Saif Aldeen Alryalat

• M.D.
• Ophthalmology at University of Jordan

As an underfunded clinical researcher working in Jordan, I am limited to pursuing inexpensive observational studies that are based on patients’ records. Happily, open-access data from repositories around the world have enabled me to make a bigger contribution to science.

Literature databases (i.e., PubMed, Scopus, and Web of Science) differ in terms of their coverage, focus, and the tool they provide. PubMed focuses mainly on life sciences and biomedical disciplines, whereas Scopus and Web of Science are multidisciplinary. The protocol described in the current study was used to search for publications from Jordania...

Purpose: In the absence of pre-admission testing for colour blindness, many of the currently practicing ophthalmologists are colour blind, accordingly their accuracy of distinguishing fine diabetic retinopathy (DR) changes is still unknown. This study aims to assess the accuracy of diagnosing and staging diabetic retinopathy and macular oedema amo...

The book provides high yield information in basic ophthalmology including anatomy, physiology, pathology, pharmacology, microbiology, and embryology that are required for preparation of ophthalmology exams. The book focusses on all parts of the eye, with special focus on basic science including appropriate amount of information on clinical science...

Diabetic macular edema (DME) is the most common cause of visual impairment among patients with diabetes mellitus. Anti-vascular endothelial growth factors (Anti-VEGFs) are considered the first line in its management. The aim of this research has been to develop a deep learning (DL) model for predicting response to intravitreal anti-VEGF injections...

Large language model (LLM) tools are transforming the way evidence is retrieved by converting natural language prompts into quick, synthesized outputs. These platforms significantly reduce the time required for literature searches, making them more accessible to users unfamiliar with formal search strategies. A close evaluation of four prominent pl...

Background ChatGPT has shown significant promise in transforming medical education by streamlining research and improving teaching methods. However, its adoption in Middle Eastern medical education has remained underexplored. This study investigated the factors influencing the adoption of ChatGPT in Jordanian medical education using a modified Unif...

Background The increasing prevalence of thyroid incidentalomas and their uncertain malignancy risk necessitates population-specific analyses. This study aimed to investigate the prevalence and characteristics of thyroid incidentalomas in patients at the University of Jordan. Methods Conducted at the Jordan University Hospital (JUH), the retrospect...

Purpose To review studies reporting the role of Machine Learning (ML) techniques in the diagnosis of keratoconus (KC) over the past decade, shedding light on recent developments while also highlighting the existing gaps between academic research and practical implementation in clinical settings. Methods The review process begins with a systematic...

Background Ocular manifestations of hyperviscosity, particularly associated with the hemodynamic changes in polycythemia, can lead to various ocular vascular events, ranging from transient monocular blindness to potentially irreversible vision loss if left untreated. Methods This is a multicenter, retrospective case series and review of literature...

Introduction Traumatic optic neuropathy (TON) can cause acute vision loss after head trauma, either due to indirect shearing forces or direct trauma, i.e., by a bony fragment of an optic canal fracture (OCF). We present a case of TON due to an isolated OCF with contralateral orbital fracture and injury. Case Presentation A 19-year old male present...

This chapter offers an in-depth clinical review of neuro-ophthalmology, focusing on the interplay between neurological systems and visual disturbances. It begins with an overview of the visual pathway, highlighting how light signals travel from the retina through the optic nerve to the brain’s visual cortex. The chapter covers common optic nerve di...

The final part of the neuro-ophthalmology clinical review covers a range of miscellaneous conditions that affect the eye and surrounding structures. It explores thyroid eye disease, myasthenia gravis, and internuclear ophthalmoplegia (INO), highlighting their neuro-ophthalmic manifestations. Additionally, the chapter examines eyelid and facial cont...

This chapter explores key conditions affecting vision in children, focusing on amblyopia, strabismus, and esotropia. Amblyopia results from poor visual development, often due to misalignment or occlusion. The chapter discusses its causes, early diagnosis, and effective treatment strategies, including patching and vision therapy. Strabismus, charact...

This chapter explores diseases of the sclera and conjunctiva, detailing their diverse presentations and causes, including infections, autoimmune disorders, drug reactions, and tumors. While many conditions are benign, some can threaten vision, highlighting the need for early diagnosis and management. Key conditions discussed include episcleritis, s...

This chapter provides a foundational overview of the cornea, emphasizing its role and importance in ophthalmology. It explores benign corneal changes and depositions, helping readers differentiate between natural variations and potential underlying issues. The discussion extends to congenital corneal anomalies and degenerative diseases, focusing on...

This chapter provides a comprehensive overview of various retinal diseases, beginning with age-related macular degeneration, a leading cause of vision loss in older adults. It then discusses diabetic retinopathy, highlighting its stages, risk factors, and management strategies. The chapter also covers hypertensive retinopathy, detailing the effects...

This chapter continues the clinical review of neuro-ophthalmology, focusing on critical conditions related to the optic disc, papilledema, pupil disorders, and cranial nerve dysfunction. It begins with a discussion on optic disc anomalies, such as optic disc drusen, morning glory anomaly, and coloboma, detailing their clinical features, implication...

This chapter offers high yield notes on uveitis, defined as inflammation of the uveal tract, which includes the iris, ciliary body, and choroid, as well as nearby structures such as the retina, vitreous, and optic nerve. It focuses on anterior and intermediate uveitis, with the following chapter covers posterior uveitis. The chapter also addresses...

This chapter continues to delve into pediatric ophthalmology, beginning with an exploration of exotropia, including its causes, diagnosis, and management. It also discusses divergent strabismus (DVD) and its implications for binocular vision. The chapter then addresses incomitant ocular motor apraxia (IOOA), emphasizing its impact on ocular alignme...

This chapter provides a comprehensive exploration of cataract surgery, beginning with an overview of cataract risk factors that contribute to the development of this common ocular condition. It delves into phacoemulsification, outlining key concepts, including innovative photodynamic fluidic techniques and various chopping methods that enhance surg...

This chapter continues the exploration of pediatric ophthalmology, focusing on critical interventions and conditions that affect vision in children. It begins with thoroughly examining strabismus surgery, covering preoperative assessment, surgical techniques, and potential postoperative complications. The discussion then shifts to retinopathy of pr...

This chapter provides an overview of orbital diseases, highlighting the orbit’s role in housing the eye and its appendages. It covers common conditions like thyroid eye disease and inflammatory disorders, detailing their clinical presentations, diagnostics, and management strategies. The chapter also examines cystic and vascular lesions, neural tum...

This chapter reviews oculoplastic disorders, starting with eyelid anatomy and its role in ocular health. It highlights meibomian gland dysfunction as a common cause of dry eye symptoms. The chapter discusses eyelid masses ranging from benign to malignant, emphasizing the importance of early detection and treatment, as well as congenital eyelid dise...

This chapter explores a range of retinal conditions, starting with hereditary retinal dystrophies. It categorizes these dystrophies into diffuse types, including rod-dominant and cone-dominant syndromes, and choroidal syndromes, detailing their genetic underpinnings and clinical manifestations. The chapter then examines retinopathy associated with...

This chapter discusses vitreous and vitreomacular surface disorders, outlining their stages and implications for visual health. It also addresses congenital vitreoretinal diseases, exploring their characteristics and management. The chapter further delves into imaging techniques used in retinal diseases, including optical coherence tomography, fund...

This chapter delves into the critical aspects of intraocular lenses (IOLs) used in cataract surgery. It begins with a detailed classification of IOLs, addressing their focality and the specific sites for lens placement, which are essential for achieving optimal visual outcomes. The chapter further explores the intricacies of IOL power calculation,...

This chapter examines the lacrimal system, detailing its anatomy, physiology, and pathological conditions. It highlights the essential role of tears in ocular health and the importance of understanding the lacrimal system for effective clinical practice. Key topics include lacrimal production and drainage systems, lacrimal gland tumors, congenital...

This chapter focuses on posterior uveitis, providing a detailed explanation of both noninfectious and infectious causes. Noninfectious uveitis is discussed in relation to conditions such as sarcoidosis, Behcet’s disease, Vogt-Koyanagi-Harada syndrome, sympathetic ophthalmia, and various collagen vascular disorders, highlighting their pathophysiolog...

This chapter continues the exploration of oculoplastic disorders, focusing on various surgical interventions and their applications. It begins with a discussion of key procedures, including temporal artery biopsy, Hughes procedure, and blepharoplasty, detailing their indications, techniques, and expected outcomes. The chapter further examines eyeli...

Chapter 1 provides a structured, high-yield review of essential topics in ophthalmology, designed to optimize exam preparation. It covers a wide range of ocular disciplines, including general ophthalmology, retina, glaucoma, cornea, lens, neuro-ophthalmology, pediatrics, and refractive lasers. This chapter offers concise yet comprehensive coverage...

Accurate keratoconus (KC) staging is vital for improving patient care and guiding clinical decision making. Choosing the right Machine Learning (ML) algorithm is key to effectively tackling this challenge and ensuring optimal performance. This paper presents a detailed comparison of eight ML algorithms commonly used in KC detection, based on a clin...

Advances in corneal imaging have generated vast datasets, making it challenging to extract clinically relevant insights. Machine Learning (ML) provides ophthalmologists with essential tools for keratoconus (KC) detection and clinical decision-making. However, effective Exploratory Data Analysis (EDA) remains crucial for identifying trends, forming...

PURPOSE To identify the possible predicting factors for developing astigmatism following penetrating keratoplasty, namely age, gender, laterality, preoperative indication for surgery, size of donor and recipient graft, and selective versus total sutures removal. Moreover, the duration of postoperative topical steroids use and if that surgery was th...

Background Certain religions require long hours of fasting, abstaining from fluid intake for durations extending up to 16 h. Lack of fluid intake may alter multiple physiological parameters, which can influence the ocular system. In this prospective study, we evaluated the effect of prolonged fasting on dry eye disease using both objective and subj...

Background: Certain religions require long hours of fasting, abstaining from fluid intake for durations extending up to 16 h. Lack of fluid intake may alter multiple physiological parameters, which can influence the ocular system. In this prospective study, we evaluated the effect of prolonged fasting on dry eye disease using both objective and sub...

Pleomorphic adenoma of the lacrimal gland (PALG) is a benign neoplasm typically presenting with gradual, painless globe displacement and/or lid swelling. We report an atypical case of PALG in a 53-year old male presenting acutely, mimicking orbital cellulitis. Imaging demonstrated an extraconal rim-enhancing soft-tissue lesion medial to the left la...

This report describes the longest case of a retained metallic intraorbital foreign body with no complications and development of delayed sensory exotropia following traumatic sclopetaria in childhood. A 9-year-old girl suffered a BB gun injury to the left eye, leading to chorioretinitis sclopetaria and loss of vision. The visual acuity was 20/800 w...

Background The prevalence of idiopathic intracranial hypertension (IIH) is rising with the global obesity epidemic. Carbonic anhydrase inhibitors (CAIs), such as acetazolamide, have been shown to be effective in IIH but can also lead to kidney stone formation. This study evaluates the risk of kidney stone development in patients with IIH treated wi...

Objective: Early detection of keratoconus (KC) allows for timely treatment and prevention of disease progression. This study aims to create an intelligent diagnostic tool to help general practitioners and ophthalmologists adopt a unified criterion for diagnosing subclinical KC (SCKC) using key corneal characteristics from Pentacam imaging devices....

Introduction: Parkinson's-induced psychosis is rather prevalent, and it has continuously been linked to poor outcomes. Therefore, detecting this presentation early on, can enhance the quality of life of Parkinson’s disease patients and is therefore a clinical and societal necessity. This systematic review and meta-analysis aimed to estimate the poo...

Dural arteriovenous fistulas (DAVFs) are rare but significant intracranial vascular malformations that are usually idiopathic and can lead to severe complications like venous hypertension and intracranial hemorrhage. We present 2 cases of DAVF occurring after venous sinus stenting (VSS) for presumed idiopathic intracranial hypertension (IIH) in a 5...

Objective: Artificial intelligence (AI) in ophthalmology is rapidly advancing and is expected to play a key role in diagnosing and managing various eye conditions. However, clinical adoption remains limited due to insufficient collaboration between AI experts and ophthalmologists. This study aims to bridge that gap by developing an AI-enabled tool...

A 38-year-old woman with trisomy 21 presented with unilateral optic nerve atrophy due to Moyamoya Disease (MMD).She had a narrow palate, epicanthal folds and moderate developmental delay. Her past ocular history was normal. Her mother noted a change in visual behavior. Neuro-ophthalmic examination showed a visual acuity of 20/80 OD and 20/25 OS and...

Objective: The aim of this study is to evaluate the 100 most highly cited articles assessing posterior communicating artery aneurysms. Methods: In May 2024, a comprehensive search was conducted in the Scopus database using the keyword “posterior communicating artery aneurysm” The top-100 most impactful articles were ranked by citation count and ana...

Background: Progressive multiple sclerosis (MS) is a chronic immune-mediated disease with a poorly understood pathophysiology. This bibliometric analysis of the literature aims to gain an overview of the current state of research on progressive MS. Methods: The Scopus database was searched using the terms "progressive" and "multiple sclerosis" i...

Aims and Objectives: We aimed to find the correlation between cardioembolic and non-cardioembolic stroke incidence with bovine arch anatomical variation. Materials and Methods: Retrospectively, we identified about 1,500 brain MRI/MRA and neck MRA studies, from which 605 patients were found to have had an acute stroke, with a mean age of 62. Images...

The impact of scientific articles is often measured using metrics such as the Journal Impact Factor (JIF) and CiteScore, which rely on citation counts and publication volume. In this study, we aimed to identify the predictors of article impact in the leading solid organ transplantation journals from 2019 to 2020. Article impact was determined using...

To assess the minimal change in visual acuity perceived by patients as important in different eye-related interventions. PubMed was utilized to search articles on each of the four major interventions: cataract surgery, keratoplasty, different glaucoma treatments, and refractive eye surgery, each combined with quality of life (QoL) and visual acuity...

Background This study proposes a decision support system created in collaboration with machine learning experts and ophthalmologists for detecting keratoconus (KC) severity. The system employs an ensemble machine model and minimal corneal measurements. Methods A clinical dataset is initially obtained from Pentacam corneal tomography imaging device...

Background: The availability and utilization of telehealth services have been rapidly increasing in the past decade, which paved the way for ophthalmological care to be offered more easily and conveniently. However, the proficiency of telehealth in the context of ophthalmical care still requires further studies to prove its effectiveness. This stud...

Optic neuritis (ON) is a common cause of acute visual loss due to optic neuropathy in adults. Although typical demyelinating ON usually recovers, some forms of autoimmune inflammatory ON may result in permanent disability. The relatively recent discovery of novel autoantibodies and their roles in the pathogenesis of ON, including aquaporin 4 (AQP4)...

Background and Aims: Oral health is a vital part of early childhood care. Parents and guardians should have appropriate oral health knowledge and be aware of—and change their perception and attitudes to—their children’s oral health to prevent oral disease. Our aim in this study was to investigate the oral knowledge, attitudes and practices of paren...

This paper provides an in-depth examination of eight Machine Learning (ML) algorithms commonly employed in diagnosing keratoconus (KC) over the past decade. The analysis is conducted using a clinical dataset accumulated by the authors from two prominent eye-care centers in Jordan over the same period. By scrutinizing the data collected from these c...

Background: Color vision deficiency (CVD) is an often-overlooked issue within the medical community, and its consequences remain insufficiently explored. We aim to evaluate how CVD affects diagnostic accuracy and distinguish between malignant choroidal melanoma and benign choroidal nevus among ophthalmologists. Methods: In this cross-sectional stud...

Breast cancer's global impact and high mortality rates drive interest in Artificial intelligence (AI) applications. AI's pattern recognition and decision-making abilities offer promise in detection, diagnosis, personalized treatment, risk assessment, and prevention. Screening and early detection are improved by AI-enhanced mammography. AI aids radi...

Overview: This study evaluates the diagnostic accuracy of a multimodal large language model (LLM), ChatGPT-4, in recognizing glaucoma using color fundus photographs (CFPs) with a benchmark dataset and without prior training or fine tuning. Methods: The publicly accessible Retinal Fundus Glaucoma Challenge "REFUGE" dataset was utilized for analyses...

Background: The debate about the theory of amyloid beta (Aβ) toxicity grew after the recent approval of the Alzheimer’s drug Aducanumab. This was especially true after one of the first articles to bring up this theory was recently criticized for being questionable. Several studies in the field of ophthalmology also used the same theory of Aβ toxici...

Purpose: Implantable Collamer Lens (ICL) implantation is a promising solution for correcting refractive errors, particularly in advanced Keratoconus (KC). Despite its increasing use, comprehensive data on its efficacy and complications remain limited, especially in regions with high KC prevalence like the Middle East.This study aims to evaluate ICL...

Purpose Patients with increased intracranial pressure and underlying hypertensive emergency may present with optic disc edema. Papilledema in this setting may be a predisposing risk factor for superimposed non-arteritic anterior ischemic optic neuropathy (NAION). We highlight the role of neuroimaging including diffusion-weighted imaging in magnetic...

Hypertension is a prominent risk factor for cardiovascular and cerebrovascular diseases. Gender differences and menopausal status contribute to blood pressure changes across the lifespan which have not been completely characterized. Our study aims to explore the impact of multiple factors on blood pressure levels in previously healthy women and men...

Objectives The main objective of our study was to assess the adherence of Jordanian patients to their glaucoma treatment after a brief educational session. Methods The current study was a randomized controlled interventional study. One hundred and ninety open-angle glaucoma patients were divided into control and intervention groups. After baseline...

With advancements in the implementation of artificial intelligence (AI) in different ophthalmology disciplines, it continues to have a significant impact on glaucoma diagnosis and screening. This article explores the distinct roles of AI in specialized ophthalmology clinics and general practice, highlighting the critical balance between sensitivity...

The management of emergent neuro-ophthalmic conditions can be a life saving encounter for the general ophthalmologist. This book is designed to help comprehensive ophthalmologists make emergency triage decisions for initial evaluation and treatment of potentially vision- or life-threatening conditions. This text is case-based and is intended to pro...

Purpose Intrastromal corneal ring segment (ICRS) implantation is a surgical technique developed with the purpose of avoiding the progression of corneal protrusion and is considered a viable option for managing patients with keratoconus as it stabilizes or improves vision thus delaying or excluding the need of more advanced surgical intervention suc...

Background Post-transplant lymphoproliferative diseases (PTLD) are a heterogeneous collection of neoplasms that occur after solid organ transplants (SOT). In the past 20 years, there has been a rise in PTLD research. This study aims to investigate the global research output and interest regarding PTLD using a bibliometric approach. Material and me...

Background: The most accurate method of intraocular lens (IOL) power calculation in cataract surgery has not been determined, and further studies are needed to reach a consensus. The aim of this study was to assess publications related to IOL power calculation formulas, mapping their yearly trends, most productive authors, top publishing countries...

BACKGROUND The United States has witnessed significant advancements in the field of organ transplantation over the course of the last five decades, as demonstrated by a notable increase in the quantity of academic research. The presence of a highly dynamic research environment necessitates continuous evaluations to maintain the integrity and progre...

OBJECTIVES Medical students have a lower quality of life (QoL) when compared to the general population. This lower QoL is associated with multiple factors such as burnout and depressive symptoms. QoL can be reflected in the degree of career satisfaction and career regret. We aim to study the prevalence of career regret in Jordanian medical students...

The growing availability of open-access data presents numerous opportunities for researchers, but also raises challenges in terms of adequately reporting methods and findings. This article presents the Reporting of Studies Conducted using Open Access Data (ROAD) guidelines: a comprehensive, practical framework developed to standardize and improve t...

Introduction The aim of this study was to assess existing annotation software that has been used in ophthalmology projects, and compare their practicality and utility in fundus image annotation tasks. Methods We first conducted a systematic search for artificial intelligence (AI) ophthalmology articles that used annotation software as part of their...

Retinitis pigmentosa (RP) is often undetected in its early stages. Artificial intelligence (AI) has emerged as a promising tool in medical diagnostics. Therefore, we conducted a systematic review and meta-analysis to evaluate the diagnostic accuracy of AI in detecting RP using various ophthalmic images. We conducted a systematic search on PubMed, S...