Background: Ispahani Islamia Eye Institute and Hospital (IIEIH) is a leading ROP screening center in Bangladesh. The study had an aim to analyze the characteristics of referred babies and identify possible bottlenecks. Methods : Electronic records of babies referred to IIEIH for a period of three years (2016-2918) were analyzed retrospectively. All the babies registered in the electronic file were screened by any of the three consultants with keen interest in ROP. Variables of interest were ROP stage, gestational age, birth weight, time to screening, referring institution and treatment modalities (laser, Anti-VEGF, retina surgery or combination). Data were exported to SPSS version 23 for Mac for descriptive and correlation analysis. P-value less than 0.05 was considered statistically significant. Results: 887 babies with ROP stage 1 or above were registered, a large majority were referred by private institutions (75%), 60% of babies were moderate pre-terms according to WHO classification, the mean birth weight was 1563±397.1 grams. ROP was largely stage 2 (37%) and 61% of babies had at least one treatment modality. The younger the gestational age and the lower the birth weight, the higher the risk of presenting with ROP with advanced stage. Conclusion : The majority of babies with ROP came from private institutions and more than half of them needed at least one treatment modality. We recommend a large study to analyze the incidence and availability of ROP services in public hospitals. Key words : Retinopathy of prematurity, screening, treatment options, Referrals

Purpose: To audit phacoemulsification cataract surgeries performed independently after a short - term training completed in a rural hospital in Kenya, and to benchmark the outcomes against WHO recommendations. Methods: This retrospective case-series study recruited patients who had had phacoemulsification cataract surgery at Sabatia Eye Hospital from January to December 2018. All the surgeries were performed by a single surgeon following a brief training in the same center. Data were collected retrospectively using a detailed questionnaire. Results: Of the one hundred and twenty eyes operated on during this period, one-hundred and sixteen eyes of 86 patients met the inclusion criteria. The mean age was 62 years and the majority of the eyes (83.6%) had vision less than 6/18 preoperatively. Co-morbidities included diabetic retinopathy (3.4%), age-related macular degeneration (2.6%), trauma (1.7%) and glaucoma (0.9%). Surgical complications were not severe enough to affect the final best-corrected visual acuity, unlike the comorbidities that were negatively correlated with visual outcomes (p-value< 0.001). Good outcomes were 81% against a WHO target of 80% for uncorrected visual acuity category, and 96.6% in the best-corrected visual acuity category against a target of 90%. The Royal College of Ophthalmology database of cataract surgery outcomes and the European Registry of Quality Outcomes for cataract and refractive surgery had comparable results. Conclusions: This local training model was based on apprenticeship and skills transfer. It can achieve high-quality visual outcomes meeting WHO recommendations.

Although rare, dengue fever-associated ocular manifestations are a valid cause of visual impairment. Clinicians usually have a dilemma between vitrectomy and medical management if there is an associated vitreous hemorrhage. Vitrectomy has been rarely reported previously in the management of vitreous hemorrhage secondary to dengue fever.We report a case of a young adult who presented with bilateral vitreous hemorrhages. The diagnosis of dengue was confirmed by serology and a typical epidemiological context. The patient presented already having undergone yttrium aluminum garnet (YAG) laser hyaloidotomy for preretinal hemorrhage in the other eye, with a subsequent vitreous spread of the hemorrhage. Vitrectomy with internal limiting membrane (ILM) peeling was performed for the affected eye and the visual acuity was fully regained after a few weeks.Dengue fever can present with dense or sub-ILM hemorrhages. In our case, the vision quickly recovered after vitrectomy and ILM peeling. We, therefore, recommend early vitrectomy in cases with vitreous hemorrhage associated with sub-ILM involvement so as not to delay visual recovery.