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PurposeAlbinism is known to disrupt emmetropisation in animal models. However, it is not clear if the same effect is seen in humans. This study aimed to investigate the refractive profile in individual diagnosed with ocular albinism (OA) and oculocutaneous albinism (OCA) based on a large dataset.MethodsRequired data from 618 individuals (61% males and 39% females) diagnosed with albinism were exported from the eyeSmart electronic medical records of L V Prasad Eye Institute. Overall, there were 112 (18%) individuals diagnosed with OA and 506 (82%) with OCA. Based on the spherical equivalent refraction (SER), individuals were classified as emmetropes, myopes, and hyperopes.ResultsThe overall spherical equivalent refraction of the individuals ranged from -25.00D to +12.00D with median 0.25 (-2.00 to 2.25). The proportion of individuals with albinism (combined OA, OCA) having hyperopia and myopia (overall: N=282;46% vs. N=245;40%) were similar (p = 0.18), and the least were with emmetropia (overall: N=91;14%). Across all the age groups (0-10, 11-20, 21-30, > 30 years) the frequency of hyperopes and myopes were significantly higher (pConclusion The presence of both high hyperopia and high myopia and very less numbers with emmetropia across all age groups indicates disrupted normal refractive development in individuals with albinism. With-the-rule astigmatism and nystagmus may result in meridional degradation of retinal image leading to impairment of normal emmetropisation process in individuals with albinism.

Purpose To describe the incidence, demographics, types and risk-factors of dry eye disease (DED) in patients presenting to a multi-tier ophthalmology hospital network in India. Methods This was an observational hospital-based study of 1,458,830 new patients presenting between 2010 and 2018. Patients with recent onset of both symptoms and signs, as defined by the tear film and ocular surface society dry eye work shop (TFOS DEWS) II guidelines, were considered as DED subjects. The data was prospectively collected using an electronic medical record system. Multiple logistic regression with odds ratio (OR) estimation was performed to identify the high risk-factors of DED. Results Overall, 21,290 (1.46%) patients were diagnosed with recent-onset DED. The incidence of DED was 2688 and 16,482 per million population in children and adults, respectively (p Conclusion The study results indicate that age, sex, residence, occupation, and socio-economic status have significant impact on development of DED. Since India is an emerging economy with a growing middle-class, increasing urban-migration and large aging population, the country is on the brink of a DED epidemic.

To report the pattern of noninfectious scleritis across a tertiary eye-care network.A three-year retrospective review of patients diagnosed with noninfectious scleritis was performed. Data were retrieved using diagnostic terms assigned to scleritis through the in-house eyeSmart-electronic medical record system.1103 patients, with a mean age of 44.33 ± 14.38 years and a median follow-up of 199.5 days (range 32-685) were enrolled. Unilateral disease was noted in 85%. Diffuse anterior scleritis (n = 542, 42.51%) and nodular scleritis (n = 482, 38.12%) were the commonest subtypes. Systemic immune disease association was present in 65 (5.89%). Treatment at onset was topical corticosteroids (n = 372, 36.54%) followed by oral non-steroidal anti-inflammatory drugs (n = 351, 34.45%), oral corticosteroids in 184 (19.04%), and immunomodulators in 32 patients (3.54%).This study depicts the pattern of various noninfectious scleritis in a large cohort of patients. The present study helped to further customize the electronic medical records to minimize several data capture limitations.

India is home to 1.3 billion people. The geography and the magnitude of the population present unique challenges in the delivery of healthcare services. The implementation of electronic health records and tools for conducting predictive modeling enables opportunities to explore time series data like patient inflow to the hospital. This study aims to analyze expected outpatient visits to the tertiary eyecare network in India using datasets from a domestically developed electronic medical record system (eyeSmart™) implemented across a large multitier ophthalmology network in India. Demographic information of 3,384,157 patient visits was obtained from eyeSmart EMR from August 2010 to December 2017 across the L.V. Prasad Eye Institute network. Age, gender, date of visit and time status of the patients were selected for analysis. The datapoints for each parameter from the patient visits were modeled using the seasonal autoregressive integrated moving average (SARIMA) modeling. SARIMA (0,0,1)(0,1,7)7 provided the best fit for predicting total outpatient visits. This study describes the prediction method of forecasting outpatient visits to a large eyecare network in India. The results of our model hold the potential to be used to support the decisions of resource planning in the delivery of eyecare services to patients.

Aims: To determine the profile of CSCR patients from a tertiary health care set-up in India. Methods and Material: A total of 2780 (2447 males and 333 females) patients with a diagnosis of CSCR were included. Data regarding the demographics, profile of CSCR and systemic diseases, if any, were collected from a tertiary eye care network in South India from January 2012 to December 2016. Results: The prevalence of CSCR was found to be 1.7% (A total 2780 patients, with mean age of 42.3±10.1 years). A total of 2031 patients had a unilateral and 749 had bilateral involvement. Acute and chronic CSCR was seen in 1932 (69.5%) and 848 (30.5%) eyes respectively. The mean uncorrected visual acuity of the patients was 0.51±0.45 log MAR (Snellen equivalent 20/60) while the mean best corrected visual acuity was 0.32±0.40 log MAR (Snellen equivalent 20/40). History of smoking and steroid use was present in 214 (7.7%) and 758 (27.3%) individuals respectively. Hypertension and diabetes mellitus was present in 106 (3.8%) and 51 (1.8%) patients respectively. Most of patients {824 (29.6%) patients} were shift-workers. Laser was done in 336 (12.1%) acute and 223 (8%) chronic CSCR patients. Photodynamic therapy was used in 12 acute and 12 chronic cases. Conclusion: Prevalence of CSCR was 1.7%. The study provides an overview of patient profile among Indian subjects.

INTRODUCTION This article describes the implementation of a novel technology tool to capture demographic distribution and clinical presentation of patients in rural vision centers using the eyeSmart electronic medical record (EMR) app in a three-tier eyecare network in India. METHODS A two-year retrospective review of all patients who presented to the rural vision centers of LV Prasad Eye Institute (LVPEI) eyecare network was performed from September 2016 to August 2018 using an in-house developed eyeSmart EMR app. RESULTS A total of 501 771 patients were captured on the eyeSmart EMR app across the LVPEI network. The ratio of males (n=273 985, 54.60%) and females (n=227 786, 45.40%) presenting to the rural vision centers was 1.2:1. The most prevalent ocular disorder was refractive errors (n=273 720, 44.32%). CONCLUSIONS This study details the demographic distribution and prevalence of ocular disorders in a large cohort of Indian patients and demonstrates the potential for real-time analytics through the use of EMR systems. This provides rigorous evidence for the community and eyecare providers that the use of a web application/tablet app (eyeSmart) aids in providing better eyecare services in rural areas. It helps in creating government policies and improves the treatment strategies for various preventable ocular disorders in India.

Background This study aims to describe the demographic distribution and ocular diagnosis of the patients presenting to the Liberia Eye Center, Monrovia, using the eyeSmart Electronic Medical Record system. # Methods A retrospective study was conducted on patients presenting to Liberia Eye Center from July 2017 to July 2018. A total of 5258 patients were examined during this period. Data was collected from eyeSmart Electronic Medical Record system database. The variables in the collected data include age, gender, location, occupation, socioeconomic status, laterality of eye affected, and ocular diagnosis. All the counties were included in the study. A total of 8234 instances of ocular diagnosis were made in 5258 patients. # Results Of the total 5258 patients, the majority of them presented from the county of Lofa (18.77%) and the least number of patients from Gbarpolu (1.62%). Out of the total children examined (16 years and under), females outnumbered males (8.25% vs. 4.87%). Among the adults, almost equal number of males (50.1%) and females (49.9%) presented to the clinic. The most common diagnosis was uncorrected refractive errors (34.89%) followed by the cornea and anterior segment disorders, cataract and glaucoma in that order. But in children aged 16 years and under, cornea and anterior segment related disorders (6.01%) were the most common diagnosis and the least common diagnosis was amblyopia (0.34%). Majority of the patients were unemployed (60.54%) and the most common profession in the remaining cohort was a student (8.96%). # Conclusions Refractive error was found to be the most common ocular diagnosis and the second most common presentation was cornea and anterior segment disorders in Liberian population. In children aged 16 years and under, cornea and anterior segment related disorders were the most common ocular diagnosis. The description of various ocular diseases and their clinical presentation for the first time in a Liberian population provides the opportunity for further research. The digitization of eye care using electronic medical record systems is a progressive step forward to help formulate strategies for health policy to combat avoidable blindness across Liberia.

Purpose: To study the relationship between the severity of myopia and the severity of diabetic retinopathy (DR) in individuals with type 1 or type 2 diabetes mellitus (DM). Methods: This retrospective study was conducted using data from electronic medical records from a multicentric eyecare network located in various geographic regions of India. Individuals with type 1 or type 2 DM were classified according to their refractive status. Severe nonproliferative DR (NPDR), PDR, or presence of clinically significant macular edema (CSME) with any type of DR was considered as vision-threatening diabetic retinopathy (VTDR). Results: A total of 472 individuals with type-1 DM (mean age 41 ± 10 years) and 9341 individuals with type-2 DM (52 ± 9 years) were enrolled. Individuals with a hyperopic refractive error had a significant positive association with the diagnosis of VTDR (odds ratio (OR) 1.26; 95%CI 1.04–1.51, P = 0.01) and moderate nonproliferative DR (OR 1.27; 95%CI 1.02–1.59, P = 0.03) in type-2 DM; however, no significant association was found in type-1 DM. After adjusting for age, gender, anisometropia, and duration of diabetes, the presence of high myopia (< - 6 D) reduced the risk of VTDR in type 2 DM (OR 0.18; 95% CI 0.04–0.77, P = 0.02), but no association was found in type 1 DM. Mild and moderate myopia had no significant association with any forms of DR in both type-1 and type-2 DM. Conclusion: Hyperopic refractive error was found to increase the risk of VTDR in persons with type 2 DM. High-myopic refractive error is protective for VTDR in type 2 DM, but not in type-1 DM.