Search

Background: The purpose of this study was to quantify how much of the burden of visual impairment (VI) and unmet need in Talagang, identified by Rapid Assessment of Avoidable Blindness (RAAB) survey data, has been addressed by Community Eye Health (CEH) programme efforts. Methods: A RAAB survey was carried out in November 2018, with 2,824 participants in Talagang Tehsil, Punjab, Pakistan, aged 50 and over. Census data were used to extrapolate survey data to the population. Alongside this, a CEH programme was launched, consisting of community eye screening, and onward referral to rural health centres, secondary or tertiary ophthalmological services, as required. This health intervention aimed to address the eye care needs surfaced by the initial survey. From 2018 to 2022, 30,383 people aged 50 or over were screened; 14,054 needed referral to further steps of the treatment pathway and more detailed data collection. Programme data were compared to estimates of population unmet needs. Main outcome measures were prevalence of VI, and proportion of need met by CEH Programme, by cause and level of VI. Results: Among those aged 50 and over, 51.0% had VI in at least one eye. The leading causes were cataract (46.2%) and uncorrected refractive error (URE) (25.0%). In its first four years, the programme reached an estimated 18.3% of the unmet need from cataract, and 21.1% of URE, equally in both men and women. Conclusions: Robustly collected survey and programme data can improve eye health planning, monitoring and evaluation, address inequities, and quantify the resources required for improving eye health. This study quantifies the time required to reach eye health needs at the community level. [ABSTRACT FROM AUTHOR]

Eye care programs, in developing countries, are often planned using the prevalence of blindness and visual impairment, often estimated from Rapid Assessment of Avoidable Blindness (RAAB) surveys. A limitation of this planning approach is that it ignores the annual overall eye care requirements for a given population. Moreover, targets set are arbitrary, often influenced by capacity rather than need. To address this lacunae, we implemented a novel study design to estimate the annual need for comprehensive eye care in a 1.2 million populations. We conducted a population based longitudinal study in Theni district, Tamil Nadu, India. All permanent residents of all ages were included. We conducted the study in three phases, (i) household level enumeration and enrollment, (ii) basic eye examination (BEE) at household one year post enrollment, and (iii) assessment of eye care utilization and full eye examination (FEE) at central locations. All people aged 40 years and above were invited to the FEE. Those aged <40 years were invited to the FEE if indicated. In the main study, we enrolled 24,327 subjects (58% aged below 40 years and 42% aged 40 years and above). Of those less than 40 years, 72% completed the BEE, of whom 20% were referred for FEE at central location. Of the people aged ≥40 years, 70% underwent FEE. Our study design provides insights for appropriate long term public health intervention planning, resource allocation, effective service delivery, and designing of eye care services for resource limited settings. [ABSTRACT FROM AUTHOR]

The article discusses 2024 research which showed gaps in Medicaid coverage for vision care across the U.S. Topics covered include the provision of routine eye exams in most fee-for-service Medicaid programs, the continuing need for policy changes to improve coverage and access, and the barriers of cost-sharing requirements. Also noted is the projected doubling of adults with vision impairment in the next 25 years due to the U.S.'s aging population.

PURPOSE: This study aims to assess knowledge, attitude, and practice (KAP) around diabetic eye disease in patients with diabetes mellitus (DM) attending primary health-care centers (PHCCs) in Jazan region, Saudi Arabia. METHODS: All diabetic patients attending eight PHCCs in Jazan region between December 2018 and December 2019 were invited to participate in this cross-sectional study. Face-to-face interviews were held to gather responses to a validated 20-item questionnaire. RESULTS: In total, 293 patients aged 9–90 years (mean 50 years, standard deviation 14 years) agreed to participate, including 189 (64.5%) females and 104 (35.5%) males. Most (n = 251; 85.7%) had type 2 DM, the remainder (42; 14.3%) having type 1 DM. The mean duration of DM was 8.2 ± 6.4 years. Eye complications were self-reported by 114 (38.9%) participants. More than one-third (36.2%) of the participants had never undergone an eye examination. Less than one-third of participants (29% and 28% respectively) had an excellent level of knowledge or practice about diabetic eye disease, and only 12% demonstrated very positive attitude. KAP levels were independently predicted by patients' age, gender, and eye complication status. CONCLUSION: KAP relating to eye disease and eye care among Saudi patients with DM were less than desired. Rigorous efforts are required to raise awareness of eye complications among diabetic patients. [ABSTRACT FROM AUTHOR]

Background: There is a growing awareness that addressing chronic as well as acute health conditions may contribute importantly to the well-being of displaced populations, but eye care service has generally not been prioritized in crisis situations. We describe a replicable model of eye care provision as delivered by Orbis International and local partners to the Rohingya and host population in Cox's Bazar, Bangladesh, and characterize the burden of vision impairment and demand for sight-restoring services in this setting.Methods and Findings: Orbis International and local secondary facility Cox's Bazar Baitush Sharaf Hospital (CBBSH) provide eye care support to the Rohingya population and the host community of all ages in Cox's Bazar, Bangladesh, with fixed vision screening locations established in Camps 4 and 11 of the Kutupalong refugee settlement. Structured outreach targets these camps and four surrounding local subdistricts, with referrals made as needed for refraction (glasses measurement) and cataract surgery to CBBSH. Between February 2018 and March 2019, 48,105 displaced Rohingya (70.3%, among whom 71.6% were children and 46.5% women) and 20,357 local residents (29.7%, 88.5% children, 54.4% women) underwent vision screening. Displaced Rohingya sought services from a total of 12 surrounding camps, within which coverage was 17.3%, including 43.3% (27,027/62,424) of children aged 5-11 years and 60.0% (5,315/8,857) of adults ≥ 60 years old. The prevalence of blindness (presenting acuity < 3/60) among Rohingya patients exceeded that among local residents by 3- to 6-fold in each 10-year age group between 18 and 59 years (P < 0.001 comparing vision between the two groups in this age range), and the prevalence of cataract requiring surgery was also higher in Rohingya patients (18-29 years: 4.67% versus 1.80%, P = 0.0019; 30-39: 7.61% versus 2.39%, P < 0.001; and 40-49 years: 7.91% versus 3.77%, P = 0.0014). A limitation of the study is lack of data on population prevalence of eye disease.Conclusions: The burden of untreated eye disease is very high among the Rohingya, particularly those in their peak working years who could contribute most to the resiliency of their community. Demand for eye care service is also great among children and adults in this population with many competing healthcare priorities. Research is needed, building on strong evidence of benefit in settled populations, to explore the specific impact of vision care on the well-being of displaced populations. [ABSTRACT FROM AUTHOR]

India has done well in eye care delivery by recognizing visual impairment and blindness as a major medical challenge. Major contributions have come from ophthalmologists (mass cataract surgery in the early 1900s; major participation of non-government organizations), policy makers (National Program for Control of Blindness and Visual Impairment 1976; systematic development under the World Bank assisted India Cataract Project, 1995-2002), and the industry (manufacturing of affordable surgical instruments and medicines). Although the country could boast of higher cataract surgical coverage and near-total elimination of trachoma, there is increasing prevalence of diabetic retinopathy and undetected glaucoma. India is in the crossroad of adherence to old successful models of service delivery and adoption of new innovative methods of teaching and training, manpower development and skill-based training, relevant medical research and product development. In the absence of these new approaches, the initial gains in eye care could not be furthered in India. A new approach, that will combine the best of the "old" tradition of empathy and the "new" technology of analytics, is required to imagine the future of eye care in India. [ABSTRACT FROM AUTHOR]

Background. Vision is critical in the development and performance of children. Factual knowledge of eye health is important for preventive and promotive eye health. Objectives. To identify eye health myths and misconceptions that are considered true in a population of Nigerian school children, with the aim of prioritizing eye health messages. Material and methods. In a cross-sectional survey, self-administered questionnaires were used to obtain pupils' views, which were elicited using statements presented as 22 ocular health myths/misconceptions and three facts in two selected secondary schools in Enugu state, Nigeria in October 2014. Frequency counts and percentages were generated using SPSS v18. A p-value of < 0.05 was considered statistically significant. Results. The sample comprised 404 males (48.5%) and 429 females (51.5%), age range 10-17 years, median 13-14 years; IQR -6). More pupils in the senior classes had previously listened to eye health talks. The most common beliefs concerned the statements "staying close to the television set will damage vision" 782 (93.9%), and "reading in dim light will damage vision" 758 (90.8%). The least commonly-held misconception was "children do not need regular eye checks" 119 (14.3%). The greatest amount of uncertainty concerned the statements "short-sightedness is worse than long-sightedness" 421 (51%), and "crossed-eye disorders cannot be corrected in children" 383 (46%). Conclusions. The majority of the children do not have information on eye health. Despite the persistence of these myths and misconceptions, this study has demonstrated that the children had a reasonable level of knowledge in terms of safe eye care practices. However, appropriate eye health messages still need to be provided. [ABSTRACT FROM AUTHOR]

Purpose: To determine the clinical features and distribution of uveitis in the pediatric age group at a referral eye care center in Shiraz, South Iran. Materials and Methods: All new cases of uveitis in patients 18‑year‑old or younger referred from January 2007 to December 2013 were enrolled in this study. The patient underwent a complete history of systemic and ocular diseases, comprehensive ophthalmic examination. Patients were classified according to the International Uveitis Study Group definitions. The definitive diagnosis was based on clinical manifestations and laboratory investigations. Results: Seventy‑seven eyes (54 patients) comprised the study sample. The mean age at the onset of uveitis was 12.5 years. The female‑to‑male ratio was 1.25. Anterior uveitis was the most frequent anatomical location (40.7%), followed by intermediate uveitis (33.3%), posterior uveitis (18.5%), and panuveitis (7.5%). Seventy‑four percent of patients presented with chronic uveitis. Noninfectious uveitis (81.5%) was the most frequent etiology. Thirty‑seven percent of patients had a specific diagnosis for uveitis, and 63% were classified as idiopathic cases. Toxocariasis was the most common infectious cause. Associated systemic diseases were present in 14.8% of patients. The most frequent systemic disease was juvenile idiopathic arthritis in 9.2% of patients. Complications occurred in 66 (85.5%) of affected eyes. The most common complications were posterior synechia (20.7%), cataract (18.8%), and cystoid macular edema (12.9%). Conclusions: Uveitis in the majority of children had an insidious onset and was chronic. Over half the patients had a specific diagnosis. Idiopathic cases were more common in the intermediate uveitis group. [ABSTRACT FROM AUTHOR]

AimsTo evaluate the efficacy of diode laser trabeculoplasty (DLT) and frequency doubled Nd : YAG laser trabeculoplasty (YLT) in primary open angle glaucoma (POAG).MethodsA total of 52 eyes of 35 patients with POAG were included. In all, 25 eyes underwent DLT (Group I) and 27 eyes underwent YLT (Group II). IOP, gonioscopy and visual fields were evaluated before and 3, 6, and 9 months and 1 year after the laser. An IOP<21 mmHg without medications or a decrease in the number of glaucoma medications with no progression of disc and field changes was considered a success.ResultsThe mean age of patients in Group I was 57.72±8.1 years and the patients in Group II had a mean age of 59.85±7.76 years. The mean prelaser IOP was 24.93±1.49 mmHg and 25.36±1.57 mmHg. The mean IOP after DLT at 12 months follow-up was 18.0±0.93 mmHg and after YLT was 18.6±1.52 mmHg. The reduction of IOP was statistically significant in both the groups at 3, 6, 9, and 12 months (P<0.001), however there was no significant difference between the two groups. Success rates in both groups were similar, 92% in Group I and 92.6% in Group II.ConclusionsDLT and Fd YLT are equally effective in controlling IOP in eyes with POAG.Eye (2006) 20, 1352–1356. doi:10.1038/sj.eye.6702108; published online 7 October 2005 [ABSTRACT FROM AUTHOR]

Survey questions are frequently used to collect data on the prevalence of vision difficulties. The 1971-1972 Health and Nutrition Examination Survey included both a question about ‘trouble with your vision even when wearing glasses or contact lenses,’ and clinical measurement of central distance visual acuity with usual corrective lenses. The question had low sensitivity for impairment of visual acuity, with variation by age and severity of impairment. Sensitivity analyses from other studies are reviewed. [ABSTRACT FROM AUTHOR]

Deep learning has recently gained high interest in ophthalmology due to its ability to detect clinically significant features for diagnosis and prognosis. Despite these significant advances, little is known about the ability of various deep learning systems to be embedded within ophthalmic imaging devices, allowing automated image acquisition. In this work, we will review the existing and future directions for 'active acquisition'–embedded deep learning, leading to as high-quality images with little intervention by the human operator. In clinical practice, the improved image quality should translate into more robust deep learning–based clinical diagnostics. Embedded deep learning will be enabled by the constantly improving hardware performance with low cost. We will briefly review possible computation methods in larger clinical systems. Briefly, they can be included in a three-layer framework composed of edge, fog, and cloud layers, the former being performed at a device level. Improved egde-layer performance via 'active acquisition' serves as an automatic data curation operator translating to better quality data in electronic health records, as well as on the cloud layer, for improved deep learning–based clinical data mining. [ABSTRACT FROM AUTHOR]