Endothelial dysfunction after scleral lens use in patients with herpetic eye diseaseHerpes simplex virus and varicella zoster virus (VZV) affect approximately 4 billion individuals globally. When the infection involves the ophthalmic division of the trigeminal nerve (V1), they are termed “herpetic keratitis” (HK) and “herpes zoster ophthalmicus” (HZO). The estimated incidence of VZV is 4/1000 people, with approximately 10–20% of cases demonstrating ocular involvement.1 HK has been approximated to affect 1.5 million people with an estimated incidence of 11.8/100,000. Together, these are thought to be the leading cause of infectious ocular blindness in the developed world.
National survey of Canadian Retina Society members on guidelines for ophthalmic care during the COVID-19 crisis: Canadian Retina Research Network (CR2N) COVID-19 Steering Committee analysisAn anonymous survey was designed by the Canadian Retina Research Network coronavirus disease 2019 (COVID-19) Steering Committee to assess awareness of, confidence in, and adherence to recent guidelines released by the Canadian Ophthalmology Society (COS) and Canadian Retina Society (CRS) for ophthalmic care during the COVID-19 pandemic.1,2 The survey was pilot-tested and validated with 9 content experts. It was then distributed via email to physician members of the CRS in May 2020 with one reminder email to maximize response rate.
Face and content validity of the SimulEYE A-Vit model for anterior vitrectomyThe ability to perform a successful anterior vitrectomy is a necessary skill for any cataract surgeon due to the nontrivial rate of posterior capsular rupture (PCR). PCR has been reported to occur in up to 5.2% of recent North American phacoemulsification surgeries, though estimates as high as 8.9% have been reported for inexperienced practitioners.1–3 PCR causing vitreous loss is associated with increased risk of complications, including retinal detachment, cystoid macular edema, and endophthalmitis.
National Ophthalmologist Wellness Survey (NOWS) 2019Recognizing the importance of physician health and wellness, and its impact on patient care and productivity, in 2017 the Canadian Medical Association (CMA) launched the online National Physician Health Survey (NPHS)1 to obtain data on the health and wellness of Canadian doctors. Although ophthalmologists who were members of the CMA were invited to participate, there was no specific category dedicated to ophthalmology. Instead, it was placed under the umbrella of surgical specialties. Due to unique differences in ophthalmology from other surgical specialties (including the fact that a significant number of ophthalmologists do not have a surgical practice),2 the authors believed that there is a need to obtain Canadian data specific to ophthalmology.
Physicians' access to primary care: results from the Canadian Medical Association National Physician Health SurveyHistorically, the medical culture has promoted a climate of self-sacrifice, with a prioritization of patient needs above all else—including physicians’ own self-care.1 The 2017 Canadian Medical Association (CMA) National Physician Health Survey revealed 30% burnout, 34% depression (screening), and 19% lifetime suicidal ideation in Canadian residents and physicians (N = 2947).2 These results are concerning and highlight the need to shift the medical culture to support self-care, and for occupational barriers to access be addressed.
Management of patients with ocular neuropathic painThe cornea, although relatively small, measuring 11.5 mm in diameter and 0.5–0.8 mm in thickness, is one of the most densely innervated structures of the human body.1 The nerves of the cornea are susceptible to damage by noxious stimuli, resulting in perception of pain. If pain is apparent in response to benign stimuli, and/or beyond the phase of normal healing, this condition is aptly named “neuropathic pain.” Other terms used to describe this condition include “pain without stain,” “corneal neuralgia,” “keratoneuralgia,” and “corneal pain syndrome.” It has been demonstrated previously that development of keratoneuralgia can occur after iatrogenic intervention, systemic disease, and chronic dry eye.
Validity and reproducibility of ophthalmologist photo grading of diabetic retinopathy and glaucomaScreening for diabetic retinopathy (DR) is an important component of diabetes management to prevent vision loss, yet many diabetic patients do not receive screening eye examinations.1 Tele-ophthalmology programs administering fundus photographs offer a potential solution, and technological advances have made automated photo-interpretation a real possibility.2 Automated algorithms are typically trained on images whose disease status has been classified by a human, so the validity of human grading is important.
Anterior approach levatorpexy for correction of congenital ptosisWe describe a novel modification of levator advancement for congenital upper eyelid ptosis, in a case series. Written informed consent was obtained from all patients/parents. Local institutional review board approval was granted.