Background:Eyesight plays an important role in our day today life. When the vision gets hampered, daily activities of an individual will be affected. The prevalence of visual impairment is increasing across the globe, with more burdens on the developing world. The uptake of low vision services remains to be low in developing countries like India.Methods:A newly constructed questionnaire using information from previously conducted telephonic interviews and article search was administered among 50 eye care practitioners from Kerala, India for the pilot study. Modifications were made in the questionnaire, based on the responses obtained from the pilot study. From their responses, awareness, knowledge, and barriers for the low vision services among eye care practitioners were assessed.Results:(1) Pilot study - the Cronbach's alpha values obtained for knowledge, awareness and barrier questions were 0.814, 0.297, and 0.810, respectively, and content validity index was found to be 0.64. (2) Main study - 211 eye care practitioners from 12 states of India took part in the study that accounted for a response rate of 16.7%. The participants included were 95 (45%) men and 116 (55%) women with a mean age of 28.18 ± 7.04 years. The lack of awareness was found to be the major barrier in the provision and uptake of low vision services from the practitioner's perspective.Conclusion:The study results showed that there is a lack of awareness among eye care practitioners about low vision services, which acts as a major barrier in the effective delivery of these services.
Purpose:To compare visual acuity with two visual acuity charts in preschool children.Materials and Methods:Visual acuity measurement with Lea symbols and Bailey-Lovie tumbling E chart was performed on children between 3 and 6 years of age. Visual acuity data from the two charts were analyzed with Bland-Altman plot to determine the limits of agreement. The Wilcoxon signed test was performed in children aged 3-4 years and in children aged 5-6 years separately to evaluate the influence of age. The inter-eye difference between the two charts were further analyzed with the paired t-test. A p value > 0.05 was considered statistically significant.Results:A total of 47 children were enrolled for the study. The average logarithm of the Minimum Angle of Resolution (LogMAR) monocular visual acuity with Lea symbols (0.17 ± 0.13) was better than the Bailey-Lovie tumbling E chart (0.22 ± 0.14). The mean difference between Bailey-Lovie tumbling E chart and Lea symbol chart was 0.05 ± 0.12 in logMAR units. A second analysis eliminating outliers showed the same result but lower differences (n = 43, 0.05 ± 0.05 logMAR units). Visual acuity results between the two charts in children aged 3-4 years showed a significant difference (p = 0.000), but not for children aged 5-6 years (p = 0.059). Inter-eye differences between the two charts was not statistically significant (p = 0.77).Conclusion:Bailey-Lovie tumbling E chart is comparable to the Lea symbols chart in pre-school children. But preference should be given to Lea symbols for children aged 3-4 years as the symbols are more familiar than a directional test for this age group.
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Purpose: To study the effect of glycaemic control as demonstrated by the change in HbA1c on corneal parameters among patients with type 2 diabetes mellitus (T2DM). Study design: Prospective study analysing corneal parameters among patients with T2DM along with fluctuations in HbA1c.Methods: A prospective, single-centre, cohort study was carried out on T2DM patients with HbA1c > 6.5% from Kasturba Hospital, Manipal, India. The subjects underwent a comprehensive eye examination. One-hundred and twenty-two subjects who fulfilled the inclusion criteria were analysed using the Huvitz 9000A to measure anterior corneal curvature followed by ultrasound pachymetry to measure central corneal thickness (CCT) at baseline and after 3 months. A simple linear regression was used to compare the mean corneal parameters, CCT and anterior corneal curvature, for each group with the mean HbA1c. The mean difference was considered statistically significant only if the value was p < 0.05.Results: We observed a significant difference between baseline and follow-up levels of HbA1c (t = 2.487; df = 53; p < 0.05). Simple linear regression analysis showed a positive correlation and revealed a mean increase in CCT of 1.893 μm (p < 0.001) and a mean increase in anterior corneal curvature of 0.069 D (p < 0.005) for every unit increase in HbA1c.Conclusions: The present study showed that changes in CCT and anterior corneal curvature occur with respect to changes in HbA1c level. Thus, careful attention is required in considering HbA1c status when performing comprehensive eye examinations in diabetic patients.
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