Factors Associated with Out-of-Pocket Expenditure among Patients Admitted for Cataract Surgery under District Blindness Control Society Scheme: A Cross-Sectional Study from a Private Medical College Hospital of South India.

Background: The National Programme for Control of Blindness and Visual Impairment in India supports the management of various conditions of the eye including cataracts. Objective: The objective of this study is to estimate out-of-pocket expenditure (OOPE) and factors associated with it among patients admitted for cataract surgery under District Blindness Control Society (DBCS) scheme. Materials and Methods: A cross-sectional study was conducted in a Medical College Hospital of Coastal Karnataka, South India. Data were collected using a predesigned semi-structured interview schedule from 100 patients admitted for cataract surgery under DBCS scheme. Costs were reported as median values with interquartile range (IQR) and compared using the Kruskal-Wallis test. Results: Median total cost incurred by the patient was INR 1700 (IQR 1052-2575). Median direct costs (1425, IQR 762.5-2200 INR) included medical expenditure (600, IQR 0-1475 INR), mainly contributed by the treatment of systemic comorbid conditions and nonmedical expenditure toward travel. Median indirect costs (400, IQR 200-600 INR) included loss of wages for the patient and the bystander. Conclusions: OOPE for cataract surgery among DBCS patients was associated with the presence of comorbidity, postponement of surgery, duration of hospital stay, and distance traveled by the patient.

Are the patients with drug sensitive tuberculosis screened for ocular manifestations? A five year analysis from a medical college hospital of Karnataka, India.

BACKGROUND: Early diagnosis and prompt treatment may be sight-saving in patients with Ocular Tuberculosis (TB). Patients on anti tubercular treatment (ATT) also need ophthalmological examination at the start of the treatment and monitoring for toxic optic neuropathy regularly till the completion of treatment. This study is a situation analysis of the referral rates to ophthalmologist and clinical presentations of ocular TB among patients admitted with drug sensitive tuberculosis (DS TB). METHODS: A five year record analysis (2013-2017) of patients admitted with DS TB in a medical college hospital setting was done. Demographic and clinical presentations of the patients were recorded. The details about the referral, clinical findings, any possible risk associated with ocular TB and ocular side effects of ATT were noted. Data was entered in Microsoft excel and analysed for descriptive statistics. RESULTS: Among 225 inpatients, only 72 (32%) patients were referred to ophthalmologist. The referral rates increased over the period of five years. Intra ocular TB was diagnosed among 11 (15.3%) patients. Only 5 patients among these had complained of reduced vision and others were asymptomatic. CONCLUSION: The referral of DS TB patients to ophthalmologist was sub optimal. All the DSTB cases need ophthalmic evaluation keeping in mind the possibility of ocular TB and also the adverse effects of ATT.

Ocular manifestations in children with developmental delay at a tertiary center in South India.

PURPOSE: Developmental delay occurs when a child exhibits a significant delay in the acquisition of milestones, in one or more domains of development. This study was planned to determine the distribution of ocular disorders and to assess the correlation between ocular findings and systemic co morbidity, antenatal and postnatal factors, and perinatal history. METHODS: This cross-sectional study included children with developmental delay <16 years of age. All children underwent complete ophthalmological evaluation including full cycloplegic refraction. Vision assessment was done as appropriate for age. Spearman's correlation test was used to analyze the correlation between ocular findings and causes for developmental delay and antenatal, perinatal, and postnatal history. RESULTS: A total of 128 children were evaluated. Mean age of the study group was 5.59 ± 2.12 years, 64.8% were males, and 76.6% of children were from rural area. Ocular findings were seen in 110 (85.93%) children, refractive error being the most common finding seen in 87 children (astigmatism n = 47, hypermetropia n = 28, and myopia n = 12). Strabismus was seen in 65 children, esotropia being the most common (n = 36). Vision impairment was present in 39.84% of children. Other ocular findings included disc pallor, cataract, ptosis, amblyopia, keratoconus, telecanthus, lagophthalmos, blepharitis, retinitis pigmentosa, and morning glory syndrome. Spearman's correlation showed no statistical association between ocular findings and various causes for developmental delay. There was a weak negative correlation between antenatal history, mode of delivery, gestational age, and ocular findings. CONCLUSION: More than three-fourths of children with developmental delay had ocular findings which necessitates the need for ocular evaluation.

Why chitosan could be apt candidate for glaucoma drug delivery - An overview.

Most of the people in the world are affected by glaucoma, which leads to irreversible blindness. Several patient friendly treatments are available, nevertheless medications lack an easy and efficient way of sustained delivery. To make the delivery with enhanced bioavailability, biodegradable and non-biodegradable polymers-based drug carriers are explored. However, ocular drug delivery issues have not been resolved yet due to less adhesiveness, poor penetration ability, pH, and temperature dependent burst releases. Chitosan is found to be effective for ocular drug delivery due to excellent physio-chemical properties in terms of overcoming the existing issues. In this review, we aim to highlight why it has been chosen and the holy grail for ocular drug delivery. Besides, we have comprehensively reviewed recent patents on chitosan as a platform for ocular drug delivery and future perspectives on factors, lacunae and challenges that need to be addressed for better ocular delivery methods for glaucoma management.