Assessment of visual gain following cataract surgeries in Oman: a hospital-based cohort study

The post-operative vision is used as benchmark to determine the quality of cataract surgery. However, late presentation and co-morbidities influence the visual gain and they should also be considered while auditing cataract surgeries. The authors present method of analysis of cataract surgeries for older than 30 years of aged patients performed by ophthalmologists in Oman during 2003. Ophthalmologists evaluated visual and ocular status of eyes with cataract. Cataract was operated using operative microscope and lens was implanted in the eye. The vision was recorded six weeks after surgery and visual gain was grouped from postoperative vision in relation to the preoperative vision. Presence of co-morbidities like glaucoma, corneal opacities, macular degenerations and others were considered while evaluating visual outcomes. 3,485 eyes operated were included in our study. 3,003 [86.2%] of them were operated by extra-capsular cataract extraction and lens implantation. Following surgery, 960 [27.5%] eyes had vision >/= 6/18. 1,483 [42.6%] eyes had vision between 6/60 and 6/18. 233 [6.8%] eyes had vision <3/60. Excellent grade of vision gain in relation to preoperative visual status was found in 2,250 [64.6%] eyes, good visual gain was in 422 [12.1%] eyes and poor' visual gain was in 335 [9.6%] eyes. Postoperative visual status was significantly associated to the co-morbidities. [p<0.001]. Nearly 14% of persons were lost to the follow up. In countries like Oman with high prevalence of trachoma, glaucoma and diabetes, the proposed grading of visual gain that accounts for the preoperative vision and the presence of co-morbidity could be better option for auditing the cataract surgery

Contact lens induced corneal ulcer management in a tertiary eye unit in Oman - a descriptive study

The corneal disease is a priority problem in Oman. We present patients with contact lens [CL] induced severe keratitis, admitted in the corneal unit of Al Nahdha Hospital in Oman. The study was conducted in 2005-2006. Ophthalmologists examined the eyes using slit lamp bio-microscope. Visual acuity was noted using Snellen's distance vision chart. Specimens of corneal scraping and CLs were sent for culture and sensitivity tests. Patients with severe keratitis were admitted and treated with medicines. Corneal and visual statuses were noted at the time of discharge from hospital and after six weeks. Numbers, percentages and their 95% confidence intervals were calculated. Pre- and post-treatment vision were compared using a scattergram. The 52 eyes of 15 males and 37 female patients with corneal ulcers were examined. Thirty-two patients were between 20 to 30 years of age. Only 13 [25%] patients had visited an ophthalmologist within 24 hours of developing severe keratitis. Seventeen [33%] had central ulcers and six [11.5%] had ulcer >/= 5 mm in size. Pseudomonas was found in 29 [55.8%] of CL and corneal material scraped from the eyes of 15 [28.8%] patients. Vision was < 6/60 [legally blind] in 12 [23.1%] eyes before and in five [9.6%] eyes after treatment. Twenty-six [50%] patients were lost to follow up. CL related severe keratitis causes visual disabilities. Prevention and proper records are essential. Treatment improves vision and hence facilities for management should be strengthened

Compliance of spectacle wear and its determinants among schoolchildren of Dhakhiliya region of Oman: a descriptive study

To determine the degree of compliance of spectacle wear and some of its determinants among school children of Dhakhiliya region of Oman. This was a cross-sectional descriptive study of a sample of 663 students who had been prescribed spectacles for constant wear. After one year, experienced field staff conducted a follow-up visit where 571 of these students were examined. Information on age, gender, type and severity of refractive error was collected from the school health records and refractionist-s report and analyzed to associate them to the compliance of spectacle wear. The majority [71.6%] of students were using spectacles at the time of follow up. The compliance rate was 65.1% in boys and 78.3% in girls. Agewise, it was 66.7% in 6-7-year-olds, 66.7% in 12-13-year-olds and 79.1% in 16-17-year olds. The rate was 72.5% among students with myopia and 67.9% among those with hypermetropia. The compliance of spectacle wear was significantly higher among students with myopic refractive error of 2.5 D or more compared to those with less than 2.5 D. The difference in the compliance rates among students with hypermetropia of different grades was not significant. The study identifies the factors of high-risk of non compliance as [a] male gender, [b] younger age, and [c] low myopic refractory error. The eye health care program of Oman should focus on these high risk groups to further improve the compliance for visual aids