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Naik A, Karthikeyan SK, Ramesh JJ, Bhaskar S, Ganapathi CA, Biswas S. An Insight into Knowledge, Perspective, and Practices of Indian Optometrists towards Childhood Myopia. Vision (Basel) 2024; 8:22. [PMID: 38651443 PMCID: PMC11036249 DOI: 10.3390/vision8020022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/25/2024] Open
Abstract
The current understanding of clinical approaches and barriers in managing childhood myopia among Indian optometrists is limited. This research underscores the necessity and relevance of evidence-based practice guidelines by exploring their knowledge, attitude, and practice towards childhood myopia. A self-administered internet-based 26-item survey was circulated online among practicing optometrists in India. The questions assessed the demographics, knowledge, self-reported clinical practice behavior, barriers, source of information guiding their management, and extent of adult caregiver engagement for childhood myopia. Of 393 responses, a significant proportion of respondents (32.6-92.4%) were unaware of the ocular complications associated with high myopia, with less than half (46.5%) routinely performing ocular biometry in clinical practice. Despite the growing awareness of emerging myopia management options, the uptake remains generally poor, with single-vision distance full-correction spectacles (70.3%) being the most common mode of vision correction. Barriers to adopting optimal myopia care are medicolegal concerns, absence of clinical practice guidelines, and inadequate consultation time. Own clinical experience and original research articles were the primary sources of information supporting clinical practice. Most (>70%) respondents considered involving the adult caregiver in their child's clinical decision-making process. While practitioners' awareness and activity of newer myopia management strategies are improving, there is plenty of scope for its enhancement. The importance of evidence-based practice guidelines and continuing education on myopia control might help practitioners enhance their clinical decision-making skills.
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Affiliation(s)
- Archana Naik
- Department of Optometry, Netra Jyothi Institute of Allied Health Sciences, Udupi 576101, Karnataka, India; (A.N.); (S.K.K.); (S.B.)
- Aloka Vision Programme, Carl Zeiss India Pvt. Ltd., Bangalore 560099, Karnataka, India
| | - Siddharth K. Karthikeyan
- Department of Optometry, Netra Jyothi Institute of Allied Health Sciences, Udupi 576101, Karnataka, India; (A.N.); (S.K.K.); (S.B.)
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India;
| | - Jivitha Jyothi Ramesh
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India;
| | - Shwetha Bhaskar
- Department of Optometry, Netra Jyothi Institute of Allied Health Sciences, Udupi 576101, Karnataka, India; (A.N.); (S.K.K.); (S.B.)
- Aloka Vision Programme, Carl Zeiss India Pvt. Ltd., Bangalore 560099, Karnataka, India
| | - Chinnappa A. Ganapathi
- Department of Paediatric Ophthalmology, Prasad Netralaya, Udupi 576101, Karnataka, India;
| | - Sayantan Biswas
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK
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Karthikeyan SK, Sundaram SM, Ve RS, Souza DD, Biswas S, Shetty MU. Design and development of a noninvasive ocular pressure estimator. Optom Vis Sci 2024; 101:164-172. [PMID: 38546758 DOI: 10.1097/opx.0000000000002114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Abstract
SIGNIFICANCE A snapshot intraocular pressure (IOP) is ineffective in identifying the IOP peak and fluctuation, especially during sleep. Because IOP variability plays a significant role in the progression of glaucoma, monitoring the IOP, especially during sleep, is essential to capture the dynamic nature of IOP. PURPOSE We aimed to design an ocular pressure estimator (OPE) that can reliably and accurately measure the IOP noninvasively over closed-eyelid condition. METHODS Ocular pressure estimator works on the principle that the external pressure applied by raising the IOP of the eyeball is transmitted through a compressible septum to the pressure sensor, thus recording the IOP. A fluid-filled pouch with a pressure sensor was placed over a rubber glove mimicking the eyelid (septum), covering the cornea of enucleated goat eyeballs. A pressure-controlled setup was connected to a goat cadaver eye, which was validated by a rebound tonometer. Cannulation of eyeballs through the lower limbus had the least difference from the control setup values documented using rebound tonometer, compared with cannulation through the optic nerve. Intraocular pressures ranging from 3 to 30 mmHg was induced, and the outputs recorded using OPE were amplified and recorded for 10 minutes (n = 10 eyes). We stratified the randomization of the number of times and the induced pressures. RESULTS The measurements recorded were found to be linear when measured against an IOP range of 3 to 30 mmHg. The device has excellent reliability (intraclass correlation coefficient, 0.998). The repeatability coefficient and coefficient of variations were 4.24 (3.60 to 4.87) and 8.61% (7.33 to 9.90), respectively. The overall mean difference ± SD between induced IOP and the OPE was 0.22 ± 3.50 (95% confidence interval, -0.35 to 0.79) mmHg across all IOP ranges. CONCLUSIONS Ocular pressure estimator offers a promising approach for reliably and accurately measuring IOP and its fluctuation noninvasively under a condition mimicking a closed eye.
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Affiliation(s)
- Siddharth K Karthikeyan
- Department of Optometry, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | | | - Ramesh S Ve
- Department of Optometry, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Donson D Souza
- Blackfrog Technologies Pvt Ltd, Manipal, Karnataka, India
| | | | - Mayur U Shetty
- Blackfrog Technologies Pvt Ltd, Manipal, Karnataka, India
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Puthran SV, Biswas S, Karthikeyan SK, Thomas J. Association of sunlight exposure with visual impairment in an Indian fishing community. Indian J Ophthalmol 2023; 71:2409-2415. [PMID: 37322650 PMCID: PMC10417968 DOI: 10.4103/ijo.ijo_2088_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 01/23/2023] [Accepted: 02/08/2023] [Indexed: 06/17/2023] Open
Abstract
Purpose Indian fishermen belong to a marginalized population and are continuously exposed to extreme occupational hazards and sunlight. A high prevalence of visual impairment (VI) is reported in the coastal fishing community. We aimed to investigate the association between VI and sunlight exposure measurement (SEM). Methods In this cross-sectional observational study, 270 eyes of 135 participants were enrolled from a coastal fishing village. Participants underwent a comprehensive ophthalmic examination, which included best-corrected visual acuity (BCVA), and anterior and posterior segment examination. Ocular Surface Disease Index (OSDI) and SEM questionnaire were administered to estimate the level of dry eye and ultraviolet-B (UV-B) exposure, respectively. VI was defined as presenting visual acuity worse than 6/12 (logarithm of the minimum angle of resolution [logMAR] > 0.3). Results The mean age and spherical equivalent were 50.56 ± 11.72 years (range: 18-80 years) and 0.36 ± 1.68 diopters (D) (range: -7.0 to +3.0 D), respectively. Age, SEM, OSDI, fishing as an occupation, and cataract were significantly associated with higher odds of VI in univariate analysis. Refraction, gender, education level, smoking status, amblyopia, systematic, and other ocular diseases were not significantly associated with VI. In the multivariate analysis, age, SEM, and presence of cataract remained significantly associated with a higher risk for VI. The area under the receiver operating characteristic curve values for age and SEM scores demonstrate a fair index of discrimination for the detection of VI. Conclusion SEM level is directly associated with a higher risk of VI among fishermen. The fishing community might benefit from regular eye examinations and awareness about the harmful effects of sunlight exposure and preventive measures.
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Affiliation(s)
- Shwetha V Puthran
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sayantan Biswas
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, United Kingdom
| | - Siddharth K Karthikeyan
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Jyothi Thomas
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Anto GJ, Sekaran S, Perumal B, Ramar N, Vaitheeswaran R, Karthikeyan SK. A study to determine the impact of IMPT optimization techniques on prostate synthetic CT image sets dose comparison against CT image sets. Rep Pract Oncol Radiother 2022; 27:161-169. [PMID: 35402035 PMCID: PMC8989438 DOI: 10.5603/rpor.a2022.0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 01/20/2022] [Indexed: 11/25/2022] Open
Abstract
Background The objective of this study is to determine the impact of intensity modulated proton therapty (IMPT) optimization techniques on the proton dose comparison of commercially available magnetic resonance for calculating attenuation (MRCA T) images, a synthetic computed tomography CT (sCT) based on magnetic resonance imaging (MRI) scan against the CT images and find out the optimization technique which creates plans with the least dose differences against the regular CT image sets. Material and methods Regular CT data sets and sCT image sets were obtained for 10 prostate patients for the study. Six plans were created using six distinct IMPT optimization techniques including multi-field optimization (MFO), single field uniform dose (SFUD) optimization, and robust optimization (RO) in CT image sets. These plans were copied to MRCA T, sCT datasets and doses were computed. Doses from CT and MRCA T data sets were compared for each patient using 2D dose distribution display, dose volume histograms (DVH), homogeneity index (HI), conformation number (CN) and 3D gamma analysis. A two tailed t-test was conducted on HI and CN with 5% significance level with a null hypothesis for CT and sCT image sets. Results Analysis of ten CT and sCT image sets with different IMPT optimization techniques shows that a few of the techniques show significant differences between plans for a few evaluation parameters. Isodose lines, DVH, HI, CN and t-test analysis shows that robust optimizations with 2% range error incorporated results in plans, when re-computed in sCT image sets results in the least dose differences against CT plans compared to other optimization techniques. The second best optimization technique with the least dose differences was robust optimization with 5% range error. Conclusion This study affirmatively demonstrates the impact of IMPT optimization techniques on synthetic CT image sets dose comparison against CT images and determines the robust optimization with 2% range error as the optimization technique which gives the least dose difference when compared to CT plans.
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Affiliation(s)
- Gipson Joe Anto
- Department of Medical Physics, Bharathiar University, Coimbatore, India
| | - Sureka Sekaran
- Department of Medical Physics, Bharathiar University, Coimbatore, India
| | - Bojarajan Perumal
- Department of Medical Physics, Bharathiar University, Coimbatore, India
| | - Natarajan Ramar
- Department of Physics, School of Advanced Sciences, Vellore Institute of Technology, Vellore, India
| | - R Vaitheeswaran
- Department of Medical Physics, Bharathiar University, Coimbatore, India
| | - S K Karthikeyan
- Department of Medical Physics, Bharathiar University, Coimbatore, India
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K Karthikeyan S, Nandagopal P, R VS, Nayak A. Challenges and impact of COVID-19 lockdown on Indian optometry practice: A survey-based study. J Optom 2022; 15:145-153. [PMID: 33414101 PMCID: PMC7762711 DOI: 10.1016/j.optom.2020.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 10/15/2020] [Accepted: 10/20/2020] [Indexed: 05/11/2023]
Abstract
PURPOSE The Indian government announced a nationwide lockdown as a preventive measure to control the prevailing COVID-19 pandemic. This survey was developed and conducted to assess the impact of lockdown on Indian optometry practice. METHODS A survey questionnaire was designed and circulated across the optometrists practicing in India through multiple social media platforms. All the data were extracted and only valid response were analyzed and reported. RESULTS A total of 691 optometrists participated in the survey. Most of the participants (22.25%) were in private practice followed by academics (14.89%). Among the valid responses collected, it was found that 43.37% of the respondents were consulting patients during the lockdown. Of these, 27.17% of optometrists were examining infectious cases and 48.68% were examining all the patients who came for consultation. Approximately 50.94% of the participated optometrist had begun telephonic/e‑mail/video consultations. In addition, 64.48% reported that optometrists were at an equal risk of clinching COVID‑19 on comparison with other domains during patient examination. Nearly 30.44% respondents felt that optometrists would face challenges in approaching the patient post COVID-19 considering the close working distance. CONCLUSION A proportion of optometrist have switched to some form of teleconsultation in order to aid patients during this prevailing pandemic. Regulatory bodies should issue appropriate guidelines regarding the safe optometry practice for the betterment of both patient and practitioners during face-to-face consultation.
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Affiliation(s)
| | - Pooja Nandagopal
- Department of Optometry, Manipal College of Health Professional, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Vivek Suganthan R
- Department of Optometry, Manipal College of Health Professional, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Anush Nayak
- Department of Optometry, Netha Jyothi college of Optometry, Udupi, Karnataka, India
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Karthikeyan SK, Ashwini DL, Priyanka M, Nayak A, Biswas S. Physical activity, time spent outdoors, and near work in relation to myopia prevalence, incidence, and progression: An overview of systematic reviews and meta-analyses. Indian J Ophthalmol 2022; 70:728-739. [PMID: 35225506 PMCID: PMC9114537 DOI: 10.4103/ijo.ijo_1564_21] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/21/2021] [Accepted: 09/21/2021] [Indexed: 12/13/2022] Open
Abstract
Myopia has reached epidemic levels in recent years. Stopping the development and progression of myopia is critical, as high myopia is a major cause of blindness worldwide. This overview aims at finding the association of time spent outdoors (TSO), near work (NW), and physical activity (PA) with the incidence, prevalence, and progression of myopia in children. Literature search was conducted in PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature, Cochrane Database of Systematic Reviews, ProQuest, and Web of Science databases. Systematic reviews (SR) and meta-analyses (MA) on the TSO, NW, and PA in relation to myopia were reviewed. Methodological nature of qualified studies were evaluated utilizing the Risk of Bias in Systematic Review tool. We identified four SRs out of which three had MA, which included 62 unique studies, involving >1,00,000 children. This overview found a protective trend toward TSO with a pooled odds ratio (OR) of 0.982 (95% confidence interval (CI) 0.979-0.985, I2 = 93.5%, P < 0.001) per extra hour of TSO every week. A pooled OR 1.14 (95% CI 1.08-1.20) suggested NW to be related to risk of myopia. However, studies associating myopia with NW activities are not necessarily a causality as the effect of myopia might force children to indoor confinement with more NW and less TSO. PA presented no effect on myopia. Though the strength of evidence is less because of high heterogeneity and lack of clinical trials with clear definition, increased TSO and reduced NW are protective against myopia development among nonmyopes.
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Affiliation(s)
- Siddharth K Karthikeyan
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Department of Optometry, Netra Jyothi Institute of Allied Health Sciences, Udupi, Karnataka, India
| | - D L Ashwini
- Department of Optometry, Sankara College of Optometry, Sankara Eye Hospital, Bengaluru, Karnataka, India
| | - M Priyanka
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Anush Nayak
- Department of Optometry, Netra Jyothi Institute of Allied Health Sciences, Udupi, Karnataka, India
- Faculty of Life and Allied Health Sciences, Ramaiah University of Applied Sciences, Bangalore, Karnataka, India
| | - Sayantan Biswas
- Visual Neurosciences Group, Singapore Eye Research Institute, Singapore
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Ganne P, Krishnappa NC, Karthikeyan SK, Raman R. Behavior of hyperreflective spots noted on optical coherence tomography following intravitreal therapy in diabetic macular edema: A systematic review and meta-analysis. Indian J Ophthalmol 2021; 69:3208-3217. [PMID: 34708775 PMCID: PMC8725144 DOI: 10.4103/ijo.ijo_1155_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Purpose: Hyperreflective spots (HRS) are considered as spectral domain optical coherence tomography biomarkers in predicting response to intravitreal therapy (IVT) in diabetic macular edema (DME). We aimed to determine if there was a quantitative reduction in HRS following IVT in DME, if the response to antivascular endothelial growth factor (anti-VEGF) drugs was different from steroids, and if HRS-response was associated with improvement in visual acuity (VA) or reduction in central macular thickness (CMT). Methods: PubMed/MEDLINE, Scopus, ProQuest, CINAHL, Wiley online, and Web of Science were searched (between January 1, 2011 and July 1, 2020). Publication bias and heterogeneity were assessed. Meta-analysis was done using the random-effects model. Results: Totally, 1168 eyes from 19 studies were eligible for inclusion. IVT was associated with a reduction in quantitative HRS (z = -6.3, P < 0.0001). Studies, however, showed heterogeneity (I2 = 93.2%). There was no difference between anti-VEGF and steroid therapies (P = 0.23). The evidence on predicting VA and CMT outcomes were limited by the number of analyzable studies, owing to the wide variation in individual study designs, and lack of randomized controlled trials. Conclusion: We could conclude that there is a definite reduction in quantitative HRS following either form of IVT. We highlight the lacunae in the existing literature on HRS in DME and propose goals for future studies to harness the advantage of this promising biomarker.
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Affiliation(s)
- Pratyusha Ganne
- Department of Ophthalmology, All India Institute of Medical Sciences, Mangalagiri, Guntur, Andhra Pradesh, India
| | - Nagesha C Krishnappa
- Department of Vitreo-Retina, BW Lions Superspeciality Eye Hospital, Bengaluru, Karnataka, India
| | - Siddharth K Karthikeyan
- Department of Optometry, Manipal College of Health Professionals, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Rajiv Raman
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
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