BackgroundThe problem of access to medical information, particularly in low-income countries, has been under discussion for many years. Although a number of developments have occurred in the last decade (e.g., the open access (OA) movement and the website Sci-Hub), everyone agrees that these difficulties still persist very widely, mainly due to the fact that paywalls still limit access to approximately 75% of scholarly documents. In this study, we compare the accessibility of recent full text articles in the field of ophthalmology in 27 established institutions located worldwide.MethodsA total of 200 references from articles were retrieved using the PubMed database. Each article was individually checked for OA. Full texts of non-OA (i.e., “paywalled articles”) were examined to determine whether they were available using institutional and Hinari access in each institution studied, using “alternative ways” (i.e., PubMed Central, ResearchGate, Google Scholar, and Online Reprint Request), and using the website Sci-Hub.ResultsThe number of full texts of “paywalled articles” available using institutional and Hinari access showed strong heterogeneity, scattered between 0% full texts to 94.8% (mean = 46.8%; SD = 31.5; median = 51.3%). We found that complementary use of “alternative ways” and Sci-Hub leads to 95.5% of full text “paywalled articles,” and also divides by 14 the average extra costs needed to obtain all full texts on publishers’ websites using pay-per-view.ConclusionsThe scant number of available full text “paywalled articles” in most institutions studied encourages researchers in the field of ophthalmology to use Sci-Hub to search for scientific information. The scientific community and decision-makers must unite and strengthen their efforts to find solutions to improve access to scientific literature worldwide and avoid an implosion of the scientific publishing model. This study is not an endorsement for using Sci-Hub. The authors, their institutions, and publishers accept no responsibility on behalf of readers.

Task sharing among various cadres of eye care workers has the potential to improve screening coverage of people with diabetes to prevent visual loss from DR.

Participants were accepting task sharing approach and believed that task sharing could improve access to eye care services for people with diabetes and better utilise the services of eye and healthcare providers.

This research provided an insight on how task sharing in DR management can be implemented by optimizing the roles of eye care workers.

Purpose: I. To determine the causes of low vision by age and sex. II. To assess the need of spectacles and low-vision devices (LVDs) in low-vision patients attending the clinic at the Khyber Institute of Ophthalmic Medical Sciences, Hayatabad Medical Complex Peshawar. III. To determine the proportion of patients with low vision whose distance visual acuity (VA) can be enhanced to 6/18 or better in the better eye and who have the potential to discern 1 M (newspaper print) after appropriate refraction and application of low-vision devices (LVDs). Design: Hospital-based, cross-sectional study. Methods: A total of 504 individuals attending the low-vision clinic between June 2000 and June 2002 were included in the study. Of this cohort, 372 (73.8%) were male and 132 (26.2%) were female. The inclusion criterion was that the individual had VA < 6/18 in the better eye after medical or surgical treatment and/or best available correction. Results: The leading cause of low vision in age group 16 years was nystagmus 28 (16.97%). While the leading cause amongst all patients was myopic degeneration (14.48%, 95% CI). The percentages of visually impaired, severe visually impaired, and blind (using the WHO low-vision criteria) were 41% (95%CI), 22.4% (95%CI), and 36.5% (95%CI), respectively. After appropriate refraction, 19% of the patients achieved a VA of 6/18 or better. With LVDs, 86% (95%CI) achieved a VA of 6/18 or better and 90% (95%CI) achieved essentially normal near visual acuity. Spectacles were the most common devices. Conclusions: Low-vision clinics have now become an integral part of comprehensive eye-care services. Any patient with some residual vision must be referred to a low-vision clinic for the possibility of exploiting his/her visual potential through LVDs or other means. With appropriate training in their use, counsel- Causes of low vision in Pakistan89