Barriers to availing refractive error services among an urban slum population in Mumbai, India

Barriers to availing refracti ve error services among an urban slum population in Mumbai, India. Background: A refractive error project for management of refractive errors in adults was undertaken in the urban slums of Mumbai, India. The project looked at the burden of refractive errors in the predominantly lower socio economic status groups as well as what common barriers prevent access to refractive services amongst this population. This presentation highlights the barriers that were elicited for availing and accessing refractive error services among the urban slum population in Mumbai, India. AIM: The study aimed to identify the common barriers to availing & accessing refractive error services among an urban slum population in Mumbai, India. Methods : A situation analysis of the community, with respect to availability of services was done as a part of the service delivery planning. The analysis revealed that services were available but the community was not accessing the same. Based on the situation analysis report a questionnaire with all perceived barriers was developed and the same was validated. Service delivery was done by establishing vision centers within the community. Trained health workers performed a door to door vision screening, identified and referred the needy population to the vision centre. Here the questionnaire was run by trained social workers on the people visiting the centers for eye examinations, who were referred by the social workers. Results : Data analysis was carried out to know the reasons for not availing the services within the community. Of the 4070 subjects who visited the vision centre, 4039 case records were complete and analyzed. The demographic associations of the use of spectacles and reasons for not availing services were assessed with age, gender, education, socioeconomic status. On further analyses it was revealed, that, 3373 (83.5%) were aware of their poor vision, of these 2000 people did not visit an eye doctor. When the questions were analyzed as economic reasons and lack of awareness, lack of awareness superseded economic reasons, as lack of awareness was 54.5% Vs economic was 53.70%. Conclusion: When refractive error service delivery was planned for this population, besides providing free spectacles, emphasis on generating awareness for need for refractive errors was also considered

A novel strategy for management of uncorrected refractive errors in urban slums

Background: Blindness and Vision impairment remains a major public health issue not only in rural but also in urban areas. Concept of using peripheral health centers to render primary health care services to the community was a WHO proposed model. However, establishing them in urban slums is a challenge as most of the slums are illegal establishments. So, aim was to establish vision centers for providing primary eye care services in the urban slums of Mumbai, West India. Methods: Vision centers were established in various slum pockets of Mumbai from the year 2008 till 2009. Refraction and screening for ocular morbidity were carried out for those who attended this center and management for uncorrected refractive errors was done. Results: Data from 6 such vision centers located in various slum pockets of Mumbai city from April 9 to March 2011 were collected and analyzed. Of the 19,550 adults, 2270 (11.61%) had moderate vision impairment with presenting visual acuity of <0.5 LogMAR in both eyes. Severe Visual impairment was seen in (723) 3.70%. Blindness was seen in (357) 1.82%. Of the 2993, which were moderately and severely visually impaired, 1893 subjects that is, 63.24% of them improved to 0.2 LogMAR or better with spectacle correction Conclusions: About 63.24% of visual impairment was due to uncorrected refractive errors, these included both moderately and severely vision impaired. Totally, 357 (1.82%) were also identified as blind. This model of vision centers has a role in the identification and management of sight-threatening problems

Myopia progression in children before and after the coronavirus disease lockdown

Background:&nbsp;The worldwide spread of the coronavirus disease (COVID-19) pandemic in 2020, followed by lockdowns, forced children to be in home confinement with increased screen time, leading to rapid progression of myopia and an increase in the prevalence of myopia. This study was aimed at determining if myopia progression seen in evidence-based practice resulted from the COVID-19 lockdown or delayed follow-ups. Methods:&nbsp;A retrospective review of case sheets of patients visiting the pediatric department of a tertiary care eye hospital in Mumbai, India, was conducted from 2017 onwards. We enrolled all children with myopia who had attended at least one follow-up visit before the COVID-19 lockdown and at least one follow-up visit post-lockdown. The spherical equivalent (SEQ) of refractive error values at baseline and pre- and post-COVID-19 lockdown follow-ups (hereinafter referred to as the “first” and “second” follow-ups, respectively) were recorded. The duration between baseline and the first follow-up visit and between the first and second follow-up visits were noted. Results:&nbsp;We enrolled 112 eyes of 56 children, including (62.5%) boys and (37.5%) girls, with a mean (standard deviation [SD]) age of 9.54 (2.82) years. The mean (SD) SEQ values at baseline and first and second follow-ups were - 4.74 (3.83), - 5.46 (3.81), and - 6.42 (3.66) D, respectively. The mean change in SEQ, mean SEQ myopia progression, and rate of myopia progression per month differed significantly between the first and second follow-up visits (all&nbsp;P&nbsp;&lt; 0.05). However, the myopia degree did not change significantly between the first and second follow-ups in eyes with low, moderate, or high myopia (all P &gt; 0.05). The mean (SD) duration of the first follow-up was 14.57 (5.68) months, while that between the first and second follow-ups was 27.96 (9.18) months, showing a significant difference (P &lt; 0.05). Conclusions:&nbsp;Our findings suggest that a longer gap between follow-up visits and myopia progression per month should be factored into the management of myopia. Considering that young children are more vulnerable, preventive measures and school reforms should be urgently implemented in India. Further retrospective multicenter studies with a larger sample size of eyes, including various refractive errors over a longer period, are required to verify these findings

International contact lens prescribing in 2013

Every year since 2001, we have reported data from an international survey of contact lens prescribing in Contact Lens Spectrum. This work, which first started in the United Kingdom, has now recorded information about more than 250,000 contact lens fits in 54 countries. Our approach is simple. We ask contact lens prescribers (optometrists, opticians, or ophthalmologists, depending on the country) to record information about the first 10 contact lens fits that they perform after the start of the survey period each year. Each fit is then weighted to reflect the volume of fits performed by each practitioner. Information is collated at our two survey offices in Manchester, United Kingdom and Waterloo, Canada. For this report of contact lens prescribing in 2013, we report data for 21,673 lens fits in 31 markets around the world

International contact lens prescribing in 2014

Since the late 1990s, the International Contact Lens Prescribing Survey Consortium has prospectively gathered information about 285,000 contact lens fits from more than 50 countries. This article presents our 14th annual summary of current trends published in Contact Lens Spectrum.\ud \ud With only minor differences in the distribution of our surveys among markets, we have continued to adopt the same approach throughout the past 18 years. Through national coordinators, we approach contact lens prescribers in each country and ask them to record information about the first 10 patients whom they fit with contact lenses after receipt of our survey form. The information collected is generic, and respondents are weighted to reflect the volume of contact lens fits undertaken by each. For this 2014 report, we present information about 25,179 contact lens fits from 32 countries..