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Purpose: To assess the ophthalmic practice pattern among ophthalmologists in India amidst the COVID-19 pandemic. Methods: An online questionnaire-based analysis was performed among members of the All India Ophthalmological Society (AIOS) and results were analyzed using SPSS software version 20. Results: A total of 2253 responses were received. The majority of the participants (72.6%) were between 30 and 60 years of age and were into private practice (64.7%). During the lockdown, over one-third of participant ophthalmologists reported not attending any OPD patients, whereas a majority (64%) provided only emergency ophthalmic services. During the COVID-19 pandemic, <15% surgeries were performed compared to the pre-COVID-19 era by 81% of participants, whereas elective surgeries were performed by only 4.3%. The proportion of participants utilizing telemedicine in ophthalmology showed a two-fold rise from the pre-COVID-19 era (21.9%) to the COVID-19 pandemic (46%). Over half of the participants reported following the AIOS guidelines, reducing clinic hours, use of screening questionnaires, minimizing staff, and use of breath shield on a slit lamp as precautionary measures to reduce the exposure. Over 95% of ophthalmologists were satisfied (score > 5/10) by the AIOS guidelines for ophthalmic practice during COVID-19. Conclusion: COVID-19 pandemic has adversely affected the ophthalmic care services across India with telemedicine emerging as a major rescue. The majority of practicing ophthalmologists are satisfied with guidelines provided by AIOS for ophthalmic care during the COVID-19 pandemic and have implemented the same in their setup.

The instrumentation used in ophthalmic clinics can be a source of epidemics in health care set up. Contact tonometry with Schiotz or Applanation tonometer is associated with nosocomial epidemic keratoconjunctivitis outbreaks. Recently identified SARS-CoV-2 (COVID -19) spreads mainly via the respiratory route and fomites and can transmit through other body fluids, including tear film. Various ophthalmic instruments can become a common source of spreading cross infections. Chemical disinfection is one of the most common methods employed to decontaminate instruments and environmental surfaces and prevent transmission of infectious pathogens to patients through medical and surgical instruments. Various chemical disinfectants are available with a varied spectrum to work on a different group of organisms. In this article, we briefly cover commonly used chemical disinfectants in ophthalmic practice like Alcohol (Ethyl Alcohol, Isopropyl Alcohol), Chlorine-based solution (mainly Sodium Hypochlorite), Glutaraldehyde, Hydrogen Peroxide, Formaldehyde, Iodophors, and Quaternary Ammonium Compounds

To review and analyse the globally established ophthalmic practice protocols during the coronavirus disease (COVID-19). A literature review using search strategy was conducted to identify appropriate publications relevant to COVID-19 and ophthalmology practice and training. The safety and feasibility of the protocols were illustrated and discussed. Challenges in different eye care settings at various international ophthalmology departments have identified and analysed to introduce solutions. Several clinical protocols were established and concerned for screening procedures, waiting area, clinical flow (ie, patients' registration, personal (patients and healthcare workers) protection), and equipment safety in the clinics and operation rooms. In the review of this protocol, the strategic and operational missions of the Academic Medical Centers (AMCs) are demonstrated and discussed. This is in addition to the sustainability of the established protocols for cataract surgeries and glaucoma clinics and training during and after COVID-19. All the protocols have established for temporary circumstances, such as postponing elective appointments and surgeries as well as applying the technology for regular follow-ups (transmission of image, video, and face-to-face interactions via widely available applications). Only, one protocol was stronger for the sustainability. Accordingly, recommendations are suggested for clinical sustainability during and after COVID-19.

The present note deals with the use of drug difluprednate in ophthalmic practice. In last few years, prednisolone acetate and betamethasone are strong steroids in use. Currently, the most widely prescribed strong topical corticosteroids in the US is prednisolone acetate 1%. While it controls inflammation effectively, it has not been shown to consistently address postoperative pain and discomfort in a large clinical trial.3 Chances of side effects like ocular hypertension and cataract formation are higher with these steroids. In june 2008 difluprednate ophthalmic emulsion 0.05% was approved by the US Food and Drug Administration (FDA) for the treatment of inflammation and pain associated with ocular surgery. This was the first ophthalmic steroid approved by the FDA since 1973 as it is high in potency and has good safety profile as well as the ability to reduce postoperative pain. [Natl J Physiol Pharm Pharmacol 2014; 4(1.000): 92-94]

There is increasing information available about the effects of the SARS-CoV-2 virus on the systemic and ocular health of patients, as well as the effects of delayed health care. This mini-review summarizes the potential complications and treatments of COVID-19. Systemic findings include respiratory illness, risk of thromboembolic events, and neurologic findings. Some patients may develop persistent symptoms even after the infection resolves. Effective treatment options include glucocorticoids, antivirals, interleukin-6 antagonists, monoclonal antibodies, Janus kinase inhibitors and vaccines. Potential ocular findings of COVID-19 include conjunctivitis, cranial nerve palsies, and microvascular changes in the retina; most symptoms resolved over time. During the lockdown periods, teleophthalmology was utilized to triage non-urgent issues; patients who did present to emergency departments tended to have more severe disease with worse visual prognoses. While transient delays in outpatient ophthalmic care may be tolerated in some patients, others experienced significant vision loss with interruptions in treatments. Resumption of ophthalmic care as soon as possible may help mitigate the effects of delayed care due to the pandemic.

A high density of infestation in human eyelids and eyelash follicles has been implicated in a variety of ocular surface conditions. However, infestation often goes undiagnosed and untreated, due to an overlap in signs and symptoms with other sources of ocular surface inflammation. We sought to refine the diagnostic technique for outpatient assessment for infestation and determine prevalence of mites in the hair follicles of eyelashes from patients in a standard ophthalmic practice. Patients recruited from a single outpatient ophthalmology clinic were examined for the presence of mites following standard ophthalmic consultation. During anterior segment biomicroscopic examination, investigators searched for cylindrical dandruff and collarettes around the base of patient eyelashes. These were removed, and individual eyelashes manipulated with tweezers to reveal mites. Presence of , cylindrical dandruff and collarettes, time taken to identify the first mite, mean number of mites per hair shaft, and patient-reported symptoms of blepharitis were recorded and analyzed to determine potential correlations. A total of 173 patients were recruited, of whom 106 were included in prevalence analyses. infestation was identified in 100/106 (94%) patients, with a mean time of 2 minutes and 20 seconds taken to find the first mite and a mean number of 3 mites identified per hair shaft. Presence of significantly correlated with the presence of cylindrical dandruff (98/106 [92%] patients; p < 0.001), but not with the presence of collarettes (62/106 [58%] patients; p = 0.230) or symptoms of blepharitis (15/106 [14%] patients; p = 0.591). These results highlight the pervasiveness of infestation, predicted by the presence of cylindrical dandruff, in the eyelashes of patients in a standard ophthalmic practice. They support the use of a non-invasive diagnostic technique to allow fast, simple identification of by ophthalmologists and optometrists in outpatient clinical practice.

Many new infectious diseases in humans have been derived from animal sources in the past 20 years. Some are highly contagious and fatal. Vaccination may not be available and antiviral drugs are not effective enough. Infectious control is important in clinical medicine and in Ophthalmology. Severe acute respiratory syndrome (SARS), as an example, is a highly contagious respiratory disease that has recently been reported in Asia, North America, and Europe. Within a matter of weeks, the outbreak has evolved to become a global health threat and more than 30 countries have been afflicted with a novel Coronavirus strain (SARS-CoV) that is the aetiologic agent of SARS. The primary route of transmission of SARS appears involving close person-to-person contact through droplets. Ophthalmologists may be particularly susceptible to the infection as routine ophthalmic examinations like direct ophthalmoscopy and slit-lamp examination are usually performed in a setting that has close doctor–patient contact. Being the Ophthalmology Department of the only hospital in the world that has just gone through the largest outbreak of SARS, we would like to share our strategy, measures, and experiences of preventing contracting or spreading of SARS infection as an infection control model. SARS is one of the many viruses against which personnel will need protecting in an ophthalmic setting. The experiences attained and the measures established might also apply to other infectious conditions spreading by droplets such as the avian influenza with H5N1.

Within the medical diagnosis group the largest subgroup comprised patients with a medical retina problem, such as age related macular degeneration (AMD) and retinal vascular disease (36%), followed by patients with ocular inflammatory disease (29%) and diabetic eye disease (9%). Categories Number of patients (%) Medical: Diabetic eye disease 5 (9) Medical retina (age related macular degeneration and vascular) 20 (36) Ocular inflammatory disease (thyroid and connective tissue) 16 (29) Neuro-ophthalmology 8 (15) Ocular surface (non-inflammatory) 5 (9) Other 1 (2) Surgical: No (%) Cataract 18 (40) Glaucoma 6 (13) Cornea/anterior segment 6 (13) Vitreoretinal disease 9 (20) Lacrimal/oculoplastics/orbit/oncology 6 (13) Ocular motility 0 (0)

Background Irrational prescription of medication is a common issue in clinical practice, particularly for eye disorders that can affect vision. This study aimed to assess the prescribing practices, drug utilization, and post-dispensing knowledge of ophthalmic medications at the University of Gondar Comprehensive and Specialized Hospital in Northwest Ethiopia. Methods An explanatory sequential mixed-methods study was conducted at the ophthalmology department of the University of Gondar Comprehensive Specialized Hospital from March 2024 to June 2024. Quantitative data were collected using an interviewer-administered structured questionnaire, and chart review was then entered into EpiData version 4.6 and analyzed using SPSS version 25. Descriptive statistics were computed and Binary logistic regression analyses identified factors influencing post-dispensing knowledge, with a significance level of p  < 0.05 and results presented with 95% confidence intervals. Qualitative data were collected through in-depth interviews and analyzed thematically using OpenCode software version 4.2. Results Most respondents were elderly and male, with a higher prevalence of ocular diseases. Ophthalmic medications were predominantly solutions (53.2%), with antibacterial drugs (41.2%), especially Tetracycline, being the most common. Fixed-dose combination drugs were primarily steroid-antibiotic combinations. The average number of drugs per prescription was 1.43, with 90.37% of prescriptions being generic and 66.8% from the National Essential Drug List. Strength, dose, frequency, and duration were recorded in 68.3%, 31.5%, 92.4%, and 31.5% of the prescriptions, respectively. Post-dispensing knowledge was good in 38% of the patients, and 11.5% used medication in both eyes despite infection in only one. Patients with a diploma or higher education (AOR = 2.46, 95% CI 1.35, 4.46) were more likely to have better medication knowledge than those unable to read or write. Conclusion Most prescribing indicators were below the e World Health Organization’s recommended standards, except for the number of drugs per prescription and the dispensing time. In addition, most ophthalmic prescriptions lacked adequate and complete prescribing information, and most patients had insufficient post-dispensing knowledge. These findings highlight the urgent need to improve prescribing practices, enhance counseling, and implement targeted educational programs to ensure safer and more effective ophthalmic care.

Background Descemet membrane endothelial keratoplasty is a preferred treatment for endothelial dysfunction, but complications, such as graft detachment and Pseudomonas keratitis, may affect results. Managing post-keratoplasty infectious keratitis poses unique challenges, with incidence varying by keratoplasty type. Diagnosis typically requires corneal scraping, and treatment strategies encompass broad-spectrum antimicrobials and surgical procedures. Case presentation This current case study examines the treatment of Pseudomonas keratitis in a 76-year-old Jewish male patient following Descemet membrane endothelial keratoplasty, exacerbated by freshwater exposure, in the left eye. Despite initial complications such as graft detachment, a comprehensive treatment plan, including the use of losartan 0.8 mg/mL ophthalmic solution for 7 months, followed by the fitting of a custom scleral toric contact lens, alleviated ocular surface symptoms and quality of vision (by questionnaires). The scleral contact lens provided excellent centration, and the patient’s best correction visual acuity enhanced from 0.9 logMAR to 0.2 logMAR, and his near best correction visual acuity improved from Jaeger 13 to Jaeger 3.0 with +2.50 D reading spectacles worn over the scleral contact lens. Additionally, the patient’s 10% low-contrast distance best correction visual acuity in the left eye enhanced from 1.3 logMAR to 0.47 (−1) logMAR in photopic conditions when using the scleral contact lens. Patient data were collected after written informed consent. Conclusions The present report emphasizes the efficacy of personalized therapeutic strategies in the postoperative management of Descemet membrane endothelial keratoplasty patients, highlighting innovative pharmacological approaches and customized scleral contact lenses in addressing complications and enhancing patient outcomes.