Ophthalmology Pakistan

Artificial Intelligence in Ophthalmology: Replacement or Augmentation

2026-04-04T20:09:07+00:00

Artificial intelligence (AI) has speedily established itself at the forefront of modern ophthalmology practice. It has proven to be matchless when it comes to analyzing large data with uneasy patterns subsequently giving an insight.¹ But does artificial intelligence performs comparable to or even exceeds the clinician’s efficacy in completion of specific tasks? The answer to this question is not an easy one and will raise further questions as to whether artificial intelligence is able to replace ophthalmologists in clinical practice?

Artificial intelligence has demonstrated maximum utility in imaging based ophthalmic specialties. Its learning algorithms have proven to be very accurate in diagnosing and staging diabetic retinopathy, age related macular degeneration and even glaucoma with the aid of optical coherence tomography and fundus photography. However, in simple and clear cut tasks the AI softwares usually excel but when it comes to clinical correlation with a real time scenario AI is not free of limitations. This gap presents a challenge of correctly interpreting heterogeneous data and workflow integration.

Tele-Optometry in Pakistan: Perceived Benefits, Challenges, and Adoption Willingness Among Optometrists

2025-12-02T04:49:38+00:00

Objective: To determine the level of awareness, attitudes, and intentions of practicing optometrists in Pakistan to use tele-optometry, and the perceived benefits, challenges, and training requirements.

Methods: A cross-sectional survey was used, but it was descriptive and comprised certified optometrists in Pakistan. A professional network, email list, and the social media platform were used to distribute a structured survey in the form of a Google Forms questionnaire to conduct data collection. The survey was conducted on 234 licensed optometrists who are now in the clinical practice. The provincial distribution, level of awareness, willingness to adopt tele-optometry, and perceived challenges were analyzed using descriptive statistics.

Result: Out of 234 respondents 45.7% were of Punjab (n=107), 24.4% of Khyber Pakhtunkhwa (n=57), 20.5% of Sindh (n=48) and 9.4% of Baluchistan (n=22). Mostly, 87% were willing to embrace tele-optometry, 11% partially willing because of drug abuse and lack of understanding of treatment directions, and a small percentage wanted to use only hands-on practice. The participants reported better access, convenience, and better follow-up care as one of the key advantages, and diagnostic restrictions, digital literacy, and regulatory issue as one of the key limitations. Furthermore, nearly 69% said that they had a need to have formal training or workshops to ensure that they successfully use tele-optometry in their practice.

Conclusion: The research shows high levels of professional acceptance and preparedness of the Pakistani optometrists to the tele-optometry service, which indicates its relevance to increasing the accessibility and sustainability of eye care. Nevertheless, the effective implementation will mandate the use of organized training initiatives, well-defined clinical guidelines, and enhanced digital infrastructure to overcome the issue of safety, diagnostic precision, and patient comprehension. Tele-optometry when combined with conventional clinic-based service can be an important instrument to lower hypocrisy in eye-care services in Pakistan.

A Comparative Study on Smartphone Based Visual Acuity Test and Conventional age-matched vision testing charts in GEN alpha and Z

2026-02-04T04:32:55+00:00

OBJECTIVE: To determine the accuracy of visual acuity measurements using smartphone application in comparison to traditional visual acuity tests in the Generation Z and Generation Alpha.

METHOD: The research was approved by National Eye Centre Lahore. The study took place on patients visiting National Eye Centre Lahore. Sample size consisted of total 132 participants which were grouped into two; 66 in generation z (1995-2009) and 66 in gen alpha (2010-2024). Distance visual acuity and near visual acuity was recorded using ETDRS chart, near logMAR chart (traditional charts) and “Snellen chart” (smartphone-based chart) at standard distance. All dependent and independent variables were kept in mind. Data was entered and analyzed using SPSS version 25. Mann Whitney test was applied to analyze the data. P value ≤ 0.005 was considered significant.

RESULTS: Mean age of the participants was 16.73 ± 6.45 in which 54.5% were female and 45.5% was male. After comparing visual acuity recorded by both methods; conventional charts and smartphone-based charts, the p value of distance visual acuity was 0.143 for both eyes and near VA had p value of 0.00. The results showed significant difference in near visual acuity and no significant difference in distance visual acuity.

CONCLUSION: It is concluded that smartphone-based distance visual acuity test represents an easy and reliable alternative to conventional age-matched vision charts for Gen Z and Gen Alpha. Smartphone-based charts prove better for near visual acuity in both generations.

Clinical Spectrum and Visual Outcomes of Assault-Related Ocular Injuries: A Five-Year Analysis Using the Birmingham Eye Trauma Terminology System

2026-02-14T18:02:50+00:00

Purpose: To determine the demographic and clinical profile of ocular trauma cases presenting to the ophthalmology department of a tertiary care hospital in Pakistan.

Material and Methods: A retrospective analysis of medical records from 340 ocular trauma cases presenting between March 2020 and August 2025 was conducted. Injuries were classified using the Birmingham Eye Trauma Terminology System (BETTS). Primary outcome measures included demographic characteristics, injury patterns, and presenting visual acuity. Secondary outcomes comprised associated injuries and complications.

Results: Males constituted the majority (289, 85%), with a mean age of 35 ± 15 years. Fist blows were the most common injury mechanism (197, 58%). Closed globe injury (CGI) was observed in 243 patients (71.5%), while open globe injury (OGI) occurred in 97 (28.5%). Presenting visual acuity of ≥ 6/12 was documented in 165 (67.9%) CGI cases and 10 (10.3%) OGI cases. Malingering was identified in 24 females (7.1%). Associated findings included adnexal trauma (228, 67.1%), hyphema (112, 32.9%), and orbital fractures (34, 10%). Endophthalmitis was noted in 31 (32%) cases of OGI.

Conclusion: Assault-related ocular trauma predominantly affected young males. The high frequency of associated injuries and secondary complications, particularly the endophthalmitis, mandates an urgent need for enhanced preventive strategies and standardized protocols for documentation and management of ocular trauma.

Safety Profile and Efficacy of Intracameral Moxifloxacin for Endophthalmitis Prevention after Uncomplicated Phacoemulsification

2026-02-21T06:44:45+00:00

OBJECTIVE: To evaluate the incidence and safety profile of postoperative endophthalmitis in cases of uncomplicated phacoemulsification with intracameral injection of moxifloxacin.

METHODOLOGY: This was a single-centered observational study conducted at the eye department, College of Medicine and Dentistry, FMH, Lahore. All patients underwent uncomplicated phacoemulsification with foldable intraocular lens implant under local anaesthesia. This was followed by intracameral injection of moxifloxacin (0.5mg/0.1ml) at the end of surgery. Prior Ethical approval was obtained from FMH IRB. Wilcoxon Signed Rank was applied to compare pre- and post-operatively visual acuity in patients.

RESULTS: In this study, 101 patients, 54 females (53.5%) and 47 males (46.5%) were included. The average age of patients was 55.38±8.10 years. Among 101 patients, 94 (93.1%) of the patients' corneas were clear, and 7 (6.9%) of the patients had microcysts. Endothelial cell count was measured in patients preoperatively and postoperatively; it was lower postoperatively, and statistical results demonstrated a highly significant difference between pre-operative and post-operative values (p < 0.001).

CONCLUSION: The study results showed that the UCVA improved from day 1 to day 30, with no evidence of postoperative endophthalmitis in cases of uncomplicated phacoemulsification. Endothelial cell count was minimally decreased postoperatively.

Characteristics of the Macula in Amblyopic Eyes Assessed by Optical Coherence Tomography

2026-02-21T06:30:38+00:00

Amblyopia is a developmental condition characterized by reduced visual acuity (VA), typically resulting from abnormal visual experiences during the brain's critical periods of development. The condition is typically associated with factors such as strabismus, anisometropia, and visual deprivation. Despite the corrective treatments, children with amblyopia fail to get their perfect vision, raising the possibility of underlying retinal abnormalities. This study aims to investigate the thickness of the macular neuroretina in amblyopic and normal eyes using Optical Coherence Tomography (OCT). Methods: A prospective observational cross-sectional study was conducted involving children aged 7 to 15 years. After visual acuity, refraction, and slit-lamp examinations, participants underwent OCT imaging using the OCT 2000 system. Detailed measurements of macular thickness and other retinal structures were obtained and analyzed. Results: Descriptive statistics showed that the right macular thickness (224–293 microns), left macular thickness (200–280 microns), and total macular thickness (224–293 microns). The correlation between age and macular thickness was strong for all measurements (r = 0.903 for right, r = 0.927 for the left, and r = 0.903 for total macular thickness). A significant difference was evaluated in region A0 between the better and amblyopic eyes (P = 0.045); no significant differences were noticed in other regions. Conclusion: The findings suggest that amblyopia may selectively affect certain macular regions, particularly in the neuroretina.