Response of L V Prasad Eye Institute to COVID-19 outbreak in India:experience at its tertiary eye care centre and adoption to its Eye Health Pyramid

AIM:To summarize the experience of response to COVID-19 outbreak at a tertiary eye care institute and its network of health facilities in India.METHODS:Our responses are based on the principles of social distancing,hand hygiene,respiratory etiquettes,surface disinfection protocol,and rational use of appropriate personal protective equipment(PPE).We describe our response in terms of administrative controls,clinical protocols,staff protection,environmental controls,and social distancing measures.We also discuss our communication strategies and monitoring systems,to ensure compliance to protocols.RESULTS:Administrative control is mainly related to formation of task force and its functions.Clinical protocols are related to patient triaging methods and clinical examination guidelines in Outpatient,Inpatient and Operating Room.Staff protection is focused on training staff on the protocols to be followed in hospital as well as at home,and use of PPE.Environmental protocol is focused on cleaning and disinfectant methods to be used in the hospital.In addition,there are systems for communication as well as monitoring compliance to protocols.CONCLUSION:We hope that these protocols and our experience would help the ophthalmic community globally and serve as a guide to protect ophthalmologists and ophthalmic care personnel,and their patients across the world.

He Eye Care System:15 Years' Efforts and Experience in Charity

正He Eye Care System (hereinafter referred to as HE), established in 1996, is China's only comprehensive eye care system with centralized advantages of hospitals, institutes, companies, teaching research centers. Dr. He Wei,

Demographics, referral patterns and management of patients accessing the Welsh Eye Care Service

Background:The Primary Eyecare Acute Referral Service(PEARS)and the Wales Eye Health Examination(WEHE)operate as enhanced optometry services for patients residing in Wales,enabling the examination of a patient presenting with an acute eye problem(PEARS)or the examination of patients at higher risk of eye disease(WEHE).The purpose of the study is to assess the demographics of patients accessing these services,referral patterns and clinical management in one Health Board in Wales(Aneurin Bevan University Health Board).Methods:Information from 2302 patients accessing the services was prospectively collected.The following information was obtained:type of examination(PEARS or WEHE),patient age,gender,self-referral or general practitioner(GP)referral and clinical management(no further action,monitor by optometrist or ophthalmic medical practitioner[OMP],refer to the Hospital Eye Service[HES],or refer to GP).Results:There were 1791(77.8%)PEARS examinations and 511(22.2%)WEHE.There were 1379(59.9%)females with a mean age of 58.61(±19.75)and 923(40.1%)males with a mean age of 56.11(±20.42).The majority of patients were self-referrals compared to GP-referrals(1793[77.9%]versus 509[22.1%]respectively).Sub-analysis indicated similar numbers of self-referrals compared to GP-referrals for the WEHE only(297[58.1%]versus 214[41.9%]respectively)but greater numbers of self-referrals for the PEARS examinations only(1496[83.5%]versus 295[16.5%]respectively).For management,75%of patients were monitored by their optometrist or OMP,17%required referral to the HES and 8%required referral to their GP.Conclusions:Higher numbers of females accessed both PEARS and WEHE services and the majority of patients self-referred.These findings have important implications for public health campaigns both for targeting specific groups(e.g.male patients)and increasing awareness among GPs.

Knowledge, attitudes and practices related to seeking medical eyecare services by adults with moderate-to-severe visual impairment in rural Yueqing, Wenzhou, China: a cross-sectional survey

AIM:To evaluate the knowledge,attitudes,and practices regarding eye-care seeking practices of visually impaired adults in a rural area Yueqing,and explore factors influencing their behavior.METHODS:A stratified sampling method was used to select 48 villages in Yueqing,from which 2400 people were selected to receive vision screenings conducted by oculists during a household visit.Those presenting visual acuity≥0.5 log MAR in either eye completed a self-designed questionnaire investigating their knowledge about medical eye-care seeking,attitudes about eye health and eye-careseeking behavior.RESULTS:Totally 165 people with moderate-to-severe visual impairment were identified(6.9%,165/2400),and 146 eligible participants were recruited(response rate:88.4%,mean age:68.6±15.0 y),among which 88(60.3%)were female.They had 82(56.2%)and 64(43.8%)monocular and binocular visual impairments respectively.A total of 67(45.9%)subjects demonstrated a high knowledge level about medical eye-care seeking and 88(60.3%)had self-rated poor vision,with 23(15%)receiving regular vision checks.The 105(71.9%)subjects had never been to hospital for an eye examination."No need"and"schedule conflicts"were the main reasons for not seeking eye care.Having extensive knowledge of medical eye-care seeking was positively associated with high education levels(OR=3.73,P=0.045)and negatively correlated with older age(OR=0.97,P=0.043).Both the self-perceived vision condition(OR=2.59,P=0.03)and regular vision check behavior(OR=6.50,P<0.01)were related with seeking eye care services.CONCLUSION:In rural Yueqing,intervention is required to increase public knowledge about seeking medical eye care among people with moderate-to-severe visual impairment,especially for the elderly and poorly education.Regular vision checks may be useful to promote their medical eye-care utilization.

Improving capacity building by implementing comprehensive eye care project,experiences from Kuandian County,China

The global campaign “Vision 2020： The Right to Sight” was officially launched in Geneva byDr. Gro Harlem Brundtland, the Director General of World Health Organization （ WHO ） in February 1999. This represents the global initiative for the elimination of avoidable blindness by the year 2020.1 Seven months later, the International Agency for the Prevention of Blindness （IAPB） General Assembly was held in Beijing, China. During the IAPB General Assembly, the Chinese Ministry of Health, China Disabled Person＇ s Federation together with WHO launched the national campaign “Vision 2020： The Right to Sight” in China.

Eye Strain Detection During Online Learning

The recent outbreak of the coronavirus disease of 2019(Covid-19)has been causing many disruptions among the education systems worldwide,most of them due to the abrupt transition to online learning.The sudden upsurge in digital electronic devices usage,namely personal computers,laptops,tablets and smart-phones is unprecedented,which leads to a new wave of both mental and physical health problems among students,for example eye-related illnesses.The overexpo-sure to electronic devices,extended screen time usage and lack of outdoor sun-light have put a consequential strain on the student’s ophthalmic health because of their young age and a relative lack of responsibility on their own health.Failure to take appropriate external measures to mitigate the negative effects of this pro-cess could lead to common ophthalmic illnesses such as myopia or more serious conditions.To remedy this situation,we propose a software solution that is able to track and capture images of its users’eyes to detect symptoms of eye illnesses while simultaneously giving them warnings and even offering treatments.To meet the requirements of a small and light model that is operable on low-end devices without information loss,we optimized the original MobileNetV2 model with depth-wise separable convolutions by altering the parameters in the last layers with an aim to minimize the resizing of the input image and obtained a new model which we call EyeNet.Combined with applying the knowledge distillation tech-nique and ResNet-18 as a teacher model to train the student model,we have suc-cessfully increased the accuracy of the EyeNet model up to 87.16%and support the development of a model compatible with embedded systems with limited computing power,accessible to all students.

For the Bright Eyes of Kids——An eye specialist's care for kids

Worries ＂I had not known that my kid had a nearsightedness of 800 degrees. Consequences would have been unthinkable if eye specialists from the city had not treated him,＂ said Yun Za, father of a student attending the No.5 Middle School of Jarud Banner （county） in Tongliao Municipality, Inner Mongolia. He is all gratitude tor doctors of the Tongliao Prevention and Treatment Center for Students＇ Eye Diseases （Tongliao Eye Center）.

Cost of pediatric cataract surgery in Maharashtra,India

AIMTo calculate the direct cost of pediatric cataract surgery, from the provider's perspective.

Artificial intelligence in ophthalmology and visual sciences: Current implications and future directions

Since its inception in 1959,artificial intelligence(AI)has evolved at an unprecedented rate and has revolutionized the world of medicine.Ophthalmology,being an image-driven field of medicine,is well-suited for the implementation of AI.Machine learning(ML)and deep learning(DL)models are being utilized for screening of vision threatening ocular conditions of the eye.These models have proven to be accurate and reliable for diagnosing anterior and posterior segment diseases,screening large populations,and even predicting the natural course of various ocular morbidities.With the increase in population and global burden of managing irreversible blindness,AI offers a unique solution when implemented in clinical practice.In this review,we discuss what are AI,ML,and DL,their uses,future direction for AI,and its limitations in ophthalmology.