Ocular Problems Research Articles

Assessment of long-term adverse events regarding different COVID-19 vaccine regimens within an 18-month follow-up study.

Early reports on coronavirus disease 2019 (COVID-19) vaccines presented the short-term adverse events (AEs). This follow-up study investigated a standard regimen based on protein subunit vaccines, PastoCovac and PastoCovac Plus, and the combinational vaccine regimens including AstraZeneca/PastoCovac Plus and Sinopharm/PastoCovac Plus. The participants were followed up to 6 months post the booster shot. All the AEs were collected through in-depth interviews using a valid researcher-made questionnaire and were evaluated regarding the association with the vaccines. Of the 509 individuals, 6.2% of the combinational vaccine participants had late AEs, of whom 3.3% suffered from cutaneous manifestations, followed by 1.1% arthralgia complaints, 1.1% with neurologic disorders, 0.3% ocular problems and 0.3% metabolic complications, with no significant difference between the vaccine regimens. For the standard regimen, 2% of the individuals experienced late AEs as (1%), neurological disorders (0.3%), metabolic problems (0.3%) and involvement of joints (0.3%). Notably, 75% of the AEs were persistent up to the end of the study. A low number of late AEs were captured in 18 months as 12 improbable, 5 unclassifiable, 4 possible and 3 probable associated AEs with the vaccine regimens. The benefits of COVID-19 vaccination far exceed the potential risks and late AEs seem to be uncommon.

Use of the World Health Organization primary eye care protocol to investigate the ocular health status of school children in Rwanda

To assess the ocular health status of primary and secondary schoolchildren in Rwanda and to explore the use of the World Health Organization (WHO) primary eye care screening protocol. This was a cross-sectional population-based study across 19 schools in Rwanda. Initial screening was carried out using the WHO screening protocol, whereby visual acuity was measured using a tumbling E Snellen chart (6/60 and 6/12). Abnormal ocular features were identified using a flashlight and history against a checklist. All children with abnormal screening were referred to an on-site ophthalmic clinic for full examination. Those who could not be treated on-site were referred to an ophthalmologist at a hospital for specialist care. A total of 24,892 children underwent ocular health screening. Of those, 1,865 (7.5%) failed the primary screening; 658 (2.6%) were false positives (35.3% of those who failed screening), and 1,207 (4.8%) true positives. The most frequently observed ocular diagnoses were allergic conjunctivitis (3.11%) and strabismus (0.26%). Refractive error was very rare (0.18%). The WHO primary eye care curriculum provides existing health personnel with an approach to school-based vision screening that uses a standardized checklist and low-cost resources. In our study cohort, results indicated a low frequency of refractive error; the overwhelming majority of ocular problems could be identified on visual inspection.

The Effect of High Molecular Weight Hyaluronic Acid and Latanoprost Eyedrops on Tear Functions and Ocular Surface Status in C57/BL6 Mice.

Anti-glaucoma eye drop treatment often induces ocular surface problems, including dry eyes, and may be associated with poor medication compliance. This study aimed to investigate the effects of a novel high molecular weight hyaluronic acid and Latanoprost eye drop on intraocular pressure, as well as the tear function and ocular surface alterations in wild type mice, comparing the results with the mice receiving commercially available Latanoprost eye drops and mice receiving no treatment. The mice were divided into three groups: Group I, control group (no treatment group); Group II, commercial Latanoprost eye drop (LP); and Group III, Comfort Shield (CS) + Latanoprost (LP) eye drop (CS + LP). The CS + LP eye drop group had an IOP lowering effect comparable to the commercial LP eye drop group. The mice receiving LP eye drops had significantly worse corneal staining scores, lesser goblet cell density(GCD), higher numbers of CD45+ staining cells, significantly higher tear film concentrations of IL-6 and IL1-b, and a significantly lower expression of corneal ZO-1 mRNA compared with the mice receiving CS + LP 7 days after eye drop instillations (p < 0.05). In conclusion, the new CS + LP formulation appeared to induce less inflammation, less corneal vital staining, and a better barrier status with an IOP lowering effect comparable to the commercial LP eye drops.

GabROP: Gabor Wavelets-Based CAD for Retinopathy of Prematurity Diagnosis via Convolutional Neural Networks.

One of the most serious and dangerous ocular problems in premature infants is retinopathy of prematurity (ROP), a proliferative vascular disease. Ophthalmologists can use automatic computer-assisted diagnostic (CAD) tools to help them make a safe, accurate, and low-cost diagnosis of ROP. All previous CAD tools for ROP diagnosis use the original fundus images. Unfortunately, learning the discriminative representation from ROP-related fundus images is difficult. Textural analysis techniques, such as Gabor wavelets (GW), can demonstrate significant texture information that can help artificial intelligence (AI) based models to improve diagnostic accuracy. In this paper, an effective and automated CAD tool, namely GabROP, based on GW and multiple deep learning (DL) models is proposed. Initially, GabROP analyzes fundus images using GW and generates several sets of GW images. Next, these sets of images are used to train three convolutional neural networks (CNNs) models independently. Additionally, the actual fundus pictures are used to build these networks. Using the discrete wavelet transform (DWT), texture features retrieved from every CNN trained with various sets of GW images are combined to create a textural-spectral-temporal demonstration. Afterward, for each CNN, these features are concatenated with spatial deep features obtained from the original fundus images. Finally, the previous concatenated features of all three CNN are incorporated using the discrete cosine transform (DCT) to lessen the size of features caused by the fusion process. The outcomes of GabROP show that it is accurate and efficient for ophthalmologists. Additionally, the effectiveness of GabROP is compared to recently developed ROP diagnostic techniques. Due to GabROP's superior performance compared to competing tools, ophthalmologists may be able to identify ROP more reliably and precisely, which could result in a reduction in diagnostic effort and examination time.

Comparative Modeling and Molecular Interaction Study for the Management of AMD and CRVO Ocular Disorder

Age Related Macular Degeneration (AMD) and Central Retinal Vein Occlusion (CRVO) are the rare and leading cause of blindness among patients with ocular problem. Many proteins are reported in the progression of these ocular disorders. Proteins which are directly involved in the development of this disorder reported in the literature, their sequence related information retrieved from biological databases. In silico technique was implemented in order to characterize the properties and structures of the proteins using ProtParam. For studying about the potential phosphorylation sites in protein generally NetPhos server was used whereas for denoting the location of signal peptide cleavage sites and their presence the server which is used is SingalP server. For prediction of secondary structure prediction of proteins is done by using SOPMA. The SOSUI server performs the identification of trans-membrane regions. The 3D dimensional structure was modeled using Swiss Model Workspace and Modeller. Ramachandran plot was used to validate the stereochemical properties of the predicted structures because it is a very important step after 3D structure prediction. Docking of screened phytochemicals with selected proteins was performed by AutoDock. Docking study revealed that Curcumin (binding energy: -8.35) and Berberine (binding energy: -7.14) can be used as better therapeutic lead molecule for the cure of CRVO and AMD respectively.

Canine ophthalmic patients with endocrine and metabolic disorders - a review

The eye is particularly sensitive to various pathological processes in the body. Ocular changes are often the first symptoms of serious systemic diseases. Due to hormonal and metabolic disturbances in patients with endocrinopathies and metabolic disorders, secondary ophthalmic diseases can occur. Systemic diseases often cause ocular problems in animal and human patients. Early diagnosis of ophthalmic symptoms can help to identify a primary cause, such as endocrinopathies, and start an effective treatment. In some cases, clinical signs of systemic diseases are poorly documented in veterinary ophthalmology. Cataracts, retinopathy, metabolic disorders and systemic hypertension are common problems in animals with diabetes mellitus. Patients with hyperadrenocorticism may develop complications secondary to hyperlipidaemia and hypertension. Acute blindness due to sudden retinal dege­ne­ration (SARDS) has been associated with pituitary-adrenal axis disorders. Growth hormone disorders can result in secondary ocular complications due to hypertension (corneal infiltrates, decreased tear production and neurological dysfunction). Animals with hyperthyroidism may have ophthalmic problems associated with systemic hypertension and subsequent retinal bleeding or detachment.

Medications Damaging Ganglion Cell Layer or Optic Nerve: Pathogenesis, Diagnosis, and Treatment; (Quinine sulfate, Methanol, Carbon monoxide, Ritonavir, Fludarabine, Ethambutol, Methotrexate, Tamoxifen)

The ocular system has dense vascularization and neural network. These structures may be exposed to the toxic effects of some systemically administered drugs. In addition, some factors that cause hypoxia by reducing oxygen transport due to high energy demand may cause different ocular problems. This article aimed to examine the effects of some drugs used systemically and some conditions leading to hypoxia that cause damage to the ganglion cell layer or optic nerve.

Characterization of red eye cases presented to the eye emergency clinic at a tertiary care hospital during COVID-19 Pandemic.

The World Health Organization (WHO) was notified by China on December 31, 2019, of a pneumonia outbreak severe acute respiratory syndrome-associated coronavirus-19 virus infection in Wuhan. This outbreak was declared by the WHO from the Public Health Emergency of International Concern to formal declaration as a pandemic on March 11, 2020. Because the public health measures like lockdown, the eye care delivery system was markedly impacted. The aim of this study was to find out if any pattern change of red eye cases among patients who attended eye accident and emergency (A and E) in a tertiary care hospital during COVID-19 pandemic in 2020 compared to 2019 and 2018. This was a cohort retrospective study which included all patients who presented to eye A and E clinic with red eye from March 1 to July 31 in 2018, 2019, and 2020. Data were analyzed using statistical tools in the SPSS software. Furthermore, the clinical records of 578 inpatients with proven COVID-19 were reviewed for any red eye problem. Out of 7895 eye patients attended eye A and E clinic during March-July of 2018, 2019, and 2020, 1573 (19.9%) patients had red eye. Males were slightly dominant with 59%, and unilateral cases were the majority among them. The most common causes of red eye in 2018 and 2019 were injury, conjunctivitis, and keratitis; whereas in 2020, a clear dominance of injury and keratitis cases was found. Only 10 (2.03%) patients out of the 493 outpatients with red eye during the 5-month period in 2020 reported a prior contact to a COVID-19 positive case; of whom nine patients had conjunctivitis, and one had a right eye open globe injury. Of the 578 inpatients with proven COVID-19, only 1 (0.17%) patient had red eye with the diagnosis of conjunctivitis. There was relatively increased number of adults reporting with red eye in 2020. Eye injuries were the most common among all years, followed by conjunctivitis and keratitis. Ocular problems, however, might be a primary or secondary COVID-19 complaint and seem to be relatively uncommon in COVID-19 individuals.

Study of health seeking behaviour in parents of children in a population-based childhood visual impairment study in North India - "CHVI 2".

The background of this study is to determine the awareness about health seeking behaviour (HSB) in parents of visually impaired children in a population-based study. The study was conducted in population <16 years in urban area of North India. A total of 20,955 (97.3%) children underwent visual acuity examination. Of these, 789 children were referred to the centrally based clinic with unaided visual acuity <6/12 in any eye for undergoing detailed ophthalmic examination. Along with ocular examination, the parents of these 789 referred children, were interviewed for the questions related to HSB, the most common ocular symptom known to them was redness of eyes followed by watering and diminution of vision, 249 (34.6%) denied for any ocular problem in their children previously, amongst the remaining 469 parents/care takers with any ocular problem, a total of 367 (51.1%) referred children wore glasses and the proportion of parents wearing glasses was similar amongst these children (11.7% fathers and 11% mothers). Amongst the 118 respondents of visually impaired children (presenting visual acuity less than 6/18 in better eye with available correction), 56 (47.5%) denied for any ocular problem in their children previously, of the remaining 62 (52.5%), parents, 58 (93.5%) had consulted various healthcare agencies, 45.8% of the respondents reported not said that their children wore glasses prescribed to them. Only 24 (20.3%) respondents were aware that Vitamin A is good for eye health. Diminution of vision, watering and redness of eyes were the most common ocular symptoms known to parents of referred children. HSB can be further improved via primary healthcare physicians by primary healthcare creating awareness about importance of wearing glasses and healthy diet in parents of visually impaired children.

Solid mechanics models in application to ophthalmology

The review presents the models on a change in the stress-strain state of the eye shell after vision correction operations and a change in intraocular pressure with the introduction of drugs into the vitreous body. All mathematical models were developed in collaboration with ophthalmologists. Mathematical models that describe the process of determining the true intraocular pressure (IOP) by applanation methods are discussed. New results in solid mechanics were obtained while studying ocular biomechanics problems. For example, the problem of the stability of a spherical shell subjected to a concentrated force and internal pressure was solved and the stability of the axisymmetric equilibrium state of annular inhomogeneous orthotropic plates under normal pressure was studied. The stress-strain states of transversely isotropic spherical and cylindrical layers subjected to internal and external pressures are discussed and the solutions obtained in the framework of the three-dimensional theory are compared with the solutions obtained by non-classical shell theories. This comparison made it possible to assess the accuracy of approximate theories.

Individualized Approaches to Diabetes Care in Nursing Homes

Although diabetes care has been widely established as a single entity, data in older, frail individuals with numerous comorbidities and have limited polymedication. This group accounts for a sizable number of nursing home residents (NHs). We came together as a group of experts with multidisciplinary (endocrinologists, geriatricians, Nurses staff, general practitioners and diabetologists) with real-world practice in this field, which is becoming more and more important globally, to compile practical, straightforward guidance on the managing of senior, fragile patients of diabetes. An Individual Care Plan (ICP), which is presented in layman's terms, is the cornerstone of a patient's diabetes treatment. This is due to the demands placed on personnel of NH (medical coordinator, manager, nurses, and caregiver working at the front lines, and the other caregiver worker which is undertraining). The actual purpose of this document, which is released when the patient is admitted, is to made prescriptions ensure that given at and followed after admission. It details the need for proper treatment, regular monitoring, and dates and times for essential examinations and testing. This entails keeping tabs on the patient's HbA1c, as well as their blood and urine glucose levels and any complications that may arise from the condition (hypoglycemia, cardiovascular disease, foot disorders, ocular problems, malnutrition, kidney failure and peripheral neuropathy). Consequentially, staff education on the unique challenges of care for an elderly person with diabetes, emergency procedures, and maintaining an up-to-date ICP for use by medical professionals is essential. Keywords: Diabetes, nursing home, polymedication

Impact of pandemic COVID-19 lockdown on penetrating keratoplasty patients.

To study the impact of the COVID-19 lockdown on the regular follow-up of keratoplasty patients. This retrospective interventional case series included 30 patients who had immunological corneal endothelial rejection out of 190 patients who came for post-PKP follow-up between September 15, 2019, and September 30, 2020. The demographics, primary diagnosis, surgical technique, time of presentation, recovery of graft, associated ocular problems, and visual acuity at 1 month were analyzed. Forward stepwise (likelihood ratio) binary logistic regression was used to find significant variables. The study population had 19 males (63.33%) and 11 females (36.67%). The mean age of the study group was 42.83 ± 18.89 (8-80) years. Of 30 patients, 19 (63.3%) presented before and 11 (36.7%) after the COVID-19 lockdown. Overall, 23 (77%) showed a reversal of graft rejection. Logistic regression showed that preoperative indications, large-sized grafts, and deep corneal vascularization were significant risk factors for non-resolution of graft rejection. It was noted that patients who presented to the hospital late had poor recovery (P = 0.002). The delay in the presentation was a significant risk factor for non-resolution of graft rejection (P < 0.01). Z-test for proportions revealed that the difference in the non-resolution of rejection on immediate or delayed treatment in patients presenting during lockdown (P = 0.002) was significant. This article is to highlight the impact of the COVID-19 lockdown on graft rejection recovery of PKP patients due to delays in follow-up. Early treatment helps in the recovery of graft transparency and the reversal of immunological graft rejection. Also, primary diagnosis, deep vascularization, and large-sized grafts were significant risk factors for non-resolution of graft rejection.

Improving assistive technology access to students with low vision and blindness in Delhi: A school-based model.

Assistive technology (AT) has recently received considerable attention around the world. Studies have shown poor access to assistive technology for visual impairment (ATVI) in schools for the blind in India. The present article aimed at designing a school-based model to improve AT access in schools and provide hands-on training, and identify types of ocular morbidities present among students. The vision rehabilitation (VR) team of a tertiary eye-care center visited schools for the blind as a part of community-based VR services. The team conducted a basic eye examination and assessed best-corrected vision acuity (BCVA) and provided VR services. Furthermore, two schools were selected to establish an ATVI learning center as a pilot model. In total, 1887 students were registered for VR and obtained their disability certificates in 2019-20. Retina problems (25.7%), globe abnormalities (25.5%), optic nerve atrophy (13.6%), and squint (12.0%) were common ocular problems identified in students. Around 50.3% of students had BCVA3 1/60 in the better eye who would be benefited from visual-based AT, and the remaining students with visual substitution AT. Further, 20.8% of them who had near vision between N18 to N24 would be benefitted from large print books. Two schools were provided ATVI with support from the WHO. Familiarization, demonstration, and initial training for ATVI were carried out. A sizable number of the students would be benefitted from visual-based AT apart from visual substitutions AT. Students were interested to have such ATVI centers in the school for academic and non-academic skills development.

Assessment Of Digital Eye Strain With The Digital Eye Strain Scoring Index (Dessi)

Purpose: The purpose of this study is to assess digital eye strain (DES) with the help of the digital eye strain scoring index (DESSI) in the urban population. Methods: The subjects were carefully selected with no ocular or systemic problems that may alter the study results and prior written consent was obtained. This study is divided into two phases. Phase 1 consists of reliability testing with Cronbach’s alpha and test-retest reliability while phase 2 consists of validity testing with internal validity, sensitivity and specificity. In phase 1 there were two visits, a baseline visit and a retest visit with 24 hours gap. DESSI was implemented on both visits. Phase 2 had two visits on the same day called the pre-task visit and post-task visit separated by one-hour task performance. Pre and post-task assessments were compared for all variables in the DESSI. The smartphone addiction scale (SAS) assessment and disability index (DI) was correlated with the no. of hours of smartphone use. The sensitivity and specificity were also assessed. Results: In phase 1, Cronbach’s alpha value was 0.82 and the co-relation coefficient was found to be acceptable to excellent whereas, in phase 2, the paired sample t-test showed statistically significant differences for all the tests compared. The SAS and DI correlation with the no. of hours of smartphone use was found to be good. The sensitivity and specificity of DESSI were fair, scoring 51% and 53% respectively. Conclusion: The digital eye strain is a useful tool for clinicians who can accurately analyze digital eye strain with acceptable to excellent test–retest reliability, internal consistency, good validity, fair sensitivity, and specificity.

A Case of Granulomatosis with Polyangiitis Concurrent Papillary Thyroid Cancer

Purpose: To report a biopsy-proven case of granulomatosis with polyangiitis (GPA) who visited for red eye and discomfort. We detected papillary thyroid cancer by a whole-body scan.Case summary: A 56-year-old female presented to our clinic with hyperemia and discomfort in the right eye for the past 1 month. The visual acuity was 0.9 in the right eye. Congestion and chemosis of the right conjunctiva were observed by slit-lamp microscopy. There was a firm, erythematous, tender mass near the right nasolacrimal duct. Impairment of adduction and infraduction and proptosis were observed. Radiologically, a 3.6 × 2.6 × 1.2 cm right orbital mass was seen in the intraorbital extraconal space, invading the right nasolacrimal duct and nasal cavity. Pathologic and supplementary investigations showed granulomatous, c-anti-neutrophil cytoplasmic antibodies (ANCA)-positive inflammation in the mass. The patient was diagnosed with GPA. Whole-body computed tomography and positron emission tomography-computed tomography revealed multiple lesions in the right orbit, nasal cavity, mediastinum, retropubic area, and left thyroid gland. Thyroid ultrasonography and biopsy led to a diagnosis of papillary carcinoma with lymph node metastasis. Topical and systemic steroids and rituximab injection were administered, and total thyroidectomy with bilateral central lymph node dissection was performed. This led to improvements in proptosis and limitation of extraocular movement.Conclusions: GPA is a rare disease that may initially present with ocular symptoms. It can be associated with malignancies even in the absence of immunosuppression. Patients with ocular problems suspected of having GPA should undergo autoimmune antibody testing, including ANCA and tissue biopsy.

Individualized Approaches to Diabetes Care in Nursing Homes

Although diabetes care has been widely established as a single entity, data in older, frail individuals with numerous comorbidities and have limited polymedication. This group accounts for a sizable number of nursing home residents (NHs). We came together as a group of experts with multidisciplinary (endocrinologists, geriatricians, Nurses staff, general practitioners and diabetologists) with real-world practice in this field, which is becoming more and more important globally, to compile practical, straightforward guidance on the managing of senior, fragile patients of diabetes. An Individual Care Plan (ICP), which is presented in layman's terms, is the cornerstone of a patient's diabetes treatment. This is due to the demands placed on personnel of NH (medical coordinator, manager, nurses, and caregiver working at the front lines, and the other caregiver worker which is under training). The actual purpose of this document, which is released when the patient is admitted, is to made prescriptions ensure that given at and followed after admission. It details the need for proper treatment, regular monitoring, and dates and times for essential examinations and testing. This entails keeping tabs on the patient's HbA1c, as well as their blood and urine glucose levels and any complications that may arise from the condition (hypoglycemia, cardiovascular disease, foot disorders, ocular problems, malnutrition, kidney failure and peripheral neuropathy). Consequentially, staff education on the unique challenges of care for an elderly person with diabetes, emergency procedures, and maintaining an up-to-date ICP for use by medical professionals is essential. Keywords: Diabetes care, nursing home, staff nurses

The influence of visual pathology on painting

AbstractPainting is, along with sculpture and architecture, the most visual of the Fine Arts and it is probably the most ancient of them. The oldest known paintings were discovered on the walls of caves in Indonesia and Spain and are believed to be more than 40 000 years old.In painting, vision is crucial both for the artists and for the viewers. Diseases affecting the eyes can have a huge impact in the artistic expression of the painters, for instance refractive errors like myopia, hyperopia and astigmatism, disorders related with age such as cataracts, presbyopia and age related macular degeneration or different pathologies including colour blindness, diabetic retinopathy, vitreal haemorrhage, retinal dystrophies, strabismus, tumours… seem to have influenced the paintings of many artists.However, it is difficult to evaluate the degree of the impact that these disorders actually have on the works of the painters. The style of an artist depends on many factors including the time or era they live in, the School of painting they belonged to, religion, politics, the influence of teachers and colleagues and, of course, their own stylistic choice. The way they perceive the world that surrounds them is surely an important factor that affects their creations, but not the only one.In this speech, we will try to look over some famous painters' works and try to explain how their ocular problems influenced their production. We will also discuss some widespread theories about alleged visual problems affecting various artists and their (lack of) accuracy.

Visual disorders and driving ability in persons with dementia: A mini review.

Impaired driving ability in patients with Alzheimer's disease (AD) is associated with a decline in cognitive processes and a deterioration of their basic sensory visual functions. Although a variety of ocular abnormalities have been described in patients with AD, little is known about the impact of those visual disorders on their driving performance. Aim of this mini-review is to provide an update on the driving ability of patients with dementia and summarize the primary visual disorders affecting their driving behavior. Databases were screened for studies investigating dementia, associated visual abnormalities and driving ability. There is consistent evidence that dementia affects driving ability. Patients with dementia present with a variety of visual disorders, such as visual acuity reduction, visual field defects, impaired contrast sensitivity, decline in color vision and age-related pathological changes, that may have a negative impact on their driving ability. However, there is a paucity in studies describing the impact of oculovisual decline on the driving ability of AD subjects. A bidirectional association between cognitive and visual impairment (VI) has been described. Given the bidirectional association between VI and dementia, vision screening and cognitive assessment of the older driver should aim to identify at-risk individuals and employ timely strategies for treatment of both cognitive and ocular problems. Future studies should characterize the basic visual sensory status of AD patients participating in driving studies, and investigate the impact of vision abnormalities on their driving performance.

Correlation of Conjunctival Impression Cytology and Clinical Examination in University Students at Lahore during the COVID-19

During COVID 19 pandemic every home-bound school, college, and university student was using computers and electronic gadgets for social networking and online education. To assess the effects of these gadgets on ocular and vision-related problems, very little research had been done on the Pakistani population, especially among university students. An analytical cross-sectional study was carried out on 355 students of University of the Punjab. Questionnaire-based data were collected by measurement of tearfilm breakup time(TBUT), the number of corneal dry spots, Schirmer’s test, and conjunctival impression cytology(CIC). Pearson correlation analysis was done on CIC score versus TBUT, Schirmer’s test and Goblet Cell Density (GCD). Analysis of variance (ANOVA) was used for mean comparison of visual acuity, TBUT, cornea spots, and Schirmer’s test to see the significance of the results. P-value≤0.05 was considered statistically significant. Out ofthe 355 students, 65% were females. The mean age of the students was 22.30 ± 6.8 years. At each level of visual acuity, there was no statistically significant difference between the meansof the different levels of visual acuity (F=0.488, p=0.614). A statistically significant meandifference was found between CIC score and TBUT (F=208.45p=&lt;0.001), CIC score andcornea spot (F=39.31, p=&lt;0.001), CIC score and Schirmer’s test (F=5.83, p=0.001). Forthe early diagnosis and management of CVS, in addition to applying the validated questionnaire and clinical dry eye tests, the Conjunctival impression cytology can be tested on a larger population to be proven as a gold slandered test.

Visual problems among video display terminal (VDT) users

To evaluate ocular problems, major symptoms and their associations among Video Display Terminal users. 100 subjects as cases and 100 subjects as controls were taken. Cases worked on computer for minimum of two hours per day while persons using computers for less than two hours a day were considered for Control group. The difference in positive fusional vergence, near point of convergence and amplitude of accommodation between two study groups was statistically significant. Dry eye was significant manifestation among cases. Three most commonly reported symptoms were Blurred vision (96 %), tired eyes (93 %) and Headache (86 %). Most of VDT users has abnormalities associated with accommodation and vergence dysfunctions. Dry eye is a significant factor associated with use of VDTs causing ocular discomfort. Duration of VDT use is directly related to the severity of the symptoms due to VDT use.