ABSTRACT
The present study was conducted as a rapid assessment of avoidable blindness survey by cluster sampling, aimed primarily to assess the outcome of cataract surgery in a rural Indian population. MethodsAn Observational Point Prevalence study including 407 pseudophakic eyes of 382 subjects, screened through Survey across District in Rural Wardha and admitted in the eye ward of a Rural Tertiary Care Teaching Centre, who gave informed consent were included in this study. History of cataract surgery (time, place, cost and provision of glasses), diabetes mellitus, past history of laser capsulotomy was recorded. Visual acuity and thorough ocular examination including grading of PCO were done. Ocular findings were recorded on pre-tested proforma. ResultsPrevalence of PCO among the pseudophakic eyes was 31.4%. Mean age of study population was 68.1 +8.3 years (range 14-86 years). Rates of PCO are noted to be minimum (21.4%) in the age group 55 - 59 years and maximum (36.1%) in the age group 75 - 79 years. Mean duration since surgery in eyes with PCO among the total 407 pseudophakic eyes included in the study was 27.9 +23.7 months (range 1 - 120 months), 14.9% eyes developed visually significant PCO in <12 months since surgery. Prevalence of PCO ranged from 14.9% in <12 months since surgery to 32.0% at <60 months since surgery (c2=23.99, p<0.05). In the study group which included 5 (23.9%) eyes with a Foldable IOL, developed PCO as compared to 133 (34.5%) in the eyes implanted with PMMA IOL. Prevalence of PCO was higher in PMMA IOL. In the study group, 45 (59.2%) eyes with a Decentered IOL had PCO as compared to 93 (28.1%) eyes within the Bag placed IOL group. There was a higher prevalence of visually significant PCO in eyes with decentered IOL, as compared to eyes within the Bag IOL placement. (c2=26.71, DF=1, p=0.00000). Out of 407 pseudophakic eyes included in the study, history of diabetes was noted in 14 persons, of whom 14 (3.4%) pseudophakic eyes were included in this study and 9 (64.3%) of these developed PCO. The prevalence of PCO was significantly higher among diabetic patients (c2=4.65, p<0.05). The presence of uveitis in pseudophakic eyes was significantly related to higher PCO rates as compared to pseudophakic eyes without uveitis. (c2=24.68, DF=1, p=0.000001). ConclusionsVisually Significant PCO is seen in 1/3rd of eyes following cataract surgery. Duration since cataract surgery is a major factor influencing its genesis. IOL material, cataract surgery type, and IOL position are also important factors. Role of diabetes and uveitis needs to be studied further.
ABSTRACT
So far, evaluation of vertebral arteries has been done by angiography with a limited data on evaluation with duplex scanning of the vertebral arteries. We wanted to study the radiological features and vertebral artery Doppler characteristics, in patients aged above 35 years with a clinical diagnosis of cervical spondylosis. METHODSThis is a case control study with a total of 120 subjects aged over 35 years (60 subjects were cases with the clinical diagnosis of cervical spondylosis and the remaining 60 subjects were age matched controls). Vertebral artery colour Doppler was performed to record peak systolic velocity, time averaged maximum velocity, diameter of the segment in grey scale in millimetres and flow volume of the vertebral artery. Statistical analysis was done using chi square test, student t test and z test with p values < 0.05 being considered statistically significant. RESULTSMajority of patients in both groups were in the age group 41 - 50 years. Among cases 39 (65%) were males and 21 (35%) were females. Most of cases had vertebral artery diameters in the range of 3.0 - 3.5 mm seen both on right [21{35%}] as well as on left side [17 {28.3%}], and a similar finding was observed in controls as well. No statistical significance was observed amongst cases and control on either right or left side. Most of the cases had vertebral artery blood flow in the range of 51-100 mL/min both on right side [26 (43.3%)] and left side [22 (36.7%). On comparing vertebral artery blood flow in the range of ≤100 mL/min and >100 mL/min, the difference was statistically significant on the left side. On comparing the number of cases and controls according to the vertebral artery blood flow velocity ≤30 cm/s and >30 cm/sec on right side, p value was 0.009 and that on the left was 0.001, both of which are statistically significant. CONCLUSIONSVertebral artery diameter is not a very reliable sign in this degenerative condition. Vertebral artery flow volume is decreased at least in one vertebral artery. Vertebral artery blood flow velocity was significantly reduced in cervical spondylosis cases compared to controls both on right side (p=0.009) and left side (p= 0.001). This makes reduced vertebral artery blood flow velocity as a very strong sign in this condition. To conclude vertebral artery ultrasound is a very useful and reliable tool in evaluation of vertebrobasilar insufficiency cases.
ABSTRACT
Eye diseases and low vision are the most significant health and socioeconomic risks in developing countries like India. Globally, 253 million people are visually impaired, of these 36 million are blind and 217 million have moderate to severe visual impairment. With population growth and increasing life expectancy, the magnitude of blindness is expected to increase further.Objectives: To study the demographic profile of individuals with visual impairment and blindness and its causes in adults aged 50 years and abovein a district of Central India.Material and methods: Cluster sampling was employed from November2015to November 2017to randomly select 3000 individuals aged 50 years or more in 30 clusters from a district of Central India. Demographic details of individuals were noted. Visual assessment was done using