Psychological impact of COVID-19 on ophthalmologists-in-training and practising ophthalmologists in India.

Purpose: To evaluate the psychological impact of the COVID 19 crisis on ophthalmologists-in-training and practising ophthalmologists during lockdown in India. Methods: An online survey was completed by ophthalmologists and ophthalmology trainees during the lockdown. The information collected included demographics (age, gender), domicile (state, union territory), current professional status (in training or practising), type of practice (solo, group, institutional, governmental, non-governmental), marital status (married, single), impact of COVID-19 on their training or practice, and impact on income and ability to meet living expenses. Psychological distress was assessed using the Patient Health Questionnaire-9 (PHQ-9). Results: In all, 2,355 ophthalmologists responded. Mean age was 42.5 (range, 25-82 years; SD, 12.05) years. Of these, 1,332 (56.7%) were males; 475 (20.2%) were still not in practice; 366 (15.5%) were single; 1,244 (52.8%) felt that COVID-19 would impact on their training or professional work; and 869 (37%) had difficulty in meeting their living expenses. The mean PHQ-9 score was 3.98 (range, 0-27; SD, 4.65). In terms of psychological impact, 768 (32.6%) had some degree of depression; mild in 504 (21.4%), moderate in 163 (6.9%), and severe in 101 (4.3%). Multivariable analysis showed that depression was significantly higher at younger age. The odds of depression decreased by 3% with 1 year increase in age. It was higher in non-practicing ophthalmologists, especially those who were considerably worried about their training or professional growth, and those with difficulty in meeting living expenses. Conclusion: A strikingly high proportion of ophthalmologists are psychologically affected and may require personalized mental health care.

Causes of vision impairment and blindness among children in schools for the blind in South Indian States of Andhra Pradesh and Telangana.

Purpose: To study the causes of severe vision impairment (SVI) and blindness among children in Andhra Pradesh (AP) and Telangana State (TS) in South India. Methods: A total of 299 children from 10 schools for the blind were examined between January and December 2017. The schools were chosen from 3 districts of AP (Guntur, Krishna and West Godavari) and 2 districts of TS (Adilabad and Mahabubnagar). The World Health Organization Prevention of Blindness' eye examination protocol for children with blindness or visual impairment (VI) was followed. Results: Based on presenting visual acuity (PVA), 248 children (82.9%) were blind, 16 children (5.3%) had SVI, 18 (6%) had moderate VI, and 17 (5.7%) were normal. The most common anatomical cause of blindness or SVI was whole globe anomaly (32%), followed by an abnormality in the retina and vitreous (26.6%). While whole globe anomalies were high both in AP (33.8%) and TS (21.6%), lens-related pathologies were higher in TS (29.7%) and retina-related abnormalities were higher in AP (29.3%). The most common cause was related to heredity (40.5%). Etiology was unknown in 33.5% of cases. Overall, 37.1% of the causes were avoidable. In AP, 33.4% were avoidable whereas in TS nearly 60% were avoidable. Conclusion: Whole globe anomaly constitutes a major cause of SVI and blindness, especially in AP. Lens-related pathologies were higher in TS. Nearly 40% of the causes were avoidable. Hence, robust screening methods and strategies must be established for timely intervention to reduce the burden on VI in children.