Elite School of Optometry

ABSTRACT Clinical Relevance Contact lenses offer effective refractive, cosmetic, and therapeutic options; however, their safe and successful use requires addressing barriers at the practitioner, patient, and healthcare system levels. Identifying and understanding these challenges are essential to improving clinical outcomes, enhancing patient satisfaction, and supporting broader global adoption. Background Despite advancements in contact lens materials and designs, adoption rates in India remain constrained by discontinuation, affordability issues, and low public awareness. This study aimed to evaluate common challenges, barriers to contact lens uptake, and strategies implemented by practitioners across India. Methods A cross-sectional survey was conducted among contact lens practitioners across six Indian zones (North, South, East, West, Central, and North-East) between January and May 2025. A structured questionnaire, assessed challenges in contact lens practice, barriers to uptake, and improvement strategies. Responses were recorded on a 5-point numerical scale. Data were analysed, employing descriptive statistics and Kruskal-Wallis tests to evaluate regional differences. Results A total of 338 (96.5%) out of 350 practitioners completed the survey. Limited availability of trial lenses and high material costs were the most frequently reported challenges (median score: 3/5, IQR: 2.0–4.0). Key barriers to contact lens uptake included lack of awareness (median: 3/5, IQR: 2.0–4.0), discomfort-related dropout (median: 3/5, IQR: 2.0–4.0), and unsupervised online purchases (median: 3/5, IQR: 2.0–5.0). High consensus was observed for improvement strategies, with practitioner education, patient awareness initiatives, affordability, and proactive contact lens recommendations scoring a median of 4/5, IQR: 3.0–5.0. No statistically significant regional differences were found (p > 0.05). Conclusions Indian contact lens practitioners face consistent challenges nationwide, with affordability, trial lens availability, and public awareness identified as primary concerns. Practitioner-driven education, patient counselling, and affordability measures are essential to enhancing contact lens practice and promoting the safe and wider adoption of contact lenses in India.

Abstract Purpose: Limited research has explored the ergonomics and musculoskeletal disorders (MSDs) among eye care professionals (ECPs) in South India. This study aims to understand this gap through in-depth interviews and rapid entire body assessment (REBA) observations. Methods: A mixed-methods study using semi-structured interviews and REBA was used to assess ergonomics and MSD risk among ECPs with over five years of experience in South Indian eye hospitals. Interviews were recorded, transcribed, and thematically analysed. REBA scores were used to evaluate MSD risk levels. Results: Twenty participants (ten optometrists and ten ophthalmologists) were included, with 70% of optometrists and 50% of ophthalmologists female. General ophthalmologists comprised 60% of the participants, with 70% performing cataract surgeries. Six themes emerged: challenges in clinical practice, duration of work, adaptive strategies, recreational activities, discontinued activities, and suggestions for ergonomic improvements. REBA indicated a medium risk for MSDs among ECPs. Conclusion: Poor posture, particularly during slit lamp examinations, was frequently associated with MSD symptoms and impacted productivity. Participants noted that improving workplace ergonomics could help alleviate these issues and enhance long-term occupational health. Further research is recommended to assess MSD risks in specific ophthalmic sub-specialities, as different clinical tasks may pose varying degrees of ergonomic challenges.

Dear Editor, Global population is significantly affected by refractive error, with an estimated 1.2 billion individuals impacted, including 1.2 million children aged 5 to 15.[1] This condition is a significant contributor to preventable blindness in children and has been reported to affect 8–10% of school-going children. The increased use of technology and small screens during the COVID-19 pandemic has likely contributed to a surge in the prevalence of refractive errors and ocular disorders, particularly in rural areas. Research on the prevalence of refractive error in and around rural areas of Tamil Nadu, such as the Tirupur district, is notably scarce, with existing studies primarily focused on urban or semiurban populations.[2-4] This study sought to address this knowledge gap by investigating the prevalence of refractive error among school-going children in rural areas surrounding the Tirupur district. This study was conducted with the necessary approvals from institutional research and ethics committees, as well as permission for school vision screening through Kannolli Kaapom Thittam between August 2022 and December 2022. The study involved vision screenings and assessments in selected schools within the Vellakoil and Kundadam blocks of Tirupur district. The assessment team, comprising optometry students and senior optometrists, ensured proper settings for vision assessments, including well-lit rooms, essential facilities, and appropriate tools such as vision charts and trial sets. Demographic details were recorded; comprehensive assessments were conducted, including unaided and aided vision using the Snellen chart, objective and subjective refraction, and other ocular health checks. Any identified cases of refractive error or other ocular issues were referred for further medical examination, and measures for the provision of spectacles, facilitated through the Kannolli Kaapom Thittam initiative, were organised free of charge. This study involved 4397 school children from 47 government schools in the Tirupur district to estimate the prevalence of refractive error. Of those, 4382 students were analysed, and 15 were referred for further ophthalmological evaluation. The participants’ mean age (SD) was 13.8 (1.6) years, with 52.4% (n = 2294) being male. The study found a refractive error prevalence of 8.99% (n = 394), with myopia being the most common at 6.27%, astigmatism was observed in 2.44% of participants and hyperopia in 0.27%. Table 1 shows the age-wise distribution of different refractive errors. Most participants (99.5%) had normal colour vision, and 82% were orthophoric. The mean weight was 44 kg (13.04), height was 5 ft (0.47), and body mass index (BMI) was 18.6 (4.94). No significant correlation was found between BMI, height, weight, and refractive error.Table 1: Age-wise distribution of refractive errorsThe study underscores the importance of addressing refractive errors among school-aged children in rural regions and the necessity of regular screening, along with the provision of accessible corrective measures. Moreover, it highlights the impact of technological engagement, particularly during the pandemic, on ocular health, emphasising the need for informed healthcare strategies and interventions in rural and urban settings. Despite ongoing debates about the efficacy of school screening programs, this study affirms their importance. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Center-surround contrast suppression-typically induced when a center pattern is surrounded by another pattern with similar spatial features-is considered a perceptual analogue of center-surround neurophysiology in the visual system. Surround suppression strength is altered in a range of brain conditions affecting young people (e.g., schizophrenia, depression, migraine) and is modulated by various neurotransmitters. The early teen years are associated with neurotransmitter changes in the human visual cortex, which could impact on excitation-inhibition balance and center-surround antagonistic effects. Hence, we predict that early adolescence is associated with perceptual changes in center-surround suppression. In this cross-sectional study, we tested 196 students at every age from 10 to 17 years and 30 adults (aged 21-34 years) to capture the preteen, adolescent, and adult periods. Contrast discrimination thresholds were measured for a central, circular, vertical sinusoidal grating pattern (0.67° radius, 2 cyc/deg spatial frequency, 2 deg/s drift rate) with and without the surround (4° radius, otherwise same spatial properties as the center). Individual suppression strength was determined by comparing the perceived contrast of the target with and without the surround. After excluding unreliable data (7% of total), we found an effect of age on perceptual center-surround contrast suppression strength, F(8,201) = 2.30, P = 0.02, with weaker suppression in the youngest adolescents relative to adults (Bonferroni pairwise comparisons between adults vs 12-year-olds P = 0.01; adults vs 13-year-olds P = 0.002). Our data demonstrate different center-surround interactions in the visual system-a key building block for visual perception-in early adolescence relative to adulthood.

Purpose:The aim of this study was to measure blur thresholds before and after refractive surgery.Methods:In this prospective cohort study conducted in a tertiary eye hospital in South India. Blur thresholds were measured for 30 young adult myopic patients 1 month prior to and after refractive surgery. Patients were asked to report three stages of blur, namely Detectable Blur (DB), Bothersome Blur (BB), and Non-resolvable Blur (NB). Blur was created by adding plus lenses (in steps of 0.12D) over their optimal subjective refraction. The blur judgments were made both monocularly and binocularly when looking through a 3 mm artificial pupil at one line above the best-corrected visual acuity.Results:A total of 30 participants were included in this study (mean age = 25.5 ± 3.8 (20–36) years; 77% female). The mean binocular preoperative blur of this group was: DB = 0.39 ± 0.26D, BB = 0.74 ± 0.28D and NB = 1.04 ± 0.42D. The corresponding mean binocular blur one-month post-operatively was DB = 0.46 ± 0.28D, BB = 0.83 ± 0.35D, and NB = 1.21 ± 0.44D. Although there was a marginal increase in the blur thresholds postoperatively, the difference was not statistically significant (DB: P = 0.320; BB: P = 0.229; NB: P = 0.054).Conclusion:All three blur thresholds showed an insignificant minimal increase at 1 month post-operatively suggesting that patients adapt to the induced blur following refractive surgery. A longer follow up would reveal how the adaptation to blur would change with time.

BackgroundDiagnosing colour vision deficiency is vital, owing to its impact on the choice of career and activities of daily living. Conventional screening methods require frequent replacement due to soiling of the materials, and hence are expensive and not feasible for large‐scale community screening. This study aims to construct and validate a new screening tool, Dalton's pseudo‐isochromatic plates (PIP), addressing the disadvantages of the conventional methods.MethodsThe two phases of the study included the construction and validation of the Dalton's PIP. Construction involved utilising specific wavelengths based on spectral tuning, selection of numerals as targets for the chart and identification of a material with durability and resistance to wear and tear. Validation of the chart was done against the 38‐plate edition of Ishihara's PIP by two masked examiners for 1,019 school children aged between 11–17-years (mean ± SD: 14 ± 2-years) as part of a school eye‐health program.ResultsThe sensitivity and the specificity of the Dalton's PIP was found to be 94.12 per cent (95% CI 71.31–99.85) and 99.60 per cent (95% CI 98.98–99.89) respectively and the positive and negative predictive values were 80 per cent and 99.90 per cent respectively. Dalton's PIP when used with a failure criterion of less than three plates correct in two screening sets had the maximum sensitivity and specificity and the area under the curve was 0.96 (95% CI 0.90–0.99, p < 0.05).ConclusionThe newly constructed Dalton's PIP is found to be a valid screening tool to detect congenital colour vision deficiency and is comparable to the Ishihara PIP. This screening tool with its shorter screening time, cost and longer durability would effectively serve in large‐scale vision screening programs.

&amp;lt;p&amp;gt;PDS 70 is the only disk known to date that hosts two massive planets clearing a large cavity in the dust distribution. The planets have been detected in both infrared and Halpha, indicating that they are still actively accreting from the planet-hosting environment. The elemental composition of the growing planetary atmospheres are bound to be related to the composition of the accreting material. Bright molecular lines of simple chemical species can be used to infer chemical properties of the material that is being accreted by the planets (as C/O and C/N ratios), as well as physical processes presently occurring in the disk (shocking of gas onto the circumplanetary disks, ionisation). In this talk, I will show new ALMA band 6 observations of PDS 70 at moderate angular resolution in two spectral settings targeting HCN and CO isotopologues, small hydrocarbons, H2CO, H13CO+ and simple S bearing molecules. The molecular emission is particularly bright, with 15 molecular lines detected and imaged. The radial and azimuthal structures of the different molecules provide unique information on the chemical and physical conditions of PDS 70.&amp;lt;/p&amp;gt;

Blindness leads to substantial enhancements in many auditory abilities, and deficits in others. It is unknown how severe visual losses need to be before changes in auditory abilities occur, or whether the relationship between severity of visual loss and changes in auditory abilities is proportional and systematic. Here we show that greater severity of visual loss is associated with increased auditory judgments of distance and room size. On average participants with severe visual losses perceived sounds to be twice as far away, and rooms to be three times larger, than sighted controls. Distance estimates for sighted controls were most accurate for closer sounds and least accurate for farther sounds. As the severity of visual impairment increased, accuracy decreased for closer sounds and increased for farther sounds. However, it is for closer sounds that accurate judgments are needed to guide rapid motor responses to auditory events, e.g. planning a safe path through a busy street to avoid collisions with other people, and falls. Interestingly, greater visual impairment severity was associated with more accurate room size estimates. The results support a new hypothesis that crossmodal calibration of audition by vision depends on the severity of visual loss.