AJO International最新文献

{"title":"Barriers to access diabetic retinopathy treatment in Sri Lanka: A qualitative study","authors":"D. M. Mangala Dharmapriya Bandara Dhanapala ,&nbsp;Mapa Prabath Piyasena ,&nbsp;M. G. L. Mahesh Premarathna ,&nbsp;P. F. Supun Chameera Fonseka ,&nbsp;Sairuban K ,&nbsp;Niruththan K ,&nbsp;Jagjit Gilhotra ,&nbsp;Robert Casson ,&nbsp;Upul Senarath","doi":"10.1016/j.ajoint.2025.100157","DOIUrl":"10.1016/j.ajoint.2025.100157","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore patient and service provider perceptions on diabetic retinopathy (DR), its treatment and barriers faced by patients when accessing care, in order to develop strategies to improve uptake and outcomes of DR treatment care pathway.</div></div><div><h3>Study Design</h3><div>A qualitative study based on 12 focus group discussions (FGDs) and 8 semi-structured interviews (SSIs) was conducted.</div></div><div><h3>Methods</h3><div>Patients were selected from three treatment care pathways: intra-vitreal injections, laser photocoagulation and vitrectomy in a tertiary care public eye hospital. Separate FGDs were conducted for males and females, as well as Sinhalese and Tamil patients, within each treatment method to examine how gender and ethnicity influenced treatment experiences and health seeking behavior. FGDs were conducted in the two main native languages separately by two experienced sociologists. The SSIs were conducted with doctors and nurses in a language preferred by each healthcare worker. A pre-defined topic guide was used in the conduction of FGDs and SSIs. The recordings of these FGDs and SSIs were transcribed and subsequently used to conduct a thematic analysis using the Socio-Ecological Model and the health systems approach as a guide. Recurring concepts were identified by review of the transcripts which informed the development of a thematic code book.</div></div><div><h3>Results</h3><div>A total of 73 patients participated in the FGDs with a majority being male (54.7 %, <em>n</em> = 40) while Sinhala was the language spoken by most (60.2 %, <em>n</em> = 44). A total of four doctors and four nurses were interviewed in the SSIs. The lack of knowledge on diabetes, DR and DR treatment modalities was identified as a key barrier to seeking early care and a significant contributor to patient dissatisfaction. In addition, inadequacy of infrastructure, lack of wayfinding signage systems in the hospital, behavior of healthcare assistants, discrimination, long waiting times, postponement of surgeries and inadequacy of information given by doctors were among many other sub-themes that were identified as barriers. Interviews with healthcare workers revealed lack of public awareness, overcrowding, lack of proper referral systems and inadequacy of opportunities for continuous professional development as major barriers.</div></div><div><h3>Conclusion</h3><div>Multi-dimensional factors at all levels of the Socio-Ecological Model were found to act as barriers to patient care, principal among which was the lack of knowledge among patients on the impact of diabetes on the eye. Tailormade strategies to address these barriers should be implemented in order to improve quality of care. Patient education, staff training and infrastructure development should be the cornerstones among such measures.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 3","pages":"Article 100157"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and phase-related changes in dry eye symptoms among Vietnamese medical students","authors":"Huong T. Vu ,&nbsp;Thanh D.L. Bui ,&nbsp;Hai T. Le","doi":"10.1016/j.ajoint.2025.100156","DOIUrl":"10.1016/j.ajoint.2025.100156","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the prevalence of dry eye (DE) symptoms among Vietnamese medical students, with a focus on differences across academic years and changes associated with an inter-semester break.</div></div><div><h3>Design</h3><div>Cross-sectional, observational study.</div></div><div><h3>Methods</h3><div>A total of 405 medical students (Years 1–6) at Pham Ngoc Thach University of Medicine, Vietnam, completed the Ocular Surface Disease Index (OSDI) questionnaire at two time points: during a four-week inter-semester break (Phase 1) and one week after returning to academic activities (Phase 2). Participants also reported their average daily study duration using digital and printed materials. Dry eye prevalence (OSDI &gt;13) and severity were analysed using multivariable models, including modified Poisson regression and cumulative logit models, adjusting for demographic, clinical, and behavioural covariates.</div></div><div><h3>Results</h3><div>DE symptom prevalence was high at both time points, increasing from 77.8 % in Phase 1 to 88.6 % in Phase 2 (<em>p</em> &lt; 0.001). A significant rise in OSDI scores was observed in Phase 2, particularly among pre-clinical students (Years 1–3), who showed higher odds of more severe symptoms compared to clinical-year students. The most affected symptom domains included visual function and environmental triggers, with “windy conditions” and screen-related tasks frequently reported as aggravating factors. Study duration did not differ significantly between phases.</div></div><div><h3>Conclusion</h3><div>Dry eye symptoms are highly prevalent among medical students and worsen following academic resumption, especially in junior cohorts. Persistent visual strain and environmental exposures may contribute. Interventions targeting modifiable risk factors are warranted to support ocular health and academic performance.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 3","pages":"Article 100156"},"PeriodicalIF":0.0,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fundus photograph interpretation of common retinal disorders by artificial intelligence chatbots","authors":"Andrew Mihalache ,&nbsp;Ryan S. Huang ,&nbsp;Marko M. Popovic ,&nbsp;Peng Yan ,&nbsp;Rajeev H. Muni ,&nbsp;Suber S. Huang ,&nbsp;David T. Wong","doi":"10.1016/j.ajoint.2025.100154","DOIUrl":"10.1016/j.ajoint.2025.100154","url":null,"abstract":"<div><h3>Purpose</h3><div>While previous studies have examined the ability of artificial intelligence (AI) chatbots to interpret optical coherence tomography scans, their performance in interpreting fundus photographs of retinal disorders without text-based context remains unexplored. This study aims to evaluate the ability of three widely used AI chatbots to accurately diagnose common retinal disorders from fundus photographs in the absence of text-based context.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Methods</h3><div>We prompted ChatGPT-4, Gemini, and Copilot, with a set of 50 fundus photographs from the American Society of Retina Specialists Retina Image Bank® in March 2024, comprising age-related macular degeneration, diabetic retinopathy, epiretinal membrane, retinal vein occlusion, and retinal detachment. Chatbots were re-prompted four times using the same images throughout June 2024. The primary endpoint was the proportion of each chatbot’s correct diagnoses. No text-based guidance was provided.</div></div><div><h3>Results</h3><div>In March 2024, Gemini provided a correct diagnosis for 17 (34 %, 95 % CI: 21–49 %) fundus images, ChatGPT-4 for 16 (32 %, 95 % CI: 20–47 %), and Copilot for 9 (18 %, 95 % CI: 9–31 %) (<em>p</em> &gt; 0.05). In June 2024, Gemini provided a correct diagnosis for 122 (61 %, 95 % CI: 53–67 %) images, ChatGPT-4 for 101 (51 %, 95 % CI: 43–58 %), and Copilot for 57 (29 %, 95 % CI: 22–35 %).</div></div><div><h3>Conclusion</h3><div>No AI chatbot use in this study was sufficiently accurate for the diagnosis of common retinal disorders from fundus photographs. AI chatbots should not currently be utilized in any clinical setting involving fundus images, given concerns for accuracy and bioethical considerations.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 3","pages":"Article 100154"},"PeriodicalIF":0.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of neutrophil-to-lymphocyte ratio and neutrophil activation with treatment response in neovascular AMD","authors":"Alexander Kai Thomsen ,&nbsp;Maria Abildgaard Steffensen ,&nbsp;Kathrine Gotfredsen ,&nbsp;Henrik Vorum ,&nbsp;Bent Honoré ,&nbsp;Mogens Holst Nissen ,&nbsp;Torben Lykke Sørensen","doi":"10.1016/j.ajoint.2025.100155","DOIUrl":"10.1016/j.ajoint.2025.100155","url":null,"abstract":"<div><h3>Purpose</h3><div>The neutrophil-to-lymphocyte ratio (NLR) and alterations of activation surface markers on circulating neutrophils have been suggested to be involved in the pathogenesis of age-related macular degeneration (AMD). The aim of this study was to investigate the relationship between NLR, activation surface markers on neutrophils, AMD stage, and treatment response in neovascular AMD (nAMD).</div></div><div><h3>Design</h3><div>Prospective cohort study.</div></div><div><h3>Methods</h3><div>Treatment-naïve nAMD patients, intermediate AMD (iAMD) patients, and healthy controls were consecutively enrolled. Treatment response in nAMD patients was categorized as good, partial and poor based on change of retinal fluid and central retinal thickness. Treatment response was evaluated after the loading phase and after one year of treatment with aflibercept 2 mg. NLR and activation surface markers on circulating neutrophils (CD11a, CD11b, CD31, CD66b, CD162, and CD182) were examined with flow cytometry. NLR and activation surface markers were compared between healthy controls, iAMD, and nAMD patients, as well as between nAMD treatment response groups. Polymorphisms in the CFH and ARMS2 genes were compared to NLR and the surface markers in nAMD patients.</div></div><div><h3>Results</h3><div>NLR was significantly elevated in nAMD patients compared to healthy controls (<em>P</em> &lt; 0.001). nAMD patients with poor 1-year treatment response had a significantly higher NLR compared to good 1-year treatment responders. Expression levels of CD11a, CD11b, CD31, CD66b, CD162, and CD182 on circulating neutrophils were elevated in nAMD patients compared to healthy controls (all <em>P</em> &lt; 0.05), however no significant differences were found between nAMD treatment response groups. No significant associations were found between CFH or ARMS2 genotypes with NLR or neutrophil surface markers in nAMD patients.</div></div><div><h3>Conclusion</h3><div>Elevated NLR was associated with a poor 1-year treatment response. The NLR and expression levels of activation surface markers on circulating neutrophils were significantly elevated in treatment-naïve nAMD patients compared to healthy controls.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 3","pages":"Article 100155"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The implementation of artificial intelligence driven diabetic retinopathy screening in a district hospital in Myanmar: a pilot study","authors":"Mya Wut Yee Soe ,&nbsp;Jasmine Ge ,&nbsp;Kan Htoo Aung ,&nbsp;Su Mon La ,&nbsp;Anna CS Tan","doi":"10.1016/j.ajoint.2025.100149","DOIUrl":"10.1016/j.ajoint.2025.100149","url":null,"abstract":"<div><h3>Purpose</h3><div>Diabetic retinopathy (DR) causes irreversible blindness. Early detection and timely treatment can prevent blindness. However, manpower and access to DR screening is challenging in remote areas. This study aims to validate and assess the acceptability of artificial intelligence assisted diabetic retinopathy screening (AI-DRS) versus standard care (SC) with slit lamp examination.</div></div><div><h3>Design</h3><div>This was a cross sectional, comparative cohort study.</div></div><div><h3>Methods</h3><div>All patients underwent a mydriatic two-field fundus photography, automatically analyzed by the AI and a dilated clinical fundus examination by a consultant ophthalmologist, blinded to the AI-DRS results. The primary outcome measure was the agreement between AI-DRS (Singapore Eye Lesion Analyzer (SELENA+) performed with a portable fundus camera) and SC, measured by sensitivity, specificity and kappa indices. Questionnaires were administered to test acceptability of AI-DRS.</div></div><div><h3>Results</h3><div>414 eyes of 207 patients (mean age 60.13, SD=9.39), male (20.3 %) and female (79.7 %) were screened. AI-DRS versus SC had a sensitivity of 85 % and specificity of 100 % with high agreement (kappa value 0.915 (<em>p</em> &lt; 0.001)). Comparing AI-DRS versus SC, 350 versus 362 eyes had no DR/mild DR, 6 versus 7 eyes had moderate/severe non-proliferative DR(NPDR), 6 versus 7 had proliferative DR(PDR). AI-DRS had more ungradable eyes versus SC (52 versus 39 eyes). Questionnaires showed 98.6 % of patients found AI-DRS acceptable.</div></div><div><h3>Conclusion</h3><div>The AI-DRS is a valid method of DR screening in suburban Myanmar populations with high rates of acceptability, may improve access and coverage of DR screening services for Myanmar and in other similar settings.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 3","pages":"Article 100149"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144572406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consistency of conflict of interest disclosures across two major ophthalmology conferences","authors":"Justin Grad ,&nbsp;Amin Hatamnejad ,&nbsp;Akashdeep Grewal ,&nbsp;Chryssa McAlister","doi":"10.1016/j.ajoint.2025.100153","DOIUrl":"10.1016/j.ajoint.2025.100153","url":null,"abstract":"<div><h3>Purpose</h3><div>To quantitatively assess the consistency of conflict of interest (COI) disclosures among presenters at two major ophthalmology conferences and to analyze trends in COI reporting over a span of four years.</div></div><div><h3>Design</h3><div>A retrospective cross-sectional study.</div></div><div><h3>Participants</h3><div>Presenters at the American Academy of Ophthalmology (AAO) and the American Society of Cataract and Refractive Surgery (ASCRS) annual meetings in 2018 and 2021/2022.</div></div><div><h3>Methods</h3><div>Publicly available COI disclosures from presenters at the AAO and ASCRS meetings were extracted and compared. The disclosures of individuals presenting at both AAO and ASCRS were analyzed, focusing on whether COIs were reported consistently across both meetings.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome was the presence of discrepancies in COI disclosures amongst individuals who presented at the two selected ophthalmology conferences within the same year.</div></div><div><h3>Results</h3><div>Among the 260 presenters who participated in both AAO 2021 and ASCRS 2022, 95 (36.5 %) had identical disclosures, while 150 (57.7 %) exhibited at least one discrepancy. On average, these presenters had 11.23 ± 14.63 disclosures at AAO and 9.88 ± 14.68 disclosures at ASCRS. Similarly, of the 432 presenters at both AAO 2018 and ASCRS 2018, 203 (47.0 %) had consistent disclosures, while 213 (49.5 %) displayed discrepancies. On average, these presenters had 13.16 ± 19.75 disclosures at AAO and 12.49 ± 15.61 disclosures at ASCRS.</div></div><div><h3>Conclusions</h3><div>Significant inconsistencies in COI disclosures were observed among presenters at major ophthalmology conferences within the same year. Nearly half of the presenters exhibited discrepancies in their disclosures, with a notable portion disclosing COIs at one conference but not the other. These findings underscore the need for standardized COI reporting systems with more rigorous verification processes to ensure transparency and trustworthiness in medical conference presentations.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 3","pages":"Article 100153"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144557325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A real-world pharmacovigilance analysis of the risk of retinal artery occlusion from medication use","authors":"Andrew Mihalache ,&nbsp;Ryan S. Huang ,&nbsp;Marko M. Popovic ,&nbsp;Kirill Zaslavsky ,&nbsp;David Sarraf ,&nbsp;SriniVas R. Sadda ,&nbsp;Rajeev H. Muni ,&nbsp;Edward A. Margolin","doi":"10.1016/j.ajoint.2025.100152","DOIUrl":"10.1016/j.ajoint.2025.100152","url":null,"abstract":"<div><h3>Purpose</h3><div>The risk of retinal artery occlusion (RAO) as related to specific drug use is unclear. Using the Food and Drug Administration Adverse Event Reporting System (FAERS), we aimed to comprehensively elicit a list of FDA-approved drugs overreported for RAO.</div></div><div><h3>Design</h3><div>Retrospective, population-based pharmacovigilance study.</div></div><div><h3>Methods</h3><div>Pharmacovigilance data were sourced from the FAERS database between October 2003 and March 2024 using Open Vigil 2.1 (Kiel, Germany) software. FDA-approved pharmacological agents which were recorded as the primary suspect drug for at least 10 reports of RAO were included. Disproportionality analyses were performed to identify positive adverse drug reaction signals by comparing drug-specific reports of RAO to the background rate of RAO reports across all other drugs in the database.</div></div><div><h3>Results</h3><div>Out of 12,345,128 adverse events reported to the FAERS database during the study period, 1,461 (0.01 %) were identified as cases of RAO. Most primary suspect drugs were indicated for eye disorders (20.7 %, <em>n</em> = 303/1,461), neoplasms (11.4 %, <em>n</em> = 166/1,461), or musculoskeletal and connective tissue disorders (7.2 %, <em>n</em> = 105/1,461). Notably, brolucizumab and tranexamic acid were significantly overreported for RAO events. These were followed by melphalan, triamcinolone, aflibercept, ranibizumab, lidocaine, sildenafil, epinephrine, bupivacaine, and rofecoxib.</div></div><div><h3>Conclusion</h3><div>Several primary suspect drugs showed disproportionately high reports of RAO in the FAERS database; however, some of these medications are indicated for conditions associated with a hypercoagulable state, a significant risk factor for RAO. These findings underscore the need for continued pharmacovigilance efforts to distinguish potential drug-related effects from the influence of underlying disease.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 3","pages":"Article 100152"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding surgical training access: A phacoemulsification course via Orbis Cybersight","authors":"Fatma Shakarchi,&nbsp;Ayorinde Cooley,&nbsp;Curtis R Martin,&nbsp;Traeson Brandenburg,&nbsp;Nicolas Zaunbrecher,&nbsp;Christopher L Shelby,&nbsp;Stephen A LoBue,&nbsp;Wyche T Coleman III","doi":"10.1016/j.ajoint.2025.100151","DOIUrl":"10.1016/j.ajoint.2025.100151","url":null,"abstract":"<div><h3>Purpose</h3><div>To highlight the potential of openly accessible online surgical courses in strengthening global ophthalmic education. We demonstrate a case study focusing on a basic phacoemulsification training course published on Orbis Cybersight, designed to support early surgical learning for ophthalmologists worldwide.</div></div><div><h3>Methods</h3><div>We developed a one-hour, self-paced online course on the basics of phacoemulsification, split into six narrated modules: Incisions, Capsulorhexis, Hydrodissection, Nucleus Removal, Cortex Removal, and IOL Insertion &amp; Wound Closure. We included quizzes for self-testing in every module. We published the course on Orbis Cybersight, a global telemedicine and training platform, and made it freely available on demand. We analyzed engagement patterns and gathered informal feedback from trainees and educators across different regions.</div></div><div><h3>Results</h3><div>The course was accessed by over 5,000 participants based in 162 countries across all seven continents, including Antarctica, working in diverse high-, middle-, and low-income settings. Most participants were ophthalmologists (2,238; 44.4 %), ophthalmology residents (837; 16.6 %), and optometrists (484; 9.6 %), while nearly 20 % (963) represented a variety of other professions, including drivers, teachers, medical students, and security guards. Approximately 1,340 participants (26.6 %) completed the course, while 2,709 (53.6 %) marked it as “in progress.” On average, participants made about five access attempts and spent a mean of 83.63 minutes to complete the course. The optional pre- and post-course quizzes showed a 39.5 % increase in participation and a 35 % relative increase in knowledge acquisition after completing the course.</div></div><div><h3>Conclusions</h3><div>Open-access platforms like Orbis Cybersight can play a key role in delivering foundational surgical education. These platforms help bridge gaps in training and promote equity in surgical education. They are impactful for sharing complex cases and essential foundational learning, without adding a financial burden for trainees globally. Our case study offers a scalable, low-cost way to help global trainees gain exposure to essential surgical steps and concepts.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 3","pages":"Article 100151"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Second victim syndrome in ophthalmology: Contributory factors and insights from the first study","authors":"Chaimae Khodriss ,&nbsp;Hicham El Bouri ,&nbsp;Reda Benmerak ,&nbsp;Rachid Tahiri ,&nbsp;Jaafar Bendali ,&nbsp;Yassine Benhaddouch ,&nbsp;Adil El Ammouri ,&nbsp;Adil Najdi ,&nbsp;Meriem El Bahloul","doi":"10.1016/j.ajoint.2025.100150","DOIUrl":"10.1016/j.ajoint.2025.100150","url":null,"abstract":"<div><h3>Purpose</h3><div>Second Victim Syndrome (SVS) refers to the psychological, physical, and professional impact experienced by healthcare providers following involvement in an adverse patient event. This study aimed to assess the prevalence of SVS among Moroccan ophthalmologists and to identify the contributory factors associated with its occurrence.</div></div><div><h3>Design</h3><div>Cross-sectional survey</div></div><div><h3>Methods</h3><div>A 58-item web-based questionnaire was distributed via WhatsApp and e-mail to 764 registered members of the Moroccan Society of Ophthalmology, including trainees. The questionnaire was structured into three sections: demographic and practice characteristics, personal experience of intraoperative adverse events (IAEs), and assessment with the Second Victim Experience and Support Tool (SVEST). A two-step statistical analysis was performed. The first step was a descriptive analysis to calculate means and standard deviations for quantitative variables and proportions for qualitative variables. The second step was an analytical approach to compare means via ANOVA.</div></div><div><h3>Results</h3><div>In total, 217 complete responses were obtained, corresponding to a response rate of 28.4 %. The respondents were specialists (62.2 %) residents (26.3 %) and professors of medicine (11.5 %), and 51.6 % worked independently in the private sector. At least one IAE was reported by 94.5 % of the participants, 92.7 % of whom felt uncomfortable with these events. The mental burden of IAEs was described as exhausting by 70.7 % of respondents, and 44.9 % reported doubting their own professional skills after an IAE. Colleagues were identified as the most effective source of support, with 75.1 % of respondents considering peer interactions helpful. Vulnerability to second victim syndrome was highest among female practitioners (<em>p</em> = 0.027), private sector physicians (<em>p</em> = 0.005), and those with less than five years of surgical experience (<em>p</em> = 0.002).</div></div><div><h3>Conclusion</h3><div>This study highlights a concerning prevalence of second victim syndrome among Moroccan ophthalmologists. Prioritizing the establishment of preventive programs, peer support groups, and dedicated psychological support structures is crucial to safeguard the mental well-being of ophthalmologists and, by extension, to ensure a high quality of patient care.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 3","pages":"Article 100150"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144479987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eye health in post-conflict and climate-vulnerable settings: Iraq as a case study for equitable, integrated primary eye care","authors":"Fatma Shakarchi","doi":"10.1016/j.ajoint.2025.100148","DOIUrl":"10.1016/j.ajoint.2025.100148","url":null,"abstract":"<div><h3>Purpose</h3><div>Vision impairment affects one in four individuals globally, disproportionately affecting low- and middle-income countries, particularly in conflict- and climate-affected settings. This brief communication uses Iraq as a case study to examine how these intersecting challenges impact eye health systems. We also aim to identify strategies for strengthening equitable, integrated primary eye health.</div></div><div><h3>Design</h3><div>A narrative case study.</div></div><div><h3>Methods</h3><div>We analyzed national health data, health system reports, and international comparator models to assess how eye care services are distributed, accessed, and integrated within Iraq’s primary healthcare system. Special attention was given to socioeconomic disparities, post-conflict infrastructure, and climate vulnerability.</div></div><div><h3>Findings</h3><div>Only 2 % of Iraq’s primary health centers offer eye-related services, which contributes to overburdened tertiary hospitals, and more than half of hospital consultations are for conditions manageable at the primary level.<span><span>¹</span></span> Access is further limited by financial barriers, uneven geographic distribution of specialists, and lack of insurance coverage. Eye health integration into primary healthcare is hindered by systemic and resource limitations.</div></div><div><h3>Conclusions</h3><div>Iraq’s experience highlights the urgent need for equitable, community-based eye care systems in fragile settings. Addressing these gaps is essential for advancing universal health coverage and meeting global development goals.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 3","pages":"Article 100148"},"PeriodicalIF":0.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144364888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}