INTRODUCTION: Refractive error remains one of the primary causes of visual impairment in children worldwide. This study describes pattern of refractive errors among primary school students in Rupandehi district, Nepal.MATERIAL AND METHODS: Records of 128 children with refractive error aged 5-15 years from both urban and rural areas in Nepal between January and March 2011 were examined for patterns in the distribution of refractive errors. SPSS statistical software was used to perform analysis.RESULTS: The commonest type of refractive errors among the children was astigmatism (47%) followed by myopia (26%) and hyperopia (19%). Children in the age group 11-15 years had higher number of eyes with refractive error as compared to their younger counterparts 5 years /or below 5 years (49% vs. 9%). 71% students were from schools located in rural areas. Among the children with refractive errors, only 44.5% students were wearing glasses. 57% of the students studying in private schools were wearing glasses but only 26.9% students from the government school were wearing glasses.CONCLUSION: A wide variation in the distribution of refractive errors between the geographic locations, gender basis, types of schools as well as between the different ethnic groups was observed.Journal of Universal College of Medical Sciences Vol. 3, No. 1, 2015: 31-36

Background: Albinism is commonly associated with high refractive errors, but some clinicians are reluctant to prescribe glasses because reduced vision persists due to additional non-refractive visual problems.Aims and Objective: The purpose of this study was to evaluate the effectiveness of glasses in people with oculocutaneous albinism in Nepal.Materials and Methods: People with Oculocutaneous albinism (OCA) were prospectively examined through an outreach program of Lumbini Eye Institute, Nepal. Glasses were prescribed to determine the objective improvement in visual acuity (VA) and strabismus. Compliance with spectacles wear was assessed by telephone contact after 3 weeks and categorized as excellent: >75% of awake hours; good: 50–75% of awake hours; fair: 26–50% of awake hours and poor: <25%.Results: Thirty one people (65% male) mean age 18 years (range: 3 to 50) with OCA were examined. Mean refractive correction was –0.40±4.3 diopters spherical equivalents (range: −11.0 to +7.0 D). Mean visual acuity at distance was 0.9±0.28(6/50) corrected and 1.150.31(5/60) uncorrected (P = 0.000) in 62 eyes. Mean neat VA was1.74±0.89M corrected and 2.06±1.20M uncorrected (P = 0.004). Forty eight per cent (15 people) had fusion with or without glasses and one had fusion only with glasses. Compliance was excellent in 52% (16), fair in 26% (8), good in 12% (4), and poor in 10% (3).Conclusion: Providing eye glasses resulted in a clinically and functionally significant improvement in visual acuity and function in people with OCA.Asian Journal of Medical Sciences Vol.8(6) 2017 30-34

Background: Paediatric blindness presents as an enormous problem to developing countries in terms of human morbidity, economic loss and social burden.Aims and Objective: The objective of this study was to observe the visual outcome of congenital and developmental cataract surgery.Materials and Methods: This study was prospective, longitudinal and interventional. The patients aged ≤15 years, diagnosed either congenital or developmental cataract and planned for cataract surgery were enrolled during March 2014 to February 2015 at Lumbini Eye Institute, Nepal. The patients underwent either: a) Lens aspiration + PPC+ Anterior Vitrectomy; b) Lens aspiration + PPC+ Anterior Vitrectomy + PCIOL; c) Lens Aspiration + PCIOL depending upon age of patient. The patients were examined after surgery day 1, day 2, after 2 weeks and after 6 weeks. Glasses were prescribed at 6 weeks from the date of surgery. Occlusion therapy was initiated in cases wherever necessary.Results: A total of 54 eyes of 43 children were included in the study. The sex ratio was 1.26 female per male with mean age of 3 years (SD ± 2.16). In the verbal group, 61.1% (33 eyes) had final visual acuity (6/6-6/18). In the non verbal group, 16.7% (9 eyes) had final visual acuity of good fixation and follow. There was a statistically highly significant improvement in post surgical Best corrected visual acuity (p< 0.001).Conclusion: Good visual outcome after pediatric cataract surgery can be obtained if surgery is performed by skilled surgeon. The awareness of pediatric cataract, early diagnosis and timely intervention to surgical treatment, and postoperative management of residual uncorrected refractive error and amblyopia are important factors for the prevention of childhood blindness from cataract.Asian Journal of Medical Sciences Vol.9(2) 2018 36-39

Introduction: Penetrating eye injury is an important cause of visual impairment in pediatric population.Aims and Objectives: To study the epidemiology and visual outcome of penetrating eye injuries in pediatric population presented to Lumbini Eye Institute, the tertiary eye hospital of western Nepal.Materials and Methods: This retrospective study was conducted at the Department of Pediatric Ophthalmology and Strabismus, Lumbini Eye Institute over a period of one year from June 2014 to May 2015. All patients of penetrating eye injuries up to the age of 15 years were included in the study. The demographics of the patient, cause and duration of injury were recorded. The presenting and final best corrected visual acuity, anterior and posterior segment findings were recorded in specially designed proforma.Results: A total number of 127 children (127 eyes) presented with penetrating eye injuries during a year. The incidence of penetrating eye injury in one year was 127 out of 12927 new patients. Minimum age was 11 months, while the maximum age was 15 years with mean of 7.29 years (SD= ±3.49). Male and female patients were 99 (78%) and 28 (22%) respectively. Involvement of right eye was seen in 69 cases (54.33%) and left eye 58 (45.67%). The most common cause of injury was wooden stick in 55 cases (43.31%) followed by iron wire 12 (9.45%) and the stone 11 (8.66%). Corneal laceration was found in 102 cases (80.31%), scleral laceration in 10 (7.87%) and corneo-scleral laceration in 15 (11.81%). Seventy three percent patients were blind at the time of presentation whereas at discharge 37.63% were blind and 11.43% of patients had visual acuity better than 6/18 at presentation whereas 35.48% had visual acuity better than 6/18 after treatment.Conclusion: Penetrating eye injury is one of the common causes attending Pediatric Ophthalmology Department. Penetrating eye injury is common in male and majority of trauma is caused by wooden stick. The awareness of ocular trauma and its consequences should be increased to reduce incidence of childhood blindness.Asian Journal of Medical Sciences Vol.7(4) 2016 84-87

Background: Influencing factors of conventional horizontal surgery for surgical outcome has not been assessed in Nepal. Aims and Objective: To assess the pre-operative factors that influences the surgical outcome of horizontal strabismus surgery. Materials and Methods: The medical records of 68 patients who underwent their first horizontal strabismus surgery at Lumbini Eye Institute from 1 st January to 30 th December 2015 were retrospectively reviewed. The collected clinical data included diagnosis, age group, visual acuity, binocular function, extraocular motility and pre and postoperative deviation. The success of surgery was defined by eye deviation less than 10 prism diopters (PD) at 6 weeks after operation. The influencing factors for surgical success (diagnosis, age group, visual acuity, binocular function, and angle deviations) were analyzed using chi square test and Mann-Whitney -U test, where ever appropriate. Results: Out of 113 patients who underwent strabismus surgery during the year, 68 patients were enrolled in the study. Majority of the patients (27, 39.7%) were >9 years of age and 52.9% were female. Thirty seven patients (54.4%) were esotropic whereas, 31 were exotropic. Preoperatively, angle of deviation ranged from 20 to 90 PD with binocular vision present in 57.4% cases. Overall, success was seen in 26 patients (38.2%). Pre-operative angle of deviation and binocular vision had statistical significance with surgical success (p = 0.012 and 0.026 respectively). Conclusion: Larger angle of deviation and poor binocular vision at presentation has higher failure rate for horizontal strabismus surgery.