniofacial clefts, syndromic craniosynostosis, Rasopathies and various malformative and multisystemic congenital syndromes. Yet its underlying pathophysiological mechanisms remain incompletely understood. Our systematic literature review aimed to delineate and classify the different conditions associated with true orbital hypertelorism based on both genetic bases and physiopathological mechanisms of orbital hypertelorism. Anomalies at different developmental stages can result in hypertelorism. Early embryonic defects - such as neurulation abnormalities, impaired fusion of frontonasal and maxillary prominences or nasal capsule hypoplasia - result in primary orbital widening. Perinatal disturbances of cranial suture fusion or skull base development, particularly of the sphenoid bone and cranial base synchondroses, contribute to hypertelorism in syndromic craniosynostoses and some RASopathies. Advances in molecular genetics have identified numerous genes implicated in these processes. However, establishing genotype-phenotype correlations remain challenging due to variable clinical expressivity and remaining confusion between true orbital hypertelorism and telecanthus or depressed nasal bridge. Better understanding of developmental, genetics and physiopathological mechanisms leading to orbital hypertelorism, is essential to improve diagnostic rate, genetic counseling and, to optimize therapeutic strategies including multidisciplinary management and surgical planning.
Background/Objectives: To evaluate whether frontal and maxillary sinus hypoplasia/aplasia are associated with differences in CT-based craniofacial morphometric measurements in adults. Methods: This retrospective case-control study included adults who presented to the otolaryngology outpatient clinic and underwent paranasal sinus CT at a single institution between 3 April 2023, and 30 May 2024. Of 3000 CT scans reviewed, 117 adults with frontal and/or maxillary sinus hypoplasia/aplasia and 53 healthy controls met the eligibility criteria. The sinus variation groups included unilateral frontal sinus variation (UFSV, n = 46), unilateral maxillary sinus variation (UMSV, n = 13), and bilateral frontal sinus variation (BFSV, n = 55); and bilateral maxillary sinus variation (BMSV, n = 3), which was described descriptively but excluded from the main statistical comparisons because of the very small subgroup size. Craniofacial morphometric distances were measured using standardized anthropometric landmarks, and group comparisons were performed using analysis of covariance adjusted for age and sex. Results: Significant adjusted between-group differences were found for left orbital breadth (p = 0.0001), left orbital height (p = 0.0250), right orbital breadth (p < 0.0001), biorbital breadth (p < 0.0001), upper facial breadth (p = 0.0204), and bizygomatic breadth (p = 0.0026). In general, the UFSV and BFSV groups showed lower adjusted values for orbital and upper facial measurements, whereas the healthy control and UMSV groups showed relatively higher adjusted means. No significant between-group differences were observed for the remaining measurements. Conclusions: Frontal sinus hypoplasia/aplasia, particularly unilateral and bilateral frontal sinus variation, was associated with selected differences in craniofacial morphology, especially in the orbital and upper facial regions, rather than demonstrating a direct effect. These findings may help to characterize craniofacial morphometric patterns in adults with sinus variation and could be considered in radiologic evaluation and preoperative assessment, but require confirmation in larger studies.
Orbital fractures are frequently associated with ophthalmological injuries, which range from minor irritation to vision-threatening trauma. This study was intended to identify predictive factors for ophthalmological injuries in patients with isolated orbital fractures, and to assess whether conventional assessment of facial trauma can reliably determine the need for specialist ophthalmological assessment. This prospective cohort study included adult patients with isolated orbital floor and/or medial wall fractures, who underwent standardised ophthalmological evaluation by an ophthalmologist. The outcome variable was the presence of ophthalmological injury. Predictor variables included demographics, injury mechanism, involvement of alcohol, fracture characteristics, and clinical symptoms. Of the 202 patients (206 eyes), 15.3% (31/202 patients) had associated ophthalmological injuries. The most common injuries were retinal haemorrhage (3.0%, six patients), full-thickness eyelid lacerations (2.4%, five patients), and vitreous detachment (2.0%, four patients). Thirteen patients (6.4%) required surgical treatment. No ophthalmological injury was detected in patients who showed no clinical signs or symptoms in the ocular region during the initial conventional facial trauma assessment, which was performed by an oral and maxillofacial surgeon (p<0.001). The results support that asymptomatic patients with isolated orbital fractures may not require a routine ophthalmologist's evaluation. However, patients with clinical signs, such as full-thickness eyelid lacerations, visual disturbances, or abnormal pupillary responses, should be urgently evaluated by an ophthalmologist. Due to the risk of delayed-onset traumatic ocular injuries, orbital fracture patients should be appropriately informed of these eye diseases and increased-risk patients should be followed closely.
Spheno-orbital meningioma (SOM) resections pose significant reconstructive challenges. Presented here is a case series of orbital and functional outcomes using polyetheretherketone (PEEK) implants and cutting guides to describe a tertiary centre's practice of using custom reconstruction to assist in improving orbital symmetry with the aim of functional improvement in symptomatic diplopia. Between June 2020 and October 2023, 13 consecutive adult patients with SOM were managed surgically by resection and custom reconstruction. Retrospectively, for each patient, clinical data including Hertel difference (HD) and orbital volume difference (OVD, the comparison of affected and unaffected orbital volumes) were collected and compared preoperatively and postoperatively. The series had a mean follow-up of 21 months. Preoperatively, 10 patients had proptosis or diplopia, and nine patients had improvement postoperatively. The mean Hertel differences improved from 4.3 mm (range 0-7 mm) preoperatively to 2.1 mm (range 0-5) postoperatively (P = 0.01). The mean OVDs increased from 1.9 cm3 (range 0.3-4.1 cm3) preoperatively to 2.4 cm3 (range 0.3-4.8) postoperatively (P = 0.30). In the authors' experience, using PEEK for custom reconstruction is a safe and effective way to improve globe position, measurable using a Hertel exophthalmometer and visual symptoms. The authors aim to propose a classification system for surgical planning, particularly where there may be benefit in utilizing virtual planning and custom reconstruction for cases with extensive bone involvement.
Desmoplastic small round cell tumor (DSRCT) is a rare, extremely aggressive soft-tissue sarcoma that primarily develops in the abdomen of children and young adults. Orbital involvement is uncommon and typically occurs late in the disease course. We present a case of a 56-year-old male who attended the ophthalmology outpatient department with rapidly progressive, painless left-eye proptosis for 15 days. Ophthalmic examination showed axial proptosis with peripapillary flame-shaped hemorrhages; therefore, neuro-orbital imaging was performed. Magnetic resonance imaging revealed a lobulated extraconal mass with contiguous extension into the anterior temporal fossa without associated bony erosion. Systemic evaluation revealed a retroperitoneal mass and multiple hepatic lesions. Computed tomography-guided biopsy confirmed DSRCT based on typical histology and immunohistochemical positivity for Wilms tumor 1, desmin, epithelial membrane antigen, vimentin, and integrase interactor-1. The orbital mass was excised through lateral orbitotomy, and the patient received systemic therapy with imatinib and multidisciplinary oncologic care. This case is notable because orbital proptosis was the first clinical manifestation of occult metastatic DSRCT. The unusual radiological finding of extra-axial intracranial extension without bone involvement further distinguishes this presentation. Ophthalmologists should consider systemic malignancy in patients with unexplained progressive proptosis. RésuméLa tumeur desmoplastique à petites cellules rondes (DSRCT) est un sarcome des tissus mous rare et très agressif, qui se développe principalement dans l’abdomen chez les enfants et les jeunes adultes. L’atteinte orbitaire est exceptionnelle et survient habituellement à un stade tardif de la maladie. Nous rapportons le cas d’un homme de 56 ans consultant pour une proptose indolore et rapidement progressive de l’oeil gauche depuis 15 jours. L’examen ophtalmologique a mis en évidence une proptose axiale associée à des hémorragies péripapillaires en flammèches, motivant une imagerie neuro-orbitaire. L’IRM a révélé une masse extraconale lobulée avec extension contiguë vers la fosse temporale antérieure, sans érosion osseuse. Le bilan systémique a retrouvé une masse rétropéritonéale et de multiples lésions hépatiques. La biopsie guidée par tomodensitométrie a confirmé le diagnostic de DSRCT sur la base de l’histologie et de l’immunohistochimie positive pour WT1, desmine, EMA, vimentine et INI-1. La masse orbitaire a été excisée par orbitotomie latérale, puis le patient a reçu un traitement systémique par imatinib et a été adressé pour une prise en charge oncologique multidisciplinaire. Cette observation est particulière car la proptose orbitaire a constitué la première manifestation clinique d’un DSRCT métastatique jusque-là occulte. L’extension intracrânienne extra-axiale sans atteinte osseuse élargit le spectre radiologique connu de cette tumeur. Les ophtalmologistes doivent envisager une néoplasie systémique devant toute proptose progressive inexpliquée.
The hydrogen evolution reaction (HER) is central to clean hydrogen production, yet its application in alkaline water electrolysis is severely limited by intrinsically sluggish kinetics and the poor long-term stability of Pt-based catalysts, particularly at industrially relevant current densities. Here, we propose a high-entropy alloying strategy that enables synergistic tuning of the electronic structure and interfacial interactions. This strategy induces reconstruction of the Pt 5d orbitals, optimizing interfacial water dissociation kinetics and reshaping the interfacial water distribution. At the same time, it promotes a more delocalized electronic structure and stronger bonding through pronounced d-p, d-d, and sp orbital hybridization, as well as vibrational coupling driven by local atomic displacements. The downshifted Pt 5d band center weakens *H adsorption, thereby facilitating hydrogen desorption while effectively suppressing surface oxidation and particle agglomeration. As a result, the FeCoNiPtIn/MWCNT catalyst delivers an ultralow overpotential of 8 mV at 10 mA cm-2 and operates stably for over 5000 h at 250 mA cm-2, far outperforming commercial Pt/C. This work integrates orbital engineering with interfacial water regulation, establishing a compelling design paradigm for durable HER electrocatalysts for large-scale renewable energy conversion.
This study demonstrates that residual palladium (Pd) species, often considered unintended impurities in organic photocatalysts, can function as highly efficient catalytic sites when atomically dispersed and strategically coordinated within molecular frameworks. A series of pyridine-terminated organic small molecules are synthesized to anchor Pd single atoms via monodentate coordination, which significantly modulates the electronic structure and catalytic behavior. Through a combination of spectroscopic, electrochemical, and computational methods, we reveal that the d z 2 orbital of Pd plays a pivotal role in facilitating hydrogen adsorption by optimizing orbital overlap with hydrogen. Furthermore, a low-energy pathway mediated by pyridyl-hydrogen radicals drastically reduces the energy barriers for hydrogen transfer steps. The pyrene core serves as a photochemical charge reservoir, while terminal pyridine groups act as active sites, collectively enhancing exciton dissociation and charge separation. This work provides new insights into the elusive role of residual metals in photocatalysis and introduces the concept of residual metal single-atom catalysis, a strategy for designing efficient metal-organic hybrid systems with high atomic utilization and well-defined mechanisms.
Globe rupture constitutes a severe form of open-globe injury and carries a guarded prognosis with a risk of permanent visual loss. The loss of the eyeball entails functional, psychological, and social repercussions that require a comprehensive approach aimed at timely diagnosis, appropriate management, and patient rehabilitation. A 2-year and 1-month-old male patient was brought by his mother to the pediatric emergency department after sustaining craniofacial and ocular trauma caused by the impact of a 45 kg domestic gas tank striking his face while playing at home. This resulted in rupture of the left eyeball and injury to the ipsilateral orbital tissue. Upon arrival at the pediatric emergency department, the patient was consolably crying and did not present any loss of consciousness. He was referred to a tertiary-level care facility for pediatric ophthalmology evaluation. An evisceration of the eyeball was performed, followed by placement of an intraorbital implant and a fenestrated conformer. Open globe trauma without a foreign body in young children, although infrequent, represents a serious ophthalmological emergency with a significant risk of permanent visual and anatomical loss. This case highlights an unusual injury mechanism in a 2-year-old child, emphasizing the vulnerability of young children in home environments and the importance of prevention. la ruptura de globo ocular constituye una forma grave de lesión de globo ocular abierto y conlleva un pronóstico inicialmente desfavorable para el órgano y la función, con riesgo de pérdida visual permanente. La pérdida del globo ocular implica repercusiones funcionales, psicológicas y sociales que demandan un abordaje integral orientado al diagnóstico oportuno, la atención adecuada y la rehabilitación del paciente. paciente hombre de dos años y un mes de edad, llevado por su madre al servicio de urgencias pediátricas tras sufrir un traumatismo craneofacial y ocular generado por el impacto de un tanque de gas de uso doméstico de 45 kg en el rostro mientras jugaba en su domicilio, lo que resultó en ruptura del globo ocular izquierdo y lesión del tejido orbitario ipsilateral. A su llegada a urgencias pediátricas, el paciente presentaba llanto consolable y no mostró pérdida del estado de alerta. Fue derivado a un tercer nivel de atención para valoración por oftalmología pediátrica; se realizó evisceración del globo ocular con colocación de implante intraorbitario y conformador fenestrado. el trauma ocular de globo abierto sin cuerpo extraño en niños pequeños, aunque infrecuente, representa una emergencia oftalmológica de alta gravedad, con riesgo significativo de pérdida visual y anatómica permanente. Este caso destaca un mecanismo de lesión poco habitual en un niño de dos años, con énfasis en la vulnerabilidad de los menores en entornos domésticos y la importancia de la prevención.
Orbital atherectomy (OA) is a highly effective atherectomy device used to treat heavily calcified coronary arteries. The technique for using OA is critical and depends on appropriate use of the dedicated guidewire. OA employs a centrifugal, differential sanding mechanism with bidirectional movement. When used with proper technique, the device appears to be associated with a low rate of complications, such as bradycardia and slow flow, compared with rotational atherectomy (RA), and results in high procedural success rates. We describe our experience with the OA device and procedural techniques in our catheterization laboratory.
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Frequent coexistence of sunken upper eyelid and tear trough deformities presents a common esthetic concern, yet little attention has been paid to concurrent surgical management of the two conditions. A single-institution retrospective study was conducted on patients who underwent tear trough deformity correction combined with upper eyelid surgery, performed either with isolated orbital fat release or orbital fat release combined with lower eyelid fat transfer. Park's grading and Hirmand classification systems were employed to assess the severity of deformities. The FACE-Q questionnaire was utilized to evaluate changes in patient satisfaction regarding periorbital appearance, psychological well-being, and social function. A total of 37 female patients were included: 13 in the fat release group and 24 in the fat release with transfer group. The loss to follow-up rate was low (10.8%). Significant improvements in eyelid esthetics and aging appraisal VAS scores were observed in both groups (p < 0.001). Intergroup comparison showed that the fat release with transfer group had greater improvement in upper eyelid appraisal compared with the fat release group (p < 0.05). Minor complications in six eyelids (8.1%) were resolved with conservative management. Overall, most patients were satisfied with the treatment outcome and their decision to undergo surgery. Lower eyelid fat transfer provides ideal volume augmentation in patients with moderate to severe sunken deformities. The combined one-stage procedure concurrently addresses two distinct esthetic concerns and avoids additional donor sites, offering a comprehensive approach to enhancing periorbital esthetics in patients with sunken upper eyelid and tear trough deformities. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Predicting electrical conductivity in perovskite and double-perovskite materials remains challenging as this property depends on various electronic, chemical, and structural factors. In this work, we evaluate classical machine-learning models trained on different descriptor sets including DFT band gap, non-orbital compositional descriptors, orbital-related descriptors, SOAP structural fingerprints, and a reduced mixed descriptor set to predict DFT-derived transport conductivity. The band gap provides a strong baseline but is insufficient to fully predict the target. The best overall performance is obtained using non-orbital compositional descriptors with Random Forest regression, while orbital-related descriptors achieve nearly comparable accuracy, confirming the importance of valence-electron characteristics. A compact mixed descriptor set preserves nearly the full predictive power of the larger descriptor spaces, showing that accurate prediction can be achieved using a small number of physically motivated variables. In contrast, SISSO showed much lower accuracy, suggesting that sparse symbolic expressions are insufficient to capture the nonlinear relationships underlying our target values. These results demonstrate that physically informed classical machine-learning models can provide an effective surrogate framework for reproducing DFT/BoltzTraP-derived conductivity trends in perovskite and double-perovskite materials.
Multi-layer low Earth orbit constellations (ML-LEOs) have become a pivotal trend in the development of satellite network systems, where their layered orbital architecture improves system performance by strategically deploying satellites in distinct orbital layers. However, two critical issues remain open: how does the configuration of ML-LEO affect its performance, and how many layers are required to achieve optimal performance? This paper first investigates the impact of the number of layers L on the capacity of ML-LEOs. By analyzing the distribution of inter-layer inter-satellite links (ISLs) and the flow count on bottleneck links, we derive a closed-form mathematical expression for ML-LEO capacity under different values of L. In particular, we show that when each layer adopts an identical constellation topology and the number of satellites per orbit equals the number of orbits, the capacity of the ML-LEO is L times that of a single-layer low Earth orbit constellation (SL-LEO). Furthermore, we present the optimal parameter configuration for ML-LEOs: the number of orbits per layer should equal the number of satellites per orbit, the number of layers should be half the number of satellites per orbit, and the optimal number of inter-layer ISLs is twice the product of the number of orbits per layer and the number of layers. Finally, extensive simulations are carried out to thoroughly verify the accuracy of the analytical results. Our analysis reveals the performance benefits of multi-layer topology and establishes a theoretical framework for parameter optimization in ML-LEO.
Background and Clinical Significance: Tumors of the lacrimal drainage system are rare but clinically important diagnostic pitfalls because they may mimic benign lacrimal drainage obstruction, chronic dacryocystitis, or sinonasal disease. Pleomorphic adenoma (PA) in this region is exceptionally rare, and delayed recognition may allow progressive extension into adjacent structures. Case Presentation: A 51-year-old woman presented with left nasal obstruction 16 years after external dacryocystorhinostomy for presumed lacrimal drainage obstruction. Examination showed a firm left lacrimal sac mass, proptosis, mild ocular motility limitation, and an intranasal mass. Computed tomography and magnetic resonance imaging showed a large lesion centered in the lacrimal sac region and extending into the nasolacrimal duct, nasal cavity, and maxillary sinus, with orbital displacement. Preoperative biopsy showed epithelial neoplastic tissue without definitive malignant features, but low-grade epithelial malignancy could not be excluded. Complete en bloc excision and medial/inferior orbital wall reconstruction with an autologous calvarial outer table bone graft were performed. The tumor measured 55 × 35 × 25 mm. Final histopathology confirmed PA without malignant transformation. At 2 years postoperatively, there was no recurrence, and proptosis and ocular motility limitation had improved. Conclusions: This case illustrates two diagnostic pitfalls: an underlying tumor may masquerade as lacrimal drainage obstruction, whereas a large benign PA may clinically and radiologically mimic malignancy. Long-standing or atypical unilateral lacrimal symptoms should prompt consideration of tumors and selected use of imaging and tissue diagnosis before lacrimal drainage surgery.
To explore a reasonable grading system for puffy eyelids and corresponding clinical management strategies. We retrospectively analyzed 132 patients with puffy eyelids who underwent double-eyelid blepharoplasty at the Department of Plastic and Laser Cosmetology of Hunan Provincial People's Hospital from January 2023 to June 2024. Patients were classified into mild, moderate, or severe based on preoperative appearance and intraoperative anatomical characteristics. Depending on the severity, either the three-point method or the incision method (orbital septum method) was selected for double-eyelid blepharoplasty, allowing for targeted treatment of the orbital fat and retro-orbicularis oculi fat (ROOF). Postoperative follow-up was conducted at 3 months to 1 year to assess the appearance of the double eyelids, complications, and patient satisfaction. Of the 132 patients, 68 cases were mild, with 55 treated by the incision method and 13 by the three-point method; 34 cases were moderate, with 29 treated by the incision method and 5 by the three-point method; and all 30 severe cases were treated by the incision method. Only 1 case required revision surgery postoperatively, with an overall satisfaction rate of 99.24%. There were no serious complications such as hematomas or infections, and all scars healed well. Establishing a clear grading system for puffy eyelids based on preoperative appearance and intraoperative anatomical characteristics, and formulating corresponding surgical plans according to these grades, is a reasonable and feasible clinical strategy. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
We develop a nonperturbative semiclassical theory of magnetotransport in Weyl semimetals, retaining the full magnetic-field dependence of the Fermi-surface conductivity in the presence of Berry curvature and orbital magnetic moment effects. We obtain closed-form expressions valid to all orders in the magnetic field within the semiclassical regime. We show that the exact continuum formulation exhibits an intrinsic infrared sensitivity associated with the singular behavior of the orbital magnetic moment, requiring a physically motivated regularization. While the full conductivity tensor reduces to the standard quadratic magnetoconductivity, we demonstrate that magnetic-field expansion and momentum integration do not commute, leading to nonanalytic contributions at the level of scalar transport coefficients. Our results identify a regime, relevant for low carrier densities or moderate magnetic fields, where magnetotransport becomes intrinsically nonperturbative and cannot be captured by conventional weak-field expansions.
Excited-state electronic structure in strongly correlated systems remains challenging due to the exponential scaling of the many-body Hilbert space and the difficulty of constructing systematically controlled active spaces. Building on the stochastic cluster expansion (SCE) framework previously developed for ground-state correlation energies, we extend the formalism to excitation gaps by expressing energy differences directly as a hierarchy of orbital-space cluster contributions. In this formulation, excitation energies are reconstructed from reduced-rank calculations involving a minimal frontier chemical subspace (FCS), treated exactly, together with stochastic sampling of the remaining orbital environment. This approach greatly diminishes the dependence on large or chemically preselected active spaces. We demonstrate the method on charge-transfer complexes and polyacenes, where accurate singlet-triplet gaps are obtained that agree with full-system results. The method converges with low-order cluster terms and provides a systematically improvable framework for excited states in correlated systems.
Airbags are designed to reduce morbidity and mortality during motor vehicle collisions; however, rare manufacturing defects may result in catastrophic injuries. We report a unique case of a 45-year-old woman involved in a low-speed collision, who sustained projectile-induced airbag trauma. Deployment of a defective airbag expelled a metallic projectile, causing complex panfacial fractures, extensive maxillary bone loss, and a full-thickness palatal defect. The patient initially received suboptimal management, necessitating secondary reconstruction at a tertiary referral center. Revision surgery included panfacial fracture realignment, orbital floor reconstruction with bone grafting, and closure of the palatal defect using a temporalis musculofascial flap, achieving satisfactory functional and aesthetic outcomes. This case underscores the distinct and potentially lethal mechanism of airbag failure associated with recalled inflators; highlights the importance of early recognition, thorough reporting, and multidisciplinary management; and provides critical insights for improving patient safety and guiding clinicians encountering similar injuries.
Immune checkpoint inhibitors (ICIs) have transformed cancer therapy by restoring anti-tumor immunity, but immune activation can disrupt ocular immune homeostasis and induce ophthalmic immune-related adverse events (OirAEs). Although uncommon, OirAEs may involve nearly all ocular compartments and can cause irreversible visual impairment or interruption of effective anticancer therapy. The 2025 international consensus criteria now provide a standardized framework for defining and classifying OirAEs. This review integrates current evidence on ICI-associated ocular toxicity, with emphasis on tissue-specific immune mechanisms and their clinical implications. Blockade of the PD-1/PD-L1 and CTLA-4 pathways may impair ocular immune privilege, expand autoreactive T-cell subsets, alter cytokine and chemokine networks, and amplify autoantibody-mediated retinal injury. These processes provide a plausible framework for understanding diverse phenotypes, including uveitis, ocular surface disease, optic neuritis, orbital inflammation, ocular myopathy, and retinopathy. We also outline a mechanism-informed management approach that balances visual preservation with maintenance of systemic anti-tumor immunity. Local corticosteroid therapy, cautious systemic immunosuppression, and selected steroid-sparing biologics should be individualized according to severity, anatomical involvement, and the oncologic context. Together, these insights support a consensus-based and mechanism-informed framework for recognizing and managing OirAEs while preserving systemic anti-tumor immunity.