Haleema A

Abstract

Background: Low vision is defined as significant reduction of vision that cannot be corrected to normal by standard optical correction, medical treatment or surgery. Global prevalence of low vision in paediatric age group is over 10 times that of paediatric blindness. Low vision aids (LVAs) are optical devices which enhance residual vision by magnifying image of object at the retinal level. Early intervention with LVAs can strengthen the vision of children with low vision, by reducing visual stimulus deprivation at an early age, and hence it improves their quality of life. Aim of this study was to identify factors associated with low vision and to assess functional status of children after using LVAs. Materials and Methods: This is a descriptive study conducted among 56 children, between 5 to 15 years age group, attended who visited in a tertiary centre with low vision during a period of 11 years. After taking history, general, systemic and ocular examination, LVAs were prescribed for near and distant vision and were assessed after 2 months. Data analysis was done by using Graphpad quickcalcs internet software. Results: Out of 56 children included in this study, 71% accepted and 29% denied LVAs for distant vision. 58.5% accepted and 12.5% denied LVAs for near vision. 28.5% did not require LVAs for vision. In older children acceptance of LVAs is found to be significantly higher compared to younger age group. Conclusions: Majority of patients are satisfied with LVAs and frequently use them. Adequate LVAs are major factors in improving quality of life. There can be deterioration of vision due to ongoing disease, so regular follow-up examinations are also necessary part of management of low vision patient.   Keywords: Best corrected visual acuity, Distant vision, Low vision aid, Near vision.

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Abstract

The aim of this study is to assess the prevalence of various ocular disorders among school going children in the age group of 5 to12 years. Aim: Vision screening is crucial for early detection of ocular disorders among young children thereby preventing the risk of uncorrectable dimunition of vision. Hence, our programme is planned as early detection of the causative factors in the childhood period and most effectively treat as early as possible. The purpose of the screening programme is to identify various ocular diseases in children like refractive errors, amblyopia, defective color vision, lid and adnexal disorders, vitamin A deficiency, allergic conjuctivitis, glaucoma, cataract and squint. Identification of such problems and its correction in early stage is crucial for their normal growth. Materials and Methods: A school based prospective cross sectional study design was adopted to examine children aged 5–12 years in randomly selected schools of Kollam district from January 2020 to March 2020. In this cross-sectional study, two Optometrist and two Ophthalmologist and other supportive staffs screened 3100 school children aged 5 to 12 years for vision and external eye examination. An Optometrist did the visual acuity testing and refraction. Detailed ophthalmic examination was done by an Ophthalmologist. The pattern of visual acuity, colour vision and ocular disorders were studied. Children needing further assessment were referred to the hospital and analysis of the data and data entry done using Microsoft office excel 2016 with Statistical software: R software (EZR 1.32). Results: A total number of 3100 students from 11 different schools were examined, 1570 of whom were males, and 1530 were females. The commonest eye disorder was refractive error 16.6% (514) in which most common was myopic astigmatism 78.2% (402) of which 322 were against the rule and 80 were with the rule astigmatism, followed by simple myopia 15.2%(78) simple hypermetropia 4.7%(25) and hypermetropic astigmatism 1.7%(9). Of these spectacles usage was found to be present only in 81.3% (418) students, rest 18.7%(96) were not aware of the refractive error. Next common eye disorder was allergic conjunctivitis 1.6%(49). Squint was present in 1.4%(42) children. Corneal opacity was present in 0.26%(8), defective color vision was there in 0.2%(6); lids and adnexal disorders 0.13%(4) and cataract 0.03%(1). There were no students with congenital anomalies, congenital glaucoma or Vitamin A deficiency. Conclusion: Uncorrected refractive error is the most common visual impairment found in school going children. There is a need to set up a regular school vision-screening programme to detect ocular disorders in order to prevent the burden on society on long term. Since most of this morbidity is either preventable or completely treatable, school screening is an effective method to reduce this burden. Keywords: Amblyopia, Ocular disorders, Prevalence, School going children.

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Abstract

Secondary sjogrens syndrome is an autoimmune disorder leading to destruction of exocrine glands with resultant classical clinical triad of dry eye, dry mouth and parotid gland enlargement in association with other systemic autoimmune diseasecommonly rheumatoid arthritis. This report highlights the unintended effect of systemic immunosuppresants given for the treatment of rheumatoid arthritis, in improving the coexistant corneal thinning and other ocular manifestation in a case ofsecondary sjogrens syndrome, which has been rarely reported. Key Messages: Modification of the immune response with systemic immunosuppressive agents improves severe keratoconjunctivitis sicca in recalcitrant secondary Sjogren syndrome. Keywords: Secondary Sjogren’s, Systemic immunosuppressant, Dry eye.  

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