ABSTRACT
Purpose: The eye surgeon's unique microsurgical skillset is developed over time from repeated and meticulous training on delicate ophthalmic tissue. The impact of COVID-19 on the delivery of regular ophthalmology services has impacted the exposure and available opportunities for skills development in the trainee. Adopting ophthalmic surgery teaching models and simulators as training resources provides solutions to enhance microsurgical skills of the trainee operating in a pandemic. Method(s): A literature search was performed to identify ophthalmic surgery skills training resources. We included prosthetic, harvested produce, non-live animal, and virtual reality and simulation devices. Human cadaveric models were excluded. Result(s): Several established and novel ophthalmic surgery training resources were identified. Low-cost prosthetic models and tissue substitutes are available to develop basic microsurgical and tissue handling skills. Harvested produce, non-live egg, porcine products, and sophisticated virtual reality devices imitate various aspects of ophthalmic tissue to allow simulation of ophthalmic surgery of varying complexity including cataract, corneal, glaucoma, vitreoretinal and strabismus surgeries. The use of ophthalmic skills training devices improved skills of trainee eye surgeons. Conclusion(s): A wide range of ophthalmic surgery training resources are available to both the individual trainee and the training organisation, and provide a wide range of accessible, evidenced solutions to augment surgical skill development not only during the pandemic but also beyond.
ABSTRACT
Purpose: The Royal Darwin Hospital's Department of Ophthalmology provide a regular outreach service to the remote communities of the Top End of the Northern Territory throughout the year. COVID-19 travel restrictions and community lockdowns has impacted the provision of scheduled outreach services typically provided to those patients residing in remote Top End communities. Method(s): A two-year retrospective analysis of patients booked into the Royal Darwin Hospital Department of Ophthalmology outreach clinics for consultations and procedures, over 2020 to 2021, were included. Records were used to identify outreach trips (number and location), patient demographics, waitlists, clinic attendance, intravitreal injections, and surgical procedures. Result(s): The Royal Darwin Hospital Department of Ophthalmology continued to provide outreach services to the remote Top End over 2020 and 2021. 6 remote communities were serviced in 2020, where 140 patients were reviewed. Eight communities were serviced in 2021, 113 patients were reviewed. Outreach services to Katherine Hospital and Gove District hospitals increased due to reduced community services. Two hundred and thirteen and 214 intravitreal injections were administered in 2020, and 2021 respectively. Total surgical procedures in 2020 and 2021 were similar, 68 and 70 respectively. Conclusion(s): The COVID-19 pandemic reduced the provision of regular outreach services provided by the Royal Darwin Hospital Ophthalmology Department, to the remote population of the Top End. Clinic reviews, intravitreal injections and surgical procedures continued at a reduced rate to the remote population of the top end.