HPCSA Ophthalmology Research Topics for Registrars – South Africa

Comprehensive list of ophthalmology research topics designed specifically for HPCSA registrars in South Africa. These topics address common and high-impact eye health challenges including cataract, glaucoma, diabetic retinopathy, HIV-related ocular disease, ocular trauma, paediatric ophthalmology, corneal disease, retinal disorders, uveitis, refractive error, and ophthalmic service delivery across district hospitals, regional hospitals, provincial hospitals, eye clinics, and tertiary academic centres.

Why These Ophthalmology Research Topics Work for HPCSA Registrars

HPCSA ophthalmology registrar research must be feasible within the 4-year training programme while addressing clinically relevant questions in South African eye care practice. Each topic below has been selected for:

• Clinical relevance: Addresses real ophthalmic problems commonly seen in South African eye clinics and hospitals
• Feasibility: Achievable within outpatient eye clinics, cataract surgical services, glaucoma clinics, diabetic eye screening programmes, casualty departments, theatre records, and retinal imaging units
• Ethical approval: Clear pathways for IRB submission, retrospective record review, informed consent where required, and supervisor approval
• Publication potential: Suitable for South African Ophthalmology Journal, SAMJ, African Vision and Eye Health, or international ophthalmology journals
• South African disease burden: Focuses on cataract blindness, glaucoma, diabetic retinopathy, ocular trauma, HIV-related eye disease, paediatric visual impairment, and resource-appropriate eye care delivery

Cataract, Glaucoma and Anterior Segment Research Topics

Topic 1: Visual Outcomes After Manual Small Incision Cataract Surgery

Research Question: What are the postoperative visual outcomes and complication rates among patients undergoing manual small incision cataract surgery in a South African public hospital?

Study Design: Retrospective or prospective observational study

Setting: Regional or tertiary hospital cataract surgical unit

Why This Works: Cataract remains a major reversible cause of blindness, surgical records and visual acuity outcomes are routinely available, and the study can evaluate preoperative vision, postoperative best-corrected visual acuity, intraoperative complications, posterior capsular rupture, corneal oedema, endophthalmitis, and follow-up attendance.

Topic 2: Barriers to Cataract Surgery Uptake

Research Question: What patient-related and health-system factors contribute to delayed presentation or non-uptake of cataract surgery?

Study Design: Cross-sectional questionnaire-based study

Setting: Eye outpatient clinic or cataract screening programme

Why This Works: Cataract surgery is highly effective but access barriers remain important, the topic can assess awareness, transport cost, fear of surgery, referral delays, waiting time, comorbidities, and socioeconomic factors affecting service uptake.

Topic 3: Glaucoma Awareness and Medication Adherence

Research Question: What is the level of glaucoma awareness and what factors are associated with poor adherence to anti-glaucoma medication?

Study Design: Cross-sectional analytical study

Setting: Glaucoma clinic or general ophthalmology outpatient department

Why This Works: Glaucoma causes irreversible visual loss, adherence is central to disease control, and the study can assess knowledge of disease, duration of treatment, number of medications, side effects, cost, follow-up distance, and visual field status.

Topic 4: Risk Factors for Advanced Glaucoma at Presentation

Research Question: What demographic, clinical, and health-system factors are associated with advanced glaucoma at first presentation?

Study Design: Retrospective case-control or cross-sectional study

Setting: Tertiary hospital glaucoma clinic

Why This Works: Many patients present late with irreversible vision loss, records can provide intraocular pressure, cup-disc ratio, visual field findings, optic nerve OCT parameters, family history, referral source, and prior treatment history.

Topic 5: Primary Open-Angle Glaucoma Progression Despite Treatment

Research Question: What factors are associated with progression of primary open-angle glaucoma despite medical therapy?

Study Design: Retrospective cohort study

Setting: Glaucoma clinic

Why This Works: Glaucoma progression can be assessed using visual fields, optic disc changes, OCT parameters, intraocular pressure trends, adherence documentation, and treatment escalation, making it suitable for a clinically useful registrar project.

Topic 6: Pseudoexfoliation Syndrome and Cataract Surgery Complications

Research Question: Are patients with pseudoexfoliation syndrome at increased risk of intraoperative and postoperative complications during cataract surgery?

Study Design: Retrospective comparative study

Setting: Cataract surgical unit

Why This Works: Pseudoexfoliation is clinically important because of zonular weakness and poor pupillary dilatation, and outcomes such as posterior capsular rupture, zonular dialysis, vitreous loss, intraocular lens placement, postoperative inflammation, and visual outcome can be compared.

Topic 7: Corneal Blindness: Clinical Profile and Causes

Research Question: What are the common causes and clinical patterns of corneal blindness among patients attending a tertiary eye hospital?

Study Design: Retrospective descriptive study

Setting: Cornea clinic or general ophthalmology outpatient department

Why This Works: Corneal blindness is preventable in many cases, causes such as infective keratitis, trauma, chemical injury, vitamin A deficiency, herpes keratitis, and post-surgical complications can be studied, with relevance for prevention and referral pathways.

Topic 8: Microbial Keratitis: Organisms and Treatment Outcomes

Research Question: What are the microbiological profile, risk factors, and treatment outcomes of microbial keratitis?

Study Design: Retrospective descriptive study

Setting: Cornea clinic and microbiology laboratory

Why This Works: Corneal infection can rapidly threaten vision, culture results and treatment records are available, and the study can assess contact lens use, trauma, HIV status, diabetes, organism profile, antibiotic sensitivity, perforation, scarring, and final visual acuity.

Topic 9: Dry Eye Disease Among Screen Users

Research Question: What is the prevalence and severity of dry eye disease among adults with prolonged digital screen exposure?

Study Design: Cross-sectional study

Setting: Eye outpatient clinic, university setting, or hospital staff population

Why This Works: Dry eye is common and increasingly relevant, validated tools such as OSDI can be used, and clinical tests such as tear break-up time, Schirmer test, and ocular surface staining can be correlated with screen time, age, gender, and environmental factors.

Topic 10: Postoperative Endophthalmitis After Cataract Surgery

Research Question: What is the incidence, clinical profile, microbiological pattern, and visual outcome of postoperative endophthalmitis following cataract surgery?

Study Design: Retrospective audit

Setting: Cataract surgical unit and retina/uveitis service

Why This Works: Endophthalmitis is a rare but serious complication, theatre and infection records can be reviewed, and the study supports surgical quality assurance, prophylaxis review, early recognition, and outcome monitoring.

Retina, Diabetes, HIV and Posterior Segment Research Topics

Topic 11: Diabetic Retinopathy Screening and Disease Severity

Research Question: What is the prevalence and severity of diabetic retinopathy among patients attending a hospital-based diabetic eye screening clinic?

Study Design: Cross-sectional descriptive study

Setting: Diabetic retinopathy screening clinic or ophthalmology outpatient department

Why This Works: Diabetes-related visual loss is increasingly important, retinal photographs and grading data may be available, and associations with duration of diabetes, HbA1c, hypertension, renal disease, and treatment history can be assessed.

Topic 12: Risk Factors for Sight-Threatening Diabetic Retinopathy

Research Question: What clinical factors are associated with proliferative diabetic retinopathy or diabetic macular oedema?

Study Design: Retrospective case-control study

Setting: Retina clinic or diabetic eye clinic

Why This Works: Sight-threatening diabetic retinopathy requires timely referral and treatment, records can provide OCT findings, fundus grading, laser treatment, anti-VEGF therapy, HbA1c, blood pressure, renal disease, and follow-up adherence.

Topic 13: Anti-VEGF Treatment Outcomes in Diabetic Macular Oedema

Research Question: What are the anatomical and visual outcomes after intravitreal anti-VEGF therapy for diabetic macular oedema?

Study Design: Retrospective cohort study

Setting: Retina clinic

Why This Works: Anti-VEGF therapy is commonly used but requires repeated follow-up, visual acuity, central macular thickness on OCT, number of injections, missed visits, and treatment response can be analysed.

Topic 14: HIV-Related Ocular Manifestations

Research Question: What are the common ocular manifestations among people living with HIV attending ophthalmology services?

Study Design: Retrospective or cross-sectional descriptive study

Setting: Ophthalmology clinic linked to HIV or infectious disease services

Why This Works: HIV remains highly relevant in South Africa, ocular conditions such as CMV retinitis, HIV retinopathy, herpes zoster ophthalmicus, uveitis, optic neuropathy, and ocular surface disease can be studied in relation to CD4 count, viral load, ART status, and immune recovery.

Topic 15: Retinal Detachment: Presentation and Surgical Outcomes

Research Question: What are the clinical presentation, risk factors, treatment methods, and visual outcomes of rhegmatogenous retinal detachment?

Study Design: Retrospective descriptive or cohort study

Setting: Tertiary retina service

Why This Works: Retinal detachment is vision-threatening, records can provide duration of symptoms, macular status, myopia, trauma, prior cataract surgery, type of surgery, anatomical success, and final visual acuity.

Topic 16: Hypertensive Retinopathy and Systemic Risk Factors

Research Question: What is the prevalence of hypertensive retinopathy and how does severity correlate with blood pressure control and systemic comorbidities?

Study Design: Cross-sectional study

Setting: Ophthalmology outpatient clinic or medical outpatient clinic

Why This Works: Hypertension is common, fundus findings can reflect systemic vascular disease, and the study can assess blood pressure, diabetes, renal disease, stroke history, and retinopathy grading.

Topic 17: Uveitis: Aetiology and Visual Outcomes

Research Question: What are the causes, anatomical classification, treatment patterns, and visual outcomes of uveitis in a South African tertiary eye clinic?

Study Design: Retrospective descriptive study

Setting: Uveitis clinic or general ophthalmology clinic

Why This Works: Uveitis has infectious and inflammatory causes, and South African data can include TB, HIV, syphilis, sarcoidosis, autoimmune disease, and idiopathic uveitis, with measurable outcomes such as complications, recurrence, and visual acuity.

Topic 18: Retinopathy of Prematurity Screening Outcomes

Research Question: What are the screening outcomes, risk factors, and treatment needs among premature infants screened for retinopathy of prematurity?

Study Design: Retrospective cohort study

Setting: Neonatal unit and ophthalmology ROP screening service

Why This Works: ROP screening is essential in neonatal care, data on gestational age, birth weight, oxygen therapy, sepsis, transfusion, ROP stage, laser treatment, anti-VEGF treatment, and follow-up completion can be collected.

Topic 19: Age-Related Macular Degeneration in Elderly Patients

Research Question: What are the clinical patterns, risk factors, and treatment outcomes of age-related macular degeneration among elderly patients attending a retina clinic?

Study Design: Retrospective descriptive study

Setting: Retina clinic

Why This Works: AMD is an important cause of visual impairment in older adults, OCT and fundus findings can classify dry and wet AMD, and outcomes after anti-VEGF therapy can be analysed where treatment records are available.

Topic 20: Central Retinal Vein Occlusion: Risk Factors and Visual Outcomes

Research Question: What systemic and ocular risk factors are associated with central retinal vein occlusion and what are the visual outcomes after treatment?

Study Design: Retrospective cohort study

Setting: Retina clinic

Why This Works: Retinal vein occlusion is commonly associated with hypertension, diabetes, glaucoma, and hypercoagulable states, and outcomes such as macular oedema, neovascularisation, anti-VEGF use, laser treatment, and final vision can be measured.

Paediatric Ophthalmology, Trauma, Neuro-Ophthalmology and Eye Care Service Research Topics

Topic 21: Ocular Trauma in Children and Adults

Research Question: What are the causes, clinical patterns, management methods, and visual outcomes of ocular trauma presenting to a South African hospital?

Study Design: Retrospective descriptive study

Setting: Eye casualty, emergency department, or ophthalmology inpatient service

Why This Works: Ocular trauma is common and preventable, records can provide mechanism of injury, open-globe versus closed-globe trauma, chemical injury, workplace injury, assault, paediatric injuries, surgery required, and final visual outcome.

Topic 22: Open-Globe Injury: Prognostic Factors for Poor Visual Outcome

Research Question: What clinical factors predict poor final visual outcome after open-globe injury?

Study Design: Retrospective cohort study

Setting: Tertiary ophthalmology trauma service

Why This Works: Open-globe injury is sight-threatening, predictors such as presenting visual acuity, zone of injury, relative afferent pupillary defect, lens injury, retinal detachment, endophthalmitis, timing of repair, and follow-up adherence can be analysed.

Topic 23: Refractive Error Among School Children

Research Question: What is the prevalence of uncorrected refractive error among school children and what factors are associated with spectacle non-use?

Study Design: School-based cross-sectional study

Setting: Schools or community eye screening programme

Why This Works: Uncorrected refractive error affects learning and quality of life, visual acuity screening and refraction are feasible, and the study can assess spectacle coverage, awareness, affordability, stigma, and access to optometry services.

Topic 24: Childhood Blindness and Severe Visual Impairment

Research Question: What are the causes of childhood blindness and severe visual impairment among children attending a tertiary ophthalmology clinic?

Study Design: Retrospective descriptive study

Setting: Paediatric ophthalmology clinic or low-vision clinic

Why This Works: Childhood blindness has lifelong consequences, causes such as congenital cataract, glaucoma, corneal opacity, retinopathy of prematurity, optic atrophy, retinal dystrophy, trauma, and refractive error can be evaluated to guide prevention and rehabilitation services.

Topic 25: Strabismus Presentation and Surgical Outcomes

Research Question: What are the clinical types, age at presentation, amblyopia status, and postoperative outcomes among children undergoing strabismus surgery?

Study Design: Retrospective descriptive study

Setting: Paediatric ophthalmology or strabismus clinic

Why This Works: Strabismus is common in paediatric ophthalmology, records can provide deviation type, refractive error, amblyopia treatment, age at surgery, surgical method, alignment outcome, and follow-up adherence.

Topic 26: Congenital Cataract: Presentation and Visual Outcomes

Research Question: What are the causes, timing of surgery, postoperative complications, and visual outcomes among children treated for congenital cataract?

Study Design: Retrospective cohort study

Setting: Paediatric ophthalmology surgical unit

Why This Works: Congenital cataract is treatable but delay worsens outcome, data on age at presentation, laterality, associated ocular/systemic conditions, surgery, aphakia or IOL placement, amblyopia therapy, glaucoma, and final vision can be studied.

Topic 27: Optic Neuritis and Demyelinating Disease

Research Question: What are the clinical features, neuroimaging findings, treatment patterns, and visual outcomes of optic neuritis?

Study Design: Retrospective descriptive study

Setting: Neuro-ophthalmology clinic or tertiary ophthalmology service

Why This Works: Optic neuritis overlaps ophthalmology and neurology, records can assess visual acuity, colour vision, RAPD, visual fields, MRI findings, multiple sclerosis, neuromyelitis optica spectrum disorder, steroid therapy, and recovery.

Topic 28: Papilloedema: Causes and Diagnostic Pathway

Research Question: What are the causes, referral patterns, investigations, and outcomes among patients diagnosed with papilloedema?

Study Design: Retrospective descriptive study

Setting: Neuro-ophthalmology clinic or ophthalmology outpatient department

Why This Works: Papilloedema requires urgent evaluation, causes such as idiopathic intracranial hypertension, intracranial mass, cerebral venous sinus thrombosis, meningitis, and malignant hypertension can be studied with neuroimaging and clinical outcome correlation.

Topic 29: Missed Follow-Up in Ophthalmology Clinics

Research Question: What factors are associated with missed follow-up among patients receiving care for chronic eye diseases?

Study Design: Retrospective cohort or cross-sectional study

Setting: Glaucoma, retina, diabetic eye, or general ophthalmology clinic

Why This Works: Missed follow-up leads to preventable vision loss, the study can assess diagnosis, distance from hospital, waiting time, appointment interval, socioeconomic factors, visual acuity, treatment burden, and disease severity.

Topic 30: Referral Patterns to a Tertiary Ophthalmology Service

Research Question: What are the common reasons for referral to a tertiary ophthalmology service and how appropriate are these referrals?

Study Design: Retrospective audit

Setting: Tertiary eye clinic or ophthalmology casualty

Why This Works: Referral quality affects service efficiency, referral letters and final diagnoses can be reviewed, and the study can identify gaps in primary eye care, optometry referral, emergency triage, and district-level management.

Getting Your HPCSA Research Protocol Generated

If you’ve selected a research topic from this list, the next step is developing a comprehensive research protocol that meets HPCSA requirements, gains supervisor approval, and successfully passes IRB review.

What a Complete Research Protocol Includes

• Title and Introduction: Clear research question and background
• Literature Review: Summary of current evidence with international journal references relevant to ophthalmology, eye health, vision science, and public health eye care
• Methodology: Detailed study design, population, sampling, inclusion criteria, exclusion criteria, ophthalmic examination methods, imaging or diagnostic tools, data collection procedures, and outcome measures
• Statistical Analysis: Sample size calculation, descriptive analysis, comparative statistics, regression analysis, diagnostic accuracy analysis, visual outcome analysis, or risk factor modelling where appropriate
• Ethical Considerations: IRB submission requirements, informed consent where applicable, confidentiality, protection of patient records, and safe handling of ophthalmic imaging data
• Timeline: Gantt chart with realistic milestones for 4-year registrar training
• Budget: Resource requirements and cost breakdown
• References: Vancouver or APA style citations

Journals for HPCSA Ophthalmology Research

South African Journals

• South African Ophthalmology Journal – National journal for ophthalmology and eye health research
• South African Medical Journal (SAMJ) – Accepts clinical ophthalmology, public health, trauma, diabetes, HIV, and service delivery research
• African Vision and Eye Health – Suitable for optometry, ophthalmology, visual impairment, and public eye health research

International Journals

• Ophthalmology – Leading international ophthalmology journal
• American Journal of Ophthalmology – Major clinical ophthalmology journal
• British Journal of Ophthalmology – High-impact ophthalmology and global eye health research
• Eye – Broad ophthalmology research journal
• Retina – Retina and vitreoretinal disease research
• Cornea – Corneal disease, keratitis, and anterior segment research
• Journal of Glaucoma – Glaucoma diagnosis, treatment, adherence, and outcome studies

HPCSA Ophthalmology Registrar Research Requirements

All HPCSA ophthalmology registrars must complete a research project during their 4-year specialist training programme. The research protocol should be developed early in training, approved by a supervisor, submitted for institutional ethics review before data collection, and aligned with clinically relevant eye health priorities in South Africa.

Given South Africa’s ophthalmic priorities – including cataract blindness, glaucoma, diabetic retinopathy, ocular trauma, HIV-related eye disease, corneal blindness, paediatric visual impairment, refractive error, retinal disease, and limited access to specialist eye care – ophthalmology research topics should be practical, ethically sound, and relevant to real-world service delivery while maintaining strong academic and methodological standards.