ABSTRACT
This study was conducted to determine awareness and practices relating to diabetic retinopathy among non-medical persons in a south Indian population. In this population-based cross-sectional study, trained social workers conducted face-to-face interviews using a semi-structured questionnaire with 200 randomly selected paramedical personnel and 204 persons randomly selected from the community. Responses were graded on a five-point scale. Over half of respondents were not aware of risk factors for diabetic retinopathy. Only one-fifth of paramedics and one-tenth of persons from the community were aware that uncontrolled diabetes was a risk factor for retinopathy. Over 75% of respondents were not aware of either laser or surgery as an intervention for retinopathy. Although 80% of respondents from the community felt that yearly eye examinations were essential, only 43.5% had ever visited an ophthalmologist. Nearly three-fourths of paramedical personnel did not have any material related to diabetes for health education. It is evident that considerable effort is required to improve awareness of diabetic retinopathy, and to translate this improved awareness to actual utilisation of services.
Subject(s)
Diabetic Retinopathy , Health Knowledge, Attitudes, Practice , Adult , Aged , Allied Health Personnel/psychology , Data Collection , Female , Humans , India , Male , Middle Aged , Pilot Projects , Surveys and QuestionnairesABSTRACT
PURPOSE: To identify barriers in utilisation of community based rehabilitation (CBR) services for incurably blind persons in rural South India. METHODS: A community-based rehabilitation programme for incurably blind persons was initiated in Theni district of southern Tamil Nadu in south India. After door-to-door enumeration and preliminary ocular screening by trained workers at the village, identified blind persons were categorised as either curable or incurable by an ophthalmologist. Trained workers provided rehabilitation, including mobility training (OM), training to perform activities of daily living (ADL), and economic rehabilitation for the incurably blind in their respective villages. RESULTS: Of the 460,984 persons surveyed, 400 (0.09%) were certified as incurably blind including 156 (39.00%) persons blind from birth. Social rehabilitation was provided for 268 (67.00%) incurably blind persons. Economic rehabilitation was provided to 96 persons, and integrated education to 22 children. Nearly one-fifth (n=68, 17.00%) of incurably blind persons refused the services provided. The major reasons for refusal included old age and other illnesses (41.18%), and multiple handicaps (19.12%). Twenty-seven (6.75%) persons had either migrated or died, and 29 (7.25%) persons were already able to function independently. CONCLUSION: Although CBR programmes provide useful services to the incurably blind, a better understanding of barriers is required to improve service utilisation. Developing a standardised data collection format for every CBR programme can result in the creation of a national database of ophthalmic diseases.
Subject(s)
Blindness/rehabilitation , Community Health Services/statistics & numerical data , Rural Population/statistics & numerical data , Visually Impaired Persons/rehabilitation , Adolescent , Adult , Aged , Aged, 80 and over , Blindness/psychology , Child , Child, Preschool , Developing Countries , Female , Humans , India , Male , Mass Screening , Middle Aged , Patient Acceptance of Health Care/statistics & numerical data , Rehabilitation/psychology , Visual Acuity , Visually Impaired Persons/psychologyABSTRACT
PURPOSE: To determine the usefulness of the Brückner test as a screening tool for detection of amblyogenic factors in developing countries. METHODS: A double blind prospective study of 101 children aged 1 to 16 years attending the pediatric ophthalmology department of a tertiary eye care center. A trained optometrist masked to clinical findings of the subject performed the Brückner test in a dark room using a direct ophthalmoscope and compared differences in brightness of the pupillary reflex of both eyes. Subsequently, subjects underwent a complete ophthalmic examination by a pediatric ophthalmologist masked to the results of the Brückner test. RESULTS: The optometrist identified 39 subjects as Brückner test positive and 62 as Brückner test negative. On clinical examination, 12 subjects had anisometropia of ≥1D and 20 subjects had manifest deviation of >4(Δ). The sensitivity of the Brückner test was 87.5% and specificity 84.1%; the positive (PPV) and negative predictive (NPV) value was 71.8% and 93.6%. The false positive and false negative rates were 28.2% and 6.5%. CONCLUSION: Although imperfect, the Brückner test may be a low cost alternative to either screening with photo screener or to no screening for amblyogenic factors in developing countries.
