Ocular Injuries After Bungee Jumping Acharya, Keshav; Mahat, Birendra; Kandel, Himal
Journal of Nepal Health Research Council,
03/2024, Letnik:
21, Številka:
3
Journal Article
Recenzirano
Odprti dostop
We present a case of ocular injuries post bungee jumping in Nepal. A 26 year old female presented to our clinic with bilateral Sub Conjunctival Hemorrhage (SCH) after bungee jumping. Her best ...corrected visual acuity was 20/20 in both eyes. No other intraocular hemorrhage was revealed in her dilated ocular examination. Conservative treatments with artificial tears were given to her and follow up visit after one week was advised. The SCH was resolved after a treatment of one week. Her visual acuity remained stable and no other ocular complications were found. To conclude, bungee jumping can be the cause of several ocular injuries. Further studies are required to identify the causes and potential risk factors. Keywords: Bungee jumping, ocular injury; sub conjunctival haemorrhage.
The aim of this review was to evaluate the evidence on quality-of-life outcomes of long-term contact lens wear.
A search for original articles that used validated measures to evaluate ...patient-reported outcomes (PROs) in long-term (≥2 years) contact lens wearers was conducted in Medline Ovid, PubMed, Scopus, Web of Science, Cochrane, CINAHL, and PsycInfo databases. The information including PRO measure (name, type, content) and key quality-of-life outcomes findings were extracted.
Seven articles that used 4 PRO measures to evaluate quality of life outcomes of long-term contact lens wear met the inclusion criteria. The median (range) number of contact lens wearers in these studies was 116 (31–247). The studies were conducted in 4 countries: USA, Spain, China, and Russia. All studies were conducted in myopic populations. None of the studies provided information on psychometric properties, validity and reliability of the PRO measures used. Five studies were conducted in children of which 3 studies evaluated PROs of myopia control contact lens wear. The studies reported that contact lens wear, including myopia control lens wear, was an effective method of refractive correction in children and adults in the long term in PRO-perspective, and resulted in a better quality of life status than with glasses. However, long-term dry eye and discomfort related symptoms were reported.
Overall, contact lens use improved quality of life status in children and adults. More research is required to better understand the long-term quality-of-life outcomes of contact lens wear.
Refractive errors are the most common causes of vision impairment worldwide and laser refractive surgery is one of the most frequently performed ocular surgeries. Clinical studies have reported that ...approximately 10.5% of patients need an additional procedure after the surgery. The major complications of laser surgery are over/under correction and dry eye. An increase in temperature may be a cause for these complications. The purpose of this study was to estimate the increase in temperature during laser refractive surgery and its relationship with the complications observed for different surgical techniques. In this paper, a finite element model was applied to investigate the temperature distribution of the cornea when subjected to ArF excimer laser at a single spot using various beam delivery systems (broad beam, scanning slit, and flying spot). The Pennes bio-heat equation was used to predict the temperature values at different laser pulse energies and frequencies. The maximum temperature increase by ArF laser (
500
Hz
frequency and
0.5
J
pulse energy) at a single spot was
33
.
94
∘
C
,
15
.
86
∘
C
,
12
.
48
∘
C
for
6
diopter correction (
65.4
μ
m
of ablation of corneal stroma) using broad beam, scanning slit, and flying spot beam delivery approaches respectively. The peak temperature due to a single pulse was estimated to be
234
.
14
∘
C
. Although the peak temperature (sufficient energy to break intermolecular bonds) exists for a very short time (
10
-
30
ns
) compared to the thermal relaxation time (
2000
-
10
,
000
μ
s
), there is some thermal energy exchange between corneal tissues during a laser refractive surgery. Heating may cause collagen denaturation, collagen shrinkage, and more evaporation and hence proposed to be a risk factor for over/under correction and dry eye.
Optometry is an independent profession which is specialised for providing comprehensive eye care including refraction and dispensing services, diagnosis and management of eye diseases and visual ...rehabilitation. In clinical settings of Nepal, optometrists are primarily recognised as refractionists and are provided with working opportunities in the same area. This report highlights other optometric services such as binocular vision, multifocal lenses, contact lenses and occupational lens design which can be provided by optometrists besides performing refraction and prescribing spectacles. Considering large proportion of optometrists with further education and being working outside the country, new specialised services can be introduced through training and workshop to the fellow optometrists so that specialised services can reach up to the public level. Keywords: Nepal; optometry; refraction services.
Background: The optometry training programme started in Nepal in 1997 with an intake of six students per year. The second optometry school was established in 2018 with an intake of 40 students per ...year.Aim: To establish a profile for Nepalese optometrists and understand their perspectives regarding the entrance examination, curriculum, infrastructure and recruitment of lecturers for a newly opened second optometry school.Setting: The prospective study respondents were contacted by email and the survey was administered online.Methods: A semi-structured questionnaire was emailed to 118 registered optometrists of the Nepalese Association of Optometrists, and the response rate of the survey was 69%. The questionnaire contained broad areas such as demographics of participants, their scope of practice, mode of entrance examination and content of the course curriculum, and availability of adequate infrastructure and lecturers.Results: A vast majority (93%) of the respondents suggested that optometrists should have been involved more in the planning of the programme. Over half of the respondents (57.5%) suggested that the programme should go ahead with a revised curriculum and well equipped laboratories. The qualitative analysis produced four broad themes: (1) quality assurance and control; (2) resources; (3) curriculum development and implementation; and (4) professional standards and opportunities. The responders expressed several strategies to address these concerns, including communicating with stakeholders and filing a case in the court for starting up a new optometry school without sufficient involvement of the existing optometrists.Conclusion: The recommendations for improvement include conducting impartial entrance examinations, establishing equipped laboratories and recruiting adequate lecturers.
Abstract Background Albinism poses a significant threat to visual functions and causes remarkable ocular morbidity often resulting in visual disabilities. The study aimed at describing the visual ...status in patients with diagnosed cases of complete oculocutaneous albinism (OCA) attending to a tertiary eye hospital in Nepal. Methods This was a cross-sectional descriptive hospital-based study of all diagnosed oculocutaneous albinotic cases (16 males and 9 females; mean age of 16 years) who visited the Department of Ophthalmology at the Institute of Medicine, for ocular consultation between September 1, 2011 and December 1, 2013. Results Twenty-five cases (50 eyes) with OCA were enrolled in the study. All the participants had maximally reduced visual acuity (mean: 1.24 ± 0.50 logMAR). Myopic astigmatism was the most common refractive error ( n = 17; 34%). 58% of all participants had with-the-rule astigmatism. Considering the spherical equivalent power, most of the eyes ( n = 30; 60%) had myopia, with overall mean SE refractive error of −1.59 ± 5.39 D. Visual acuity improved significantly with refractive correction in place (paired sample t -test, p < 0.05). Horizontal pendular nystagmus was the most common nystagmus ( n = 34 eyes; 68%). Alternating esotropia and alternating exotropia each were observed in 16% of participants who had strabismus (40% of all cases). The diaphanous iris, foveal hypoplasia and poliosis were the most consistent clinical features. Conclusion Patients with OCA present with a broad spectrum of visual deficits that impair the visual functions. Significant improvement in visual acuity following optical correction serves as an impetus to the reduction of visual disabilities in individuals with albinism.
To address this terrible situation, we propose the following solutions: in the short term, conduct regular eye health camps with appropriate management locally. In the long term, to strengthen ...primary eye care and integrate it into general health, by training primary health care workers in primary eye care (more specifically assessing visual acuity) establishing adequate referral channels. Currently, unfortunately, much of eye care service delivery remains centered on the district headquarters and accessible places, with other remote regions left unattended. We hope our report will awaken all concerned to the dire need for equitable eye care across the country.
To identify and assess the quality of questionnaires used to measure quality of life in keratoconus and guide selection of the most appropriate questionnaire for evaluating the impact of keratoconus.
...A literature search was carried out in Scopus, Web of Science, PubMed, MEDLINE, Cochrane, and PsycINFO databases. Articles that described a questionnaire to measure quality of life in keratoconus were included. Information on psychometric properties and validity was extracted and analyzed based on a set of quality criteria. Finally, the impact of keratoconus and its management methods on quality of life was reviewed.
The search yielded 331 publications, of which 45 articles describing 18 (12 ophthalmic including 2 keratoconus-specific and 6 generic) questionnaires were reviewed. Most of the articles (40, 88.9%) described ophthalmic questionnaires not specific to keratoconus. The National Eye Institute Visual Function Questionnaire was the most frequently used questionnaire (n = 26). Only 4 articles provided information on psychometric properties. The Keratoconus Outcomes Research Questionnaire, the only validated keratoconus-specific questionnaire, had the most superior psychometric properties. However, it consists of items on only 2 domains of quality of life (activity limitation and symptoms). Overall, keratoconus management methods (spectacles, contact lenses, and cross-linking in early stages, corneal transplantation in late stages) improved quality of life. The quality of life scores were associated with clinical measures including visual acuity, corneal topography, pachymetry, and keratoconus severity.
There is a need for a comprehensive and high-quality patient-reported outcome measure in keratoconus. A questionnaire should be chosen based on the purpose and the quality of the questionnaire. This review guides selection of an appropriate questionnaire.
Importance
This study qualitatively explores the impact of refractive error on adults, particularly after correction.
Background
The study aimed to explore the impact of refractive error on quality ...of life.
Design
Cross‐sectional; in‐depth telephone and face‐to‐face semistructured interviews; qualitative study with inductive and deductive processes.
Participants
Forty‐eight adults with refractive error (including presbyopia) were recruited from the Flinders Vision, the Ashford Advanced Eye Care and among Flinders University staff and students, in South Australia.
Methods
The interviews were audio‐recorded, transcribed verbatim, coded and analysed using thematic analysis.
Main Outcome Measures
Themes and categories
Results
The median age of the participants was 49 years (min: 22 years; max: 76 years). Most of them were female: (29; 59%). Most of them (36; 75.0%) had myopia followed by hyperopia (12; 25.0%). Twenty‐two (45.8%) participants had astigmatism. Similarly, 23 (47.9%) of them were presbyopes. Most of the participants (39; 81.3%) wore glasses; 17 (35.4%) used contact lenses, and 17 (35.4%) had undergone refractive surgery. A total of 2367 comments were coded. Thematic analysis resulted into six themes that informed about quality of life issues in people with refractive error. Concerns about cosmetic appearance, personal health and safety, difficulties in day‐to‐day activities and inconveniences rendered in daily life were identified as the most important themes.
Conclusions and Relevance
The findings of this study enrich the understanding on the issues important in people with refractive error. The quality of life issues identified will be used to develop a refractive error‐specific item bank.
Purpose
Spectacle non‐tolerance or adverse events to spectacle wear are serious concerns for both patients and practitioners. Non‐tolerance may contribute to a negative impact on the practitioner’s ...ability and practice. Therefore, a detailed understanding of frequency and causes of spectacle non‐tolerance in clinical ophthalmic practice is essential. This review aimed to determine the prevalence and causes of non‐tolerance to spectacles prescribed and dispensed in clinical practice.
Method
The current systematic review included quantitative studies published in the English language that reported spectacle non‐tolerance in clinical practice. A comprehensive search was conducted in PubMed, Scopus and the Web of Science database for studies published until 13 July 2020. An adapted version of the Newcastle‐Ottawa Scale (NOS) modified for cross‐sectional studies was used to assess the quality of each included study. Five investigations with 205,478 study participants were included in the review. The prevalence of spectacle non‐tolerance from individual studies was pooled using MetaXL software. The pooled prevalence of spectacle non‐tolerance was 2.1% (95% CI: 1.6–2.7) ranging from 1.6% to 3.0%. The papers were also reviewed to identify the potential causes of non‐tolerances. Nearly half reported that non‐tolerance (47.4%) was due to an error in refraction. Other causes identified were errors related to communication (16.3%), dispensing (13.5%), non‐adaptation (9.7%), data entry (8.7%), binocular vision (7.4%) and ocular pathology (6.4%).
Summary
This review improves our understanding of spectacle non‐tolerance in clinical practice. This is important because non‐tolerance may lead to spectacle wear discontinuation, which may deprive patients of optimal vision. Increased non‐tolerance in clinical practice may affect a clinician’s reputation and incur additional costs associated with reassessments and replacements. Spectacle non‐tolerance occurred due to a multitude of factors related to optical dispensing and wearer adaptation. Therefore, there is a need for vigilance while prescribing spectacles. The limited evidence highlights the need for more studies, especially in limited‐resource settings, to improve the quality of refractive error services.
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