Varsha, Alex (2018) To assess functional vision in children with bilateral aphakia and pseudophakia. Masters thesis, Christian Medical College, Vellore.
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Abstract
INTRODUCTION: Functional vision is defined as vision loss in terms of the individual’s abilities and skills to perform activities of daily living. Congenital cataract is one of the treatable causes of childhood blindness worldwide. Cataract has significant long-term impact on functional visual ability and quality of life in children and young people. Good visual performance is not just determined by good visual acuity but also by visual functions like contrast sensitivity and stereopsis which may be affected in children with bilateral cataract. Most studies done on congenital and developmental cataract have concentrated on visual acuity outcomes after cataract surgery. Only few studies have been done to determine the functional vision outcome after cataract surgery. We have conducted this study to see how visual functions influence the functional vision which in turn affects the quality of life in school going children. METHODS: It was a cross sectional study which extended over a period of 1 year 6 months (From March 2016 to August 2017). Participants included children aged 5-15 years who came to the outpatient department and peadiatric ophthalmology clinic of Schell eye hospital and who have undergone bilateral cataract surgery with or without intraocular lens implantation and were on, regular follow up. Children with co-existing ocular conditions like corneal scar in the visual axis and posterior segment pathology like macular scar as well as children with developmental delay were excluded. RESULTS: There is no correlation between mother’s education and functional vision. (P = 0.4451). There is no correlation between father’s education and functional vision (P = 0.3814). On comparing, lens status with gender, P value is 0.137) 76% of study patients had good visual acuity. On comparing of Lea logmar vision to functional vision based on child’s questionnaire, corelation coefficient was -0.066 (95% CI: -0.338 to 0.216). Comparison of Lea logmar vision to functional vision based on mother’s questionnaire, corelation coefficient was -0.114 (95% CI: -0.381 to 0.169). 62% children had good near vision. 44 children had good functional vision score. According to Mother’s questionnaire, above 80% in score was taken as good outcome.The percentage of good outcome is 88% (95% CI: 75.7). According to child’s questionnaire, above 80% in score was taken as good outcome. The percentage of good outcome is 88% (95% CI: 75.7). Positive correlation between mother and child’s questionnaire was obtained (r) = 0.365 (95% CI: 0.180 to 0.637) There were 4 children with good stereopsis and 27 children with no stereopsis. Correlation of visual acuity and functional vision according to child’s questionnaire is -0.066, (95% CI: -0.338 to 0.216). Correlation of visual acuity and functional vision according to mother’s questionnaire is -0.114, (95% CI: -0.381 to 0.169). Correlation of stereopsis to functional vision according to child’s questionnaire is 0.189 (95% CI: -0.097 to 0.447). Correlation of stereopsis to functional vision according to mother’s questionnaire is 0.099 (95% CI: -0.184 to 0.367). Correlation of contrast sensitivity to functional vision according to mother’s questionnaire is 0.118 (95% CI: -0.166 to 0.384) Correlation of contrast sensitivity and functional vision according to child’s questionnaire is 0.032 (95% CI: -0.249 to 0.307). There is no difference in post op vision between pseudophakic and aphakic children. Comparison of functional vision in pseudophakia and aphakia (As per child’s questionnaire) is P value= 0.261. Comparison of functional vision in pseudophakia and aphakia (As per mother’s questionnaire) is P value= 0.385. Nil significant statistical difference between the contrast sensitivity in pseudophakic and aphakic children. P value= 0.161. There is a clinically acceptable difference stereopsis in pseudophakics and aphakics which is statistically not significant (p-value = 0.112). CONCLUSION: Most children had good functional vision. Mostly all children in the study had good contrast sensitivity. Lot of children had no depth perception (stereopsis) post surgery. Around 25% of the children were found to have low vision but despite of this they had good functional vision. Hence, it was concluded that there is no correlation between functional vision and the visual acuity and visual functions like stereopsis and contrast sensitivity. In pseudophakic and aphakic children, vision, functional vision and contrast sensitivity are not correlated. There is no difference in post op visual acuity and functional vision between pseudophakic and aphakic children which in turn shows that there is no hurry to put intraocular lens in a child post congenital/developmental cataract surgery. There is no statistical difference between the contrast sensitivity and stereopsis in pseudophakic and aphakic children but clinically there is a significant difference between these two groups which shows that stereopsis can be affected by the presence/absence of intraocular lens.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | functional vision ; children ; bilateral aphakia ; pseudophakia. |
| Subjects: | MEDICAL > Ophthalmology |
| Depositing User: | Subramani R |
| Date Deposited: | 14 Jul 2018 19:17 |
| Last Modified: | 14 Jul 2018 19:17 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/8799 |
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