BACKGROUND

The COVID-19 pandemic has led to the rapid adoption of telemedicine in the Philippines; however, there is limited empirical evidence about how physicians and patients view this new form of care.

OBJECTIVE

Our main objective is to evaluate Tele-Ophthalmology for the Management and AssessmenT of Ophthalmic Symptoms (TOMATO), a tele-ophthalmology program implemented in a national tertiary eye referral center in the Philippines. We specifically aim to evaluate the patient characteristics, patient satisfaction, and ophthalmologists' perception of TOMATO telemedicine for eye care.

METHODOLOGY

We employed a prospective, cross-sectional, questionnaire-based study among patients and physicians who participated in TOMATO during the study period.

RESULTS

Atotal of 10,551 patients consulted TOMATO, from January to December 2021, with cataract as the most common diagnosis. During its pilot implementation, TOMATO received a low satisfaction rate of 33% among patients due to numerous barriers to its use, including technical and interpersonal problems. Filipino ophthalmologists had good knowledge and a positive attitude towards the use of TOMATO, with a mean score of 3.53 out of 5.

CONCLUSIONS

Tele-ophthalmology is a promising technology for improving access to eye care in the Philippines, but there are still some challenges that need to be addressed, such as improving the user experience, ensuring data security, and training future ophthalmologists in its use.

Human ; Telemedicine ; Philippines

Objective: This paper demonstrated the effectiveness of intrastromal injection of levofloxacin 1.5% ophthalmic solution in the management of recalcitrant Gram-positive bacterial keratitis. Methods: This is a report on two cases of recalcitrant bacterial keratitis encountered at the External Diseases and Cornea Clinic of the Department of Ophthalmology and Visual Sciences at the Philippine General Hospital. Results: Two middle-aged females presented with bacterial keratitis unresponsive to previous antibiotic treatment with impending corneal perforation. The Gram stain of the corneal scraping in the first case revealed Gram-positive cocci, while the second case showed encapsulated Gram-positive bacilli and encapsulated Grampositive cocci in chains. In both cases, repeated intrastromal injections of levofloxacin 1.5% in addition to increasing the frequency of topical levofloxacin 1.5% resulted in marked improvement in visual acuity and resolution of deep stromal infiltrates and hypopyon. Conclusion These cases highlighted the utility of intrastromal levofloxacin 1.5% ophthalmic solution in the management of recalcitrant Gram-positive bacterial keratitis.
Fluoroquinolones ; Levofloxacin

OBJECTIVE

This study compared the demographics, clinical profile, treatment, and outcomes of retinoblastoma patients seen at medical institutions in the Philippines between two time periods: 2010 to 2015 and 2016 to 2020.

METHODS

This was a multicenter, analytical, cohort study using review of medical charts and databases of retinoblastoma patients seen in 11 medical institutions from 2010 to 2020.

RESULTS

There were 636 patients (821 eyes) included in this study: 330 patients were seen in 2010 to 2015 while 306 in 2016 to 2020. More cases per annum were seen in the latter timeline. The number of patients with unilateral disease was not significantly different between the two time periods (p=0.51). Age at onset of symptom, age at initial consultation, and delay in consult were also not significantly different between the two time periods (p > 0.05). Patients had significantly different distributions of intraocular grades (p < 0.0001) and systemic staging (p < 0.0001) between the two time periods. Enucleation was the most common surgical treatment performed in both timelines. There was significant difference in the status of patients based on the need for systemic chemotherapy (p < 0.01). There was significant difference in outcome between the two time periods, including the proportions of living and deceased patients.

CONCLUSION

This study compared the most comprehensive data on retinoblastoma patients in the country. There was no improvement in early health seeking behavior based on similar age at initial consult and delay in consult. Enucleation remained the most common treatment mode as opposed to chemotherapy due to similar percentage of patients with unilateral disease, an indication for enucleation rather than chemotherapy.

Human ; Retinoblastoma ; Philippines ; Epidemiology ; Treatment ; Therapeutics