Introduction: Children from the developing world are more prone to going blind from avoidable and preventable causes. In Nepal, children in private schools are reported to have a higher ocular morbidity than those in government schools, with myopia being the major cause of the morbidity. This study was designed to evaluate ocular morbidity in students from both types of school. Methods: This was a cross-sectional, comparative study among students from government and private schools of Kathmandu. Eye examination was carried out evaluating visual acuity, color vision, refractive status, binocular vision status, and anterior and posterior segment findings. Results: A total of 4,228 students from government and private schools were evaluated. The prevalence of ocular morbidity was 19.56 % with refractive error (11.9 %) being the major cause of the morbidity, followed by strabismus and infective disorders. No signifi cant difference in the prevalence of ocular morbidity and refractive status was found in the students from government and private schools. Conclusions: A signifi cant number of children of school-going age have ocular morbidity with no signifi cant difference in the prevalence in the students from government and private schools. Research exploring the effect of various risk factors in the progression of myopia would be helpful to investigate the refractive status in children from these different types of schools. Keywords: Myopia, ocular morbidity, school Students

The development of sensitivity to radial optic flow discrimination was investigated by measuring motion coherence thresholds (MCTs) in school-aged children at two speeds. A total of 119 child observers aged 6-16years and 24 young adult observers (23.66+/-2.74years) participated. In a 2AFC task observers identified the direction of motion of a 5° radial (expanding vs. contracting) optic flow pattern containing 100 dots with 75% Michelson contrast moving at 1.6°/s and 5.5°/s and. The direction of each dot was drawn from a Gaussian distribution whose standard deviation was either low (similar directions) or high (different directions). Adult observers also identified the direction of motion for translational (rightward vs. leftward) and rotational (clockwise vs. anticlockwise) patterns. Motion coherence thresholds to radial optic flow improved gradually with age (linear regression, p<0.05), with different rates of development at the two speeds. Even at 16years MCTs were higher than that for adults (independent t-tests, p<0.05). Both children and adults had higher sensitivity at 5.5°/s compared to 1.6°/s (paired t-tests, p<0.05). Sensitivity to radial optic flow is still immature at 16years of age, indicating late maturation of higher cortical areas. Differences in sensitivity and rate of development of radial optic flow at the different speeds, suggest that different motion processing mechanisms are involved in processing slow and fast speeds.

Introduction: Color Vision defect can be observed in various diseases of optic nerve and retina and also a significant number of people suffer from the inherited condition of red and green color defect.  Methods: A cross-sectional descritptive study was designed with purposive sampling of students from various schools of Kathmandu Valley. All children were subjected to color vision evaluation using Ishihara Isochromatic color plates along with other examination to rule out any other causes of color deficiency.  Results: A total of 2001 students were examined, 1050 male students and 951 females with mean age of 10.35 (±2.75) and 10.54 (±2.72) respectively. Among the total students examined, 2.1% had some form of color vision defects. Of the male population , 3.9% had color vision defects while none of the female was found with the deficiency.  Conclusions: The prelevance of color vision defect in Nepal is significant and comparable with the prelevance quoted in the studies from different countries. Keywords:color vision; congenital red green color effect; Nepal; prevalence.

The RNFL thickness measurements with SD-OCT are lower in glaucomatous eyes as compared to age-matched GS and normal eyes in the Nepalese population. A high resolution SD-OCT could aid significantly in the early diagnosis of glaucoma in Nepal.

Purpose To determine the causes of visual impairment and the use of low vision devices in patients attending the low vision clinic in Trinidad and Tobago. Methods A retrospective study of the 222 patients attending the low vision clinic at the University of the West Indies, St Augustine Campus was conducted. The presenting visual acuity, causes of low vision and blindness, and prescribed low vision devices were recorded and analysed to determine the major causes of visual impairment and improvement in visual acuity with low vision aids. Results Out of the total 222 participants, 66.66% ( n = 148) had low vision while the rest (33.33%, n = 74) were legally blind. Glaucoma was the major cause of low vision (31.08%) and blindness (28.38%) followed by diabetic retinopathy (20.94%, low vision and 20.27%, blindness). A total of 193 low vision devices were prescribed, 79.79% ( n = 154) near devices and 20.20% ( n = 39) distance devices. The low vision devices were effective in improving both near visual acuity (120 participants reading 1M or 2M) and distance visual acuity (VA better than 3/60). Conclusion The major causes of vision impairment in Trinidad and Tobago were glaucoma and diabetic retinopathy and low vision devices are effective in improving visual acuity. A comprehensive approach to dealing with the causes of low vision and low vision services are required to mitigate the burden of visual impairment in the country.

PURPOSE. Directly comparing the motion and form processing in neurologic disorders has remained difficult due to the limitations in the experimental stimulus. In the current study, motion and form processing in amblyopia was characterized using random dot stimuli in different noise levels to parse out the effect of local and global processing on motion and form perception. METHODS.A total of 17 amblyopes (8 anisometropic and 9 strabismic), and 12 visually normal subjects monocularly estimated the global direction of motion and global orientation in random dot kinematograms (RDK) and Glass patterns (Glass), whose directions/orientations were drawn from normal distributions with a range of means and variances that served as external noise. Direction/orientation discrimination thresholds were measured without noise first then variance threshold was measured at the multiples of the direction/orientation threshold. The direction/orientation and variance thresholds were modelled to estimate internal noise and sampling efficiency parameters.RESULTS. Overall, the thresholds for Glass were higher than RDK for all subjects. The thresholds for both Glass and RDK were higher in the strabismic eyes compared with the fellow and normal eyes. On the other hand, the thresholds for anisometropic amblyopic eyes were similar to the normal eyes. The worse performance of strabismic amblyopes was best explained by relatively low sampling efficiency compared with other groups (P < 0.05). CONCLUSIONS.A deficit in global motion and form perception was only evident in strabismic amblyopia. Contrary to the dorsal stream deficiency hypothesis assumed in other developmental disorders, deficits were present in both motion (dorsal) and form (ventral) processing.

To establish the optimum grading increment which ensured parity between practitioners while maximising clinical precision.Methods: Second year optometry students (n=127, 19.5 ± 1.4 years, 55% female) and qualified eye care practitioners (n=61, 40.2 ±14.8 years, 52% female) had 30 seconds to grade each of bulbar, limbal and palpebral hyperaemia of the upper lid of 4 patients imaged live with a digital slit lamp under 16x magnification, diffuse illumination, with the image projected on a screen. The patients were presented in a randomised sequence 3 times in succession, during which the graders used the Efron printed grading scale once to 0.1 precision, once to 0.5 precision and once to the nearest integer grade in a randomised order. Graders were masked to their previous responses.Results: For most grading conditions less than 20% of clinicians showed a ≤0.1 difference in grade from the mean. In contrast, more than 50% of the student graders and 40% of experienced graders showed a difference in grade from the mean within 0.5 for all conditions under measurement.Student precision in grading was better with both 0.1 and 0.5 grading precision than grading to the nearest unit, except for limbal hyperaemia where they performed more accurately with 0.5 unit precision grading. Limbal grading precision was not affected by grading step precision for experienced practitioners, but 0.1 and 0.5 grading precision were both better than 1.0 grading precision for bulbar hyperaemia and 0.1 grading precision was better than 0.5 grading precision and both were better than 1.0 grading precision for palpebral hyperaemia. Conclusion:Although narrower intervals scales maximise the ability to detect smaller clinical changes, the grading increment should not exceed one standard deviation of the discrepancy between measurements. Therefore, 0.5 grading increments are recommended for subjective anterior eye physiology grading (limbal, bulbar and palpebral redness).

Optometry education in Nepal began in 1998 in collaboration with the University of Auckland, New Zealand, with the primary objective of addressing the unmet needs of eye health and vision care. Over the last two decades, the development of Optometry education has seen significant progress, including a shift from a three-year to a four-year curriculum, an increase in the uptake of students, and recent launches of two additional Bachelor's degree and a Master's degree programs. Complementary to the educational progress, several professional advances have occurred in the intervening years. These include the formation of the Nepalese Association of Optometrists that oversees the professional development and oversee the rights, welfare, security, and protection of Optometrists, memberships into the World Council of Optometry and the Asia Pacific Council of Optometry, integration of the profession into the governmental regulatory body Nepal Health Professional Council, and formulation of the code of ethics and minimum requirements for a Bachelor's level University degree program in Optometry. This article briefly presents the historical events leading to the establishment of Optometry in Nepal and the evolution of the program in the intervening years.