Purpose:Keratoplasty patients require regular and timely follow-ups. During this COVID-19 pandemic which restricted global travel, we developed a novel real-time, hybrid teleophthalmology approach to comanage international keratoplasty patients between Singapore and Indonesia.Methods:A retrospective consecutive observational study of 72 corneal patients (63 were postkeratoplasty) who attended a virtual corneal clinic (VCC) between June 2020 and April 2021 at JEC Eye Hospitals (JEC) in Jakarta, Indonesia. ZOOM Meeting software (Zoom Video Communication Inc, San Jose, CA) was used to simultaneously connect the Singapore corneal specialist at Eye & Cornea Surgeons (ECS), Singapore, using a real-time approach. Clinical examinations included full panels of video-linked corneal, glaucoma, and retinal imaging and investigations performed before real-time video-linked slit-lamp examination, with immediate clinical decision making between corneal specialists and patients.Results:VCC enabled effective real-time clinical evaluation and collaborative clinical decisions, with full patient interaction, with the aim of maintenance of graft clarity, visual function, and management of comorbidities—a) topical and systemic medications were adjusted in 79.2% of patients; b) further referrals to glaucoma, retinal, and oculoplastic subspecialists were made in 16.6% of cases; c) additional adjunctive surgical procedures were performed at JEC in 6.9% cases; and d) government permission was obtained for 4 patients (5.6%) to fly to Singapore for urgent corneal surgery.Conclusions:The virtual corneal clinic is a novel real-time hybrid teleophthalmology approach which is effective in the comanagement of international keratoplasty patients and represents the advances in ophthalmic telemedicine.

To examine the demographics and outcome of management in patients admitted with sports-related eye injuries in one of Jakarta's eye hospitals. Methods: Retrospective analysis 24 patients who admitted to a tertiary eye hospital in Jakarta with sportsrelated eye injuries between 2014 to 2019 was conducted. Standard descriptive statistical methods were used for analysis. Results: Out of 534 patients admitted to our hospital with ocular trauma between 2014 to 2019, 24 patients (4.5%) had sport-related eye injuries. Most patients were male (17/24, 70.8%), below 25 years old (18/24, 75%) and students (7/24, 29.2%) by occupation. The most common cause of injury was badminton (9/24, 37.5%) followed by ball games (6/24, 25%) and fishing (3/24, 12.5%). Most patients suffered from closed globe injuries (16/24, 66.7%). Anterior segment of the eye was mostly involved (16/24, 66.7%) with hyphema being the most common clinical presentation (11/24, 45.8%), followed by palpebrae edema (5/24, 20.8%). Patients were mostly admitted with moderate visual impairment (14/24, 58.3%). Most patients were managed by medical treatment (16/24, 66.7%) while those with more severe presentations underwent surgeries (7/24, 29.2%). Complications such as secondary glaucoma (1/24, 4.2%) and graft-rejection (1/24, 4.2%) were recorded. Conclusion:The incidence of sports-related eye injuries increases every year. Badminton was responsible for the most cases of sports-related eye injuries. These injuries could result in severe complications. Protective eyewear could prevent these injuries.

Intraocular foreign bodies (IOFBs) are the most common emergency cases in ophthalmology causing severe visual impairment to blindness. We present nine male patients with IOFBs, aged 28–64 years old, which displayed a wide spectrum of findings. Based on IOFB location, four cases were intravitreal, two were intraretinal, two were intralenticular and one was intracorneal. The most common material was metal, from hammering projectiles (six patients). The injuries mainly occurred at workplace (five patients). All IOFBs were successfully extracted. Initial visual acuity (VA) ranged from light perception to 20/32; six patients had better final VA, up to 20/20. A wide range of ocular manifestations is associated with IOFBs. Removing retained IOFB procedure is dependent on location, nature, lens opacity and vitreoretinal involvement. Meticulous ocular examination and imaging modality are vital to identify the IOFB presence. Various visual outcomes depend on zone involvement, IOFB size and level of difficulties of surgery.