Rees G.,University of Melbourne |
Xie J.,University of Melbourne |
Chiang P.P.,Singapore Eye Research Institute |
Larizza M.F.,University of Melbourne |
And 7 more authors.
Patient Education and Counseling | Year: 2015
Objective: To investigate the effectiveness of a low vision self-management programme (LVSMP) in older adults. Methods: Participants (n= 153) were existing clients of a national low vision rehabilitation organisation randomly allocated to usual services (n= 60) or usual services plus LVSMP (n= 93). The LVSMP was an 8-week group programme facilitated by low vision counsellors. The primary outcome was vision-specific quality of life (QoL) measured using the Impact of Vision Impairment (IVI) questionnaire. Secondary outcomes emotional well-being, self-efficacy and adaptation to vision loss were measured using the depression, anxiety, stress scale (DASS), general self-efficacy scale (GSES), and short form adaptation to age-related vision loss scale (AVL12). Results: At one and six month follow-up assessments, no significant between-group differences were found for vision-specific QoL, emotional well-being, adaptation to vision loss or self-efficacy (p>. 0.05). Univariate and multivariate analyses revealed no impact of the intervention on outcome measures. Conclusions: In contrast to previous work, our study found limited benefit of a LVSM programme on QoL for older adults accessing low vision services. Practice implications: When implementing self-management programmes in low vision rehabilitation settings, issues of client interest, divergence of need, programme accessibility and fidelity of intervention delivery need to be addressed. © 2014 Elsevier Ireland Ltd.
How can a city's infrastructure cope with this sudden influx of pilgrims, and the demands for food, water, shelter, and safety they bring with them? And how can communities worldwide become more resilient and livable? These kinds of questions drive Associate Professor Ramesh Raskar, a native of Nashik, and his Camera Culture group at the MIT Media Lab. With support from the MIT Tata Center for Technology and Design, Raskar's group is forging a new co-innovation model linking researchers at MIT with energetic students in India to work on problems across key fields such as health care, education, and the environment. They are using Nashik as a proving ground for solutions that can work at massive scale, under the umbrella of an initiative called Emerging Worlds. This January, the Camera Culture group traveled to Nashik to host a week-long innovation camp, where they mentored teams of students who had traveled from all around India to participate. "The real world of innovation is not in Boston," Raskar said at the camp's opening session. "You have to get out in the world, collaborate, and apply research. For innovators, Nashik is a perfect starting point." No one knows this better than Shantanu Sinha, who attended a camp in 2013, when he was an undergraduate at the Indian Institute of Technology Bombay. Now, he's a master's student at MIT and a fellow in the Tata Center. He says that during these camps, they are looking for two things: interesting problems and interesting people. "We think of these camps as a way to find exciting problem statements and vet solutions in the field," he says. "It's also a way to recruit talented people to work with us long-term." That's what makes the Emerging Worlds model different from hackathons, incubators, and accelerators, according to Raskar. It goes far beyond the one-week camps; there are now three permanent innovation centers in India (Hyderabad, Mumbai, and the new DISQ Innovation Centre in Nashik) where teams of young researchers collaborate with their colleagues 8,000 miles away at MIT. Raskar says the new Nashik center will "provide a readymade pilot site for many MIT and non-MIT projects. This way, researchers don't spend unnecessary time finding stakeholders and scheduling meetings. It all happens in an integrated ecosystem." "The motivation for building these centers, from our point of view, is that we need constant support in India," says Anshuman Das, a postdoc in the Media Lab and Tata Center. "We can't just come twice a year and hope to make a difference. Our efforts need to go on all year." "Startups, incubators, and entrepreneurship may not be the only venture model for India," Raskar says. He sees co-innovation between universities, governments, and the private sector as a promising avenue for tackling complex challenges. "Ramesh says innovation is all about people," says Tata Fellow Tristan Swedish, a master's student in the Media Lab. "It's so great to talk to diverse people and understand what their ideas are." One of Camera Culture's focus areas is affordable, high-impact health technologies. Innovations like these look to fill the gap for underserved communities in India where primary care doctors and specialists are not readily available. These tools hope to aid frontline health care workers and allow people to screen for diseases at early stages. Sinha and Swedish's work focuses on early diagnosis of the conditions that cause preventable blindness. Sinha is developing an easy-to-use ocular imaging device to enable out-of-clinic examination of the anterior segment of the eye on a large scale. Swedish is developing a new class of user-centric retinal imaging systems inspired by computational photography and machine learning. The co-innovation model has made it easier for them to iterate through designs. Working with the LV Prasad Eye Institute in Hyderabad, they are able to confer with doctors on the needs of the patients and design devices based on their input. Pushyami Rachapudi, a master's student at International Institute of Information Technology Hyderabad, has worked with the team since January 2015, and is instrumental in transitioning ideas into clinic-ready devices that have the potential to be deployed through LV Prasad's network. Raskar's success with the EyeNetra, a mobile eye-test device developed in collaboration with LV Prasad, helped spawn this model. "Moving from the initial idea to an device is really difficult, so we need someone on the ground who can provide us the right context and design parameters," says Swedish, noting that the Hyderabad and Cambridge labs are in daily communication. Rachapudi even did a six-month internship at the Media Lab. "We thought it would be a great opportunity to learn from her," Sinha says. Meanwhile, Das and Tata Fellows Mrinal Mohit and Guy Satat are exploring a similar approach to ear, skin, and oral imaging, with help from their collaborators in Mumbai. "It's very efficient to do a lot of research at MIT, where we have great facilities," Mohit says. "Once we nail that down, the collaborations we have in India help us validate the technology." This method allows Camera Culture to have a fast-moving, iterative prototyping process, with diverse teams of engineers, software developers, and designers working literally around the clock on opposite sides of the globe. "I am a maker and I love to build things," says Akshat Wahi, who works at the center in Mumbai. "MIT Emerging Worlds gave me an opportunity apply my skills in new ways that I hadn't imagined before." Wahi and others like him have forgone the chance to earn higher salaries at big corporations, opting to join Emerging Worlds instead. Das attributes it to their desire to "do something bigger than just a job." Sai Sri Sathya, a software engineer, left Microsoft to join the effort in Mumbai. "The impact I could create at Microsoft was much less than what I can do for Emerging Worlds." Raskar is hoping that impact will eventually reach billions of people—starting with his hometown. Explore further: Laser-based camera can see around corners
Naidoo K.S.,University of KwaZulu - Natal |
Naidoo K.S.,Brien Holden Vision Institute |
Leasher J.,Nova Southeastern University |
Bourne R.R.,University of New South Wales |
And 11 more authors.
Optometry and Vision Science | Year: 2016
The purpose of this systematic review was to estimate worldwide the number of people with moderate and severe visual impairment (MSVI; presenting visual acuity G6/18, Q3/60) or blindness (presenting visual acuity G3/60) due to uncorrected refractive error (URE), to estimate trends in prevalence from 1990 to 2010, and to analyze regional differences. The review focuses on uncorrected refractive error which is now the most common cause of avoidable visual impairment globally. The systematic review of 14,908 relevant manuscripts from 1990 to 2010 using Medline, Embase, and WHOLIS yielded 243 high-quality, population-based cross-sectional studies which informed a meta-Analysis of trends by region. The results showed that in 2010, 6.8 million (95% confidence interval [CI]: 4.7Y8.8 million) people were blind (7.9% increase from 1990) and 101.2 million (95% CI: 87.88Y125.5 million) vision impaired due to URE (15% increase since 1990), while the global population increased by 30% (1990Y2010). The all-Age age-standardized prevalence of URE blindness decreased 33% from 0.2% (95% CI: 0.1Y0.2%) in 1990 to 0.1% (95% CI: 0.1Y0.1%) in 2010, whereas the prevalence of URE MSVI decreased 25% from 2.1% (95% CI: 1.6Y2.4%) in 1990 to 1.5% (95% CI: 1.3Y1.9%) in 2010. In 2010, URE contributed 20.9% (95% CI: 15.2Y25.9%) of all blindness and 52.9% (95% CI: 47.2Y57.3%) of all MSVI worldwide. The contribution of URE to all MSVI ranged from 44.2 to 48.1% in all regions except in South Asia which was at 65.4% (95% CI: 62Y72%). We conclude that in 2010, uncorrected refractive error continues as the leading cause of vision impairment and the second leading cause of blindness worldwide, affecting a total of 108 million people or 1 in 90 persons. Copyright © 2016 American Academy of Optometry.
Chhablani J.,L V Prasad Eye Institute |
Nayak S.,L V Prasad Eye Institute |
Jindal A.,L V Prasad Eye Institute |
Motukupally S.R.,Prasad Eye Institute |
And 7 more authors.
Journal of Ophthalmic Inflammation and Infection | Year: 2013
Background: The purpose of the present study was to evaluate the microbiological spectrum and antimicrobial susceptibility in patients with scleral buckle infection. Medical records of all the patients diagnosed as buckle infection at L. V. Prasad Eye Institute between July 1992 and June 2012 were reviewed in this non-comparative, consecutive, retrospective case series. Findings: A total of 132 eyes of 132 patients underwent buckle explantation for buckle infection during the study period. The incidence of buckle infection at our institute during the study period was 0.2% (31 out of 15,022). A total of 124 isolates were identified from 102 positive cultures. The most common etiological agent isolated was Staphylococcus epidermidis (27/124, 21.77%) followed by Mycobacterium sp. (20/124, 16.13%) and Corynebacterium sp. (13/124, 10.48%). The most common gram negative bacilli identified was Pseudomonas aeruginosa (9/124, 7.26%). The median interval between scleral buckling surgery and onset of symptoms of local infection was 30 days. All eyes underwent buckle explantation and median time interval between primary SB surgery and explantation was 13 months. Recurrent retinal detachment was observed in two cases at 7 and 48 months, respectively, after buckle explantation. Gram positive, gram negative, and acid-fast organisms isolated from 2003 to 2012 were most commonly susceptible to vancomycin (100%), ciprofloxacin (100%), and amikacin (89%). Susceptibility to ciprofloxacin during the same time period was observed in 75% (15/20), 100% (13/13), and 87% (7/8) of gram positive, gram negative, and acid-fast isolates, respectively. Conclusion: Scleral buckle infection is relatively rare and has a delayed clinical presentation. It is most commonly caused by gram positive cocci. Based on the current antimicrobial susceptibility, ciprofloxacin can be used as empirical therapy in the management of scleral buckle infections. © 2013 Chhablani et al.
Kumar H.,Lv Prasad Eye Institute |
Monira S.,Lv Prasad Eye Institute |
Rao A.,Prasad Eye Institute
Seminars in Ophthalmology | Year: 2014
Purpose: To identify the referral pattern and identify causes of missed referrals to low-vision services in a tertiary eye care center. Methods: A retrospective review of all the hospital records of patients seen from September-December 2012 was done to identify patients with visual impairment. Low vision was defined as has a best-corrected visual acuity (BCVA) in the better eye of <20/60 to light perception (as per WHO definition); or a visual field of <20° from the point of fixation. The frequency of referrals in this database was used to identify referral patterns of physicians and also causes for missed referrals for these patients. Results: Of 14,938 hospital medical records reviewed during the period, 499 patients missed low-vision services with a mean age of 46 ± 18.2 years, including 158 females. Among those missed, 12.07% were in the age group 0-15 years, while 30.9% of the patients were >60 years, with 157 requiring rehabilitative services and training. Causes for missed referrals were clear misses or non-referrals by the physician (39%), non-acceptance of services by the patient (53%), loss from appointment desks (4.5%), and loss to follow-up (3.5%). Conclusion: Missed referral to low-vision services in tertiary centers can be considerable; these need to be identified for optimal utilization and delivery of these services to patients with low vision. © 2014 Informa Healthcare USA, Inc. All rights reserved: reproduction in whole or part not permitted