Eye Care Hospital Research Articles

Neuro-Ophthalmology in South India.

We were greatly interested in the article by Dhiman et al (1) discussing their experience with neuro-ophthalmology in a central government–funded tertiary eye care hospital in North India. We wish to share our experience from a private nongovernmental organization (NGO) tertiary eye care hospital in South India. Our hospital offers services to patients in 3 tiers as per their choice: (1) paying section (where patient pays for the services); (2) free direct section (where consultation is free and the surgeries are steeply subsidized); (3) camp section (where consultation and surgeries [mainly cataract] are free). In our retrospective analysis from January 2017 to December 2017, there were 143, 946 referrals to various specialty clinics, of which 9,238 (6.4%) were referred for neuro-ophthalmic evaluation. Of these, 7,387 patients were referred from paying hospitals and 1851 were referred from free direct and camp sections. For our analysis, we included only the paying section referrals, of which 1851 patients (25%) were excluded as they turned out to be non–neuro-ophthalmic cases, compared to 16% in the study by Dhiman et al. Thus, our patient cohort comprised 5,402 patients. We compared our results with those of Dhiman et al. Optic nerve disorders were seen in 64.6% (n = 3,511) of our patients compared to 63.8% (n = 1,020) in their study. We saw 84.6% (n = 2,971) of optic nerve disorders without disc edema and 15.4% (n = 540) with disc edema compared to 67% (n = 635) and 33% (n = 335), respectively, in their study. The most common optic nerve disorder without disc edema was traumatic optic neuropathy seen in 13% (n = 383) compared to 27.7% (n = 190) in their study. In the optic disc edema group, ischemic optic neuropathy was present in 34.4% (n = 186) of cases compared to 37.6% (n = 126) in their study. Papilledema was seen in 23% (n = 124) compared to 23.2% (n = 78) in their study. The most common cranial nerve palsy occurred with the sixth nerve in 44.3% (n = 314), followed by third nerve in 26% (n = 184), fourth nerve in 11.3% (n = 80), and seventh nerve in 18.4% (n = 130). Dhiman et al reported involvement of sixth, third, fourth, and seventh nerves with frequencies of 44%, 21.9%, 20.1%, and 14%, respectively. Our comparative analysis demonstrated that the occurrence of neuro-ophthalmic diseases in 2 diverse tertiary care centers in North India (central government funded) and South India (NGO) is quite similar. We strongly agree with Dhiman et al that in a vast country like ours, with a population of over a billion people, more subspecialty-trained neuro-ophthalmologists are needed.

Prevalence of Strabismus and its type in Pediatric age group 6-15 years in a tertiary eye care hospital, Karachi

Prevalence of Strabismus and its type in Pediatric age group 6-15 years in a tertiary eye care hospital, Karachi

Current profile of secondary glaucoma in a Northern India tertiary eye care hospital

ABSTRACTPurpose: To study the current profile of secondary glaucoma in all age groups of patients presenting to a tertiary eye care hospital in Northern IndiaMaterials and methods: In this retrospective study, files of 5725 patients who were newly diagnosed to have glaucoma in our tertiary eye care centre from January 2014 to December 2016 were reviewed. Detailed data were collected from patient’s records, including history, best-corrected visual acuity (BCVA), intraocular pressure (IOP), slit-lamp biomicroscopy findings, gonioscopy, and fundus findings. Demographic data, aetiology, and management in all these patients were also noted.Results: Out of 5820 patients who visited glaucoma outpatient department (OPD) in a tertiary eye care hospital during 1 January 2014 to 31 December 2016, 5725 patients were diagnosed to have glaucoma by the glaucoma specialists. Five thousand three hundred and six patients (92.68%) were diagnosed to have primary glaucoma and 419 patients (7.32%) were diagnosed to have secondary glaucoma. The leading causes of secondary glaucoma were found to be neovascular glaucoma (17.42%), trauma (14.80%), post-keratoplasty (13.60%), post-cataract surgery (13.13%), and lens-induced glaucoma (12.41%). Secondary glaucoma was found to be an important cause of visual morbidity with 71.17% eyes presenting with BCVA < 6/60, IOP > 30 mm Hg in 62% eyes and 72% with cup-to-disc ratio of ≥0.7:1.Conclusion: Secondary glaucoma is an important cause of visual morbidity. Timely diagnosis and prompt management are essential to prevent irreversible visual loss due to secondary glaucoma.

Role of anterior segment optical coherence tomography for safer management of mature white cataracts

Role of anterior segment optical coherence tomography (AS-OCT) for safer management of mature white cataracts. Patients with mature white cataracts attending the outpatient department of a tertiary eye care hospital, aspiring to have cataract surgery performed, were scheduled for elective phacoemulsification and intraocular lens implantation by two surgeons during the period of October 2017 to March2018. A prospective interventional study of 30 patients. All patients with mature cataracts and absence of any retinal pathology had AS-OCT to assess the presence or absence of intralenticular subcapsular fluid pockets. The patients with thepresence of subcapsular fluid pockets (Group 1) underwent 30-gauge needle aspiration fluid aspiration followed by capsulorhexis and phacoemulsification and those without any fluid (Group 2) underwent Utrata forceps-assisted capsulorhexis. The study comprised 30 eyes of 30 patients, of which15eyes (50%) had subcapsular fluid and 15 eyes (50%) had no fluidon AS-OCT. Of the 15 eyes in Group 1, 13 eyes (86.7%) underwent complete circular curvilinear capsulorhexis (P=.001), with a surgical success rate of 87%, whereas 2eyes (13.3%) hadcapsular runaway complications. Of the 15 eyes with no subcapsular fluid, 13 eyes (86.7%) underwent complete circular curvilinear capsulorhexis (P=.001), whereas 2 eyes (13.3%) had posterior capsule rupture. Thus, 87% of the cases had uneventful capsular outcomes in each group. The detection of subcapsular fluid on AS-OCT allows better planning and management with 30-gauge assisted-needle drainage of fluid, thus decreasing the chances for capsular runaway complications with better surgical outcomes.

Satisfied patients? An investigation of eye care services in hospitals in South India

Background: Competition across the healthcare sector has arguably led to better services and improved efficiency. In this market, patient satisfaction remains an extremely important indicator of quality. Patient satisfaction is a person's feeling of pleasure, or disappointment, resulting from a comparison between a perceived expectation against their outcome. Satisfied patients may help to drive changes in hospitals, which could result in a better understanding of patient quality. Aim: The aim of this study was to identify patient's satisfaction levels in different cluster groups regarding eye care services in South India. Method: A questionnaire was distributed to 454 patients who had already visited leading eye care hospitals. Descriptive statistics and cluster analysis were used to test the number of groups. Results: Three cluster groups were identified as: unmarried young students, middle-aged males, and an elderly female group. Managerial implications: Healthcare providers and managers can analyse the quality of service across the various groups through segmentation and clustering so that healthcare services can be provided according to the patients' needs and expectations.

A ten year study of prevalence, antimicrobial susceptibility pattern, and genotypic characterization of Methicillin resistant Staphylococcus aureus causing ocular infections in a tertiary eye care hospital in South India

Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of vision threatening ocular infections. This study aimed to determine the prevalence and antimicrobial susceptibility pattern of MRSA and their genotypic characterization in ocular infections. The study period was from January 2007 to December 2017 in Aravind Eye Hospital, Madurai. Retrospective analysis of clinical records found a total of 1306 Staphylococcus aureus in various ocular infections. Among these, 274 (21%) were found to be MRSA with an increased incidence from 9% in 2007 to 38% in 2017 (P = .007). MRSA was isolated commonly from lacrimal sac infection 89 (32%), lid infection 55 (20%), keratitis 45 (16%) and orbital infection 34 (12%). MRSA isolates showed 100% sensitivity to vancomycin, 91% to chloramphenicol and majority of MRSA isolates were resistant to all fluoroquinolones. MSSA strains showed very minimal resistance to chloramphenicol (5%) and also there was no resistance to vancomycin. In case of the MSSA isolates, resistance to fluroquinolones (ciprofloxacin, gatifloxacin, moxifloxacin, ofloxacin and levofloxacin) was found to increase during study period. Methicillin-resistance is conferred by the carriage of Staphylococcal Cassette Chromosome mec (SCCmec) and most of our isolates were belonged to SCCmec type V and IV which is known to be community acquired MRSA. MLST sequencing on seven housekeeping genes revealed, sequence type ST772 was predominant followed by ST22. Agr typing identified most of the isolates (69) were agr type II (77%). By spa typing, there are 16 spa types were identified, among which 60% of the isolates had t657 spa type.

Barriers and enablers to low vision care services in a tertiary eye care hospital: A mixed method study.

Purpose:Visual impairment is a major health concern all over the world. Globally, it has been studied that utilization of low vision care (LVC) services varies from 3% to 15%. This study describes barriers to access the LVC services and suggest enablers to improve the uptake of services in a tertiary eye care hospital.Methods:A snapshot qualitative research design with purposive sampling was adopted. Qualitative part of the study involved 13 eye care practitioners (ECPs) and 7 patients with low vision participated in one to one in-depth interviews. The interviews were audio recorded, transcribed, inductively coded, and analyzed. The barriers to access LVC services were identified and enablers to improve the uptake of services were implemented. The referral rate and utilization of LVC services were analyzed in the quantitative part.Results:Themes emerged out of qualitative part of the study were barriers, perceived benefits, and enablers to improve the uptake of LVC services. Barriers among ECPs included lack of awareness on referral criteria and available LVC. Barriers among patients were lack of knowledge and understanding about the need for services. The enablers included development of referral criteria and referral pathway to LVC services, creating awareness of LVC services to patients and ECPs, stratification levels of LVC services, and implementation of LVC counseling chamber. Referral rate improved from 25.6% to 51.2% and the utilization of services increased from 67.9% to 81.7% after implementation of the recommended enablers.Conclusion:Execution of stratified enablers increased the uptake of LVC services benefiting more number of people with low vision in this study.

Long-term safety of posterior chamber implantable phakic contact lens for the correction of myopia

PurposeTo review the safety of the implantable phakic contact lens (IPCL V1, Caregroup Sight Solutions, India) for correction of myopia and myopic astigmatism.MethodsRetrospective interventional case series including 134 eyes which underwent IPCL implantation for correction of myopia and myopic astigmatism at a tertiary eye care hospital in South India. Intraoperative and postoperative complications were analyzed. The following parameters were analyzed at preoperative and 1, 6 and 12 month postoperative visits: visual acuity (in logMAR) and manifest refraction, slit lamp bio microscopy, dilated fundus examination, IOP and endothelial cell density measurement.ResultsNo intraoperative complications were noted. Cataract was the most common postoperative complication, wherein three eyes (2.2%) underwent observation for visually insignificant anterior subcapsular cataract and one eye (0.7%) required surgical intervention. Four eyes developed transient increased IOP due to steroid response (3 eyes) and pupillary block glaucoma (1 eye). The endothelial cell loss noted over a 1-year follow-up was 2.01%±4.12% (P=0.71). One eye developed hypopyon on the third postoperative day, which resolved subsequently with an unaided vision of 20/20. No vision threatening complications were noted. The mean follow-up in the cohort was 25.66±16.45 months.ConclusionThe IPCL is a safe and effective treatment modality for correction of myopia and myopic astigmatism.

Awareness, utilization and barriers in accessing assistive technology among young patients attending a low vision rehabilitation clinic of a tertiary eye care centre in Delhi.

Purpose:People with visual disability need assistive technology to improve their body functioning and performance. The purpose of the present study was to understand the awareness, use and barriers in accessing the assistive technology among young patients attending visual rehabilitation clinic of a tertiary eye care hospital in Delhi.Methods:A cross-sectional study was conducted on consecutively recruited patients registered for the first time in visual rehabilitation clinic of the community ophthalmology department of the tertiary eye centre during June and July 2018. A study tool consisting of 42 assistive technologies was developed. Patients were screened for distance visual acuity both presenting and binocular pinhole vision using an ‘E’ chart with two optotype (6/18, 6/60).Results:85 patients (69.4% male) were enrolled from the VR clinic. 83.5% of the patients had a best corrected binocular vision acuity <6/18 to 1/60. There was good awareness of only 2 of the 42 devices (>67% of the participants): near optical magnifiers, walking long canes. There was moderate awareness of 10 devices (34-66% of the participants) and poor awareness of the rest (<33%). Likewise, participants reported moderate usage of 3 out of the 42 devices and poor usage of the remaining devices. Non-availability of devices was the most frequently reported barrier in the study.Conclusion:The awareness and utilization of assistive technologies for visual disability was poor in patients attending visual rehabilitation clinic. Hospitals could procure assistive technologies and introduce strategies to improve awareness as well as promote utilization.

Visual and Refractive Outcomes Following Simultaneous Phacoemulsification and Pterygium Excision with Conjunctival Autograft

Purpose - This study aims at analyzing the visual and refractive outcomes following simultaneous phacoemulsification and pterygium excision with conjunctival autograft (CAG). Setting-Tertiary eye care hospital in South India. Design-Retrospective study. Methods-508 eyes that underwent simultaneous phacoemulsification with pterygium excision between 2011-2017 were included in the study. Exclusion criteria-Pre-operative astigmatism of > 2 D, grade 3 pterygia, recurrent or double head pterygia, traumatic or complicated cataract. Pre-operative evaluation-clinical examination, keratometry, IOL power calculation, retinoscopy and subjective refraction. Procedure-Phacoemulsification with foldable monofocal IOL followed by pterygium excision with conjunctival autografting using tissue glue. Post-operative follow up-Periodically up to 6 months. Results- Mean pre-operative best corrected visual acuity (LogMAR) was 0.41+/-0.46 with post-operative mean being 0.04+/-0.12 (p=0.001). Mean pre-operative and post operative astigmatism were -1.25+/-0.60 D and -0.73+/-0.58 D (p=0.001) respectively. Mean post-operative myopic spherical error was -0.85+/-0.48 D. 34.33% of the patients had a post-operative refractive error out of which 87.42% had myopia and 12.57% had a hypermetropic error (<1D). 63.27% of the eyes with myopic error had an error of < 1 D. Most commonly seen complication was sub conjunctival haemorrhage followed by graft retraction in 12 and 10 eyes respectively. Conclusion- The combined single step procedure of phacoemulsification with pterygium excision in indicated cases, is safe and effective with good visual outcomes. The post-operative myopic residual error can be anticipated and reduced by slightly under correcting the IOL power in patients with concurrent pterygium to optimize the visual outcome.

Diabetic Retinopathy Diagnosis from Retinal Images Using Modified Hopfield Neural Network.

Disease diagnosis from medical images has become increasingly important in medical science. Abnormality identification in retinal images has become a challenging task in medical science. Effective machine learning and soft computing methods should be used to facilitate Diabetic Retinopathy Diagnosis from Retinal Images. Artificial Neural Networks are widely preferred for Diabetic Retinopathy Diagnosis from Retinal Images. It was observed that the conventional neural networks especially the Hopfield Neural Network (HNN) may be inaccurate due to the weight values are not adjusted in the training process. This paper presents a new Modified Hopfield Neural Network (MHNN) for abnormality classification from human retinal images. It relies on the idea that both weight values and output values can be adjusted simultaneously. The novelty of the proposed method lies in the training algorithm. In conventional method, the weights remain fixed but the weights are changing in the proposed method. Experimental performed on the Lotus Eye Care Hospital containing 540 images collected showed that the proposed MHNN yields an average sensitivity and specificity of 0.99 and accuracy of 99.25%. The proposed MHNN is better than HNN and other neural network approaches for Diabetic Retinopathy Diagnosis from Retinal Images.

Amniotic membrane transplantation with or without autologous cultivated limbal stem cell transplantation for the management of partial limbal stem cell deficiency.

PurposeTo compare the outcomes of amniotic membrane transplantation (AMT) vs cultivated limbal stem cell transplantation (LSCT) in eyes with partial limbal stem cell deficiency (LSCD) following chemical burns.MethodsEyes with unilateral partial LSCD (#180° involvement) were randomized in two groups to undergo either pannus resection combined with AMT or pannus resection combined with LSCT in a tertiary eye care hospital. Primary outcome measures were time to corneal epithelialization and absence of conjunctivalization of the cornea. Patients were followed up at 1 week, 1, 3, 6, and 12 months after the surgical procedure.ResultsThere was no difference between mean age (30.85±5.8 vs 28.64±6.4 years, P=0.40) and sex distribution of patients between the two groups at baseline. Mean time to corneal epithelialization was 10.45±5.8 days in the AMT group and 11±3.9 days in the LSCT group (P=0.43). At the end of 1 year, there was no significant difference between the degree of conjunctivalization of cornea, (P=0.06) corneal vascularization, (P=0.08), and clarity (P=0.07) in both groups.ConclusionOur study showed that AMT alone is a useful therapeutic modality in cases with partial LSCD due to ocular chemical injury. Stem cell transplantation may not be required in these cases.

Reducing Waiting-time of Preterm Babies at a Retinopathy of Prematurity Clinic: A Quality Improvement Project

To decrease the waiting time for preterm babies visiting the Retinopathy of prematurity clinic in a tertiary eye hospital. Interventional study. Tertiary eye care hospital. All preterm babies reporting for screening and follow up at Retinopathy of prematurity clinic. A quality improvement team comprising of a faculty (team leader), two senior residents, two junior residents, one nursing officer, and a registration staff was constituted. Fish bone analysis was done to understand various reasons for the high waiting time for preterm babies. Baseline data was collected followed by multiple Plan-Do-Study- Act (PDSA) cycles. Average waiting-time, maximum waiting-time, and last baby entry-time were measured. The median average waiting-time, maximum waiting-time and last baby entry-time at baseline were 90.5 min (range 74.1 to 118.8 min), 177.5 min (range 160 to 190 min) and 111 min (90 to 118 min), respectively. At the end of 3rd PDSA cycle, these reduced to 77.6 min (range 55.2 to 94.3 min), 122 min (range 110 to 135 min), and 60 min (range 45 to 80 min), respectively and were sustained; the decrease from baseline being 14.3%, 31.2%, and 46%, respectively. The time spent in the waiting area at the Retinopathy of Prematurity clinic was significantly reduced by simple changes in the process flow.

Urban diabetic retinopathy teleophthalmology screening: results and impact at the service corridor

ObjectiveTo assess real-world results and the impact on a hospital service corridor for screening for DR through an urban community teleophthalmology service. MethodsRetrospective analysis at the hospital service corridor of 148 diabetics referred to it following DR teleophthalmology screening of 1185 type II diabetics. ResultsOf the screened diabetics, 87.4% (n = 1036) were exempted from face-to-face clinical examination (FFCE) in a traditional hospital eye care pathway and continued monitoring through teleophthalmology under a watch-and-wait attitude, while 12.5% (n = 148) were recommended for an FFCE. The FFCEs revealed that significant DR was present in 48.2% or in 5.6% of this screened diabetic population. Reasons for referral were findings of significant DR in 40.5%, of which diabetic macular edema (DME) represented 86.6%, other incidental significant sight-threatening findings represented 32.4% (4% of the screened diabetics), and insufficient image quality was obtained for the other 27.0%. Optical coherence tomography (OCT) imaging at FFCE confirmed DME in 26.4% and led to treatment. Patients referred for insufficient image quality showed significant pathology in 90.2%, of whom 63.4% underwent further monitoring or treatment. The readers requested the FFCEs for 148 patients within 1 month of the reading in 19.6%, 3 months in 26.3%, 4–12 months in 47.3%, and 12 months in 6.7% over the 34 months of the study. Compliance with FFCEs was 91.9%, absolute in 78.4% and relative in 21.5%. The availability of OCT at the imaging site would have impacted 4.5% of the screened diabetics by enabling teleophthalmology monitoring of 91.6%, identifying just-in-time interventions for DME treatments in 26.4% and reducing by 25% the need for referral of OCT-negative reader-identified DME. ConclusionThe FFCEs generated at the hospital service corridor by an urban community DR screening teleophthalmology project did not impact negatively on its services; moreover, the service corridor was exempted from providing FFCEs to 87.4% of the diabetic population it serves. This study may help provide cost-efficiency indications for a screening protocol that would include OCT availability at the imaging site and measure its positive effects. While DR of which DME was the main cause of referral for FFCE, incidental significant sight-threatening findings were significant and approached DR as a cause of referral; this supports the recommendation of continued human intervention in DR teleophthalmology screening at this time and for this population, until automatic computer-aided diagnosis systems can recognise biomarkers associated with other significant fundus diseases. As a secondary gain this project benefited individuals in need of care who were lost to the traditional eye care pathway. Good compliance with the follow-up FFCE further supports teleophthalmology in its effort to provide better access to DR screening.

ROLE OF EARLY VITRECTOMY IN THE TREATMENT OF FUNGAL ENDOPHTHALMITIS.

To study whether immediate pars plana vitrectomy at the time of sampling vitreous for culture alter the visual and structural outcomes in fungal endophthalmitis. Surgical results of 66 consecutive patients with culture-positive fungal endophthalmitis attending a tertiary eye care hospital in eastern India were analyzed. Based on the timing of vitrectomy, they were divided into 2 groups: Group 1-immediate vitrectomy (n = 31) and Group 2-diagnostic vitrectomy alone (n = 35) as the first-line intervention. The demographics, clinical features, and visual and structural outcomes were compared between the groups. The proportion of postoperative (54.83 vs. 51.42%), traumatic (29.03 vs. 34.28%), and endogenous (16.12 vs. 14.28%) endophthalmitis and clinical signs such as pain (54.83 vs. 60%), lid edema (48.38 vs. 48.57%), conjunctival congestion (87.09 vs. 94.28%), and corneal involvement (87.09 vs. 80%) in Groups 1 and 2, respectively, were comparable. Logarithm of the minimum angle of resolution vision improvement in Group 1 was significant (P = 0.0278) though there was no statistically significant difference in posttreatment vision between the groups (P = 0.322). Phthisis was seen in 25.8% in Group 1 and 25.7% in Group 2 (P = 0.993). Aspergillus species was the most common fungal pathogen isolated. Early vitrectomy plus intravitreal antifungals in a subset of clinically suspected fungal endophthalmitis resulted in statistically significant visual improvement over diagnostic vitrectomy plus intravitreal antifungals (P = 0.013). A strong clinical suspicion that translates into early vitrectomy plus intravitreal antifungal antibiotics leads to favorable visual and structural outcomes. A long wait till microbiological confirmation to institute antifungal therapy may result in poorer outcome.

Оценка различных видов хирургических вмешательств при глаукоме по данным офтальмологических стационаров г. Курска

Оценка различных видов хирургических вмешательств при глаукоме по данным офтальмологических стационаров г. Курска

Prevalence and Risk Factors of Dry Eye Disease in Kuantan, Malaysia

Background: To determine the prevalence of dry eye disease (DED) at Jalan Hospital Eye Care, International Islamic University Malaysia (IIUM), Kuantan, Malaysia. Methods: The dry eye symptoms and tear breakup time test (TBUT) values retrieved from the medical records of 643 patients were retrospectively analysed. Dry eye cases with one or more symptom were included. ‘Yes’ or ‘no’ responses were used in discriminant analysis of tear abnormality (TBUT < 5 seconds). Results: The crude prevalence of DED was 48.5%, the age-adjusted prevalence was 43% in women <50 years of age, and 68.4% in those ≥50 years of age. Contact lens wear and low TBUT values were associated with DED risk in men. Age of ≥50 years and a low tear meniscus height (TMH) score were associated with risk of DED symptoms in women. Conclusions: The prevalence of DED in optometric outpatients at IIUM was relatively high, especially in the elderly population. Symptoms and signs were poorly associated with DED. TBUT performed well in diagnosing dry eye and may be useful to improve the assessment of patients with dry eye problems in this region.

Visual outcomes of patients bilaterally implanted with the extended range of vision intraocular lens: A prospective study.

Purpose:The aim of this study was to analyze the objective and subjective visual outcomes of patients bilaterally implanted with the extended range of vision intraocular lens (EROV IOL), the Tecnis Symfony.Methods:This was a prospective interventional case series conducted at a tertiary eye care hospital in South India. The study included patients with bilateral implantation of EROV IOLs. The uncorrected and corrected visual acuity for distance, intermediate, and near vision was recorded at 6 weeks and 6 months’ postoperative visit. A subjective questionnaire was administered to assess spectacle independence, photic phenomenon, and overall satisfaction. All data were recorded using Microsoft Excel worksheet. The analyses were performed using SPSS for windows software.Results:Our study included fifty patients with bilateral implantation of EROV IOLs. The mean age was 59.84 ± 11.68 years. The mean uncorrected binocular distance, intermediate, and near visual acuity (in standard decimal equivalent) was 0.89,0.99 and 0.99 respectively, at 6 months’ postoperative visit. Ninety-six percent of the patients did not require spectacles for distance and 98% of the patients were free from spectacles for intermediate and near vision. 94% of our patients perceived no or minimal photic phenomena such as glare and halos. The mean subjective patient satisfaction score (out of 10) for distance, intermediate, and near was 9, 10, and 9, respectively.Conclusion:The EROV IOLs demonstrated high levels of spectacle independence for distance, intermediate, and near vision. The incidence of photic phenomena observed was minimal with a high level of patient satisfaction.

Efficacy and outcome of 0.7mg sustained release dexamethasone implant in a Tertiary Eye Care Hospital over a period of one year-A retrospective study

The present article retrospectively elaborates the indication and the final visual acuity at 1 year in a cohort of 28 patients administered with 1 or more doses of 0.7 mg intravitrealozurdex over a period of 1 year. Data of 28 eyes of 28 patients was retrived from the medical record division. Majority of the patients were in the age group of 50–60 years. The most common indication was vascular occlusion (n=15) followed by post cataract extraction (n=7), diabetic macular edema (n=6). 5 patients had raised IOP one-two months following injection. 19 pts had prior intravitrealantiVEGF injection. 2 patients repeatedozurdex injection at 6 months. There was a difference of 173 +/-90.5 (p<0.0001)in the 1 year CRT value.

Vision Screening of Ophthalmic Nursing Staff in a Tertiary Eye Care Hospital: Outcomes and ocular healthcare-seeking behaviours.

This study aimed to evaluate ocular healthcare-seeking behaviours and vision screening outcomes of nursing staff at a tertiary eye care hospital. This study was conducted between April and September 2016 among all 500 nurses employed at the King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. Data were collected on age, gender, use of visual aids, the presence of diabetes, a history of refractive surgery and date of last ocular health check-up. Participants were tested using a handheld Spot™ Vision Screener (Welch Allyn Inc., Skaneateles Falls, New York, USA). A total of 150 nurses participated in the study (response rate: 30.0%). The mean age was 41.2 ± 8.9 years old. Distance spectacles, reading spectacles and both types of spectacles were used by 37 (24.7%), 32 (21.3%) and 10 (6.7%) nurses, respectively. A total of 58 nurses (38.7%) failed the vision screening test. Visual defects were detected for the first time in 13 nurses (8.7%). With regards to regular eye checkups, 77 participants (51.3%) reported acceptable ocular healthcare-seeking behaviours; this factor was significantly associated with age and the use of visual aids (P <0.01 each). A high proportion of participants failed the vision screening tests and only half displayed good ocular healthcare-seeking behaviours. This is concerning as ophthalmic nurses are likely to face fewer barriers to eye care services than the general population.