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  1. Article: A study of the role and educational needs of ophthalmic specialist nurses.

    Rattanasirivilai, Pornjittra / Shirodkar, Amy-Lee

    British journal of nursing (Mark Allen Publishing)

    2021  Volume 30, Issue 14, Page(s) 858–864

    Abstract: Aims: To explore the current roles, responsibilities and educational needs of ophthalmic specialist nurses (OSNs) in the UK.: Method: A survey of 73 OSNs ranging from band 4 to band 8 was undertaken in May 2018.: Findings: 73% of OSNs undertake ... ...

    Abstract Aims: To explore the current roles, responsibilities and educational needs of ophthalmic specialist nurses (OSNs) in the UK.
    Method: A survey of 73 OSNs ranging from band 4 to band 8 was undertaken in May 2018.
    Findings: 73% of OSNs undertake more than one active role, with 59% involved in nurse-led clinics; 63% felt formal learning resources were limited, with 63% reporting training opportunities and 21% reporting time as major barriers to further training. More than 38% emphasised hands-on clinic-based teaching had a greater impact on their educational needs. Some 64% were assessed on their skills annually and 59% felt confident with their skill set.
    Conclusion: The Ophthalmic Common Clinical Competency Framework provides a curriculum and assessment tools for OSNs to use as a structure to maintain clinical skills and knowledge. Eye departments should use this as guidance to target learning needs and improve standards of care to meet the changing needs of society.
    MeSH term(s) Clinical Competence ; Curriculum ; Humans ; Needs Assessment ; Nurse's Role ; Ophthalmology/education ; Specialties, Nursing/education ; Surveys and Questionnaires
    Language English
    Publishing date 2021-09-14
    Publishing country England
    Document type Journal Article
    ZDB-ID 1119191-0
    ISSN 0966-0461
    ISSN 0966-0461
    DOI 10.12968/bjon.2021.30.14.858
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  2. Article ; Online: Cost-effective and adaptable cataract surgery simulation with basic technology.

    Kaur, Simerdip / Shirodkar, Amy-Lee / Nanavaty, Mayank A / Austin, Michael

    Eye (London, England)

    2021  Volume 36, Issue 7, Page(s) 1384–1389

    Abstract: Purpose: To assess the subjective validity of a cost-effective and adaptable cataract surgery simulation technique using basic technology.: Methods: We devised and filmed a range of simulation techniques that mimic steps of phacoemulsification ... ...

    Abstract Purpose: To assess the subjective validity of a cost-effective and adaptable cataract surgery simulation technique using basic technology.
    Methods: We devised and filmed a range of simulation techniques that mimic steps of phacoemulsification cataract surgery using various "everyday" basic materials. This video was combined in a "parallel" fashion with live cataract surgery so that all steps of surgery were simulated. Subsequently, we distributed an online subjective validation questionnaire on Google Forms with the embedded simulation video in a generic invitation that was forwarded via email and/or text messages/WhatsApp messenger amongst Ophthalmologists of all grades within our regions (Kent, Surrey and Sussex, London and Wales Postgraduate Deaneries).
    Results: Face validity: 66 (99%) participants agreed that the explanations in the video were clear and 53 (79%) concurred with the realistic feel of simulated technique. Instrumentation and adaptations demonstrated were deemed user friendly and conducive to replicate by 99% participants. Content validity: 60 (90%) of participants agreed the techniques described in the video reflected the technical skills required to train cataract surgeons. Forty-nine (74%) agreed that the simulation techniques were relevant for acquiring other generic and transferable microsurgical and manual dexterity skills.
    Conclusions: We demonstrated subjective validity of our cost-effective cataract simulation technique. Our model can be used as an adjunct to intraocular and virtual reality training for cataract surgery by removing the barrier of cost and improved exposure to real instruments used in cataract surgery.
    MeSH term(s) Cataract ; Cataract Extraction/methods ; Clinical Competence ; Computer Simulation ; Cost-Benefit Analysis ; Humans ; Technology
    Language English
    Publishing date 2021-06-25
    Publishing country England
    Document type Journal Article ; Video-Audio Media
    ZDB-ID 91001-6
    ISSN 1476-5454 ; 0950-222X
    ISSN (online) 1476-5454
    ISSN 0950-222X
    DOI 10.1038/s41433-021-01644-5
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  3. Article ; Online: Proning related bilateral anterior ischaemic optic neuropathy in a patient with COVID-19 related acute respiratory distress syndrome.

    Clarke, Kirsty Michelle / Riga, Vivi / Shirodkar, Amy-Lee / Meyer, Joel

    BMC ophthalmology

    2021  Volume 21, Issue 1, Page(s) 276

    Abstract: Background: Non-arteritic ischaemic optic neuropathy (NAION) is a rare but harmful complication of prone positioning. Prone mechanical ventilation is a therapeutic strategy which has been used extensively during the COVID-19 pandemic to treat acutely ... ...

    Abstract Background: Non-arteritic ischaemic optic neuropathy (NAION) is a rare but harmful complication of prone positioning. Prone mechanical ventilation is a therapeutic strategy which has been used extensively during the COVID-19 pandemic to treat acutely hypoxemic patients with COVID-19 related acute respiratory distress syndrome (ARDS). Though a small number of cases of unilateral NAION have been reported in patients testing positive for the SARS-CoV-2 virus, we describe what is to our knowledge, the first reported case of bilateral NAION occurring in a patient proned extensively for the treatment of COVID-19 related ARDS. We consider the potential aetiological factors leading to NAION after prone mechanical ventilation in patients with COVID-19 and suggest strategies to protect against its development.
    Case presentation: We report a case of severe, irreversible, visual impairment secondary to bilateral anterior ION in a fifty-five-year-old male who underwent eight episodes of prone mechanical ventilation to treat COVID-19 related ARDS. Once weaned from his sedation he reported bilateral painless vision loss, and bedside ophthalmological assessment identified a reduced visual acuity of 3/30 unaided in the left eye and counting fingers in the right. Dilated indirect ophthalmoscopy revealed inferotemporal optic disc oedema with splinter haemorrhages in the right eye and mild disc oedema, temporal pallor, and nerve fibre layer haemorrhages inferiorly in the left eye. Humphrey visual field 24 - 2 testing confirmed a severely constricted visual field with macular sparing on the right and depressed inferonasal vision with preserved peripheral vision on the left eye. OCT disc imaging shortly after diagnosis revealed bilateral disc swelling and flame haemorrhages in the right eye.
    Conclusions: NAION is a devastating, but preventable complication of prone positioning, which may pose significant risk of vision loss in patients with COVID-19 related ARDS.
    MeSH term(s) COVID-19 ; Humans ; Male ; Middle Aged ; Optic Neuropathy, Ischemic/diagnosis ; Optic Neuropathy, Ischemic/etiology ; Pandemics ; Respiratory Distress Syndrome/diagnosis ; Respiratory Distress Syndrome/etiology ; Respiratory Distress Syndrome/therapy ; SARS-CoV-2 ; Visual Acuity
    Language English
    Publishing date 2021-07-13
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 2050436-6
    ISSN 1471-2415 ; 1471-2415
    ISSN (online) 1471-2415
    ISSN 1471-2415
    DOI 10.1186/s12886-021-02028-9
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  4. Article ; Online: Trainee confidence managing ocular trauma.

    Shirodkar, Amy-Lee / Yeo, Damien Cm / Shuttleworth, Mr Gary

    Eye (London, England)

    2019  Volume 33, Issue 4, Page(s) 691–692

    MeSH term(s) Clinical Competence ; Education, Medical, Graduate ; Eye Injuries/therapy ; Humans ; Ophthalmology/education
    Language English
    Publishing date 2019-01-07
    Publishing country England
    Document type Letter
    ZDB-ID 91001-6
    ISSN 1476-5454 ; 0950-222X
    ISSN (online) 1476-5454
    ISSN 0950-222X
    DOI 10.1038/s41433-018-0328-4
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  5. Article ; Online: Moving postgraduate ophthalmology education online-experiences of a nationalised live video-linked series.

    Malick, Huzaifa / Kaur, Simerdip / Veeramani, Pratibha / Shirodkar, Amy-Lee

    Eye (London, England)

    2020  Volume 35, Issue 9, Page(s) 2633–2635

    Keywords covid19
    Language English
    Publishing date 2020-08-28
    Publishing country England
    Document type Letter
    ZDB-ID 91001-6
    ISSN 1476-5454 ; 0950-222X
    ISSN (online) 1476-5454
    ISSN 0950-222X
    DOI 10.1038/s41433-020-01157-7
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  6. Article ; Online: Emergency ophthalmology services in the United Kingdom: a snap-shot of service provision.

    Shirodkar, Amy-Lee / Morris, Daniel S / Yeo, Damien C M / Lim, M Kim / Desai, Parul

    Eye (London, England)

    2020  Volume 35, Issue 12, Page(s) 3433–3434

    MeSH term(s) Humans ; Ophthalmology ; Surveys and Questionnaires ; United Kingdom
    Keywords covid19
    Language English
    Publishing date 2020-11-16
    Publishing country England
    Document type Letter
    ZDB-ID 91001-6
    ISSN 1476-5454 ; 0950-222X
    ISSN (online) 1476-5454
    ISSN 0950-222X
    DOI 10.1038/s41433-020-01284-1
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  7. Article ; Online: Ophthalmic emergencies presenting to the emergency department at the University Hospital of Wales, Cardiff, UK.

    Rehan, Shahzaib M / Morris, Daniel S / Pedlar, Lee / Sheen, Nik / Shirodkar, Amy-Lee

    Clinical & experimental optometry

    2020  Volume 103, Issue 6, Page(s) 895–901

    Abstract: Background: Community-based optometry services are increasingly used as a primary resource for patients with acute eye problems. The Eye Health Examination Wales (EHEW) is an example of one such established scheme. The aim of the project was to show how ...

    Abstract Background: Community-based optometry services are increasingly used as a primary resource for patients with acute eye problems. The Eye Health Examination Wales (EHEW) is an example of one such established scheme. The aim of the project was to show how the aforementioned pathway has affected the presentation of ocular conditions to a general emergency department and the eye casualty department at the same hospital.
    Methods: Clinical data were collected prospectively over a one-month period. The records of 100 consecutive patients with ocular pathology presenting to a general emergency department were analysed. Numbers were also obtained for the number of patients seen under the EHEW scheme by community optometrists for the same period. The notes of patients referred to ophthalmology or back out to the community optometry scheme were followed to monitor for re-attendance in either setting.
    Results: Eighty-five per cent of patients were walk-in cases. The most common diagnosis made in the emergency department was 'no abnormality found' in 37 per cent. Eighty per cent of all conditions were discharged from the emergency department. Fifteen per cent of all cases, mainly foreign body-related, were followed up in the emergency eye clinic and 10 per cent were sent to EHEW for follow-up. No cases re-presented to a hospital service at a later date.
    Conclusion: At least 37 per cent of emergency department cases could have been potentially avoided had the patient presented to the EHEW scheme. The pathway for patients to be sent from the emergency department to an EHEW optometrist does not appear to delay presentation to an ophthalmologist thereafter. Further promotion of the EHEW service is needed to change patient behaviours and reduce avoidable attendance to overstretched emergency departments.
    MeSH term(s) Emergencies ; Emergency Service, Hospital ; Hospitals ; Humans ; Referral and Consultation ; United Kingdom ; Wales/epidemiology
    Language English
    Publishing date 2020-02-17
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639275-1
    ISSN 1444-0938 ; 0816-4622
    ISSN (online) 1444-0938
    ISSN 0816-4622
    DOI 10.1111/cxo.13050
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  8. Article ; Online: Personal Protective Equipment (PPE) use among emergency eye care professionals in the UK during the COVID19 pandemic.

    Shirodkar, Amy-Lee / De Silva, Ian / Verma, Seema / Anderson, Sarah / Dickerson, Polly / Walsh, Francine / Siriwardena, Dilani / Dhawahir-Scala, Felipe

    Eye (London, England)

    2020  Volume 34, Issue 7, Page(s) 1224–1228

    Abstract: EEC staff were provided with rapidly changing personal PPE guidance by Public Health England (PHE) with specific subspecialty advice from the British Emergency Eye Care Society (BEECS) and the Royal College of Ophthalmologists (RCOphth) UK during the ... ...

    Abstract EEC staff were provided with rapidly changing personal PPE guidance by Public Health England (PHE) with specific subspecialty advice from the British Emergency Eye Care Society (BEECS) and the Royal College of Ophthalmologists (RCOphth) UK during the COVID19 pandemic. BEECS undertook a baseline survey of its members after the initial response from the RCOphth 16/3/20 mirroring Public Health England (PHE) advice and a follow- up survey after the guidance was updated on 9/4/20. A combined total of 84 responses were received. Improvements after RCOphth changes between the two surveys from hospital respondents showed increases in temperature screening (13%), scrub use (34%), use of aprons (31%), masks (4%), eye protection (35%), gloves (25%) and slit lamp guard (1%). Our findings demonstrate a positive and significant adaptation of PPE in response to change in guidance published by PHE, RCOphth and BEECS between 16/3/20 and 11/4/20. The COVID19 pandemic has rapidly taken over the normal activity of Ophthalmic departments creating unprecedented challenges. Following initial confusion and vulnerability expressed by EEC professionals to PPE guidance, most Trusts appear to have adapted and are doing similar things. The response has been swift and effective as a result of good team work and early advice from BEECS and the RCOphth. On the whole, management teams are listening.
    MeSH term(s) COVID-19 ; England/epidemiology ; Humans ; Ophthalmology ; Pandemics ; Personal Protective Equipment ; SARS-CoV-2 ; United Kingdom/epidemiology
    Keywords covid19
    Language English
    Publishing date 2020-05-21
    Publishing country England
    Document type Journal Article
    ZDB-ID 91001-6
    ISSN 1476-5454 ; 0950-222X
    ISSN (online) 1476-5454
    ISSN 0950-222X
    DOI 10.1038/s41433-020-0970-5
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  9. Article ; Online: Outcomes of Nd: YAG Goniopuncture After Viscocanalostomy/Phacoviscocanalostomy.

    Mathews, Divya / Shirodkar, Amy-Lee / Ahnood, Dana / Garrick, Adesuwa

    Journal of glaucoma

    2016  Volume 25, Issue 6, Page(s) e562–8

    Abstract: Purpose: The aim of this study is to evaluate the safety and efficacy of laser goniopuncture (LGP) to lower intraocular pressure (IOP) post-viscocanalostomy (VC)/phacoviscocanalostomy (PVC). Outcomes include: IOP reduction from pre-LGP levels and the ... ...

    Abstract Purpose: The aim of this study is to evaluate the safety and efficacy of laser goniopuncture (LGP) to lower intraocular pressure (IOP) post-viscocanalostomy (VC)/phacoviscocanalostomy (PVC). Outcomes include: IOP reduction from pre-LGP levels and the need for further topical antiglaucomatous medication or surgery.
    Patients and methods: A total of 541 eyes that underwent VC/PVC between 2009 and 2012, at the Stanley eye unit in Abergele were included in the study.
    Inclusion criteria: All patients who had LGP at any timepoint after VC/PVC when target IOP was not achieved +/- progression in visual field with at least 6 months of follow-up data.Statistical analysis was performed on IOP values pre- and post-LGP, involving χ, Fischer exact, Mann-Whitney U, and Wilcoxon tests. A P-value of <0.05 was accepted as the level of significance.
    Results: Of the 515 included eyes, 136 (26%) required LGP after a mean of 15.11±9.73 months after surgery (95% confidence interval, 13.46-16.76 mo), ranging from 1 to 42 months. LGP reduced IOP significantly from a mean of 22.92±5.80 to 17.08±5.30 mm Hg immediately for all eyes, a reduction of 5.84 mm Hg (or a 25% reduction) (P<0.0001). IOP significantly reduced in the VC group with a mean reduction of 7.60 mm Hg compared with 4.85 mm Hg in the PVC group immediately after the procedure (P=0.0038). LGP was required sooner in the VC group compared with PVC, 11.35 and 14.57 months, respectively (P=0.0393). A total of 69 (62%) eyes were commenced on topical IOP-lowering medications, mean 7.26±6.41 months after LGP.
    Conclusions: This study supports previous evidence that LGP enhances the IOP-lowering success of VC/PVC. The advantages of LGP are that it is a minimally invasive clinic-based procedure with a low complication rate.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Filtering Surgery/methods ; Glaucoma, Open-Angle/physiopathology ; Glaucoma, Open-Angle/surgery ; Humans ; Intraocular Pressure/physiology ; Laser Therapy/methods ; Male ; Middle Aged ; Phacoemulsification/methods ; Tonometry, Ocular ; Treatment Outcome ; Visual Fields ; Young Adult
    Language English
    Publishing date 2016
    Publishing country United States
    Document type Journal Article
    ZDB-ID 913494-3
    ISSN 1536-481X ; 1057-0829
    ISSN (online) 1536-481X
    ISSN 1057-0829
    DOI 10.1097/IJG.0000000000000333
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  10. Article ; Online: Personal Protective Equipment (PPE) use among emergency eye care professionals in the UK during the COVID19 pandemic

    Shirodkar, Amy-lee / De Silva, Ian / Verma, Seema / Anderson, Sarah / Dickerson, Polly / Walsh, Francine / Siriwardena, Dilani / Dhawahir-Scala, Felipe

    Eye

    2020  Volume 34, Issue 7, Page(s) 1224–1228

    Keywords Ophthalmology ; General Arts and Humanities ; covid19
    Language English
    Publisher Springer Science and Business Media LLC
    Publishing country us
    Document type Article ; Online
    ZDB-ID 91001-6
    ISSN 1476-5454 ; 0950-222X
    ISSN (online) 1476-5454
    ISSN 0950-222X
    DOI 10.1038/s41433-020-0970-5
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