A cross-sectional survey of prospective healthcare professionals' knowledge, attitudes and perceptions of medical Cannabis.

Background: Compounds isolated from Cannabis possess many beneficial effects creating a renewed worldwide interest in its therapeutic potential. With increased legalization for medicinal use globally, healthcare professionals must be familiar with the drug's uses and potential adverse effects. Objective: To determine prospective healthcare providers' knowledge, attitude and perception to medical Cannabis. Method: A self-administered online questionnaire comprising 21 questions to assess the knowledge, attitude and perception of medical Cannabis was distributed via google forms among students at the Faculty of Medical Sciences, the University of the West Indies, St Augustine Campus. Chi-square analysis was used to detect significant associations between demographics and measured variables. A p-value <0.05 was considered significant. Results: Popular perceived therapeutic benefits of Cannabis were chronic pain (91.2%), anxiety (84.2%) and seizures (71.1%), and identification of the risks associated with the use of Cannabis was low. Users of Cannabis were able to identify indications and symptoms that can be treated with Cannabis but were less aware of the adverse effects of the drug than non-users (p < 0.001). More than three-quarters (87.3%) believed they could identify therapeutic uses and adverse effects but only 14.2% were ready to answer queries from patients. The main source of Cannabis information was the internet and information was lacking in the medical school curriculum. Conclusion: The majority of students could not identify the drug's indications and adverse effects. There is a need to improve training for all prospective medical personnel to cater for the change in legislation status.

A novel tool for quantitative measurement of distortion in keratoconus.

BACKGROUND: Keratoconus is associated with thinning and anterior protrusion of the cornea resulting in the symptoms of blurry and distorted vision. The commonly used clinical vision tests such as visual acuity and contrast sensitivity may not reflect the symptoms experienced in keratoconus and there are no quantitative tools to measure visual distortion. In this study, we used a quantitative test based on vernier alignment and field matching techniques to quantify visual distortion in keratoconus and assess its relation to corneal structural changes. METHODS: A total of 50 participants (25 keratoconus and 25 visually normal) completed the experiment where they aligned supra-threshold white target circles in opposite field in reference to guidelines and circles to complete a square structure monocularly. The task was repeated five times and the global distortion index (GDI) and global uncertainty index (GUI) were calculated as the mean and standard deviation respectively of local perceived misalignment of target circles over five trials. RESULTS: Both GDI and GUI were higher in participants with keratoconus compared to controls (p < 0.01). Both parameters correlated with the best corrected visual acuity, maximum corneal curvature (Kmax), topographical keratoconus classification (TKC) and central corneal thickness (CCT). CONCLUSION: Our findings show that the quantitative measure of distortion could be a useful tool for behavioural assessment of progressive keratoconus.

A retrospective study of causes of visual impairment and use of low vision devices in the low vision clinic in Trinidad and Tobago.

PURPOSE: To determine the causes of visual impairment and the use of low vision devices in patients attending the low vision clinic in Trinidad and Tobago. METHODS: A retrospective study of the 222 patients attending the low vision clinic at the University of the West Indies, St Augustine Campus was conducted. The presenting visual acuity, causes of low vision and blindness, and prescribed low vision devices were recorded and analysed to determine the major causes of visual impairment and improvement in visual acuity with low vision aids. RESULTS: Out of the total 222 participants, 66.66% (n = 148) had low vision while the rest (33.33%, n = 74) were legally blind. Glaucoma was the major cause of low vision (31.08%) and blindness (28.38%) followed by diabetic retinopathy (20.94%, low vision and 20.27%, blindness). A total of 193 low vision devices were prescribed, 79.79% (n = 154) near devices and 20.20% (n = 39) distance devices. The low vision devices were effective in improving both near visual acuity (120 participants reading 1M or 2M) and distance visual acuity (VA better than 3/60). CONCLUSION: The major causes of vision impairment in Trinidad and Tobago were glaucoma and diabetic retinopathy and low vision devices are effective in improving visual acuity. A comprehensive approach to dealing with the causes of low vision and low vision services are required to mitigate the burden of visual impairment in the country.