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Asante DB, Tsegah KM, Afrifa-Yamoah E, Kyei S, Dzidzor DJ, Anokye R. Facial dermatosis papulosa nigra, a risk for the development of pterygium and myopia: a descriptive cross-sectional study in Ghana. J Public Health Afr 2023. [DOI: 10.4081/jphia.2022.1757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background. Dermatosis papulosa nigra (DPN) affects sun-exposed areas such as the face, neck, and trunk. The prevalence of pterygium and myopia in DPN patients in Ghana has not been studied. In this study, we examined the risk and protective factors for pterygium and myopia in DPN patients. Materials and Methods. The study involved 100 participants with facial DPN. A standard ophthalmic exam was performed using a portable slit lamp and a 3.5X magnified loop. Participants completed a closed- ended questionnaire. Logistic regression was used to summarize the level of association between DPN, myopia, and pterygium, as well as demographic factors (gender, age, occupation, family history of lesion and skin complexion). Results. 70% and 84% of participants had pterygium and myopia. Age, gender, complexion, and sun exposure were associated with pterygium and myopia (p < 0.05). Higher grade of pterygium and myopia were prevalent in the aged population. Both univariate and multivariable models highlighted that increasing age and sun exposure (outdoor) were risk factors for developing higher grade of pterygium and myopia in the DPN participants, while light skin color and male gender were respectively identified as protective factors. Conclusions. Our study is the first to examine pterygium and myopia in facial DPN patients. Most Ghanaians with facial DPN are at risk for developing pterygium and myopia.
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Tandon R, Vashist P, Gupta N, Gupta V, Yadav S, Deka D, Singh S, Vishwanath K, Murthy GVS. The association of sun exposure, ultraviolet radiation effects and other risk factors for pterygium (the SURE RISK for pterygium study) in geographically diverse adult (≥40 years) rural populations of India -3rd report of the ICMR-EYE SEE study group. PLoS One 2022; 17:e0270065. [PMID: 35862365 PMCID: PMC9302760 DOI: 10.1371/journal.pone.0270065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 06/03/2022] [Indexed: 12/04/2022] Open
Abstract
Purpose To determine the prevalence and risk factors for pterygium in geographically diverse regions of India. Methods A population-based, cross-sectional multicentric study was conducted in adults aged ≥40 years in plains, hilly and coastal regions of India. All participants underwent a detailed questionnaire-based assessment for sun exposure, usage of sun protective measures, exposure to indoor smoke, and smoking. Detailed ocular and systemic examinations were performed. Pterygium was diagnosed and graded clinically by slit-lamp examination. Association of pterygium with sociodemographic, ophthalmological, and systemic parameters was assessed. Physical environmental parameters for the study period were estimated. Results Of the 12,021 eligible subjects, 9735 (81% response rate) participated in the study. The prevalence of pterygium in any eye was 13.2% (95% CI: 12.5%-13.9%), and bilateral pterygium was 6.7% (95% CI: 6.2–7.2). The prevalence increased with age (<0.001) irrespective of sex and was highest in those aged 60–69 years (15.8%). The prevalence was highest in coastal (20.3%), followed by plains (11.2%) and hilly regions (9.1%). On multi-logistic regression, pterygium was positively associated with coastal location (P<0.001), illiteracy (P = 0.037), increasing lifetime sun exposure (P<0.001), and negatively associated with BMI ≥25 kg/m2 (P = 0.009). Conclusion Pterygium prevalence is high in the rural Indian population. The association of pterygium with several potentially modifiable risk factors reflects its multifactorial etiology and provides targets for preventive measures.
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Affiliation(s)
- Radhika Tandon
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
- * E-mail:
| | - Praveen Vashist
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Noopur Gupta
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Vivek Gupta
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Saumya Yadav
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Dipali Deka
- Regional Institute of Ophthalmology, Guwahati, India
| | | | - K. Vishwanath
- Pushpagiri Vitreo Retina Institute, Secunderabad, Telangana, India
| | - G. V. S. Murthy
- Indian Institute of Public Health, Hyderabad, India
- Clinical Research Department, Public Health Eye Care & Disability, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Das AV, Senthil S. Year One of COVID-19 Pandemic: Effect on Presentation of Patients With Glaucoma in a Multi-Tier Ophthalmology Network in India. FRONTIERS IN OPHTHALMOLOGY 2022; 2:900988. [PMID: 38983572 PMCID: PMC11182134 DOI: 10.3389/fopht.2022.900988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 06/14/2022] [Indexed: 07/11/2024]
Abstract
Objective To describe the demographics and clinical profile of patients with glaucoma presenting during the novel coronavirus (COVID-19) lockdown and unlock phases in India. Methods This retrospective hospital-based comparative study included patients presenting between March 25, 2017, and March 31, 2021. All patients who presented with glaucoma disorders were included as cases. The demographic and clinical data of these glaucoma patients were collected using an electronic medical record system. Results Overall, 34,419 patients (mean 47 per day) diagnosed with glaucoma diseases presented to the network and were included for analysis. The mean age of the patients was 54.16 ± 18.74 years and most were male (n=21,140; 61.42%) from the urban region (n=12,871;37.4%). On categorizing based on the timeline of the COVID-19 pandemic, most of the patients presented pre-COVID-19 (n=29,122; 84.61%), followed by a minority (n=175; 0.51%) during the lockdown and the rest (n=5,122; 14.88%) during unlock phase. An increasing number of patients with secondary glaucoma (n=82; 46.86%) and presenting from the local intra-city (n=82; 46.86%) was seen during the lockdown. There was a 6.6-fold increase in neovascular glaucoma and a 2.7-fold increase in lens induced glaucoma during the lockdown phase ((p<0.001) for both). There was a significant increase in subjects in 4th decade (p<0.03) and a decrease in subjects in 7th decade (p<0.008) during the lockdown period. Conclusion The presentation of patients with glaucoma disorders to the hospital is evolving due to the COVID-19 pandemic. The footfalls of patients during the unlock regained to two-thirds of the pre COVID-19 level. During the lockdown, the older patients were less, there was an increase in younger patients and those with secondary glaucoma, and the majority presenting from within the city.
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Affiliation(s)
- Anthony Vipin Das
- Department of EyeSmart EMR & AEye, L V Prasad Eye Institute, Hyderabad, India
- Indian Health Outcomes, Public Health and Economics Research Center, L V Prasad Eye Institute, Hyderabad, India
| | - Sirisha Senthil
- VST Glaucoma Centre, L V Prasad Eye Institute, Hyderabad, India
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Rauniyar D, Das AV. Consanguinity and ocular disorders in India: Electronic medical records driven big data analytics. Indian J Ophthalmol 2022; 70:2401-2407. [PMID: 35791120 PMCID: PMC9426102 DOI: 10.4103/ijo.ijo_1553_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Purpose: To describe the distribution of ocular disorders in patients with a family history of consanguinity presenting to a multi-tier ophthalmology hospital network in India. Methods: This cross-sectional hospital-based study included 2,805,267 new patients presenting between August 2010 and April 2021. Patients with a family history of consanguinity were included as cases. The sociodemographic and clinical data were collected using an electronic medical record system. Results: Overall, 20,445 (0.73%) new patients were documented to have a family history of consanguinity. The prevalence rates were 4.04% in children (age: <16 years) and 0.21% in adults. The mean age of the patients was 11.87 ± 11.06 years. The majority of the patients were males (56.48%) and students (54.43%) by profession. The majority (93.05%) of the patients were in the 0–30-years age bracket, with over half of them (53.71%) presenting in the first decade of life. A significant number of patients were from higher socioeconomic status (73.48%) and the rural region (47.62%). The most common degree of consanguinity documented was second degree (3.95%). The most common ocular disorders associated with a high proportion of consanguinity were congenital hereditary endothelial dystrophy (CHED) (100%), corneal macular dystrophy (83.78%), xeroderma pigmentosum (80.95%), and ocular albinism (73.59%). A tenth of the patients (9.8%) reported a similar history of ocular disorders among the family members and more commonly among the siblings (70.4%). Conclusion: Consanguineous marriages are not uncommon in India. They cause ocular disorders that cause visual impairment in a significant majority of those affected in their early decades of life. Genetic counseling plays a role in prevention.
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Affiliation(s)
- Divya Rauniyar
- Bausch and Lomb School of Optometry, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | - Anthony Vipin Das
- Department of eyeSmart EMR and AEye; Indian Health Outcomes, Public Health and Economics Research Center, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
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Tyagi M, Das AV, Kaza H, Basu S, Pappuru RR, Pathengay A, Murthy S, Agrawal H. LV Prasad Eye Institute EyeSmart electronic medical record-based analytics of big data: LEAD-Uveitis Report 1: Demographics and clinical features of uveitis in a multi-tier hospital based network in Southern India. Indian J Ophthalmol 2022; 70:1260-1267. [PMID: 35326028 PMCID: PMC9240530 DOI: 10.4103/ijo.ijo_1122_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Purpose To describe the demographics and epidemiology of uveitis presenting to a multi-tier ophthalmology hospital network in Southern India. Methods Cross-sectional hospital-based study of 19,352 patients with uveitis presenting between March 2012 and August 2018. Results In total, 1,734,272 new patients were seen across the secondary and tertiary centers of our multi-tier ophthalmology hospital network during the study period. Among them, 25,353 eyes of 19,352 patients were diagnosed with uveitis and were included in the study. Uveitis constituted 1.11% of all cases. The majority of patients were male (60.33%) and had unilateral (68.09%) affliction. The most common age group was 21-50 years with 12,204 (63.06%) patients. The most common type of uveitis was anterior uveitis, which was seen in 7380 (38.14%) patients, followed by posterior uveitis in 5397 (23.89%) patients. Among the infectious causes, tuberculosis was the most common etiology (2551 patients, 13%) followed by toxoplasmosis (1147 patients, 6%). Conclusion Uveitis constituted 1.11% of all cases presenting to our clinics. It was more common in the age group of 21-50 and was predominantly unilateral. Anterior uveitis was the most common subtype seen in 38%.
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Affiliation(s)
- Mudit Tyagi
- Uveitis and Ocular Immunology Services; Srimati Kanuri Santhamma Center for Retina & Vitreous Diseases, L V Prasad Eye Institute, Hyderabad, India
| | - Anthony Vipin Das
- Department of eyeSmart EMR & AEye, L V Prasad Eye Institute, Hyderabad, India
| | - Hrishikesh Kaza
- Uveitis and Ocular Immunology Services, L V Prasad Eye Institute, Hyderabad, India
| | - Soumyava Basu
- Uveitis and Ocular Immunology Services, L V Prasad Eye Institute, Hyderabad; Retina and uveitis service, L V Prasad Eye Institute, Bhubaneswar, India
| | - Rajeev R Pappuru
- Uveitis and Ocular Immunology Services; Srimati Kanuri Santhamma Center for Retina & Vitreous Diseases, L V Prasad Eye Institute, Hyderabad, India
| | - Avinash Pathengay
- Retina and Uveitis Department, GMR Varalakshmi Campus, L V Prasad Eye Institute, Visakhapatnam, Andhra Pradesh, India
| | - Somasheila Murthy
- Uveitis and Ocular Immunology Services; The Cornea Institute, L V Prasad Eye Institute, Hyderabad, India
| | - Hitesh Agrawal
- Uveitis and Ocular Immunology Services; Srimati Kanuri Santhamma Center for Retina & Vitreous Diseases, L V Prasad Eye Institute, Hyderabad, India
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Das AV, Narayanan R, Rani PK. Effect of COVID-19 Pandemic on Presentation of Patients With Diabetic Retinopathy in a Multitier Ophthalmology Network in India. Cureus 2021; 13:e19148. [PMID: 34873499 PMCID: PMC8631499 DOI: 10.7759/cureus.19148] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2021] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE This study aimed to describe the demographics and clinical profile of patients with diabetic retinopathy (DR) presenting during the novel coronavirus disease 2019 (COVID-19) lockdown and unlock phases in India. METHODS This hospital-based cross-sectional study included patients presenting from March 25, 2019, to March 31, 2021. All patients who presented with DR were included as cases. The data were collected using an electronic medical record system. RESULTS In total, 88,012 patients diagnosed with retinal diseases were presented to the network and included for analysis. There were 21,271 (24%) DR patients during the study period and the majority were men (71%) from the urban area (45%). An increasing number of patients with proliferative DR (56%), sight-threatening DR (79%), need for vitreoretinal procedures (31%), and intravitreal injections (19%) were seen during the lockdown (phase one-four). There was a significant increase in the number of patients with blindness in pre-lockdown (20%), lockdown (32%), and post-lockdown (26%). Patterns of sight-threatening DR and blindness were similar in both fresh and follow-up patients. CONCLUSION The presentation of DR patients in hospital is evolving because of the COVID-19 pandemic. The footfalls of patients during the unlock (phase 1-10) regained to two-thirds of the pre-COVID-19 level. There was an increase in patients with sight-threatening DR and the need for vitreoretinal surgery and intravitreal injections during the lockdown (phase 1-4).
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Affiliation(s)
- Anthony V Das
- Department of eyeSmart Electronic Medical Record (EMR) and AEye, L. V. Prasad Eye Institute, Hyderabad, IND
| | - Raja Narayanan
- Department of Vitreoretinal Diseases, L. V. Prasad Eye Institute, Hyderabad, IND
| | - Padmaja K Rani
- Department of Vitreoretinal Diseases/Tele-Ophthalmology, L. V. Prasad Eye Institute, Hyderabad, IND
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Das AV, Pillutla NL, Chaurasia S. Clinical profile and demographic distribution of Terrien's marginal degeneration in a multitier ophthalmology network in India. Indian J Ophthalmol 2021; 69:3482-3486. [PMID: 34826979 PMCID: PMC8837287 DOI: 10.4103/ijo.ijo_609_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose: To describe the clinical profile and demographic distribution of Terrien’s marginal degeneration (TMD) in patients presenting to a multitier ophthalmology hospital network in India. Methods: This cross-sectional hospital-based study included 2,470,793 new patients presenting between September 2012 and September 2020 (~8 years period). Patients with a clinical diagnosis of TMD in at least one eye were included as cases. The data were collected using an electronic medical record system. Results: Overall, 184 (0.007%) new patients were diagnosed. Over half of patients were males (56.52%) with bilateral affliction (54.89%). The mean age of the patients was 38.63 ± 16.75 years. Majority (28.26%) of the patients were between 21 and 30 years of age bracket. The number of patients were from rural and urban districts were comparable (41.85% vs. 48.37%). The most common clinical signs were ectasia/thinning (50.53%), corneal scar (44.21%), and prominent nerves (5.26%). Associated ocular comorbidities included vernal keratoconjunctivitis in 6 (2.11%) eyes, meibomitis in 6 (9.7%) eyes, squamous blepharitis in 2 (3.2%) eyes, dry eye in 2 (3.2%) eyes, cataract in 46 (74.2%) eyes, and glaucoma in 6 (9.7%) eyes. Most of the eyes had mild or no visual impairment (43.86%). Two (0.7%) eyes had spontaneous perforation patients. None of patients had hydrops in the years of follow-up. Keratoplasty was performed in 3.86%. Conclusion: TMD is a rare disease affecting patients seeking eye care at the ophthalmology network. It commonly affects adult males and is predominantly bilateral. The disease progression is slow, and risk of spontaneous perforation was low. At initial presentation, visual impairment was mild to moderate in majority and the most common surgical intervention was cataract surgery during the study period.
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Affiliation(s)
- Anthony V Das
- Department of eyeSmart EMR and AEye, L V Prasad Eye Institute, Hyderabad, Telangana, India, , Hyderabad
| | - Nimeshika L Pillutla
- Department of eyeSmart EMR and AEye, L V Prasad Eye Institute, Hyderabad, Telangana, India, , Hyderabad
| | - Sunita Chaurasia
- Cornea and Anterior Segment Services, L V Prasad Eye Institute, Hyderabad, Telangana, India
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Das AV, Pillutla LN, Chaurasia S. Clinical profile and demographic distribution of pellucid marginal corneal degeneration in India: A study of 559 patients. Indian J Ophthalmol 2021; 69:3488-3493. [PMID: 34826981 PMCID: PMC8837343 DOI: 10.4103/ijo.ijo_553_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose: The aim of this study was to describe the clinical profile and demographic distribution of pellucid marginal corneal degeneration (PMD) in patients presenting to a multitier ophthalmology hospital network in India. Methods: This cross-sectional hospital-based study included 2,470,793 new patients presenting between September 2012 and September 2020 (~8 years period). Patients with a clinical diagnosis of PMD in at least one eye were included as cases. The data were collected using an electronic medical record system. Results: Overall, 559 (0.02%) new patients were diagnosed with PMD. The prevalence rates were 0.004% in children (age <16 years) and 0.03% in adults. The majority of patients were males (70.13%) with the bilateral affliction (77.1%). The mean age of the patients was 37.91 ± 13.19 years. The majority (30.23%) of the patients were between 31 and 40 years of age. A significant number of patients were from higher socioeconomic status (93.74%) and from the urban region (45.08%). Of the 990 eyes, the most common clinical signs were ectasia/thinning (58.99%), corneal scar (17.47%), and corneal hydrops (1.01%). The majority of the eyes (87.97%) were managed with either spectacles or contact lenses. Among those who had surgical intervention, collagen cross-linking was the most performed procedure (5.25%) followed by cataract surgery (4.14%). Conclusion: PMD is a rare disease affecting patients seeking eye care in India. It commonly affects adult males and is bilateral in nature. The disease progression is slow and usually occurs beyond 3 years. Conservative management is more common than surgical intervention.
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Affiliation(s)
- Anthony V Das
- Department of eyeSmart EMR and AEye, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Lalitha N Pillutla
- Department of eyeSmart EMR and AEye, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sunita Chaurasia
- Cornea and Anterior Segment Services, L V Prasad Eye Institute, Hyderabad, Telangana, India
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Das AV, Chaurasia S, Joseph J, Roy A, Das S, Fernandes M. Clinical profile and microbiological trends of therapeutic keratoplasty at a network of tertiary care ophthalmology centers in India. Int Ophthalmol 2021; 42:1391-1399. [PMID: 34822053 PMCID: PMC8613725 DOI: 10.1007/s10792-021-02127-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 11/12/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe the clinical profile and microbiology trends in patients undergoing therapeutic keratoplasty at a multi-tier ophthalmology hospital network in India. METHODS This cross-sectional hospital-based study included 3147 eyes undergoing therapeutic keratoplasty between Jan 2016 and Dec 2020 (5 years period) as cases. The demographic data, clinical profile and microbiological analysis were collected using an electronic medical record system. RESULTS Of a total of 13,625 eyes with microbial keratitis(non-viral), 3147 (23.1%) underwent therapeutic keratoplasty during the study duration. Majority of patients were males (68.35%), from a rural geography (49.89%) and in 51-60 years age bracket (23.74%). The mean age of the patients was 50.54 ± 15.83 years. Two-thirds of patients were from lower socio-economic strata (66.63%) with an agrarian background (36.51%). Of the 3,147 eyes, fungus (51.8%) was the most common indication of therapeutic keratoplasty followed by bacteria (16.87%) and parasite (1.27%). No organisms could be identified in about a third (29.33%) of the cases. Between 2016 and 2020, the trend of therapeutic keratoplasties for fungal infections steadily grew (39.9% vs 45.49%) while the bacterial infections showed a steady decline (23.15% vs 11.81%). CONCLUSIONS Medical cure rate was seen in majority of those with microbial keratitis, and 23.1% eventually required management with therapeutic keratoplasty. Fungal keratitis was the most common indication for therapeutic keratoplasty. Male gender, rural setting, low socio-economic background and agricultural occupation are common risk factors for patients undergoing therapeutic keratoplasty in India.
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Affiliation(s)
- Anthony Vipin Das
- Department of eyeSmart EMR and AEye, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sunita Chaurasia
- Cornea and Anterior Segment Services, L V Prasad Eye Institute, Hyderabad, 500034, Telangana, India.
| | - Joveeta Joseph
- Jhaveri Microbiology Center, Brien Holden Eye Research Center, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | - Aravind Roy
- Kode Venkatadri Chowdary Campus, L V Prasad Eye Institute, Vijayawada, India
| | - Sujata Das
- Mithu Tulsi Chanrai Campus, L V Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Merle Fernandes
- Grandhi Mallikarjun Rao Varalakshmi Campus, L V Prasad Eye Institute, Vishakhapatnam, Andhra Pradesh, India
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Das AV, Prashanthi GS, Das T, Narayanan R, Rani PK. Clinical profile and magnitude of diabetic retinopathy: An electronic medical record-driven big data analytics from an eye care network in India. Indian J Ophthalmol 2021; 69:3110-3117. [PMID: 34708751 PMCID: PMC8725066 DOI: 10.4103/ijo.ijo_1490_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose: This study aimed to describe the clinical profile and magnitude of diabetic retinopathy (DR) in patients presenting to a multitier eye hospital network in India. Methods: This cross-sectional hospital-based study included 263,419 individuals with diabetes mellitus (DM) presenting between February 2012 and February 2021 (9-year period). The data were collected using an electronic medical record (EMR). Patients with a clinical diagnosis of DR in at least one eye were included in the analysis. Severe nonproliferative DR/proliferative DR/diabetic macular edema (DME) were considered sight-threatening DR (STDR). Results: In the study period, 25% (n = 66,913) were new patients diagnosed with DR. The majority of patients were males (70%). The mean age of the patients was 57 ± 10 years. The risk factors for DR were increased age: 30 to 50 years (odds ratio [OR] = 2.42), and 51 to 70 years (OR = 3.02), increased duration of DM: 6 to 10 years (OR = 2.88) and >10 years (OR = 6.52), blindness (OR = 2.42), male gender (OR = 1.36), lower socioeconomic status (OR = 1.43), and rural habitation (OR = 1.09). STDR was seen in 58% (n = 38,538) of examined patients. Risk factors for STDR were increased age 31 to 50 years (OR = 3.51), increased duration of DM: 6 to 10 years (OR = 1.23) and >10 years (OR = 1.68), blindness (OR = 3.68), male gender (OR = 1.12), and higher socioeconomic status (OR = 1.09). Conclusion: Every fourth person with DM was found to have DR, and every second person with DR had STDR in this study cohort. These real-world big data might provide greater insight into the current status of DR. Additional big data from similar EMR-based sources will help in planning and resource allocation.
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Affiliation(s)
- Anthony Vipin Das
- Department of EyeSmart EMR and AEye; Indian Health Outcomes, Public Health, and Economics Research Center, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Gumpili Sai Prashanthi
- Department of EyeSmart EMR and AEye; Indian Health Outcomes, Public Health, and Economics Research Center, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Taraprasad Das
- Smt. Kanuri Santhamma Center for Vitreo-Retinal Diseases, Hyderabad, Telangana, India
| | - Raja Narayanan
- Smt. Kanuri Santhamma Center for Vitreo-Retinal Diseases; Indian Health Outcomes, Public Health, and Economics Research Center, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Padmaja Kumari Rani
- Smt. Kanuri Santhamma Center for Vitreo-Retinal Diseases, Hyderabad, Telangana, India
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Abstract
Big data holds great promise to help unravel insights to bridge the gap in human understanding. There has to be an emphasis on the quality of the data points being collected to ensure meaningful analysis. India has made significant strides to lay down a strong framework through the National Digital Health Blueprint and the National Health Stack for the future. There is a need to focus on the first important step of collection of a “good quality” data point through the implementation of electronic medical records by the health care providers. In India, 60 million individuals move below the poverty line every year because of the expenses related to unforeseen illness that adversely affects the individual's welfare and the nation's economic growth. With an out-of-pocket expense rate currently at 70% and the government's health budget at a mere 1.3% of its GDP (gross domestic product), data-driven decisions are the need of the hour for policy making and to ensure equitable, efficient, and excellent delivery of health care. There is a huge potential to harness the power of big data to generate insights to address the four big challenges of health care in India – availability, accessibility, affordability, and acceptability.
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Affiliation(s)
- Anthony Vipin Das
- Department of eyeSmart EMR and AEye; Indian Health Outcomes, Public Health and Economics Research Center, L V Prasad Eye Institute, Hyderabad, Telangana, India, Telangana
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Rajendrababu S, Durai I, Mani I, Ramasamy KS, Shukla AG, Robin AL. Urgent and emergent glaucoma care during the COVID-19 pandemic: An analysis at a tertiary care hospital in South India. Indian J Ophthalmol 2021; 69:2215-2221. [PMID: 34304213 PMCID: PMC8482884 DOI: 10.4103/ijo.ijo_635_21] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Purpose: To describe the demographic profiles, clinical characteristics, and clinical outcomes of patients presenting with glaucoma emergencies during the COVID-19 lockdown in India. Methods: This retrospective, cross-sectional, observational case series involved review of medical records of all patients presenting to the glaucoma service during the COVID-19 lockdown period and comparison with the previous year (March 23 to June 23, 2020 Vs 2019) in a tertiary center in India. Results: We found a 78.9% reduction in overall outpatient visits (54,345 vs. 257,339; P < 0.001) and 80.9% reduction in the number of glaucoma outpatient visits (4,788 vs. 25,083; P < 0.001). Additionally, the proportion of true glaucoma emergency visits significantly increased by 62.4% in 2020 Vs 2019 (1,408/4,788 (29.4%) vs. 4,542/25,083 (18.1%); P < 0.001). Lens-induced glaucomas were the most common glaucoma surgical emergency (13.4%) in 2020. Moreover, comparison of procedures demonstrated a proportionate decrease in incisional glaucoma surgeries (70/115 (60.86%) vs. 806/939 (85.83%); P < 0.001) and an increase in the proportion of emergency cataract surgeries (129/475 (27.15%) vs. 170/2715 (6.26%); P < 0.001) and transscleral cyclophotocoagulation (45/115 (39.13%) vs. 133/939 (14.16%); P = 0.0001) during 2020 vs. 2019. Conclusion: Our study demonstrated a 62% increase in the proportion of visits that were true glaucoma emergencies. Additionally, the proportions of emergency cataract surgeries increased by 4.3 times and the proportion of transscleral cyclophotocoagulation increased by 2.8 times during the pandemic. More nonincisional procedures and less diagnostic testing were performed to minimize postoperative visits and virus transmission. Further understanding of the profile of emergencies may help in developing novel strategies to anticipate future challenges in managing glaucoma care during subsequent waves of the pandemic.
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Das AV, Mohamed A, Chaurasia S. Recent indications of endothelial keratoplasty at a tertiary eye care center in South India. Int Ophthalmol 2021; 41:3277-3285. [PMID: 34021829 DOI: 10.1007/s10792-021-01889-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 05/12/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To describe the patient demographics and recent clinical indications of endothelial keratoplasty (EK) in patients presenting to a tertiary eye care center in India. METHODS This cross-sectional hospital-based study included 2,182 patients who underwent EK between Jan 2016 and Dec 2019 (4 years period). The data were collected using an electronic medical record system. RESULTS Overall, 2,632 eyes of 2,182 patients underwent EK during the study period. Median age was 62 (IQR: 48-70) years and adults (94.45%) comprised most of the cohort. More commonly, the patients were male (55.59%) and from the higher socioeconomic strata (67.51%). The corneal signs included corneal edema (70.93%), corneal scarring (29.60%), corneal vascularization (16%) and guttae (12.88%). The major indications of EK were post-cataract surgery corneal edema in 1331 (50.57%) patients, endothelial dystrophy in 537 (20.4%) patients, failed graft in 535 (20.33%) patients causing a vision impairment of > 20/400-20/1200 in about a half (45.55%) of the patients. Descemet stripping endothelial keratoplasty (DSEK) and Descemet membrane endothelial keratoplasty (DMEK) were performed in 2075 (78.84%) and 557(21.16%) patients, respectively. CONCLUSION EK is commonly performed during the sixth decade of life and in males. The most performed procedure is DSEK. The commonest indication was post-cataract surgery corneal edema.
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Affiliation(s)
- Anthony Vipin Das
- Department of eyeSmart EMR & AEye, L V Prasad Eye Institute, Hyderabad, India
| | - Ashik Mohamed
- Ophthalmic Biophysics, L V Prasad Eye Institute, Hyderabad, India
| | - Sunita Chaurasia
- The Cornea Institute, L V Prasad Eye Institute, L V Prasad Marg, Banjara Hills, , Hyderabad, 500034, Telangana, India. .,Ramayamma International Eye Bank, L V Prasad Eye Institute, Hyderabad, India.
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Das AV, Chaurasia S. Clinical Profile and Demographic Distribution of Corneal Dystrophies in India: A Study of 4198 Patients. Cornea 2021; 40:548-553. [PMID: 32740009 DOI: 10.1097/ico.0000000000002450] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/03/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe the clinical profile and demographic distribution of corneal dystrophy in patients presenting to a multitier ophthalmology hospital network in India. METHODS This cross-sectional hospital-based study included 2,151,584 new patients presenting between March 2012 and December 2019 (∼8 year period). Patients with a clinical diagnosis of corneal dystrophy in at least 1 eye were included as cases. The data were collected by using an electronic medical record system. RESULTS Overall, 4198 new patients (0.20%) were diagnosed with corneal dystrophy. The prevalence rates were 0.19% in children (age < 16 years) and 0.20% in adults. Most patients were women (51.86%). The mean age of the patients was 43.61 ± 21.39 years. Most patients (18.79%) were between 61 and 70 years of age. The most common anatomical location of the dystrophy was endothelium (51.71%), followed by stroma (43.55%) and Bowman membrane/epithelium (4.73%). The most common corneal dystrophy was Fuch endothelial corneal dystrophy (41.89%). Most eyes had mild or no visual impairment (43.43%). Of the 8193 eyes, 998 eyes (12.18%) underwent a corneal surgery. Among those who underwent surgical intervention, endothelial keratoplasty was the most commonly performed surgical procedure (52%), followed by penetrating keratoplasty (22%). CONCLUSIONS Corneal dystrophy is a rare disease, affecting patients seeking eye care in India. Endothelial dystrophies were the most common, followed by stromal dystrophies. Among the stromal dystrophies, macular dystrophy was the most common. At initial presentation, visual impairment was mild to moderate in most patients, and surgical intervention was needed in 12.18% of the eyes during the study period.
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Affiliation(s)
- Anthony Vipin Das
- Department of eyeSmart EMR & AEye, L V Prasad Eye Institute, Hyderabad, Telangana, India; and
| | - Sunita Chaurasia
- Cornea and Anterior Segment Services, L V Prasad Eye Institute, Hyderabad, Telangana, India
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Kaliki S, Das AV. Ocular and Periocular Tumors in India: An EyeSmart Electronic Medical Record Analysis of 9633 Cases from a Referral Center. Middle East Afr J Ophthalmol 2021; 27:199-203. [PMID: 33814815 PMCID: PMC7993046 DOI: 10.4103/meajo.meajo_275_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/29/2020] [Accepted: 06/01/2021] [Indexed: 11/13/2022] Open
Abstract
PURPOSE: To describe the epidemiology of ocular and periocular tumors in patients presenting to a multi-tier ophthalmology hospital network in India using the electronic medical records (EMRs) system. METHODS: A retrospective, observational, referral, hospital-based study of 1,142,098 patients. The data were collected using the in-house developed EyeSmart EMR system. RESULTS: During a 6-year study period, 9633 (0.8%) new patients were diagnosed with eye tumors. Of the 9633 patients, 5209 (54%) were male and 4424 (46%) were female. Of all tumors, 6372 (65%) were benign, 282 (3%) were pre-malignant, and 3089 (32%) were malignant in nature, respectively. Overall, the three most common tumors included retinoblastoma (n = 1167, 12%), ocular surface squamous neoplasia (n = 957, 10%), and conjunctival nevus (n = 903, 9%). The three most common benign tumors included conjunctival nevus (n = 903, 9%), eyelid nevus (n = 358, 4%), and orbital dermoid cyst (n = 344, 4%). The three most common malignant tumors included retinoblastoma (n = 1167, 12%), ocular surface squamous neoplasia (n = 957, 10%), and sebaceous gland carcinoma (n = 202, 2%). The most common tumor in 0–10 years' age group was retinoblastoma (n = 1163, 42%), 11–30 years was conjunctival nevus (n = 408, 16%), and > 30 years was ocular surface squamous neoplasia (n = 801, 17%), respectively. CONCLUSIONS: The present study results indicate the incidence and distribution of ocular and periocular tumors in a large cohort in India. Retinoblastoma is the most common tumor encountered in a referral-based comprehensive ophthalmic oncology practice in India. The use of EMRs enables to capture the structured information and big data analysis of the same.
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Affiliation(s)
- Swathi Kaliki
- The Operation Eyesight Universal Institute for Eye Cancer (SK), L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Anthony V Das
- Department of EyeSmart EMR and AEye (AVD), L V Prasad Eye Institute, Hyderabad, Telangana, India
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Das AV, Basu S. Epidemic keratoconjunctivitis in India: electronic medical records-driven big data analytics report IV. Br J Ophthalmol 2020; 106:331-335. [PMID: 33229346 DOI: 10.1136/bjophthalmol-2020-317330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/17/2020] [Accepted: 11/07/2020] [Indexed: 11/03/2022]
Abstract
AIMS To describe the clinical profile of epidemic keratoconjunctivitis (EKC) in patients presenting to a multitier ophthalmology hospital network in India. METHODS This retrospective hospital-based study included 2 408 819 patients presenting between August 2010 and February 2020. Patients with a clinical diagnosis of EKC in at least one eye with a recent onset (≤1 week) were included as cases. The data were collected using the eyeSmart electronic medical record system. RESULTS Overall, 21 196 (0.9%) new patients were diagnosed with EKC, of which 19 203 (90.6%) patients reported a recent onset (≤1 week) and were included for analysis. The median age was 32 (IQR: 22-45) years and adults (84.5%) were commonly affected. Most of the patients were male (62.1%) and unilateral (53.4%) affliction was commoner. The most common presenting symptom was redness (63.7%), followed by watering (42.1%). Preauricular lymphadenopathy or tenderness was documented in 1406 (7.3%) cases at presentation. A minority of the eyes had visual impairment worse than 20/200 (7.8%) due to associated ocular comorbidities. The involvement of the cornea was seen in 7338 (38.2%) patients and corneal signs included subepithelial infiltrates (26.3%), epithelial defect (1.4%), corneal oedema (0.9%) and filaments (0.4%). Of the patients who had corneal involvement, 496 (2.6%) patients had a chronic course beyond 1 month of which 105 (0.5%) had a course beyond 1 year. CONCLUSION EKC is a self-limiting condition that is commonly unilateral and predominantly affects males. About one-third of the patients have corneal involvement which rarely has a chronic course.
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Affiliation(s)
- Anthony Vipin Das
- Department of eyeSmart EMR & AEye, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sayan Basu
- The Cornea Institute, LV Prasad Eye Institute, Hyderabad, Telangana, India
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Garrigan H, Ifantides C, Prashanthi GS, Das AV. Biogeographical and Altitudinal Distribution of Cataract: A Nine-Year Experience Using Electronic Medical Record-Driven Big Data Analytics in India. Ophthalmic Epidemiol 2020; 28:392-399. [PMID: 33213243 DOI: 10.1080/09286586.2020.1849741] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Purpose: To use electronic medical record data to study the altitude, UV exposure, and biogeographical distribution of senile cataract in India.Methods: This is a hospital-based, cross-sectional study of patients over 40 years old with an ophthalmologist-confirmed diagnosis of senile cataract (cortical, nuclear, posterior subcapsular, or a combination) in either or both eyes. Electronic medical record data entered between August 2010 to December 2019 were extracted from a large multi-tiered ophthalmology network in India. Residential districts were classified into their respective biogeographical zone based on nationally reported boundaries, and altitude at the geographic centroid was determined using Google Earth. Occupations were classified as low UV exposure and high UV exposure. Descriptive statistics, hypothesis testing, and multiple logistic regression analysis were done.Results: In the 1,127,232 eligible patients, associations were found between high UV exposure (OR = 1.47, 95%CI: 1.45-1.49), low socioeconomic status (OR = 1.54, 95%CI: 1.52-1.55), rural geographies (OR = 1.32), female gender (OR = 1.33, 95%CI: 1.32-1.34), and older age (OR≥3.98) with cataract. This Indian patient population did not demonstrate increased formation of cataracts at higher altitudes (OR≤0.97). Patients residing in the Deccan Peninsula (OR≥1.56) and those with high UV exposures within each increasing altitude category, except >750 m, (OR≥1.09) had higher odds of senile cataract comparatively.Conclusion: Female gender, occupations with high UV exposure, rural geography and increasing age were observed to have greater odds of developing senile cataract. Increased likelihood of cataracts in populations residing at low altitudes and within the Deccan Peninsula may be attributed to greater hospital development in those areas.
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Affiliation(s)
- Hannah Garrigan
- Sidney Kimmel Medical College and College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA
| | - Cristos Ifantides
- Department of Ophthalmology, University of Colorado/Denver Health, Denver, CO, USA
| | | | - Anthony Vipin Das
- Department of eyeSmart EMR & AEye, LV Prasad Eye Institute, Hyderabad, Telangana, India
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Khanna RC, Marmamula S, Cicinelli MV, Mettla AL, Giridhar P, Banerjee S, Shekhar K, Chakrabarti S, Murthy GVS, Gilbert CE, Rao GN. Fifteen-year incidence rate and risk factors of pterygium in the Southern Indian state of Andhra Pradesh. Br J Ophthalmol 2020; 105:619-624. [PMID: 32732344 DOI: 10.1136/bjophthalmol-2020-316359] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 05/20/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE To report 15-year incidence rate and associated risk factors of pterygium among people aged 30 years and above at baseline in the rural clusters of longitudinal Andhra Pradesh Eye Disease Study (APEDS III). METHODS The baseline APEDS I included 7771 participants of which 6447 (83%) were traced and 5395 (83.7%) were re-examined in APEDS III. To estimate the incidence of pterygium, we selected participants who were 30 years and above at baseline (4188), of which 2976 were traced and 2627 (88.3%) were examined, and based on inclusion criteria, 2290 participants were included in the study. The incidence rate of pterygium was defined as the proportion of people free of pterygium at baseline who had developed the condition at 15-year follow-up (range 13-17 years). Univariate and multivariable analyses for risk factors were undertaken. RESULTS The sex-adjusted incidence rate of pterygium was 25.2 per 100 person-years (95% CI 24.8 to 25.7) which was significantly higher for men than women (26.3 per 100 person-years (95% CI 25.6 to 27.0) and 24.7 (95% CI 24.1 to 25.3) respectively). At the multivariable analysis, male gender (RR: 1.35, 95% CI 1.0 to 1.83), no formal education (RR: 2.46, 95% CI 1.22 to 4.93), outdoor occupation (RR: 1.47, 95% CI 1.14 to 1.9) and lower body mass index (BMI) (<18.5) (RR: 1.25, 95% CI 1.02 to 1.55) were associated with increased risk of pterygium. CONCLUSIONS The overall incidence rate of pterygium was high in this rural population, especially in men and those engaged in outdoor activities, lack of formal education and with lower BMI. It is likely that greater exposure to ultraviolet light is a major contributing factor, thus warranting preventive strategies.
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Affiliation(s)
- Rohit C Khanna
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- University of Rochester, School of Medicine and Dentistry, Rochester, NY, USA
| | - Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- Wellcome Trust/Department of Biotechnology India Alliance Research Fellow, LV Prasad Eye Institute, Hyderabad, India
| | - Maria Vittoria Cicinelli
- Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele, via Olgettina 60, 20132, Milan, Italy
| | - Asha Latha Mettla
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
| | - Pyda Giridhar
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
| | - Seema Banerjee
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
| | - Konegari Shekhar
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
| | - Subhabrata Chakrabarti
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
| | - Gudlavalleti V S Murthy
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Indian Institute of Public Health, Hyderabad, India
| | - Clare E Gilbert
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Gullapalli Nageswara Rao
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
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Das AV, Dave TV. Demography and Clinical Features of Chalazion Among Patients Seen at a Multi-Tier Eye Care Network in India: An Electronic Medical Records Driven Big Data Analysis Report. Clin Ophthalmol 2020; 14:2163-2168. [PMID: 32801626 PMCID: PMC7395707 DOI: 10.2147/opth.s263146] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 06/23/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To describe the prevalence, demographics and clinical presentations of chalazion in patients presenting to a multi-tier ophthalmology network in India. Materials and Methods This was a cross-sectional observational multi-centric hospital-based study of 1,982,058 new patients presenting between 2010 and 2019. Patients with both symptoms and signs of chalazion were considered as subjects. The data were retrieved using an electronic medical record system. Results Overall, 11,270 (0.57%) new patients were diagnosed with chalazion. Of these, 1,085 (10%) patients had recurrent chalazia. The prevalence rates were 0.95% in children and 0.51% in adults. Males accounted for 51% of the cases, and 79% had unilateral affliction. The commonest age group affected was the third decade of life (31%). Of the 13,691 affected eyes with chalazion, 39% were located in the upper eyelid, 6% were lateral in position and 3% have multiple swellings at presentation. Conservative treatment was the preferred treatment modality in 85%. Incision and curettage were performed in 15% eyes and intralesional steroid in 0.55% eyes. Of the 15% patients that were advised surgery, 9% underwent the procedure with a conversion rate of 58%. Conclusion Only a miniscule percentage of patients seeking eye care in India are affected by chalazion. It is slightly more common in males and is usually unilateral and largely affects the upper eyelids. It is recurrent in a tenth of the cases. Conservative management is the preferred modality.
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Affiliation(s)
- Anthony Vipin Das
- Department of eyeSmart EMR & AEye, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Tarjani Vivek Dave
- Ophthalmic Plastic Surgery Service, L V Prasad Eye Institute, Hyderabad, Telangana, India
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Das AV, Narayanan R. Demographics and clinical presentation of patients with ocular disorders during the COVID-19 lockdown in India: A report. Indian J Ophthalmol 2020; 68:1393-1399. [PMID: 32587174 PMCID: PMC7574071 DOI: 10.4103/ijo.ijo_1171_20] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Purpose: The aim of this study is to describe the demographics and clinical profile of patients with ocular disorders presenting during the novel coronavirus (COVID-19) lockdown in India. Methods: This cross-sectional hospital-based study included patients presenting between March 23, 2020 and April 19, 2020. All patients who presented to the emergency department were included as cases. The data were collected using an electronic medical record system. Results: Overall, 1,192 patients (mean 42.57 per day) presented to the ocular emergency department and were included for analysis. The median age of the patients was 35 (Interquartile range, IQR: 20-52) years and they were mostly adults (77.85%). The majority of patients were male (62.16%) and presented from the local metropolitan region (56.21%). On triaging based on the ocular disorders at presentation, the majority of the patients were emergency related (65.02%), followed by urgent (8.14%) and routine (26.85%) in nature. The most common emergencies were microbial keratitis (23.74%), followed by corneal trauma (16.39%). There was an increasing trend seen in emergency patients (46.11%; week 1 to 71.78%; week 4) and a decreasing trend seen in routine patients (45%; week1 to 21.20%; week 4). A subset of patients (23.49%) underwent surgery where indicated and the most commonly performed procedures were vitreo-retinal procedures (32.86%) followed by trauma related (31.43%). Conclusion: The enforcement of the nationwide lockdown due to COVID-19 resulted in a fewer patients presenting to the hospital. The majority of them presented from the local metropolitan region and the common emergencies were microbial keratitis and corneal trauma. About one fourth required a surgical intervention which was most commonly a vitreo-retinal procedure.
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Affiliation(s)
- Anthony Vipin Das
- Department of eyeSmart EMR and AEye, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Raja Narayanan
- Smt. Kanuri Santhamma Center for Vitreo-retinal Diseases, L V Prasad Eye Institute, Hyderabad, Telangana, India
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Das AV, Rani PK, Vaddavalli PK. Tele-consultations and electronic medical records driven remote patient care: Responding to the COVID-19 lockdown in India. Indian J Ophthalmol 2020; 68:1007-1012. [PMID: 32461415 PMCID: PMC7508108 DOI: 10.4103/ijo.ijo_1089_20] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Purpose: To describe the experience of tele-consultations addressed at the centre of excellence of a multi-tier ophthalmology hospital network in India during the ongoing novel coronavirus (COVID-19) lockdown. Methods: This cross-sectional hospital-based study included 7,008 tele-consultations presenting between March 23rd and April 19th 2020. A three-level protocol was implemented to triage the calls. The data of patient queries were collected using a Google Form/Sheets and the tele-calls were returned using the patient information retrieved from the electronic medical record system. Results: Overall, 7,008 tele-calls were addressed, of which 2,805 (40.02%) patients where a clinical-related query was answered were included for analysis. The most common queries were related to redness/pain/watering/blurring of vision (31.52%), closely followed by usage of medications (31.05%). The majority of the queries were directed to the department of cornea (34.15%), followed by retina (24.74%). Less than one-fifth of the patients were from the lower socio-economic class (16.08%) and one-fourth were new patients (23.96%). The most common advice given to the patient was related to management of medications (54.15%) followed by appointment related (17.79%). Emergency requests requiring further evaluation by an ophthalmologist accounted for a small percentage (16.36%) of patients. Conclusion: Tracking of tele-consultations and access to patient information from the electronic medical records enabled a timely response in an ongoing lockdown due to the COVID-19 pandemic. The current experience provided valuable insights to the possibility of managing patient follow-up visits remotely in the future.
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Affiliation(s)
- Anthony V Das
- Department of eyeSmart EMR and AEye; Department of Tele Ophthalmology; Indian Health Outcomes Public Health and Economics Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Padmaja K Rani
- Department of Tele Ophthalmology, L V Prasad Eye Institute, Hyderabad, Telangana, India
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