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Vilas Kovai

Other affiliations: Brien Holden Vision Institute
Bio: Vilas Kovai is an academic researcher from Liverpool Hospital. The author has contributed to research in topics: Health promotion & Health literacy. The author has an hindex of 6, co-authored 15 publications receiving 86 citations. Previous affiliations of Vilas Kovai include Brien Holden Vision Institute.

Papers
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TL;DR: In this paper, the authors analyzed the impact of myopia on individuals and society; summarizing the evidence for recent research on the prevalence of myopic and high myopia, lifetime pathological manifestations of myopathy, direct health expenditure, and indirect costs such as lost productivity and reduced quality of life (QOL).
Abstract: The global burden of myopia is growing. Myopia affected nearly 30% of the world population in 2020 and this number is expected to rise to 50% by 2050. This review aims to analyze the impact of myopia on individuals and society; summarizing the evidence for recent research on the prevalence of myopia and high myopia, lifetime pathological manifestations of myopia, direct health expenditure, and indirect costs such as lost productivity and reduced quality of life (QOL). The principal trends are a rising prevalence of myopia and high myopia, with a disproportionately greater increase in the prevalence of high myopia. This forecasts a future increase in vision loss due to uncorrected myopia as well as high myopia-related complications such as myopic macular degeneration. QOL is affected for those with uncorrected myopia, high myopia, or complications of high myopia. Overall the current global cost estimates related to direct health expenditure and lost productivity are in the billions. Health expenditure is greater in adults, reflecting the added costs due to myopia-related complications. Unless the current trajectory for the rising prevalence of myopia and high myopia change, the costs will continue to grow. The past few decades have seen the emergence of several novel approaches to prevent and slow myopia. Further work is needed to understand the life-long impact of myopia on an individual and the cost-effectiveness of the various novel approaches in reducing the burden.

82 citations

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TL;DR: Investigating the information-seeking experiences of patients with Type 2 diabetes and how these influenced self-management behaviours found inconsistent and insufficient information from healthcare professionals undermined patients' ability to self-manage diabetes.

22 citations

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TL;DR: A good VT can enhance patient satisfaction, however, patient expectations are not only confined to the provider but also other factors such as ability to pay and convenient transportation that helps patients reach the location of the VC with ease.
Abstract: Aim : This paper intends to discuss the patients' perspective on the determinants of primary eye care services from vision centers (VC) in rural India. Materials and Methods : A retrospective study design and interview method was used on 127 randomly selected patients who accessed the 4 VCs in 2007. Factor analyses and linear regression models were used to predict the associations with patient satisfaction. Results : The three factors derived from factor analyses were: (1)-vision technician (VT), (2)-location of VC, and (3)-access to VC; explaining 60% of the variance in total patients' satisfaction with VC. The first model (R2 : 0.61; F 1,124=144.36, P <0.001), indicated that respondents who had 'difficulty to travel to the place of VC' and those who can afford to pay had less satisfaction with VT services. The second model (R2 =0.18; F 1,124=29.5, P <0.001) explained that respondents' difficulty to identify the building of VC had decreased patients' satisfaction and the third model (R2 =0.36; F 1,124=45.6, P <0.001) indicated that those who had to travel<5 km to the VC and had 0.38 units of increased satisfaction level with the services of VC. Conclusion : A good VT can enhance patient satisfaction. However, patient expectations are not only confined to the provider but also other factors such as ability to pay and convenient transportation that helps patients reach the location of the VC with ease.

19 citations

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TL;DR: Beyond accessibility and cost of surgery, other social and infrastructural factors need to be addressed to increase the uptake of cataract surgery in illiterate individuals in a tribal area of India.
Abstract: Purpose: To assess the reasons for refusing cataract surgery in illiterate individuals in a tribal area of India.Methods: A prospective study evaluated 1046 subjects who had undergone screening in eye camps and included 398 of 492 referred subjects with cataract who refused to seek cataract surgery. Subjects were assessed to elicit general and specific reasons for non-compliance. Multiple logistic regression analysis was applied to determine the associations; p < 0.05 was considered significant.Results: Overall, 83% (329/398) of subjects reported that they could manage with their current vision. The five most common reasons they did not proceed with cataract surgery were: fear of losing current vision, work priority, lack of support systems, a dependency due to old age, and expenses required after surgery. Odds of seeking treatment were lower among unemployed subjects (odds ratio, OR, 0.4, 95% confidence interval, CI, 0.19–0.86; p = 0.01) and in patients with family income <1000 Indian rupees per ...

17 citations

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TL;DR: Better accuracy was achieved in measurement of VA and identification of children with visual impairment using UVA measurement compared to PVA, which is recommended for teacher-based vision screening programs.
Abstract: Purpose: To assess validity of teacher-based vision screening and elicit factors associated with accuracy of vision screening in Vietnam.Methods: After brief training, teachers independently measured visual acuity (VA) in 555 children aged 12–15 years in Ba Ria – Vung Tau Province. Teacher VA measurements were compared to those of refractionists. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for uncorrected VA (UVA) and presenting VA (PVA) 20/40 or worse in either eye. Chi-square, Fisher’s exact test and multivariate logistic regression were used to assess factors associated with accuracy of vision screening. Level of significance was set at 5%.Results: Trained teachers in Vietnam demonstrated 86.7% sensitivity, 95.7% specificity, 86.7% positive predictive value and 95.7% negative predictive value in identifying children with visual impairment using the UVA measurement. PVA measurement revealed low accuracy for teachers, which was significantly a...

15 citations


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TL;DR: One in three blind people was blind due to cataract, and one of six visually impaired people was visually impaired due toCataract remains a major public health problem despite major improvements in terms of reduction of prevalence.
Abstract: Purpose: To estimate prevalence and number of people visually impaired or blind due to cataract. Methods: Based on the Global Burden of Diseases Study 2010 and ongoing literature research, we examined how many people were affected by moderate to severe vision impairment (MSVI; presenting visual acuity <6/18, ≥3/60) and blindness (presenting visual acuity <3/60) due to cataract. Results: In 2010, of overall 32.4 million blind and 191 million vision impaired, 10.8 million people were blind and 35.1 million were visually impaired due to cataract. Cataract caused worldwide 33.4% of all blindness in 2010, and 18.4% of all MSVI. These figures were lower in the high-income regions ( 40%) in South and Southeast Asia and Oceania. From 1990 to 2010, the number of blind or visually impaired due to cataract decreased by 11.4% and by 20.2%, respectively; the age-standardized global prevalence of cataract-related blindness and MSVI reduced by 46% and 50%, respectively, and the worldwide crude prevalence of cataract-related blindness and MSVI reduced by 32% and 39%, respectively. The percentage of global blindness and MSVI caused by cataract decreased from 38.6% to 33.4%, and from 25.6% to 18.4%, respectively. This decrease took place in almost all world regions, except East Sub-Saharan Africa. Conclusions: In 2010, one in three blind people was blind due to cataract, and one of six visually impaired people was visually impaired due to cataract. Despite major improvements in terms of reduction of prevalence, cataract remains a major public health problem.

271 citations

Journal ArticleDOI
TL;DR: The virtual clinic showed an improved patient journey time compared with that experienced within the general glaucoma outpatient department, and there exists a discrepancy between patient management decisions of reviewers, suggesting that some may be more risk averse than others when managing patients seen within this model.
Abstract: Background This article describes the development of a virtual glaucoma clinic, whereby technicians collect information for remote review by a consultant specialist. Design and methods This was a hospital-based service evaluation study. Patients suitable for the stable monitoring service (SMS) were low-risk patients with "suspect", "early"-to-"moderate" glaucoma who were deemed stable by their consultant care team. Three technicians and one health care assistant ran the service. Patients underwent tests in a streamlined manner in a dedicated clinical facility, with virtual review of data by a consultant specialist through an electronic patient record. Main outcome measure Feasibility of developing a novel service within a UK National Health Service setting and improvement of patient journey time within the service were studied. Results Challenges to implementation of virtual clinic include staffing issues and use of information technology. Patient journey time within the SMS averaged 51 minutes, compared with 92 minutes in the glaucoma outpatient department. Patient satisfaction with the new service was high. Conclusion Implementing innovation into existing services of the National Health Service is challenging. However, the virtual clinic showed an improved patient journey time compared with that experienced within the general glaucoma outpatient department. There exists a discrepancy between patient management decisions of reviewers, suggesting that some may be more risk averse than others when managing patients seen within this model. Future work will assess the ability to detect progression of disease in this model compared with the general outpatient model of care.

55 citations

Journal ArticleDOI
TL;DR: Treating just two 6- to 8-year-old subjects with ortho-k instead of single-vision spectacles could prevent one subject from developing rapidly progressing axial elongation during this critical 2-year period of treatment.
Abstract: Purpose To determine the relative risk of rapid progression and number needed to treat (NNT) in younger and older children using combined data from the retardation of myopia in orthokeratology (ROMIO) and toric orthokeratology-slowing eye elongation (TO-SEE) studies. Methods Data from 136 subjects of two studies, ROMIO and TO-SEE, were retrieved (72 orthokeratology [ortho-k]: 37 ROMIO, 35 TO-SEE; 64 control: 41 ROMIO, 23 TO-SEE) and the myopia control effect on younger (6-8 years) and older (9-12 years) subjects evaluated. The rate of axial elongation was classified as not rapid (axial elongation = 0.36 mm/year). Results Cumulative frequency curves showed that the younger subjects in the control group had the greatest and most rapid axial elongation at the end of 24 months. In the younger subjects, ortho-k lens wear significantly reduced the risk of rapid progression by 88.8% (P = 0.002). The 2-year NNT for the younger ortho-k subgroup was 1.8, suggesting that treating just two younger subjects with ortho-k would prevent one subject from experiencing rapid progression over a 2-year period of treatment. The 2-year NNT for the older ortho-k subgroup was 11.8, which was statistically insignificant (P = 0.197). Conclusions Orthokeratology significantly reduced risk of rapid progression in younger subjects. Treating just two 6- to 8-year-old subjects with ortho-k instead of single-vision spectacles could prevent one subject from developing rapidly progressing axial elongation during this critical 2-year period.

53 citations

Journal ArticleDOI
TL;DR: The authors identified how Culturally and linguistically diverse (CALD) communities are defined in epidemiological research in Australia and provided a definition of CALD status that aids the consistency and interpretability of epidemiological studies.
Abstract: Objective: To identify how Culturally and Linguistically Diverse (CALD) communities are defined in epidemiological research in Australia and provide a definition of CALD status that aids the consistency and interpretability of epidemiological studies. Methods: Peer-reviewed literature from January 2015 to May 2020 was searched via four databases (Ovid Medline combined with PubMed, Embase, Emcare, and CINAHL) to identify quantitative studies of CALD people in Australia. Results: A total of 108 studies met the criteria for inclusion in the review. Country of birth was the most commonly used CALD definition (n = 33, 30.6%), with combinations of two or more components also frequently used (n = 31, 28.7%). No studies used all the components suggested as core to defining CALD status. including country of birth, languages other than English spoken at home, English proficiency, and indigenous status. Conclusions: There was considerable inconsistency in how CALD status was defined. The review suggests that CALD status would best be defined as people born in non-English speaking countries, and/or who do not speak English at home. Additionally, indigenous peoples should be considered separately. This recommended definition will support the better identification of potential health disparity and needs in CALD and indigenous communities.

51 citations

Journal ArticleDOI
TL;DR: The provision of school-based eye-care programmes has great potential to reduce ocular morbidity and developmental delays caused by childhood vision impairment and blindness, while also attempting to reduce misconceptions and stigma among children and their parents.
Abstract: Objective To review interventions improving eye-care services for schoolchildren in low- and middle-income countries. Methods We searched online databases (CINAHL, Embase®, ERIC, MEDLINE®, ProQuest, PubMed® and Web of ScienceTM) for articles published between January 2000 and May 2018. Eligible studies evaluated the delivery of school-based eye-care programmes, reporting results in terms of spectacle compliance rates, quality of screening or attitude changes. We considered studies to be ineligible if no follow-up data were reported. Two authors screened titles, abstracts and full-text articles, and we extracted data from eligible full-text articles using the availability, accessibility, acceptability and quality rights-based conceptual framework. Findings Of 24 559 publications screened, 48 articles from 13 countries met the inclusion criteria. Factors involved in the successful provision of school-based eye-care interventions included communication between health services and schools, the willingness of schools to schedule sufficient time, and the support of principals, staff and parents. Several studies found that where the numbers of eye-care specialists are insufficient, training teachers in vision screening enables the provision of a good-quality and cost-effective service. As well as the cost of spectacles, barriers to seeking eye-care included poor literacy, misconceptions and lack of eye health knowledge among parents. Conclusion The provision of school-based eye-care programmes has great potential to reduce ocular morbidity and developmental delays caused by childhood vision impairment and blindness. Policy-based support, while also attempting to reduce misconceptions and stigma among children and their parents, is crucial for continued access.

48 citations