Browsing by Author "Shrestha, JB"
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Publication Refractive and Binocular Vision Status and Associated Asthenopia among Clinical Microscopists(Kathmandu University, 2022) Kaiti, R; Shrestha, JB; Dev, MK; Pradhan, AABSTRACT Background Clinical microscopists are at a greater risk of developing binocular vision anomalies and asthenopia. Objective To assess the refractive and binocular vision status and to explore the association between the presence of asthenopic symptoms and microscopy work among clinical microscopists working at medical laboratory department. Method This cross-sectional study involved 37 clinical microscopists working at medical laboratory department of Dhulikhel Hospital, Nepal. The study was conducted from January to December 2013. Only those participants who had been using microscope for at least a year were enrolled in this study. Each participant underwent distance visual acuity (VA) assessment, refractions, and orthoptic evaluation, including measurement of distance and near phoria, near point of convergence (NPC), near point of accommodation (NPA), positive fusional vergence (PFV), adduction, and calculation of accommodation convergence/accommodation (AC/A) ratio. The tear test was also carried out in each subject. Information about use of glasses, microscopy work (duration, and time spent per day in microscope), and visual symptoms associated with the use of microscope such as eye strain, headache, double vision, and near vision were collected. Result The mean age of the clinical microscopists was 29 ± 5.7 years. The prevalence of refractive error was 56.76% and the mean spherical equivalent (SE) refractive error was -0.77 ± 0.86 D. Refractive error had neither correlation with microscopy work and asthenopic symptoms associated with it, and nor with binocular vision parameters- NPC, AA and AC/A ratio. However, there was a positive association between asthenopic symptoms and microscopy work. There was statistically significant difference between symptomatic and asymptomatic subjects for binocular vision parameters, including NPC, AA and positive fusional vergence (PFV) for near. Conclusion Microscopy work has an impact on near binocular vision. Asthenopic symptoms bear a positive association with microscopy work. Refractive error has no significant correlation with either microscopy works or associated asthenopic symptoms. KEY WORDS Asthenopia, Binocular vision, Microscopists, Orthoptic, Refractive errorPublication Retinoblastoma at a tertiary level eye centre, Nepal(Institute of Medicine, 2018) Shrestha, JB; Shrestha, GB; Joshi, SNAbstract Introduction: Retinoblastoma is the most common intraocular malignant tumor in children occurring in approximately 1 in 18,000 live births. With early detection and management, lives of many children can be saved, eyes can be preserved and vision can be restored. The study was aimed at finding out the clinical features, methods of management and outcome of the disease in a tertiary eye care centre of institute of medicine in Nepal. Methods: A prospective case series study was done between 2014 -2017 at BP Koirala Lions Centre for Ophthalmic Studies, Institute of medicine, Nepal. The diagnosis of retinoblastoma was made on the basis of history and clinical examination. Additional information was obtained from radiological procedure whenever required. International classification of retinoblastoma (Shields) was used to clinically classify the retinoblastoma lesion and the management depended on the stage of the disease. Results: A total of 36 patients with retinoblastoma fulfilled the inclusion criteria of the study, 23 males and 13 females with sex ratio: 0.57. Median age at diagnosis was 36±13.825 months. In 19.4% of cases the disease was bilateral. Leukocoria, red eye and proptosis were common signs observed in 46.5%, 33.3 % and 16.3% of case respectively. Enucleation and exenteration were the commonest modality of treatment. Six patients died during the course of treatment and during follow up period and 8 patients were lost before one year of follow up. Conclusions: Despite the advances in the field of retinoblastoma, the prognosis still remains poor due to delay in presentation in our centre. Key words: management, Nepal, retinoblastomaPublication Treatment of Anisometropic Amblyopia in children with refractive correction(Institute of Medicine, 2009) Kaphle, D; Shrestha, JB; Paudel, PAbstract Background: The main purpose of the study is to determine the effectiveness of spectacles alone in the treatment of anisometropia in paediatric population. Methods: A hospital based prospective study was conducted on twenty children (involving twentysix eyes) with freshly diagnosed anisometropic amblyopia of mild to moderate grade. Optimal refractive correction was provided with spectacles alone and was followed at every 3 weeks until amblyopia resolved. Results: The mean line of improvement in visual acuity in 3 weeks was 0.85 ± 0.65 snellen lines. The mean line improvement in second follow up was 0.80 ± 0.70 lines. There was statistically significant (p=0.04) decrease in inter-ocular acuity (IOD) for anisometropia of 1 to 2.0D. The IOD improvement was associated with age (1.53 snellen lines in more than 8 years) in first follow up (p=0.001). IOD also decreased in children of more than 8 yrs. Conclusions: As in nearly half of the participants, especially who has minimal interocular acuity difference, anisometropic amblyopia resolved to normal acuity within first three weeks, we can conclud that the early improvement of visual acuity is related to lesser amount of anisometropia, age and sex. Keywords: Anisometropic amblyopia, amblyopia resolution, inter-ocular difference (IOD), refractive correction