Title: AN OBSERVATIONAL STUDY REGARDING THE IMPROVEMENT OF VISION AFTER EXTRACAPSULAR CATARACT SURGERY
1 AN OBSERVATIONAL STUDY REGARDING THE IMPROVEMENT OF VISION AFTER EXTRACAPSULAR CATARACT SURGERY
Dr. TAPASVI PUWAR
National Programme for Control of Blindness Eye Awareness
One of the basic Human Right is to see and therefore it is to be ensured that no citizen goes blind needlessly or being blind does not remain so if by reasonable deployment of skill and resources his eye sight could be prevented from deteriorating and if already lost could be restored
Resolution of the Central Council of Health Family Welfare at its meeting in the year 1975.
3 Magnitude of Problem
According to the 1999-2000 statistics ---- 180 million people are visually impaired out of which
45 million are blind
Also 80 of it is falls in the preventable category.
The current prevalence is 0.2 to 1.1
The current prevalence rate is 1.1
Cataract is still the leading cause of blindness in India contributing to about 50 -90 of the cases.
The major age group affected are between 45 to 50 yrs.
4 RESEARCH QUESTION
To survey the post operative improvement of vision in 100 patients suffering from cataract and who underwent extracapsular cataract extraction and whether there are any complications or not.
5 REVIEW OF LITERATURE
Visual Acuity of less than 3/60 (snellen) or its equivalent i.e inability to count fingers at a distance of 3 mts. is termed as blindness.
Definition Any opacity of crystalline lens of eye leading to loss of details and clarity.
Barriers To Surgery
Ignorance of facilities
Services too far
No one to accompany
Old Age so no need felt
Other eye in good condition
Waiting for the cataract to mature
Type Of Study Observational Study
After getting permission from the respective HOD of the concerned depts. we went to the ophthalmology OPD and collected the data from 100 postoperative patients who underwent cataract operation by the extracapsular cataract extraction technique at Nagri Eye Hospital.
We collected their personal data and their vision before and after the surgery.Also we asked about any complications suffered by them.
After collecting the data we anlaysed it and found out the results.
8 TIME LINE CHART Time Period (weekly) 9 ANALYSIS TABLE 1 AGE WISE DISTRIBUTION OF STUDY POPULATION The mean age is 59.99 yrs the age group 60 -69 yrs has the highest cases. 10 TABLE 2 SEX WISE DISTRIBUTION OF STUDY POPULATION TABLE 3 ADDICTION WISE DISTRIBUTION OF STUDY POPULATION No. of persons 11 TABLE 4EDUCATION WISE DISTRIBUTION OF STUDY POPULATION 0 Illiterate 3 11th to 12th standard 1 1st to 7th Standard 4 Graduation 2 8th to 10th Standard 5 Post Graduation 12 TABLE 5 DURATION OF DIAGNOSIS AND OPERATION WISE DISTRIBUTION OF STUDY POPULATION The mean duration that has elapsed between diagnosis and operation is 2.2 months. 13 TABLE 6SUBJECTIVE VISION IMPROVEMENT WISE DISTRIBUTION OF STUDY POPULATION 14 TABLE 7 VISION BEFORE AND AFTER CATARACT SURGERY This table shows the vision before and after the cataract surgery. A 6/6 E 6/24 B 6/9 F 6/36 C 6/12 G 6/60 D 6/18 This classification is according to the Snellens chart for distant vision. 15 Applying the Z TEST to check the significance of the vision improvement After the cataract surgery. Z value 18.09 Std error 0.042 . 0.042 x 1.96 0.0823 which is less than z value. So the test is significant and hence it shows that people undergoing a cataract Surgery will have an improvement of vision. 16 TABLE 8 COMPLICATION WISE DISTRIBUTION OF STUDY POPULATION 17 CROSS TABLES
TABLE 1 AGE V/S
Applying the CHI SQUARE TEST to check the significance of age and complication Chi square value 0.79 which is less than the table value. So the test is not significant. That means statistically there is no high risk age group for postoperative complications. 18 TABLE 2EDUCATION V/S COMPLICATIONS Applying the CHI SQUARE TEST to check the signifance of this cause and effect relationship 19 Applying the CHI SQAURE TEST to check the significance of this cause and effect relationship The chi square value is 4.04 which is more than the table value. This shows that the test is significant. This shows that illiterate people suffer from more complications most probably due to unhygienic practice and improper care after surgery. 20 SUMMARY AND CONCLUSIONS
Cataract has constantly been one of the leading causes of blindness in India. However recently there has been a decline in the number of people suffering from blindness due to cataract.
This is due to the better facilities of surgery available to the common man.Also many programmes regarding the prevention control and treatment modalities have been undertaken by the Govt.Of India.
NPCB Launched in 1976 it has been striving to decrease the prevalence of blindness in India.
VISION 2020 RIGHT TO SIGHT
Goal -- Elimination of avoidable blindness by the year 2020.
Under this program cataract is one of the target disease including other 4 like DR Glaucoma Refractive Errors and Childhood Blindness.
According to the survey we conducted and based on the cross examination we carried out we came to the conclusion that the only modifiable factor associated with the prevention of complication is EDUCATION.
The maximum number of complications occurring are those among uneducated people either due to unawareness or lack of carefulness.
If we educate the people about the pros and cons of cataract we can encourage them to come in for a timely surgery and better results of vision and probably very minimal complications.
Also we need to educate them to remove the barriers to surgery as seen above.
The other less modifiable factor is the duration between the diagnosis and operation which is largely dependent on again education. Although many people have a delay due to medical indications but majority of them delay the surgery due to unawareness and superstitions.
But under the study we carried out we have thankfully found out that majority of the patients have operated within the duration of 1 to 2 months.
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