Refractive error is a defect in the optical system of the eye which prevents light from being brought to a single point focus on the retina, thus reducing normal vision. This optical defect is the second most common cause of visual impairment globally as well in Nepal. At present, there are 285 million visually impaired people in the world. An estimated 4 out of 5 visual impairment (80%) can be prevented or cured, uncorrected refractive errors are the leading cause (42%) followed by cataract (33%). A descriptive cross sectional study was conducted to determine the proportion of undergraduate medical students with refractive errors in Nepal Medical College, and to identify factors associated with it. A total of 210 medical students volunteered for this study, with 100 males (47.6%) and 110 females (52.4%). The age of these students were between 18 to 26 years, with an average of 20.5 years. The proportion of medical students with refractive error was slightly more than half (51.4%), with simple myopia being the leading type (42.9%), followed by astigmatism (7.1%) and simple hypermetropia (1.4%). Parental history of refractive error was observed to be significantly associated with that of the medical students. There was also a significant association between refractive error and the daily use of mobile phones and laptops. However, years spent in medical education were not observed to be significant.

The human eye is an important organ as it provides sight and proper coordination in various tasks. The function of the eye is mediated by the 2nd cranial nerve or the optic nerve. Damage to any part of the optic nerve usually results in poor vision, dyschromatopsia (colour blindness), diminished sensitivity to bright light, poor contrast sensitivity, defective afferent pupillary and visual field defects. The commonest ocular disorders are usually attributed to refractive errors such as: myopia, hypermetropia and astigmatism. A healthy eye is necessary for a conducive learning and teaching environment in any academia. Eye screening to rule out any ocular disorder is of utmost importance, especially in medical education, because these students need to be detected early and treated on time to ensure their optimal academic work. Therefore, this study was attempted to determine the proportion of visual disorders among the first year health professional students at Nepal Medical College, and to identify factors associated with it. A total of 115 students were enrolled for this study, where males accounted for 51.3%, while females accounted for 48.7%, respectively. The minimum age was 18 years and maximum was 23 years, with a mean of 19.69 years, and a standard deviation of ±1.14. Almost eight out of ten students (78.3%) had some form of ocular disorders, with many of them having more than one disorder. Females outnumbered the males (51.1%; 48.9%) with respect to the occurrence of eye disorders. The commonest eye disorders were: refractive errors in 60 (52.7%) students, followed by dry eye disease in 23 (20.0%) students, cataract in 2 (1.7%) students, Duane’s retraction syndrome in 1, color vision defect in 1 student and 2 students had other manifestations. Based on ethnicity, slightly more than half of the participants were Khas-Aryans (60.0%), while Adibasi-Janjatis and Madhesis had similar participation of 20.9% and 19.1% respectively. More than three quarters of the participants were MBBS students (82.6.%), followed by BDS students (13.0%) and BSc Nursing students (4.4%). The association between ocular disorders and gender was not statistically significant(p value = 0.35). However, a statistically significant association was observed between gender and refractive errors (p value=0.002). There was no association observed between the status of students’ refractive error and parental status of refractive error (p value =0.099)

The purpose of this study was to evaluate the ophthalmic causes of headache among patients attending tertiary care hospital. This was a descriptive, cross sectional hospital-based study. One hundred and thirty-two patients with ocular cause of headache excluding primary headache and pediatrics patients during one year were included. Detail ocular examination was done including visual acuity, refraction, binocular vision assessment like convergence insufficiency and fusional insufficiency, anterior and posterior segment examination. Among headache patients, female was 106 (80.3%) and male was 26 (19.7%). The prevalence of headache in female was 6.9% and in male was 2%. Headache was more common in age group 18-29 (59.8%). The mean age of presentation was 29.9 ± 10.2 years (range 18-61 years). Out of 132 patients with headache, 104 (78.8%) had refractive error, 15 (11.4%) had fusional insufficiency, 6 (4.5%) had convergence insufficiency, 10 (7.6%) had anterior segment diseases and 5 (3.8%) had posterior segment diseases. Among refractive errors, both eyes astigmatism was the commonest 48 (36.5%) followed by both eyes simple myopia 44 (33.4 %) which was statistically significant with ocular headache (p=0.000). Ocular anomalies other than refractive error may coexist with headache complaints. Therefore, thorough ocular examination should be done in all patients suffering from headache.