Situation analysis of optometric education in the Eastern Mediterranean Region

Background: There is a scarcity of research evidence about the state of optometric education in the Eastern Mediterranean Region (EMR). Aims: To survey the state of optometric education offered within the EMR to provide evidence for policy-makers and stakeholders. Methods: Twenty-two purposively selected key academic stakeholders completed a semistructured questionnaire about the state of optometric education in their respective countries between August 2021 and January 2022. Results: Data from 19 (86%) of the 21 countries and 1 territory were included in the analysis. Eight (36.4%) countries offered bachelor’s degree programmes and 5 (22.7%) offered a diploma, but 6 (27.3%) did not offer any optometry education. Saudi Arabia offered a Doctor of Optometry programme. Programmes were accredited by an accreditation body and programmes in 7 countries underwent periodic quality audits. Morocco had the highest average number of graduates per annum (n = 305), while Yemen had only 20. Conclusion: EMR countries differ with respect to numbers of optometric education programmes, curricular competency levels, and systems to monitor quality standards. There is a need for regional collaboration to foster harmonization towards offering quality optometric education programmes.

A review of corneal imaging methods for the early diagnosis of pre-clinical Keratoconus

BACKGROUND

Keratoconus (KC) is a corneal ectasia characterised by steepening corneal curvature, changes in refractive error and corneal thickness that result in visual impairment. Early signs of KC include displacement of the thinnest part of the cornea from the central position, changes in the corneal epithelial layer cell distribution, variations in the anterior corneal astigmatism/posterior corneal astigmatism relationship and a variation in corneal thickness. It is important that we review the corneal imaging methods for the diagnosis of preclinical KC.

METHOD

An online literature search was carried out on PubMed. Only publications detailing corneal assessment procedures were considered for this review and any publication on instruments that did not generate KC predictability indices were also excluded from the review. The 308 publications were reviewed.

DISCUSSION

Corneal assessment techniques, with the ability to characterise both the anterior and posterior corneal surfaces, are invaluable in the diagnosis of pre-clinical KC. Reflection based and elevation based corneal imaging systems should be used in conjunction with other assessments such as higher order aberration measuring systems to improve sensitivity and reliability in the diagnosis of pre-clinical KC. Ultra high resolution ultrasound can detect pre-clinical KC. The ability to asses both the epithelium and endothelium makes anterior surface optical coherence tomography a superior technique for pre-clinical KC diagnosis. There is a positive correlation between central corneal thickness and corneal hysteresis. Corneal biomechanics should be considered in conjunction with other corneal assessments in the diagnosis of pre-clinical KC.

The straight and marrow - a primary care approach to anaemia

Anaemia remains a common global health issue with approximately a quarter of the worlds’ population affected despite universal initiatives to address the disorder. Iron deficiency anaemia and anaemia of chronic disease remain the two top ranking causes of anaemia globally and when these conditions co-exist, diagnosis is often challenging. In South Africa, high-risk groups include children, pregnant women and human immunodeficiency virus infected individuals. The morbidity and mortality associated with anaemia mandates the correct identification of the underlying cause, thus ensuring early, appropriate management. This review proposes morphological assessment with the appropriate baseline biochemical testing as the initial approach to unexplained anaemia in a primary health care setting in South Africa, in order to expedite diagnosis and ensure appropriate management.