Effect of oculomotor exercises in patients with non-specific chronic neck pain and associated visual complaints

Background

Neck pain is a common musculoskeletal disorder, the most common type being non-specific chronic neck pain. It usually involves postural or mechanical causes. In Individuals with neck pain, a notable prevalence of visual complaints has been predominantly reported. It can be linked to the mismatch in the cervical afferent output.

Objective

This study aimed to assess the effect of oculomotor exercises on neck pain, neck disability, gaze stability and visual complaints among individuals with non-specific chronic neck pain and associated visual complaints.

Methods

A total of 32 individuals with non-specific chronic neck pain and associated visual complaints were equally randomised into two groups. To receive either: stretching to the sternocleidomastoid and anterior scalene along with neck Isometric exercises (Group A, conventional) or the conventional protocol along with oculomotor exercises (Group B, experimental). The protocol was given for three alternate days a week for three weeks, a total of nine sessions. The outcome measures were the Visual Analogue Scale (VAS) for pain, Neck Disability Index (NDI) for disability, Dynamic Visual Acuity (DVA) test for gaze stability and Visual Complaints Index (VCI) for visual complaints.

Results

Significant results were seen for the DVA (p = 0 . 002 ) and VCI (p = 0 . 024 ), suggesting improvements in gaze stability and visual complaints using oculomotor exercises.

Conclusion

From this study, we highlighted that oculomotor exercises along with conventional treatment led to improvement in visual complaints and gaze stability in patients with non-specific chronic neck pain and associated visual complaints.

Post-COVID-19 Physiotherapy Rehabilitation: A Case Report

Coronavirus Disease 2019 (COVID-19) is a severe disease mostly affecting the respiratory system. Even after the acute symptoms of COVID-19 subside, there are many post acute symptoms that are still present in the COVID-19 survivors. Post-COVID-19 fatigue is seen to affect people of all age groups. This case report emphasises on the Physiotherapy view point. There are very few studies showing the benefits of Physiotherapy exercises in Post-COVID-19 manifestations. A 21-year-old female presented to physiotherapy department. An 8-week Physiotherapy protocol was given and outcomes were assessed before and after the treatment protocol. The presented symptoms were found to be relieved, thus, showing the effectiveness of Physiotherapy in Post- COVID-19 phase.

Willingness to pay for cataract surgery in Kathmandu valley

AIM

A cross sectional study was carried out on 78 screened cataract patients of two screening camps in Kathmandu valley, Nepal, to assess the willingness to pay for cataract surgery.

METHODS

A non-probability sampling technique with open ended and close ended questionnaires was used.

RESULTS

The average age of patients was 68.8 years. The ratio of men and women was 0.9:1. 42.3% (33) of patients were willing to pay for cataract surgery. Among them 48.5% (16) of people were willing to pay less than dollars 13 and 51.5% (17) were willing to pay more than dollars 13. The mean was dollars 2.3 (SD dollars 15.5) per case. Patients with bilateral cataract were more willing to pay than unilateral cases. Poverty (44.4%, 20) was the main barrier for unwillingness to pay for cataract surgery. Other reasons were the lack of family support (28.9%, 13), lack of knowledge of surgery and belief that it was an unnecessary procedure (15.6%, seven), and waiting for a free surgical service (11.1%, five).

CONCLUSION

This study clearly indicates that although there was awareness of the availability of treatment and services provided within the reach, people are not willing to pay for the surgery and use the facility primarily because of poverty. Hence, to change patients' attitudes, a more holistic approach is needed, keeping in view the cultural, social, and economic background of the society.

Ketamine anaesthesia for paediatric ophthalmology surgery

AIMS

Children with treatable, vision impairing conditions may not have access to surgical care when they live in regions where anaesthesia is unavailable. The use of ketamine anaesthesia in a developing region was studied to determine its safety and effectiveness.

METHODS

This is a consecutive series of 679 children who had a variety of paediatric eye disorders necessitating a short general anaesthesia. Ketamine was administered intravenously by a paediatrician with training in paediatric resuscitation procedures. Both intraocular and extraocular procedures were performed. The location of treatment was the Tilganga Eye Hospital in Kathmandu, Nepal, a developing region of the world. The study took place over a 5 year period.

RESULTS

All procedures were performed without any anaesthetic complications. No child required unanticipated resuscitation or laryngeal intubation. Postoperative dysphoria occurred occasionally and was difficult to measure quantitatively. This side effect of ketamine resolved by the first postoperative day.

CONCLUSION

Ketamine is an effective agent for both intraocular and extraocular surgery in the paediatric age group. None of the children in this series needed resuscitation or intubations, and the ophthalmic surgery was carried out safely. Ketamine can be used safely in any ophthalmic procedure of short duration by a person having some training in anaesthetic resuscitation procedures. Because of its simplicity and safety, ketamine may be useful in a simple ophthalmic setup in the developing word.

Paediatric cataract blindness in the developing world: surgical techniques and intraocular lenses in the new millennium

Paediatric cataract blindness presents an enormous problem to developing countries in terms of human morbidity, economic loss, and social burden. Managing cataracts in children remains a challenge: treatment is often difficult, tedious, and requires a dedicated team effort. To assure the best long term outcome for cataract blind children, appropriate paediatric surgical techniques need to be defined and adopted by ophthalmic surgeons of developing countries. The high cost of operative equipment and the uneven world distribution of ophthalmologists, paediatricians, and anaesthetists create unique challenges. This review focuses on issues related to paediatric cataract management that are appropriate and suitable for ophthalmic surgeons in the developing world. Practical guidelines and recommendations have also been provided for ophthalmic surgeons and health planners dealing with childhood cataract management in the developing world.