Objectives: To measure the productivity of cataract surgeons in Africa and assess the factors that predict high productivity. Methods: A questionnaire on productivity and working environments was sent to all cataract surgeons trained in Malawi, Uganda, Tanzania, and Kenya. In addition, 2 meetings and in-depth discussions were held to elicit information on strategies to improve productivity among surgeons in general. Results: More than 77 000 cataract surgeries were performed in the years 2000 through 2004, resulting in an annual productivity rate of 243 surgeries per surgeon. Higher productivity was associated with having 2 or more cataract surgical sets, a well-functioning operating microscope, 3 or more nursing support staff, and a community program that includes transporting patients to the hospital. Conclusion: Strategies for training, supporting, and supervising cataract surgeons in Africa need to be revised to create conditions amenable to greater productivity.

Asian ancestry. Despite this, individuals of African ancestry remain understudied in genomic research for blinding disorders. OBJECTIVES To perform a genome-wide association study (GWAS) of African ancestry populations and evaluate potential mechanisms of pathogenesis for loci associated with primary open-angle glaucoma. DESIGN, SETTINGS, AND PARTICIPANTS A 2-stage GWAS with a discovery data set of 2320 individuals with primary open-angle glaucoma and 2121 control individuals without primary open-angle glaucoma. The validation stage included an additional 6937 affected individuals and 14 917 unaffected individuals using multicenter clinic-and population-based participant recruitment approaches. Study participants were recruited from

This study compared a novel low-cost solar powered direct ophthalmoscope called the Arclight with a traditional direct ophthalmoscope (TDO). After appropriate training, 25 Malawian eye healthcare workers were asked to examine 12 retinal images placed in a teaching manikin head with both the Arclight ophthalmoscope and a traditional direct ophthalmoscope (Keeler Professional V.2.8). Participants were scored on their ability to identify clinical signs, to make a diagnosis and how long they took to make a diagnosis. They were also asked to score each ophthalmoscope for ‘ease of use’. Statistically significant differences were found in favour of the Arclight in the number of clinical signs identified, correct diagnoses made and ease of use. The ophthalmoscopes were equally effective as a screening tool for diabetic retinopathy, and there was no statistically difference in time to diagnosis. The authors conclude that the Arclight offers an easy to use, low cost alternative to the traditional direct ophthalmoscope to meet the demands for screening and diagnosis of visually impairing eye disorders in low-income and middle-income countries.

The prevalence and causes of blindness and vision impairment in a refugee population are comparable with those of the general population. Lack of basic eye care services in the health center for refugees is a major concern. The health care facility in the settlement camp needs to be upgraded to provide comprehensive eye care including refractive care services.