This article emphasizes the interlink between eye and the skin, helping to diagnose systemic diseases based on the ocular manifestations. A complete care of eyes by the ophthalmologist will require simultaneous skin care and treatment of the systemic cause.
Introduction: Subjective refraction helps in establishing the suitable lens for a patient. But it also needs a patient’s cooperation for the proper estimation of the refractive error. Aim: To determine the impact of counselling of Optometrists on subjective refraction and spectacle prescription to patients attending Ophthalmology Out Patient Department (OPD) at their first visit. Materials and Methods: This was a cross-sectional study conducted for a period of two months from June 2020 to July 2020. All patients attending the OPD at Department of Ophthalmology at R L Jalappa Hospital and Research Centre, Tamaka, Karnataka, India, were included in the study. A total of 120 patients, whose vision was <6/9, were included in each group. Group A, before counselling the Optometrists and Group B, after counselling the Optometrists by systemic random sampling method. The number of patients who required spectacle correction and those who were given spectacle prescriptions at their first visit were identified. The data was analysed using Statistical Package for the Social Sciences (SPSS) version 22.0. Results: In Group A, out of 120 patients only 62 patients (51.7%), had undergone subjective refraction along with spectacle prescription at their first visit. In Group B, (88.3%) 106 patients out of 120, underwent subjective refraction and spectacle correction was given on their first visit. Conclusion: This study shows a clear positive impact of counselling to Optometrists and the importance of counselling in achieving patient’s satisfaction.
Aim: To study the incidence, management, and outcome of complex cataract cases in a tertiary eyecare center. Material and methods: Retrospective observational study with analysis of recordsdone for patients who were operated on for complex cataract from December 2019 to February2020. Results: 300/10,000 patients had complex cataracts requiring additional surgical skills,advanced equipment, and better patient counseling. 5.3% (16/300) of patients needed intracameraladrenaline whereas 1.3% (4/300) needed Visco mydriasis. A capsular tension ring was implanted in4.3%(13/300) of patients. 4% (12/300) underwent sphincterotomies whereas 2% (6/300) had toundergo synechiolysis. Iris hooks were used in only 0.6% of patients (2/300). Posterior capsularrent was seen in 1.6%(5/300) which was managed by placing a Posterior chamber IOL in the sulcus.2.6% (8/300) had implantation of the iris-claw lens and 2.3% (7/300) were left aphakic forsecondary IOL to be implanted at a later date. The visual outcome was better than 6/18 in 76% ofpatients. 24% of patients had an improvement in their visual acuity by a line or 2 but was less than6/18 due to corneal degenerations, corneal scarring, Retinal pathologies, and colobomas.Conclusion: Although these cataracts demand more expertise on behalf of the surgeon, theoutcome can be very rewarding if done with proper planning. The knowledge of small incisioncataract surgery is highly valuable in such situations.
To assess the visual acuity, identify the cause for reduced vision & to advice patients regarding correction of vision in drivers for safe driving. Analysis of a cross-sectional study of people having a history of driving — two-wheeler, four-wheeler or autorickshaw was done. Best corrected visual acuity (BCVA) less than 6/6 in the better eye were selected for the study through screening camps for KSRTC bus drivers, Autorickshaw drivers and patients coming to the OPD of R L Jalappa Hospital & Research Center in Kolar district, having a history of driving a two-wheeler, four-wheeler & autorickshaw were included. Patients who have stopped driving due to reduced vision were excluded from the study. After taking an informed consent, patients underwent a comprehensive ophthalmic examination. Those patients who were identified as having decreased vision were advised regarding the necessary treatment. Out of 706 patients, 87.99 % of drivers in this study were males and majority belonged to the age group between 20-30 years. 29.17 % of patients did not have driving license though they were driving either 2 or four-wheeler vehicles or Autorickshaws. 41% of patients did not have any eye checkup prior to our examination and after our examination was done 58.9% of patients were advised spectacle correction. This highlights the need for intensified health education to encourage drivers who experience these defects to seek prompt medical help and advice. The prevalence of refractive errors among the study population also indicates the need to enforce the law on comprehensive eye examination by appropriate professionals, as enshrined in the law, rather than just measuring visual acuity prior to acquiring or renewing drivers’ licenses, as is currently the case. Keywords: Best corrected visual acuity; drivers; reduced vision; RTA
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