Cataract is the leading cause of blindness globally and surgery is the only known measure to deal with it effectively. Providing high quality cataract surgical services is critical if patients with cataract are to have their sight restored. A key focus of surgery is the outcome of the procedure. In cataract surgery this is measured predominantly, using visual acuity. Population- and hospital-based studies have revealed that the visual outcome of cataract surgery in many low and middle income settings is frequently sub-optimal, often failing to reach the recommended standards set by the World Health Organization (WHO). Another way of measuring outcome of cataract surgery is to ask patients for their views on whether surgery has changed the functioning of their eyes and their quality of life. There are different tools available to capture patient views and now, these patient-reported outcomes are becoming more widely used. This paper discusses the visual outcome of cataract surgery and frames the outcome of surgery within the context of the surgical service, suggesting that the process and outcome of care cannot be separated. It also discusses the components of patient-reported outcome tools and describes some available tools in more detail. Finally, it describes a hierarchy of challenges that need to be addressed before a high quality cataract surgical service can be achieved.

Aim. To report the case of congenital bilateral upper eyelid eversion with severe chemosis that was successfully managed conservatively. Report. The patient was a six-hour-old male neonate with bilateral congenital upper eyelid eversion and severe chemosis, following uneventful delivery. Conservative management consisted of the application of antibiotic ointment and padding the exposed conjunctiva with 5% hypertonic saline-soaked gauze. The eyelids reverted spontaneously on day 3 and the condition was completely resolved by the third week. Conclusion. Congenital upper lid eversion is usually a benign condition which responds well to conservative treatment. Creating awareness amongst healthcare professionals is essential.

Compared to Europe, glaucoma prevalence appears to be nearly an order of magnitude higher in this rural African population.

Purpose:A pilot investigation to transfer the established corneal collagen crosslinking (CXL) procedure in European eyes into clinically affected African eyes and to optimize the treatment by adapting the riboflavin composition.Materials and Methods:CXL was performed in 15 eyes (11 patients) with advanced stages of keratoconus in the Eye Clinic of Bafoussam in the West Region of Cameroon. The following six riboflavin compositions with different portions of active swelling additives were applied: Solution 1 (0.5% methylhydroxypropylcellulose [MHPC]), solution 2 (1.0% MHPC), solution 3 (1.7% MHPC), solution 4 (5% dextran), solution 5 (10% dextran) and solution 6 (no active swelling ingredient). The central corneal thickness (CCT) was measured by ultrasound pachymetry before and after de-epithelialization and at least every 10 min during CXL.Results:The application of the riboflavin solutions resulted in the following mean final CCT values: 172 ± 15% using solution 1 (60 min/n = 5); 183 ± 8% using solution 2 (60 min/n = 5); 170% using solution 3 (60 min/n = 1); 80% using solution 4 (45 min/n = 1); 99% using solution 5 (45 min/n = 1) and 150 ± 13% using solution 6 (50 min/n = 2).Conclusions:The combination of riboflavin compositions with swelling and stabilizing effects on the corneal stroma seems necessary in African eyes with advanced keratoconus. Further studies are required to confirm these primary results.

PANO demonstrated visual field defects in patients with glaucomatous optic disc. Defects correlated significantly with glaucomatous optic nerve head morphological alterations. Healthy eyes obtained normal results. More studies are needed to establish PANO.

Controlled cyclophotocoagulation with the 940 nm laser is a safe method which can be applied as the first-choice treatment to African primary open-angle glaucoma eyes. Individual IOP prediction, however, is very difficult.

Ophthalmological care in Cameroon is still being developed, although surgery for cataract and glaucoma is well established in several centres across the country. Our objective was to train the local doctors of the Presbyterian Eye Hospital (Acha) in Bafoussam and Douala to perform the most common oculoplasty procedures. The German Ophthalmological Society funded the project with a short-term lectureship of 2 weeks. We now present the results of the first two visits to Acha. We saw 96 oculoplastic patients and performed 44 surgeries. Most of the cases were nasolacrimal duct obstructions, cicatricial ectropion and lagophthalmos following trauma, as well as socket deformities. We were able to perform lid and socket reconstructions as well as dacryocystorhinostomies and other oculoplastic interventions. During the second visit, we had the opportunity to perform general anaesthesia and were able to tackle some of the initial challenges for oculoplastic surgery. The acquisition of instruments and materials are ongoing and training of the local doctors has just started after an analysis of the cases presenting in this particular setup.

A bstract Aim and objective To compare the results of a new automated glaucoma test—Pattern–Noise (PANO)—to the Humphrey Visual Field Analyzer-II (HFA), the fundus area cup-to-disk ratio (CDR), and a frequency doubling technology (FDT) stimulus. Materials and methods This was a prospective study performed in the West-Region of Cameroon. Two hundred and nineteen eyes of 122 adult patients were included with a clinical suspicion of normal-tension or primary open-angle glaucoma and no other major ocular pathology. Eyes were examined with PANO, HFA (24-2 SITA standard), and FDT-stimulus in a randomized order followed by clinical assessment of the CDR. Results Parametric correlation of the mean contrast threshold of PANO with the mean contrast threshold of FDT-stimulus, total deviation of HFA, and area CDR was 0.94, −0.85, and 0.62, respectively ( p < 0.001 for all values). Spatial distribution of sensitivity thresholds is highly correlated ( p < 0.001) at all points in the visual field between PANO and HFA. With cut-off values of 3 ± 1 dB for HFA mean deviation and 4 ± 1 for PANO mean contrast threshold and after eliminating borderline cases, PANO's sensitivity was 95% and specificity 60%. The mean patient age was 45.2 ± 15.8 years. Mean thresholds of PANO and FDT-stimulus decreased with increasing age. Mean examination time was 7.1 ± 1.8 minutes for PANO, 5.9 ± 1.3 minutes for HFA, and 4.7 ± 1.3 minutes for FDT-stimulus. The mean percentage of false-positives per examination was 4.95% for PANO, 4.62% ( p = 0.025) for FDT-stimulus, and 2.10% for HFA. Conclusion The results showed that PANO was successful in suspecting the presence of glaucoma. Pattern–Noise examination led to findings that were significantly correlated to HFA, FDT stimulus, and area CDR. Some patterns of defect were also correlated. Furthermore, PANO showed a reasonable examination time and error rate. Clinical significance Affordable and robust visual field devices are lacking in large parts of the developing world. Comparing them to established methods is a prerequisite to their clinical use. How to cite this article Hannen T, El-Khoury S, Patel R, et al. Comparison of the Automated Pattern–Noise (PANO) Glaucoma Test with the HFA, an FDT Stimulus, and the Fundus Area Cup-to-disk Ratio. J Curr Glaucoma Pract 2021;15(3):132–138.