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Background Retinopathy of prematurity (ROP) is a proliferative disease of the ocular retinal vasculature in premature infants, being a leading cause of preventable childhood blindness. The COVID-19 pandemic serves as an additional barrier to access to care and referral, potentially leading to more cases of advanced stage ROP. Although surgery can be done, ROP at this stage is highly associated with poor functional outcome irrespective of surgery. This case series aims to report advanced stage (stage 5) ROP in premature infants during the COVID-19 pandemic. Methods A retrospective case series of medical records of paediatric patients with ROP was performed at Cipto Mangunkusumo National Referral Hospital between March 1, 2020 and December 31, 2021. This case series included new patients that presented to our clinic from March 2020 to December 2021 with stage 5 ROP. Results A total of 19 eyes of 10 patients with stage 5 ROP were included in this study. Mean chronologic age at presentation to our referral centre was 7.0 4.0 months. Upon presentation, all had stage 5 ROP with negative blink reflex to light, and none of the eyes in this cohort underwent surgical intervention. Mean gestational age was 30.3 3.2 weeks and mean birth weight was 1,276.7 366.4 g. Conclusion There was an observable surge of stage 5 ROP at our referral centre with irreversible blindness. This highlights the need for proper ROP screening in all hospitals in Indonesia to prevent delay in detection and care of advanced stage ROP.

Background: Anterior segment dysgenesis (ASD) is an ocular malformation that can lead to childhood blindness. Although ASD prevalence is rare, it is potentially devastating for children and caretakers. We aim to report the clinical features of ASD patients in a tertiary referral center in Indonesia. Methods: We conducted a retrospective review of medical records of ASD patients in the Pediatric Ophthalmology clinic in Cipto Mangunkusumo National Central Public Hospital, Jakarta, Indonesia between January 1, 2018, and December 31, 2021. Results: A total of 172 eyes of 107 children with ASD were included in this study. Most of the patients were male, aged 3.4 years ±5.0 SD at first examination, 67.3% patients came from outside Jakarta, and 75.6% of eyes had bilateral ASD. Most common clinical manifestations was congenital corneal opacities (CCO), microcornea, and congenital glaucoma. The most common visual acuity (VA) was fixation and following light/object. Intraocular pressure (IOP) increased in 41% eyes. The most common surgery performed was glaucoma surgery, which was performed in 6.4% of eyes in the study. Conclusion: ASD has a devastating impact on children's VA, along with its poor prognosis despite surgery thus contributes largely to childhood blindness. ASD detection and management is highly challenging in children, and increased awareness on ASD is pivotal in earlier referral and treatment of ASD.

A congenital cataract is preventable blindness in children and is associated with intrauterine rubella infection known as congenital rubella syndrome (CRS), mostly found in developing countries. This study aims to describe the profile of unilateral cataracts in children with CRS, which are more difficult to manage than bilateral ones. As a retrospective study, we reviewed complete medical records of children with CRS and unilateral cataracts at Cipto Mangunkusumo hospital from 2017 to 2020. Fifteen patients were included, mostly male and from outside Jakarta.The mean age of onset was 2.9 months, while the average age at first presentation and surgery was 27.7 months and 29.1 months, respectively.No correlation was found between patients’ residential distance from the hospital towards duration between onset of symptoms and first presentation to the hospital. 100% and 66.7% of patients had leukocoria and microcornea as ocular manifestations. The majority of systemic manifestations are congenital heart disease.66.7% of children underwent cataract surgery without IOL implantation. Improvement of visual acuity postoperatively was observed in 13.3% of patients, and 66.7% of patients used contact lenses for visual rehabilitation. 60% of patients had posterior capsule opacity within six months of follow-up. The challenge of wearing contact lenses in children makes the risk of amblyopia even greater