Gullapalli N Rao

• L V Prasad Eye Institute

Background: To report 15-year incidence rate of primary open angle glaucoma (POAG) in the Andhra Pradesh Eye Disease Study (APEDS). Methods: A population-based longitudinal study was carried out at three rural study sites. Phakic participants aged ≥40 years who participated at baseline (APEDS I) and the mean 15-year follow-up visit (APEDS III) w...

Background: To report the 15-year incidence rate of pseudo-exfoliation (PXF), PXF glaucoma and regional variation among rural participants in the Andhra Pradesh Eye Disease Study (APEDS) III. Methods: This population-based longitudinal study was carried out at three rural study sites. Individuals of all ages who participated at baseline with a m...

Sustainable Development Goal 3 (SDG 3) 2030 calls for healthy lives and promoting well-being for all ages. Healthcare refers to the entire range of curative, preventive, promotive, and rehabilitative care delivered at all care levels, from the primary (often in the community) to the tertiary level (hospitals). Health financing refers to the sourcin...

Purpose: To report 15 year incidence rate of visual loss(blindness and visual impairment (VI)), causes and risk factors for participants in Andhra Pradesh Eye Disease Study III(APEDS III). Design: Population based cohort study METHODS: From 2012-16, all rural participants were interviewed and underwent a comprehensive eye examination, including,...

Purpose To investigate the prevalence, causes and risk factors for vision impairment (VI) among the elderly population in Telangana State, India. Methods A population-based cross-sectional study were conducted in four districts. All participants had eye examinations including visual acuity assessment for distance and near, anterior segment examina...

The World Report on Vision suggests that universal eye health coverage (UEHC) can be achieved through an integrated people-centered eye care (IPCEC) delivery. This study provides an estimation of capacity building of facilities and workforce to attain UEHC through IPCEC in South East Asia (SEA) beyond 2020. The data sources on the magnitude of blin...

Globally, 32.4 million individuals are blind and 191 million have moderate or severe visual impairment (MSVI); 80 of cases of blindness and MSVI are avoidable. However, great efforts are needed to tackle blindness and MSVI, as eye care in most places is delivered in isolation from and without significant integration with general health sectors. Suc...

Background: To compare the agreement and diagnostic accuracy of vision screening conducted by trained community eye-health workers (CEHWs) and teachers with reference to vision technicians in Movva Mandal (sub-district) in Krishna District in the Indian state of Andhra Pradesh. Methods: As part of a large epidemiological study on visual impairme...

Importance: The study highlights the burden of Near Visual Impairment (NVI) in India BACKGROUND: NVI is a common condition that can be addressed through provision of spectacles. The study aims to assess the prevalence of NVI and spectacle coverage among those aged ≥40 years south Indian state of Telangana. Design: Population based cross sectiona...

Objective To assess the prevalence and causes of visual impairment (VI) among a rural population aged 40 years and older in the state of Telangana in India. Design Population-based cross-sectional study. Setting Districts of Adilabad and Mahbubnagar in south Indian state of Telangana, India. Participants A sample of 6150 people was selected usin...

Objective To assess the visual outcomes after cataract surgery among urban and rural population aged ≥40 years in the South India state of Andhra Pradesh. Methods A population based cross-sectional study was conducted in which 7800 subjects were sampled from two rural and one urban location. Visual Acuity was assessed and eye examination were perf...

Purpose: The aim was to develop and validate an instrument to measure job satisfaction in eye-care personnel and assess the job satisfaction of one-year trained vision technicians in India. Methods: A pilot instrument for assessing job satisfaction was developed, based on a literature review and input from a public health expert panel. Rasch ana...

Purpose: To assess the prevalence and causes of unilateral visual impairment (VI) in the South Indian state of Andhra Pradesh. Methods: A population-based cross-sectional study was conducted among individuals aged ≥40 years in one urban and two rural locations, using rapid assessment methodology. A 2-stage cluster random sampling method was used...

Purpose To evaluate cataract surgery visual outcomes and associated risk factors in rural secondary level eye care centers of L V Prasad Eye Institute (LVPEI), India. Methods The Eye Health pyramid of LVPEI has a network of rural secondary care centres (SCs) and attached vision centres (VCs) that provide high quality comprehensive eye care with per...

Purpose: To assess clinical competency of 1-year trained vision technicians (VTs) in detecting and referring causes of visual impairment in India. Methods: Eye examination results and management plans for 328 patients examined by 24 VTs in 24 vision centers of LV Prasad Eye Institute in Andhra Pradesh were compared with those of a standard optom...

PurposeTo describe the rationale, objectives, study design and procedures for the longitudinal Andhra Pradesh Eye Disease Study (APEDS).DesignLongitudinal cohort studyParticipantsSurviving cohort from the rural component of APEDSMethods During 1996–2000, Andhra Pradesh Eye Disease Survey (APEDS) was conducted in three rural (n = 7771) and one urban...

Background Selection of a standard professional is crucial for assessing the clinical performance of other eye-care personnel. This paper describes the selection considerations and the clinical competency assessment of two optometrists required to select a ‘standard optometrist’ (SO) for evaluating the clinical performance of vision technicians in...

Background: Measurements of refractive errors through subjective or automated refraction are not always possible in rapid assessment studies and community vision screening programs; however, measurements of vision with habitual correction and with a pinhole can easily be made. Although improvements in vision with a pinhole are assumed to mean that...

Objective To assess the barriers to uptake of eye care services among those with avoidable impairment in the population aged ≥40 years in the South Indian state of Andhra Pradesh. Design Cross-sectional study. Setting Community setting. Participants Of 7800 participants recruited from one urban and two rural locations using a two-stage cluster rand...

‘So that all may see’ is an audacious goal in a nation where 800 million live in villages where water, food and healthcare are part of the daily struggle. While soft drink and shampoo sellers have penetrated the ‘bottom of the pyramid’, quality eye-care providers have not. To reach this goal the LV Prasad Eye Institute was started in 1987 in Hydera...

Background/aim: The Andhra Pradesh Eye disease Study (APEDS) was a conventional cross-sectional study conducted in four locations during 1996-2000. Ten years later, a Rapid Assessment of Refractive Errors (RARE) survey was conducted in one of the geographical regions. The prevalence of visual impairment (VI), uncorrected refractive error (URE), sp...

A large-scale prevalence survey of blindness and visual impairment (The Andhra Pradesh Eye Diseases Study [APEDS1]) was conducted between 1996-2000 on 10,293 individuals of all ages in three rural and one urban clusters in Andhra Pradesh, Southern India. More than a decade later (June 2009-March 2010), APEDS1 participants in rural clusters were tra...

To assess the prevalence and causes of visual impairment in urban and rural population aged ≥40 years in the South India state of Andhra Pradesh. A population based cross-sectional study was conducted in which 7800 subjects were sampled from two rural and an urban locations. Visual Acuity (VA) was assessed using a tumbling E chart and eye examinati...

To assess the prevalence and patterns of spectacles use in South India state of Andhra Pradesh. A population-based cross sectional study PARTICIPANTS: 7800 subjects aged ≥ 40 years, sampled from one urban and two locations. Two stage cluster random sampling method was used to enumerate 7800 subjects. Distance Visual Acuity and near vision were asse...

Blindness is a major global public health problem and recent estimates from World Health Organization (WHO) showed that in India there were 62 million visually impaired, of whom 8 million are blind. The Andhra Pradesh Eye Disease Study (APEDS) provided a comprehensive estimate for prevalence and causes of blindness for the state of Andhra Pradesh (...

Reliable information is required for the planning and management of eye care services. While classical research methods provide reliable estimates, they are prohibitively expensive and resource intensive. Rapid assessment (RA) methods are indispensable tools in situations where data are needed quickly and where time- or cost-related factors prohibi...

This paper intends to discuss the patients' perspective on the determinants of primary eye care services from vision centers (VC) in rural India. 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 associati...

Context : Globally, limited data are available on changing trends of blindness from a single region. Aims : To report the changing trends in the prevalence of blindness, visual impairment (VI), and visual outcomes of cataract surgery in a rural district of Andhra Pradesh, India, over period of one decade. Settings and Design : Rural setting; cross-...

Purpose To examine the psychometric characteristics of the World Health Organization Quality of Life instrument—modified Indian version (modified WHOQOL) and its subscales in adults with visual impairment (VI) using Rasch analysis. Methods Cross-sectional data were of people aged ≥40 years with VI (n = 1,333) who responded to the modified WHOQOL in...

To investigate the prevalence of uncorrected refractive errors, presbyopia and spectacle coverage in subjects aged 40 years or more using a novel Rapid Assessment of Visual Impairment (RAVI) methodology. A population-based cross-sectional study was conducted using cluster random sampling to enumerate 1700 subjects from 34 clusters predominantly inh...

To compare the satisfaction of patients with the services of Vision Center services (primary eye care) in large village (s) and small village (s) in rural settings in Andhra Pradesh state, India. MATERIALS AND METHODs: We have administered standard questionnaires to randomly selected patients to assess patient satisfaction when assessing Vision Cen...

Reliable data are a pre-requisite for planning eye care services. Though conventional cross sectional studies provide reliable information, they are resource intensive. A novel rapid assessment method was used to investigate the prevalence and causes of visual impairment and presbyopia in subjects aged 40 years and older. This paper describes the d...

To assess the barriers to the uptake of refraction services in the age group of 15-49 years in rural Andhra Pradesh, India. A population-based cross-sectional study was conducted using cluster random sampling to enumerate 3300 individuals from 55 clusters. A validated questionnaire was used to elicit information on barriers to utilisation of servic...

To investigate the role of confocal microscopy as a diagnostic modality in microbial keratitis and to determine inter- and intraobserver variation in the analysis and interpretation of confocal microscopy findings. Prospective, double masked, nonrandomized, observational clinical trial. We included 146 consecutive patients with clinically suspected...

To review the previous year's literature related to prevalence of blindness in general, blindness due to cataract, cataract surgical coverage (CSC) and cataract surgical rates (CSRs). Cataracts are the major cause of blindness and visual impairment in developing countries and contributes to more than 90% of the total disability adjusted life years....

Little or no work has been carried out in developing countries on costs to patients and patient benefits in accessing primary eye care services. The purpose of this study was to assess the indirect, direct, and overall costs of patients accessing vision care at vision center services (New Primary Eyecare Approach) as compared with the nearest priva...

To design a randomized controlled trial (RCT) to compare the effectiveness of four different strategies to deliver low vision rehabilitation services. The four arms of the RCT comprised-center based rehabilitation, home based rehabilitation, a mix of center based and home based rehabilitation, and center based rehabilitation with home based non int...

Clear transparent cornea is essential for normal vision. The corneal transparency is lost by trauma, dgenerations, dystrophies, infections, and inflammation affecting the cornea. Sight-threatening corneal opacity needs corneal transplantation to restore transparency. Among the human organ transplantation procedures corneal transplantation has best...

To investigate the prevalence of uncorrected refractive errors, presbyopia and spectacle coverage in subjects aged 15-50 years using rapid assessment methodology in the Mahabubnagar district of Andhra Pradesh, India. A population-based cross sectional study was conducted using cluster random sampling to enumerate 3,300 subjects from 55 clusters. Un...

To review the epidemiological characteristics, microbiological profile, and treatment outcome of patients with suspected microbial keratitis. Retrospective analysis of a non-comparative series from the database was done. All the patients presenting with corneal stromal infiltrate underwent standard microbiologic evaluation of their corneal scraping...

To assess prevalence, potential risk factors and population attributable risk percentage (PAR) for age-related maculopathy (ARM) in the Indian state of Andhra Pradesh. A population-based study, cross-sectional epidemiological study was conducted in the state of Andhra Pradesh in India during 1996 and 2000. Participants from 94 clusters in one urban...

To report the prevalence, risk factors and associated population attributable risk percentage (PAR) for refractive errors in the South Indian adult population. A population-based cross-sectional epidemiologic study was conducted in the Indian state of Andhra Pradesh. A multistage cluster, systematic, stratified random sampling method was used to ob...

To assess prevalence, potential risk factors and population attributable risk percentage (PAR%) for diabetic retinopathy (DR) in the Indian state of Andhra Pradesh. A population-based study, using a stratified, random, cluster, systematic sampling strategy, was conducted in the state of Andhra Pradesh in India during 1996 and 2000. Participants fro...

Sannapaneni Krishnaiah1,2,3, Marmamula Srinivas1,2,3, Rohit C Khanna1,2, Gullapalli N Rao1,2,31L V Prasad Eye Institute, Banjara Hills, Hyderabad, India; 2International Center for Advancement of Rural Eye Care, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India; 3Vision CRC, University of New South Wales, Sydney, NSW, AustraliaAim: To report...

A bstract A 21‐year‐old febrile lady presented to the emergency service with severe lid oedema, conjunctivitis, dry mouth and abdominal skin rash. Over 5 days, she developed silvery scales and pustules on the lids, and generalized pustules on an erythematous base. Multiple focal sterile corneal infiltrates were seen. Haematological investigations a...

A few recent studies have shown that poverty is an exacerbating and often determining factor in the incidence of disabling conditions, including visual impairment. Recent estimates from the World Health Organization indicate that 90 per cent of all those affected by visual impairment live in the poorest countries of the world. India is home to one-...

To understand the reasons why people in rural south India with visual impairment arising from various ocular diseases do not seek eye care. A total of 5,573 persons above the age of 15 were interviewed and examined in the South Indian state of Andhra Pradesh covering the districts of Adilabad, West Godavari and Mahaboobnagar. A pre-tested structure...

Aim: To study the manifestations of progressive herpes simplex virus endotheliitis. Methods: The records of 10 eyes of 6 patients diagnosed with herpes simplex virus endotheliitis were reviewed in this retrospective case series. All patients attended the LV Prasad Eye Institute between August 1997 and May 2001. Data collection included patients' de...

A bstract A 6‐year‐old Bangladeshi girl presented with total limbal stem cell deficiency in the left eye, secondary to a 6‐month‐old chemical injury. The patient had also previously undergone two limbal transplantation surgeries. At the authors’ centre the child underwent autologous cultured limbal epithelium transplantation, on human amniotic memb...

To evaluate the results of amniotic membrane transplantation (AMT) for ocular surface reconstruction in chemical and thermal injuries. Retrospective review of case records of patients who had undergone AMT for chemical injuries (January 1998 to May 2001). Seventy two eyes of 69 patients were studied of which 24 were acute cases (median-2 days, rang...

To determine the impact of visual impairment and eye diseases on quality of life (QOL) in an older population of Andhra Pradesh in southern India. The World Health Organization (WHO) QOL (WHOQOL) instrument was adapted as a health-related quality of life (HRQOL) instrument for administration to adults participating in the Andhra Pradesh Eye Disease...

To assess the role of confocal microscopy for in vivo detection of Nocardia in patients with microbial keratitis. Retrospective interventional case series. Three patients with microbiologically proven Nocardia keratitis. Confocal microscopy. We performed confocal microscopy in microbiologically proven cases of Nocardia asteroides keratitis. A maske...

To determine the prevalence of ocular trauma and proportion of blindness and visual impairment due to ocular trauma in a rural population of southern India. Population-based cross-sectional epidemiological study. A total of 7771 subjects of all ages, representative of the rural population of Andhra Pradesh. The subjects underwent a detailed intervi...

To determine the prevalence of presbyopia in the state of Andhra Pradesh in south India. Comprehensive ocular examinations including logMAR (logarithm of the minimum angle of resolution) distance and near (presenting and best corrected) visual acuity, slit lamp biomicroscopy of the anterior segment, and dilated posterior segment examinations were p...

To report the clinical outcome of autologous cultivated limbal epithelial transplantation. Eighty-six patients' records and their clinical photographs were reviewed for demographics, primary etiology, type of limbal transplantation, ocular surface stability, visual acuity, final outcome and possible factors affecting outcome and complications. Eigh...

To determine the prevalence of consanguinity and its potential associations with eye diseases in Andhra Pradesh state of south India. As part of a demographic interview schedule, prior to clinical examinations, trained investigators collected information regarding consanguinity of the parents from subjects randomly chosen for a population-based cro...

To study the incidence of graft rejection and the predictive factors for its reversibility. It is a retrospective study of 1927 consecutive penetrating keratoplasties performed between January 1990 and January 2000 with more than 6 months follow up. A total of 224 rejection episodes were noted in 183 patients. Of these, 184 first rejection episodes...

To assess prevalence, potential risk factors, and population attributable risk percentage (PAR%) for age-related macular degeneration (AMD) in the Indian state of Andhra Pradesh. A population-based study, using a stratified, random, cluster, systematic sampling strategy, was conducted in the state of Andhra Pradesh in India from 1996 to 2000. Parti...

To report the outcome of pterygium surgery performed at a tertiary eye care centre in South India. Retrospective analysis of medical records of 920 patients (989 eyes) with primary and recurrent pterygia operated between January 1988 and December 2001. The demographic variables, surgical technique (bare sclera, primary closure, amniotic membrane tr...

To explore the awareness of glaucoma amongst the rural population of Andhra Pradesh, India. A total of 7775 subjects of all ages, representative of the rural population of Andhra Pradesh, participated in the Andhra Pradesh Eye Disease Study. The responses of subjects older than 15 years (n=5573) who completed a structured questionnaire regarding aw...

Providing high-quality eye care to all people in a sustainable manner is a major challenge for all eye care organizations in the world. Development of an efficient and effective system is critical. Appropriate infrastructure and Human Resources along with predetermined referral pathways are fundamental to derive optimal outputs and outcomes at prim...

The amniotic membrane, composed of 3 layers, the epithelium, basement membrane, and the stroma, was first used along with the chorion as a biologic membrane to promote healing of skin burns in 1910. In ophthalmology, it was used in 1940 in the management of conjunctival defects. Its revival in the 1990s was due to its ability to reduce ocular surfa...

To report cultivated epithelial transplantation in 2 patients with vernal keratoconjunctivitis (VKC) with severe ocular surface disease. Two patients initially diagnosed with burnt-out VKC presented with bilateral photophobia, decreased vision, and corneal neovascularization. The first patient underwent living-related conjunctival-limbal allograft...

To describe the early results of penetrating keratoplasty (PKP) in patients who had earlier received limbal transplantation (LT). Prospective, non-comparative interventional case series comprising of four patients with limbal stem cell deficiency (LSCD) due to chemical injury (Cases 1, 2, 4) and xeroderma pigmentosum (Case 3). Cadaveric kerato-limb...

To describe the early results of penetrating keratoplasty (PKP) in patients who had previously undergone cultivated limbal epithelium transplantation. Medical records of patients with limbal stem cell deficiency due to chemical burns who underwent PKP after cultivated limbal epithelium transplantation were reviewed for demographics, primary etiolog...

To report the annualized incidence of microbial keratitis with extended wear of low oxygen transmissible (Dk/t) disposable soft contact lenses from prospective postmarket clinical trials. Seven hundred ninety subjects were enrolled at the L.V. Prasad Eye Institute (LVPEI), Hyderabad, India from March 1993 to March 2000, resulting in 1231 patient ey...

India, the second most populous country in the world, is home to 23.5% of the world's blind population. In 1976 India became the first country in the world to start a national program for control of blindness. All surveys in the country have shown that cataract is the most common cause of blindness and all prevention of blindness programs have been...

To investigate the associations between tobacco smoking and various forms of cataracts among the people of a state in India. A population-based cross-sectional epidemiologic study was conducted in the south Indian state of Andhra Pradesh (AP). A total of 10,293 subjects of all ages from one urban and three rural areas, representative of the populat...

To assess the efficacy of amniotic membrane for treatment of partial limbal stem cell deficiency (LSCD). Medical records of four patients with partial LSCD who underwent pannus resection and amniotic membrane transplantation (AMT) were reviewed for ocular surface stability and improvement in visual acuity. Clinico-histopathological correlation was...

To review the in vitro susceptibility and the clinical response to 0.3% ciprofloxacin in Staphylococcus aureus keratitis. This is a non-comparative case series derived from a prospectively collected database and analysed retrospectively. One hundred and twenty one patients presenting in the cornea service of LV Prasad Eye Institute, Hyderabad, Indi...

To determine the distribution of perceived visual ability for functional vision performance among persons with low vision in the Indian state of Andhra Pradesh. As part of a population-based epidemiologic study, the Andhra Pradesh Eye Disease Study (APEDS), a 16-item visual function questionnaire was designed and applied to 7363 persons older than...

To report the frequency, outcome, and atypical histology in corneal dystrophies. Corneal buttons of patients diagnosed with corneal dystrophy as noted in the records of the ophthalmic pathology register over a period of 6 years were included in this study. The sections from formalin-fixed, paraffin-embedded tissues were reviewed specifically for th...

To evaluate the clinical, microbiologic, and histopathologic features of dematiaceous fungal keratitis cases presenting with pigmented, raised, plaque-like infiltrate. Consecutive case series. Microbiology-proven cases of fungal keratitis presenting with a pigmented infiltrate were included in the study. A detailed clinical and microbiological eval...

To report the clinical features and outcome of patients with pellucid marginal corneal degeneration (PMCD). Retrospective noncomparative case series. Retrospective chart review of 116 eyes of 58 patients with PMCD seen between 1990 and 2002 at the Cornea Service at L.V. Prasad Eye Institute, Hyderabad, India. The diagnosis of PMCD was based on the...

To report the clinical features and topographic findings of superior pellucid marginal corneal degeneration (PMCD). Retrospective chart review of 15 eyes of eight patients of superior PMCD. Detailed history, visual acuity at presentation, degree of astigmatism, slit-lamp examination findings, topographic features, and Orbscan findings were noted wh...

To determine the "awareness of eye donation" and "willingness to pledge eyes for donation" in the rural population of Andhra Pradesh, southern India. A total of 7,775 subjects of all ages, representative of the rural population of Andhra Pradesh, participated in the Andhra Pradesh Eye Disease Study (APEDS). Subjects older than 15 years were intervi...

To evaluate the type and incidence of adverse events seen with daily disposable hydrogel contact lens wear compared with a control (spectacle) group over 12 months. Prospective, randomized, observer-masked, comparative clinical trial. Two hundred eighty-one myopes with no prior contact lens wear experience were enrolled from August to December 1996...

To report the clinical picture and outcome of fungal infection of self-sealing wounds in cataract surgery. Retrospective noncomparative case series. Seven postoperative cataract patients. Seven consecutive patients who underwent cataract surgery in different locations in India and developed microbiologically proven fungal infection of the surgical...

Corneal infiltrates are commonly observed during adverse reactions associated with contact lens wear. Broad ranges of presentations are encountered, and there is no well-established classification system. The aim of this paper is to categorize corneal infiltrates associated with soft lens wear and present the typical clinical characteristics associ...