No abstract

PurposeTo describe program planning and effectiveness of multistage school eye screening and assess accuracy of teachers in vision screening and detection of other ocular anomalies in Rayagada District School Sight Program, Odisha, India.MethodsThis multistage screening of students included as follows: stage I: screening for vision and other ocular anomalies by school teachers in the school; stage II: photorefraction, subjective correction and other ocular anomaly confirmation by optometrists in the school; stage III: comprehensive ophthalmologist examination in secondary eye center; and stage IV: pediatric ophthalmologist examination in tertiary eye center. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of teachers for vision screening and other ocular anomaly detection were calculated vis-à-vis optometrist (gold standard).ResultsIn the study, 216 teachers examined 153,107 (95.7% of enrolled) students aged 5–15 years. Teachers referred 8,363 (5.4% of examined) students and 5,990 (71.6% of referred) were examined in stage II. After prescribing spectacles to 443, optometrists referred 883 students to stage III. The sensitivity (80.51%) and PPV (93.05%) of teachers for vision screening were high, but specificity (53.29%) and NPV (26.02%) were low. The specificity and NPV, in general, were higher in ocular anomaly detection but varied from disease to disease.ConclusionMultistage school screening is rapid and comprehensive in a resource-limited community. Regular training and periodic reinforcement of teachers for vision assessment and other ocular anomaly identification are required for further success of the strategy.

No abstract

ObjectiveTo report our operative experience with precision pulse capsulotomy (PPC) for anterior capsulotomy in a paediatric cataract series.Methods and analysisThis study is a retrospective interventional, descriptive series of consecutive paediatric eyes (≤16 years) undergoing cataract surgery using PPC. Surgical time and the time required to perform PPC was recorded. Any intraoperative and postoperative adverse events were noted. Postoperatively, visual acuity, anterior segment examination and intraocular pressure (IOP) were recorded for all children at day 1, 1 week and 1 month.Results21 eyes of 14 patients were included in the study, with the median age at surgery of 6.0 years (IQR; 5-7.75, range=1–16 years). Male to female ratio was 11:3. 13 eyes had lamellar cataract, 3 eyes had total cataract, 2 had posterior subcapsular cataract, 2 had traumatic cataract, while 1 eye had sutural cataract. Median surgical time was 26 min (IQR 21-32) and median PPC time was 75.0 secs (IQR 56-86.5). The anterior capsulotomy was round and complete in most cases, except in one case due to faulty suction. All patients underwent a successful in the bag implantation of intraocular lens with capsulotomy margins overlapping the optic edges in 19 eyes (90%). Median PPC size was 5.54 mm (n=9, IQR 5.39 -5.75) which was slightly larger than expected. None of the cases had any intraoperative or postoperative adverse events with no radial tears of capsulotomy. Postoperatively, the mean final follow-up was 5.71+3.20 weeks.ConclusionTo conclude PPC can be used as an alternative to manual continuous curvilinear capsulorhexis in paediatric cataract surgery producing round well- centred and strong capsulotomy with an easier learning curve.