The role of corneo-scleral junction in soft contact lens fitting: Case report on nanophthalmos.

BACKGROUND: Nanophthalmos is rare developmental ocular condition characterized by a small eye with short axial length, high hyperopia and high lens to eye volume ratio due to arrested development of eye ball as a result of scleral inelasticity. OBSERVATIONS: A 33 year old woman who presented with a complaint of blurring of distance and near vision in both eyes since childhood came to LV Prasad Eye Institute on July 2017. Best corrected visual acuity was 20/60 using soft contact lens +23.50 diopters for the right and left eyes. Axial lengths of two eyes were markedly shortened along with steep corneal curvatures. Visante anterior segment ocular coherence tomography showed a steep (convex) corneo-scleral junction (CSJ) which might be the reason for ill-fitting with conventionally estimated soft contact lens (SCL) parameters. Finally, selection of the customized hydrogel soft contact lens base curve close to flatter corneal curvature and small diameter showed characteristics of optimal lens fit. CONCLUSION: The corneo-scleral junction profile plays significant role in soft contact lens fitting. An eye with a profile of convex CSJ would require a lens with steeper curvature compared to conventional measurements. Cases of nanophthalmos would require observation of the profile with the help of optical coherence tomography in addition to measurement of corneal curvature prior to fitting soft contact lenses.

Knowledge, attitude, practice and associated factors towards spectacles use among adults in Gondar town, northwest Ethiopia.

BACKGROUND: Refractive error is the main cause of visual impairment in the world. Spectacles are the most frequently used options for correcting refractive errors. In addition, they can be used for protection and fashion. It is the simplest, cheapest and only method used in developing countries like Ethiopia. This study aims to explore the knowledge, attitude, practice and associated factors towards spectacles use among adult population of Gondar town, northwest Ethiopia. METHODS: Community based cross sectional study was conducted on 780 participants using a pre-tested structured questionnaire in Gondar. Data were analyzed using Statistical Package for Social Sciences (SPSS) 20 version computer software. Association and strength between variables was determined using odds ratio with 95 % confidence interval. RESULT: A total of 780 study subjects participated in this study. The male to female ratio was 1:2.4. The median age of the participants was 29 (±22 IQR) with a range of 18-86 years. About fifty percent of participants were married and 284 (36.4 %) were educated up to secondary school. Seven hundred and three (90.6 %) participants had adequate knowledge about spectacles and 90.4 % had favorable attitude towards spectacle use. About 25 % of the participants have been using spectacles during the study. Participants with primary school education (AOR: 2.79, 95 % CI 1.20-6.50) had good knowledge about spectacles. Housewives (AOR = 3.40, 95 % CI; 1.35-8.54) and participants who unable to read and write (AOR: 3.51, 95 % CI 14-10.72) had favorable attitude towards spectacles use. CONCLUSION: Gondar town adult population has adequate knowledge and favorable attitude towards spectacles. However, practice of spectacles use is poor. Eye health education related to spectacles utilization need to be given due emphasis by eye care professionals in collaboration with University of Gondar and Gondar town administration.