No abstract

Background: Glaucomas remain asymptomatic until severe, indicating that the actual number of affected individuals may be higher than those diagnosed. Objective: To study the clinical patterns of glaucoma cases in the Eastern Province of Saudi Arabia. Patients and Methods: This retrospective study was conducted at King Fahd Hospital of the University, Al-Khobar, and Dhahran Eye Specialist Hospital, Dhahran, Saudi Arabia. The medical records of all patients with glaucoma who visited these hospitals from January 2015 to December 2018 were critically reviewed. Data regarding patients' demographic characteristic, clinical data and their medical and surgical management techniques were collected and analyzed. Results: A total of 999 patients were included, of which 52.9% were males, 94.8% were Saudi, and the mean age was 58.8 years. Bilateral involvement was observed in 82.3% of cases. Primary open-angle glaucoma (POAG) was the most prevalent type of glaucoma (27.7%), followed by secondary glaucomas (26.7%), primary angle-closure glaucoma (PACG) (18.2%), primary congenital glaucoma (2.7%), and juvenile open-angle glaucoma (2.2%), which were the most frequent glaucoma subsets. Conclusion: The study population was most affected by POAG, secondary glaucomas and PACG. Knowledge regarding prevalence of glaucoma is important to plan services, allocate resources, and prevent blindness.

Objective: Evaluate the knowledge, attitudes, and practices of surgical loupes among ophthalmologists and determine the relationship between this tool and musculoskeletal disorders. Methods: An anonymous, internet-based survey via Google forms was distributed among ophthalmologists (trainees and consultants) working in Saudi Arabia between December 2020 and January 2021. Results: 93 surveys were completed, and 82% reported pain with operating during the past 12 months. Neck pain was reported in 87%, shoulder pain 81%, and lower back pain 73%. 68% chose to rest without seeking professional care. 47% of participants exercise regularly. 69% attributed the pain to “bending or twisting your neck.” 55% of surgeons owned loupes, only a third used loupes regularly. 40% indicated limited field of vision as the main limitation. Chi-Squared analysis showed that musculoskeletal (MSK) pain is a risk among all ophthalmic surgeons. It was more prevalent among surgeons with longer experience. Higher rates of pain noted with increased surgical volume and prolonged operating time. Additionally, more frequent loupe use was associated with an increased prevalence of pain. None were found to be statistically significant. Finally, the activity level was significantly associated with a lower prevalence of pain (P = 0.028). Conclusion: We established that the majority of participants experienced occupational MSK pain. Most participants owned loupes. Only a third used loupes regularly. This is most likely due to prolonged operating time, static positioning, and neck flexion, producing the “head forward” posture. Young ophthalmologists should be encouraged to apply ergonomic principles to safeguard against future MSK injuries.

Objective To determine the preference for dacryocystorhinostomy (DCR), patient selection criteria for endoscopic DCR, endoscopic DCR technique, and barriers to adoption of endoscopic DCR. Method Cross-sectional study conducted from May-December 2021. A survey was sent to oculoplastic surgeons. Questions on demographic characteristics, type of clinical practice, technique preferences, barriers and facilitators to adoption of endoscopic DCR were included. Results 245 participants completed the survey. Most respondents were located at an urban site (84%), were in private practice (66%), and had been in practice for more than 10 years (58.9%). Sixty one percent perform external DCR as the first line procedure for treating primary nasolacrimal duct obstruction. The most common factor influencing the surgeon's decision to perform endoscopic DCR was the patient's request (37%) followed by endonasal exam (32%). The most common barrier for not performing endoscopic DCR was the lack of experience and lack of training during fellowship (42%). The most worrisome complication for most respondents was failure of the procedure (48%), followed by bleeding (30.3%). Eighty one percent believe surgical mentorship and supervision during initial cases would facilitate endoscopic DCR learning. Conclusions External Dacryocystorhinostomy is the preferred technique for treating primary acquired nasolacrimal duct obstruction. Learning endoscopic DCR early during fellowship training and high surgical volume to improve the learning curve dramatically impacts the adoption of the procedure.