The effect of blue light filter on visual and task performance.

PURPOSE: This study aimed to determine the effect of the blue light (BL) filter on the different tasks performed on a laptop on a daily basis. METHODS: Forty subjects were required to perform a 45-minute task on the laptop screen with or without the BL filter on two different days. In the first task, subjects were made to watch a video. In the second task, subjects were made to read a passage from the laptop for 3 minutes, and reading speed was calculated. In the third task, subjects were made to enter the data on the laptop. The time taken to fill in the data was recorded. After the completion of the task, questionnaires were administered. Pre- and post-task accommodative tests were performed. RESULTS: Forty emmetropes with a mean age of 21 ± 2 were recruited. In visual performance, the subjective response showed a significant difference in visual fatigue level with and without the filter. A statistically significant difference was seen in reading speed and data entry during task performance with and without the filter. Pre- and post-task accommodative parameters showed variable responses. CONCLUSION: This study showed that the use of a BL filter improves task performance, but subjectively, people experienced more visual fatigue while using the filter.

The economic burden of glaucoma on patients.

Purpose: To determine the economic burden of glaucoma on patients. Methods: A cross-sectional study was conducted on glaucoma patients diagnosed at least 6 weeks prior to the study and on topical anti-glaucoma medications. After consenting, patients were asked about their monthly income, education, occupation, treatment duration, drugs being used, cost of drugs, one bottle lasts for, financial dependence for treatment, glaucoma surgery, transportation means and cost, etc. Also, information regarding government reimbursement of medical costs was collected. Results: Seventy-four patients aged 60.18±11.5 years (40 males and 34 females) were enrolled. Majority were retirees (37.84%) and Homemakers (29.73%). Fifty (68%) participants didn't earn anything. Sixty-three patients had bilateral involvement and 52.70% were on treatment for >3 years. Prostaglandin analogs were most commonly used drugs (34.21%). Average cost of medications and travelling was ₹669.46 per month and ₹203.38 per visit respectively. Majority were financially responsible for their own treatment (62.16%). Patients had an average monthly income of ₹7108.11. Low-income group spent 26.08 % of their monthly salary on glaucoma treatment. Low-moderate and high-income group spent 5.17% and 1.50% of their monthly income respectively. Only 4.05% were covered by government reimbursement. Gender (P=0.019), occupation (P=0.010), whether undergone surgery (P=0.007), whether accompanied (P=0.027), hours lost during each visit (P=0.016) and treatment impression (P=0.027) showed statistical significance when associated with financial dependence. Conclusion: Treatment should be modified according to the patient's socioeconomic status. Glaucoma education programs and screening camps in remote areas would help in early detection of the disease.

Online survey about keratoconus management by optometrists.

Purpose: The aim of the study was to survey keratoconus management by optometrists in India. Methods: A validated online survey questionnaire was circulated to all optometrists from India who had completed 4 years of optometry programs. Practitioners were asked general contact lens practice questions and keratoconus management-related questions. For analysis, data were imported into SPSS (IBM Corp. 2011). Results: A total of 159 optometrists responded to the questionnaire, of whom 10.7% of practitioners had >10 years of experience and the remaining 89.3% had <10 years. Only 45.3% of respondents had corneal topography in their practice. Approximately 55% of practitioners prescribed gas permeable (GP) lenses. Around 77.4% of practitioners considered that a combination of multiple factors is necessary for keratoconus investigations. In addition, 91.8% of practitioners used the keratoconus severity classification. Also, 73% of practitioners consider that GP contact lens (CL) fitting is more difficult in keratoconic eyes than in healthy eyes. The average number of GP diagnostic lenses used in keratoconus CL fittings was 3.93 ± 1.92. A majority of practitioners calculate back optic zone radius (BOZR) using the manufacturer's guidelines (based on manual keratometry [39.6%] or based on corneal topography [40.3%]). Around 40.3% of respondents prefer to refer patients to another optometrist for CL fitting before consulting an ophthalmologist for surgical intervention. Finally, half of the respondents participate in co-management with ophthalmologists after surgical treatment (54.1%). Conclusion: This study provides details about the management of keratoconus by optometrists in India. Keratoconus patient care could be improved with new evidence-based guidelines for the management and referral of these patients that would provide guidance on GP CL fitting procedures. Furthermore, it determines referral criteria and enhances co-management between optometrists and ophthalmologists.

Subjective and objective assessment of the eye drop instillation technique: A hospital-based cross-sectional study.

PURPOSE: To objectively and subjectively evaluate eye drop technique and assess communicated instructions, and reported problems with eye drop instillation among tertiary care sample eye drop users. METHODS: A cross-sectional, observational study was carried out among patients attending our outpatient clinic from June to September 2020. Eligible participants obtained through convenient sampling were assessed for their eye drop instillation performance. The objective evaluation was made using observation of a demonstration and subjective assessment through responses to an interview. Patient inclusion criteria were being aged ≥18 years and using eye drops for ≥ one month; excluded if having a disability in communication or physical barriers in using eye drops. The patient reported difficulties and previous education about the instillation were also obtained. RESULTS: Participants (n = 84) had a mean age of 50.3 ± 14.0 years. During the demonstration, almost everyone (86.9%) successfully instilled at least one drop in the eye. None of the participants exhibited a perfect drop technique. The most common deviations were failing to close the eye (60.7%), touching the bottle to the eye or eyelid (36.9% of patients), and multiple blinks after drop instillation without nasolacrimal occlusion (25.0%). Forty percent of patients reported ≥1 problem and only a small sample recalled having had education in the eye drop instillation technique. CONCLUSION: Most participants failed to properly execute the eye drop technique. A proactive role of the prescribing practitioner to assess a patient's ability to instill eye drops correctly could be helpful.

Impact of the use of digital devices on eyes during the lockdown period of COVID-19 pandemic.

PURPOSE: The purpose of this study is to observe pattern of digital device use and the various ocular, visual and systemic symptoms associated with them during the lockdown period of the novel coronavirus disease (COVID-19) pandemic. METHODS: Two hundred and thirty-three volunteers were included in web-based open e-survey. The survey was designed on the 'Survey Monkey' website and distributed through social media platform. The information was collected regarding hours and numbers of digital devices along with numbers of digital activities carried out during the pandemic. A pretested symptom questionnaire was also included regarding ocular, visual and systemic symptoms before and during lockdown. The statistical analysis was carried out using Statistical Package of Social Science software. RESULTS: During the pandemic, most of the respondents were engaged in more than two digital activities (73.81%) over more than two digital devices (48.50%) for more than six days (65.66%). Maximum respondents were mobile users (97.85%) spending major time on social media (89.70%). Symptoms including watering eyes (P = 0.000), dry eyes (P = 0.000), shoulder pain (P = 0.020), back pain (P = 0.003) and headache (P = 0.043) showed positive correlation with hours of digital device use per day during lockdown, while itching eyes (P = 0.036) and pain behind eyes (P = 0.025) were the major symptoms in those engaged in a greater number of digital activities. Moreover, red eyes (P = 0.040) were more prominent in respondents using multiple devices for a greater number of hours. CONCLUSION: A big jump in digital activities on multiple digital devices was seen during lockdown which are more prone to ocular symptoms. Acceleration of ocular and systemic symptoms was particular with rise in time spending on digital devices.

Unilateral inferior altitudinal visual field defect related to COVID-19.

Ocular manifestations of COVID-19 are still being studied. Posterior segment involvement in viral entities is either direct viral involvement or a delayed immune response to the antigen. A 22-year-old woman presented with history of perceiving absolute inferior scotoma in the right eye for 4 days and history of fever and sore throat 10 days ago. Fundus examination revealed disc edema and vessel tortuosity. Humphreys Field Analyzer confirmed inferior field defect and Optical Coherence Tomography showed superior, nasal and inferior retinal nerve fiber layer thickening in the right eye. Patient was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcription polymerase chain reaction (RT-PCR) testing. Patient received three doses of injection methylprednisolone over 3 days. There was subjective resolution of scotoma reported 3 weeks posttreatment. We bring forward the first reported case of parainfectious optic neuritis associated with COVID-19.

Comprehensive diabetes care: The Goa model.

Diabetes mellitus continues to increase in epidemic proportions globally as well as in India. Poor glycemic control in long-standing diabetes mellitus eventually leads to chronic complications such as retinopathy, nephropathy, neuropathy, and cardiovascular disease. Diabetic retinopathy is emerging as an important cause of avoidable visual impairment and blindness in India across all strata of society. Much of this vision loss can be prevented by improving control of known risk factors, annual fundus screening, with prompt treatment of individuals with sight-threatening retinopathy. The Queen Elizabeth Diamond Jubilee Trust has made a significant contribution by supporting such a program across India, including Goa. The newly established medical retina clinic at Goa Medical College now provides facilities for screening, a detailed evaluation of advanced retinopathy, and therapeutic modalities such as laser and intravitreal injections. The peripheral centers are equipped to screen all people with diabetes mellitus and refer those with sight-threatening retinopathy to the medical college. The provision of a foot scanner to evaluate the risk of foot ulcers and microalbuminuria assessment as part of the nephropathy screening would encompass the entire gamut of diabetic microvascular complications. The next decade would provide evidence if this initiative, with the enthusiastic partnership of the state government, results in reduction of blindness in the people of Goa and an overall reduction in diabetes-related morbidity and mortality.

Lipemia retinalis in a 27 day old neonate: A case report.

Familial combined hyperlipidemia, which presents as hypercholesterolemia or hypertriglyceridemia, is the commonest form of genetic hyperlipidemia and is associated with premature coronary artery disease. This is a rare case report of a 27 day-old neonate born out of a third-degree consanguineous marriage, with grade III lipemia retinalis secondary to familial-combined hyperlipidemia.

Awareness and knowledge on eye donation among Allied Health Sciences, medical, and nursing students in Goa.

PURPOSE: To assess the awareness and knowledge on eye donation among students of Allied Health Sciences (AHS), medical, and nursing. METHODS: A cross-sectional descriptive study was conducted using a standard predesigned and pretested closed-ended structured questionnaire based on eye donation to obtain information about awareness and knowledge from AHS, medical, and nursing students of Goa. RESULTS: Three hundred and forty participants participated in the study. The majority of the participants [97.9% (95% CI: 95.8-99.2)] were aware of the existence of eye donation. Mass media (62.9%) was the foremost source of information. However, only 145 [42.6% (95% CI: 37.3-48.1)] participants were willing to donate their eyes. AHS, medical, and nursing students stood apart significantly in their awareness and knowledge. Only 60 [17.6% (95% CI: 13.7-22.1)] participants were aware that the whole eye can be removed from the donor while 215 [63.2% (95% CI: 57.9-68.4)] were wrongly aware that the cornea can be removed separately. Awareness about eye donation was not associated with willingness to donate eyes. CONCLUSIONS: Although awareness regarding eye donation was satisfactory, there was lack of willingness to donate eyes. There is a need to bridge the gap between eye bank and donors.

Accidental henpeck as a cause of devastating eye injury.

Ocular Trauma by the peck of a hen can cause grievious eye injuries. We report a rare case of uniocular blindness in a 5 year old girl ,following a hen peck which caused a penetrating eye injury along with a total retinal detachment.

A Hairy Affair: Ophthalmia nodosa Due to Caterpillar Hairs.

PURPOSE: To study different clinical presentations, course, and final outcomes of ophthalmia nodosa, a rare disease caused by hairs of the caterpillar. METHODS: A total of 29 eyes of 17 patients with the disease presenting to our institute in 2013 were included. RESULTS: Patients presented with foreign body sensation (94%), photophobia (88%), lacrimation (82%), redness (94%), and eyelid edema (82%). Hairs were found in the conjunctiva (89.6%), cornea (65.5%), and even anterior chamber (3.4%). There was a conjunctival nodule in two eyes (6.8%). Resolution of symptoms occurred in 3-21 days. Treatment included topical steroids, cycloplegia, and removal of hairs with forceps. More than one sitting was required in 17 eyes (62.9%) due to reactional inflammation, precluding visualization of all the hairs. CONCLUSIONS: Ophthalmia nodosa is a relatively rare condition with subtle findings, which can be missed, causing considerable discomfort to the patient if the hairs are not removed.