Aims To evaluate the safety, visual outcome and complications of manual small incision cataract surgery (MSICS) in the treatment of patients with brunescent and black cataract (BBC). Methods In a non-randomised interventional case series, 102 consecutive patients with BBC underwent cataract extraction by MSICS, with staining of the anterior capsule by trypan blue. Results Of the 102 eyes with BBC, MSICS was performed through superior scleral tunnel (SST) in 31 eyes (30.4%) and through temporal scleral tunnel (TST) in 71 eyes (69.6%). The main intraoperative complication was posterior capsule rupture in two patients (2.0%). Postoperatively, 20 eyes (19.6%) developed corneal oedema. Mild iritis was seen in six eyes (5.9%) and moderate iritis with fibrin membrane formation occurred in three eyes (2.9%). On the 40th postoperative day, 80 patients (78.4%) achieved uncorrected visual acuity of 6/18 or better, and 99 (97.1%) had best-corrected visual acuity of 6/18 or better. Patients in the SST group had significantly higher postoperative astigmatism compared to those in the TST group (À1.08 D vs À0.72 D, P ¼ 0.017). Conclusion MSICS with trypan blue staining of the anterior capsule is a safe and effective method of cataract extraction for patients with BBC.

Aim To understand the barriers in utilisation of low vision assistive products (LVAPs) from the perspective of patients with low vision. Methods Patients referred to low vision clinic in a tertiary eye care hospital in India who were prescribed LVAPs but were un-willing to accept the products were interviewed using questionnaires. Data pertaining to the age, diagnosis, gender, occupation, preferred LVAPs, patient's perception of vision loss and the primary reason for non-acceptance of LVAPs were analysed.Results A total of 235 among the 413 patients who noticed improvement in visual performance with LVAPs were unwilling to utilise these products. The questionnaire revealed that 53% of the patients who felt they were not candidates for LVAPs were experiencing severe visual impairment (p < 0.02). Non-acceptance was highest (68.6%) in patients < 15 years of age. The most common causes of non-acceptance were social stigma in patients < 40 years (41.3%; p < 0.0001), fear of loss of employment in patients 41-60 years (26.6%; p < 0.01) and low necessity in patients > 60 years (25%; p < 0.001). Denial of the magnitude of their illness was more common in patients above 60 years (16.5%). Non-acceptance rate was lowest for macular disorders (39.6%) and highest for retinitis pigmentosa (81%). Among devices, hand and stand magnifiers had the lowest non-acceptance rate (41%). Telescopes and electronic devices had the highest rate of non-acceptance (92% and 89%, respectively). Conclusion Reasons for poor utilisation of LVAPs are multifactorial extending beyond affordability or accessibility. Knowledge of these barriers can help in creating content for awareness campaigns among patients, healthcare professionals and general society. Further research is necessary on the psychological and psycho social contributors to this process.

A school vision screening program involving ACTs resulted in more efficient screening than a program involving STs at about a third of the cost and also improved compliance with hospital referral.

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A case of severe capsular phimosis following implantation of an acrylic intraocular lens (hydrophobic acrylic with polymethylmethacrylate haptics) in a patient with pseudoexfoliation is described.