A profile of low vision among the blind school students in Lumbini Zone of Nepal

INTRODUCTION

There is an increasing awareness about the needs of students with low vision, particularly in developing countries where programs of integrated education are being developed. However, the appropriate low vision services are usually neither available, nor affordable.

OBJECTIVES

To study the profile of students with low vision in Lumbini Zone of Nepal.

MATERIALS AND METHODS

A cross-sectional study included students with low vision from 8 integrated schools. The reading performance was measured using their own text-books with optical low vision devices prescribed for near reading. The reading rates were measured on a range of print sizes. The Standard Clinical Low Vision Assessment Form and the National Low Vision Program protocol were used. SPSS software was used in data analysis.

RESULTS

Of 46 students enrolled, 23 had a mild visual impairment, 18 had severe visual impairment and 5 were blind. Spectacles were needed for 29 (63 %) students. Of the 11 students who had been wearing glasses, the visual acuity improved in 4 with a change in prescription. 91 % of the students had near vision better or equal to 1.5 M with optical low vision services for near reading. The reading rate was 24 WPM at the age of 5 years, whereas at the age of 21 years, it was 55 WPM.

CONCLUSION

The majority of the students with low vision need optical low vision services. Accurate refraction is important in these students. The reading rate increases significantly with improved near visual acuity.

Surgical outcome of pars plana vitrectomy: a retrospective study in a peripheral tertiary eye care centre of Nepal

BACKGROUND

Trans-pars plana vitrectomy (TPPV) is an effective surgical procedure to retain the useful vision in vitreoretinal diseases.

OBJECTIVE

To evaluate the surgical outcome of pars plana vitreoretinal surgery.

STUDY DESIGN

Retrospective non-comparative interventional case series.

MATERIALS AND METHODS

A hospital-based retrospective interventional study of series of cases was carried out in retina clinic of Lumbini Eye Institute, Nepal, over a period of one-and-a-half years. Records of 64 patients who underwent vitreo-retina surgeries were reviewed. Demography, duration of symptoms, risk factors and indications, preoperative and post-operative visual acuity, intra-operative and post-operative complications were analyzed.

OUTCOME MEASUREMENT

The parameters studied were post-operative visual acuity and complications.

RESULTS

Of 64 patients, 61% presented 2 months after the onset of symptoms. Preoperatively, 65.5% had visual acuity of hand motions to 3/60 followed by perception of light only in 26.6%. The main indication for TPPV was vitreous haemorrhage (VH), in 53%. The visual acuity improved to better than 6/60 in patients with VH (68%), whereas, overall, in 72% of the subjects, it improved by 2 lines postoperatively. The commonest intra-operative complications were iatrogenic retinal break (5, 7.8%) at the sclerostomy site.

CONCLUSION

The main indication for TPPV is vitreous haemorrhage. Useful vision can be restored by pars plana vitrectomy in the majority of the patients. Retinal break is the commonest complication of TPPV.

Causative organisms in microbial keratitis, their sensitivity pattern and treatment outcome in western Nepal

Introduction: Corneal infection is one of the major causes of monocular blindness in developing countries. Objective: To determine the epidemiological characteristics, predisposing factors, microbiological pattern, sensitivity pattern and treatment outcome of microbial keratitis. Materials and methods: A retrospective analysis of hospital records of 414 patients with diagnosed infective keratitis was done. The outcome measures were microbial isolates, their sensitivity to therapeutic agents and treatment outcome. Results: Of the total, 312 (75.4 %) patients were farmers by profession, 138 (33.3 %) had a history of ocular trauma and 17(4.1 %) were using topical corticosteroids. Among the 138 cases of the corneal ulcer with trauma, 52 (37.68 %) had fungi isolated in culture (RR=0.54, 95% CI = 0.44 – 0.68) and 32 (23.19 %) had a bacterial growth. Cultures were positive in 300 (72.5 %) cases, having 138 (33.3 %) patients with pure fungal infection, 121 (29.2 %) with pure bacterial and 41 (9.9 %) with mixed infection. Fusarium spp was the most common fungal pathogen while Staphylococcus epidermidis was the commonest bacterial isolate. The most sensitive antibiotics for the Gram positive bacteria was cephazolin (84.92 %), while for Gram negative, ciprofloxacin and ofloxacin were the most effective (79.31 %). Of 414 cases of corneal ulcers, 363 (87.7 %) cases healed completely. Conclusion: Microbial keratitis is mostly seen in farmers in this part of the world. Fusarium and Staphylococcus epidermidis were the most common isolates. Cephazoline and ofloxacin were the most effective antibiotics for Gram positive and Gram negative organisms respectively. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5863 NEPJOPH 2012; 4(1): 119-127