Background:Uncorrected refractive error is an avoidable cause of visual impairment.Aim:To compare the magnitude and determinants of uncorrected refractive error, such as age, sex, family history of refractive error and use of spectacles among school children 6-15 years old in urban and rural Maharashtra, India.Study Design:This was a review of school-based vision screening conducted in 2004-2005.Materials and Methods:Optometrists assessed visual acuity, amblyopia and strabismus in rural children. Teachers assessed visual acuity and then optometrists confirmed their findings in urban schools. Ophthalmologists screened for ocular pathology. Data of uncorrected refractive error, amblyopia, strabismus and blinding eye diseases was analyzed to compare the prevalence and risk factors among children of rural and urban areas.Results:We examined 5,021 children of 8 urban clusters and 7,401 children of 28 rural clusters. The cluster-weighted prevalence of uncorrected refractive error in urban and rural children was 5.46% (95% CI, 5.44-5.48) and 2.63% (95% CI, 2.62-2.64), respectively. The prevalence of myopia, hypermetropia and astigmatism in urban children was 3.16%, 1.06% and 0.16%, respectively. In rural children, the prevalence of myopia, hypermetropia and astigmatism was 1.45%, 0.39% and 0.21%, respectively. The prevalence of amblyopia was 0.8% in urban and 0.2% in rural children. Thirteen to 15 years old children attending urban schools were most likely to have uncorrected myopia.Conclusion:The prevalence of uncorrected refractive error, especially myopia, was higher in urban children. Causes of higher prevalence and barriers to refractive error correction services should be identified and addressed. Eye screening of school children is recommended. However, the approach used may be different for urban and rural school children.

Purpose:We present the level of Knowledge, Attitude and Practice (KAP) among diabetic patients regarding eye complications and their care.Materials and Methods:A cross sectional study was conducted in 2008 at seven regions of Oman. Arabic speaking nurses interviewed diabetics at clinics. They used a closed ended questionnaire with 15 questions. The responses were analyzed and the KAP were grouped into excellent (>80%), good (60 to 79%), average (40 to 59%), poor (20 to 39%) and very poor (<20%). They were also compared among epidemiologic variants.Result:Of the 750 participants, ‘Excellent’, grade of knowledge about diagnosis and eye care was present in 547 (72.9%) and 135 (18%) persons respectively. The ‘excellent’ grade of attitude about eye involvement and eye care was found in 135 (18%) and 224 (29.9%) participants. The practice for undergoing eye check up and accepting treatment was of ’excellent’ grade in 390 (52%) and 594 (79.2%) respectively. Age (OR = 0.98), Sharqiya region (OR = 25) and ‘5 to 9’ duration of DM (OR = 2.1) were associated with the knowledge. ‘<1 year’ duration (OR = 0.3) and Dhakhiliya region (OR = 39) were associated with the attitude while ‘5 to 9 year’ duration (OR = 3.4) was associated with better practices.Conclusions:Knowledge about eye complications and care is satisfactory among persons with diabetes. However, levels of attitude and practice were less than desired and should be improved. This could strengthen program approach for early detection and care of eye complications of diabetes in Oman.

Diabetic retinopathy (DR) is a global health burden. Screening for sight-threatening DR (STDR) is the first cost-effective step to decrease this burden. We analyzed the similarities and variations between the recent country-specific and the International Council of Ophthalmology (ICO) DR guideline to identify gaps and suggest possible solutions for future universal screening. We selected six representative national DR guidelines, one from each World Health Organization region, including Canada (North America), England (Europe), India (South-East Asia), Kenya (Africa), New Zealand (Western Pacific), and American Academy of Ophthalmology Preferred Practice Pattern (used in Latin America and East Mediterranean). We weighed the newer camera and artificial intelligence (AI) technology against the traditional screening methodologies. All guidelines agree that screening for DR and STDR in people with diabetes is currently led by an ophthalmologist; few engage non-ophthalmologists. Significant variations exist in the screening location and referral timelines. Screening with digital fundus photography has largely replaced traditional slit-lamp examination and ophthalmoscopy. The use of mydriatic digital 2-or 4-field fundus photography is the current norm; there is increasing interest in using non-mydriatic fundus cameras. The use of automated DR grading and tele-screening is currently sparse. Country-specific guidelines are necessary to align with national priorities and human resources. International guidelines such as the ICO DR guidelines remain useful in countries where no guidelines exist. Validation studies on AI and tele-screening call for urgent policy decisions to integrate DR screening into universal health coverage to reduce this global public health burden.