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Introduction: The choroid, particularly the choroidal vasculature, plays an important role in the pathophysiology of various ocular diseases. Diurnal variation in the thickness of the choroid has been reported in previous studies. This study aimed to find the mean amplitude of diurnal variation of sub-foveal choroidal thickness among adults with healthy eyes visiting the outpatient Department of a tertiary eye care centre. Methods: A descriptive cross-sectional study was conducted among adults with healthy eyes presenting to the outpatient Department of a tertiary eye care centre from 1 February 2023 to 3 June 2023 after obtaining ethical approval from the Institutional Review Committee. After a comprehensive medical eye examination, sub-foveal choroidal thickness measurement was performed using enhanced depth imaging optical coherence tomography at the baseline and subsequent interval afterwards. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 60 eyes, the mean amplitude of the diurnal variation of subfoveal choroidal thickness was 35.16±14.08 microns (31.59-38.72, 95% Confidence Interval). The mean amplitude for the right eye was 36.30±14.08 microns, and for the left eye, it was 34.23±14.08 microns Conclusions: The amplitude of diurnal variation of subfoveal choroidal thickness from this study was found to be similar to other studies done in international settings.

Introduction: Keratitis is the infection and inflammation of the cornea. Microbial keratitis is a potentially sight-threatening corneal condition. The aim of this study was to find out the prevalence of positive microbiological culture among patients with infective keratitis visiting the Cornea Unit of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients with a clinical diagnosis of infective keratitis presenting to the Cornea Unit of a tertiary eye care centre from 16 October 2020 to 16 March 2021 after obtaining ethical approval from the Ethical Review Board. After slit-lamp examination, corneal scrapings were performed under aseptic conditions which were subjected to Gram stain, potassium hydroxide preparation and culture for bacterial and fungal pathogens. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 428 patients, 337 (78.73%) (73.24-84.33, 95% Confidence Interval) had a positive microbiological culture. A total of 213 (49.76%) of enrolled samples had a prior history of ocular trauma. Aspergillus species 68 (20.17%) and Streptococcus species 33 (9.79%) were the most common organisms isolated from fungal and bacterial corneal ulcers respectively. Conclusions: The prevalence of positive microbiological culture among patients with infective keratitis from this study is similar to the pattern reported from similar settings.

Introduction: Diabetic retinopathy is a major microvascular complication of diabetes, and may progress to sight-threatening stages causing blindness with a consequent decrease in their quality of life. This study aimed to find out the prevalence of blindness among patients with type II diabetes mellitus attending the Outpatient Department of Ophthalmology of a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted among patients with type II diabetes mellitus presenting to the Outpatient Department of Ophthalmology of a tertiary care centre from 2 August 2021 to 30 June 2022 after receiving ethical approval from the Institutional Review Committee (Reference number: 74/2021). Diabetic patients underwent detailed eye examination including vision, slit lamp biomicroscopy examination, and fundus evaluation with full pupil dilation. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 449 type II diabetic patients, blindness was seen in 17 (3.79%) (2.02-5.56, 95% Confidence Interval) patients. Among them, 1 (5.88%) had severe non-proliferative diabetic retinopathy, 3 (17.65%) had proliferative diabetic retinopathy and 8 (47.06%) had severe diabetic macular oedema. Conclusions: The prevalence of blindness among patients with type II diabetes mellitus was less than in other studies conducted in similar settings. Screening and timely management of diabetic retinopathy could reduce the prevalence of blindness due to diabetic retinopathy.

Myopia poses a significant burden on the healthcare system, economy and quality of life. It is an emerging global public health challenge and requires interventions to delay or stop onset and progression. With changing times and evidence, the concepts of myopia are changing along with the treatment and control strategies. Behavioural modifications including increased outdoors time and reduced near work, optical and pharmaceutical management options are reviewed. This paper presents a current overview on the concepts of myopia, and is expected to summarize updates on myopia control methods.

Introduction: Non-strabismic binocular vision dysfunctions are visual disorders that affect the person’s binocular vision and visual outcome while performing near tasks and are very common among medical students. This study aimed to find out the prevalence of non-strabismic binocular vision dysfunction among the medical students of a teaching hospital. Methods: A descriptive cross-sectional study was conducted among medical students of a teaching hospital from 25 April 2022 to 25 May 2022. Ethical approval was obtained from the Institutional Review Committee of the same institute (Reference number: 139/17). A detailed ocular evaluation including history, visual acuity, refraction, and detailed orthoptic evaluation was done. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Out of 284 students, 79 (27.81%) (22.60-33.02, 95% Confidence Interval) had non-strabismic binocular vision dysfunctions. Convergence insufficiency was the commonest one seen in 38 (48.10%), followed by divergence excess seen in 8 (10.12%) and convergence excess seen in 8 (10.12%) students. Conclusions: The prevalence of non-strabismic binocular vision dysfunction among medical students was lower than in other studies conducted in similar settings.

AIM: To study clinical profile of amblyopia and also the outcomes of occlusion therapy among the amblyopes.METHODS: This was a hospital-based longitudinal study by design. Data were collected from April 2015 to April 2016 in Ophthalmology Department of Dhulikhel Hospital. Presenting visual acuity, chief complaint at presentation, age at presentation, refractive status, binocularity and fixation patterns were assessed in all the children with amblyopia. Improvement in visual acuity was also noted in all the subjects after occlusion therapy, which is a most commonly used modality of treatment for amblyopia.RESULTS: Among 1 092 children examined during the study period, 60(5.49%)were amblyopic. Among them, 35(58.30%)were females and 25(41.70%)were males. The mean age at presentation was 8.87±3.29 years. Meridional amblyopia was the most prevalent subtype seen in 43.3%(n=26)of children followed by anisohypermetropic amblyopia(20%, n=12). The most common refractive error was astigmatism accounting for 58.30% of the total cases followed by hypermetropia(22.50%)and myopia(7.50%). Compliance with spectacle wear combined with occlusion therapy and active vision therapy was 73.30%(n=44). There was a statistically significant improvement in visual acuity of the amblyopic eyes after the different treatment strategies after 3mo(P=0.002).CONCLUSION: Prevalence of amblyopia and associated visual impairment is still a public health issue in developing countries like Nepal. Lack of awareness and lack of community or preschool vision screening for children lead to late presentation and significant visual impairment associated with the condition. The burden can easily be reduced with screening camps, timely referrals and proper interventions.

Purpose Improving eye health awareness in the underserved population is a universal eye health priority. The ubiquity of cell phones and internet usage provides new and innovative opportunities for health promotion. This study evaluated the effect of mobile health intervention (text message link) to promote eye health literacy (EHL) of priority ocular morbidities. Methods This study was an intervention evaluation and employed a two-armed pre-test post-test approach. Baseline assessment on EHL was performed on 424 university students. Participants were categorised into intervention and control groups, using the 1:1 allocation ratio. The intervention and control group received a text message alone and text message with a link, respectively. EHL was assessed via a self-administered questionnaire. The primary outcome measures were changes in EHL scores between baseline and one month post-intervention. Descriptive analysis was performed to assess the cost-effectiveness of the intervention. Results With low attrition and a response rate of 95.6%, 409 responses were eligible for analysis. The mean age of the participants (49.4% males and 50.6% of females) was 19.9±1.68 years. Baseline EHL scores were low, and there was no correlation with a demographic profile (all pConclusion Text message link demonstrated effectiveness for improving the EHL scores; the low baseline EHL scores substantially improved with intervention. The text message link intervention is a cost-effective method and could be considered in advocating for eye health in developing countries, particularly during global emergencies.

AIM: To determine the refractive and binocular vision status in clinical microscopists.METHODS: It was an observational and cross sectional hospital based study. One hundred and three microscopists working at Tribhuvan University Teaching Hospital were recruited in the study. All subjects had a comprehensive eye examination including static retinoscopy, dynamic retinoscopy and orthoptic evaluation. Information about their visual symptoms associated with microscopy was also collected.RESULTS: The prevalence of refractive error in this group of microscopists was 69.90%. Majority of the subjects were myopic(68.93% of total subjects)with the mean myopic error of -1.58±1.89 D. Convergence insufficiency was found in 61.20% of the study population. Prevalence of accommodative insufficiency and infacility were 41.30% and 40.06% respectively. Fusional vergence was also reduced in this study population. The outcomes of this study were expected to increase the awareness about the refractive and binocular vision anomalies among this population.CONCLUSION: There was found to be increased prevalence of refractive error in clinical microscopists, especially myopia. Majority of them had vergence and accommodative anomalies. Most of the subjects reported asthenopic symptoms associated with their microscopy work, which may affect their work efficiency.

Purpose: This study was undertaken to find correlations between visual functions and visual disabilities in patients with diabetic retinopathy. Method: A cross-sectional study was carried out among 38 visually impaired diabetic retinopathy subjects at the Low Vision Clinic of B.P. Koirala Lions Centre for Ophthalmic Studies, Kathmandu. The subjects underwent assessment of distance and near visual acuity, objective and subjective refraction, contrast sensitivity, color vision, and central and peripheral visual fields. The visual disabilities of each subject in their daily lives were evaluated using a standard questionnaire. Multiple regression analysis between visual functions and visual disabilities index was assessed. Result: The majority of subjects (42.1%) were of the age group 60–70 years. Best corrected visual acuity was found to be 0.73 ± 0.2 in the better eye and 0.93 ± 0.27 in the worse eye, which was significantly different at p = 0.002. Visual disability scores were significantly higher for legibility of letters (1.2 ± 0.3) and sentences (1.4 ± 0.4), and least for clothing (0.7 ± 0.3). Visual disability index for legibility of letters and sentences was significantly correlated with near visual acuity and peripheral visual field. Contrast sensitivity was also significantly correlated with the visual disability index, and total scores. Conclusion: Impairment of near visual acuity, contrast sensitivity, and peripheral visual field correlated significantly with different types of visual disability. Hence, these clinical tests should be an integral part of the visual assessment of diabetic eyes.

Introduction and purpose: Informed consent means the process whereby patients are informed of all the necessary information about health care and subsequent treatment plans. In socioeconomically developing semi-urban setting, where most of the patients are illiterate, we wanted to assess knowledge, attitude and anxiety of patients towards informed consent. Methods: Patients were recruited from the waiting list for ophthalmic surgery at the department of Ophthalmology, Dhulikhel Hospital. A detail optometric and ophthalmologic evaluation was carried out. Data were collected through a 12-item questionnaire and an 8-item Likert scale. Statistics included regression analysis, chi-square test as well as frequency and percentages. Results: Of 42 questionnaire responders, female participation was high (64.3%). Sixty two percent of patients wanted the physician to decide for or against the surgery. Most of (69%) patients thought that by signing the consent they were agreeing for surgery and few (16.7%) thought that the consent was a legal document. Twenty two patients (52.4%) gave importance to the surgical intervention even though there were chances of serious complications. The preoperative anxiety was affected by surgical outcome (81%), complication (40.5%) and anaesthesia (9.5%). The patients prioritized the preoperative information on nature of illness, need for operation and the chances of vision improvement after surgery. Conclusion: Most of patients wanted the doctor to decide their treatment. Many patients wanted to know about the disease, treatment and the success rate of surgery. The success of the operation, the anaesthesia and the long list of complications tended to provoke anxiety.