Latin American ophthalmology practitioner's perception on current COVID-19 pandemic / Percepção do profissional latino-americano de oftalmologia sobre a atual pandemia de COVID-19

ABSTRACT Purpose: To assess the perception of Latin American ophthalmology practitioners regarding coronavirus disease 2019 (COVID-19) exposure risk, knowledge about personal protection measures, and prioritization of patients. Methods: Self-administered voluntary anonymous survey (Google Drive forms) was distributed via text message to ophthalmology practitioners from May 01 to May 05, 2020. Results: Three hundred seventy-one practitioners (45% response rate) comprising 118 (27.6%) residents, 111 (40.5%) ophthalmologists, and 142 (32.8%) sub-specialists completed the survey. Among them, 106 (32.6%) thought that they were at a high risk of acquiring COVID-19 during the course of work. Furthermore, 273 (69.1%) believed that the current guidelines were insufficient to identify COVID-19 patients. The survey also revealed that 265 (59.5%) were not trained to use personal protective equipment (PPE), and even with its correct use, 341 (91.5%) still felt that they were at risk of acquiring COVID-19. Moreover, 80% of the respondents were of the view that staff members were not knowledgeable about national protocols for attending COVID-19 patients. However, only 9 (2%) considered changing their profession to ameliorate COVID-19 contagion risk. Conclusion: This survey has revealed the issues faced by ophthalmology practitioners in Latin America during their routine practice. These concerns and anxiety about COVID- 19 pandemic seem to be the same worldwide. It is important to reinforce the confidence of ophthalmology practitioners on current guidelines for attending COVID-19 patients. It is also necessary to conduct training programs on PPE usage and ensure that PPE items are available at all times to enhance the quality of care and minimize the spread of the disease.

RESUMO Objetivos: Avaliar a percepção do risco de exposição da Doença de Coronavírus 2019 (COVID-19), conhecimento sobre medidas de proteção pessoal entre os profissionais de oftalmologia latino-americanos e priorização de pacientes com Covid-19. Métodos: Pesquisa anônima voluntária autoadministrada (formulários do Google Drive) distribuída por mensagem de texto para profissionais de oftalmologia em 1º a 5 de maio de 2020. Resultados: Trezentos e setenta e um profissionais completaram a pesquisa (taxa de resposta de 45%), composta por 118 residentes (27,6%), 111 oftalmologistas (40,5%) e 142 subespecialistas (32,8%). 106 profissionais (32,6%) sentiram-se em alto risco de adquirir o COVID-19 no trabalho. 273 (69,1%) acreditavam que as diretrizes atuais não são suficientes para identificar os pacientes com COVID-19. 265 (59,5%) não tinham treinamento para usar os equipamentos de proteção individual (EPI) e, mesmo com seu uso correto, 341 (91,5%) ainda se sentiram em risco de adquirir COVID-19. 80% consideraram que a equipe de trabalho não tem conhecimento de protocolos nacionais para o atendimento aos pacientes com COVID-19. Apenas 9 dos profissionais (2%) consideraram mudar a profissão para minimizar o risco de contágio por COVID-19. Conclusão: Esta pesquisa mostra a escassez de pessoal e treinamento específico que os praticantes de oftalmologia na América Latina enfrentam em sua prática diária. Essas preocupações e ansiedade parecem ser as mesmas em todo o mundo com a pandemia de COVID- 19. É importante reforçar a confiança dos profissionais de oftalmologia nas diretrizes atuais de atendimento ao paciente com COVID-19 e também disponibilizar programas de treinamento sobre o uso de EPI e também itens de EPI disponíveis em todos os momentos para garantir a qualidade do atendimento e a disseminação mínima da doença.

Latin American ophthalmology practitioner's perception on current COVID-19 pandemic.

PURPOSE: To assess the perception of Latin American ophthalmology practitioners regarding coronavirus disease 2019 (COVID-19) exposure risk, knowledge about personal protection measures, and prioritization of patients. METHODS: Self-administered voluntary anonymous survey (Google Drive forms) was distributed via text message to ophthalmology practitioners from May 01 to May 05, 2020. RESULTS: Three hundred seventy-one practitioners (45% response rate) comprising 118 (27.6%) residents, 111 (40.5%) ophthalmologists, and 142 (32.8%) sub-specialists completed the survey. Among them, 106 (32.6%) thought that they were at a high risk of acquiring COVID-19 during the course of work. Furthermore, 273 (69.1%) believed that the current guidelines were insufficient to identify COVID-19 patients. The survey also revealed that 265 (59.5%) were not trained to use personal protective equipment (PPE), and even with its correct use, 341 (91.5%) still felt that they were at risk of acquiring COVID-19. Moreover, 80% of the respondents were of the view that staff members were not knowledgeable about national protocols for attending COVID-19 patients. However, only 9 (2%) considered changing their profession to ameliorate COVID-19 contagion risk. CONCLUSION: This survey has revealed the issues faced by ophthalmology practitioners in Latin America during their routine practice. These concerns and anxiety about COVID- 19 pandemic seem to be the same worldwide. It is important to reinforce the confidence of ophthalmology practitioners on current guidelines for attending COVID-19 patients. It is also necessary to conduct training programs on PPE usage and ensure that PPE items are available at all times to enhance the quality of care and minimize the spread of the disease.

Muscle transposition for the treatment of paralytic strabismus. Retrospective review of 23 cases / Transposição muscular para o tratamento do estrabismo paralítico. Revisão retrospectiva de 23 casos

Abstract Introduction: Muscular transposition procedures are used when there is no ocular rotation in a particular direction due to alterations of the extraocular muscles such as paralysis, agenesis or congenital anomalies. The objective of this study is to characterize the patients treated with this procedure and determine the percentage of correction of the deviation angle obtained after surgery in the Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology Unit. "Dra. Ana María Illescas Putzeys", Hospital de ojos y oídos "Dr. Rodolfo Robles V. Methods: A retrospective, descriptive, observational study was conducted with review of records of patients operated on muscle transposition during the years 1999 to 2016. Results: Twenty-three rectus muscle transposition procedures were performed. Thirteen were male (56.5%). The mean age was 42 years. In our series, an average correction of 42 PD (82%) was obtained regardless of the type of paralysis or the surgical procedure performed. Conclusion: In selected cases of paralytic strabismus, the main approach may be only muscle transposition with augmentation (posterior intermuscular fixation suture), with good results, similar to those obtained with muscle transposition using adjuvants such as botulinum toxin treatment.

Resumo Introdução: Os procedimentos de transposição muscular são utilizados quando não há rotação ocular em nenhuma direção determinada devido a alterações dos músculos extraoculares, como paralisia, agenesia ou anomalias congênitas. O objetivo deste estudo é caracterizar os pacientes tratados com este procedimento e determinar a porcentagem de correção do ângulo de desvio obtida após a cirurgia na Unidade Pediátrica de Oftalmologia, Estrabismo e Neuro-Oftalmologia. "Dra. Ana María Illescas Putzeys", Hospital de ojos y oídos "Dr. Rodolfo Robles V. Métodos: Foi realizado um estudo retrospectivo, descritivo, observacional, com revisão dos registros de pacientes operados para transposição muscular nos anos de 1999 a 2016. Resultados: Foram realizados vinte e três procedimentos de transposição do músculo reto. Treze pacientes eram homens (56,5%). A idade média foi de 42 anos. Em nossa série, foi obtida uma correção média de 42 PD (82%), independente do tipo de paralisia ou do procedimento cirúrgico realizado. Conclusão: Em casos selecionados de estrabismo paralítico, a principal abordagem pode ser apenas a transposição muscular com aumento (sutura de fixação intermuscular posterior), com bons resultados semelhantes aos obtidos com a transposição muscular com a utilização de adjuvantes como o tratamento com toxina botulínica.