A SINGLE CASE STUDY ON THE EFFECT OF AYURVEDIC MANAGEMENT IN TIMIRA W.S.R. TO MYOPIA – A CASE STUDY

Introduction - Myopia is the most common Refractive error of the eye seen in children and young adults and it has become more prevalent in recent years and is a cause of concern the world over. Myopia commonly referred to as near or shortsightedness. Some of the clinical features of Vataja Timira can be correlated with Myopia. Timira is counted under the Drishtigata Rogas [1] described by Sushruta. Timira involving first and second patala in terms of symptoms, anatomical structures involved and the pathogenesis of the disease. Timira begins with the blurring of vision gradually leading to the deterioration of eyesight. Shastrokta lakshanas of Vatika Timira such as bhramantiva sa pashyati, aavil darshan, vyaavidha darshan, aruna darshan [2]. Materials and Methods - A 20-year-old male, came to Shalakya Tantra OPD in National Institute of Ayurveda, deemed to be University Jaipur (R.J.), with chief complaints of defective vision for distance in both eyes, pain in both eyes and watering from both eyes since 4 months. He was treated with Nasya, Netra Pariseka, one sitting of Tarpana, Triphala guggulu, Patoladi eyedrops and Netramritam eyedrops. Result - At the end of the study, improvement in the visual acuity in both eyes, improvement in pain in both eyes and watering from both eyes have reduced. Conclusion -Thus, it can be concluded that Ayurvedic treatments are helpful to control Myopia. Keywords: Myopia, Nasya, Tarpana, Netra pariseka, Timira, Triphala Guggulu.

E-learning As an Innovation Model for Disabilities (Defective Vision)

Permenristekdikti number 46 of 2017 concerning Special Education and Special Services in Higher Education. It is intended that students with disabilities can obtain educational services according to their needs, so that they can learn and achieve optimal academic achievement. There are many ways or solutions that are tried to be given for students with disabilities so that obstacles in the learning process can be minimized, but these methods do not go far to help solve the difficulties faced by students with disabilities. One of the ways or solutions given is that students with disabilities also need to be proactive and communicative in lectures or students must interact actively in social relationships which are commonly called SKSD. But that doesn't help much. Therefore, The proponent develops an e-learning innovation model that aims to embrace all students, both students with disabilities and general students, to both learn and get the same education without having to have differences and difficulties. The results obtained from this application are that this innovation model is applied to language skills courses, students with disabilities who initially do not have self-confidence after attending this lecture become confident and of course the sense of difference no longer occurs, in the end students' learning abilities and achievements both students with disabilities and general students can increase.

SERENDIPITY DOES HAPPENS - A CASE REPORT OF MYOPIA TREATED WITH AYURVEDIC MODALITY

Myopia is the most common Refractive Error of the eye, seen in children, young adult & it has become more prevalent in recent years and is a cause of concern world over. On the basis of Symptoms, Myopia can be correlated with Vataja Timira w.r.t. Simple Myopia. Purpose: While performing research on Allergic Conjunctivitis it is observed that Allergic Symptoms are minimized and also there was vision improvement. Hence treated one patient of Simple Myopia for the purpose of case study for one month and reporting this case in detail. Materials & Methods: A 22years male patient came to OPD of Shalakyatantra with chief complaints of defective vision for distance in both eyes since 2 months treated with Kantakari Mula SiddhaKshira Ghrita Aschyotana. Results: At the end of study, improvement in visual acuity in both eyes were found. Conclusion: Thus, it can be concluded that Ayurvedic approaches are helpful to control Myopia.

Knowledge and Preference for Refractive Surgery and Preferred Methods of Refractive Correction among Patients with Significant Refractive Errors Attending Bharatpur Eye Hospital, Nepal

Background: Refractive errors are a major cause of defective vision in all age groups. Although contact lens and refractive surgery are popular, still spectacles are the traditional and most widely used method of optical correction. The main objective of the study was to determine the knowledge and preference for refractive surgery and preference for refractive correction. Materials and Methods: Questionnaire based study was conducted among 252 participants aged between 22-40 years with significant refractive errors (>±1.00D) for a period of three months between June to August 2017. Participants who had prior refractive surgery and not willing to participate were excluded from the study. Results: One hundred and forty (55.6%) were males and majority (76.6%) of the participants were in the age range 22-30 years. Myopia (60%) was more prevalent followed by astigmatism (38%) and hypermetropia (2%) with refractive power between 1-3 D in 72.5% of participants. Only 61(24%) of the participants had knowledge about refractive surgery. Forty three percentages of them knew from their friends, internet was source of information for 36% and only 19% of them knew from eye care professionals. Majority (87.3%) preferred spectacles 4.8% preferred contact lens and only 8% preferred refractive surgery as methods of refractive correction. Only 44% showed willingness for refractive surgery when available at Bharatpur Eye Hospital. Participants with prior knowledge (p=0.002), higher refractive error and longer duration of glass wear (P=0.005) had more preference for refractive surgery. Conclusion: The knowledge, preference and willingness for refractive surgery were less with spectacle being the most preferred methods of refractive correction.

Methoxsalen-induced advanced bull’s eye maculopathy

A number of systemic medications are known to cause macular toxicity, and bull’s eye maculopathy is caused by some of them like hydroxychloroquine and clofazimine. A 55-year-old female, known case of vitiligo with history of undergoing methoxsalen–ultraviolet A therapy, presented with painless defective vision in both eyes. Fundus examination and autofluorescence showed macular degeneration with bull’s eye configuration. Optical coherence tomography showed perifoveal loss of photoreceptors and outer retinal thinning with foveal sparing appearing as ‘flying saucer’. Multifocal electroretinogram showed pan-macular suppression of waveforms. Patient was diagnosed as case of methoxsalen-induced advanced macular toxicity. This is the first reported case of methoxsalen-induced advanced bull’s eye maculopathy.

Characteristics of Victims of Fall-Related Accidents during Mountain Hiking

The study evaluated characteristics of non-fatal mountain hiking accidents caused by falls. Questionnaires were sent to mountain hikers who suffered a fall-related accident in Tyrol (Austria) during a 3-year period. The questionnaire included details of socio-demographic data, physical activity, medication intake, defective vision, breaks, fluid intake, level of fatigue, muscle soreness, use of backpacks, use of hiking sticks, and type of shoes. Data of 405 individuals (57% females and 43% males) were included in the analyses. Victims were 56 ± 15 years of age, had a body mass index of 24.8 ± 3.5, and indicated 4.2 ± 3.9 h/week regular physical activity. A defective vision was reported by 70% of the victims, breaks were frequent (in 80%), and alcohol intake was rare (4%) among the interviewed hikers. Subjective level of fatigue was low and only 5% reported muscle soreness. A backpack was carried by 83% of the victims and the average weight was higher in males compared to females. The majority (61%) of the victims wore ankle-height hiking shoes with a profiled sole. Victims of non-fatal falls in mountain hiking are older than the general population of mountain hikers and are often afflicted with defective vision.

DISTRIBUTION OF PEDIATRIC CATARACTS BY SEX, AGE GROUPS, LATERALITY, TYPE AND PRESENTATION IN POPULATION OF D.I.KHAN DISTRICT, PAKISTAN

Background: Pediatric cataracts cause significant visual disability worldwide. The objectives of this study were to determine the distribution of pediatric cataracts by sex, age groups, laterality, type and presentation in population of D.I.Khan District, Pakistan. Materials & Methods: This descriptive study was carried out at Department of Ophthalmology, Gomal Medical College, D.I.Khan, Pakistan from January 2015 to December 2015. Sample was collected from Eye unit, DHQ Teaching Hospital, D.I.Khan. Pediatric cataract patients under 14 years of age were included in the study. Demographic variables were sex and age groups. Research variables were laterality, type and presentation. All variables being nominal were analyzed through frequency and percentages. The observed and expected distribution of pediatric cataract by sex, age groups, laterality, type and presentation were respectively tested by chi-square goodness of fit test. Results: Out of a sample of 47 patients, 29 (61.7%) were boys and 18 (38.3%) girls, 22 (46.81%) were <5 years and 25 (53.19%) 5-14 years of age. Thirty three (70.21%) had unilateral and 14 (29.79%) bilateral cataracts. Type was congenital/ developmental in 27 (57.45%) patients and traumatic in 20 (42.55%). Presentation was by defective vision in 23 (48.94%), leukocoria 14 (29.79%), strabismus 7 (14.89%) and screening in 3 (6.38%) cases. The observed distribution of pediatric cataract by sex (p=.0158), age groups (p=.00002), laterality (p=<.00001) and type (p=<.00001) was similar to expected, while for presentation, it was different than expected (p=.1033). Conclusion: The prevalence of pediatric cataract was higher for boys than girls and higher for older children (5-14 years) than younger (<5 years) children. Unilateral were more common than bilateral cataracts and the congenital/ developmental were more common than traumatic cataracts. Defective vision was the most common presentation of pediatric cataracts.

Safety and efficacy of Nd:YAG laser capsulotomy in management of posterior capsular opacification

Background: At present, the only effective treatment of posterior capsular opacification (PCO), which is the most common complication of modern cataract surgery, is Neodymium-Yttrium Aluminum Garnet (Nd:YAG) laser capsulotomy. There are few complications associated with this easy and quick laser capsulotomy. The current study was conducted in a tertiary hospital of Odisha with an objective to find the safety and efficacy of Nd:YAG laser capsulotomy in the management of defective vision due to posterior capsular opacity.Methods: The study was conducted among the patients attending the Ophthalmology out patient department of a tertiary hospital in Odisha with defective vision due to posterior capsular opacity after cataract surgery. Nd:YAG laser capsulotomy was carried out in all patients with significant PCO. Visual acuity and intraocular pressure were recorded before and after the procedure. The cases were carefully followed up and looked for any complication and visual acuity was assessed during follow up visits.Results: In the study 184 participants were included. Visual improvement was observed in 97.8% participants. Visual acuity improved to 6/6 in 21.73 %, 6/9 in 36.41 % cases, 6/12 in 15.21 % cases. Raised IOP was recorded among 46% of participant after 4 hrs of laser capsulotomy which was later observed among 12% of participants on follow up visit at 1 week. The most common complication recorded was transient rise of IOP (46.3%) followed by aqueous flare (28.8%).Conclusions: Nd:YAG laser capsulotomy is a noninvasive, effective, relatively safe procedure for PCO with good visual outcome.