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Background: The shadow curriculum is an emerging concept in curriculum studies that has not yet garnered significant attention in medical education. It includes programs and activities outside formal education to improve students' academic performance in the formal educational system., Objective: In this study, we designed and developed an online course based on the shadow curriculum and evaluated its effect on students' learning and academic performance., Methods: This study represents a form of developmental research, with the study population comprising medical and dental students from universities of medical sciences in Iran. The course was conducted at the Smart University of Medical Sciences, following the ADDIE instructional design approach in three phases. The initial two phases involved designing and implementing the program according to the students' needs and requirements. In the third phase, we evaluated the program using the Kirkpatrick model. In the first level evaluation, the reaction of 70 students in the course was investigated. To assess the impact of the course, pre and post-tests were administered to 30 students. Finally, the effect of the course on students' success in the comprehensive exams for basic medical sciences, dentistry, and pre-internship was analyzed by examining the passing and failing statuses of 83 and 57 students who participated in the September 2023 and February 2024 exams., Results: The results indicated that the students responded positively to the program. The analysis of pre-test and post-test scores showed a significant improvement in the students' academic performance across all the subjects presented in the course, including basic medical sciences, dentistry, and pre-internship (p < 0.01, p < 0.05). Overall, the descriptive analysis of the program's influence on the students' success in comprehensive exams in basic medical sciences, dentistry, and pre-internship showed that 70 out of 83 participating students passed the September 2023 comprehensive exams. Additionally, 51 out of 57 participants completed the comprehensive exams in February 2024., Conclusions: In an era where the shadow curriculum is reshaping learning and the educational landscape, the findings presented in this study indicate that this type of curriculum should be given special attention in the theoretical, research, and practical dimensions of the field of medical education., (© 2024. The Author(s).)

This Letter explores the transformative impact of stealth assessment on medical education and its potential to enhance learning outcomes. Stealth assessment, an innovative approach, subtly measures students' learning progress while the students interact with rich and engaging environments, seamlessly integrating assessment within authentic learning activities. By mirroring the testing scenario with the learning format, stealth assessment mitigates test-related anxiety and promotes continuous engagement in training. It also plays a pivotal role in evaluating non-cognitive skills and attributes, such as empathy and ethical decision-making, which are often overlooked by traditional testing methods. Stealth assessment offers advantages in scalability and efficiency, leveraging technology and automation to streamline data analysis and feedback generation. The adoption of stealth assessment in medical education holds the promise of nurturing self-directed learning, reflective practices, and the development of nuanced skills necessary for medical practice, ultimately producing competent and well-rounded healthcare professionals., Competing Interests: The authors declare no conflicts of interest., (Copyright: © Journal of Advances in Medical Education & Professionalism.)

Competing Interests: The authors declare no conflicts of interest.

Background: Mobile learning has played an important role during the COVID-19 pandemic and medical schools now consider it as an effective educational method in current and future crises. In this qualitative study, an attempt was made to demonstrate the principles of designing a mobile learning strategy in medical education from the perspective of experts., Materials and Methods: The study was conducted by the qualitative content analysis method. The data were collected from July 2022 to Feb 2023. Twelve participants were included in this study from Iran's medical universities, consisting of two members of the Higher Council of Virtual Education, three educational directors, three clinical faculty members, two faculty members specializing in e-learning and medical education, an educational vice, and a dean. Data were collected using semi-structured interviews and analyzed by Granheim and Lundman's (2004) method., Results: Out of twelve participants in the study, eight (66%) were males and four (44%) females. Data were classified into eight categories and one theme. Based on the participants' experiences, the main theme, that is, "the principles of medical education design in mobile learning," included pedagogical component, interactive design, effective and comprehensive analysis, achieving objectives with the mobile learning platform, generating micro- and interactive e-content, teaching-learning interactive methods, course implementation and interactive evaluation at both micro- and macro-levels., Conclusion: Data analysis revealed that in addition to the eight principles in the medical education design in mobile learning, the participants prioritized the two principles of pedagogical component and interactive design over other principles in educational design. Using a successful mobile learning strategy in situations of restrictions limiting physical presence may improve the quality of medical education., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Education and Health Promotion.)

A student support system (SSS) has a crucial role in the absorption, retention, and success of students in virtual learning. The purpose of this scoping review was to identify and map the available evidence regarding the dimensions and components of the SSS in virtual learning. This study was conducted in accordance with the methodology of the Joanna Briggs Institute (JBI) for scoping reviews. Our search strategy was based on using search engines, such as MEDLINE, EMBASE, Scopus, WoS, CINAHL, ERIC, PsycINFO, ProQuest, and Google Scholar. The articles were published in renowned medical education journals, including Medical Education, Medical Teacher, and Academic Medicine, and the reference lists of identified and reviewed articles were searched manually. The search results were imported into EndNote X20, and after removing duplicates and screenings, 42 studies met the inclusion criteria and were included in the review. A descriptive- analytical approach was employed, including a numerical count of study characteristics (quantitative) and template analysis (qualitative). Five dimensions were identified in the SSS in virtual learning: types of support, domains of support, stages of support, instigating of support, levels of support, and their components and subcomponents. The findings of this study depict a comprehensive roadmap and have an important contribution to the knowledge body of SSS in virtual learning. We suggest system developers, planners, and higher education officials to improve the quality of virtual learning by applying these findings in their planning and decision-making., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Education and Health Promotion.)

Purpose: To determine the indications and surgical outcomes of intraocular lens (IOL) exchange in pseudophakic patients at Labbafinejad Tertiary Referral Center between 2014 and 2019., Methods: In this retrospective interventional case series, the medical records of 193 patients with a history of IOL exchange were reviewed. Preoperative data, including clinical characteristics, indications of the first and second IOL implantation, intra- and postoperative complications due to IOL exchange, and the pre-and postoperative refractive error and best-corrected visual acuity (BCVA) were considered the outcome measures in this study. All postoperative data were analyzed at least six months after follow-up., Results: The mean age of our participants was 59.13 ± 20.97 years old at the time of the IOL exchange, with a male percentage of 63.2%. The mean follow-up after the IOL exchange was 15.72 ± 16.28 months. The main indications of IOL exchange were IOL decentration (50.3%), corneal decompensation (30.6%), and residual refractive errors (8.3%). 57.10% of patients with the postoperative spherical equivalent at -2.00 diopter (D) to + 2.00D. The mean best-corrected visual acuity was 0.82 ± 0.76 LogMAR before the IOL exchange and was improved to 0.73 ± 0.79 LogMAR after the surgery. Corneal decompensation (6.2%), glaucoma (4.7%), retinal detachment (4.1%), cystoid macular edema (2.1%), and uveitis (1%) were found as the postoperative complications. There was only one case with suprachoroidal hemorrhage during IOL exchange., Conclusions: IOL decentration followed by corneal decompensation was the most common indication of IOL exchange. After IOL exchange, the most complications during follow-up were corneal decompensation, glaucoma, retinal detachment, and cystoid macular edema., (© 2023. The Author(s).)

Purpose: To estimate the level of job satisfaction among ophthalmologists in Iran and determine the associated factors that may impact their overall job satisfaction., Methods: In this cross-sectional study, 181 ophthalmologists (79.0% male) were interviewed by the Warr-Cook-Wall questionnaire with 7-point-Likert scale, which transformed responses from a 0 (most dissatisfied) to 100 (most satisfied). Questionnaires were randomly distributed among registered ophthalmologists at the 29 t h Annual Congress of the Iranian Society of Ophthalmology in November 2019. Satisfaction under each scale was considered as a score of > 60% of the total score., Results: A total of 181 ophthalmologists with a mean age of 47.8 ± 12.1 years and 16 ± 12 years of practice participated in the present study. They were mostly satisfied with their job as a whole (88.1%, mean score: 60.6 ± 20.7) and dissatisfied with their income (55.9%, mean score: 47.6 ± 20.3). High levels of job satisfaction was found among ophthalmologists with longer duration of practice (P < 0.001) while lower levels of satisfaction were identified among those who worked in academic centers (P = 0.004)., Conclusion: In this study,high levels of job satisfaction were found among ophthalmologists with longer duration of practice while low levels of satisfaction were identified among ophthalmologists who worked in academic centers. The factors of salary and working hours accounted for the least levels of job satisfaction., Competing Interests: The authors declare that they have no conflict of interest., (Copyright © 2022 Sabbaghi et al.)

Competing Interests: There are no conflicts of interest.

Introduction: Mobile learning is one of the innovative teaching techniques that help medical students gain knowledge and skills. One of the factors that expanded the use of this strategy was the COVID-19 pandemic. However, the educational pedagogy of such technology has been neglected. This article aimed to critically review available mobile learning models in medical education to suggest a comprehensive model in the field of mobile learning., Methods: We conducted this critical review based on the five steps of the Carnwell and Daly method. For a comprehensive systematic search from 2000 to April 2021, the following keywords were used: Personal Digital Assistant, m learning, Mobile learning, Ubiquitous learning, U learning, medical students, and medical education. 3176 studies in PubMed, Scopus, ERIC, Magiran, and Web of Science were identified. In total, 8 articles entered the study., Results: Eight models of mobile learning in medical education were identified. The key features of each model were extracted and integrated into the new model for the successful design and implementation of mobile learning. This model includes three main elements of mobile learning: 1-stakeholders, 2-interaction, and 3-technology, which are influenced by external factors including Mobiquette, legitimacy, and awareness., Conclusion: The results of this study are an important contribution to the knowledge collection in mobile learning in medical education. We introduced a comprehensive model of mobile learning including specific characteristics of strategies in the context of medical education., (Copyright: © Journal of Advances in Medical Education & Professionalism.)

Purpose: To identify the psychological impact of coronavirus disease on ophthalmologists practicing in Iran between August and December 2020., Methods: In this cross-sectional online survey, a standard Patient Health Questionnaire- 9 (PHQ- 9) was completed by 228 ophthalmologists who were practicing in Iran. The PHQ- 9 questionnaire was revised by adding two additional questions specifically applicable for the assessment of the psychological impact of coronavirus disease on the Iranian ophthalmologists. An organized classification regarding the assessment of different depression severities identified as no (0-4), mild (5-9), moderate (10-14), or severe (15-21) was then considered for data analysis., Results: The mean age of our participants was 49.0 ± 15.61 years and the majority of them (67.1%) were male. Depression was discovered in 73.68% ( n = 168) with different severities ranging from mild ( n = 61, 26.75%), moderate ( n = 63, 27.63%), and severe ( n = 44, 19.3%). It was found that participants with depression were older as compared to those without depression ( P = 0.038). Higher percentages of severe depression were noticed in the high-risk regions contaminated with corona virus as compared to the other low-risk regions ( P = 0.003). Based on multivariable models, we determined that ophthalmologists who were somewhat concerned about their training/ profession (OR: 0.240; 95% CI: 0.086-0.672; P = 0.007) and those with no concerns about their income had lower association with depression (OR: 0.065; 95% CI: 0.005-0.91; P = 0.042)., Conclusion: High prevalence of depression was observed among older aged Iranian ophthalmologists living in high-risk contaminated regions who possessed serious concerns with respect to their training/profession and income. It is recommended that the health policymakers of Iran pay more attention to the ophthalmologists who experience the aforementioned factors., Competing Interests: The authors report no conflict of interest., (Copyright © 2022 Kalantarion et al.)

Introduction: The Continuing Medical Education (CME) programs in the medical community aim to improve the knowledge of practitioners and its effect on changing their performance. Previous studies showed that CME causes minimum changes in physicians' behaviors, so it is important to pay attention to the views of this group. In this regard, this qualitative study aimed to explain the Iranian Ophthalmologists' perceptions and experiences concerning the CME Programs in Iran., Methods: In this qualitative study, 18 participants, including 10 subspecialists and 8 general ophthalmologists, were recruited to participate in in-depth interviews concerning their experiences with CME. The required data were collected from April 2018 to Feb 2019. Each interview was conducted in medical universities; eye research centers; and the ophthalmology departments, offices, and operating rooms of public and private hospitals. The current study was performed using a content analysis based on the Granheim and Lundman's methods. The codes, sub- categories, categories, and themes were then explored through an inductive process in which the researchers moved from specific to general., Result: The data obtained from interviews, and filed notes were analyzed and then classified into the following four themes: "growth and development of the ophthalmology's CME program over time", "challenges of the ophthalmology's CME program", "reasons for the participation of the ophthalmologist in the CME program", and "strategies for improvement"., Conclusion: Based on the qualitative study's results, in spite of growth and development of the design and implementation of the Ophthalmologic CME programs, we are still facing multiple challenges. Enhancing the interactivity between the providers and participants can also improve the ophthalmology CME programs., (Copyright: © Journal of Advances in Medical Education & Professionalism.)

The current outbreak of coronavirus disease 2019 (COVID-19) across the world forced universities to suspend learning to limit the spread of the virus. Many medical schools have shifted to online education as an information delivery mechanism where the educator and learner are separated in space and potentially also in time. This systematic review aims to explore and understand the variety of distance learning strategies in medical students in the contexts of COVID-19. A systematic review was conducted in Web of Sciences, PubMed, Educational Resources and Information Center, and Scopus from December 2019 to July 2020. Eight sets of terminology were used, combining "Distance learning" AND "Medical education" AND "Pandemic." Studies were reviewed independently by two reviewers. Data were extracted and quality appraised using QualSyst tools, and synthesized by performing thematic analysis. A total of 473 articles were identified after removing duplicates and 314 records were screened, of which 125 were included in this study. The primary articles were 52 primarily qualitative articles. Five learning strategies consisted of technology-enhanced learning (TEL), simulation-based learning, technology-based clinical education, mobile learning, and blended learning. Tools, methods, and learning resources associated with these five learning strategies were extracted from the articles. Our review highlights that TEL and simulation-based learning were more commonly used than others in distance learning in medical education during the COVID-19 pandemic. These strategies have the potential to improve learners' level of knowledge and performance through making online learning resources such as Massive Open Online Courses, virtual clinical cases, and blended sources accessible., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Education and Health Promotion.)

Competing Interests: There are no conflicts of interest.

Identifying the learners' problems is important. Besides, many factors are associated with academic failure, among which time management and stress are more important than any others based on evidence. By using a systematic review and meta-analysis, this study aims to synthesize the findings of studies about the correlation of time management and stress with academic failure to suggest a more in-depth insight into the effect of these two factors on academic failure. Four databases were searched from the inception of January 2018. Publication bias was evaluated visually using funnel plots and sized up by Egger's test. Ninety-four articles were found to be qualified for inclusion after full-text review and additional manual reference made. Of these, 8 were studies of educational interventions that were reviewed in this paper. Regarding the relation of stress and academic performance, the Funnel plot (results not shown) and Egger's test showed no publication bias in the studies ( P = 0.719). Based on this result, the estimated pooled correlation (reverted by hyperbolic tangent transformation) between stress and academic performance was found to be -0.32 (95% confidence interval: -0.38--0.25). In conclusion, the review recognized a series of potentially mutable medium-to-large correlates of academic achievement, time management, and stress. It would be essential to have experimental data on how easily such self-regulatory capacities can be altered, and these interventions could help students enhance their potential, providing empirical tests for offered process models of academic achievement., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Education and Health Promotion.)

Objectives: Problem students is one of the important issues in medical education. This study aimed to identify the problem students and the ways for managing these students from the educational experts view. Purposive sampling was used, and data collection continued until data saturation was achieved. Data analysis was performed by the content analysis method based on the Heidegger approach. We interviewed 12 educational experts who had a history of dealing with "problem students"., Results: After data analysis, five main themes and 28 categories, and 164 codes were extracted. The reasons for changing a student to a problem students was: student self-regulation skills, multilayer interactions, curriculum failure, identification policy and supportive solutions. The results indicated that despite revision in the curriculum, there were shortcomings in identification and management of problem students. According to participants, existence of a comprehensive system and a capable counseling center can identify the problem student sooner. On the other hand by improving self-regulation skills, active teaching methods and frequent formative evaluation and the use of supportive strategies, problem student can be encouraged to complete their education successfully. This study emphasized faculty development, reviewing the faculty member recruitment, strengthening counseling centers, improving the exams.

Purpose: To evaluate the effect of a mobile-based screening programme on eye care utilization in Iran., Method: In this cluster randomized community trial, a representative sample of residents aged≥50 years from urban and rural areas in four districts in Tehran province were enrolled. The clusters were randomly assigned to one of the three parallel arms; the mHealth arm with digital data collection, vision screening test and retina evaluation using an integrated mobile application, the conventional arm with manual data collection and screening tests using Snellen chart and Fundus photography at the local primary healthcare facility, and the control arm with manual data collection without screening tests. The main outcome measure was eye care utilization which was defined as at least one visit to an optometrist or ophthalmologist., Results: Of 3312 eligible individuals, 2520 (76.1%) participated. In the first 3 months after the screening programme, eye care utilization was higher among those who were referred by the mHealth method (35.6% 95%CI: 31.1-40.4%) compared to those referred by the conventional method (32.7%, 95%CI: 27.5-38.2%) and to those observed in the control arm (4.5%, 95%CI: 3.2-6.0). Eye care utilization improved (OR = 1.5, 95%CI: 1.2-1.9) among the referred people after the screening programme compared to the utilization before this programme; however, this improvement was significantly higher in the mHealth method (OR: 1.7, 95%CI: 1.2-2.4) compared to the conventional method (OR: 1.2, 95%CI: 0.8-1.8)., Conclusion and Relevance: The mobile-based screening programme can significantly improve eye care utilization at the community level.

Background: To describe the protocol for developing a national inherited retinal disease (IRD) registry in Iran and present its initial report., Methods: This community-based participatory research was approved by the Ministry of Health and Medical Education of Iran in 2016. To provide the minimum data set (MDS), several focus group meetings were held. The final MDS was handed over to an engineering team to develop a web-based software. In the pilot phase, the software was set up in two referral centers in Iran. Final IRD diagnosis was made based on clinical manifestations and genetic findings. Ultimately, patient registration was done based on all clinical and non-clinical manifestations., Results: Initially, a total of 151 data elements were approved with Delphi technique. The registry software went live at www. IRDReg.org based on DHIS2 open source license agreement since February 2016. So far, a total of 1001 patients have been registered with a mean age of 32.41±15.60 years (range, 3 months to 74 years). The majority of the registered patients had retinitis pigmentosa (42%, 95% CI: 38.9% to 45%). Genetic testing was done for approximately 20% of the registered individuals., Conclusion: Our study shows successful web-based software design and data collection as a proof of concept for the first IRD registry in Iran. Multicenter integration of the IRD registry in medical centers throughout the country is well underway as planned. These data will assist researchers to rapidly access information about the distribution and genetic patterns of this disease., (© 2020 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Purpose: To design a screening program for prevention of blindness at the community level in Iran., Methods: In this qualitative study, the components and properties of the screening program were identified using a participatory action research method with focus group meetings (FGMs) with relevant health care providers and authorities. A content analysis approach was used for data analysis., Results: In total, 18 stakeholders including six ophthalmologists with different sub-specialties participated in the five FGMs. The screening program aims to discover vision-threatening eye conditions in people aged 50 years and over. Primary health care workers deliver the program including vision tests and fundus imaging with the support of an ophthalmic technician. Retina specialists perform decision-making. Referral plans are interacted through an automated digital program. The screening environment, feedback, ethics and medical legal issues are other main components of the program., Conclusion: This study presents the initial concepts and components of a screening program for prevention of blindness in the adult population in Iran. The program has the potential to improve eye health at the community level and may potentially be replicated as a model for similar settings elsewhere., Competing Interests: There are no conflicts of interest.

Purpose: To compare the corneal power measurements obtained using different topographic instruments after myopic photorefractive keratectomy (PRK)., Methods: Patients with myopia who were candidates for corneal refractive surgery were sequentially included. Pre-PRK and six months post-PRK corneal powers were measured using Javal manual keratometer, Orbscan II, Galilei, Tomey TMS4, and EyeSys 2000 topographers. Measured values were compared with those obtained using the clinical history method (CHM)., Results: This study included 66 eyes of 33 patients. The lowest keratometric measurements were obtained using the Galilei topographer (42.98 ± 1.69 diopters, D) and the highest measurements were obtained using the Javal manual keratometer (43.96 ± 1.54 D) preoperatively. The same order was observed postoperatively. Effective refractive power (EffRP) measured using EyeSys was most similar to the values obtained using CHM (ICC, intraclass correlation coefficient = 0.951), followed by the total corneal power measured using the Galilei system (ICC = 0.943). The values obtained using the adjusted EffRP formula (EffRP - 0.015*Δ Refraction - 0.05) were more consistent with the values obtained using CHM (ICC = 0.954) compared to those obtained with the adjusted average central corneal power formula measured using the Tomey system (ICC = 0.919)., Conclusion: Post-PRK corneal powers measured using the adjusted EffRP formula were the most similar to values obtained using CHM., Competing Interests: There are no conflicts of interest.

Purpose: To evaluate the risk factors for pterygium in the dry, high altitude province of Ilam, Iran., Methods: The study included patients who presented to ophthalmology clinic. The patients were divided into two groups: 210 diagnosed with pterygium or pinguecula (unilateral or bilateral), and 210 healthy controls. Demographic variables, living environment, disease type, disease laterality, family history of pterygium as well as history of smoking, working outdoors, baking, welding, ocular conditions (trachoma keratopathy, glaucoma, refractive error, and dry eye), use of glasses, ultraviolet light exposure, and systemic conditions were collected from both groups and compared for risk assessment., Results: Univariate analysis revealed that age ( P = 0.001), sex ( P = 0.001), family history of pterygium ( P = 0.001), positive history of smoking ( P < 0.001), history of baking ( P = 0.045), welding experience ( P < 0.001), severe blepharitis ( P < 0.001), hyperopia ( P < 0.001), dry eye ( P < 0.001), hypertension ( P < 0.001), ischemic heart disease ( P < 0.001), obesity ( P = 0.038), and primary residential area ( P = 0.025) had significant associations with increased incidence of pterygium. However, in multivariate analysis, only family history of pterygium, cigarette smoking, history of baking, age, and severe blepharitis were significantly associated with the incidence of pterygium ( P <0.001, P <0.001, P = 0.002, P = 0.023 and P = 0.002, respectively)., Conclusion: This study tested more risk factors related to the prevalence of pterygium compared to previous studies. It also confirmed previously established risk factors. Family history of pterygium and blepharitis were risk factors that have not been reported in previous studies and were found to be significantly associated with the development of pterygium in this study., Competing Interests: There are no conflicts of interest.

Objective: To assess the national health system for management of diabetes mellitus (DM) in Iran, with particular focus on diabetic retinopathy (DR)., Materials and Methods: In this qualitative study, the national stakeholders related to DR and DM management system were invited to participate. Two researchers performed interview using a semi-structured questionnaire recommended by the World Health Organization titled "Tool for Assessment of Diabetic Retinopathy and DM Management Systems". The questionnaire contains seven different sections, each consisting of closed and open-ended questions, and a final Likert-type score, ranging from 1 indicating the worst to 4 indicating the best status. Inconsistencies were resolved through a collective decision of the research team, followed by a focus group discussion with stakeholders at the Ministry of Health., Results: Fourteen stakeholders out of 15 total invitees were interviewed (response rate: 93.3%). There were national priorities, defined policies, and running programs (score = 3), but the care system should be strengthened in terms of implementation of clinical guidelines, with specific reference to the availability of regular screenings for DR (score = 2). The network of care providers, health information systems, and promotional programs were insufficient (score = 2). The health workforce and technology for DR and DM were acceptable (scores 4 and 3, respectively); however, there were concerns about the appropriate distribution and utilization of resources and out-of-pocket costs paid by patients., Conclusion: The existence of national policies, programs, a qualified workforce, and modern technology is promising. Nevertheless, other aspects of the health system need to be improved to ensure access to health and eye care for people with DM and achieve universal health coverage.

Purpose: To describe prophylactic patterns employed against endophthalmitis after cataract surgery in Iran., Methods: This cross-sectional study included 486 ophthalmologists filling in a self-administered questionnaire during the 20(th) Annual Congress of the Iranian Society of Ophthalmology in December 2010, Tehran, working in both private and academic medical centers. Prophylactic measures used preoperatively, intraoperatively and postoperatively and self-reported rates of endophthalmitis were assessed as the main outcome measurements., Results: In the preoperative phase, 75.5% of surgeons used povidone-iodine in the conjunctival sac and 71.4% of them did not use antibiotics. The rate of intraoperative prophylaxis was 61.9% either in the form of intracameral antibiotics or subconjunctival injection (mostly cephazolin or gentamicin). Only 7.8% of participants used intracameral cephalosporins. Postoperative antibiotics [mostly chloramphenicol (57%) and ciprofloxacin (28%)] were used by 94.2% of surgeons. On average, ten years of practice were required to observe one case of endophthalmitis., Conclusion: The surgeons in present setting used various prophylactic regimens against endophthalmitis after cataract surgery. Setting a local and evidence-based clinical practice guideline seems necessary.

Purpose: To determine general awareness and knowledge about cataracts, glaucoma and diabetic retinopathy (DR), as common avoidable causes of blindness in an Iranian population., Methods: This cross-sectional population-based survey was performed on residents over 45 years of age in Tehran. The sampling frame was the list of all landline phone numbers registered by the Telecommunications Center of Iran, through which systematic random sampling was performed. Data was collected by phone-call interviews and completing a semi-structured questionnaire. Awareness was defined as whether the respondent had ever heard of the disease. Knowledge was assessed by realizing different aspects of each disease., Results: Of a total of 1,084 eligible people including 574 (52.9%) women and 510 (47.1%) men were included and 957 subjects (response rate, 88.3%) completed the interview. Awareness regarding glaucoma, cataract and DR was 46.6% (95% confidence interval [CI]:43.4 -49.8%), 82.9% (95% CI: 80.5 -85.3%) and 86.2% (95% CI: 84-88.4%). In addition, 19.2% (95% CI: 16.7 -21.7%), 57.3% (95% CI: 54.2-60.4%) and 72% (95% CI: 69.2 -74.8%) of respondents could give at least a basic definition of the mentioned diseases, respectively. Only 22.6% (95% CI: 20-25.2%) and 41.6% (95% CI: 38.5-44.7%) realized glaucoma and DR as a treatable condition; in contrast, 77.2% (95% CI: 74.5-79.9%) categorized cataract as treatable. Only 19% and 7.1% knew that DR and glaucoma may commence without any apparent symptoms., Conclusion: Compared with cataract and DR, most participants had limited information about glaucoma. In addition, few of the respondents were familiar with the initial symptoms of DR and glaucoma.