Abhilash B

Abstract

Introduction: Covid-19 pandemic has led to children missing schools due to which eye care screening activities at schools have taken a backseat. To mitigate this home based visual acuity estimation smartphone applications are increasingly being used for the purpose of tele-ophthalmology purposes, although with no validation of the same. We aim to fulfil this lacunae. Materials and Methods: Current study was a cross sectional analysis on 286 eyes of 148 children aged between 6years to 14years attending our OPD from April 2021 to June 2021, with non-acute ocular symptomatology. Snellen’s distant visual acuity was compared against the visual acuity recorded by smart phone based Isight pro app and Peek acuity smart phone app. Statistical analysis was performed by Bland Altmann analysis by using SPSS version 21 and p Results: The mean differences between the smartphone-based test Isight pro and the Snellen’s chart and the smartphone-based test Peek acuity and Snellen’s acuity data were 0.06 (95%CI, 0.04–0.08) and 0.07 (95%CI,0.05–0.09) logMAR, respectively. Time taken to test visual acuity by Snellen’s chart was approximately 118.2±21.38 seconds, whereas with Isight pro and Peek acuity smart phone apps the time for testing was approximately 92±15.88 seconds and 94.03±19.73 seconds respectively. P Conclusions: The mean visual acuity was comparable with Snellen’s chart and ETDRS based smart phone apps like Isight pro and Peek acuity. The mean time to assess visual acuity was slightly more in Snellen’s acuity than with smart phone based apps. Inability to access eye care services through screening activities in schools has been mitigated effectively by using these smart phone apps. Hence these smart phone apps can be effectively used in tele-ophthalmologic practice and screening activities in these COVID-19 pandemic times. Keywords : ETDRS, Visual acuity, Smart phone, Teleophthalmology.

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Abstract

Background & Objectives: Comparative analysis of the post-operative anti-inflammatory effect of topical 0.1% dexamethasone sodium eye drops, topical 1% prednisolone acetate eye drops and difluprednate 0.05% topical eye drops after small incision cataract surgery at a tertiary eye care institute in India.  Materials and Methods: The current study was a prospective randomised control study conducted from June 2019 to January 2021 at a tertiary eye care institute in India after taking due clearance from the institutional ethical committee. 300 eyes of 215 patients were enrolled into the study and divided into three groups consisting of 100 eyes in each group. Group A patients received topical Dexamethasone 0.1% eye drops, group B & C received Prednisolone acetate 1% and difluprednate 0.05% eye drops respectively. Level of significance was kept at p Results: Baseline IOP values between the three groups did not show any statistical significance. Significant difference in the analgesia was observed in the difluprednate 0.05% group. AC cells & flare was decreased by around the 7th day of treatment in difluprednate and prednisolone acetate eye drops treated groups.  Conclusion: To conclude our study opines that, dexamethasone is non-inferior and equally efficacious to prednisolone and difluprednate in the management of post cataract surgery inflammation. Although difluprednate 0.05% provides superior analgesia and early clearance of AC cells & flare, which may further aid in early visual rehabilitation and recovery. Keywords: Difluprednate, Prednisolone, AC cells, Flare, IOP.

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Abstract

Background: Discrepancies have been reported between the results of objective refraction obtained with autorefraction (AR), retinoscopy, and the correction which is accepted by patients on subjective refraction. Aims: To assess the refractive status of school age children using retinoscopy and autorefraction, and estimate the accuracy of each in acceptance of subjective correction. Study Settings & Design: It was a prospective cohert study. Materials and Methods: School children of 6-15 years were enrolled for the study, after obtaining informed consent from the parent/guardian and assent from the children. 140 eyes of 70 children were evaluated in this study. Cycloplegia achieved using Cyclopentolate 1% eye drops and was examined by both retinoscopy and autorefraction. Subjective refraction was done and the relative accuracy of both methods with respect to subjective correction was noted. Statistical Analysis: The results were compared and statistical analysis was carried out using Chi-square test with p0.05. Results: The spherical power estimated by retinoscopy, was accepted subjectively by 89.3% eyes, while 35% eyes accepted the spherical refractive power estimated by autorefraction. The cylindrical power, estimated by retinoscopy, was accepted by 49.2% eyes, while, 72.8% eyes accepted AR values. Estimation of axis of cylinder on retinoscopy were accepted by 55.7% eyes, while those of autorefraction by 75.7% eyes. The diagnostic accuracy of retinoscopy and autorefraction were comparable, but higher agreement was found with retinoscopy for spherical power component, while autorefraction was slightly better for cylindrical refractive error. Conclusion: Conventional retinoscopy is still the most accurate objective method to estimate the refractive status in children and can be considered a reliable starting point for subjective refraction, however, autorefraction has comparable accuracy and can be a valuable aid to prescribe cylindrical correction. Keywords: Autorefraction, Cylinder, Myopia, Refraction, Retinoscopy.

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