I will need this paper one day.
Colleagues from India published recently a RCT, which evaluated subconjunctival anesthesia for manual small incision cataract surgery.
Not surprisingly, it does not provide akinesia. However, its anesthesia is sufficient for more or less comfortable surgery. It’s only obstacle is a chemisis, which is especially disturbing for novice surgeons.
In the western world it is rare, to miss an OSSN and excise it as pterigium without no-touch technique etc. In one retrospective study from the US it was only in 0,3% of all cases of pterygium excision.
Assessment of eye drop instillation techniques among patients with primary open angle glaucoma in a Nigerian tertiary hospital
Olapeju A Sam-Oyerinde et al. Int Ophthalmol. 2021.
Approximately everyone does not wash their hands before the instillation. And ~30-40% touch the eye during inatillations. This was tested in Nigeria on glaucoma patients.