Organized by Lotus Optometry Alumni Association and Lotus ... · Optometry in 1993 from City, University of London. His academic career began at UniversitiKebangsaan Malaysia in 1985,

10TH Shree Naval P. Baliwalla Scientific Session

1 Copyrighted Material

Organized by Lotus Optometry Alumni Association and Lotus College of Optometry



Published by Chitkara University Publications

10th Shree Naval P. Baliwalla

Scientific SessionOrganized by Lotus Optometry Alumni Association and Lotus College of Optometry



ISBN No. 9789382782353

Copyright @2019 by Chitkara University Publications, ChandigarhThis edition is published by arrangement with Chitkara University Publications.

This Abstract book published with licensed under a Creative Commons Attribution- CC-BY 4.0 International License. This license permits one to use, remix, tweak and reproduction in any me-dium, even commercially provided one give credit for the original creation.

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CONTENTS

Session I: Low Vision and Public HealthEffect of Peripheral Visual Field Loss on Balance 12Open Eyes to Donate Eyes 13Vision Related Quality of Life in Patients with Glaucoma seen in anEye Hospital in Pune 14Prevalence of Myopia among Indian School Children in Kuala Lumpur 15

Session II: Contact LensesTear film quality and quantity with SiHi contact lens material 17(Lotrafilcon B VS Comfilcon A)Corneal Topographic Changes Post Short-term Day Time Wear ofOrtho-K Lenses under Open Eye Conditions 18Comparison of Visual Functions with Spectacles and Semi ScleralLenses in Keratoconus 19Assessing Scleral Contact Lens Satisfaction in a Keratoconus Population 20Reshaping the Toric Corneas by Orthokeratology - A Case Study 21

Session III: Clinical DiagnosticsMacular Thickness in Cystoid Macular Odema Pre and Post Avastin Injection 23Optical Image Quality Metrics in Eyes Implanted with Full RangeVersus Monofocal IOL 24Visual Function and Subjective Perception of Patients with full ThicknessMacular Hole 25Lid Wiper Epitheliopathy in Prosthetic Eye 26Correlation of Macular Pigment Optical Density with Retinal NerveFibre Layer and Ganglion Cell Complex in Normal Indian Eyes 27Diabetic Retinopathy with Maculopathy: A Case Study 28

Session IV: Clinical Optometry and Binocular VisionPhotostress Recovery Test time Using Different ColourWavelengths in Normal Subject 30Color Vision Test Under Different Light Sources 31Relationship of CDR and AVR with Anthropometric Parameters inMyopic Chinese 32Binocular Vision Assessment Before and After Using Virtual Reality Gadget 33A Case of Convergence Excess with Refractive Accommodative Esotropia 34

Poster PresentationBinocular Vision Anomalies Among Table Tennis Players 36Clock Hour Evaluation of Retinal Thickness in Diabetic Retinopathy 37Differentiating Acute Zonal Occult Outer Retinopathy (AZOOR)from other retinal lesions 38IOP Comparison of Glaucomatous & Non-glaucomatous Patients byCataract Surgery 39Visual Screening of Children in Integrated Schools in Ahmedabad 40Selection of IOL for Pediatric Cataract 41Effectiveness of Road Race (3D) Game in VTS4 Software for Normal& CI Subjects 42



CONTENTS

Changes in Visual Acuity and Contrast Sensitivity Post Short TermWear of Ortho-K Lenses 43Effect of Smartphone on Accommodation & Vergence in Bright & DarkIllumination 44Construction and Validation of International Reading Speed Texts(IReST) Chart in Marathi 45Mobility Task Related Questionnaire in Patients with Retinal Diseases 46A Survey of Satisfaction with Wearing Ocular Prosthesis 47Foveal Microvasculature Metrics in Normal and Diabetic Subjects 48Students Educational Background, Perception and Expectation towardsOptometry in Mumbai 49Fusional Vergence Measurement with Prism Bar in Front of DominantEye & Non Dominant Eye 50Profile of Ocular Conditions among children Referred from School Eye 51Corneal Wavefront Analysis in Normal Myopic Patients using PlacidoBased Topoghrapher 52Prevalence of Anisometropia and its Clinical picture in School-childrenof Mumbai, India 53Refractive Error Trends Among Public and Private Schools inKanchipuram district 54Recognizing the Reasons for Patient not Getting Operated for Cataractin Rural Areas 55To Measure Central Corneal Thickness after Short-term day TimeWear of Ortho-K lenses 56Accommodative Responses Towards Auditory Stimulus 57Axial Length to Corneal Radius of Curvature Ratio and Refractive Errors 58The Similarity in Disssimilar: Macular Thickness Comparison Using 3different SD OCTs 59Performance and Preference of New Video Magnifier Versus ExistingVideo Magnifier 60Identify the Principle Issues While Implementation the New ElectronicHealth Record 61Effect of Stress on Visual Functions in MumbaiSchool Going Children 62Early Retreatment with Trans PRK of Patient Developing PartialButton Holing During LASIK 63Induced Prismatic Effects due to Poorly Fitted Spectacle 64Concerns of An Anophthalmic Subject Towards Prosthetic Eye 65Prevalance and Management of Nystagmus in France 66Visual Capability Assessment for Athletes Livingwith a Mental Disability 67Review of Different Materials used in Spectacle Frames 68The Effects of Cosmetics on the Eye 69Community Eye health and Vision Care Services by VisionSolidev from Jan-December 2018 70A Survey on Relevance of the VisionSoliDev Activityfor Access to Eye and Vision Care 71



Preface

Shree Naval P Baliwalla, our Founder is considered as the father of Indian Optometry for his contribution to the profession. Lotus College has celebrated his birth anniversary on February 23rd as Founder’s day every year since 2005. To honor his memory, a scientific session was introduced as a part of Founder’s day in 2010. In the past, this session was open only to students and alumni of Lotus College. The whole concept of this session is to encourage young optometry students to share their research, thereby to aspire them to develop the profession both clinically and academically.

The daylong event included scientific papers, whereby, the objective of selecting research papers was to convince the audience that the research presented are important, valid, and relevant for the practitioners and academicians present. In total, the scientific committee received over 111 abstracts from all over India and abroad. Of them, 22 oral papers and 34 posters were selected. Consent from reviewers was obtained, and according to their area of specialty, abstracts were directed for a review with the scoring sheet. Reviewers supported us from across the country by evaluating and sharing their comments. The highest scored abstracts were then selected for Oral and poster presentations.

Our esteemed judges on the day were Dr. Maninder Singh Setia and Dr. Ramesh S. Ve, Dr. Maninder Singh is a trained dermatologist and epidemiologist/public health specialist. He has won young scientist awards for his presentations at national and international conference & has also authored/co-authored many manuscripts. He has demonstrated achievements in initiating & leading international collaborative research projects & advanced longitudinal data modelling for health outcomes. He has been associated with Lotus College for many years in training faculty for grant applications and giving feedback to M.Optom research papers to refine them. Second judge was Dr.Ramesh S.Ve, from Manipal Academy of Higher Education. Dr.Ramesh is an Optometrist and heads the Optometry department at Manipal. He is a well-known researcher and some of his publications on Glaucoma are considered gold standard studies enlisted for compulsory reading for Optometry graduates. He has many awards and collaborative projects to his credit.

Posters were prior rated by Mr. Aditya Goyal, renouned optometrist. He is name for his excellence in the field of Optometry and has trained and mentored many young optometrist. Dr. Preethi Pradhan, Dean- School of Health sciences, Chitkara University. She is a PhD holder in Healthcare management from IIT Madras. Her interest is in the area of training and capacity building of HR for Healthcare. She also teaches total quality management, curriculum design for healthcare related programs. Dr. Krishna Kumar Principal Elite School of Optometry. His publications on occupational optometry and low vision care are the most cited ones. He has received several accolades to his credit. Mr. Amod Gogate from Johnson and Johnson Vision Care and as a Contact lens educator. We thank to all the reviewers and judges for all the support.



Student presenting his posters to the judge, Dr. Krishna Kumar Ramani and Mr. Amod Gogate.

Student from Bengalore presenting her research paper under oral category.

Student from Malaysia, presenting her paper under oral category.

Student from Chennai giving insights about is research to the judges. He is also the winner for Best Poster.



Speakers Presentation



Dr. Krishna KumarPrincipal, Elite School of Optometry

Dr. Krishna Kumar did his graduation from the Elite School of Optometry and is attached with the same institute since 1992. Initially he joined as an Optometrist in clinical services, later period between 1997 and 2003 was heading the Optometry department at SankaraNethralaya. From 2004 he is heading the Elite School of Optometry.

Topic: Accommodating people with visual impairment in workplace

Dr. Vanessa Moodley Senior lecturer at University of Kwa Zulu Natal, South Africa

Dr. Vanessa Moodley, the past academic leader in the Discipline of Optometry, has served in various administrative leadership capacities in the optometry department, faculty at the university. DrMoodley has published articles in academic journals and presented numerous papers at national and international conferences. She is committed to lead initiatives towards transforming optometric education globally to become more socially accountable and has developed a Socially Accountable Quality Assurance Framework for Optometric Education (SAQAFOE) to this end. At an international level she serves on the Legislation, Regulation and Standards Committee of the World Council for Optometry(WCO) and regionally chairs the Education Committee of the African Council of Optometry(AFCO).

Topic: Keratoconus Management: Is it time for a new strategic approach

Prof. Azrin Ariffin Deputy Vice Chancellor, Student Affairs & Dean, Faculty of Optometry & Vision Science

Prof. Azrin Ariffin obtained his optometric qualification in 1984 from the University of New South Wales in Sydney, Australia and later earned a PhD in Clinical Optometry in 1993 from City, University of London.His academic career began at UniversitiKebangsaan Malaysia in 1985, and progressed through the ranks in a period that spanned 20 years. Prof. Azrin was the first ever appointed Professor of Optometry in Malaysia and he is also credited as the first Dean of an Optometry school in the country.

Prof. Azrin is on the Malaysian Optical Council and various professional committees that deal with opto-political matters. He also sits on some special committees of the Malaysian Qualifications Agency and the Ministry of Higher Education, on educational issues at large.

Topic: TBUT-- The Queen of all Tests in Clinical Tear Film Dynamics Assessment



Dr. Ramesh S Ve Associate Professor & Head, Department of Optometry, School of Allied Health Sciences, Manipal

Dr Ramesh.S.Ve began his carrier in 2001 and has academic, clinical and research experience in the field of optometry, vision science and eye care. He is currently an Associate professor and Head, Department of Optometry, School of Allied Health Sciences, Manipal Academy of Higher Education. He completed his Doctorate (PhD) in 2014 Birla Institute of Technology and Science, Pilani, India. His thesis was aimed at estimating 5 year progression of glaucoma, both structural and functional changes evaluated using ophthalmic imaging and perimetry tests as part the Chennai Glaucoma Study, SankaraNethralaya, Chennai.

He has received the Indo-US Public Health Research Post-doctoral Research fellowship-2014 at Wilmer Eye Institute, Johns Hopkins University, Baltimore, USA. He has received over 2.5 crores research grants from national and industry funding agency. He has 53 research articles in peer reviewed indexed journals.

Topic: Evidence-based Practice for Better Clinical Decision making and Educational Tool

Prof. Francois Vievelle Optician Optometrist

Prof. Francois Vievelle, is a graduate as an optician in France, certified in optometry and contact lens fitting in England (London course of optometry). He is a Vice president of NGO: “Vision Solidarite Development”. He is Qualified as “Clinical director” for Special Olympics. He is currently serving as a trustee of Optic 2000 group, a first optical group in France for 12 years. He is an acting trustee of opticians French Syndicate and ICO (Institut et Centre d’ Optometrie)

Topic: Novel Dispensing Options for Children – Cases Studies with Possible Solutions



Session ILow Vision and Public Health



Effect of Peripheral Visual Field Loss on BalanceShaikh Anam Mo Javed, Rutul Shah

Lotus College of Optometry

Aim

To assess the effect of peripheral visual field loss on static and dynamic balance.

Method

An observational study was carried out on 16 nor-mal subjects between the ages of 18- 25 years. A complete Optometric Evaluation was performed to rule out any ocular condition. Complete history of the patient was taken to rule out any pathological condition of the patient. Visual acuity, refraction, slit lamp and fundus evaluation was performed on all patients, IOP was also measured. All emmetropes with normal visual fields were included in the study. Those with any refractive error, ocular pathology, past ocular surgery, neurological, pulmonary, ves-tibular abnormalities were excluded from the study. Goggle simulator was constructed to occlude the patient’s peripheral visual field. The central 20° and 10° was left unoccluded. The simulator was constructed which was adjusted for each individual

according to their IPD .Balance was assessed using the berg balance scale under the simulated periph-eral visual field occlusion condition and without any simulator. The patients were graded according to the difference observed in performance without any simulator and with the simulators.

Results

The difference in balance was analyzed for 16 subjects with peripheral field occluded.

There was significant difference found when peripher-al field was occluded with 20° simulator and 10° sim-ulator. Both static and dynamic balance was affected with peripheral field occluded.

Conclusion

Peripheral visual field loss can cause significant bal-ance problem.



Open Eyes to Donate EyesReema Dandavate, Menda Purushottam Naidu,Rakesh V kaushal

ITM

Aim

The aim of this is to find out awareness about eye do-nation among young people and to find out reasons for not donating.

Method

The design chosen for this study was a nonexper-imental convenience sampling of young adults at the various tertiary eye care hospitals in Mumbai and Navi Mumbai. The study was done and inves-tigated by a self-examined questionnaire. Respond-ents were provided with proper explanation of the study’s purpose and how their information would be used prior to signing the informed consent. Each respondent was then asked to fill out the question-naire after the consent was signed. Once completed, the respondents were offered further education on eye donation. A total of five hundred respondents were included in the study with age ranging be-tween 16 to 36 year, with hundred being exclud-ed, as the forms were incomplete. Responses to the survey were summarized with frequency counts and percentages. Association between level of educa-tion and knowledge about eye donation was evalu-ated using chi-square test. Statistical analyses were performed using Microsoft excel.

Results

There were total six hundred responses recorded, out of which hundred were incomplete hence excluded from the study. Out of 500 responses included for the analysis there were 58% (290) male and 42 %( 210) female. Age of the subjects varied from 16 to 36 years with mean age of 24.06 ± 5.20 years. The majority 66.8 % (334) of subjects knew that eyes can be donated after death but only 40.11% (134) knew that the ideal time of donation was within 6 hours of death. Out of 334 subjects who were aware about eye donation, only 33.83% (113) subjects had pledged for donation. Conscious reasons for not donating eyes by the subjects were: had no specific reason 46.60%(103), did not know where and how to pledge for eye donation 26.24%(58), objection by family members 18.10%(40), and unsuitability due to ocular issues, health issues and religious 9.05%(20).Chi square test shows that level of education of the subjects was highly associated with the awareness and knowledge about eye donation (p<0.001).

Conclusion

Though there is awareness about eye donation, the knowledge is poor. There is necessity to emphasize on spreading the knowledge along with awareness of eye donation.



Vision Related Quality of Life in Patients with Glaucoma seen in an Eye Hospital in Pune

Mamta Tandale, Rituparna Ghoshal, Somnath Ghosh, Roopali Nerlikar, Sina MotallebiDYPatil

Aim

Measuring vision related quality of life (VRQOL) provides patients perception about the impact of the eye disease on his or her QOL. Literature on QOL in Indian patients with glaucoma is limited. Thus, the purpose of the present study was to evaluate the im-pact of QOL in patients with glaucoma and to further assess its association with different demographic and visual functions.

Method

In this, prospective cross sectional study, patients with any type of Glaucoma in at least one eye were recruit-ed from a tertiary eye hospital in Maharashtra. Mar-athi version of National Eye Institute Visual function questionnaire-25 (NEI-VFQ-25) was administered for all participants. Demographic characteristics includ-ing age, gender, and duration of vision loss were re-corded. Best corrected distance visual acuity (BCDVA) was recorded using a ETDRS logMAR chart. Visual field (VF) was tested using Humphrey field analyzer. Estermen binocular visual field test programme was run to evaluate binocular visual filed and the seeing and non-seeing points were recorded for each of the patients. All the data were analyzed using SPSS soft-ware. Descriptive statistics, Pearson correlation and independent t test were employed for statistical anal-ysis.

Results

A total of 36 patients with age range from 27 to 78 years, diagnosed with glaucoma were recruit-

ed. The mean BCDVA was 0.4±0.06 logMAR with the range from 0.1 to 0.6 logMAR. In binocular VF test, mean non seeing points was 9.47 ± 10.82 which varied from 0 to 49. Similarly, the mean of seeing points was 110.5 ±10.82 with the range from 71to120. The mean NEI-VFQ composite score (NEI-VFQ CS) was 65.69 ± 10.34. Role difficulty (48.50 ± 9.23) and dependency (50.48±6.34) fol-lowed by mental health (55.65±7.56), ocular pain (58.68±9.24) were the most affected subscales whereas color vision (90.56±9.23), near activities (80.56±9.45) were least affect. No significant dif-ference in NEI-VFQ CS between genders, type of glaucoma was found (p> 0.05). Similarly, age, dura-tion of disease did not show any signet correlation with NEI-VFQ CS(r=-0.07, 0.2 respectively; p> 0.05). Binocular VF parameters including seeing and non-seeing points showed no correlation with NEI-VFQ CS(r=+0.084,-0.09 p>0.05).

Conclusion

Patients with glaucoma seen in an eye hospital in Pune exhibited a lower NEI-VFQ CS irrespec-tive of their age, gender, type of glaucoma and extend of VF loss. Various domains of life such as role difficulties, dependency, mental health, oc-ular pain were affected. Thus, the present study emphasizes the need of developing necessary management strategies to address this QOL is-sues in these patients.



Prevalence of Myopia among Indian School Children in Kuala LumpurFakhruddin Shamsheer Barodawala, Indira Madhavan, Uma Mageswari Batumalai, Azrin Esmady Ariffin

SeGi University, Malaysia

Aim

Refractive error is one the universal causes of visual impairment among children that affect a large per-centage of the population worldwide. Studies on the prevalence of refractive errors are scarce among Indi-an children population in Malaysia. Hence, this study aimed at determining the prevalence of refractive error among Indian schoolchildren in Kuala Lum-pur.

Method

The Refractive Error Study in Kuala Lumpur Indian Schoolchildren (REKLIS) is a population-based study of refractive error in school children aged between 7 to 11 years old. Subjects were recruited from National Indian primary schools in Kuala Lumpur. Approval for the study was obtained from the Ministry of Educa-tion and Federal Territory of Education Department before the schools were approached. A total of 1462 Indian schoolchildren 7–11 years of age participated in this study. The subjects consisted of 733 (50.1%) boys and 729 (49.9%) girls. Non-cycloplegic autore-

fraction was used to determine the refractive error. Myopia was defined as a SER of 1.00 dioptre (D) or worse, hyperopia as a SER of +0.50 D or more, and astigmatism as cylindrical power equal to or worse than 0.75 DC.

Results

Out of 15 schools that were approached, 12 schools participated in the study. A total of 2275 schoolchil-dren were enumerated for the study out of which 1462 children were examined. The prevalence rates of myopia, hyperopia and astigmatism were 28.9%, 6.9% and 35.4% respectively. The prevalence of an-isometropia was 7.7%.

Conclusion

Myopia was the most common type of refractive error found in this population. Further investi-gation to identify the cause of myopia is needed in order to slow down the increase in severity of myopia among Indian schoolchildren.



Session IIContact Lenses



Tear film quality and quantity with SiHi contact lens material (Lotrafilcon B VS Comfilcon A)

Divyani Rauniyar, Vandhana KamathShankara College of Optometry

Aim

CL and Tear Film interfere with each other. Differ-ent generation of SiH CL is available in market. Each Generation has their unique features. Tearfilm quality and quantity is important for the comfort and health of a CL wearer while prescribing contact lens. So, it is important to understand how generations of SiH CL interfere with tear film.

Method

A prospective experimental study was performed, 20 subjects (40 eyes) with age between 18-25 years were participated. Prior permission and consent were taken from each individual. The healthy sub-jects who have not wear contact lens at least from 3 months was enrolled in the study. Baseline eval-uation was done. NIBUT, SMR I & SMR II, TMH test were performed for baseline, 15 days and 30 days. Baseline value of 40 eyes was compared with (Lotrafilcon B) first generation of SiH CL materi-al with (Comfilcon B) Third generation of SiH CL material after 15 days & 30 days. Data was analyzed with SPSS v 23 software.

Results

20 Subjects with mean value of 20.55 ± 1.70 years Participants in situ. NIBUT, SMRI, SMR II & TMH is showing statistically with after wearing Comfilcon A material having P value (0.00,0.01,0.001&0.01) af-ter 15 days & (0.009,0.001,0.00 &0.00) after 30 days respectively. NIBUT & TMH was showing statisti-cally significant with Lotrafilcon B material having P value (0.00,0.00) after 15 days & (0.00,0.00) after 30 days. SMR II showing statistically significant only after 30 days having P value 0.018.SMR I was not showing statistically significant. Comparing both the lens material, the difference was not show-ing statistically significant.

Conclusion

Current study concludes that Contact Lens dis-turbs the normal structure of tear film by al-tering tearfilm quality and quantity. First gen-eration and third generation of Silicon hydrogel CL material even though having unique material properties equally interfere with tear film quality and quantity.



Corneal Topographic Changes Post Short-term Day Time Wear of Ortho-K Lenses under Open Eye Conditions

Aastha Parekh, Pancham KulkarniLotus College of Optometry

Aim

Evaluation of corneal topographic changes post short-term day time wear of Ortho-K lenses under open eye conditions.

Method

An experimental study was carried out on 17 my-opic eyes on subjects of mean age 21 ± 3 years. An initial case work up was done to document the sub-ject’s demographic data. Each subject underwent routine eye examination followed by assessment for the best fit Orthokeratology - reverse geometry lenses (Fargo; Paragon Vision, USA) which were selected by empirical method. The subjects wore lenses monocularly for 30 minutes and 2 hours on separate occasions under open eye conditions. The corneal topographic changes were monitored us-ing TMS-4 (Tomey Corporation, USA). Changes in parameters like average corneal power (ACP), sur-face asymmetry index (SAI), simulated keratometry (Sim K), irregular astigmatic index (IAI) and corne-

al eccentricity index (CEI) were recorded for post 30 minutes and post 2 hours of lens wear.

Results

17 myopic eyes were included in the study. The Flat K of 7.86 ± 0.30 mm at baseline increased to 7.94 ± 0.27 mm at 30 minutes and 8.04 ± 0.29 mm at 2 hours. Mean SAI values of 0.25 ± 0.08 at baseline increased to 0.47 ± 0.120 at 30 minutes and 0.54 ± 0.51 at 2 hours which were non-significant. The mean ACP shows flattening from 43.45 ± 1.33 D at baseline to 43.03 ± 1.35 D at 30 minutes and 42.58 ± 1.47 D at 2 hours. Mean CEI of 0.56 ± 0.09 at baseline reduced to 0.45 ± 0.14 at 30 minutes and 0.37 ± 0.14 at 2 hours.

Conclusion

The parameters of corneal topography demon-strated rapid changes to the application of re-verse geometry lenses within 30 minutes of lens wear with continuous increase in effect over 2 hours.



Comparison of Visual Functions with Spectacles and Semi Scleral Lenses in Keratoconus

Khushali Joshi, Mr. Atanu SamantaNagar School of Optometry

Aim

Aim of this study is to compare of visual functions with spectacles and with semi scleral lenses in kerato-cous.

Method

Nineteen keratoconus subjects who were fitted with Rose K2 XL semi scleral contact lenses with age range of 15-50 included in the present study. We assessed visual functions with spectacles except the fifth visual function (Visual field) in this study. The visual functions such as best corrected distance visual acuity measured with logMAR chart, near visual acuity measured with continuous text chart, contrast sensitivity measured with pelli robson chart, stereo acuity measured with titmus fly test and color vision measured with ishihara chart. After fitting of Rose K2 Xl semi scleral CLs, we again as-sessed visual functions with Rose K2 Xl semi scleral CLs. Data were collected and analyzed.

Results

Nineteen subjects (34 eyes) assessed with Rose K2 XL semi scleral contact lenses. There was statisti-

cally significant change is improving in visual acu-ity, contrast sensitivity and stereo acuity. The best corrected distance visual acuity improved from spec-tacles 0.3393±0.3832 to rose k2 xl semi scleral CLs 0.1711±0.1669 (p value<1.6519E-06), near visual acuity improved from spectacles 9.9393±7.3605 to rose K2 XL semi scleral CLs 7.4117±5.4130 (p val-ue<0.002), contrast sensitivity improved from spec-tacles 1.5090±0.3110 to rose k2 xl semi scleral CLs 1.7911±0.1923 (p value<1.0863E-09), stereo acuity improved from spectacles 221.66±223.29 to rose k2 xl semi scleral CLs 154.66±189.76.(p value>0.08). No abnormality detects in color vision. Statistical analysis was done using T test.

Conclusion

Rose K2 semi scleral CLs may provide good visual functions with all day comfort progression with irregular corneas specially keratoconus.



Assessing Scleral Contact Lens Satisfaction in a Keratoconus PopulationTrupti Shah, Hiral Korani, Prasad Sawant


Aim

To assess perceived and related experiences of adopt-ed keratoconic scleral contact lenses wearers and to compare these subjective clinical effects with previous experiences. Hypothesis made here is there is no sig-nificant difference in comfort and satisfaction between other contact lens modalities worn by the keratoconic population.

Method

It was a questionnaire based observational study. Satisfaction questionnaire designed at Texas eye research and technology center and OSDI ques-tionnaire was administered on keratoconus patients wearing scleral contact lenses (ScCL) for a mini-mum of 4 hours or more per day, for a period of one year or more. Patients who had an experience of wearing other contact lens modalities and un-dergone C3R procedure were included. The fitting criteria included a minimum vault of 200 microns, Limbal clearance of 10-50mm, scleral zone show-ing bearing and landing zone showing no blanch-ing. Patients with a history of dry-eyed and any other systemic illness causing dry eyes were ex-cluded from the study.

Results

The total number of responses analysed were 25. out which 80% were male and 20% female. 92%were diagnosed with bilateral keratoconus 8% were uni-lateral. 76%of patients had moderate severity of keratoconus and 24%had advance cone. The mean the age of participants was 32+/-10 years. The mean age of diagnosis of 21,-/-the mean scleral Lens diameters 18.5 diameter+/- 1 .In-dependent T-test was performed to compare and un-derstand the comfort of lens feeling of dryness and improvement in vision within the severity of the dis-ease. 60% of patients strongly felt ScCL provided bet-ter level of comfort less feeling of dryness and good improvement in vision compared to previous lens mo-dality. 40% of the patients experienced midday foggy vision once a day after 4 hours of wear. 60% never experienced Midday day fogging.

Conclusion

The pilot study clearly reveals that scleral con-tact lenses are favored by keratoconus patient over their last lens worn. The only limitation to these lenses is that the wearers wearing time is disrupted due to mid-day fogging.



Reshaping the Toric Corneas by Orthokeratology - A Case StudyFakhruddin Shamsheer Barodawala

SEGi University, Malaysia

Introduction

Orthokeratology or Ortho-k lenses are specially de-signed hard lenses which are approved by the FDA to be worn during sleeping hours. These lenses are re-verse geometry lenses which help to reshape the cor-nea by flattening the central cornea thereby giving the wearer a spectacle free vision during daytime. Ortho - k lenses are also used as myopia control lenses.

Patient Profile

The presenting patient is an anisometrope with right eye having high myopia and astigmatism while the left eye has moderate myopia with astigmatism. The patient is an occasional dailies toric soft lens wearer (SCL). The ocular and health history is unremark-able. The patient had last worn the SCL 2 weeks back. The patient enjoys the vision with the current glasses but is looking for an option to be spectacle independent specially while playing sports. Patient had tried using spherical ortho-k lens which cor-

rected mostly the spherical component of the re-fractive error but there was a significant amount of residual astigmatism. Patient visual acuity after full correction by spherical ortho-k lenses, was 6/12 and 6/18 in the right and left eye respectively. Since the visual outcome was not favorable, we fitted her with toric ortho-k lenses after a washout period of 8 days once the cornea came back to the baseline.

Intervention and Outcomes

Good visual outcome was achieved with the to-ric ortho-k lenses. During aftercare visit after 1.5 months, an asymptomatic epithelial mosaic staining was observed. Hydrogen peroxide disinfection sys-tem (AO-Sept) was prescribed. On follow-up after a week, there was no corneal staining. Patient was advised to use hydrogen peroxide twice a week from thereafter. Visual performance and ocular health was unremarkable and patient enjoys the spectacle independent vision during the day time.



Session IIIClinical Diagnostics



Macular Thickness in Cystoid Macular Odema Pre and Post Avastin Injection

Manish Yadav, Pandurang Kulkarni, Shajer Shaikh

Wavikar College of Optometry

Aim

To Compare macular thickness in cystoid macular edema patients, pre and post Avastin Injection.

Method

It was a retrospective case series where subjects aged 40 years and above diagnosed with cystoid macular oedema and injected with Avastin injection between January 2018 to October 2018 were includ-ed. Subjects with history of any previous injections, missing data were excluded. Macular thickness was assessed using Cirrus HD-OCT 4000 (Zeiss) at different locations and zones pre and post Avastin injections. All the injections were given by single surgeon. Data was analyzed using paired t test.

Results

Eight subjects with mean±SD age 61.0 ± 19.73 were enrolled. The mean±SD IOP was 14.37± 2.56

mmHg. The mean±SD pre and post avastin central macular thickness was 517.4±101.1 and 320.4± 119.1 microns respectively. Statistical significant reduction in central macular thickness was not-ed (p<0.001). Reduction in macular thickness was noted at all locations and zones however it was not statistically significant (p>0.05) except outer nasal (p=0.003) and inner temporal (p=0.023).

Conclusion

Avastin injection is efficient to decreases the mac-ular thickness in case of cystoid macular edema.



Optical Image Quality Metrics in Eyes Implanted with Full Range Versus Monofocal IOL

Rahul Saradge, Sonam Rothe, Smitesh Shah, Sonal Shah, Onkar PirdankarIsha Netralaya, Kalyan, Maharashtra

Aim

Multifocal IOLs resulted in higher intraocular aber-rations and thereby could affect optical image quality. Newly launched Full Range IOL has better optical de-sign and thereby could results in lesser intraocular ab-erration. Our aim is to compare Visual outcomes and optical Image quality metrics in eyes implanted with Full range (FR) versus monofocal (MNF) IOL.

Method

It was a prospective study design Subjects who were implanted with FR IOL (Hanita SeeLens) and MNF IOL (Tecnis, ZCB00) were enrolled in the study. Subjects with cataract grade NS I-III, aged between 40 -75 years, pre-operative best corrected visual acuity 6/12 or worse, corneal astigmatism <2.00D were included in the study. Subjects with any cor-neal pathology, irregular astigmatism, previous re-fractive surgery, glaucoma, any retinal pathology, intra-operative complications were excluded. Post operatively 1 month ± 7 days, we measured uncor-rected distance, near and intermediate visual acui-

ties. Also, internal HOA for 4 mm pupil and mod-ulation transfer function (MTF) by HOYA i-Trace aberrometer and compared.

Results

Thirty seven and 20 eyes were implanted with FR and MNF IOL with mean± SD age of 53.92±8.10 and 63.55± 4.89 respectively. Chi square test were used to analyzed uncorrected distance visual acui-ties which were similar (p=0.19) in both the IOLs however uncorrected near and intermediate visual acuities were significantly different (p<0.001). Two sample t test revealed no statistically significant dif-ference in internal HOA (p>0.05) among both IOLs except spherical aberrations (p<0.01) which was significantly different. MTF were similar with both the IOLs.

Conclusion

We noted similar intraocular HOA in eye im-planted with Full Range and Monofocal IOL. This could be attributed to the design of the IOL.



Visual Function and Subjective Perception of Patients with full Thick-ness Macular HoleSamiyasultana Kazi, Helly Shah

Nagar School of Optometry

Aim

To assess the visual ability of patients with full thick-ness macular hole and its effect on their quality of life.

Method

(1) Visual acuity was measured using Snellen’s acu-ity chart.

(2) Contrast sensitivity was measured using Pelli Robson chart.

(3) Colour vision was measured using Ishihara chart.

(4) Amsler grading was measured using Amsler’s chart with diagonal line.

(5) NEI VFQ Questionnaire was filled by the patient.

Results

The current study quantitatively indicated all 20 pa-tients had unilateral involvement. 80% of patients

had FTMH in Left eye. Out of 20 patients exam-ined 80% were female patients, most of them (50%) in the age group of 51-60 years. Metamorphopsia is an important factor not only in visual functioning, but also in the subjective visual function in patients with FTMH. The current study also shows that there is drop in the contrast sensitivity in the patients with FTMH.

Conclusion

Primary health-care providers play an important role in early detection and referral of patients with FTMH. Delay in detection and referral may lead to visual disability and thus impairment of the patient’s quality of life.



Lid Wiper Epitheliopathy in Prosthetic EyeShraddha Purohit, Hiral Korani


Aim

Prosthetic eye wearers frequently complain of dry-ness, watering, discharge and discomfort. This could be due to friction between the lid and the prosthetic eye and presence of surface deposits. Thus leading to anatomical changes of the anopthalmic scoket. Hence, the purpose is to investigate lid wiper epitheliopathy and meibomian gland dysfunction in prosthetic eye in comparison to fellow normal eye.

Method

Patients between the age group of 18 to 60 years wearing prosthetic eye for more than 6 months ir-respective of the fitting quality were included. If they used eye drops, then were asked to discontin-ue for a week. Lid abnormalities like lid lacerations, lid malposition, chalazion, hordeolum, conjunctivi-tis or tearing due to nasolacrimal duct obstruction were excluded. Patients consuming alcohol, or any systemic medication were excluded. Patient consent for their participation in the study was taken. Mei-bomian orifices obstruction to assess the meibum quality, Meibomian gland evaluation to understand the dropout rates, and Lid Wiper Epitheliopathy

was evaluated in the prosthetic eye and comparing it with the fellow normal eye.

Results

The mean age of the patients was 35.33 ± 12.33. There were 3 females and 12 males in the study. The mean time period of wearing the prosthetic eye was 12.33 ±9.825. Wilcoxon Signed Rank Test was done and significant difference was observed between the eye wearing prosthesis and the fellow normal eye in the Meibography score (p < 0.00) and presence of Lid Wiper Epitheliopathy (p < 0.00). There was no significant difference seen in the expressibility of meibum in the eye wearing prosthesis versus the fellow normal eye (p=0.102). Incidence of LWE in prosthetic eye was observed in all the patients.

Conclusion

The pilot study states that, long standing wear of prosthetic eye shows profound loss of Meibomian gland and presence of Lid wiper epitheliopathy. However, further analysis needs to be done to see the relation between anatomical changes of the socket and presence of Discharge.



Correlation of Macular Pigment Optical Density with Retinal Nerve Fibre Layer and Ganglion Cell Complex in Normal Indian Eyes

Rikta paul, Rituparna Ghoshal, Somnath Ghosh, Mukunda Chaitanya Akkali

D Y Patil

Aim

Macular pigment optical density (MPOD) is a new technique that permits early diagnosis of diseases like glaucoma and age related macular degeneration. Lit-erature on MOPD and its correlation with different macular parameters in normal eyes are limited.Thus the purpose of the study was to measure MOPD and to further correlate it with retinal nerve fiber layer and ganglion cell complex in normal Indian eyes.

Method

Subjects without any ocular pathology were included in this cross sectional single centre study. All participants have undergone complete ophthalmic examination including vision, refraction, slit lamp and intra ocular pressure measurement. Macular pigment optical density was determined using the macular pigment densitometer (Tinsley Ophthalmic, Surrey, UK) whereas optical coherence tomography (Optovue Avanti OCT) was used for measurement of ganglion cell complex and retinal nerve fiber layer. While measuring MPOD, three readings were taken for each eye. Average of these three readings was considered while analysis of data. All data was analyzed using SPSS software. Descriptive statistics, Pearson correlation were employed for statistical analysis.

Results

72 eyes of 72 participants were examined (36.1% males and 63.8% females). Mean age of partici-pant’s was 24.36±4.32 years. Majority of the pa-tients (79.1%) were emmetropic while (20.9%) were myopic. Mean best corrected visual acuity was 0.02 logMAR whereas mean intra ocular pressure was 13.32 ± 2.16 mm of Hg. Mean ± standard deviation MPOD was 0.40±0.19 density units whereas, mean ± standard retinal nerve fiber thickness was 102±8 micron and mean ganglion cell complex was 97.75±6 micron Mean MPOD in male was 0.33±0.16 densi-ty unit and mean MPOD in female was 0.42±0.19. This difference was statistically significant (p=0.000). However, macular pigment optical den-sity poorly correlated with retinal nerve fiber layer thickness (r=0.07, p=0.55) and ganglion cell com-plex (r=0.051, P=0.66).

Conclusion

In present study established the average MPOD in normal Indian eyes. Female had higher MOPD compared to males. However, there was poor cor-relation between MPOD with ganglion cell com-plex and retinal nerve fiber layer.



Diabetic Retinopathy with Maculopathy: A Case StudyZulekha Mohamed Elias

SEGi University

Introduction

Diabetic retinopathy is a progressive condition with microvascular alterations resulting to severe vision loss if left untreated. It is one of the leading causes of blindness among working adults. Advanced manifes-tation of DR results to diabetic maculopathy, affecting the macular region.

Patient Profile

The presenting patient is a hyperope with astigma-tism in both eyes, along with near add. The patient is a diabetic, which is under control, but not optimal; and has undergone cataract surgery in both eyes. The patient has also undergone laser treatment for diabetic retinopathy. The external health was unre-markable with normal IOP in both the eyes. Inter-nal ocular health revealed cotton wool spots, hard

exudates and haemorrhages in the RE, scarring, cotton wool spots and hard exudates in the LE. OCT was done to further evaluate the status of the macula. The patient has CSME in the right eye and mild maculopathy in the left eye.

Intervention and Outcome

The patient was diagnosed with diabetic retinopa-thy with maculopathy. The patient was referred to retinal ophthalmologist. A focal laser in the RE, along with NSAIDS and artificial tears was the mode of treatment suggested. Comprehensive eye examination including the internal and external eye health examination is essential in primary eye care setup. Optometrist plays an important role in di-agnosing, referring and co-managing patents with ophthalmologists.



Session IVClinical Optometry and

Binocular Vision



Photostress Recovery Test time Using Different Colour Wavelengths in Normal Subject

Manashwi KarkiSankara College of Optometry

Aim

Photostress Recovery test is based on the principle of visual pigment bleaching on exposure to intense light. This study was done to find out the variation in PSRT when the retina is subjected to light of different wave-length.

Method

Prospective experimental study was conducted at Bangalore where subject between age group of 16-25 years participated. Permission and consent was taken and comprehensive eye examination was done. The baseline PSRT was taken by dazzling macula with di-rect ophthalmoscope light (2,400 LUX) held approxi-mately 3 cm away from cornea for 10 seconds and were asked to read one line above BCVA and time taken to do so was recorded. Same procedure was repeated for Red, Green and Blue wavelength of light.

Results

Total 35 subjects were included in the study (70 eyes) with the mean age of 20.26 years. The mean baseline PSRT was 27.25 seconds, PSRT with red was 10.88 seconds, with green was 8.14 seconds and blue was 7.30 seconds. The comparison between baseline PSRT and PSRT with different wavelength was clinically significant (P value < 0.05). Similarly, the PSRT with Red was more than PSRT with Green and Blue, which was statistically significant, but the differences be-tween values of PSRT with Green and Blue were not clinically significant.

Conclusion

The PSRT with direct ophthalmoscope was significant-ly higher than PSRT with a single wavelength of light. The recovery time was least for blue, followed closely by green wavelength light, and was more for red light.



Color Vision Test Under Different Light SourcesVaishaly Singh, Aparna S

Sankara College of Optometry

Aim

Color vision plays a very crucial role during a regular eye examination. This study takes one of the standardized aspect i.e. illumination, to see how a small deviation in the source of illumination affect the final result of colour vision testing. It will help to understand how colour vision test results vary, when done under different source of illumination.

Method

This experimental study was conducted with n=55 participants of age groups 18 to 26 year. Inclusion criteria were Trichromats, with no history of ocu-lar pathology. Color vision test under different light sources (Daylight, LED, CFL, Tungsten, and Fluores-cent) was assessed with FM100 hue test. After that error scores were calculated and interpreted by using

FM 100 software. Time taken to complete the test also analyzed.

Results

In Trichromats, there was a significant change in error score under different light sources. There was increase in error with the tungsten light source (p=.000).Simi-larly there was statically significantly reduction in er-ror score with LED (P=0.009) and with fluorescent (p=0.003).

Conclusion

People tend to make more error under tungsten light than other sources. Though, under fluorescent and LED sources color discrimination was better subjectively subjects were more comfortable with fluorescent light.



Relationship of CDR and AVR with Anthropometric Parameters in Myopic Chinese

See Jia Shin , Shah Farez OthmanSEGi University

Aim

Anthropometric measurements are used to assess the size, shape and composition of the human body. Cup Disc Ratio (CDR) and Arterioenous Ratio (AVR) are measurements of the optic nerve and the ratio of the arteries to veins in the retina respectively. The present study was undertaken to investigate the relationship of CDR and AVR with anthropometric parameters in Malaysian Myopic Chinese.

Method

It was a clinical cross-sectional study where subjects with an age range from 18 to 28 years were included. Each subject underwent a complete optometric examina-tion including history taking, clinical refraction, A-scan, tonometry, slit lamp examination and funduscopy. Axial length was measured using A-scan ultrasound biom-etry and IOP was measured using Nidek Non-Contact Tonometer. Height, weight and waist circumference were measured and body mass index (BMI) was cal-culated. Fundus images were captured using Topcon Non-Mydriatic Retinal Camera (TRC-NW300). Image J software was used to assess cup-disc diameter and arte-riole-venule diameter from the fundus images, and CDR and AVR was calculated. The measurement was done for one of the eye for all subjects.

Results

A total of eighty four (84) young adults (68% females and 32% males) were studied. The mean spherical equivalent ratio (SER) was -4.22 ± 2.22D, the mean axial length (AL) was 25.10 ± 1.32 mm, and the mean intraocular pressure (IOP) was 13.66 ± 1.89 mmHg. Data collected was normally distributed. The average height and waist circumference measured in centime-ters (cm) across all subjects was 164.50 ± 7.96 cm and 76.32 ± 8.01cm respectively. BMI was calculated for all the subjects and the mean BMI was 21.16 ± 3.19 kg/m2. The mean of CDR was 0.34 ± 0.52 and the mean AVR was 0.72 ± 0.08. Parametric Pearson’s cor-relation coefficient was used to correlate the variables. None of the anthropometric parameters was found to be associated with CDR and AVR in the present study (p > 0.05).

Conclusion

In conclusion, there is no relationship between CDR and AVR with anthropometric parameters (i.e. height, BMI, WC) in Malaysian myopic Chinese. Hence, it was not necessary for these parameters to be taken into con-sideration in CDR and AVR measurement during rou-tine clinical examination.



Binocular Vision Assessment Before and After Using Virtual Reality Gadget

Venkatesh Surabathula, Rupa Kotla, Aparna S, Diwakar RaoSankara College of Optometry

Aim

Binocular single vision is a state of simultaneous vision, which is achieved by the coordinated use of both the eyes and forms single image by process of fusion. Use of VR devices has reported to cause visual fatigue and binocular stress. Thus, it is necessary to know about how it affects the binocular vision.

Method

58 subjects, who satisfied inclusion criteria based on the comprehensive eye examination, were included in the study. Binocular vision assessment were done by examiner 1 includes sensory tests (W4DT, Stereop-sis, CV), Motor tests (cover test, prism bar cover test, modified thorington, AC/A , saccades and pursuits), Accommodation tests(NPA, AA, MEM, NRA & PRA, AF), Vergence tests (NPC, NFV & PFV, and VF). Af-ter the baseline binocular vision assessment, subjects were asked to watch Virtual Reality video for 30 min-utes. Once subjects finished watching the VR video, binocular vision assessment was repeated by examin-er 2. All the data were analyzed using SPSS software, version 23. Paired T-test was used to compare all Sen-sory, Motor, Accommodative and Vergence tests.

Results

After watching VR there was no statistically signifi-cant change in stereopsis (and phoria distance. There was statistically significant decrease in amplitude of accommodation (p=0.001) after watching VR. MEM significantly increased towards lag after watching VR (p=0.001). There was statistically significant dif-ference in NPC where it was receded after watching VR (p=0.000). There was also significant increase in fusional ranges for near NFV (p=0.009) & PFV (p=0.043) as well as VF after VR (p<0.000). AC/A is decreased after watching VR but not statistically sig-nificant change.

Conclusion

Watching VR for 30 minutes can cause significant changes in BV functions like accommodation and vergence. It also causes asthenopic symptoms like headache, dizziness and eyestrain. The people who watch VR for hours need to be taken enough care to keep their binocular vision status unaffected. These results provide helpful information for establishment of guidelines for VR manufacturers.



A Case of Convergence Excess with Refractive Accommodative Esotropia

Nikita Mapuskar, Atul Seth, Soumik Dey, Bhushan ChariLaxmi College of Optometry

Introduction

Esotropia is the most advanced form of Convergence Excess (CE). Prevalence of CE is found to be ranged between 0.8 to 15% according to various studies. Most of the CE cases are related with excessive accommo-dation. In majority of uncorrected hyperopes it was found that excessive amount of accommodation is re-quired, thus it requires excessive convergence (high AC/A) resulting in CE.

Patient Profile

Patient has visited the Laxmi Eye Institute (LEI) with a history of esotropia with RE: +5.75/-2.25 x 10 & LE: +5.75/-2.50 x 160. Patient was advised glasses with alternate day occlusion. On evaluation with Prism bar cover test the patient was ortho for far and controlled ET for near and patient was asked to follow the same. 2 months later the patient complained of squint. On eval-uation with PBCT it was observed to have ortho for far & 14-16 ∆D BO for near. Bifocals RE: +5.00/-2.50 x 10 & LE: +5.00/-2.00 x 160 with Addition of +2 Ds was

prescribed. On next f/u it was observed to have ortho for far and near through glasses. Through upper segment it was observed to have ortho for far & 10∆D for near. On f/u, cover test found to be ortho and gross stereopsis was absent. New glasses were prescribed with +0.50D reduction in power for both eyes. On next few f/u vis-its as ET was controlled through bifocals and it was ad-vised to continue the same but later Add was reduced to +1.50Ds.

Interventions and Outcomes

Patient had a complaint of right eye squint since few months and had a large angle esotropia on evaluation. Atropine refraction was advised which revealed high hyperopic refractive error. Glasses were prescribed with occlusion of the good eye. ET for far was con-trolled like refractive ET, but the near ET was still ob-served. There was convergence excess observed. Later bifocals were advised which controlled ET for both far & near through glasses. As there was improvement Add was further reduced.



PosterPresentation



Binocular Vision Anomalies Among Table Tennis PlayersAnusha.H.K, Monisha Mary. J, Diwakra Rao


Aim

As table tennis is dynamic sports the players use more of their binocular vision in order to keep the ball sin-gle and clear. Reduce human error and effort Hypoth-esis: Binocular vision anomalies will not affect the per-formance of the table tennis players.

Method

An observational study which was conducted in various table tennis academies in Bengaluru age group b/w 10-30 year. Permission was taken from the coordinator and from various academies. Brief history was taken and all binocular assessment was performed. Diagnosis along with their performance, as informed by the coach, was made. The data was analyzed with help of SSPS soft-ware.

Results

on relating the performance of the players with the binocular vision anomalies like CI, AI , CI with AE are more among bouncer & intermediate players. Binocu-lar vision function like NPC, AA, PRA, AF & MEM was found to be better in tournament compared to bounce and intermediate.

Conclusion

Present study reveals that relating the performance of the player with the binocular vision anomalies & binoc-ular vision functions were more among the bouncer& intermediate players than compared to tournament.



Clock Hour Evaluation of Retinal Thickness in Diabetic RetinopathyPratik More, Shajer Shaikh, Onkar Pirdankar

Wavikar College of Optometry

Aim

To evaluate retinal thickness in different clock hour’s sectors in diabetic retinopathy and age matched normal.

Method

It’s a prospective study where subjects diagnosed with diabetic retinopathy and age matched visually normal were included. Subjects with previous history of ocu-lar surgery or previous injection, other ocular disease that could affect retinal thickness, other systemic dis-eases were excluded. All subjects underwent detailed examination including refraction, best corrected visual acuity, IOP were noted. Retinal thickness in different clock hours sector (1-12) were measured using Cirrus HD-OCT 4000 (Zeiss) in eyes with diabetic with (DR) and without (DN) retinopathy and age matched nor-mals and compared using one way Anova and Tukey Post Hoc test.

Results

Forty nine were normal, 8 were diabetic without retin-opathy and 30 were diabetic retinopathy eyes with mean±SD age 59.8±10.91, 72.0±7.67 and 66.0±7 .64 years respectively were enrolled. Mean±SD IOP was similar in all the 3 groups. In diabetic retinopa-thy, significant RNFL thinning was noted in superi-or (F=4.42, P=0.015) and Nasal quadrant (F= 3.37, P=0.004). Retinal thickness was significantly affect-ed at 2, 3, and 6 O’clock position (P<0.05) however at other positions it was similar in all the 3 groups (p>0.05). Tukey Post Hoc Test revealed RNFL thick-ness in diabetic normals was lesser than healthy nor-mals however not significantly different.

Conclusion

In our study we noted significant thinning of RNFL at 2 and 3 O’clock position. This could provide more insights towards management of diabetic retinopathy.



Differentiating Acute Zonal Occult Outer Retinopathy (AZOOR) from other retinal lesions

Bhumin Parekh, Dhaivat Shah, Aparna G, Rajiv RamanElite School of Optometry

Introduction

AZOOR is characterized by gradual onset of de-creased vision with field loss related to zone of out-er retinal dysfunction and presence of photopsia. Patients usually present with a scotoma with fundus showing retinal atrophy and mottling of the RPE in the areas involved as AZOOR progresses. This case depicts how specific findings of ERG, OCT and FA helped to differentiate AZOOR from PPCRA, SC and RP.

Patient Profile

A 60 years old female came for second opinion as she was elsewhere diagnosed to have late onset Retinitis Pigmen-tosa (RP). She had complaints of diminution of vision in right eye and photopsia for a year. Fundus showed the presence of bony spicules in both eyes. A differential di-agnosis of Pigmented Paravenous Chorioretinopathy(P-PCRA), RP, Serpiginous choroiditis(SC) and AZOOR was made. Optos widefield fundus photo, Swept Source OCT, Full Field and Multifocal ERG and Fundus Aut-ofluorescence (FA) aided in reaching and confirming the

diagnosis of AZOOR. Recent loss of visual acuity and photopsia are common ocular symptoms associated with AZOOR patients, while night blindness and progressive visual field loss are observed in RP patients, and PPCRA patients are asymptomatic. The clinical appearance of the AZOOR lesions include a demarcating line of pro-gression evident in FA and trizonal degeneration of out-er retina, RPE, and choroid including zonal progression evident in FA and OCT.

Interventions and Outcomes

A diagnosis of AZOOR was made and patient was started on Oral Prednisolone. It is very essential to un-derstand and explain the patient that the aim of treat-ment is to stagnate the disease, and lifelong therapy might be required to prevent progression. This makes it very important to correctly diagnose and manage the condition at the earliest to prevent foveal involvement and permanent vision loss. Multimodal imaging thus has paramount importance for diagnosis and prognosis of AZOOR.



IOP Comparison of Glaucomatous & Non-glaucomatous Patients by Cataract Surgery

Haney Patel, Reema RavalNagar School of Optometry

Aim

To find the effect of Phcoemulsification & Intraocular lens implantation on Intra-ocular Pressure & glaucoma medication in POAG patient & Normal patient with cararact types upto NS-2, PSC, CS & PPC.

Method

This Study included measurement of IOP in 35 non-glaucomatous patients having cataract & 35 Pri-mary-open angle glaucomatous patients having cata-ract, with excludation crietria of secondary glaucoma,

PACG, Complicated cataract & any ocular Co-morbid-ity. All 70 patients measured IOP By NCT Before & after cataract surgery having f/up on 1st day, 1st week & 2nd week.

Results

The Outcomes of this study showed that IOP decrease on an average 2.3mm/Hg of POAG Patients with also decrease anti-glaucoma medication & 2.1mm/Hg of Normal patients after surgery.



Visual Screening of Children in Integrated Schools in AhmedabadSimran Ramchandani, Optom Helly Shah


Aim

The aim of this study is to screen the students of the integrated schools and to find the visual efficiency of these students; to identify the avoidable causes of visual impairment and blindness and to recommend spectacles, low vision aids in improving visual perfor-mance and response in children with low vision.

Method

The initial examination begins with visual function assessment questionnaire which includes ocular his-tory, family ocular history and chief complain of the students, questions regarding near and distance vision task problem, glare problem, mobility problem, color vision problem, daily living skills problem. The assess-ment includes pupillary assessment, oculo-motor as-sessment, and anterior segment assessment. Distance visual acuity is measured with Single Isolated Chart

and Kay Picture Chart and near visual acuity is meas-ured with Reduced Snellen’s Chart and Continuous N-Notation Text Chart. Non cycloplegic refraction was done in all the participants. Optical and Non-Op-tical Low vision aids were recommended based on ini-tial evaluation and the students’ visual needs.

Results

From this study, it has been seen that the most common cause of visual impairment is Pthysical eye 85 (28.14%) followed by Refractive Error 84 (27.81%). Nystagmus contributed 80 (26.49%) of visual impairment and Optic Nerve (Atrophy) contributed to 70 (23.17%) of visual impairment. In severely visually impaired stu-dents Non-Optical devices are recommended in mild and moderately visually impaired students Optical de-vices are recommended.



Selection of IOL for Pediatric CataractPrashant Pawar, Manoj Bhiwate

Laxmi College of Optometry

Introduction

IOL power selection is very crucial while operating pediatric cataract. Selection of lower power will be beneficial to patient which will lead to emmetropization as the age increases and reduces the chances of myopia after few years.

Patient Profile

A 6 year old female child presented with Left Eye (LE) mature cataract. Systemic and family history was within normal limits. On performing detail clinical ex-amination her Best Corrected Visual Acuity (BCVA) improved to 6/9p in RE and was PL PR +ve in LE on `c’ chart. Fundus Examination was within normal limits in RE and poor view in LE .A detailed Pre-Op-

erative examination was performed which included Keratometry and A-scan Ultrasound. IOL Power was then calculated using SRK/T formula.


She was advised for left eye cataract extraction with foldable Monofocal IOL under Guarded Visual Prognosis (GVP).IOL power obtained was +25.50D. A 10% of reduction in this value was done by considering age related emmetropization and thus +23.00D IOL was selected for implantation. After 1 month, her IOP was normal in BE. Her BCVA was +1.00/-0.75x180 Add: +2.50D, 6/9p, N6 in RE and +2.00/-1.00x180 Add: +2.50D, 6/6p, N6 in LE.



Effectiveness of Road Race (3D) Game in VTS4 Software for Normal & CI Subjects

Jitendra Kumar Sahoo, Rishiraj Sahani, Diwakar RaoSankara College of Optometry

Aim

Purpose:Home based therapy is possible.Suitable for paediatric age groups, as it is in the form of a game.Reduce human error and effort.Hypothesis: There is no such significant difference in accommodation and vergence between pre,post and post after 3 hour of therapy.

Method

24 subjects (12-Normal, 12-CI) were selected of age between 18-25, having BCVAfor Dist. & near 0.00 log MAR & 20/20 respectively.Aphakic, psuedophakic, strabismic,amblyopic & high ref.error ware exclud-ed.1st consent form were signed, demographic data, history, VA, refraction, comprehensive eye checkup was performed, Base line Binocular Vision assessment was done. Allowed to play Road Race game (BI) for 20 minutes, performed accommodation & vergence tests,

post & post after 3 hour. Similarly after 7 days repeat with BO. Data analyzed by SPSS V23 by using paired T test.

Results

There ia a significant improvement in NP-C(BREAK:p=0.00)(Recovery=0.00), Fusional Range (NFV: p=0.01)(PFV: p=0.00)& VF(p=0.00) with BO therapy, Improvement only fusional range in BI & There are improvement in monocular Accommodative Facility & lag of accommodation in MEM & also mo-nocular NPA is receding in both BI & BO therapy.

Conclusion

Road Race game in VTS4 software can be used as an effective tool or therapy for improving fusional ranges and near point of convergence in Convergence Insuffi-ciency subjects



Changes in Visual Acuity and Contrast Sensitivity Post Short Term Wear of Ortho-K Lenses

Jyosthna Serra, Pancham Kulkarni Lotus College of Optometry

Aim

This study evaluated the effect of short-term Orthokeratology (OK) lens wear in open eye condition on visual acuity (VA) and contrast sensitivity (CS).

Method

15 eyes of 10 young adult subjects (10 eyes) with mean age 21 + 3 years wore reverse-geometry lens-es (Fargo; Paragon Vision, USA) monocularly in open eye condition for 30 minutes and 2 hours on separate occasion. VA was recorded using logMAR chart and CS was recorded using Vector Vision CSV-1000E (Ohio, USA) test. VA and CS were recorded post 2 hours of OK lens wear and the measurements were repeated again after 1 week of washout lens period, post 30 minutes of OK lens wear.

Results

Mean unaided baseline VA values improved from 0.804 + 0.34 log at baseline to mean 0.494 + 0.4 log post 30 minutes and mean 0.376 + 0.45 log post 2 hours of lens wear. Similarly, the mean CS values improved for all spatial frequencies with mean unaided baseline CS values improving from 0.814 + 0.39 log to mean 1.29+ 0.34 log post 2 hours and mean 1.20 + 0.36 log post 30 minutes of Ok lens wear.

Conclusion

VA and CS displayed good improvement post 2 hours and post 30 minutes of lens wear with greater improvement post 2 hours of lens wear.



Effect of Smartphone on Accommodation & Vergence in Bright & Dark Illumination

Monica Mareena J, Vandana kamath, Diwakar RaoSankara College of Optometry

Aim

To study effect of smart phone on accommodation and vergence before and after using a smart phone in bright and dark illumination with different posi-tion.

Method

It is a prospective study where the subjects were par-ticipated from Sankara College of Optometry, Ban-galore. The following test i.e. Near point of accom-modation, amplitude of accommodation, NRA-PRA Accommodative facility, NPC, vergence facility; Neg-ative fusional vergence and positive fusional vergence evaluation were done. Then, the subjects were made to read a novel on a smart phone in bright and dark illumination in erect and supine position for 30 min-utes again accommodation and vergence test were re-peated. Data analysis was done by using paired T- test with the help of SPSS software V23. The accommo-dation and vergence functions tests were compared for before and after reading novel on a smart phone in bright and dark illumination in erect and supine posi-tion about an half an hour.[bright illumination erect

position (72lux)& supine(52lux)& Dark illumination erect position (2 lux) & supine (3lux)].

Results

A total of 30 subjects were evaluated under the Mean age group of 19.97±1.67 years (range, 18-30years).Out of 30 subjects, 22 (73%) were females and 8 (27%) were males. There is significant change statistically and clinically in accommodation components such as NPA, AA and NRA, MEM and vergence components such as NFV before and after reading novel on a smart phone in bright and dark illumination in erect and supine po-sition about 30 minutes.

Conclusion

The prolonged reading of novel in the smart phone in bright &dark illumination in erect and supine position which was for a period of half an hour shows statisti-cally significant effect on accommodative components such as NPA, Amplitude of Accommodation and NRA, MEM &also there was statistically significant effect on vergence components such as NFV.



Construction and Validation of International Reading Speed Texts (IReST) Chart in Marathi

Prathamesh Shasane, Rutul Shah Lotus College of Optometry

Aim

To construct and validate International Reading Speed Texts (IReST) reading speed chart in Indian regional language of Marathi.

Method

It is an experimental study in which visually normal subjects between age group of 18-35 years with quali-fication of at least 10th standard and having ability to read and speak both English and Marathi languages fluently will be included. Visual acuity for distance and near should be 6/9 or better and N8 or better mo-nocularly and binocularly respectively with normal binocular vision parameters. Subjects having any type of ocular pathology, symptomatic binocular vision anomalies or any known attention deficit/cognitive impairment will be excluded from the study. The first stage of methodology will include linguistic trans-lation of English version of IReST in Marathi by a linguistic expert. Time taken to read each text will

be recorded using a stopwatch. Error words (missing words, wrongly read words) and re-read words, will be recorded and compared with the English version of IReST chart. Finally, words per minute for Eng-lish and Marathi will be calculated using the follow-ing formula: [Words per minute = Total no of words read x 60 / Time taken by subject to read a text] and compared. Statistical analysis will be done as the third stage of methodology.

Results

Time taken to read each text and words per minute in both English and Marathi for 10 subjects was analysed. The time taken to read each text in both English and Marathi didn’t show a significant difference however, the words per minute did show a significant difference.

Conclusion

IReST Marathi can be efficiently used for measuring reading speed.



Mobility Task Related Questionnaire in Patients with Retinal DiseasesShivani Gandhi, Rutul ShahLotus College of Optometry

Aim

The aim of the study is to assess mobility task related questionnaire in patients with retinal diseases. Ques-tionnaire can be used to establish the spatial extent of person’s mobility and to assess the difficulty for people with impaired vision to do daily living activities.

Method

It is an observational study in which subjects above the age of 18 years with any retinal disease, visual acuity less than 6/18(0.48Logmar) in the better seeing eye and having field loss in any part of the quadrant are included in this study. Subjects taking any prescrip-tion drugs or having any vestibular abnormalities are excluded from the study. The methodology consisted of detailed demographic data, battery of optometric tests which included visual acuity, subjective refrac-tion, visual field evaluation, fundus evaluation and a series of questionnaire is administered related to mo-bility task including four sub topics- Outdoors, In-doors, Shopping and Public Transport.

Results

Subjects were asked to rate the difficulty of four goals which was applicable and the difficulty of the tasks un-derpinning the goal on the basis of Likert scale. The most difficult tasks experienced by patient were orien-tating in public transport and the least difficult tasks were in indoor category. With increasing age, threats to mobility increase in prevalence and include problems such as impairments in physical, cognitive, and sensory functioning.

Conclusion

Questionnaire can help to determine the areas of par-ticular difficulty to address rehabilitation and mobility training services. It can be used to plan individual’s re-habilitation needs or as outcome measures to determine the effect of interventions.



A Survey of Satisfaction with Wearing Ocular ProsthesisPinki Bharati, Vandhana Kamath


Aim

Ocular prosthesis gives good cosmetic appearance from children to older age group weather is it stock or custom made prosthesis. It also help to improve self-esteem and psychosocial impact on subjects. So it is important to know how much patients are satisfied after wearing ocular prosthesis or not.

Method

A prospective questionnaire based study was per-formed with 35 subjects who are already wearing ocu-lar prosthesis between the age group of 3 to 75 years. The Prosthetic questionnaire was asked based on The prosthetic is comfortable to wear, looks realistic, meets all my expectation (i.e., appearance, color etc.),enhance my self –esteem, enhance my integrations into socie-ty, enhance how people perceive me and My Ocularist is helpful and approachable. Data was collected and analyzed by using the IBM SPSS V.23.0 for Microsoft windows. The satisfaction rate and the comparison

between male and female were analyzed by using the descriptive statistical analyzed.

Results

35 subjects with mean age 22.40 ± 18.50 years of participated in study. Overall Result of questionnaire showed that, Ocular Prosthesis was Comfortable 68%, Realistic 63%, Expectation 63%, Enhance My Self Esteem 71%, Enhance My Integrations Into Society 74%, Perceive 77%, Helpful And Approachable 91%, Information Needed Regarding My Ongoing Care 94%in subjects. Males and Females have different approach for ocular prosthesis.

Conclusion

In this study it was found that overall rate of satisfaction with ocular prosthesis was 94.1%. Most of the subjects were very much satisfied with their ocular prosthesis. These may have impact on their psychological & social status.



Foveal Microvasculature Metrics in Normal and Diabetic SubjectsPooja Ballewar, Supriya Patil, Pushpanjali Ramteke, Amit Nene, Smitesh Shah, Onkar Pirdankar

Isha Netralaya

Aim

To compare foveal microvasculature metrics in normal and diabetic subjects.

Method

Its a prospective study where diabetic subjects with-out retinopathy and age matched normal subjects with best corrected visual acuity of 0.2 logMAR or better were included. Subjects with previous history of ocular and systemic disease, ocular surgery were excluded. All subjects underwent detailed examina-tion including refraction, best corrected visual acu-ity, IOP, anterior and posterior segment examina-tion. Foveal microvasculature metrics such as foveal avascular zone (FAZ) area and perimeter, acircularity index (AI), foveal vessels density (FD) were meas-ured using Optovue OCT angio and compared using 2 sample t test.

Results

Twenty normal eyes and 12 diabetic eyes with mean±SD age of 51.00±8.23 and 55.83±5.44 (p=0.06)were analyzed. The mean±SD FAZ area in diabetic and age matched subjects were 0.38±0.08 and 0.36±0.11 respectively. The mean±SD FAZ area in diabetic and age matched subjects were 0.38±0.08 and 0.36±0.11 mm2 respectively. The mean±SD FAZ perimeter in diabetic and age matched subjects were 2.40±0.03 and 2.33±0.3 mm respectively. Statistical analyses revealed non significance difference in FAZ sizes between di-abetics and age matched normals. Acircularity index was significantly higher in diabetics as compared to normals (p=0.04) however foveal vessels density was similar in both the groups (p=0.08).

Conclusion

FAZ area, perimeter and vessel density is similar in di-abetics and age matched normal.



Students Educational Background, Perception and Expectation towards Optometry in Mumbai

Pooja Salunke, Swapnali DubhashiLotus College of Optometry

Aim

The purpose of the study is to understand students’ knowledge, background, perception and expectation towards optometry.

Method

It is a questionnaire based study in which personal interviews were conducted for pilot study on fresh-ly passed graduate students, based on the discussion questionnaire was formed and a focused group study was conducted among 3rd and 4th years optometry students, and a final questionnaire was formed and personally distributed among all the optometry col-leges in Mumbai.

Diploma holders and B –Vocational program are excluded in the study.

Results

Questionnaire were distributed to 3rd and 4th year optometry students and passed graduates, from those participants 28.57% were male and 71.42%

participants were female. Average HSC score was 64.16%. 57.14% participants 1st choice of study after HSC was Medicine and others had different choice and only 7.14% participants had optometry as the 1st choice of study after HSC. 50% of participant’s parents encouraged to choose optometry as their profession as they had their own optical background. 71% are proud to tell others that I am studying optometry and get good opportunity and employment. Status of optometry was compared to the other health care profession and the result showed that optometry is similar to physiotherapy and its higher than occupational therapy and pharmacy. After graduation 42% wants to do higher studies and aim to have their own specialty clinics. 21.42% of them have considered changing course during academics and 78.57% are happy to choose Optometry.

Conclusion

The results showed that Optometry is intellectually satisfying and financially rewarding career.



Fusional Vergence Measurement with Prism Bar in Front of Dominant Eye & Non Dominant Eye

Pranav Sandam, Monica Samant, Bhushan ChariLaxmi College of Optometry

Aim

It is a prospective study which was carried out to determine whether there was any change in fusional vergences when measured by placing prism bar in front of dominant eye & non dominant eye. We have considered null hypothesis Ho as µ1 = µ2, assuming that there will not be any difference in the values of fusional vergences measured in front of dominant eye and non dominant eye.

Method

47 subjects between the age group of 15 to 35 years with BCVA of 6/9 or better for distance and N6 for near have been included in the study. Measured phoria of less than or equal to 10∆D & stereopsis of 60 secs of arc has been included. Subjects with any history of ocular pathology & ocular surgery, subjects with strabismus & amblyopia have been excluded. As the enrollment of subject is done, a detailed history was obtained & preliminary examination has been performed, which includes visual acuity assessment, objective & subjective refraction. Stereopsis was measured for assessing binocular status and maddox rod test has been performed for measuring the phoria. For identifying the dominant eye Portas’s test was performed. Positive fusional vergences and negative fusional vergences measurement has been assessed

using prism bar for near & distance in front of dominant eye & non dominant eye respectively.

Results

The fusional vergences both Negative and Positive vergences were measured for distance as well as near and their break values were considered to compare between the dominant eye and the non-dominant eye. The break values for the fusional vergences between the dominant and non-dominant eye were compared using z-test (Two samples for means). The observation we found was having a statistical significant difference in PFV for near (p = 0.000028) whereas the other observations NFV (Distance), NFV (Near) and PFV (Distance) were not statistical significant with p values at (p = 0.92), (p = 0.39) and (p = 0.18) respectively performed at 95% confidence interval (level of significance 0.05).

Conclusion

The observations from the findings we obtained show that there was a statistical significant difference in PFV for near. Thus it is necessary to record or have a note of the eye in front of which the prism bar is placed while assessing fusional vergences. This will help the examiner to determine in front of which eye the prism bar should be used to assess fusional vergences post therapy sessions.



Profile of Ocular Conditions among children Referred from School Eye Screening

Ambika C, Anuradha NElite School of Optometry

Aim

1. Understanding the profile of children with ocular problems would help to know the most prevalent ocular problems among children. 2. This profile would give an overview of common ocular conditions among children and thus would help to plan the professional requirements and training needs of School Eye Screening team.

Method

School Eye Screening included a three phased screen-ing protocol that included basic vision screening, re-fraction and referral to the base hospital. The children whose vision did not improve with spectacles and or identified with other ocular problems were referred to the base hospital for further management. All the data of school eye screening conducted by the institution for children aged 6-17 years between June 2016 and May 2018 (two academic years) were retrospectively analyzed. Demographic and clinical information of the children referred were collected. The reasons for the referrals were further grouped into four major groups, depending upon pri-mary reason to referral includes, Surgical, Medical, Refractive, Unidentified and Others. Conditions that need an immediate attention to avoid complications (Urgent referral), conditions that exhibits visible oc-ular signs and data with documented visit to any hos-pital or having previous glass prescription were also taken into account.

Results

Among 164731 children screened in 607 schools in Kanchipuram district, 2484 (1.5% with 95% CI 1.5 - 1.6) children (mean age 10.7±3.48 years) were referred. The children were referred under 18 group of conditions like Strabismus, high myopia, amblyopia, neuro, cataract and related complications, retina, trauma, ptosis, cornea, vernalkerato conjunctivitis, oculoplasty, high hyperopia, keratoconus, uvea, Glaucoma, conjunctivitis/ hemorrhage, unidentified cause and cycloplegic refraction. These referrals were grouped under 5 major categories, Surgical 613 (25.4% 95% CI 23.7-27.1), Medical 146 (5.9% 95% CI 5.0-6.9), Refractive 1119 (45.03% 95% CI 43.1-47.0), unidentified causes 259 (10.4%) and others 330 (13.3%). More than 75% of the children referred with conditions like high myopia, keratoconus and retina had presenting visual acuity <6/9. Among the children referred 66.7% were urgent referral, 29.7% had visible ocular signs and 19.7% were had treatment before the screening was done.

Conclusion

Strabismus, High myopia and Amblyopia were the most commonly referred conditions in this profile. Regular eye screening provided with necessary equipments and trained Primary Eye Care Professionals can contribute in prevention of childhood blindness.



Corneal Wavefront Analysis in Normal Myopic Patients using Placido Based Topoghrapher

Harsh Prajapati, Optom. Usman MemonNagar School of Optometry

Aim

To evaluate the corneal wavefront aberrations in different grades of normal myopic eyes by using the placido disc topographer.

Method

A cross sectional observational study of 280 eyes of 162 patients with age ranging from 18-40 years who came for refractive surgery workup were included in the study. All patients were undergone comprehensive ophthalmic eye examination. Corneal topography performed with atlas 9000 topographer. patients with spherical power range -0.50D to -20.00d with corneal astigmatism up to -2.00 were divided into 4 group(each group n=70 eyes) namely mild myopia, moderate myopia, high myopia and very high myopia according their spherical equivalent power. spherical equivalent power, mean keratometry value, corneal cylinder power and wavefront data were collected and analysed between the groups.

Results

Two hundred eighty eyes of 162 subjects with mean age of 24.35±4.24 years were studied. There were no statstical difference in mean age, mean keratometry values in all four groups (P>0.05). Wavefront aberrations shows there was no statistical significant

difference of Z(2,-2), Z(3,-3), Z(3,1),Z(3,3),Z(4,4),Z(4,-2),Z(4,0)and High RMS, in Mild-moderate, Mild-High and Mild- very high myopia groups(ANOVA P≥0.05)and there was a statistical difference found in Z(2,2), Z(4,2), Z(4,4), Low RMS Between groups (ANOVA P≥0.05).

Conclusion

Higher order aberrations have no significant relationship with degree of myopia in normal eyes. In our population spherical aberration is little higher in myopic eyes.



Prevalence of Anisometropia and its Clinical picture in School-children of Mumbai, India

Manan Gala, Rutul ShahLotus College of Optometry

Aim

To evaluate the prevalence of Anisometropia and its clinical picture in school children of Mumbai, India.

Method

It is a school based cross-sectional study in which 3675 participants aged between 6-18 years were included. Eye checkup camps were conducted in 12 different schools where children were screened for refractive status of their eyes. Anisometropia was defined as difference of 0.75D and greater between two eyes in terms of Spherical Equivalence. Anisometropic Chil-dren were further underwent series of tests which included Cover test, Near point of Convergence, Near point of Accommodation, Monocular Estimation Method for Lead/Lag of Accommodation, Fusion and Stereopsis.

Results

Out of the 3675 students screened, 72 students had Anisometropia >0.50D which accounts for 1.959%.

Out of 72 Anisometropic children, 9.72% was Amblyopic, 18% Strabismic, 1.38% trauma induced and 70.83% Refractive Anisometropics. Also, 79% had mild, 12.5% had moderate and 8.3% had severe level of Anisometropia. 23.7% children were found with Suppression and 10.1% with Diplopia. Stereopsis was poor in 37.7% and was absent in 22.6% children. Near point of Convergence and Accommodation was receded in 19.6% and 21.27% children respectively. Accommodative lag was found in 52.83%, lead in 5.66% children on Monocular Estimation Method (MEM).

Conclusion

In this study, the prevalence of Anisometropia in 3675 participants between 6 to 18 years of age was found to be 1.959%. Among which Mild Anisometropia(SE difference 0.75D and < 2.0 D) was found to be highest followed by Moderate(SE difference ≥ 2.0 and < 3.0 D) and Severe(SE difference ≥ 3.0D).



Refractive Error Trends Among Public and Private Schools in Kanchipuram district

Subhiksha.R, N.AnuradhaElite School of Optometry

Aim

To assess the trend change in refractive errors among children studying in public and private schools in kanchipuram district.

Method

Data from School eye screening conducted under REACH programme between June 2017-October 2018 were analyzed. Collected data was classified based on public and private schools. 11219 children with 6002 males were present in private school and 60139 children with 26727 males in public schools. Spherical equivalent method was used to define myopia and hyperopia ,greater than or equal to -0.50D was considered as myopia and greater than or equal to +0.75D as hyperopia. Astigmatic correction was prescribed in minus cylinder form and it was defined as cylindrical error less than or equal to 0.50D in any axis.

Results

A total of 71358 children were present in 107 schools with the age range of 6 to 17 years. The prevalence

of spherical equivalent refractive error was found to be high in private schools (10.99%) than in public schools (4.06%) p<0.05. Myopia was found to be the most prevalent refractive error with 4.05% and 10.75% in public and private schools respectively. Prevalence of hyperopia was 0.02% and 0.2%, astigmatism 2.27% and 7.27% in public and private schools. As the age increases spherical equivalent value shifted towards less positive that ranged from -1.48 to -2.05D in private schools and -1.25 to -1.98D in public school.

Conclusion

Prevalence of refractive error was found to be much higher in private schools. Reasons for this difference could be due to educational pattern, lifestyle activities such as duration of gadgets usage and hours of near work, further studies on these components might help us in better understanding.



Recognizing the Reasons for Patient not Getting Operated for Cataract in Rural Areas

Sahil S Mhatre, Menda Purushottam Naidu, Rakesh V kaushal ITM

Aim

To understand and find out the obstacle for cataract patients not getting operated even after getting diagnosed with cataract in rural area.

Method

In this survey based study three hundred and fifty subjects of rural area of Thane and Raigad district of Maharashtra were examined and surveyed. Subjects aged 40 years and above and having cataract in either of the eye were included for the survey. Subjects were given a brief about survey and consent was taken be-fore administrating the survey. Questionnaire used in our study was adapted from the previous literature and modified. Reasons for subjects not getting oper-ated even after getting diagnosed with cataract were analyzed and reported.

Results

Out of three hundred and fifty subjects surveyed, 44 %( 154) were not willing to go for cataract surgery.

Among the subjects not willing to get operated 24% wanted to take second opinion. Twenty two percentage of the subject had family issues and were avoiding from getting operated. Fourteen percent had financial issues where as eight percent subjects had some or the other systemic illness so was avoiding to get operated. Twelve percent had fear for getting operated and six percent were following some rituals and were avoiding operation. Fourteen percentage of the subjects had no specific reasons they just didn’t want to get operated, this could be because of lack of knowledge and awareness.

Conclusion

Lack of awareness and knowledge of cataract and its management plays a major role in creating barriers in rural areas. Reasons like family issues, lack of trust in outcome for free cataract surgeries, subject’s economic condition and fear of operation were the barriers in rural areas. Thus creating awareness may surely reduce blindness due to cataract in rural areas.



To Measure Central Corneal Thickness after Short-term day Time Wear of Ortho-K lenses

Sana Sayed, Pancham KulkarniLotus College of Optometry

Aim

This study investigated central corneal thickness (CCT) changes induced by reverse-geometry lenses worn in open eye condition for short term duration.

Method

15 eyes of 10 young adult subjects with mean age 20.8 years (±1.48) wore reverse-geometry lenses (Fargo; Paragon Vision, USA) monocularly for 30 minutes and for 2 hours on separate occasions in open eye condition. CCT changes were monitored using the Non-contact Specular Microscope (Topcon SP-3000p; Topcon Corporation; Tokyo, Japan) after lens removal. A comfort and quality of vision based questionnaire was given to all the subjects at the end of study period.

Results

The mean CCT values were 496.6 microns which reduced to 495.1 microns post 30 mins of lens wear and further reduced to 486.7 microns post 2 hours of lens wear. Based on the responses of questionnaire 70% subjects reported mild to none level of discomfort.

Conclusion

CCT changes demonstrated rapid changes to the application of reverse geometry lenses within 30 minutes of lens wear with continuous decrease in thickness post 2 hours lens wear.



Accommodative Responses Towards Auditory StimulusSebin C Sebastian


Aim

Accommodation is the process in which the lens changes its shape for focusing the objects. Using stimulative and sedative music the lens is accommodating and relaxing.

Method

48 Subjects, satisfied inclusive criteria were included in the study after performing comprehensive eye exam-ination for all. Binocular vision assessment was done. After the baseline BV assessment, subjective hearing test, the subject is asked to listen for 1.5 minute stimu-lative music and sedative music respectively.

Results

Total 18 male and 30 female were participated in the study. After listening stimulative music, there was no

statistically significant change in NPA (p>0.05). There was statistically significant increase in AF and MEM towards lag (p<0.0.5). After listening to sedative music there was no significant change in NPA and AF(P>0.05). There was significant change in MEM towards Lead (p<0.05).

Conclusion

There was significant change in stimulative music and accommodation was getting relaxed. So it can be used as therapy for Accommodative Insufficiency and Accommodative Excess.



Axial Length to Corneal Radius of Curvature Ratio and Refractive Errors

Srushti Rajendrakumar Patel, Reema RavalNagar School of Optometry

Aim

The aim of the study is to compare the ratio of axial length (AL) to corneal radius of curvature (CRC) in myopic, hyperopic and emmetropic subjects.

Method

In this study, after performing objective and subjective refraction, biometric measurements (AL and (CRC) were performed in myopic, hyperopic and emmetropic eyes under the age group of 20 to 41 years.

Results

Total 150 patients had participated in this study. Mean AL/CRC is 3.03 and 3.04 in female and male respectively. Mean AL/CRC is 3.19 in myope, 2.9065 in hyperope and 3.01 in emmetrope respectively.

Conclusion

AL/ CRC ratio is highest among myopes followed by emmetropes and lowest in hyperopes. Minimal changes in AL/CRC can lead to large changes in refractive error.



The Similarity in Disssimilar: Macular Thickness Comparison Using 3 different SD OCTs

Supriya Patil, Thaksen Ambikar, Pushpanjali Ramteke, Smitesh Shah, Onkar Pirdankar Isha Netralaya

Aim

To compare foveal, parafoveal and perifoveal thickness using different OCT.

Method

A prospective study where normal subjects age be-tween 20-50 years were included. Subjects with any ocular surgery, systemic and retinal disease were ex-cluded. All the subjects underwent foveal, parafoveal thickness and perifoveal thickness measurement using Optovue OCT, Optovue OCT Angio and Zeiss OCT.

Results

Forty eyes of 20 subjects with mean ±Sd age 22.2±1.66 years were included. The foveal and perifoveal

was similar among all three instruments (p>0.05). Parafoveal thickness measured using three instrument was similar except superior region (p<0.05). Superior parafoveal thickness was statistically significantly lower with Zeiss OCT as compared to Optovue OCT Angio however this difference was clinically insignificant.

Conclusion

Foveal, parafoveal and perifoveal thickness measured using Optovue OCT, Optovue OCT Angio and Zeiss OCT was similar and can be used interchangeably.



Performance and Preference of New Video Magnifier Versus Existing Video Magnifier

Hiral Korani, Akshat Wahi, Soonali patel, Sneha Gokhale, Sneha Nair, Abdul Kader, Sai Sri SathyaLotus College of Optometry

Aim

Visually impaired with reading difficulties are often rehabilitated with magnification. Studies have shown that with magnification, reading speed can be improved by great magnitude. To compare reading speed and preference with new portable video magnifier versus existing video magnifier.

Method

Subjects between 15-50 years having visual acuity better or worse than 1 and 0.1 LogMAR in the better seeing eye for distance and near respectively with existing magnifier and able to read English fluently were included. Subjects having intellectual disability were excluded. Subjects underwent complete low vision evaluation and reading speed was measured between new portable video magnifier, and existing video magnifier and optical devices on MNREAD.

Results

The mean reading speed in 50 subjects with optical device was 47.87, existing video magnifier was 71.79

and new portable video magnifier was 72.08. No significant difference was found in reading speed between the existing video magnifier and new portable video magnifier. However, statistical significant difference was found in the reading speed between optical device and new portable video magnifier. Large effect size of 2.56 was seen on comparing reading speed between optical magnifier and new portable video magnifier. This indicates that new portable video magnifier performs clinically better than as compared to optical devices. Subject did express a clear preference for new portable video magnifier versus other video magnifiers. The strength of new video magnifier was its portability, followed by usefulness and adjustment of the device compared to existing video magnifier and optical devices.

Conclusion

The current study provides clinicians with objective performance data and subjective preference data of new portable video magnifier that can be used to help patients with vision impairment.



Identify the Principle Issues While Implementation the New Electronic Health Record

Chandini Arora Coventry University England

Aim

This study is to identify the principle issues of Electronic health record, while implementing the new Electronic health record system.

Method

This research method considers PICO Population, Patient, Problem, Intervention comparison, and out-come. It is extensively used for quantitative research. PEO are the widely used for qualitative research, whereas PCO is more important for qualitative re-search question.

Results

The principle issues faced by the electronic health record was delayed in the process by the untrained

staff, Not having previous data when it converts one software to another, cost effect due the less patients, infrastructure matters, reputation of the hospital and providing this as a lack of services. Solution to these problems was take backup first before implementing a new setup, trained the staff well this will reduce the cost effect and improve the quality service.

Conclusion

As we noticed the issues, a proposed solution was given for the same. Recently an author has implemented and practiced the solution with the positive result.



Effect of Stress on Visual Functions in Mumbai School Going Children

Zulfikar S. Barodawala, Aksha ShettyLotus College of Optometry

Aim

Childhood Stress can be present in any setting that requires the child to adapt or change. Stress may be caused by positive changes, such as starting a new activity, but it is most commonly linked with negative changes such as illness or death in the family. In this study we are trying to access effect of stress in school going children in Mumbai on their visual functions.

Method

In this study, Inclusion criteria for the subject are, age from 8 years till 15 years and has no ocular pathological and ocular surgeries which can violate their visual functions. For testing Distance and Near visual acuity, LogMAR (4m) chart and ‘M’ Grade charts are used respectively. For Stereopsis, Titmus Fly test was used. For Contrast Sensitivity, Pelli Robson Contrast Sensitivity Chart (1m) was used. For Colour Vision, Ishihara (16 Plates) was used, and for Visual Fields Confrontation was performed. A 21 Questions Questionnaire namely SiC Questionnaire was used to assess the Stress Score, taking an average gave us a GSM (Global Mean Score) which further helped us to relate it with the visual functions.

Results

The sample size of the study is 90 of which 36 are found to be males and 54 are found to be females. The mean age of the sample population was found to be 12.23 ± 2.20 years. There was no difference found in colour vision and visual field throughout the sample population. Global Mean Score shows slightly higher level of stress in females compared to males. Stress was found to be higher in Myopic patients followed by Astigmatic patients followed by Emmetropic Patients followed by Hyperopic patients. Stress showed a gradual increase with increase in Age. Increased stress shows slight decrease in the contrast sensitivity of the sample population.

Conclusion

There was no difference found in colour vision and visual field throughout the sample population. Global Mean Score shows slightly higher level of stress in females then males. Stress was found to be higher in Myopic patients. Stress showed a gradual increase with increase in Age. Increased stress shows slight decrease in the contrast sensitivity of the study population.



Early Retreatment with Trans PRK of Patient Developing Partial Button Holing During LASIK

Madhavi Panchamia, Chinmaya Sahu Sahu Eye Hospital

Introduction

It is universally accepted that retreatment following a flap complication in LASIK should be after 3 months. There is no clarity as to the correct time for retreatment using Photorefractive keratectomy. There is apprehension regarding accuracy of retreatment and corneal haze formation if retreatment is done earlier.

Patient Profile

A 24 years old female patient with -6.50 DS, Pachym-etry : 554 microns and else within normal limits was to undergo LASIK with a 130 microns blade and Car-riazo pendular microkeratome. Suction was achieved

and ascertained by the beep sound, pupillary dilatation and loss of perception of light.


Once the microkeratome passed through the eye and the flap was about to be lifted, the flap was found to be crumpled with tissue adherent on the stromal bed extending in a band shaped form from centre to periphery. The flap was gently repositioned; no full thickness button hole was noted. OASIS BCL was kept in place and trans PRK was done after a week as per the new refraction. The patient had follow up till 2 weeks later at which time her unaided vision was 6/6P and cornea was clear.



Induced Prismatic Effects due to Poorly Fitted SpectacleAnjali Ahuja, Optom. Usman Memon


Aim

To determine the prevalence and understand the associated prismatic effects of poorly fitted spectacle in asymptomatic wearers.

Method

A quantitative, descriptive study was conducted from May 2018 to August 2018 at an Optical outlet during internship posting. Hundred asymptomatic spectacle wearers were selected for the study. With the frames in the habitual wearing position, the pupil centers were marked with a blue ink marker and thereafter the distance IPD was measured with the help of pupillometer. The optical centers of each lens were marked with a black marker and power was measured using lensometer. The distance between these markings were then measured to determine the centration distance and it was compared to distance IPD. Oblique cylinders were resolved into horizontal and vertical components. Any prismatic effect present was thereafter calculated using Prentice’s Rule and recorded.

Results

A comparison of marked optical centers and IPD revealed that 100% subjects were wearing decentered

lenses. As per ANSI tolerance, of the 200 eyes the horizontal prismatic effect was effective in OD of 47% subjects with effect of 1.31 ±0.91∆D for lenses of power ≤ ±2.75D and 17% with effect of 3.28 ±1.78∆D for lenses of power ≥ ±2.75D. For OS; 43% with effect of 1.27 ±0.90∆D for lenses of power ≤ ±2.75D and 25% with effect of 3.52 ±1.44∆D for lenses of power ≥ ±2.75∆D in the horizontal meridian. Vertical prismatic effect was effective in OD of 30% subjects with effect of 0.20 ±0.47∆D for lenses of power ≤ ±3.375∆D and 13% noticed vertical differences between PRP was greater than 1mm with 1.72 ±1.47∆D for lenses of power ≥ ±3.375∆D in vertical meridian. and in OS; 34% subjects noticed effect of 0.24 ±0.51∆D for lenses of power ≤ ±3.375∆D and 14% subjects noticed vertical differences between PRP was greater than 1mm with 1.85 ±1.69∆D for lenses of power ≥ ±3.375∆D in vertical meridian.

Conclusion

All the subjects were wearing decentered lenses and majority of them experiencing a prismatic effect exceeding beyond the ANSI tolerance limit. Prism adaptation may account for subjects being asymptomatic.



Concerns of An Anophthalmic Subject Towards Prosthetic EyeAkshita Vyas, Hiral Korani Lotus College of Optometry

Aim

To identify concerns of artificial eye wearers and investigate whether these has changed since they lost their eye.

Method

A questionnaire was presented to 15 subjects wearing prosthetic eye. Participants aged between 18- 60 years, wearing prosthetic since more than 6 months were included. Questionnaire includes General concerns and prosthetic eye Concerns. Wilcoxon test was used to see the changes in concern overtime. The ordinal regression was used to find the association of demo-graphics variable with current level of concerns.

Results

At the time of eye loss participants were mainly concerned about their health of remaining eye,

receiving good advice, mucoid discharge and size of the prosthetic eye. In the current time, participants were more concerned about mucoid discharge. 60% people complained that frequency of discharge is very high. Over the time concerns mainly, appearance, getting good advice, fullness of orbit and size were found to be reduced p< 0.005. On comparing the association between demographics and current concerns no statistical significance found.

Conclusion

Watering, crusting and mucoid discharge was the most chief present day concern after size and health of the remaining eye. However, more research is needed to address this distressing problem.



Prevalance and Management of Nystagmus in FranceCamille Lemarchand

Institut et Centre d’Optométrie, Vision Solidev, France

Aim

A review of prevalence and management options for Nystagmus.

Method

Nystagmus is an involuntary movement of both eyes. Both eyes turn on the same side. Nystagmus is due to bad regulation of neuronal network which control the position of the eye that cannot be treated. There are different types of nystagmus. Acquired nystagmus and Congenital nystagmus. The risk of developing amblyopia and strabismus is higher with Nystagmus. Every year 550 children in France are detected with Nystagmus, taking the prevalence rate to 1/ every 1500 children. Evidence based literature search was done to explore best possible management options.

Results

Literature showed several options for management are available like spectacles, contact lenses as well as surgical options. The most suitable option is contact lenses as the lens moves with the eyes, thereby improving fixation and reducing the beat of the nystagmus. The visual field is improved and allows stable correction of corneal astigmatism. Contact lenses also stimulate accommodation in myopes and further reduce the nystagmus.

Conclusion

In conclusion, to compensate for nystagmus, you have to weigh the pros and the cons of the different management solutions. The contact lenses are the best solution with many advantages compared to the others solutions.



Visual Capability Assessment for Athletes Living with a Mental Disability

Marie-Anne Balayn Institut et Centre d’Optométrie, Vision Solidev, France

Aim

Special Olympics Opening Eyes is a program, worldwide for assessing the eye health of mentally challenged individuals. The objective of this study is to evaluate the visual abilities of this specific population, for whom access to the usual care circuit is more difficult.

Method

During the Special Olympics event was organized in June 2017 in France, several mentally challenged ath-letes gather, A detailed vision screening was conduct-ed over two days. The assessment included detailed history, visual acuity, refraction, eye movements, ste-reopsis using Randot E, and color vision for visual capabilities. Eye health was assessed using slit lamp

evaluation, direct ophthalmoscopy, pupil evaluation and intraocular pressure using a non-contact tonome-ter, where ever feasible.

Results

294 athletes were evaluated over two days. 32% received new corrective glasses and 44% received sunglasses; 20% were referred to an ophthalmologist for further examination.

Conclusion

This screening and evaluation action has improved access to vision health and addressed the important and specific needs of athletes with intellectual disabilities.



Review of Different Materials used in Spectacle FramesLelouch Chloé


Aim

A review of different material used to make spectacle frames, its sources, advantages and disadvantages for eye wear.

Method

Organic or plastic materials:

Cellulose acetate is a natural plastic extracted from cotton, which is then converted into a clump board that is cut and assembled to obtain a frame. Optyl is a hypoallergenic epoxy resin. The frames made with this material are translucent. Natural materials: Wood: Several types of exotic wood are used and the wooden parts are usually varnished to maintain the aesthetic appearance of the material. Horns can be used in combination with other materials. The horn is precious; it is worked only by hand in a traditional way. Metals: Stainless steel: is an alloy of iron and chromium. It allows designers to create design frames with a unique look Titanium / Nickel Alloys: Shape memory glasses are made from

a metal alloy, titanium and nickel.

Results

Disadvantage of cellulose acetate: 80% loss, we cannot mount polycarbonate lenses. Advantage: not allergic, resistant, easy polishing, cutting and filing easy, easy to adjust. Advantages of Optyl: solid, lightweight, hardness and the fact that once heated, the material automatically returns to its original shape. The wood remains fragile and is not adaptable it cannot be deformed to be adjusted. Stainless steel is hypoallergenic and recommended for people with fragile skin, it is also stainless. Titanium / nickel alloy get possible to create very strong frames. They can be bent, crushed with a hammer, or twist them in all directions and above all they are very light.

Conclusion

Many materials can be used in eyewear. The optician has the possibility of extending his range of frames to his customers.



The Effects of Cosmetics on the Eye Marie-Anne Balayn


Aim

A literature review on effects of cosmetics on the eye.

Method

A literature review was done to understand the harm-ful effects of eye cosmetics such as eye shadow (pow-der or cream), pencils for the eyes or eyeliner (liquid, pencil or gels), mascara, etc.

Results

The undesirable effects of cosmetics included various possible infections such as: Chalazion, stye, blepharitis, and bacterial conjunctivitis. The etiology of it was due to bacteria spread in the eye and also contaminated the cosmetic itself. Substance (deposit) penetrating into the eye (waste on the tear film), eye irritation, evaporation of tears ( dry eye), and tear film tear stability, tearing, hyperemia (red eye) or itching. The other causes were due to avoid or limit the undesirable

effects, there are various solutions to be brought such as: to use the Kohl (al-kahal or kajal in Hindu) instead of the pencil for the eyes or the eyeliner, to pay attention to the information on the terms of use (age of the products, quantities used, expiry date). To avoid or reduce the adverse effects of eye makeup, the following tips could be followed.

Conclusion

1. Do not use the tester products in the store and do not add water to the products.

2. Sharpen the ends of the pencils and eyeliner, before the application, use the tools sold with the product

3. Wash your hands before putting on makeup.

4. Use only the makeup appropriate for the eye, and always remove makeup before sleeping.



Community Eye health and Vision Care Services by Vision Solidev from Jan-December 2018

Lucie Marchaud Institut et Centre d’Optométrie, Vision Solidev, France

Aim

Several underprivileged people in France do not have access to social security system and Vision Solidev provides free eye and vision care services to this population.

Method

Vision Solidev partners with several community based organizations to conduct eye camps for underprivileged population. They reach out to them through organizations for homeless people and homes for the aged. Vision Solidev offers the eye camps with help of volunteers and optometry undergradutes from Institut et Centre d’Optométrie.

Results

With several Vision Solidev services days throughout 2018, over 1500 adults and children were examined

and 452 were given spectacles during the first semester and during the second semester of the year, spectacles was dispensed to 864 of them. Since its inception in 2011, Vision Solidev has examined over 4500 adults and children and dispensed over 2900 pairs of spectacles to the needy population.

Conclusion

Vision Solidev predominantly works around Paris and its suburbs. They solicit partnerships from other NGOs and Volunteers from all over France to increase their outreach and touch more lives.



A Survey on Relevance of the VisionSoliDev Activity for Access to Eye and Vision Care

Victor MarchaudInstitut et Centre d’Optométrie, Vision Solidev, France

Aim

People who are homeless or in great difficulty lose the awareness of their health, and the relationship they have with their bodies deteriorates over time; sight is one of the many issues coming directly from this lack of self-awareness. This is in addition to the difficul-ty of accessing the traditional health care system, or even a refusal to do so.

Method

In order to reach out to the marginalized population,-VisionSoliDev, in partnership with several charitable associations, has since January 2011 rendered free eye examinations and spectacles to people who are not covered by the social security system. Vision Solidev along with Galileo, conducted a survey on “”Knowl-edge, Satisfaction and Expectations”” regarding its services. The survey was conducted in the 4th quar-ter of 2017 with social workers of 42 branches of 25

associations in Ile de France. Topics covered by the questionnaire:• Seniority of the relationship with Vision SoliDev• Annual volume of beneficiaries sent to Vision

SoliDev • Evaluation of the quality of contact with Vision

SoliDev• Evaluation of the satisfaction and improvement of

the daily life of the beneficiaries

Results

The survey and results, highlights the need to simplify the management circuit in order to avoid the risk of abandonment.

Conclusion

Vision Solidev proposes 4 different strategies to for improve access to visual health and glasses for people in precarious situations.



Lotus College of OptometryMumbai

Documents

Organized by Lotus Optometry Alumni Association and Lotus ... · Optometry in 1993 from City, University of London. His academic career began at UniversitiKebangsaan Malaysia in 1985,