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Objective: To assess the level of satisfaction of patients who access the Ophthalmic counselling services anchored by trained social workers of the University of Calabar Teaching Hospital, Calabar, NigeriaMethods: A cross-sectional study of serial consenting participants was done. Ethical approval was obtained from the University of Calabar Teaching hospitals’ ethics committee. Data was obtained using a semi-structured intervieweradministeredquestionnaire. Data were collated and analyzed using the SPSS for Windows (version 20, SPSS inc. Chicago, IL, USA). Modified Likert scale (very satisfied, satisfied and not satisfied) was used to rate the satisfaction level.Results: A total of 120 respondents met the inclusion criteria and were enrolled into the study. Majority of the respondents (60%) were male with an overall mean age of 45.32± 1.82. Over a quarter (28.3%) of the respondents were in the age bracket of 41-50. Glaucoma (48.3%) was the most common eye condition of the respondents. Seventy-five percent of the respondents were satisfied with the average time spent for the counselling services while 76.7% were satisfied with the overall ophthalmic counselling services they received with 46.7% believing that the service was provided by a social worker.Conclusion: Majority of the Patients were satisfied with the Ophthalmic counselling services mainly anchored by social workers. Training and retraining of allied support staff to render ophthalmic counselling services in order to ease the workload of the Ophthalmologist should be encouraged in resource-limited settings.Keywords: Patients satisfaction, ophthalmic counselling service, NigeriaFunding: None declared

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a highly infectious coronavirus, has been rapidly spreading after its surge in China in December 2019. It is currently a global pandemic. A myriad of transmission routes have been documented, however established thus far, are respiratory droplet, contact and airborne transmissions. Susceptible persons at proximity, usually within 1-2 m, to infected persons are largely at risk of being infected. Unfortunately, health workers usually evaluate patients within this distance. Eye care professionals (ECPs) are faced with a higher risk scenario of being infected as they undertake routine clinical eye examination procedures at a close face-to-face proximity to patients, which place them at a high risk of respiratory droplets and aerosolised particles, particularly from asymptomatic and pre-symptomatic carriers. The slit lamp examination procedure is typically at a distance of between 0.25 m and 0.5 m. While undertaking certain procedures on the slit lamp, such as gonioscopy and slit lamp indirect ophthalmoscopy, the ECP holds the accessory lenses either directly on the patient's eye or at about 5-10 cm from the patient's face, respectively. The authors found it pertinent to articulate this narrative review article to guide slit lamp examination practice by ECPs during routine ophthalmic evaluation, with a view to reducing the spread of SARS-CoV-2 to ECPs. In conclusion, ECPs are at increased risk of infection due to high-risk scenarios for routine slit lamp examination procedures of the eye. Adherence to standard precautionary measures with slit lamp use is highly recommended.

BackgroundThe travel distance from home to a treatment centre, which may impact the stage at diagnosis, has not been investigated for retinoblastoma, the most common childhood eye cancer. We aimed to investigate the travel burden and its impact on clinical presentation in a large sample of patients with retinoblastoma from Africa and Europe.MethodsA cross-sectional analysis including 518 treatment-naïve patients with retinoblastoma residing in 40 European countries and 1024 treatment-naïve patients with retinoblastoma residing in 43 African countries.ResultsCapture rate was 42.2% of expected patients from Africa and 108.8% from Europe. African patients were older (95% CI −12.4 to −5.4, pConclusionsFewer than half the expected number of patients with retinoblastoma presented to African referral centres in 2017, suggesting poor awareness or other barriers to access. Despite the relatively shorter distance travelled by African patients, they presented with later-stage disease. Health education about retinoblastoma is needed for carers and health workers in Africa in order to increase capture rate and promote early referral.

Background: Corneal diseases are major causes of severe visual impairment and blindness in developing countries, unfortunately. Keratoplasty, which is a major treatment modality, is either nonexistent or at its infancy in these climes. Indications for penetrating keratoplasty (PKP) and the short-term success and survival rates vary in different geographical locations. We sought to evaluate the indications and short-term success rates of penetrating keratoplasty (PKP) in a Nigerian Private Practice Setting in South South Nigeria. Patients and Methods: It was a retrospective audit of 12 patients that had undertaken PKP in the hospital by December 2017. Data obtained from medical records included demographic information like age and sex. Others included preoperative diagnosis, indications for surgery, and pre- and postoperative best corrected visual acuity (BCVA) of subjects. Other information included intraocular pressure pre- and postoperatively, levels of corneal clarity, presence of other ocular comorbidities, and documentation of preoperative graft failure risk assessments. All patients in the series had optical penetrating keratoplasty, performed by a single experienced surgeon for purpose of vision restoration. Results: The mean age of the patients was 50.1 years, with a standard deviation of ± 15.5 years. The indications for PKP were bullous keratopathy seven (58.3%) and five corneal scars (41.7%). The etiological distribution was six patients with pseudophakic bullous keratopathy, one patient was postuveitic bullous keratopathy, three patients were postinfectious corneal scar, and two patients were postmeasles adherent leucomatous corneal scar. Pre-PKP 10 patients (83.4%) were corneal blind on the affected eye and the corneal clarity grades were 2 patients (16.7%) in grade 0, 7 patients (58.3%) in grade 1, and 3 patients (25.0%) in grade 2. At 6 months post-PKP, three patients (25.0%) remain blind in the affected eye, two patients (16.7%) in pre-PKP blind category moved to SVI, one patient (8.3%) with SVI and five patients (41.7%) with blindness at pre-PKP had respectively moved to MVI, and one patient (8.3%) with MVI at pre-PKP had regained normal vision. At 6 months post-PKP, corneal clarity improved from grades 0–2 to grades 3 and 4, in 25% and 75% of the patients, respectively, compared to the pre-PKP grades 0, 1, and 2, in 16.7%, 58.3%, and 25.0% of patients, respectively. Conclusion: In this study, bullous keratopathy and corneal scar were the main indications for penetrating keratoplasty. The short-term (6 months) success and survival of corneal grafts were reasonably good.

Background: Cataract is the leading cause of blindness in developing countries. Phacoemulsification is beyond the reach of many in these resources limited setting. Manual Small Incision Cataract Surgery (SICS) is a safe, low-cost, high-quality alternative. This is a review of outcome of SICS performed by trainee Surgeons during the first SICS training course in our centre. Patients and Methods: Eleven experienced Extracapsular Cataract Extraction (ECCE) surgeons from training centers across Nigeria were selected for a weeklong SICS training and conversion course. A review of visual outcome and complications of surgeries performed by these trainees on adult subjects is here reported. Results: Eighty-two eyes met the inclusion criteria. Male to female ratio was 1.4:1. Intraocular lenses were implanted in 80 eyes (97.5%). Visual outcome at 3 months post-operatively was good in 58 eyes (70.7%), borderline in 20 (24.4%), and poor in 4 (4.9%) subjects. The most common late post-operative complication, resulting in poor outcome was uncorrected aphakia in 2 (2.4%) eyes. Conclusion: The outcome did not meet World Health Organization (WHO) recommendations but was better than that reported for ECCE in the country. Conversion to SICS may not be difficult for competent ECCE surgeons as trainees achieved reasonable dexterity with acceptable post-operative outcome and complications profile in one week. To maximize patient safety and good outcome, a longer training period is recommended.