The impact of COVID-19 on compliance to amblyopia treatment in a tertiary eye care center

Purpose: To investigate the impact of the coronavirus disease 2019 (COVID?19) outbreak on compliance to amblyopia therapy from the perspective of parents of amblyopic children. Methods: The participants for the qualitative study were enrolled from the medical records of a tertiary eye care center during the COVID?19 pandemic. The trained researcher conducted telephonic interviews consisting of validated 15 open?ended questions for 15 min. The questions were related to patients’ compliance toward amblyopia treatment and the date of follow?up with their practitioners. The data collected were entered on Excel sheets in the participant’s own words and later converted to a transcript for analysis. Results: A total of 217 parents of children with amblyopia who were due for follow?up were contacted through telephone. The response rate for willingness to participate was only 36% (n = 78). Of these, 76% (n = 59) of parents reported that their child was compliant toward the treatment during the therapy period and 69% reported that their child was currently not on treatment for amblyopia. Conclusion: In the current study, we have observed that although reported compliance by parents during the therapy period was good, around 69% of patients had discontinued amblyopia therapy. The main reason for the discontinuation of therapy was the failure to visit the hospital during the scheduled follow?up with the eye care practitioner.

Cost-Effectiveness of Photoscreeners in Screening at-Risk Amblyopia in Indian Children

Objectives: Amblyopia is the most common cause of preventable vision impairment in children. This study tried to evaluate the cost-effectiveness of photoscreeners in identifying refractive errors making children at risk of amblyopia. Materials and Methods: This was designed as a prospective, open?label, randomized controlled study to compare the cost?effectiveness of photoscreeners (2WIN Adaptica and Plusoptix) versus autorefractor and Mohindra retinoscopy to identify the at?risk amblyopia. This study was conducted from October 2018 to December 2018 in coordination with Nanna Kannu school screening project and children in the age group of 5–11 years were included in the study. The photoscreening was done by lay screeners. Asupervising ophthalmologist collated all data. Cost-effectiveness was calculated for the individual instruments and compared. The average time is taken for each instrument to record the refractive error was calculated and compared with the Mohindra retinoscopy. Results: Number of children included in this study was 2910. The mean age of the children was 7.82 + 0.65 years. The mean time taken for 2WIN Adaptica was 6 sec, Topcon –10 s, and Plusoptix –4 s. Plusoptix showed the minimal time for screening a child when compared to all other methods. The Plusoptix and 2WIN Adaptica were shown to be cost?effective when compared to Mohindra retinoscopy (P < 0.05). Conclusion: Photoscreening using Plusoptix and 2WIN Adaptica with lay screeners was < seven times the cost incurred and five times faster than the trained optometrists using either autorefractor or Mohindra retinoscopy and thus more cost?effective in screening a large number of young children with at-risk amblyopia at the community level.

Amyloidosis of lacrimal gland.

Primary localized amyloidosis of lacrimal gland is a rare occurrence. This report describes a female patient with isolated amyloidosis of the lacrimal gland. A 45-year-old Indian woman presented with a swelling over the left lacrimal gland region. Computed tomography showed uniform enlargement of the lacrimal gland. A lacrimal gland biopsy revealed amyloidosis. No systemic involvement was detected on further investigation. To our knowledge, this is the first report of lacrimal gland amyloidosis from India and our report also highlights the importance of lacrimal gland biopsy in diagnosing lacrimal gland masses.