Prevalence of visual disturbances among medical undergraduate students of a tertiary care teaching hospital in South Kerala

Background: Uncorrected errors of refraction are the leading cause of moderate to severe visual impairment. This study helps to determine the risk factors and prevalence of refractive error among medical students and to evaluate the uncorrected visual acuity among them. Aim was to study the prevalence and risk factors of visual disturbances among medical undergraduate students. Methods: A cross sectional study was conducted among 200 undergraduate medical students. Data on socio-demographic characteristics, type of refractive errors, risk factors for refractive errors and frequency of eye examinations were collected through questionnaires. Uncorrected visual acuity was detected using Snellens chart and near vision was tested using jaeger抯 chart. Appropriate statistical tests were applied and data was analysed using statistical package for the social sciences (SPSS) version 21. Results: Out of the total 200 study participants, majority were females (61.5%), mean age of the study participants was 21.51�33, 11.5% were examined for the first time through this study, 51% were suffering from some sort of visual disturbance among which 80% were having myopia, 50% of the study participants spent more than two hours per day reading books, 72.5% had habit of reading in dim light. Uncorrected visual acuity was seen among 22% of the study subjects and 15% with positive family history of refractive errors showed uncorrected visual acuity. Conclusions: This study was an effort to identify the risk factors and determine the prevalence of refractive errors, 22% of subjects had uncorrected visual acuity; myopia was the common refractive error observed among the study participants followed by hypermetropia and astigmatism.

Brain abscess in older children with uncorrected tetralogy of Fallot

Tetralogy of Fallot is the most common cyanotic congenital heart disease. Corrective surgery is indicated during infancy for the best outcome, however, due to poor availability and affordability of surgery, many children of resource-poor settings live with uncorrected tetralogy of Fallot. They suffer from dreaded complications like brain abscess, in later years of life. We report 3 cases of tetralogy of Fallot who developed brain abscess during their childhood.

Study-of-phacoemulsification-vs-phacotrabeculectomy-in-management-of-primary-angle-closure-glaucoma

Introduction: The study was conducted to evaluate IOP management by surgical modalities such as combined trabeculectomy and phacoemulsification and phacoemulsification surgery alone. Vision impairment is a major public health problem and the burden is increasing with increase in aged population. This study wasAims And Objectives: undertaken for study the IOP management by surgical modalities such as combined trabeculectomy and phacoemulsification and phacoemulsification surgery alone. A pre-designed prospective study was conducted at the OPD of upgraded Department of Ophthalmology at LLRM Medical College, Meerut. A total of 60 patients were divided in to two equal groups randomly and studied. Majority of the patients in both the groups wereObservation And Result: aged between 61 – 70 years. Females outnumbered males in this study which was statistically significant between the two groups. The mean pre- operative intra ocular pressure was 23.3 mm Hg in combined surgery group and 23.9 mm Hg in cataract surgery alone group. Mean Intra ocular pressure decreased regularly in each follow up more in combined group than the cataract surgery alone group. The mean intra ocular pressure after 1 years follow up in combined surgery group was 10.8 mm Hg and 13.4 mm Hg in the cataract surgery alone groups which was statistically significant. Mean BCVA before the operation was 3.2 in combined surgery group and 3.8 in cataract surgery before surgery. Mean BCVA declined after 1 year of follow up in combined surgery group was 1.9 and 2.7 in cataract surgery alone group which was statistically significant. The surgery success was complete in 80.0% of the combined surgery group and 60% of the cataract alone group. Criteria For Failure Of Surgeries Ÿ The IOP >23 MMHG at the end of 1 year or Ÿ The IOP not reduced by 20 % from base line at the end of 1 year Conclusion: This study was mainly undertaken to study the efficacy of combined trabeculectomy with cataract extraction and cataract only on primary angle closure glaucoma. This study had found that, the reduction of intra ocular pressure in both the groups but more prominent in combined surgery group than cataract alone surgery group.

On addressing the burden of uncorrected refractive errors

@#Uncorrected or unaddressed refractive error (URE) is the leading cause of treatable visual impairment (VI) globally. A significant factor is the prohibitive costs of corrective options. The World Health Organization recently recommended the use of effective refractive error coverage (eREC) to determine the burden and management of URE. To increase eREC, spectacles should be made available and affordable. Most developing countries use ready-made glasses produced in bulk to address presbyopia. Timor-Leste employed a tiered- pricing for these ready-made spectacles which were found to be effective. The Philippines can adopt similar initiatives considering that prescription spectacles are not covered by its national health insurance. Prescription spectacles should also receive coverage from the national insurance. Policies should also be created that will set-up optical units inside government hospitals and primary health care units that can dispense low cost or free prescription spectacles. Dedicated government posts for optometrists should be created to man the said units. Existing colleges of optometry can partner with nearby public health facilities to man their optical units similar to partnerships made for other health professions. State universities can also consider opening colleges of optometry where they can tie up return services conditions or follow ladderized programs based on community demands similar to existing ones for other health professions

Comparative study of anatomical and functional recovery of eye along with patient satisfaction score after small-incision cataract surgery and phacoemulsification cataract surgery

Purpose: Functional recovery after cataract surgery depends on the anatomical recovery of the eye. This study compared the improvement in visual function parameters after uniocular manual small-incision cataract surgery (MSICS) and phacoemulsification cataract surgery. Methods: This study included 310 patients divided randomly into two groups: 155 who received MSICS (MSICS group) and 155 who underwent phacoemulsification (phaco group) for cataract treatment. Outcome measures assessed included vertical and horizontal keratometry reading. The mean corneal astigmatism tear function measured using Schirmer 1 test results were recorded preoperatively, and on postoperative day 1, day 7, and day 30. Optical coherence tomography (OCT) was done to record the average central macular thickness (?m) on day 7 and day 30. Results: The mean corneal astigmatism and anterior chamber inflammation were more in the MSICS group than in the phaco group immediately postoperatively. However, no statistically significant difference was found between the groups with respect to corneal sensation, mean corneal astigmatism, tear film function, and visual outcomes on postoperative day 30. Uncorrected visual acuity was better in the phacoemulsification group than in the manual SICS group on postoperative day 1, day 7, and day 30 (P < 0.001). Conclusion: Both phacoemulsification cataract surgery and manual small-incision sutureless cataract surgery (MSICS) are safe and effective for visual rehabilitation. Phacoemulsification is the preferred technique where resources are available with the advantages of less mean corneal astigmatism, less anterior chamber inflammation, and better uncorrected visual acuity (UCVA) in the immediate postoperative period

Re-inventing the straight incision with a single central suture in manual small-incision cataract surgery to minimize surgically induced astigmatism

Purpose: To calculate the surgically induced astigmatism (SIA) in MSICS through a superiorly placed straight scleral incision closed with a single, central, perpendicular 10?0 polyamide suture and to document any suture?related complaints and complications. Methods: A retrospective, hospital?based study was carried out in 50 cases of uncomplicated senile cataract (>50 year) with nuclear sclerosis ? grade 4, 搘ith the rule� astigmatism who underwent MSICS through a superior, straight incision with a single, central, perpendicular 10?0 nylon suture. Patients with 揳gainst the rule� astigmatism, keratoconus, pre?existing corneal opacity, astigmatism >2D, distorted or oblique mires, and previous ocular surgeries and unwilling to participate were excluded. Results: The mean age of the patients was 64.81 + 2.824 years, with a male: female ratio of 1.38:1. The mean SIA at day 7, week 6, and 12 weeks was 0.539 + 0.118, 0.529 + 0.134, and 0.524 + 0.129, respectively. Only 6 patients (12%) complained of foreign body sensation. No patient developed any suture?related complications. Conclusion: SIA is significantly reduced in straight incision by applying a single, central, and perpendicular 10?0 polyamide suture, as compared to a straight incision without a suture.

Observation and study on uncorrected distance visual acuity and ocular adjustment function before and after excimer laser photorefractive keratectomy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the changes of uncorrected distance visual acuity(UCDVA)and ocular accommodation before and after excimer laser photorefractive keratectomy(PRK).METHODS: A retrospective study. There were 120 patients(240 eyes)who underwent PRK surgery in our center from December 2017 to December 2019 divided into two groups according to the diopter of spherical equivalent(SE): 70 cases with SE≤-6.00D in the mild to moderate myopia group and 50 cases with -6.00D&#x003C;SE≤-9.00D in the high myopia group which were observed and analyzed. The UCDVA(LogMAR), monocular accommodative amplitude(AMP), negative relative accommodation(NRA), positive relative accommodation(PRA)and monocular accommodative flipper(AF)were measured before and after operation at 1wk, 1 and 3mo. RESULTS: In the group of low-moderate myopia and high-myopia group, the UCDVA at 1wk, 1 and 3 mo after operation was significantly increased compared with those before operation(all P&#x003C;0.01). The increase of UCDVA of low to moderate myopia group was better than that in the high myopia group at 3mo after operation(P&#x003C;0.05). Monocular AMP in the both groups firstly decreased and increased afterwards, and there was a significant decrease than that before operation at 1wk and 1mo after operation(P&#x003C;0.01). AMP reached and was better than that before operation at 3mo after operation(P&#x003C;0.01). The increase of low to moderate myopia group was both higher and faster than that of high myopia group. Compared with PRA before operation, the patients of low to moderate myopia group decreased at 1wk after operation(P&#x003C;0.01), postoperative levels at 1mo recovered to preoperative level(P&#x003E;0.05)and postoperative at 3mo was superior to preoperative operation(P&#x003C;0.05); High myopia group did not change significantly at 1wk and 1mo after operation compared with preoperative operation(P&#x003E;0.05), and increased at 3mo after operation compared with preoperative level(P&#x003C;0.01). For low to moderate myopia group, there was no significant difference in preoperative and postoperative NRA, and at 1wk after operation, NRA of high myopia group temporarily increased compared with preoperative operation(P&#x003C;0.01). At 1mo after operation, it returned to the preoperative level(P&#x003E;0.05), and significantly increased at 3mo after operation compared with preoperative operation(P&#x003C;0.01). Monocular AF for both groups significantly decreased at 1wk after operation compared with preoperative operation, recovered at 1mo after operation and was significantly better at 3mo after operation(all P&#x003C;0.01); The low-to-moderate group increased more than the high-myopia group.CONCLUSION: PRK has a good correction effect for myopia below -9.00D, and people in low to moderate myopia have a better postoperative UCDVA correction effect than those in high myopia. The eye accommodation will be abnormal in a short period after operation. The recovery and improvement time of accommodative function in low-moderate myopia group are shorter than that in high myopia group, but both groups can recover and improve at 3mo after operation compared with the preoperative levels.

Effective analysis of transepithelial corneal collagen cross-linking surgery for progressive keratoconus / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyze the effectiveness of transepithelial-corneal collagen cross-linking for 1a after the treatment of progressive keratoconus and discuss its clinical significance. <p>METHODS:A total of 45 cases(48 eyes)of progressive keratoconus who underwent accelerated transepithelial-corneal collagen cross-linking in our hospital from Jan. 2017 to Dec. 2018 were collected. After 1a of postoperative follow-up, the changes of visual acuity, corneal thinnest point thickness, corneal endothelial cell count, corneal cross-linking line depth, Km of anterior corneal curvature and corneal biomechanical parameters before and after surgery were analyzed.<p>RESULTS:Compared with preoperative, the uncorrected visual acuity(UCVA)was improved obviously postoperative in this group patients(<i>P</i><0.05), but the best-corrected visual acuity(BCVA), corneal thinnest point thickness and corneal endothelial cell counts were no significant change(<i>P</i>>0.05). At 6mo and 1a postoperative, Km of anterior corneal curvature(48.54±2.57, 48.77±2.29D)are decreased significantly, the first flatten width of corneal biomechanical parameters(1.52±0.21, 1.57±0.22mm)were significantly lower(<i>P</i><0.05). The absolute value of the second flattening velocity(0.82±0.09, 0.82±0.18m/s)was significantly increased(all <i>P</i><0.05).<p>CONCLUSION:Accelerated transepithelial-corneal collagen cross-linking surgery for progressive keratoconus can significantly improve the UCVA and corneal biomechanics postoperative, but the BCVA was not significantly improved.

Clinical observation on removing or reserving the epithelial flap in high myopia correction by LASEK / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To compare the clinical effects of removing or reserving the epithelial flap in high myopia correction by laser subepithelial keratomileusis(LASEK). <p>METHODS: Retrospective analysis of 58 patients(115 eyes)with high myopia received LASEK were selected and divided into reserving the epithelial flap group(30 patients, 59 eyes)and removing epithelial flap group(28 patients, 56 eyes)according to the order of the alternating vists. The changes of corneal irritation, epithelial healing time,uncorrected visual acuity and the occurrence of haze after surgery were observed.<p>RESULTS:Postoperative 1d, 2d, 3d, respectively, the pain score of the two groups were 1.64±0.64, 1.57±0.57; 0.83±0.49, 0.84±0.56; 0.36±0.48, 0.34±0.47, respectively, the differences were not significant(<i>P</i>>0.05). Postoperative 1wk, 1mo, 3mo, respectively, the uncorrected visual acuity of two group was 0.15±0.06, 0.12±0.05; 0.032±0.004, 0.041±0.003; 0.018±0.004, 0.022±0.005, and the differences were not significant(<i>P</i>>0.05). After 1mo, 3mo of surgery, the differences of the haze less than grade one of the two group, respectively, and were not significant(<i>P</i>>0.05), the differences of the haze of grade two of the two groups, respectively, and the differences were significant(<i>P</i><0.05). The epithelial healing time of the two groups were 4.22±0.30d, 3.89±0.32d(<i>P</i><0.05). The number of epithelial delayed healing of two groups was 0 eye and 10 eyes(<i>P</i><0.05).<p>CONCLUSION:It was similar both the changes of corneal irritation and uncorrected visual acuity of two groups,the rate of level two haze was higher in removing epithelial flap group. The time of healing of epithelium was quick than reserving the epithelial flap group,but the rate of delayed healing and poor healing of epithelium was higher than reserving the epithelial flap group. Therefore, for high myopia, it is worthy of clinical application of reserving the epithelial flap by LASEK.

Meta-analysis of the effects of different lengths of orthokeratology on myopia in adolescents / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To systematically evaluate changes in dioptre, keratometry results, uncorrected visual acuity, and ocular axis in teenage patients with myopia using orthokeratology lens for different durations. To understand and determine the duration for using orthokeratology lens more accurately in these patients and to provide correct and reliable treatment guidance for these patients.<p>METHODS: Computerised search was conducted to retrieve studies from PubMed, CBM, WanFang Data, VIP, and CNKI databases, from the establishment of the databases to April 2019. The search yieldedrelevant studies on the use of orthokeratology to control the development of myopia in teenage patients. After two researchers independently conducted literature screening, data extraction, and methodological quality evaluation, a Meta-analysis was performed using RevMan 5.3 software.<p>RESULTS: Finally, 8 relevant studies were selected, which included 1 136 teenage patients with myopia. The Meta-analysis revealed that after wearing orthokeratology lens for 1wk, keratometry results changed without statistical significance \〖1wk: <i>MD</i>=0.91, 95% <i>CI</i>(-0.01-1.83), <i>P</i>=0.05\〗. However, after using orthokeratology lens for 1, 3, 6, and 12mo, keratometry results decreased \〖1mo: <i>MD</i>=0.82, 95% <i>CI</i>(0.12-1.53), <i>P</i>=0.02; 3mo: <i>MD</i>=1.31, 95% <i>CI</i>(0.63-2.00), <i>P</i><0.05; 6mo: <i>MD</i>=1.35, 95% <i>CI</i>(0.62-2.09), <i>P</i><0.05; 12mo: <i>MD</i>=1.41, 95% <i>CI</i>(0.68-2.41), <i>P</i><0.05\〗. Further, after 12mo of using orthokeratology lens, the increase in dioptre was effectively controlled \〖12mo: <i>MD</i>=2.61, 95% <i>CI</i>(1.52-3.71), <i>P</i><0.05\〗, and the uncorrected visual acuity improved \〖12mo: <i>MD</i>=-0.81, 95% <i>CI</i>(-0.84--0.79), <i>P</i><0.05). The ocular axis did not show a statistically significant increase \〖12mo: <i>MD</i>=-0.06, 95% <i>CI</i>(-0.21-0.09), <i>P</i>=0.44\〗. <p>CONCLUSION: The use of orthokeratology lens cannot only reducekeratometry values, but also control the growth of the ocular axis. However, these results can be achieved only after long-term wear.

Accuracy of noncycloplegic refraction performed at school screening camps

Purpose: The aim of this study was to compare noncycloplegic refraction performed in school camp with that performed in eye clinic in children aged 6� years. Methods: A prospective study of children with unaided vision <0.2 LogMAR who underwent noncycloplegic retinoscopy (NCR) and subjective refraction (SR) in camp and subsequently in eye clinic between February and March 2017 was performed. A masked optometrist performed refractions in both settings. The agreement between refraction values obtained at both settings was compared using the Bland朅ltman analysis. Results: A total of 217 eyes were included in this study. Between the school camp and eye clinic, the mean absolute error � standard deviation in spherical equivalent (SE) of NCR was 0.33 � 0.4D and that of SR was 0.26 � 0.5D. The limits of agreement for NCR were +0.91D to ? 1.09D and for SR was +1.15D to -1.06D. The mean absolute error in SE was ?0.5D in 92.62% eyes (95% confidence interval 88%�%). Conclusion: A certain degree of variability exists between noncycloplegic refraction done in school camps and eye clinic. It was found to be accurate within 0.5D of SE in 92.62% eyes for refractive errors up to 4.5D of myopia, 3D of cylinder, and 1.5D of hyperopia.

Orthokeratology lens and conventional frame glasses for ocular parameters of myopia adolescent / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the effects of overnight orthokeratology lens and conventional frame glasses on the myopic diopter, uncorrected visual acuity and ocular parameters of myopia adolescent. <p>METHODS: Totally 102 cases of(204 eyes)of adolescent myopia patients were randomly divided into observation group and control group with 51 cases(102 eyes)in each group during April 2014 to April 2017. Control group was only given conventional frame glasses, and observation group was given overnight orthokeratology lens. The myopic diopter and uncorrected visual acuity(UCVA)before wearing glasses and at 1wk, 1, 3, 6mo and 1a of wearing glasses, and the ocular parameters before wearing glasses and at 1a after wearing glasses were observed in the two groups, and the occurrence of complications was compared between the two groups. <p>RESULTS: After 1wk to 1a of wearing glasses, the myopic diopter in observation group was gradually decreased(<i>P</i><0.05), and there was no significant difference in control group(<i>P</i>>0.05), but there was statistically significant difference between-groups at different time points(<i>P</i><0.05). After 1wk to 1a of wearing glasses, the UCVA in observation group showed a increasing tendency(<i>P</i><0.05), and the UCVA in observation group after 6mo to 1a of wearing glasses was significantly higher than that in control group(<i>P</i><0.05). At 1a after wearing glasses, the axial length, corneal endothelial cell density, central anterior chamber depth, and intraocular pressure in observation group were not significantly different from those before wearing glasses(<i>P</i>>0.05), and the axial length in control group was significantly longer than that before wearing glasses and that in observation group(<i>P</i><0.05). The total incidence rates of complications in observation group and control group were 10.8% and 6.9% respectively(<i>P</i>>0.05).<p>CONCLUSION: Overnight orthokeratology lens for adolescent myopia can effectively correct the myopic diopter, and improve the uncorrected visual acuity. It is less harmful to the eyes and less complications, and it is safe and reliable in clinical application.

Correlation between Uncorrected Visual Acuity and Macular Distortion in Idiopathic Epiretinal Membrane Patients

PURPOSE: To evaluate the association between degree of retinal abnormalities and uncorrected visual acuity (UCVA) in idiopathic epiretinal membrane (ERM) patients with a small amount of refractive error. METHODS: We retrospectively reviewed 49 eyes (37 patients) of idiopathic ERM patients. We investigated the association between visual acuity and macular status (central macular thickness [CMT], outer retinal integrity score, and inner retinal irregularity index) that was assessed by optical coherence tomography using multiple linear regression analysis. We defined visual acuity difference (VAD) as the difference between UCVA and best-corrected visual acuity (BCVA). We divided patients into two groups according to VAD size and compared clinical characteristics between the two groups. We also investigated factors associated with VAD using multiple linear regression analysis. RESULTS: BCVA showed significant association with CMT and outer retinal integrity score, while UCVA showed significant association with CMT and inner retinal irregularity index. Patients with a large VAD showed a similar level of BCVA compared to the small VAD group (logarithm of the minimum angle of resolution [logMAR], large VAD group 0.11 ± 0.11 vs. small VAD group 0.13 ± 0.12, p = 0.585). However, UCVA was worse (logMAR, large VAD group 0.44 ± 0.14 vs. small VAD group 0.18 ± 0.14, p < 0.001) and inner retinal irregularity was higher (large VAD group 1.06 ± 0.04 vs. small VAD group 1.04 ± 0.03, p < 0.001) in patients with a large VAD. On multiple linear regression analysis, the absolute value of spherical equivalent (standardized coefficient β 0.521, p < 0.001) and inner retinal irregularity index (standardized coefficient β 0.448, p < 0.001) were significantly associated with VAD. CONCLUSIONS: UCVA was associated with inner retinal irregularity in idiopathic ERM patients with a mild degree of refractive error. Inner retinal irregularity was also associated with degree of VAD, suggesting that the effect of refractive error correction is greater in patients with more distorted retina.

Effect of cataract surgical incision on original astigmatism and tear film stability of corrected cornea / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the effect of the size of cataract surgical incision on original astigmatism and tear film stability of corrected cornea.METHODS: Totally 92 cataract patients (92 eyes) who were admitted to our hospital from July 2014 to July 2016 were randomly divided into the control group and the observation group,46 cases (46 eyes) in each group.Both groups were treated by clear corneal tunnel incision phacoemulsification combined with intraocular lens implantation.The incision of the control group was 3.0mm while of the observation group was 1.8mm.The uncorrected visual acuity,corneal astigmatism,Schirmer I test (SⅠt) and break-up time (BUT) were detected before surgery and at 1d,1wk,1mo and 3mo after surgery.The surgery induced astigmatism (SIA) was recorded at 1d,1wk,1 and 3mo after surgery.RESULTS: There were significant differences in the uncorrected visual acuity between the two groups at 1 and 3mo before surgery (P0.05).At 1wk,1 and 3mo after surgery,SIA of two groups decreased continuously,and the SIA of the observation group was significantly lower than that of the control group at 1d,1wk and 1mo after surgery (P0.05).SⅠt and BUT in the observation group were less or shorter than those in the control group at 1wk after surgery (P0.05).CONCLUSION: Compared with 3.0mm standard incision,1.8mm clear corneal incision can reduce SIA and shorten the time for corneal stability recovery.

Prevalence of uncorrected refractive errors of rural population aged ≥ 50 years in Funing county, Jiangsu province / 眼科新进展

Objective To investigate the prevalence of uncorrected refractive errors among urban population aged 50 years and above in Ftming county,Jiangsu province.Methods Survey research was conducted and randomly cluster sampling was used to select individuals aged ≥50 years for visual acuity test and eye examination in Funing county,Jiangsu province.The criteria of uncorrected refractive errors in this study was defined as an improvement of at least 0.2 log MAR (equivalent to 2 lines) in the best corrected visual acuity with the base vision ＜ 0.5 log MAR in daily life.The quantitative data were expressed as mean ± standard deviation,and t-test was used for comparison between groups,and while the count data were expressed as rate or composition ratio,and the x2 test was adopted for comparison between the groups.Logistic regression was used to examine the effect of possible factors (i.e.age and gender) on the prevalence of uncorrected refractive errors.Results A total of 6145 persons aged 50 years and above were enumerated and 5947 (96.8％) participants were examined,of whom 2388 had uncorrected refractive errors,with the prevalence of 40.2％.The prevalence of uncorrected refractive errors for myopia only,hyperopia only,astigmatism,and for hyperopia and astigmatism were 84.4％,84.2％,64.1％ and 100％,respectively.Moreover,the higher prevalence of uncorrected refractive errors presented in elderly person (OR =1.07,P ＜ 0.00l) and female (OR =1.38,P ＜ 0.001),and education was a protective factor for junior high school (OR =0.74,P =0.003) and high school (OR =0.55,P ＜ 0.001).Conclusion Uncorrected refractive errors presented high prevalence in rural population aged 50 years and above in Funing county,Jiangsu province,which are the leading cause of visual impairment.

Prevalence of visual impairment due to uncorrected refractive error: Results from Delhi‑Rapid Assessment of Visual Impairment Study.

Aim: To estimate the prevalence of visual impairment (VI) due to uncorrected refractive error (URE) and to assess the barriers to utilization of services in the adult urban population of Delhi. Materials and Methods: A population‑based rapid assessment of VI was conducted among people aged 40 years and above in 24 randomly selected clusters of East Delhi district. Presenting visual acuity (PVA) was assessed in each eye using Snellen’s “E” chart. Pinhole examination was done if PVA was <20/60 in either eye and ocular examination to ascertain the cause of VI. Barriers to utilization of services for refractive error were recorded with questionnaires. Results: Of 2421 individuals enumerated, 2331 (96%) individuals were examined. Females were 50.7% among them. The mean age of all examined subjects was 51.32 ± 10.5 years (standard deviation). VI in either eye due to URE was present in 275 individuals (11.8%, 95% confidence interval [CI]: 10.5–13.1). URE was identified as the most common cause (53.4%) of VI. The overall prevalence of VI due to URE in the study population was 6.1% (95% CI: 5.1–7.0). The elder population as well as females were more likely to have VI due to URE (odds ratio [OR] = 12.3; P < 0.001 and OR = 1.5; P < 0.02). Lack of felt need was the most common reported barrier (31.5%). Conclusions: The prevalence of VI due to URE among the urban adult population of Delhi is still high despite the availability of abundant eye care facilities. The majority of reported barriers are related to human behavior and attitude toward the refractive error. Understanding these aspects will help in planning appropriate strategies to eliminate VI due to URE.

Prevalence and Risk Factors for Undercorrected Refractive Errors among South Korean: KNHANES 2008-2012

PURPOSE: To assess the prevalence and risk factors of undercorrected refractive error in South Korea. METHODS: We analyzed 36,162 participants for estimating prevalence using the Korean National Health and Nutrition Examination Survey (KNHANES, 2008-2012). Undercorrected refractive error was defined as an improvement of at least 2 lines in best corrected visual acuity compared with the presenting visual acuity in the right eye. Proportion of undercorrected refractive error by occupation was presented, and associated sociodemographic factors were evaluated by multivariable logistic regression. RESULTS: The prevalence of undercorrected refractive error among all participants and among adults was 8.5% (n/N, 6,954/36,162) and 18.8% (n/N, 3,980/19,884), respectively. The proportion of undercorrected refractive error was higher among those with did not wear spectacles or contact lenses (23.1%) than among spectacle or contact lens wearers (8.1%). The proportion of participants who gained more than four or more lines of best corrected visual acuity was 7.2% (n = 2,606) for the all age group. In terms of occupation, farming, fishing, and forestry occupations (22.8%, 570/2,499) and laborer (20.2%, 497/2,457) were more likely to have undercorrected refractive error. Age groups of 10s, 70s, or 80s (30s as a reference group), female sex, lower income, lower education level, and living without a spouse were associated with undercorrected refractive error. CONCLUSIONS: People of older age, female sex, and lower socioeconomic status were more likely to have undercorrected refractive error. This suggests that a public-health approach is needed for preventing visual impairment via proper vision correction.

Observation on phacoemulsification and intraocular lens implantation surgical intervention of complicated cataract in patients with uveitis / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the efficacy of phacoemulsification and intraocular lens implantation surgical intervention of complicated cataract in patients with uveitis. ●METHODS:Retrospective study. A total of 57 cases (57 eyes ) with complicated cataract with uveitis were involved in the study from Jan. 2015 to Dec. 2015. All cases underwent phacoemulsification and intraocular lens implantation surgery successfully. The postoperative reaction, effect, complications and so on were retrospectively analyzed after phacoemulsification and intraocular lens implantation surgery. The date of visual outcome was analyzed using Non - parametric Wilcoxon test. ●RESULTS: lris were bleed in 21 eyes ( 37%) , 4 eyes ( 7%) with posterior capsule rapture and posterior chamber intraocular lens was not implanted in 4 eyes ( 7%) . The uncorrected visual acuity ( UCVA ) was significantly increased after surgery. The UCVA of 8 eyes (14%) were 0. 1 or better before surgery, and the UCVA of 42 eyes (74%) were 0. 1 or better 3mo after surgery, the difference was statistically significant ( Z=23. 42, P ● CONCLUSION: The phacoemulsification combined intraocular lens implantation surgical intervention of complicated cataract in patients with uveitis has good effect and fewer complications.

Outcome of laser surgery for mild myopia and myopic astigmatism / Шинэ санаа Шинэ нээлт

LASIK is the most popular treatment method for correction of the refractive errors of ophthalmology its development in 1990 and number of patients has continued to increase.The safety and efficacy of LASIK surgery have been reported several times by numerous researchers and doctors, but all studies have made abroad. This time we have summarized postoperative outcomes of LASIK surgery, which have performed in our country. Consequently 103 patients (206 eyes) who underwent LASIK surgery in “Bolor-Melmii” eye clinic between 2007 and 2011 were enrolled. The retrospective method of study was used to evaluate postoperative outcomes. Preoperative UCVA of 0.04-0.4 improved to 0.5-1.2(decimal) at 1 day after surgery and during 1 year after surgery revealed minimal but wasstable. Preoperative mean sphere equivalent of 2.2+/-0.72D improved at the 1 year by +/-0.5D in 161 eyes (78.15%), by +/-1.0D in 39 eyes (18.9%) and by +/-2.0D in 6 eyes (2.9%)after surgery. Mean sphere equivalent and astigmatism improved to -0.46 +/-0.4D and -0.43+/-0.34D respectively at 1 year after surgery. Improvement of the sphere equivalent and its stability during a year period of study proves that LASIK surgery is an effective with stable improvements and safe procedure for correcting myopia/myopic astigmatism. No severe complications occurred during and after surgery.

lmpact of incision position of phacoemulsification cataract exaction on corneal astigmatism / 国际眼科杂志(Guoji Yanke Zazhi)

To compare the impact of different incision positions of phacoemulsification cataract exaction on corneal astigmatism. ●METHODS: Totally 412 patients ( 456 eyes) who had undergone the phacoemulsification and lOL implantation from June 2006 to June 2013 were randomly divided into two groups (each 228 eyes): observation group (incision above the middle of the limbus for the rule astigmatism, at the temporal for against the rule astigmatism, at the top of the temporal regulation on the maximum curvature of the meridian of the cornea for oblique astigmatism, at the top of the temporal for patients without astigmatism);control group ( incision at top and middle of limbus), using a 3mm cornea scleral tunnel incision without suture, 2mm from the limbus. Corneal refractive status of preoperative and postoperative at different times were detected by corneal refractive, comparing the impact of different surgical incision on postoperative corneal astigmatism. ●RESULTS:The visual acuity of 1, 3mo postoperative of observation group was significantly better than the control group ( P ●CONCLUSlON:lncision at the corneal curvature of the largest radial could correct preoperative astigmatism and improve visual acuity to a certain extent.