Uncorrected and corrected refractive error experiences of Nepalese adults: a qualitative study.

PURPOSE: The aim of this study was to explore the impact of corrected and uncorrected refractive error (URE) on Nepalese people's quality of life (QoL), and to compare the QoL status between refractive error subgroups. METHODS: Participants were recruited from Tilganga Institute of Ophthalmology and Dhulikhel Hospital, Nepal. Semi-structured in-depth interviews were conducted with 101 people with refractive error. Thematic analysis was used with matrices produced to compare the occurrence of themes and categories across participants. Themes were identified using an inductive approach. RESULTS: Seven major themes emerged that determined refractive error-specific QoL: activity limitation, inconvenience, health concerns, psycho-social impact, economic impact, general and ocular comfort symptoms, and visual symptoms. Activity limitation, economic impact, and symptoms were the most important themes for the participants with URE, whereas inconvenience associated with wearing glasses was the most important issue in glasses wearers. Similarly, possibilities of having side effects or complications were the major concerns for participants wearing contact lens. In general, refractive surgery addressed socio-emotional impact of wearing glasses or contact lens. However, the surgery participants had concerns such as possibility of having to wear glasses again due to relapse of refractive error. CONCLUSION: Impact of refractive error on people's QoL is multifaceted. Significance of the identified themes varies by refractive error subgroups. Refractive correction may not always address QoL impact of URE but often add unique QoL issues. This study findings also provide content for developing an item-bank for quantitatively measuring refractive error-specific QoL in developing country setting.

Ocular findings in leprosy patients in Nepal in the era of multidrug therapy.

PURPOSE: Detailed ophthalmic evaluation was performed to determine the prevalence of ocular complications among leprosy patients on multidrug therapy and those released from multidrug treatment. DESIGN: Observational case series. METHODS: Leprosy patients at Tribhuvan University Teaching Hospital from April 1, 2001, through September 30, 2002, underwent detailed ophthalmic evaluation including slit-lamp biomicroscopy, dilated funduscopy, and applanation tonometry. RESULTS: We evaluated 58 leprosy patients. A majority (72%) was receiving treatment for multibacillary leprosy; 14% belonged to posttreatment multibacillary and paucibacillary groups. Ocular involvement was found in 57% of patients. In the multibacillary group, 55% had ocular involvement, which was more than double that found in the paucibacillary group (25%), although this finding was not statistically significant (P =.187). Among patients with ocular complications, 48% had visual disability and another 45% had threatened vision; 9% met World Health Organization guidelines for blindness. Uveitis and its complications were the predominant causes of visual disability (88%). CONCLUSION: Ocular complications and visual disability are high among leprosy patients in Nepal even after completing multidrug therapy.