RESUMEN
The aim of this perspective is to promote the theory of salutogenesis as a novel approach to addressing ophthalmologic inflammatory conditions, illustrating several concepts in which it is based upon and how they can be applied to medical practice. This theory can better contextualize why patients with similar demographics and exposures are not uniform in their clinical presentations. Stressors in daily life can contribute to a state of ill-health and there are various factors that help alleviate their negative impact. These alleviating factors are significantly impaired in people with poor vision, one of the most common presentations of ophthalmologic conditions. Salutogenic principles can guide the treatment of eye conditions to be more respectful of patient autonomy amidst shifting expectations of the doctor-patient relationship. Being able to take ownership of their health and feeling that their cultural beliefs were considered improves compliance and subsequently gives more optimal outcomes. Population-level policy interventions could also utilize salutogenic principles to identify previously overlooked domains that can be addressed. We identified several papers about salutogenesis in an ophthalmological context and acknowledged the relatively few studies on this topic at present and offer directions in which we can explore further in subsequent studies.
RESUMEN
Purpose: To measure the prevalence and causes of visual impairment (VI) among the 40+ age population in two coastal districts of India and to determine the levels of effective cataract surgical coverage (eCSC) and effective refractive error coverage (eREC) in the study population. Methods: A cross-sectional study was done on 4200 people chosen using cluster sampling in two coastal districts of Odisha, an eastern state in India. A team consisting of trained optometrists and social workers conducted the ocular examination which included unaided, pinhole, and aided visual acuity assessments followed by examination of the anterior segment and lens. Results: Overall, 3745 (89.2%) participants were examined from 60 study clusters, 30 in each district. Among those examined, 1677 (44.8%) were men, 2554 (68.2%) were educated and number? (17.8%) used distance spectacles during the survey. The prevalence of VI adjusted for age and gender was 12.77% (95% CI 11.85-13.69%). Multiple logistic regression showed that older age (OR 3.1; 95% CI 2.0-4.7) and urban residence (OR 1.2; 95% CI 1.0-1.6) were associated with VI. Being educated (OR 0.4; 95% CI 0.3-0.6) and using glasses (OR 0.3; 95% CI 0.5-0.2) were found to provide protection; therefore, resulting in lower instances of VI. Cataract (62.7%) and uncorrected refractive errors (27.1%) were the two main causes of VI. The eCSC was 35.1%, the eREC for distance was 40.0%, and the eREC for near was 35.7%. Conclusion: VI remains a challenge in Odisha, as the prevalence is high and the surgical coverage is poor. Nearly 90% of VI is avoidable indicating that targeted interventions are required to address this problem.
RESUMEN
PURPOSE: The objective of the study was to assess the awareness and health-seeking practices related to cataract in urban slums of Delhi. METHODS: This study design was a population-based cross-sectional study. Participants aged 18-60 years were recruited from randomly selected five slums of South Delhi. They were interviewed using a semi-structured interview schedule on awareness and eye health-seeking practices related to cataract. The practices were recorded if the respondents themselves or any other member of the family was diagnosed with cataract in previous 2 years. RESULTS: A total of 1552 respondents participated in the study, of which, 89.9% had heard of cataract but only (42%) were aware of any symptom of cataract. The common symptoms of cataract reported by the participants were white opacity in eyes (25.9%) and loss of vision (20.6%). Surgery as a treatment of cataract was known to only 559 (40.1%) participants. Awareness about surgery as treatment of cataract was significantly higher among people aged 45-60 years (adjusted odds ratio = 2.89, 95% confidence interval = 2.11-3.97) and in educated people (adjusted OR = 3.69 95% CI = 2.37-5.73). Out of 84 respondents who had been diagnosed with cataract, the health-seeking practices were observed by 70 (83.3%) participants. Among them, 51 (72.9%) had undergone surgery and another 19 (27.1%) had been advised to wait for surgery. Most of the operated patients 48 (94.1%) attended the postoperative follow-up. CONCLUSION: The study findings suggest the majority of participants have heard of cataract, but there is low awareness of its symptoms and treatment, and good eye health-seeking practices observed for cataract in urban slum population. Gaps in awareness observed can be filled up by implementing proper eye health education programs.