ABSTRACT
We compared vision and quality of life [VQL] of children aged 5-15 years and operated for unilateral and bilateral cataract between 2008 and 2010 in western India. In this cohort study, ophthalmologists assessed vision, anterior and posterior segment of eyes with cataract. Children completed a functional vision questionnaire [LVP-FVQ]. Follow up at 6 months after surgery included the best corrected visual acuity [BCVA], FVQ and eye assessment. The improvement of BCVA and quality of life were compared in group of unilateral and bilateral cataract. A total of 20 [70%] bilateral and 7 [39%] unilateral cataract were operated within 1 month of detection. All 48 eyes with bilateral cataract were congenital and 12 [67%] unilateral cataract were traumatic. Among bilateral group, 27 eyes [56.2% [95% confidence interval [CI] 44.4-72.2]] and in unilateral group 11 eyes [61.1% [95% CI 38.6-83.6]] had vision >/= 20/60 at 6 months follow up. The visual gain was significantly higher in children who were operated between 1 month and 1 year of detection [adjusted Odds ratio [OR] = 15.6 P = 0.03]. Positive impact on VQL in bilateral group was noted in 50%, 27%, and 13% children for subscale of distant vision, near vision, and field of vision, respectively. There was positive impact in these subscales among children with unilateral cataract. Thirty percent eyes with bilateral cataract and 22% of eyes with unilateral cataract improved their vision. Surgery within 1 month of cataract was significant predictor of improved vision [OR = 16.6 P = 0.02]. Vision and VQL improved in children with unilateral and bilateral cataract. However, it was better 6 months following surgery in children with bilateral cataract than in children with unilateral cataract
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Vision, Ocular , Quality of Life , Child , Cohort Studies , Surveys and QuestionnairesABSTRACT
We present the outcomes of a survey conducted in Nandurbar, a tribal district of Maharashtra, India. It was based on "Rapid Assessment for Avoidable Blindness" methodology and conducted in 2009 in Nandurbar, a tribal district of Maharashtra, India. We examined persons of 50 years and older ages. Ophthalmic assistants noted the distant vision [best corrected vision [BCV] and as presented]. Ophthalmologist examined eyes of persons with vision less than 6/18. The principal cause of impairment in each eye and the most "preventable" or "treatable" cause were assigned. We calculated the prevalence rates of bilateral blindness, severe visual impairment [SVI], and moderate visual impairment [MVI]. We examined 2,005/2,300 persons [response rate 87.2%]. The prevalence of blindness, SVI, and MVI for the BCV was 1.63% [95% CI 1.11-2.15], 5.93% [95% CI 4.96-6.90], and 14.6% [95% CI 13.2-16.1], respectively. The prevalence of blindness, SVI, and MVI for the presented vision was 1.87% [1.32-2.42], 6.72% [95% CI 5.70-7.74], and 19% [95% CI 17.4-20.6], respectively. Unoperated cataract was responsible for 77% of different visual disabilities. The coverage of existing cataract surgery service was 9.4%. Lack of knowledge about cataract surgery was the main cause of unoperated cataract among 41% of interviewed participants with cataract and SVI. Unoperated cataract was the main curable cause of visual disabilities in tribal population of India. Increasing awareness and offering cataract surgeries at affordable cost in the district would reduce visual disabilities
ABSTRACT
AIM: To calculate the direct cost of pediatric cataract surgery, from the provider's perspective.pediatric ophthalmology department of a comprehensive community eye care center in western India. Fixed costs included those of the building, interior decoration, outpatient department's equipment, operation theater equipment, personnel, administration and hospital maintenance. The consumable costs included materials used during surgery. Only direct costs were considered. Outpatient department consultation, Rs.606 ($15.53) for operation theater equipment use, and Rs. 2 427($62.23) for personnel. The consumable costs ranged from Rs.1 452 ($37.23) to 15 267 ($391.46), depending on the protocol used. The net average cost of pediatric cataract surgery ranged from Rs. 4 722 ($122) to Rs. 18 537 ($475) per eye. CONCLUSION: Cataract surgery is cost intensive for children with cataract. Pediatric ophthalmologists should decide about most cost effective standards of care to rationalize consumable cost.