Background Childhood blindness and low vision have become major public health problems in developing countries. The purpose of this study was to categorise the causes of visual impairment according to aetiology and provide detailed local information on visually impaired children seeking low‐vision services in a tertiary eye centre in Nepal. Methods A retrospective study was conducted of all visually impaired children (visual acuity of less than 6/18 in the better eye), aged less than 17 years seen in the low‐vision clinic at the Sagarmatha Chaudhary Eye Hospital in Lahan between January 1, 2012 and December 31, 2013. Results Of the 558 visually impaired children, the majority were males, 356 (63.7 per cent). More than half (56.5 per cent) of the children were in the 11 to 16 years age group. Many of the low‐vision children (52.9 per cent) were identified as having moderate visual impairment (visual acuity less than 6/18 to 6/60). Most children were diagnosed with childhood (36.2 per cent) or genetic (35.5 per cent) aetiology, followed by prenatal (22.2 per cent) and perinatal (6.1 per cent) aetiologies. Refractive error and amblyopia (20.1 per cent), retinitis pigmentosa (14.9 per cent) and macular dystrophy (13.4 per cent) were the most common causes of paediatric visual impairment. Nystagmus (50.0 per cent) was the most common cause of low vision in the one to five years age group, whereas refractive error and amblyopia were the major causes in the six to 10 and 11 to 16 years age group (17.6 and 22.9 per cent, respectively). Many of the children (86.0 per cent) were prescribed low‐vision aids and 72.0 per cent of the low‐vision aid users showed an improvement in visual acuity either at distance or near. Conclusion Paediatric low vision has a negative impact on the quality of life in children. Data from this study indicate that knowledge about the local characteristics and aetiological categorisation of the causes of low vision are essential in tackling paediatric visual impairment. The findings also signify the importance of early intervention to ensure a better quality of life.

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Purpose: Vision 2020 and the Global Action Plan 2013-2019 prioritise primary eye care (PEC) as an important component of reducing avoidable blindness. Studies in sub-Saharan Africa have demonstrated that current PEC provision is poor. There has been no evaluation of the current practice of PEC among primary health care workers (PHCWs) in Nepal. Methods: A mixed methods descriptive cross-sectional study with semi-structured interviews and focus group discussions (FGDs) was carried out in Eastern Nepal. Government employed PHCWs working at health posts in three districts were invited to take part in a PEC knowledge and skills assessment. Each health post was assessed for ophthalmic equipment and medications. Three focus group discussions and eight semi-structured interviews were carried out with community ophthalmic assistants, PHCWs and a district health manager. Results: 107 PHCWs in 35 health posts took part in the quantitative study. Only 8.4% had received eye care training. 27.1% PHCWs could diagnose a corneal ulcer, 83.2% conjunctivitis, 75.7% cataract and 54.2% ophthalmia neonatorum. Only 14.0% could measure visual acuity, and 5.7% of HPs had a vision chart. Ophthalmic assistants described their concern for the low level of PEC at health posts. PHCWs were keen to receive training and highlighted the need for greater government support in the provision of eye care services. Conclusion: PEC knowledge and skills among PHCWs in eastern Nepal is inadequate to provide quality PEC services. There is a pressing need for PEC training in the region, provision of ophthalmic equipment and greater government support for eye care.

Eyelid and ocular adnexal involvement is most commonly found in patients with herpes zoster ophthalmicus followed by corneal complication and uveitis. There needs to be awareness of ocular involvement, which can be sight threatening, among the HZO patients and other medical departments and an increased emphasis on regular ophthalmic examination.

Background: Corneal ulcer is a sight threatening disease of significant public health concern. Early diagnosis with microbiological identification of the causative organism and institution of the proper medical therapy are important for successful visual recovery. Objectives: To find out the demographic and predisposing factors associated with corneal ulcers, evaluate management of ulcers on the basis of clinical features and corneal scraping results. Methods: It was a retrospective clinical study conducted among 1897 subjects with microbial keratitis in Sagarmatha Choudhary Eye Hospital, Lahan, Nepal from January 2010 to December 2014. Assessment included detailed eye examination with slit lamp for size, depth and location of ulcer, presenting visual acuity on internally illuminated Snellen's chart, and corneal scrapings for Gram's stain and 10% Potassium hydroxide wet mount. A standard treatment was delivered on the basis of clinical features and corneal scraping results. Subjects were evaluated subsequently after 48 hours, one week, two weeks, three weeks and four weeks of initiation of therapy. Non-responding cases were admitted to perform re-scraping and to modify therapy. Results: Majority of subjects (71.2%) belonged to the age group of 26 to 55 years (71.2%), presented after two weeks (82.3%) and used non-prescription eye drops (71.9%) before visiting to the eye hospital. Ocular trauma (54.5%) was the most commonly reported predisposing factor. The central and paracentral ulcers comprised of 72.8% of ulcers withsize greater than 2mm in 2.7% and moderate ulcer in 71.1%. Microbiological test revealed fungal ulcers in 78.1% subjects. Presenting visual acuity better than 6/18 was reported in 7% only. Conclusion: Corneal ulcer was one of the commonly reported eye disease in Terai region of Nepal. Trauma is the commonest cause of corneal infection. Fungal corneal ulcers werecommonly noted.