Intravitreal injection practice patterns among Chinese ophthalmologists

AIM:To describe the practice patterns of intravitreal injections(IVIs)among ophthalmologists in China.METHODS:This was a cross-sectional online survey.Ophthalmologists who had performed accumulated more than 100 injections were contacted by the Brightness Center,a hospital-based national network,to complete an anonymous,24-question,internet-based survey.They were surveyed on practices in injection techniques,pre-,and post-injections procedures.RESULTS:A total of 333 ophthalmologists from 28 provinces/municipalities/autonomous regions responded to the survey(50.68%response rate).The 91.29%of the respondents evaluated systemic risk factors by medical history,electrocardiogram(ECG)and blood test.All the respondents used pre-injection prophylactic antibiotics.Most checked intraocular pressure(IOP,99.1%)and blood pressure(96.1%)before injections.A majority of the respondents performed injections in the operating room(98.8%),wore masks(99.7%),gloves(99.4%)and sterile surgical clothing(96.1%),performed topical anesthetics(97.9%),and applied povidone-iodine(95.8%)pre-injection.The 61.26%of the respondents dilated pupil.About half of the respondents(51.05%)performed bilateral injections in the same setting.Superior temporal quadrant(40.54%)was the most frequent site of injection.Around three quarters used 30-gauge needles.Most respondents(97.9%)measured the site of injection from limbus.More than half(53.45%)performed conjunctiva displacement prior to injection.The 32.43%of the respondents checked IOP post-injection and 87.99%physicians checked hand motion(HM)or counting fingers(CF)after injection,while 36.94%observed optic nerve perfusion.All participants used topical antibiotics post-injections.Most physicians(91.89%)reviewed patients on the following day.CONCLUSION:This study provides a description of the real-world practice patterns in IVIs in China and offers critical information regarding education and training of ophthalmologists and amendment of local society guidelines.

Series Reports for World Eminent Ophthalmologists (Part 1) Brief Introduction on Prof. George C. Y. Chiou. PhD

Dr.George Chiou is Professor and Director of the Institute of Ocular Pharmacology and Professor of Neuroscience and Experimental Therapeutics at Texas A&M University System Health Science Center.He has served as Head of Department of Medical Pharmacology and Toxicology for 27.5 years until the department was reorganized in 2006.He also is an Adjunct Professor of Surgery and Ophthalmology at Texas A&M University College of Medicine,

Public＇s knowledge of the differences between ophthalmologists and optometrists：a critical issue in eye care service utilisation

AIM：To assess the public＇s knowledge of the differences between ophthalmologists and optometrists and identify the factors associated with knowledge.METHODS：The study was a population-based random survey of adults aged 18 years or older conducted in Enugu,south eastern Nigeria,between March and June,2011.Data on respondents＇ socio-demographics,clinical profile,and knowledge of the differences between ophthalmologists and optometrists were collected using a 28-item questionnaire.Data were analysed using descriptive and analytical statistics.Values of P〈0.05 were considered statistically significant.RESULTS：The respondents（P=394） comprised 198 males and 196 females（sex ratio =1.01：1）,aged 18-70（30.9 ±10.8） years.The majority of respondents were single（57.4%）,possessed secondary education（96.9%）,employed（65.2%） and had no health insurance（77.4%）.Their clinical profile showed previous eye exam 54.1%,spectacle wear 41.6%and contact lens wear 5.6%.In the multivariate analysis,participants＇ good knowledge of the differences between ophthalmologists and optometrists was significantly associated with educational status（OR：0.32,95%CI：0.23-0.44,P〈0.0001,β =-0.988）,employment status（OR：1.8,95%CI：1.45-2.25,P〈0.0001,β=0.124）and previous eye examination（OR：1.63,95%CI：1.29-2.07,P〈0.0001,β =0.549）.CONCLUSION：Participants＇ socio-demographic and clinical characteristics are important predictors of good knowledge.The findings may have implications for all stakeholders in eye care delivery.There is need for knowledge enhancement,by the government and eye care providers,through population-based eye health literacy campaigns.

Perception and Practice of Undergoing Glaucoma Screening among Ophthalmologists

Background: Globally, glaucoma remains the leading cause of irreversible blindness. Early detection and treatment is mainstay of prevention of blindness from glaucoma. Purpose: This study was done to assess the perception and glaucoma screening practice of ophthalmologist in Nigeria. Methods: This is a cross-sectional descriptive study. A pretested structured questionnaire was administered to all the ophthalmologists who attended the general plenary session of the 2013 annual conference of the Ophthalmological Society of Nigeria (OSN). Result: Of the 115 respondents, 63 (54.8%) were females;mean age was 39.7 ± 9.3 years. Majority 69 (60.0%) were less than 40 years old. Presence of systemic risk factors to glaucoma was reported by 19 (16.5%), out of which 9 (47.4%) were hypertension, 2 (10.5%) were Diabetes Mellitus, 2 (10.5%) were other cardiovascular diseases, and 6 were unspecified others. Among the respondents, 28 (24.3%) had positive family history;29 (25.2%) had Myopia;and 3 (2.6%) were known glaucoma patients already on treatment. Majority 91 (79.1%) had positive attitude towards glaucoma screening. Although 98 (85.2%) have ever had a full eye examination, only 56 (48.7%) were routine. There was no statistically significant relationship between sex, age group, religion, positive family history, professional status, attitude and glaucoma screening. Conclusion: The attitude of Nigerian Ophthalmologists to glaucoma screening was high but actual screening practice was below expectation in view of their presumed high knowledge of the risk of blindness from glaucoma. In-house campaign aimed at promoting self-glaucoma screening among this high-cadre eye care providers is warranted.

Smart phone apps every ophthalmologist should know about

We are living in a mobile world,where the number of medical apps is surging in recent years.Over 320000 healthcare apps are now available as shown in the latest research.The major function and potential of these apps vary,from assisting the learning and practice of clinicians as well as achieving better outcomes of patients to preventing eye diseases through the education of healthy individuals.However,based on the various features,ophthalmology apps nowadays contain a wide range of subjects and focus on dif ferent stakeholder s in the ophthalmic practice,including but not limited to doctors,patients,and researchers.Here,we review special and advanced apps that ophthalmologists will find useful in their clinical practice.

Comparison Study of Funduscopic Exam of Pediatric Patients Using the D-EYE Method and Conventional Indirect Ophthalmoscopic Methods

Purpose: The D-EYE device, a new fundoscopic smartphone lens, has demonstrated its utility in a clinical setting to detect and document ocular pathology, but has not been tested in the pediatric population. A prospective study was performed to explore the application of D-EYE in pediatric fundus examinations. Methods: Patients ages 3 - 18 years old underwent dilated fundus examinations by masked examiners using the video function of the D-EYE, while indirect ophthalmoscopy was performed by apediatric ophthalmologist. The examiners independently analyzed the D-EYE videos for the presence or absence of abnormalities, cup-to-disc (c/d) ratios and optic nerve size and color. The D-EYE video findings were compared to indirect ophthalmoscopy findings. Results: The study included 172 eyes from 87 patients. In comparing D-EYE to indirect ophthalmoscopy for detecting fundus abnormalities, the sensitivity was 0.72, specificity was 0.97, positive predictive value (PPV) was 0.77, negative predictive value (NPV) was 0.97, positive likelihood ratio (LR) was 27.8, and negative LR was 0.29. The agreement rate between the D-EYE video graders for the c/d ratio within a value of 0.1 was 97.0%. Multiple, distinct abnormalities were discovered using the D-EYE device, including nystagmus, optic nerve hypoplasia, optic disc edema, peripapillary atrophy, disc pallor, and optic disc drusen. Conclusion: Fundoscopic imaging using the D-EYE smartphone lens reliably detects the presence of fundus abnormalities and has good reliability in assessing c/d ratios. The video capability is useful in patients with nystagmus or those who are poorly compliant with the examination and allowed for effective teaching by the pediatric ophthalmologist.