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Purpose: The aim of this study was to create vision standards for various tasks performed by hairdressers and to assess the spectacle compliance and its impact at work. Methods: The observational cross-sectional study enrolled hairdressers in and around Chennai, Tamil Nadu. It was done in three phases: (i) Job profiling from visual task analysis, creating vision standards for various hairdressing tasks and arriving at test protocols; (ii) Comprehensive eye examination, and (iii) Assessment of spectacle compliance and its impact on work. Descriptive analysis using Microsoft Excel and SPSS (IBM SPSS Statistics Version 21.0) was performed. Results: There were 305 participants with a mean age of 48 (SD ± 12) years. The visual acuity demand was found to be 6/18 and N15, for distance and near, respectively. Appropriate spectacles were prescribed for 203 (67%) hairdressers. Even with the best possible refractive correction, a few hairdressers did not meet the distance (13) and near (11) visual acuity standard. In all, 54 hairdressers were referred for further examination to a tertiary eye care center for lenticular changes, retinal abnormalities, and glaucoma screening. Among the subjects who were dispensed with spectacles, 181 (86%) were available for telephonic spectacle compliance assessment, and 164 (90%) were compliant with spectacle usage at work. Improved visual ability was reported by 133 (81%) hairdressers at work. Conclusion: This study provides vision standards for hairdressers. From the visual task analysis, hairdressing tasks were found to be visually demanding and hazardous. The study emphasizes that providing appropriate spectacle correction showed a clinically evident positive impact at work.

Context: Various systems are available to stage glaucomatous field defects into different severity grades. Still, the preference for such systems among Indian eye care practitioners (ECPs) and the consensus between them are not explored. Purpose: To compare the clinical performance of perimetric glaucoma staging systems and to assess their preference patterns among Indian ECPs. Setting and Design: Retro-prospective cross-sectional study. Methods: Three investigators stratified 400 perimetry reports using four systems: Hodapp Anderson Parrish (HAP), enhanced Glaucoma Severity Staging (eGSS), Advanced Glaucoma Intervention Study (AGIS), and Collaborative Initial Glaucoma Treatment Study (CIGTS). Their performance was compared in terms of agreement and association. Following this, 30 ECPs from across the country segregated a subset of reports (n = 20) into different stages based on their system of choice, and their preferences/perceptions about the available perimetry staging systems were enquired and documented. Statistical Analysis Used: Descriptive statistics, Kruskal–Wallis, Cohen's kappa, and Spearman's correlation. Results: For the consolidated severity stages, substantial agreements (K ranging from 0.61 to 0.75) were found between all the systems, except for HAP–CIGTS (K = 0.58) and AGIS–CIGTS (K = 0.51). All ECPs were aware of perimetry staging systems, and a high preference was reported for HAP (97%) due to ease of implementation and interpretation. Conclusion: Among the four staging systems, the highest agreement was found between HAP and eGSS. A majority of ECPs proposed the need for a uniform classification system across the practices for clinical comparisons and patient education. [ABSTRACT FROM AUTHOR]

Pathophysiology of pseudoexfoliation syndrome (XFS) can be influenced by environmental factors such as solar exposure/occupational factors and genetic factors. The study aims to assess the association of lifetime ocular UV exposure and its impact on the risk of development of XFS. All eligible subjects underwent a comprehensive ocular examination. XFS was defined as precipitates on the pupillary border, cornea, and angle of anterior chamber or lens in at least one eye without any clinical signs of glaucoma. A standardised questionnaire was administered to assess the lifetime UV exposure. Conjunctival ultraviolet autofluorescence (CUVAF) photography was taken to detect the conjunctival changes with exposure to UV radiation. Ascorbic acid concentration in the aqueous humour was measured. A total of 404 subjects of which 274 (controls) and 130 (XFS cases) were studied. There were 204 males (50.5%) and 200 females (49.5%).Lifetime UV exposure (OR: 1.14, 95% CI: 1.02–1.30, p: 0.032), CUVAF damage (OR: 1.03, 95% CI: 1.01–1.06, p: 0.008) and outdoor worker (OR: 1.87, 95% CI: 1.18–3.00, p: 0.008) were positively associated with XFS. Usage of spectacles (OR: 0.63, 95% CI: 0.39–0.95, p: 0.030) and ascorbic acid concentration in aqueous (OR: 0.47, 95% CI: 0.23–0.99, p: 0.038) were found to be protective against XFS. Besides genetic factors, environmental factors such as lifetime ocular UV exposure and outdoor work are significantly associated with the risk of XFS. CUVAF can be used as a non-invasive tool to detect preclinical sun damage in outdoor workers. [ABSTRACT FROM AUTHOR]

Greater usage of digital devices and change of work pattern as working from home have created an impact on both visual and musculoskeletal systems. Developing an understanding of these changes could assist in providing appropriate care. The current study aims to elicit the changes in work patterns due to COVID-19 lockdown and understand the impact of the usage of digital devices on the visual system and musculoskeletal system. A survey was designed using Delphi technique and circulated through electronic communication sources using Google form to the working population and students across India, who consented to participate. The survey had components designed to develop an understanding of work patterns, digital device usage, associated visual/ocular symptoms, work-related musculoskeletal disorder (WRMSD) symptoms, and relevant information on psychological factors, and practice of yoga/exercises. There were 1302 valid responses. Mean age of respondents was 24 (IQR 11) years and 548 (42.1%) were male. A total of 1231 (94.5%) reported having one or many visual and ocular symptoms associated with the use of digital devices and 1140 (87.6%) responses indicated WRMSD symptoms. Of the symptomatic respondents, 561 (43.1%) had reported visual/ocular symptoms and 586 (45%) WRMSD symptoms during lockdown, which they did not experience during regular work. Risk factors for visual/ocular symptoms and WRMSD were females, spending more than 6 h on digital devices, taking breaks from digital devices after 2 h, inability to maintain a fair sleep schedule, and inability to make ergonomic modifications at home. A high prevalence of both visual/ocular symptoms (43.1%) and WRMSD symptoms (45%) was encountered during COVID-19 lockdown. [ABSTRACT FROM AUTHOR]

In the last decade, there have been reports on the prevalence of glaucoma from the Vellore Eye Survey, Andhra Pradesh Eye Diseases Survey, Aravind Comprehensive Eye Survey, Chennai Glaucoma Study and West Bengal Glaucoma Study. Population-based studies provide important information regarding the prevalence and risk factors for glaucoma. They also highlight regional differences in the prevalence of various types of glaucoma. It is possible to gather important insights regarding the number of persons affected with glaucoma and the proportion with undiagnosed disease. We reviewed the different population-based studies from India and compare their findings. The lacunae in ophthalmic care that can be inferred from these studies are identified and possible reasons and solutions are discussed. We also discuss the clinical relevance of the various findings, and how it reflects on clinical practice in the country. Since India has a significantly high disease burden, we examine the possibility of population-based screening for disease in the Indian context.

Purpose: Studies have reported the usage of metformin being associated with the reduced risk of progression of glaucoma. The current study aims to determine the association of metformin usage among subjects with diabetes mellitus and the six-year incidence of primary open-angle glaucoma (POAG). Methods: In this prospective cohort study, subjects who did not have glaucoma at the baseline and had a follow-up after a six-year interval were included. Details such as medical and drug history, applanation tonometry, gonioscopy, pachymetry, optic disc evaluation, and automated perimetry were collected. Incident POAG was defined as subjects who do not have glaucoma at baseline and developed glaucoma as classified International Society of Geographical and Epidemiological Ophthalmology Classification at the follow-up. The association between the subjects who were on metformin for treatment of diabetes mellitus and development of incident POAG was assessed. Results: Among the 4302 eligible participants, 128 (3%) had incident POAG. There were 905 (21.0%) subjects who had diabetes mellitus of which 142 (15.7%) were using metformin. Of the subjects with POAG, 92 (71.9%) were nondiabetics and 36 were diabetics (28.1%). Among the diabetics, the incidence of POAG among those on metformin was 5.6% (8 participants) and those not on metformin was 3.6% (28 participants). There was no difference in the incidence of POAG in subjects with diabetes mellitus, with and without metformin use (P = 0.25). Logistic regression showed no association of metformin use with the incidence of POAG (OR: 1.33, 95 CI: 0.58-3.04, P = 0.49) after adjusting for age, gender, and place of residence. Conclusion: The current study did not find any association between the effects of metformin on the incidence of POAG. [ABSTRACT FROM AUTHOR]

Purpose: To compare patient preference for Swedish Interactive Threshold Algorithm (SITA) standard 24-2 protocol in Humphrey visual field analyzer (HVF) and full threshold N-30 protocol in frequency doubling perimetry (FDP) by primarily evaluating their perception about the test procedure and test targets along with surveying the factors that influence the patient concentration during perimetry and elements that determine the level of perimetry task difficulty. Methods: This study enrolled a subset of subjects from the Chennai Glaucoma Study. Each subject underwent a comprehensive ophthalmic examination after which they were randomly allocated to perform HVF and FDP with a 30-minute interval between the two procedures. SITA standard 24-2 protocol in HVF and full threshold N-30 protocol in FDP were used. This was followed by the administration of a questionnaire that mainly assessed the components such as (a) the patient preference for test procedure and test targets, (b) the factors influencing the patient concentration during perimetry performance, and (c) the impression about the level of perimetry task difficulty. The patient responses from the survey for each of the subcategories were obtained and analyzed using Chi-square test. Results: A total of 42 subjects with a mean age of 59.7 (SD 9.7) years were included, among which 18 (42.86%) were male and 24 (57.14%) were female. Thirty-two (76.19%) subjects felt both FDP and HVF were easy to perform, eight subjects (19.05%) felt that both perimetry techniques were difficult to perform, and two subjects (4.76%) found FDP procedure was easier than HVF, whereas the distribution was not statistically significant (Chi-square, p = 0.7). Pressing the button as a response to peripheral stimulus perception and inability to maintain steady central fixation for prolonged duration were the most commonly reported factors that influenced the level of difficulty of the perimetry tasks. A dark room ambience set for performing HVF was preferred by 32 (76.20%) subjects. Conclusion: There was no significant difference in the patient preference for test procedure and peripheral test targets. A black central fixation as in FDP and dark room ambience set for HVF were preferred. [ABSTRACT FROM AUTHOR]

We report a case of six-year-old boy who presented with a progressive intracorneal cyst in the left eye. Anterior segment optical coherence tomography (AS-OCT) was performed, and it showed the location of the cyst in the corneal stroma. Its dimension was measured to be 7.09 × 2.12 mm. The cyst aspiration was successfully done. AS-OCT helped in the management and follow-up of the condition. [ABSTRACT FROM AUTHOR]

Purpose To determine the prevalence of congenitally abnormal disc (all anomalies) in an adult population in southern India. Methods Subjects aged ≥40 years (n=6013) underwent a complete ophthalmic examination. Optic disc anomalies were diagnosed according to the definitions given in the article. Results Optic disc anomalies were found in 81 eyes of 66 (1.1%, 95% CIs 0.00834 to 0.01361) patients. The prevalence of each anomaly in the descending order was peripapillary myelinated nerve fibre (0.28%), epipapillary glial tissue on the optic disc (0.28%), peripapillary vascular loops (0.16%), tilted disc (0.09%), optic disc coloboma (0.08%), optic nerve hypoplasia (0.04%), optic disc pit (0.04%), optic disc pigmentation (0.03%), optic nerve head drusen (0.03%), Bergmeister's papilla (0.03%), optic disc pit and coloboma (0.01%). Conclusions The prevalence of optic disc anomalies is 1.1% in the adult South Indian population. [ABSTRACT FROM AUTHOR]