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Macular hole (MH) is uncommonly seen in association with retinitis pigmentosa (RP), optic disc pit or choroidal coloboma. The visual disability in eyes with RP, optic disc pit or choroidal coloboma can range from mild to severe. However, the macula may not be involved in the primary pathology and hence, the central vision may be preserved in these eyes. If a MH develops in such eyes the central vision is lost, making the patient severely vision disabled. A perceived poor prognosis in such patients may lead to no intervention. However, an attempt should be made to repair and restore the macula in these situations in order to conserve the vision and limit disability. These eyes can however pose unique surgical challenges. We report our experiences of operating on cases of MH associated with unusual concomitant pathologies such as RP, choroidal coloboma, and optic pit. The outcomes and the surgical challenges differed greatly from the conventional idiopathic MH surgery.

Background : We present the outcomes of a survey conducted in Nandurbar, a tribal district of Maharashtra, India. It was based on Rapid Assessment for Avoidable Blindness methodology and conducted in 2009 in Nandurbar, a tribal district of Maharashtra, India. Materials and Methods : We examined persons of 50 years and older ages. Ophthalmic assistants noted the distant vision [best corrected vision (BCV) and as presented]. Ophthalmologist examined eyes of persons with vision less than 6/18. The principal cause of impairment in each eye and the most preventable or treatable cause were assigned. We calculated the prevalence rates of bilateral blindness, severe visual impairment (SVI), and moderate visual impairment (MVI). Result : We examined 2,005/2,300 persons (response rate 87.2%). The prevalence of blindness, SVI, and MVI for the BCV was 1.63% (95% CI 1.11-2.15), 5.93% (95% CI 4.96-6.90), and 14.6% (95% CI 13.2-16.1), respectively. The prevalence of blindness, SVI, and MVI for the presented vision was 1.87% (1.32-2.42), 6.72% (95% CI 5.70-7.74), and 19% (95% CI 17.4-20.6), respectively. Unoperated cataract was responsible for 77% of different visual disabilities. The coverage of existing cataract surgery service was 9.4%. Lack of knowledge about cataract surgery was the main cause of unoperated cataract among 41% of interviewed participants with cataract and SVI. Conclusion : Unoperated cataract was the main curable cause of visual disabilities in tribal population of India. Increasing awareness and offering cataract surgeries at affordable cost in the district would reduce visual disabilities.

prevalence of diabetes mellitus (DM) was reported to be 12.3% in the population aged 18 years and above. [2] Applying this figure to the adult population on Oman would indicate that there were 112,000 diabetics at the beginning of 2014. [3] The increase in the prevalence of DM and the increase in life expectancy of people with diabetes will result in a significant increase in visual disability due to the ocular complications of diabetes. Currently, the National Diabetes Register in Oman has 80,000 patients with diabetes. [2] Based on World Health Organization (WHO) recommendations, these individuals will require a yearly assessment or screening for diabetic retinopathy (DR). [4] Given that the range of DR prevalence reported for Oman is between (14.5% and 42.2%, there are between 16,000 and 47,000 cases of DR throughout the country. [5,6] Of these, nearly 10% (1,600–4,700 cases) have sight-threatening diabetic retinopathy (STDR) requiring laser and/or intravitreal injections of anti-angiogenic factors for treating proliferative diabetic retinopathy and diabetic macular edema. [7]