Current Issues
Current Issues - Vol. 22, No. 3, July - September 2026
Al-Shifa Journal of Ophthalmology
Editorial:
Closing the Gap: Why Autonomous AI Needs Human Partners in Eye Care
Mehmona Asgher
When The Healer Needs Healing: Assessing Burnout Among Ophthalmologists Using The Copenhagen Burnout Inventory
Amna Rizwan, Muhammad Ali Haider, Nida Khalid
Objective: To evaluate the prevalence of burnout among ophthalmologists in Pakistan. Additionally, the study aimed to identify specific personal, professional, and demographic characteristics that may increase the likelihood of experiencing burnout.
Methods: This descriptive cross-sectional study was conducted at Al-Ehsan Welfare Eye Hospital, Lahore from February 2025 to July 2025. After obtaining approval from the hospital ethical committee, we included 126 ophthalmologists by non-probability convenient sampling. They filled out a questionnaire based on the Copenhagen Burnout Inventory (CBI) to classify burnout. Data analysis was performed using SPSS version 20 with frequency and percentage computed for qualitative data, and the mean and standard deviation computed for quantitative data. Independent samples t-test was performed to check whether differences in means were statistically significant with p-value <0.05.
Results: Mild burnout was seen in 58.7% of ophthalmologists, moderate burnout was seen in 35.7%, and high burn out was seen in 5.6% of ophthalmologists. The mean CBI burn out score is significantly higher in ophthalmologists with age below 45 years (p=0.000), general ophthalmologists (p=0.001), and in consultant ophthalmologists and senior registrars (p=0.000). It is higher for those working less than eight hours per day (p=0.002).
Conclusion: This study demonstrated that burnout is a significant concern among ophthalmologists in Pakistan, with more than half experiencing mild burnout and over onethird moderate burnout. Although only a small proportion exhibited high burnout, the presence of this severe form among specific subgroups highlights the need for targeted interventions.
Effectiveness of Intralesional Bevacizumab in Grade I/II Pterygium as Primary Treatment
Sumra Munir, Bilal Humayun Mirza, Aleena Shah, Maimoona Mohsin, Muhammad Rizwan Khan, Faud Ahmad Khan Niazi
Objective: To determine the effect of Intralesional Bevacizumab in pterygium (grade I/II) as primary treatment in terms of mean change in size.
Methods: The quasi-experimental study was conducted in the Ophthalmology Department, Benazir Bhutto Hospital, Rawalpindi, over a period of 6 months, from July 2019 to January 2020. Thirty eyes of patients aged 25–70 years with primary grade I or II pterygium were enrolled using consecutive sampling technique. We measured a reduction in the pterygium size by comparing the baseline measurements with those obtained 1 week, 1 month and 3 months after intralesional injection of 0.1 mL of 2.5mg bevacizumab. We analysed the data using SPSS version 22. Paired sample t-test was applied to compare pre and post injection change in size of pterygium. p-value <0.05 was considered statistically significant.
Results: The mean age of total study population was calculated to be 49.07±12.06 SD years. 66.7% (n=20) patients were males and 33.3% (n=10) were females. The mean pterygium length at baseline was found to be 2.26±1.05mm. We observed a statistically significant difference (p-value ≤0.05) in length of pterygium at 1 week, 1 month and three months after treatment when paired sample t-test was employed.
Conclusion: The size of pterygium following the use of intralesional injection of bevacizumab was found to be significantly less at 1 week, 1 month and 3 months, when compared with baseline values.
The Effect of Near Work on The Onset and Severity of Convergence Insufficiency in Individuals Aged Between 8 Years to 35 Years
Syeda Umaima Fasih, Zille Khadija Siddiqui, Muhammad Nizamuddin, Ammara Zafar Taj, Salma Saleem, Quratulain Paracha
Purpose: To evaluate the effect of near work on the onset and severity of convergence insufficiency in individuals aged between 8 years to 35 years
Methods: A prospective cross-sectional study was conducted on 150 participants aged between 8-35 years undertaking ≥2 hours/day of near work were enrolled using a convenient, non-probability sampling technique from March 2025 to June 2025 from the Outpatient Department, Khairun-Nisa Eye Hospital, Karachi, Pakistan. Convergence insufficiency was evaluated using Near Point of Convergence (NPC) measurement and the Convergence Insufficiency Symptom Survey (CISS). Chi-Square test was applied to analyze the data in SPSS version 27, with p-value < 0.05 considered statistically significant.
Tear Film Instability as a Contributing Factor to Visual Discomfort in Presbyopic Patients Aged 40 Years and Above
Hamdia Fatima, Muhammad Jalil, Hadia Iqbal, Alishba Munir, Aminah Rafiq, Nazish Nazir
Purpose: To evaluate visual discomfort associated with tear film instability in presbyopic patients and investigate its prevalence according to age and gender.
Methods: A cross-sectional study conducted from February 2025 to June 2025 in hospitals of the twin cities of Pakistan. The non-random purposive sampling technique was considered in this study. Data was calculated using EPI software. A total of 384 presbyopic patients completed the Ocular Surface Disease Index (OSDI) questionnaire. Data analysis was performed with the use of SPSS version 25, and correlation was measured with crosstabs with chi-square tests. The p-value <0.05 was considered statistically significant.
Results: Majority of participants experienced strong visual discomfort. Severity of OSDI was statistically significant with regards to gender (χ² = 23.36, p = 0.005) and not age (χ² = 3.62, p = 0.305). Most frequently occurring symptoms included blurred vision (82.9%), screen pain (84.9%) and difficulty in reading (86.9%). Symptoms' severity was slightly higher for women of 45-50 years old.
Efficacy of Therapeutic Meibomian Gland Expression in Evaporative Dry Eye
Nimra Tanveer, Muhammad Shaheer, Kiran Shahbaz, Muhammad Moin, Ammara Rasheed
Objective: To analyze the impact of therapeutic meibomian gland expression in evaporative dry eye patients.
Methods: The quasi-experimental research was done at Institute of Ophthalmology, Mayo Hospital, Lahore, between March, 2025 and August, 2025. Total sample size consisted of 78 participants recruited through non probability convenience sampling. Patients aged 18-35 were assessed for evaporative dry eye through OSDI score, meibography, non-invasive first and average tear film analysis, to detect meibomian gland dysfunction. Patients having MGD underwent Therapeutic Meibomian Gland Expression as treatment for MGD. The assessments were repeated after two weeks in order to assess any changes in the symptoms and the functioning of the glands. All the data were documented with caution and analyzed with SPSS version 26. Statistical comparison was done by applying paired t test and a p-value <0.05 was regarded as significant.
Results: Non-Invasive First Tear Break Up Time improved in both the eyes (OD; p = 0.026, OS; p < 0.001), and NI Average TBUT improved in both eyes (OD; p = 0.013, OS; p < 0.001). Meiboscore significantly improved (p < 0.001) in both upper and lower lids of both eyes. OSDI scores had shown significant symptomatic improvement where normal (OSDI < 12) and mildto-severe (OSDI > 12) categories had reduced significantly (p < 0.001).
Conclusion: It is concluded from the findings of this study that Therapeutic Meibomian Gland Expression (MGE) is safe and effective for evaporative dry eye due to MGD.