Impact of COVID 19 pandemic on number of destructive ocular surgery (Evisceration) at tertiary care hospital


Narayon Chandra Bhowmik1 , Ruhi Mannan2 , Ferdous Akhter Jolly3 , Purabi Rani Debnath4 , Manash Kumar Goswami5 , Ashraf Sayeed6


Background: Evisceration surgery is the removal of the intraocular contents after excision of the cornea, while preserving the scleral shell. Evisceration surgery can be performed as ‘last resort’ for many severe end-stage ophthalmic conditions with complete loss of the vision.

Methods: The purpose of this study is to evaluate the infuence of COVID 19 pandemic on the number of incidence of evisceration surgery. We included in our retrospective review, all eviscerations performed between January 2018 and December 2021 at the Department of Ophthalmology of BIRDEM General Hospital, Dhaka. Clinical indications were classifed into six groups: painful blind eye due to endophthalmitis, absolute glaucoma, Perforating corneal ulcer, severe trauma, phthisis bulbi and cosmetic reasons. All patients seen during the study period with a diagnosis of painful blind eye were identifed through review of medical records and included in the study. Incidence was determined for three monthly between January and December 2020 & 2021 and compared to data from prior years (2018,2019) via ANOVA test to evaluate for changes of trend of evisceration surgery after the onset of the pandemic.

Result: Evisceration was performed in 58 eyes of 58 patients (54.3% males, age 42.0 ± 18.4 years). The most common indications of evisceration were endophthalmitis, absolute glaucoma, perforating corneal ulcer. Painful blind eye due to endophthalmitis (31.03%) was the most common clinical indication for evisceration, followed by absolute glaucoma (25.86%), Perforating corneal ulcer (15.52%), severe trauma (10.34%) phthisis bulbi (12.07%) & cosmetic reasons (5. 17%).The incidence of painful blind eye rose signifcantly between January to December, 2021 compared to the same time frame in 2018, 2019 and 2020. The rise in evisceration surgery incidence in 2021 was statistically signifcant (P <0.05) when compared to the years 2018,2019 and 2020. The most common demographic characteristics were age 41-60 years and male gender. Painful blind eye and phthisis bulbi due to endophthalmitis and absolute glaucoma represent the most common indications for ocular evisceration. Reduced number of clinical follow up during COVID 19 pandemic correspond to an increased incidence of painful blind eye.

Conclusion: This risk could have been minimized, by maintaining proper follow up, by taking the medication or not discontinuing medication without permission of physician.

Keywords: Evisceration, COVID 19 pandemic, Endophthalmitis

  1. Assistant professor & Resident surgeon,Department of Ophthalmology

    BIRDEM General Hospital, Dhaka

  2. Registrar, Department. of Ophthalmology

    BIRDEM General Hospital, Dhaka

  3. Associate Professor, Department. of Ophthalmology

    BIRDEM General Hospital, Dhaka

  4. Professor, Department of Ophthalmology

    BIRDEM General Hospital, Dhaka

  5. Professor and Head, Department of Ophthalmology

    BIRDEM General Hospital, Dhaka

  6. Ex-Head and Professor, Department of Ophthalmology

    BIRDEM General Hospital, Dhaka

Volume 5, Number 2, July 2023
Page: 18-22