PURPOSE:
To investigate the impact of coronavirus infection disease-19 (COVID-19) pandemic on ophthalmic referrals within an academic tertiary center in Oman.
METHODS:
Retrospective chart review of internal referrals received and evaluated by the ophthalmology department between March 1and August 31, 2020 (COVID-19 period) compared to a corresponding period in 2019 (pre COVID-19). Data included patient demographics, referral details, ocular diagnosis, intervention, and discharge plan.
RESULTS:
Referral volume significantly decreased by 58.2%; from 2019 prepandemic to 510 (
P
= 0.001), with the lowest in April and May 2020. Patient demographics did not differ significantly, but “urgent” referrals reduced by 96.2% (
P
< 0.001). Main reasons for referrals were reduced vision and screening in both periods. During pandemic, referrals for screening purposes increased from 30.3% to 37.9% (
P
= 0.013) and for reduced vision decreased from 30% to 23.3% (
P
= 0.021). Dry eye syndrome increased in frequency during 2020 (from 2.9% to 7.3%,
P
= 0.002) but cataracts and conjunctivitis both decreased (from 4.7% to 2.1%,
P
= 0.046 and from 2.3% to 0.3%,
P
= 0.013, respectively). Ocular trauma remained stable (from 0.8% to 0.3%,
P
= 0.456), but the proportion of chemical injuries increased by 13.7% (
P
= 0.025). There was a drastic decrease in interventions from 37% to 26.1% (
P
< 0.001) and an increase in discharge rate from 61.2% to 75.8% (
P
< 0.001).
CONCLUSION:
The impact of COVID-19 pandemic on ophthalmic referrals within a tertiary academic centre in oman referral reductions and changes in pattern and characteristics as an epiphenomenon of COVID-19 reflect the extent of impact specifically in an Omani context. This information is vital for planning proper resource utilization, the adoption of innovative care delivery, and improving referral system pathways.
Objective:To assess the visual outcome and complications of 25-gauge micro incision vitrectomy surgery (MIVS) in diabetic vitreous haemorrhage.Methods:This Quasi Experimental study was conducted at LRBT, Tertiary eye care hospital Karachi, from February 2012 to January 2013. Sixty eyes of sixty patients with uncontrolled type II diabetes mellitus (DM) were included. There were 43 (71.7%) males and 17 (28.3%) females. Age range was 40 – 60 years. All randomly selected patients underwent 25-gauge sutureless micro incision vitrectomy surgery for diabetic vitreous haemorrhage. Main outcomes measured were best corrected visual acuity (BCVA) assessed with logMAR and post-operative complications. Follow ups were at one day, one week, one month, three months and six months post-operatively.Result:Best corrected visual acuity (BCVA) gradually improved in majority of subjects in each subsequent follow up visit. Preoperative visual acuity was 1.023 ±0.226 logMAR, which was improved after final follow up to 0.457±0.256 and P-value was < 0.001. Five patients developed recurrent vitreous haemorrhage during study period, one patient developed cataract (1.7%), one (1.7%) had ocular hypotony defined as intraocular pressure < 5 mmHg and one (1.7%) developed endophthalmitis.Conclusion:25-gauge micro incision vitrectomy surgery (MIVS) is an effective sutureless parsplana vitrectomy surgery which has good visual outcome in diabetic vitreous haemorrhage with minimum manageable complications.
Aplastic anemia is a rare, usually autoimmune disorder of bone marrow stem cells leading to pancytopenia and hypoplastic marrow that presents with anemia, infection or bleeding which can be potentially sight and life-threatening. Patients with aplastic anemia may present with various ocular manifestations; lid and orbital hematoma, sub-conjunctival hemorrhage, sudden visual loss due to vitreous hemorrhage or retinopathy and optic disc edema. A young male patient had symptomatic sever bilateral hemorrhagic retinopathy secondary to aplastic anemia; succeeding systemic allogenic hematopoietic stem-cell transplantation showed almost complete spontaneous resolution of the retinopathy and significant improvement in vision over a period of 16 weeks.
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