title: Emerging evidence on the crystalline water-light interface in ophthalmology and therapeutic implications in photobiomodulation: first communication.
abstract: OBJECTIVE
  The purpose of this study was to present preliminary evidence of the exclusion zone (EZ) and photobiomodulation (PBM) phenomena relating to ophthalmology.
  
  
  BACKGROUND
  Water is the main media and fluid found in ocular tissues. Water is also an important photoacceptor and energy storage medium. Eyes are abundantly exposed to environmental radiant energy. Therefore, multiple light-energy-absorption mechanisms may exist, including those associated with the recently discovered fourth phase of water, known as EZ.
  
  
  METHODS
  Retrospective analysis of published data indicative of EZ phenomena related, in this first communication, to the retina and optic nerve (ON), using surgical microscopy and diffusion-weighted magnetic resonance imaging (MRI).
  
  
  RESULTS
  Images showing removal of the internal limiting membrane (ILM) aided by preservative-free triamcinolone acetonide (TA) during macular hole surgery show continuous whitish lines indicative of water-layer ordering at the interface between collagen matrices and TA crystals. Apparent diffusion coefficient (ADC) results further exhibit an axis parallel to the ON, which may be an ocular expression of the EZ linked to the steady potential of the eye.
  
  
  CONCLUSIONS
  Although existing results are still being decoded and analyzed in light of the state of the art studies of light-water interactions, they suggest a new understanding of the eye's bioenergetic environment, which may have deep implications in ocular physiology as well as in the pathophysiology, diagnosis, and treatment of blinding diseases using light-based therapies such as photobiomodulation. Research is needed to confirm the interpretation of these findings and validate potential ophthalmic applications.
authors.affiliation: Fundalas, Foundation for Interdisciplinary Research and Development , Caracas, Venezuela .
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rodríguez-Santana
authors.forename: Luis
authors.initials: L
authors.lastname: Santana-Blank
mesh_terms: D006801:Humans; D008027:Light; D009799:Ocular Physiological Phenomena; D018462:Photobiology; D014867:Water
chemical_list: D014867:Water