Ceylon Medical Journal 2018; 63 (S2): s3-s9 DOI: http://doi.org/10.4038/cmj.v63i5.8735This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. planners to identify priority regions for specific interventions to reduce the prevalence of blindness, visual impairment and disability.
Introduction There is paucity of data on the epidemiology of visual impairment in Sri Lanka.Objectives Estimate the prevalence and determine causes and risk factors of visual impairment among adults aged 40 years in Sri Lanka.Methods Multistage, stratified, cluster random sampling was used to select a nationally representative sample aged 40 years. All participants underwent vision testing, autorefraction and a basic eye examination. Participants with a presenting acuity of <6/12 in either eye underwent detailed eye examination, assessment of bestcorrected acuity if required, and a cause of visual loss assigned.Results 5,779 of those enumerated (6,713) were examined (response rate 86.1%). The prevalence of blindness was 1.7% (95% confidence interval [CI]: 1.3-1.99%) and low vision was 17% (95% CI: 16.0-18.0%). Cataract (66.7%) and uncorrected refractive errors (12.5%) were the commonest causes of blindness. Uncorrected refractive errors (62.4%) and cataract (24.2%) were the commonest causes of low vision. Blindness was significantly higher in older age groups (OR 132.4: 95%
Introduction Cataract surgical coverage and visual acuity outcomes are important population level indicators for monitoring access to and the quality of cataract surgery, allowing subgroups with poorer access to be identified. Data on these indicators are not available for Sri Lanka at national level. Objectives Determine cataract surgical coverage and the outcomes of cataract surgery in a nationally representative sample of adults aged 40 years. Methods Cluster random sampling with proportionate to size procedures was used. All participants were interviewed to obtain data on education level, movable assets, and the year and place of cataract surgery, if applicable. Presenting and best corrected visual acuities were measured. All participants underwent slit lamp examination, including a dilated examination of the fundus. Cataract surgical coverage was calculated at the person level vision of <3/30, <6/60 and <6/18. Outcomes of cataract surgery were categorized as good (6/18 or better), borderline (<6/18-6/60) or poor (<6/60). Results A total of 345 persons among the 5,779 participants who were examined had undergone cataract surgery in one or both eyes (486 eyes). Cataract surgical coverage, which was high overall 85.4% for vision <3/60; 79.1% for vision <6/60), was significantly higher in younger age groups (Odds Ratio [OR] 5.65, 95% confidence interval [CI] 1.42-22.52), those in urban areas (OR 2.8, 95% CI 1.01-7.74) those with higher socioeconomic status (OR 6.0; 95% CI 1.96-18.4).
Postpartum haemorrhage (PPH) due to multiple vaginal lacerations is difficult to manage and tamponade is used as a life-saving measure. Condom catheter with stay sutures at the vaginal introitus for this purpose has not been reported. We describe successfully managing PPH due to multiple vaginal lacerations following a forceps delivery using a condom tied to an 18 FG Foley catheter. The device was introduced to the vagina, inflated with 700 mL of normal saline and was held in situ by sealing the vaginal introitus with interrupted nylon stitches running between the labia minora. Condom catheter is cheap and freely available in low-resource settings. The preparation and application can be done by a less experienced operator.
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