Search

Optimisation of vision screening programmes can result the detection of refractive anomalies in a high proportion of school children. The Refractive Errors Among Children (REACH) programme aims to optimise outcomes of school-based vision screening in India by collaborating with hospitals and monitoring eye care throughout school attendance. REACH delivers school vision screening using pocket vision screeners (cards presenting rows of seven 0.2 logMAR Sloan letters at a 3 m viewing distance) in five states across India. Children who fail screening are referred for detailed evaluation including refraction, those requiring cycloplegic refraction are referred to partner hospitals. Spectacles are dispensed as needed and compliance is assessed. All data are recorded electronically. Out of 2,240,805 children aged 5 to 18 (mean 11.5; SD ±3.3) years, 2,024,053 have undergone REACH screening in 10,309 schools predominantly in rural locations (78.7%) and government-funded (76%). Of those screened, 174,706 (8.6%) underwent detailed evaluation. A higher proportion of children in private or urban schools (11.8% and 10.4% respectively) were referred for detailed evaluation than those in government-funded or rural schools (5.9% and 7.2%, respectively; p < 0.001). The proportion referred for detailed evaluation differed by state (p < 0.001), from 4.0% in West Bengal to 14.4% in Kerala. The REACH programme screened a high proportion of school children, providing further care and follow-up to optimise visual outcomes. [ABSTRACT FROM AUTHOR]

Purpose: This study investigates how and in what circumstances a school‐based eye health programme, the Refractive Errors Among CHildren (REACH) programme, achieved its desired outcomes: accessibility, standards of refractive care, fidelity and availability of comprehensive services, for over 2 million school children in six districts across India. Methods: We conducted a realist evaluation to identify programme aspects and their causal relationships with outcomes. Deductive and inductive thematic analysis of qualitative data included three phases: 1. theory gleaning, 2. eliciting programme theory, 3. revisiting programme theory. The Initial Programme Theories (IPTs) were developed and revised through review of the literature, programme documents and field notes. We reviewed informal and formal discussions from the participatory advisory workshops and conducted semi‐structured interviews with key stakeholders for the development and refinement of the IPTs. We based our analysis on the programme designers' perspective; used contexts, mechanisms and outcomes configuration for the analysis and presentation of the findings and reported the revised IPTs for the REACH programme. Results: We identified four major programme aspects of the REACH programme for evaluation: programme governing unit, human resource, innovation and technology and funding. Based on the intended outcomes of the programme, themes and contexts were sorted and IPTs were defined. We revised the IPTs based on the analysis of the interviews (n = 19). The contexts and mechanisms that were reported to have potential influence on the attainment of favourable programme outcomes were identified. The revisions to the IPTs included: co‐designing a collaborative model and involving local government officials to reinforce trust, community partnerships; local well‐trained staff to encourage participation; use of the web‐based data capturing system with built‐in quality control measures and continued technical support; pre‐determined costs and targets for the outputs promoted transparency and adherence with costs. Conclusion: This process provided a comprehensive understanding of the opportunities and possibilities for a large‐scale school eye health programme in diverse local contexts in India. This illustrated the importance of embracing principles of system thinking and considering contextual factors for School Eye Health programmes in low and middle‐income countries. [ABSTRACT FROM AUTHOR]

Dear Editor, Dr. Sen et al. need to be congratulated for their work on causes of delayed presentation of pediatric cataracts in India.[[1]] There have been studies about how delayed presenting cataracts in children fare after pediatric cataract surgery, but none on the exact causes of delay from India.[[2]] While lack of awareness was the cause between detection by a family member (mostly mother) and presenting to the hospital (delay 1 as per author), like studies from China, South Africa, Zambia[[3]],[[4]],[[5]]; cost was the major factor for delay in posting for surgery (delay 2). Barriers, costs, and attitudes toward pediatric cataract surgery at two large facilities in China and India. Barriers to follow-up for pediatric cataract surgery in Maharashtra, India: How regular follow-up is important for good outcome. [Extracted from the article]

In this article, the decoloration capacity of acid-activated Schumannianthus dichotomus (ASD) toward a model organic cation is described: methylene blue (MB) from aqueous phase. The characterization of the developed adsorbent was focused on proximate, ultimate analysis, Fourier transform infrared spectroscopy, scanning electron microscopy, X-ray diffraction, surface area, and porosity analysis to understand the adsorbent-adsorbate retention as well as interpretation of experimental results. It has been found that adsorbent is essentially microporous-mesoporous in nature with Brunauer-Emmett-Teller surface area of 1199.98 m2 g−1. The effect of various operating parameters on adsorption such as pH, adsorbent dose, contact time, and temperature was monitored. The suitability of Freundlich, Langmuir, and Temkin adsorption models to the experimental data was investigated for MB-adsorbent system. The results showed that equilibrium data for all MB-adsorbent system fitted the Langmuir model best (R2 = 0.99), yielding monolayer adsorption capacity of 336.70 mg g−1 at 303 K. The pseudo-second-order kinetic model provides best correlation (R2 = 0.999) of the experimental data with rate constant of 0.0157 g mg−1 min−1. The thermodynamics parameters Δ Gº, Δ Hº, and Δ Sº evaluated as −9.51 (kJ mol−1), −36.16 (kJ mol−1), and −87.93 (J mol−1 K−1), respectively, revealed that adsorption process is feasible, spontaneous, and exothermic in nature. © 2013 American Institute of Chemical Engineers Environ Prog, 33: 1148-1157, 2014 [ABSTRACT FROM AUTHOR]

The article focuses on the unavailability of health care facilities particularly eye care in the Sunderbans, which stretches from India and Bangladesh.

BACKGROUND. The prevalence and causes of blindnessin children vary widely between regions. Few epidemiological data are availableon the relative importance of the major congenital anomalies of the globe(i.e., microphthalmos, anophthalmos, coloboma) as causes of blindness in children.The aim of this study was to determine the re-gional variation in the proportionof severe visual impairment and blindness due to congenital abnormalitiesof the globe in children in schools for the blind and in those identifiedthrough Community Based Rehabilitation programs. Other objectives were toestimate the prevalence of blindness due to major congenital abnormalities,and to investigate their etiology. METHODS. Data on the causes of blindness in children were collected between1990 and 1998 using standard methods, definitions and reporting form in 26countries. Children were examined in schools for the blind and in CommunityBased Rehabilitation programs. RESULTS. Of 7,113 children aged 3-15 years with severe visual impairmentand blindness examined, 762 (10.7%) had microphthalmos, 161 (2.3%) had anophthalmos,and 96 (1.3%) had coloboma. There are large regional differences in the proportionof severe visual loss in blind school children, ranging from 1.4% in Cubato 33.2% in Sri Lanka. Severe visual loss due to congenital abnormalitiesof the globe is estimated to affect between 0.4 and 16.2/100,000 childrenin the countries studied. An underlying cause could not be identified in 84.2%. CONCLUSIONS. Major congenital abnormalities of the globe are importantcauses of severe visual loss in children, particularly in Asian countries.Further research into etiology is warranted in order to plan prevention programs. [ABSTRACT FROM AUTHOR]

Purpose: Albinism is a group of genetic disorders, showing a broad spectrum of different phenotypes. The purpose of this study was to screen known candidate genes for oculocutaneous albinism (OCA) and ocular albinism (OA) mutations in Indian patients., Methods: Blood samples were collected from 23 probands and 13 affected family members from 23 genetically unrelated Indian families (22 diagnosed as OCA and 1 diagnosed as OA) and analyzed by bidirectional DNA sequencing of the classic OCA genes--tyrosinase (TYR, or oculocutaneous albinism IA), pink eyed dilution (P; or oculocutaneous albinism II (OCA2]), tyrosinase-related protein 1 (TYRP1), solute carrier family 45, member 2 (SLC45A2; or membrane-associated transporter protein [MATP])--and the OA1 gene, G protein-coupled receptor 143 (GPR143)., Results: Three missense mutations, c. 715 C>T (R239W), c. 896 G>A (R299H), c.1255 G>A (G419R), and one termination c. 832 C>T (R278X), were identified in TYR, as well as one novel mutation, c.1453 G>A (G485R) in P. One novel single nucleotide polymorphism (SNP) was identified in both TYR and P; few reported SNPs were identified. The G>A base substitution caused relatively conservative amino acid changes, which altered glycine to arginine residues within the topological domain. The novel OCA2 mutation was not present in 100 control samples. This study identified two probands carrying mutations alone, 16 probands carrying SNPs alone, 4 probands carrying both mutations and SNPs and only one proband carrying neither mutations nor SNPs., Conclusions: Although sequence analysis was performed with all five candidate genes, only four (17.39%) of the 23 probands showed mutations in TYR and 2 probands (8.69%) showed an unreported novel mutation in P. Genetic counseling for phenotypical diagnosis and genetic mutation screening of these genes will help to minimize the incidence of OCA and OA in future generations.

Purpose: Oculocutaneous albinism type 1 (OCA1) patients demonstrate a partial or total lack of melanin in the skin, hair and eye. OCA1 is an autosomal recessive genetic disorder caused by mutations in the TYR gene located at chromosome band 11q14-q25. The purpose of this study was to carry out genetic analysis of OCA1 in Indian families., Methods: Genomic DNA was isolated from blood leukocytes of all the individuals in this study. Haplotype analysis was performed at the TYR locus using informative microsatellite markers. Eight sets of primers were used to amplify the entire coding region of the TYR gene for bidirectional direct sequencing mutation analysis., Results: Two novel deletions (c.937del8, c.1379del2) and a previously known nonsense mutation (R278X) in the TYR gene were identified from a total of 8 oculocutaneous albinism patients in India., Conclusions: Our study reports the distribution of two novel frameshift and a previously reported nonsense mutations in four OCA1 families from the Indian population. These findings will contribute to the development of a diagnostic method for OCA1 carrier status and genetic counseling for OCA1 affected families.