Ophthalmology Pakistan

Oct in glaucoma; a valuable diagnostic tool

Dr. Imran Ahmad — Mon, 17 Apr 2023 00:00:00 +0000

Glaucoma is a leading cause of blindness worldwide, and early detection and management are crucial to prevent vision loss. Optical coherence tomography (OCT) is being used these days as an important tool in the repertoire of ophthalmologists. OCT provides high-resolution images of the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and other relevant structures, enabling clinicians to detect subtle changes in these structures before visual field defects become apparent.

Level of satisfaction of eye care service provider with their equipment

Sahra Bashir, Muhammed Suhail Sarwar — Fri, 01 Jul 2022 00:00:00 +0000

OBJECTIVES: The main purpose of this study is to check the satisfaction level of equipment used by Eye Care Professionals (ECP) and to evaluate the sanitary conditions and quality of instruments in public and private hospitals.

METHOD AND MATERIALS: A cross sectional study was conducted on 101 eye care professionals who were doing job in public and private sectors. Consent was taken from them. A self made questionnaire was distributed among them. The confidentiality was maintained. The study was conducted between Septembers to December 2020. The research protocol was approved by the Ethical Review Board of College of Ophthalmology and Allied Vision Sciences, Lahore. The study methods adhered to the tenets of the Declaration of Helsinki for the use of participles in biomedical research.

RESULTS: A total of 101 questionnaires were distributed. Each questionnaire had 18 questions. Among those 74% were satisfied with the quality of the equipments of the hospitals and their sanitary conditions. Also, 72% have good command on using their equipment.

CONCLUSION: This study concludes that the eye care professionals (ECP) are satisfied with their equipments available in their hospitals and majority of them have good command on equipment usage.

KEY WORDS: Eye care professional; Public health; Job satisfaction; Optometrists.

Locating thinnest point of cornea in relation to visual axis in healthy eyes

Motiba Tahir, Muhammad Suhail Sarwar, Hameeda Haider — Fri, 01 Jul 2022 00:00:00 +0000

OBJECTIVE:The main intention of this research was to find out the corneal thinnest point in accordance with thevisual axis in healthy corneas.

METHOD: This comparative cross-sectional included 120 subjects (female:61, male 59). The mean age of female patients was 29.11±8.3 years and 27.20±8.77 years of male. This study was carried out at Mayo Hospital, Lahore. The data was collected through, non-random convenient sampling technique, self-made proforma after taking the patient’s consent. Data thinnest point of thecornea, TX, TY, kappa distance, KX and KY of both eyes were measured. We converted theright eye horizontal axis values to left eyes by multiplying -1 to the right eye’s horizontal values.

RESULTS: The corneal thinnest point was situated at 0.57±0.4 mm inferotemporal to the visual axis in healthy corneas. The mean central point of the cornea was 555.2±26.46 µm, respectively. The CCT mean was 547.9±26.02 µm respectively. The thinnest point mean was 544.83±27.14 µm respectively. The TX mean was 0.03±0.51mm respectively. The thinnest X laterality mean was 0.44±0.25 mm respectively. The thinnest y-axis mean was -0.36±0.30 mm respectively. The kappa distance mean was 0.17±0.10 mm respectively. The KX mean was 0.00±0.16 mm respectively. The kappa x laterality mean was 0.0607±0.15 mm respectively. The Ky mean was 0.01±0.124 mm respectively.

CONCLUSION: The corneal thinnest point was found at 0.57±0.4 mm inferotemporal from the visual axis in normal eyes. The x-axis meant was 0.44±0.25 mm, and the y-axis means was ‑0.36±0.30 mm.

KEYWORDS: Keratoconus, angle kappa, CCT.

Developing a disability inclusive model for low vision service

Tahira Razzaq, Madiha Nazly, Muhammad Suhail Sarwar, Muhammad Anwar Awan — Fri, 01 Jul 2022 00:00:00 +0000

PURPOSE: To develop a disability inclusive framework or a model to ensure the provision of both clinical and rehabilitation components of management to the low vision persons. And to determine the impacts of low vision services on the quality of life and adjustment to visual loss.

METHOD: A Descriptive Cross-sectional study was done on 62 subjects by using a Non-probability convenient sampling method. The participants of both genders were included in this study and were of different age groups. A self-designed questionnaire was also used during this study. The informed consent form was also signed by every participant individually before starting the procedure. Duration of study was 3 months after approval of synopsis.The Ethical Review Board of College of Ophthalmology and Allied Vision Sciences also approved the whole Research Protocol.

RESULTS: Total 62 participants were included in this study. About 95% said that they feel difficulty to do things due to this vision problem. Almost 42% said that they have problems to read white boards in normal room illumination, 46.8% said that they don’t get information at the same time like other students get and 17.7% also told that their teachers didn’t support them in this regard. About 37% had confidence to make their own way to school and 64% had faced problems to participate in recreational and social activities. And 67.7% said that they have no confidence to move safely at night. More than 60% of the Families behavior was supporting towards their education. Almost 69.4% didn’t have independence to do their own work and more than 30% were also restricted to participate in the events. The care providers and doctors were encouraging and majority of the patients were getting proper attention. All of the questions results were significant (having p-value < 0.05) except two of them, in which people were uncomfortable roaming outside their homes and friends were letting them down for their special needs.

CONCLUSION: This article provided the clear perception and understanding for the development of a model or framework for low vision and rehabilitation services known as “Clinico-social model”. It included all the approaches to help LV Persons to overcome all the barriers that they are facing in their daily life and their rehabilitation to develop enough confidence in them to get independent. And this disability inclusive model(DIM) also helped to divert the attention of care providers along with different hospitals& organizations towards persons with visual disabilities. And the approach of the persons with the visual impairment towards the LV services was seen less due to their exclusion from the society based on their disabilities.

KEYWORDS: Low vision, Visual Disorder, Rehabilitation.

Protocols and techniques in visual assessment of children with various disabilities

Aaima Batool, Ayesha Saleem, Haleema Sadia — Fri, 01 Jul 2022 00:00:00 +0000

PURPOSE: To evaluate the understanding of eyecare providers about the protocols and techniques for visual assessment of children with disabilities.and implementation of that knowledge in clinical practice.

METHOD: Descriptive cross-sectional study was carried out by 47 eyecare professionals working in different eyecare units from September to December 2021. The participants included both males and females which were working in different clinical setups. They were asked to fill a self-designed questionnaire to evaluate their knowledge about protocols and techniques for visual assessment of children with disability. Data was entered and analyzed by using SPSS vs. 25. Frequency and percentages were calculated by standard deviation. The p-value was calculated by Pearson Chi-square method. Informed consent was taken from each participant.

RESULTS: Results were taken out from the self-designed questionnaire which showed that out of 47 participants, 33 were males and 14 were females, 32 were optometrists and 15 were ophthalmologists.p-value is insignificant (p≥0.05) which shows both optometrists and ophthalmologists had good perception and knowledge about standards or protocols of visual assessment and when it comes to techniques, they had used different charts, tools and methods during visual functions assessment in children with various disabilities.

CONCLUSION: Eyecare professionalshave fair knowledge about the protocols and techniques for assessment. Both optometrists and ophthalmologists follow the protocols of assessment and apply various techniques for visual function assessment in children with disabilities.

KEYWORDS: Visual functions, visual acuity, contrast sensitivity, visual field, color vision and glare sensitivity.

Challenges in visual assessment of people with psychosocial disability

Nimra Zaheer, Beenish Latif; Shaheer Suhail Sarwar, Maria Zaheer — Fri, 01 Jul 2022 00:00:00 +0000

AIMS AND OBJECTIVE: To explore the Challenges faced by an Optometrist and Ophthalmologist in Visual Assessment of People with Psychosocial Disability.

METHOD: This was a cross sectional study involving the use of self-designed questionnaire to evaluate the challenges in visual assessment of people with psychosocial disability. Chi Square test was applied. A sample size of total 32 practitioners was taken and asked to fill the questionnaire regarding challenges they face. This study was conducted in September, October and November 2021.

RESULTS: There were a total of 32 subjects. Out of 32 subjects 23 (71.9%) were male and 9 (28.1%) were females. We took two categories of eye care practitioners; Ophthalmologist and Optometrist. After filling self-made questionnaire, we concluded that Ophthalmologist and Optometrist have to face a lot of challenges in dealing with people with psychosocial disability. Most of the time they face difficulty in communicating with psychosocial person. They face difficulty in performing various procedures as they find the people with psychosocial disability uncooperative. They face aggressive attitude. They try to keep them comfortable and ensure friendly behavior. They try to keep themselves calm. They apply ethical codes in dealing with such persons. P value shows insignificant results which shows that both ophthalmologist and optometrist face equal challenges in dealing with people with psychosocial disability.

CONCLUSION: Visual assessment of uncooperative people with psychosocial disability is challenging for ophthalmologists and optometrists. They face many difficulties in assessing visual functions of people with psychosocial disability. They face hurdles in communication and interaction with people of psychosocial disability.

KEYWORDS: Challenges, Intellectual Disability, Ethical codes, Psychosocial Disability

Evaluation of reading score in children having different types of amblyopia

Hafiza Bisma Latif, Ayesha Sarfraz; Haleema Sadia — Fri, 01 Jul 2022 00:00:00 +0000

OBJECTIVES: To evaluate reading score words per minute in amblyopic children with the continuous-text reading-acuity test MNREAD.

METHOD: Thirty-one participants with amblyopia (age range from 8-years to 6-years) were included in the study. Visual acuity, stereopsis, fusion, and angle of deviation of all children were assessed. MNREAD chart was used to assess binocular reading speed (wpm) in amblyopic children. Pearson chi-square was used to test the significance of results.

RESULT: Out of 31 children with amblyopia, 58.1% were male. Anisometropic amblyopia was identified in 32.2% while 67.7% had strabismic amblyopia. Participants were further grouped according to the severity of amblyopia i.e., mild amblyopia found in 19.4% participants, moderate amblyopia was present in 35.5% while 45.2% had severe amblyopia. Most of the participants (87.1%) had no stereopsis. More than half of the participants (54.8%) had manifest deviation, 19.4% had latent, while 25.8% were orthophoric respectively. Suppression in amblyopic eye was noted at 33cm and 6m in 41.9% and 61.3% participants respectively. The minimum recorded reading speed was 24.00 wpm while maximum recorded reading speed was 88.00 wpm. A significant correlation (p=0.014) was found between severity of amblyopia and reading score (wpm). There was no correlation found between angle of deviation and reading score (wpm) (p=0.247) while there was a high significant correlation found between type of amblyopia and reading score (wpm) (p<0.01).

CONCLUSION: Reading score (wpm) in amblyopic children was moderately negatively correlated with the severity of amblyopia and type of amblyopia. Strabismic amblyopic children read more slowly as compared to anisometropic amblyopic children. Children with severe form of amblyopia had lower reading speed as compared to moderate and mild type amblyopic children.

KEY WORDS: Reading score, Amblyopia, MNREAD, Children