medical surgical nursing - Rajiv Gandhi University of Health Sciences

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medical surgical nursing - Rajiv Gandhi University of Health Sciences
PROFORMA FOR REGESTRATION OF SUBJECT FOR
DISSERTATION
MR. REJO GEORGE MATHEW
1ST YEAR M.Sc NURSING
MEDICAL SURGICAL NURSING
YEAR 2010-2012
PADMASHREE COLLEGE OF NURSING
GURUKRUPA LAYOUT, NAGARBHAVI
BANGALORE-560072
0
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA
PROFORMA FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION
1
NAME
OF THE CANDIDATE
Mr. REJO GEORGE MATHEW
I YEAR M.Sc. NURSING
AND ADDRESS
GURUKRUPA LAYOUT
80 FEET ROAD
NAGARBHAVI
BANGALORE-560072
Padmashree College of Nursing
2
NAME
OF THE INSTITUTION
Bangalore
3
COURSE
OF THE STUDY AND
1st Year M.Sc Nursing
Medical Surgical Nursing
SUBJECT
4 OF ADMISSION
DATE
21/04/2010
5
TITLE
OF THE STUDY
A Study to Assess The Knowledge and
Attitude of Students Regarding LaserAssisted In Situ Keratomileusis (LASIK)
Eye Surgery For Correcting Refractive
Eye Disorders, in Selected Arts Colleges,
Bengaluru.
1
6. BRIEF RESUME OF THE INTENDED WORK
6.1 INTRODUCTION
“It is a mistake to believe that even though the glasses do no good they cannot
do harm. Glasses keep up the strain. A person wearing glasses for myopia has to
strain all the time in order to make the eyeball elongated sufficiently to fit the
glasses”.
William H Bates, MD, Better Eyesight magazine, September 1922
A refractive error is a common eye disorder that can sometimes be so severe that
it causes visual impairment. Its alarming to know that the incidence of these are high
through-out the world
Refractive Eye Disorders are conditions where optical elements of an eye are
unable to focus light rays on the retina which results in blurry vision.
The visual system consists of the internal and external structures of the eye ball,
the refractive media, and the visual pathways. The internal structures are the iris, lens,
ciliary body, choroid, and retina. The external structures are the eyebrows, eyelids,
eyelashes, lacrimal system, conjunctiva, cornea, sclera, and the extraocular muscles.
The entire visual system is important for visual function. Light reflected from an
object in the field of vision passes through the transparent structures of the eye and, in
doing so, is refracted (bent) so that a clear image can fall on the retina. From the
retina, the visual stimuli travel through the visual pathway to the occipital cortex
where they are perceived as an image.
The eyeball is composed of three layers. The tough outer layer is composed of
the sclera and the transparent cornea. The middle layer consists of the uveal tract
( iris, choroid, and ciliary body ) and the innermost layer is the retina.
2
For the light to reach the retina, it must pass through a number of structures: the
cornea, aqueous humor, lens, and vitreous. Each structure has a different density and
plays a role in helping the image fall focused on the retina. The transparent cornea is
the first structure through which light passes. It is responsible for the majority of light
refraction necessary for clear vision.
Refraction is the ability of the eye to bend light rays so that they fall on the
retina. In the normal eye, parallel light rays are focused through the lens into a sharp
image on the retina. When the light does not focus properly, it is called a refractive
error.1
An extrapolated statistics of Refractive Eye Disorders in Southern Asia in a year
showed a prevalence rate of 12,579,562 in Afghanistan, 62,356,089 in Bangladesh,
964,221 in Bhutan, a whooping 469,884,072 in India, 70,233,674 in Pakistan, and
8,781,690 in Sri Lanka 2
Common refractive errors of the eye are myopia, hyperopia, and astigmatism.
Traditional method for correcting these errors is using glasses and contact lens based
on the dioptres measured. It is estimated that More than six out of 10 adults in the
U.S. need some type of corrective eyewear. There are approximately 35.4 million
contact lens wearers in U.S. More than 14 million people in the U.S. and 135 million
worldwide have low vision (defined as visual acuity less than 20/70 in the better eye).
The numbers are expected to double by 2030 3
Refractive eye disorders such as short, long sight and astigmatism are measured
in units known as dioptres. The bigger the number, the larger the refractive error and
the thicker the glasses or contact lenses.4 The glasses prescription is written as a series
of numbers e.g. -4/-3 x 180. Here, the first number shows the amount of short or long
sight one have. A minus sign in front of the number shows one is short sighted while a
plus sign shows that the person is long sighted. The second number shows how much
astigmatism (ovalness) the eye has, and the third number shows the axis or direction
of the astigmatism.
3
Myopia is the medical term for short sightedness. Myopia occurs when the eye is
too long for the eye's focusing system, causing light to be focused in front of the
retina, making distant objects appear blurry. However near objects may be focused
clearly. About 90% of myopes have a refractive error of less than -6.00 dioptres.
Myopia is classified according to the corrective power needed.
For example:

Mild myopia less than -3.00 dioptres

Moderate myopia -3.00 to -6.00 dioptres

Severe myopia -6.00 to -9.00 dioptres

Extreme myopia more than -9.00 dioptres
Hypermetropia (also known as hyperopia), or long sight, occurs when the eye is
too short for the eye's focusing system, causing light rays to be focused behind the
retina. Younger people who are not very long sighted may be able to see clearly by
using their focusing muscles. As people get older and approach middle age, their
focusing ability deteriorates, and presbyopia begins to develop. Long sighted people
who could focus to see clearly when younger, may find their vision deteriorates and
they need glasses as they get older. Some people who are very long sighted may need
glasses from a young age.4
Astigmatism is a common eye condition that's characterized by an irregular
curvature of the cornea. Astigmatism occurs in nearly everybody to some degree. For
significant curvature, treatment is required.
A person's eye is naturally spherical in shape. Under normal circumstances, when
light enters the eye, it refracts evenly, creating a clear view of the object. However,
the eye of a person with astigmatism is shaped more like a football or the back of a
spoon. For this person, when light enters the eye it is refracted more in one direction
than the other, allowing only part of the object to be in focus at one time. Objects at
any distance can appear blurry and wavy.5
|A new and effective method for permanently correcting refractive eye disorders
eliminating or reducing the need for the use of correcting glasses and contact lenses is
the LASIK eye surgery. LASIK surgery (laser assisted in situ keratomileusis) is a
4
laser surgery procedure for vision correction. The technique involves using a laser
which is controlled by a computer to reshape the front surface of the eye (cornea).
LASIK eye surgery can be used to correct short sight, long sight and astigmatism.
The process involves high tech instruments that are only used by trained
professionals. An incision is completed very near the cornea so that a flap is made.
The thickness of the flap will depend on what the current vision status of the patient
is. Extreme care is taken to ensure the flap is the precise thickness in order to offer the
patient optimum vision after the surgery is completed.
The flap is moved so that the cornea can be accessed by the professionals
completing the surgery. It is here that the correction to the vision is done with a laser.
After the professional is satisfied with the work the flap is put back into place. Care is
taken to make sure it is placed exactly where it should be. There aren’t any stitches to
keep the flap in place. This is due to the fact that our eyes have a type of suction that
keeps it in place where it should be on its own. This means one won’t have any
scarring or other concerns around the eye area.6
A report from the American Society of Cataract and Refractive surgery indicates
LASIK’s success rates. With 16.3 million patients having had LASIK worldwide, and
more than a decade of clinical study and technological innovation behind it, LASIK is
considered among the most successful elective procedures available today. 95.4% of
LASIK patients worldwide report satisfaction with the outcome of their procedure.
Approximately the same percentage would recommend LASIK to a friend or would
elect to undergo the procedure again. More than 95.2 percent of LASIK patients in the
U.S. are satisfied with the outcome of their procedure. Outside the U.S., studies from
France, India, Iran, Ireland, The Netherlands, Scotland, South Africa, Spain, Turkey,
United Arab Emirates, and The United Kingdom, report very similar patient
satisfaction rates of about 95.6%. The total range of satisfaction rates in individual
studies was from 87.2% to 100%.7
5
6.2 NEED FOR THE STUDY
Worldwide refractive error is the cause of blindness in 8 million persons (18% of
all causes of blindness second only to cataract) and the cause of visual impairment in
145 million persons accounting for over 50% of all causes of visual impairment 8, 9
In a study done To determine the incidence and progression rates of myopia in
young Singaporean children taking a sample of 528 7-year-olds, 325 8-year-olds, and
166 9-year-olds, with 737 Chinese, 229 Malaysians, and 53 Indians, showed Both the
incidence and progression rates of myopia to be high in Singaporean children with
results showing incidence of 47.7%, 38.4 and 32.4% for 7, 8, and 9 year-old children,
respectively.10
In a study conducted by dept of epidemiology, National Taiwan University
covering a population of 4 million school children aged between 7 – 18 years to
determine the trend in myopia over a 20 year period in Taiwan, conducted in 1983,
1986, 1990, 1995 and 2000, showed that mean prevalence of myopia among 7 year
olds increased from 5.8% in 1983 to 21% in 2000. At the age of 12, the prevalence of
myopia was 36.7% in 1983 increasing to 61% in 2000, Corresponding figures for 15
year olds being 64.2% & 81% respectively. The prevalence of myopia increased from
from 74% in 1983 to 84% in 2000 for children aged between 16 & 18 years.11
In an attempt to report the prevalence of refractive errors in a rural south Indian
population, Four thousand eight hundred subjects (age, >39 years) from rural south
India were enumerated for a population-based study. All participants underwent
complete ophthalmic evaluation. Myopia and hyperopia were 26.99% and 18.70%
and age and gender adjusted for the rural Tamil Nadu population were 30.97% and
17.94%, respectively. Hyperopia was more common among women than men and was
negatively associated with nuclear sclerosis and positively with diabetes mellitus. 12
Under-corrected refractive error is the most common cause of reversible
blindness in India. Studies from urban India suggest that 49.3 million of those aged
≥15 years may have refractive errors.13
6
In a hospital-based study in Nigeria, myopia was found to be the commonest
refractive error in the 16-25 age group. The number of myopic patients is expected to
be more in the 16-25 age group14
Refractive errors are so high throughout the world that the corrective eye wear
users are increasing rapidly.
LASIK eye surgery helps to correct these refractive eye disorders effectively. In
2005 there were 1.5 million refractive surgery procedures performed in the U.S.
(1,425,000 LASIK, 67,500 PRK, and 7,500 LASEK).15
In a study done to measure patient attitudes toward methods of refractive
correction among cross-sectional populations of contact lens wearers in 2002 and
2004 at the School of Optometry contact lens clinic at Indiana University, 59% (under
30 years) showed enthusiasm for LASIK, while the rate decreased to 33% in those
above 30 years of age16
All these statistical studies provide strong support for conducting the present
research. Refractive errors are high among students, prompting them to use glasses or
contact lenses. Even though they cry against glasses and contact lenses, they fail to
see the alternative measures available to solve the problem permanently. Many have a
bias towards laser surgeries as being dangerous, and causing body image
disturbances.
The researcher’s own personal experiences that many of his colleagues and
friends lack knowledge regarding LASIK eye surgery and their bias towards this
surgery made him think about the problem. The researcher, himself being a myopic,
had a prejudice against all laser surgeries as being costly and harmful, until he heard
about LASIK in detail from a friend who had undergone the treatment. This motivated
the researcher to conduct this study to assess the students knowledge and attitude
regarding LASIK eye surgery with a view of preparing an informational module.
7
6.3 STATEMENT OF THE PROBLEM
A study to assess the knowledge and attitude of students regarding LaserAssisted In Situ Keratomileusis (LASIK) eye surgery for correcting refractive eye
disorders in selected arts colleges, Bangalore.
6.4 OBJECTIVES
1. To assess the existing knowledge regarding LASIK eye surgery among
students
2. To assess the attitude of students regarding LASIK eye surgery
3. To correlate the knowledge and attitude of students regarding LASIK eye
surgery
4. To associate knowledge and attitude of students on LASIK eye surgery with
selected demographic variables
5. To develop an informational module on LASIK eye surgery based on the
findings
6.5 OPERATIONAL DEFINITIONS
1. KNOWLEDGE:
The state of knowing about a particular fact or situation. In this study it refers to
the correct responses obtained from students regarding LASIK eye surgery as
measured by a self administered questionnaire.
2. ATTITUDE:
It refers to opinion, belief and feelings expressed by the students regarding
LASIK eye surgery for correcting refractive eye disorders
3. STUDENT:
An individual of age group 18-24 yrs undergoing degree or postgraduate courses
in selected arts college, Bangalore
8
4. LASIK EYE SURGERY:
LASIK (Laser-Assisted in situ keratomileusis) is a type of refractive laser eye
surgery for correcting myopia, hyperopia and astigmatism, which is designed to
change the shape of cornea to eliminate or reduce the need for glasses and contact
lenses
5. REFRACTIVE EYE DISORDERS:
Condition where ones vision is impaired due to shortened or elongated eyeball
resulting in hyperopia (far sightedness) and myopia (short sightedness) or irregularity
in the curve of cornea resulting in astigmatism.
6.6 ASSUMPTIONS
1. LASIK eye surgery is the most recent and effective measure for correcting
refractive eye disorders commonly found among college students, but students
may not have adequate awareness about it
2. Students may have a favourable attitude towards LASIK eye surgery, which
may vary depending on their economic status.
6.7 HYPOTHESES
H1- There will be a significant correlation between knowledge and attitude of
students regarding LASIK eye surgery
H2- There will be a significant association of knowledge and attitude on LASIK
eye surgery with selected demographic variables
6.8 REVIEW OF LITERATURE
The term literature review refers to the activities involved in identifying and
searching information on a topic and developing an understanding of the state of
knowledge on topic.
9
Also review of literature is a written summary of the state and the art of a
research problem. Literature review is an essential step in the whole process of
research. Therefore the researcher has reviewed literature with regard to the problem
by referring books, journals, thesis, etc.
Studies related to prevalence of refractive eye disorders
Hospital-based
studies
in
Nigeria
involving
1,824
patients,
myopia,
hypermetropia, and astigmatism were found in 39.2%, 23.33%, and 21.80% eyes
respectively 17
In a study to determine the prevalence of refractive errors in the young and
middle-aged adult population in Norway, refractive errors were measured in a
population-based sample of young (20-25 years) and middle-aged (40-45 years) adults
participating in the Helseundersøkelse i Nord Trøndelag (HUNT) Health Study,
conducted in the County of Nord-Trøndelag in Norway, taking a A total of 3137
persons (1248 young and 1889 middle-aged adults) with corrected visual acuity > or =
0.5, the prevalence of myopia was found to be 35.0% in the young adult group and
30.3% in the middle-aged group. Myopia was significantly higher in women aged 2025 years (36.4%) than in men aged 40-45 years (28.1%).18
In another study done to determine the prevalence and risk factors of myopia in
urban and rural Victoria, Australia, where a total of 3271 (83%) urban and 1473
(91%) rural residents were examined showed that the younger age groups also had
higher usage of myopic corrective lenses throughout their lives than the older age
groups, indicating an increased use of myopic corrective lenses in recent times.
Myopia was found to be significantly higher in people with higher education levels, in
clerks and professionals, in people born in southeast Asia, and in people with higher
degrees of nuclear opacity. 19
A population-based prevalence survey of 1043 adults 21 or more years of age
was conducted in five rural villages and one provincial town of the Riau Province,
Sumatra, Indonesia to determine the prevalence rates of myopia, hyperopia,
10
astigmatism. The study showed the age-adjusted overall prevalence rates of myopia,
hyperopia and astigmatism to be 26.1%, 9.2%, and 18.5% respectively.20
Studies suggesting relationship between higher education and refractive eye
disorders
Study done to determine the epidemiology of refractive errors in an adult Chinese
population in Singapore showed that increasing educational levels, higher individual
income, professional or office-related occupations, better housing, and greater
severity of nuclear opacity were all significantly associated with higher rates of
myopia21
In a study done to estimate the prevalence of refractive errors among adult black
and white Americans and to identify risk factors associated with these refractive
errors, myopia was seen to increase with increasing years of education, and this
association was stronger among younger subjects. Hyperopia declined with increasing
years of education, and this association was also stronger among younger than older
subjects. Education was not associated with astigmatism.22
A three-year longitudinal refraction study was performed among 224 Norwegian
engineering students to investigate the effect of near-work on development and
progression of myopia measuring their refraction at the beginning and the end of three
year study period. The examinations concluded that there was a significant
relationship between refractive change towards myopia and high educational
demands23
To find out whether the development of myopia is related to the level of
education, a study was done in two big ophthalmic outpatient clinics in Jordan
including 968 subjects. The frequency of myopia was higher in the educated group in
both men and women. A significant relationship was found between the level of
education and myopia in the whole study group24
A study was done to examine the prevalence of myopia in rural and urban
schoolchildren in Xiamen, China, and to assess the impact of environmental factors
on rates of myopia. The data obtained suggest the prevalence of myopia is higher in
11
the city than in the countryside. One possible explanation for these different rates
could be that schoolchildren in the city spend more time reading and writing outside
of school compared with children in the countryside. Myopic children in both the city
and the countryside spent more time reading and writing compared with nonmyopic
children. This increased near-work activity may contribute to the prevalence of
myopia25.
Studies related to knowledge and attitude towards refractive eye disorders and
corrective surgeries
In a study designed to investigate communities perceptions of refractive errors, to
assess sociocultural patterns, practices, and attitudes towards the use of spectacles,
and to investigate issues related to the affordability and availability of spectacles in
rural and urban communities in Pakistan, results showed that many people did not
understand what refractive error services were offered and did not consider
themselves as having refractive errors. Many discontinued spectacle wearing citing
community pressure and cosmetic factors. The stigma attached to spectacle use was
apparent in women, who were keen to know about the other options available, such as
contact lenses and refractive surgery26
In a study done to determine the awareness, use, and barriers to use of eye
services in Fiji's Central Province, a cross-sectional survey study design with random
clusters of households was used where 267 household members, presenting distance
and near visual acuities were measured, and the perception and satisfaction with their
vision were recorded. Results showed that only 66% of household members with
previous eye problems had consulted eye care services, the proportion being even
lower for those in the older age groups. Rural dwellers expressed satisfaction with
their vision, despite being more likely to regard it as limiting their activities and being
less likely to seek conventional care. The reasons given for not seeking conventional
care were “fatalistic attitude” (“did not bother”, “could manage”, or accepted the
condition: 57%), expense (12%), and fear (8%).27
Survey was done among successful contact lens wearers to determine their
attitudes toward refractive surgery taking in a sample of one hundred thirty-three
consecutive successful myopic contact lens wearers older than 21 years. More than
12
75% of those surveyed indicated that they would consider either procedure at any
time in the future. A statistically significant correlation was found among patients
younger than 40 years who frequently expressed an interest in undergoing corrective
surgeries.28
Studies related to LASIK eye surgery
LASIK is a type of surgery that takes place in order to offer someone the ability
to see better without having to rely upon eyeglasses or contacts29
The technique involves using a laser which is controlled by a computer to
reshape the front surface of the eye (cornea). This re-shaping of the cornea helps
improve vision thus eliminating or at least reducing the need for correction with
spectacles or contact lenses.30
Laser eye surgery doesn't appear to have long-term effects on the cells that line
the inside of the cornea, a new study has found. The study included 29 eyes of 16
patients who had undergone laser in situ keratomileusis (LASIK). The researchers
compared the annual rate of corneal endothelial cell loss in the eyes of the patients
who had laser surgery with 42 eyes of people who didn't have laser surgery and found
no significant endothelial cell loss after LASIK even after 9 years proving its long
term effectiveness.31
In another study, a team of researchers from Spain tracked LASIK surgery (laser
in-situ keratomileusis) where one hundred eyes corrected with LASIK was studied
after 10 years. The findings showed its safety in long term durability32.
A study was done to evaluate the effectiveness, predictability, and safety of laser
in situ keratomileusis (LASIK) in 143 eyes with myopia from 8.00 to 20.00 diopters.
It showed that LASIK was effective and predictable in the correction of high myopia
but was more accurate for myopia up to 12.00 D.33
Two-hundred patients were surveyed telephonically to establish their degree of
satisfaction with LASIK. Patient anonymity was assured. Results showed that after
13
LASIK, 95% of 200 patients wore no distance optical correction and was satisfied
with the procedure. 99% expressed their will to opt for the procedure again.34
7. MATERIAL AND METHODS
7.1 SOURCE OF DATA
The data will be collected from the students of selected arts colleges.
7.2 METHODS OF COLLECTION OF DATA
I.
Research design
Non experimental – descriptive correlational design will be used to assess the
knowledge and attitude of students
II.
Research variables
Study variables:
Knowledge and attitude of students regarding LASIK eye surgery
Extraneous variable:
Demographic variables of the students such as age, gender, course and year,
history of refractive eye disorder, previous history of eye surgery, area of residence,
religion previous exposure to information.
III.
Setting
Study will be conducted in selected arts college, Bangalore.
IV.
Population
All students who are attending degree and post graduate courses in selected arts
college at Bangalore
14
V.
Samples:
Students attending degree and post graduate courses in selected arts college at
Bangalore who fulfill the inclusion criteria will be the sample. Sample size would
be 90
VI.
Criteria for selection of the sample
Inclusion criteria:
The Study includes
1. Students of age group 18-24 attending degree and post graduate courses in
selected arts college at Bangalore
2.
Students who are willing to participate in the study ( age group 18-24 yrs)
Exclusion criteria:
The study excludes
1.
Who are not available at the time of data collection
2.
Students who have undergone any surgery for correcting refractive eye
disorders
VII. Sampling technique:
Probability Sampling- Simple Random Sampling- Lottery method will be adopted
for selecting the sample
VIII. Tool for data collection:
Data will be collected in following sections:
Section A: An interview schedule on demographic variables consisting of age,
gender, course and year, history of refractive eye disorder, area of residence, religion,
previous exposure to information.
Section B: Self administered questionnaire to assess the knowledge of students on
LASIK eye surgery
Section C: 3 point Likert scale will be used to assess the level of attitude of students
towards undergoing LASIK eye surgery
15
IX. Methods of data collection:
Phase 1: After obtaining the permission from concerned authorities and informed
consent from the samples, the investigator will collect the baseline demographic data.
Phase 2: The investigator will administer the self administered questionnaire to assess
the knowledge of students on LASIK eye surgery.
Phase 3: The investigator will administer Likert scale to assess the level of attitude of
students towards undergoing LASIK eye surgery.
Phase 4: Based on the study findings, the investigator will prepare an informational
module regarding LASIK eye surgery that will be distributed to the students.
The duration of data collection will be 4 weeks.
X. Plan for data analysis
Descriptive statistics:
Frequency, percentage distribution, mean and standard deviation will be used to
analyse the level of knowledge and attitude.
Inferential statistics:
Correlation co-efficient will be used to correlate knowledge and attitude among
students regarding LASIK eye surgery.
Chi square test will be used to analyse the association of knowledge and attitude
among students regarding LASIK eye surgery.
XI. Projected out come
After completing the study the researcher will come to know the level of
knowledge and attitude of students regarding LASIK eye surgery. Based on the study
16
findings, the investigator will prepare an informational module regarding LASIK eye
surgery that will be distributed to the students.
7.3 Does the study require any investigations or interventions to the
patients or other human beings or animals?
No, the study requires only assessment of knowledge and attitude of students
because the investigator is planning only for descriptive study and no active
manipulation is involved in the study.
7.4 Has ethical clearance obtained from your institution?
Yes, Formal permission is obtained from the head of the institution. Permission
will be taken from the concerned authorities of the Arts college and informed consent
will be obtained from the research subjects. Institutional ethical committee review has
been enclosed.
17
8. LIST OF REFRENCES
1.
Lewis, Collier, Heitkemper. Medical Surgical Nursing, Assessment and
Management of Clinical Problems. 4th ed. Missouri: Mosby- year Book Inc;
1996; 411-412
2.
Wrong Diagnosis. Available from
http://www.wrongdiagnosis.com/r/refractive_eye_disorders/stats-country.htm
3.
Eye Health Statistics at a Glance. Available from
http://www.aao.org/newsroom/press_kit/upload/Eye_Stats_3-5-07.pdf
4.
Refractive Disorders of the Eye. Available from
http://www.wefixeyes.co.nz/laser_surgery/refractive_disorders.php
5.
Medicine net. Available from
http://www.medicinenet.com/astigmatism/article.htm
6.
LASIK Eye Surgery review. Available at
http://www.LASIK-review.com/
7.
USA Eyes. Available from
http://www.usaeyes.org/LASIK/library/LASIK-success-rate.htm
8.
Foster A, Gilbert C, Johnson G. Changing patterns in global blindness: 19882008. Community Eye Health. 2008 Sep; 21(67):37-39.
9.
Holden BA. Uncorrected Refractive error: the major and most easily avoidable
cause of vision loss. Community Eye Health. 2007 Sep; 20(63):37-39.
10.
Saw SM, Tong L, Chua WH, et al. Incidence and progression of myopia in
Singaporean school children. IOVS. 2005 Jan; 46(1): 51–57.
18
11.
Lin LLK, Shih YF, Hsiao CK, et al. Prevalence of myopia in Taiwanese
schoolchildren: 1983 to 2000. Annals Academy of Medicine Singapore. 2004
Jan; 33(1): 27–33
12.
Prema Raju, S. Ve Ramesh, Hemamalini Arvind, et al. Prevalence of
Refractive Errors in a Rural South Indian Population: Investigative
Ophthalmology and Visual Science. 2004 Dec; 45(12) 4268-4272
13.
Rakhi Dandona, Lalit Dandona, Thomas J Naduvilath. Refractive Errors in an
Urban Population in Southern India: The Andhra Pradesh Eye Disease Study.
Investigative Ophthalmology and Visual Science. 1999 Nov; 40(12): 28102818
14.
Patricia Hrynchak. Prescribing spectacles: reasons for failure of spectacle lens
acceptance: Ophthalmic and Physiological Optics. 2006 Jan; 26(1):111-115.
15.
Seang-Mei Saw, Gus Guzzard, David Koh, et al. Prevalnce Rates of
Refractive Errors in Sumatra, Indonesia. Investigative Ophthalmology and
Visual Science. 2002 Oct; 43(10): 3174-3180
16.
Riley C, Chalmers RL. Survey of contact lens-wearing habits and attitudes
toward methods of refractive correction: Optometry and Vision Science. 2005
Jun; 82(6):555-61.
17.
Adeoti CO, Egbewale BE. Refractive errors in Mercyland Specialist Hospital,
Osogbo, Western Nigeria: Nigerian postgraduate Medical Journal. 2008 Feb;
15(2) :116–119
18.
Midelfart, Kinge B, Midelfart S et al. prevalence of Refractive Errors in
Young and Middle Aged Adults in Norway. Acta Ophthalmologica
Scandinavica. 2002 Oct; 80(5): 501-505.
19
19.
Matthew Wensor, BOrth, Cathy A, et al. Prevalence and Risk Factors of
Myopia in Victoria, Australia. Archives of Ophthalmology. 1999 May;
117(5):658-663
20.
Seang-Mei Saw, Gus Gazzard, David Koh, et al. Prevalence Rates of
Refractive Errors in Sumatra, Indonesia.Investigative Ophthalmology and
Visual Science. 2002 Oct; 43(10): 3174-3180
21.
Tien Yin Wong, Paul J. Foster, Joscelin Hee, et al. Prevalance anr Risk
Factors for Refractive Errors in Adult Chinese in Singapore. Investigative
Ophthalmology and Visual Science. 2000 Aug; 41( 9): 2486-2494
22.
J Katz, J M Tielsch, A Sommer. Prevalence and Risk Factors for Refractive
Errors in an Adult Inner City Population. Investigative Ophthalmology and
Visual Science.1997 Feb; 38(2): 334-340
23.
Bettina Kinge, Anna Midelfart , Geir Jacobsen et al. The Influence of NearWork on Development of Myopia among university students: a three- year
longitudinal
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21
9.
Signature of the candidate
10. Remark of the guide
:
: Study will be beneficial in assessing
student’s awareness regarding
LASIK eye surgery which is a newer
trend in ophthalmology
11. Name of designation of
11.1 Guide
: Dr. Mrs. Fathima.L
Principal
11.2 Signature
:
11.3 co-guide (if any)
: Miss. Shoba G,
Asst. Professor.
11.4 Signature
:
11.5 Head of the department
: Dr. Fathima.L
Principal
11.6 Signature
:
12.
12.1 Remark of the principal
: The study is relevant, feasible and
appropriate for the specialty
chosen
12.2 Signature
:
22

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