Research Proposal On

Study Regarding the Visual Problems and their Causes:

A view point of Eye Specialist

By Name Candidate for Masters in Sports Sciences and Physical Education

Supervisor Name Dept of SPS, Gomal University Dera Ismail Khan

Department of Sports Sciences and Physical Education Gomal University, Dera Ismail Khan, Khyber Pakhtunkhwa, Pakistan

Table of Contents
Chapter 1 INTRODUCTION .......................................................................................................... 3 1.1 Background ........................................................................................................................... 3 1.1.1 Vision problems ............................................................................................................. 6 1.1.2 Causes ............................................................................................................................ 6 1.2 Statement of the Problem ...................................................................................................... 7 1.3 Objectives of the Study ......................................................................................................... 7 1.4 Significance........................................................................................................................... 8 1.5 Research questions ................................................................................................................ 8 Chapter 2 LITERATURE REVIEW ............................................................................................... 9 2.1 Existing Research.................................................................................................................. 9 2.1.1 Difficulty Seeing Near Objects .................................................................................... 11 2.1.2 Difficulty Seeing Distant Objects ................................................................................ 11 2.1.3 Cloudy Vision .............................................................................................................. 11 2.1.4 Loss of Peripheral Vision............................................................................................. 12 2.1.5 Eye Twitching .............................................................................................................. 12 2.1.6 Itchy, Watery Eyes ....................................................................................................... 13 2.1.7 Floaters ......................................................................................................................... 13 2.1.8 Flashes.......................................................................................................................... 13 2.1.9 Other Vision Problems and Symptoms ........................................................................ 14 2.1.10 Schedule an Exam with an Ophthalmologist for Diagnosis ...................................... 14 Chapter 3 RESEARCH METHODOLOGY ................................................................................. 15 3.1 Survey Approach ................................................................................................................ 15 3.2 Population & Sample .......................................................................................................... 15 3.3 Data Collection Methods .................................................................................................... 15 3.4 Tools for Data Analysis ...................................................................................................... 16 References ................................................................................................................................. 17 Annexure 1 Questionnaire ........................................................................................................ 18

Chapter 1 INTRODUCTION

1.1 Background Eyes are organs that detect light and convert it into electro-chemical impulses in neurons. The simplest photoreceptor cells in conscious vision connect light to movement. In higher organisms the eye is a complex optical system which collects light from the surrounding environment, regulates its intensity through a diaphragm, focuses it through an adjustable assembly of lenses to form an image, converts this image into a set of electrical signals and transmits these signals to the brain through complex neural pathways that connect the eye via the optic nerve to the visual cortex and other areas of the brain. Eyes with resolving power have come in ten fundamentally different forms possess a complex optical system. Vision loss from age-related eye disease meets the criteria for a public health problem. It is common, costly and the prevalence is increasing. Vision loss is a threat to the wellbeing of the entire community (Clisby & Fowler, 2000).

There are effective treatment strategies to prevent visual loss and to maintain or increase the quality of life among those who have suffered irreversible visual impairment. Partnerships with groups like governmental and non-governmental organizations can be quite valuable in reaching people in need of education, diagnosis and treatment. After assessing the vision conservation efforts in different areas, the agencies identified numerous public health opportunities to address the growing problem of visual impairment and blindness. The recommendations are a "call to action" for public health to prevent morbidity from vision loss and blindness by increasing public awareness; integrating and coordinating timely screening, diagnosis and treatment programs in communities; ensuring continuity between medical treatment and supportive care for eye conditions associated with aging; and monitoring the status of visual impairment, using methods that can identify people affected, the extent of their visual impairment and the services they receive (Ferris & Tielsch, 2004).

Infectious Conjunctivitis (also known as pinkeye) occurs when the conjunctiva becomes infected by a bacteria or virus. Redness and a discharge are usually present. The discharge may be watery

or thick with lashes sticking together in the morning. There should be no significant change in vision or severe discomfort. Viruses cause most cases of conjunctivitis. It can be difficult to distinguish viral from bacterial infections. Conjunctivitis, whether viral or bacterial, almost always clears up within seven to ten days without eye drops. Viral conjunctivitis is highly contagious. It may spread easily from one eye to the other and throughout a family or society within a few days. Antibacterial eye drops will not decrease the spread of a viral infection (Olitsky et al, 2007).

Allergic Conjunctivitis produces itchy, watery, red eyes associated with other allergy symptoms. It is usually in both eyes. Cool compresses are used to decrease itching and antihistamine eye drops may be prescribed. Iritis usually involves pain like a deep ache, redness, and sensitivity to light in one eye. There is no discharge and the pupil is often smaller in the affected eye. Iritis may occur as a complication of infection, trauma, contact lens wear, or for unknown reasons. Patients with iritis are often instructed to wear dark glasses, take oral pain medications, and use eye drops that relax the eye muscles. You may need to see an ophthalmologist to follow this condition until it resolves (Clisby & Fowler, 2000).

Corneal injury (also known as keratitis) may occur with trauma, contact lens wear, infection, or excessive exposure to ultraviolet light (sunlight, tanning bed, or welding arc). The corneal nerve endings are quite sensitive; therefore, injury will present with moderate to severe pain. Vision may be affected and the eye is usually very sensitive to light. Increased tearing is often present. An orange stain (fluorescein) is often used to visualize the extent of the injury. Eye drops that numb the surface of the eye may be needed to thoroughly examine the eye; however, repeated use of these drops slows healing and may allow further corneal injury. Muscle spasm of the iris is thought to play a role in the pain associated with corneal injury. If the pain is severe, drops may be prescribed by an ophthalmologist that relaxes the muscles of the iris (make the pupil larger) (Sterns & Cormick, 2007). Hordeolum (also known as a sty) is an infection of the eyelid localized to one of the glands that lubricate the eye. It is usually caused by the bacteria called staphylococcus. It usually will resolve on its own with warm compressions, other times antibiotics are required. Occasionally

the hordeolum must be opened and pus drained out. Chalazion is a firm, non-tender bump on the eyelid that represents a chronic, sterile inflammation of an oil gland of the eyelid. Treatment includes applying warm, moist compresses 4 times a day. If there is no response after several weeks, an ophthalmologist may incise the lesion or inject it with steroids. Subconjunctival Hemorrhage is a sudden, painless, bright red staining of the white of the eye when a small blood vessel breaks. It may follow coughing, straining, vomiting or trauma, but is often spontaneous. Vision is not disturbed unless another injury is also present. The eye will clear in several weeks without any specific treatment (Clisby & Fowler, 2000).

Many people believe that dyslexia is exclusively a phonological problem. Certainly most dyslexics have great difficulty with mentally separating the sounds of words into their constituent phonemes to match with their written alphabetic form (Bradley & Bryant, 1985). But this is not usually their only difficulty. Many dyslexics experience visual problems when reading, often in addition to their phonological ones. These visual symptoms probably result from slight unsteadiness of the eyes when they are trying to fixate on the letters being read. This in turn results from their inheriting a mild impairment of the magnocellular component of the visual system which plays an important role in controlling eye movements because it provides the major input to ocular motor areas of the brain such as the posterior parietal cortex, cerebellum and superior colliculus (Olitsky et al, 2007).

This slight magnocellular impairment affects particularly the most vulnerable ocular motor control system, which is the control of the vergence eye movements that point the eyes together to focus on near targets as when reading. Hence dyslexics binocular vergence control tends to be unstable compared to normal readers. Because their eyes tend to wobble, letters may seem to move around, merge, flip and jump over each other. This is the reason why dyslexics tend to confuse the order of letters when attempting to read. However occluding one eye for reading only helps children up to the age of 10, and only in those who have not established fixed dominance of one eye; this seems to cause unsteady convergent fixation on the words being read. However in older children and adults with poor vergence control, whether they have fixed or unfixed ocular dominance, we have found that vergence exercises can often be very helpful. If the exercises improve the subjects vergence control then their reading improves dramatically.

Likewise in children with poor eye tracking of moving targets pursuit-tracking exercises can often help to improve their reading (Clisby & Fowler, 2000).

A common complaint for people with vestibular disorders is that they have difficulty with their vision. They have problems focusing on an object or perceive that objects are moving from side to side or revolving around them (vertigo). They may see their visual field jiggle or bounce (oscillopsia) or have double vision (diplopia). When they hold their heads still, the problems disappear. The optometrist, who conducts eye exams while a patients head is securely braced against a head rest, is often unaware that a vestibular problem exists. When the optometrist then explains the normal results of the exam, such patients may become disgruntled or frustrated because the test results dont reflect the symptoms that they experience in the course of daily life (Chung & Singh, 2009).

1.1.1 Vision problems

There are many types of eye problems and vision disturbances, such as:

Halos Blurred vision (the loss of sharpness of vision and the inability to see fine details) Blind spots or scotomas (dark "holes" in the vision in which nothing can be seen)

Vision loss and blindness are the most severe vision problems. 1.1.2 Causes Vision changes and problems can be caused by many different conditions. Some include:

Cataracts: -- Cloudiness over the eye lens, causing poor nighttime vision, halos around lights, and sensitivity to glare. Cataracts are common in the elderly.

Glaucoma: Increased pressure in the eye, which is most often painless. Vision will be normal at first, but over time you can develop poor night vision, blind spots, and loss of vision to either side. Glaucoma can also happen suddenly, which is a medical emergency.

Macular degeneration: Loss of central vision, blurred vision (especially while reading), distorted vision (straight lines will appear to be wavy), and colors that look faded. The most common cause of blindness in people over age 60.

Eye infection, inflammation, or injury Floaters: -- Tiny particles drifting inside the eye, which may be confused with retinal detachment.

Retinal detachment: Symptoms include floaters, sparks or flashes of light in your vision, or a sensation of a shade or curtain hanging across part of your visual field.

Optic neuritis: Inflammation of the optic nerve from infection or multiple sclerosis. You may have pain when you move your eye or touch it through the eyelid.

Temporal arteritis: Inflammation of an artery in the brain that supplies blood to the optic nerve

Migraine headaches: Spots of light, halos, or zigzag patterns that appear before the start of the headache.

1.2 Statement of the Problem As we all know, the eyes are the organs responsible for sight. The eye is a sensitive organ, with only a small layer of skin (the eyelid), some hair (the eyebrow) and eye fluid or tears to protect it. This is why various triggers can cause serious eye irritation. Factors such as wind, environmental pollutants and toxins, allergies, and bright light can cause common eye problems such as bloodshot red eyes, inflamed eyes, dry eyes, itchy eyes or eye strain.

1.3 Objectives of the Study 1. As visual problem is common to the community, so it is essential to explore the causes to reduce the disease by helping in maintaining the level of healthy environment. 2. To explore the visual problems among the community, Dera Ismail Khan, KPK, Pakistan. 3. To compute the respective roles of medicine and care tips to every individual, group and total sample.

4. To test the hypotheses about the role of precautionary measurements in determining the visual dilemma of the subjects of the study. 5. To get the firsthand experience of the Research Methodology in Sports Sciences by working on the Literature and Field-work in the pursuit of a Real World problem.

1.4 Significance 1. The visual problem is a persistent and common dilemma and there is an acute need of exploring the solution of the problem faced by the community. This study will strive to make a substantial contribution to fill the existing gap in understanding the visual problem, their causes and their valuable augmentation in Pakistan. 2. Although major determinants of visual problems are universal however the levels of precautionary measurements and the necessary medical requirements change the story in every setting. This research will come up with a customized picturesque of the issue that can be instantly utilized. 3. This is a unique research as it is the first of its kind about the community of Dera Ismail Khan, KPK, Pakistan. 4. The findings will make a contribution to the existing databases of knowledge about the issues of visual problems among the community of Dera Ismail Khan in KPK and Pakistan. 1.5 Research questions 1. 2. 3. 4. 5. 6. 7. What causes loss of central vision? What could cause spots in the vision? What are some tips for relieving dry eyes? How can one stay active with vision loss? Can headaches and vision loss after a stroke be related? What causes swelling under the eyes? When are glasses required?

Chapter 2 LITERATURE REVIEW

2.1 Existing Research There are many types of eye problems and visual disturbances. These include blurred vision, halos, blind spots, floaters, and other symptoms. Blurred vision is the loss of sharpness of vision and the inability to see small details. Blind spots (scotomas) are dark "holes" in the visual field in which nothing can be seen. Regular exams are essential for uncovering glaucoma and other diseases that may otherwise remain undetected until they cause serious vision problems. Changes in vision, blurriness, blind spots, halos around lights, or dimness of vision should always be evaluated by a medical professional. Such changes may represent an eye disease, aging, eye injury, or a condition like diabetes that affects many organs in your body (Clisby & Fowler, 2000). Whatever the cause, vision changes should never be ignored. They can get worse and significantly impact the quality of your life. Professional help is always necessary. As you determine which professional to see, the following descriptions may help: Opticians dispense glasses and do not diagnose eye problems. Optometrists perform eye exams and may diagnose eye problems. They prescribe glasses and contact lenses. In some states, they treat diseases that affect the eyes. Ophthalmologists are physicians who diagnose and treat diseases that affect the eyes. They also perform eye surgery. These doctors may also provide routine vision care services, such as prescribing glasses and contact lenses. Sometimes an eye problem is part of a general health problem. In these situations, your primary care provider should also be involved. Vision changes and problems can be caused by many different conditions. Some include: Presbyopia: Difficulty focusing on objects that are close. Often becomes noticeable in your early to mid 40s. Cataracts: Cloudiness over the eye lens, causing poor nighttime vision, halos around lights, and sensitivity to glare. Daytime vision is eventually affected. Common in the elderly.

Glaucoma: Increased pressure in the eye, causing poor night vision, blind spots, and loss of vision to either side. A major cause of blindness. Glaucoma can happen gradually or suddenly if sudden, it's a medical emergency. Diabetic retinopathy: This complication of diabetes can lead to bleeding into the retina. Another common cause of blindness. Macular degeneration: Loss of central vision, blurred vision (especially while reading), distorted vision (like seeing wavy lines), and colors appearing faded. The most common cause of blindness in people over age 60. Eye infection, inflammation, or injury. Floaters: Tiny particles drifting across the eye. Although often brief and harmless, they may be a sign of retinal detachment. Retinal detachment: Symptoms include floaters, flashes of light across your visual field, or a sensation of a shade or curtain hanging on one side of your visual field. Optic neuritis: Inflammation of the optic nerve from infection or multiple sclerosis. You may have pain when you move your eye or touch it through the eyelid. Temporal arteritis: Inflammation of an artery in the brain that supplies blood to the optic nerve. Migraine headaches: Spots of light, halos, or zigzag patterns are common symptoms prior to the start of the headache.

Other potential causes of vision problems include fatigue, overexposure to the outdoors (temporary and reversible blurring of vision), and many medications. Medications that can affect vision include antihistamines, anticholinergics, digitalis derivatives (temporary), some high blood pressure pills (guanethidine, reserpine, and thiazide diuretics), indomethacin, phenothiazines (like Compazine for nausea, Thorazine and Stelazine for schizophrenia), medications for malaria, ethambutol (for tuberculosis), and many others. Whether they entail loss of vision or irritation of the eye, vision problems have a variety of symptoms. The pain and diminished function, while uncomfortable and sometimes even debilitating, are important in helping you and your doctor determine what precisely is wrong with your eye and how you can fix it. Please take a moment to learn about some common signs of eye dysfunction and what they may indicate (Ferris & Tielsch, 2004). Long-term blurry or distorted vision can have a number of root causes. Most commonly, it is the result of a simple refractive error, which causes the light to be focused at some spot other than

where it needs to be focused on the back of the retina. Astigmatism lies within this category of vision problems; in this case, the cornea (the transparent outer layer of the eye in front of the iris and pupil) is shaped unevenly, causing different portions of the light entering the eye to be focused at different depths. Common astigmatism treatments include eyeglasses and contact lenses. Among the more serious causes of distorted vision is macular degeneration, which can occur with age. It often causes the patient to lose central vision and see objects toward the middle of their field of view as warped. This condition can cause blindness if left untreated, so please contact an ophthalmologist for a macular degeneration diagnosis if you feel you may be experiencing these eye symptoms (Clisby & Fowler, 2000).

2.1.1 Difficulty Seeing Near Objects Nearsightedness, or myopia, is a type of refractive error caused by the eyeballs being too long from front to back. Patients with this condition, which exists from birth, can see things very close to the face alright, but their vision becomes increasingly blurry as the distance to the object being viewed increases. The most prevalent myopia treatment methods involve prescription eyewear such as glasses and contact lenses, but LASIK surgery is becoming an ever more popular and effective long-term solution. 2.1.2 Difficulty Seeing Distant Objects In contrast to myopia, hyperopia causes people to be farsighted. This refractive error is a result of eyeballs that are too short, and it makes objects that are farther away appear clearer than objects that are up close. Basic hyperopia treatment methods include contact lenses. Patients over 18, though, may consider LASIK as a permanent solution. 2.1.3 Cloudy Vision Cloudy vision, wherein the visual image becomes obscured as if seen through a mist, is most often a symptom of cataracts. This condition, most likely a result of a stiffening of the eye lens with age, causes progressively worse vision problems as time goes by, and may even lead to blindness if left untreated. Cataract removal is possible in many cases via surgery, so it is important to catch the disease as soon as possible. Cloudy vision can also come about in the presence of other medical conditions, some of which are very serious. Vitamin A deficiency,

some STDs, and eye tumors can all cause the vision to appear foggy. Given the range of possibilities, patients experiencing this problem are encouraged to contact a professional eye care specialist as soon as possible. 2.1.4 Loss of Peripheral Vision While discerning the small details of an objects appearance requires us to focus on it with the central part of our vision, our peripheral vision is also very important. Being able to detect motion at the edges of our field of view allows us to sense incoming danger such as cars running stop signs and react instinctively. An impairment of this ability, while not debilitating, can be quite dangerous. Some vision problems, including retinitis pigmentosa, are known to deteriorate the breadth and quality of peripheral vision. The most prominent of these conditions, though, is glaucoma. This disease, which takes several different forms of varying severity, is caused by a blockage of the normal flow of fluid in the eye. Loss of peripheral vision is the first of the eye symptoms it causes, though in many cases people do not notice it as it is happening. As the glaucoma progression continues, the disease can lead to extreme pain and even blindness. Glaucoma treatment options are usually effective, but much more so if the disease is caught early. 2.1.5 Eye Twitching Involuntary eye twitching, which goes by the technical name nystagmus, is an eye symptom that can result from a number of different conditions. Most cases last only a few days and disappear without the cause ever being discovered. In more serious instances, though, head trauma, stroke, and brain tumors can upset the nerve signals that control the eyes. Balance disorders, such as Mnires disease and ear infections, can upset the bodys perception of motion, causing the eyes to twitch into new positions in response. A number of congenital conditions can also lead to twitching eyes. The severity of vision problems caused by nystagmus varies from case to case, but it is useful in helping doctors identify underlying diseases. Treatment, when feasible, usually focuses on dealing with the root problem.

2.1.6 Itchy, Watery Eyes Prolonged itchiness and watering of the eyes is among the more common vision problems. These symptoms usually indicate that the patient has some type of eye allergies to pollen, pet hair, or to some other foreign substance in the environment. The eyes often become red and very uncomfortable, though significant vision loss is rare. Similar eye symptoms are also associated with temporary irritation and overuse of the eye, which should resolve itself once the problem has been corrected. Dry eye is another symptom, which tends to affect people as they age. Treatment options available depend on the cause of the problem. 2.1.7 Floaters Floaters are dark, distinct spots in the vision field caused by the presence of non-transparent substances in the fluid of the eyeball. As they block some light from reaching the retina, they can cause significant vision problems. Floaters are among the symptoms that arise after retinal detachment, in which the retina peels away from its underlying supports and ceases to function properly. This condition often caused by trauma to the head and much more likely in those who suffer from severe myopia, constitutes an emergency and can lead to permanent blindness if not treated immediately. Diabetic retinopathy, which afflicts many people with diabetes as they get older, causes the blood vessels in the retina to become weak and more likely to burst. The blood that seeps into the eye as a result often forms floaters. Diabetic retinopathy is often treated with laser photocoagulation or vitrectomy surgery. Floaters can also be caused by vitreous detachment, but this is not as serious a problem as diabetic retinopathy or retinal detachment. 2.1.8 Flashes Like floaters, flashes are eye symptoms associated with of retinal detachment. People who see flashes often describe them as being like an arc of light across the field of vision, or a light bulb going on and off. In more common and less dangerous cases, flashes are caused by vitreous detachment. Because of the danger of retinal detachment and its long-term consequences, though, people who see flashes are advised to see a physician immediately.

2.1.9 Other Vision Problems and Symptoms Many other vision problems can occur, and their symptoms are highly varied. Eye pain crops up in many people from time to time, from irritating scratches on the cornea to debilitating internal pressure, which might signal a dangerous form of glaucoma. Crusting of the eyelid is another common eye symptom; it usually is a side effect of allergies or an infection of the eye tissue such as pink eye. Another eyelid problem that some people experience is hyperpigmentation, or a darkening of the lids color, which usually indicates the presence of eczema. These and the other eye symptoms listed on this page are by no means a comprehensive list of all things that can go wrong with the eyes. If you suspect that you may be developing an eye condition, please contact a physician for a professional diagnosis immediately. 2.1.10 Schedule an Exam with an Ophthalmologist for Diagnosis The information on this page may help you learn more about the potential seriousness of any eye symptoms you may be having, but it is no substitute for a professional evaluation. To avoid permanent vision problems, please have your symptoms examined immediately by scheduling an appointment with an ophthalmologist in your area right away (Chung & Singh, 2009).

Chapter 3 RESEARCH METHODOLOGY

3.1 Survey Approach An analysis of the social research methodologies suggests that survey is the handy tool for managers to collect primary data using questionnaire and interviews about the perceptions and attitudes of employees. It is noted somewhere that questionnaire approach is the most frequently used mode of observation in the social sciences (Babbie, 1993:256-257).

3.2 Population & Sample The universe or population is the entire group of items in which the researcher is interested and wishes to plan to generalize (Boyd et al., 1977:302-303). A population is a collection of all the elements we are studying and about which we are trying to draw conclusions (Levin, 1984:9). The population of interest in this research project consisted of all the community in Dera Ismail Khan, Khyber Pakhtunkhwa, Pakistan.

Sampling is a common practice and everyone is used to drawing conclusions about a large group on the basis of a small portion or sample. For instance, newspapers report the results of studies in which public opinion on some question is estimated by collecting opinions from a few selected individuals (Boyd et al., 1977:301). Sampling is the process of selecting a sufficient number of elements from the population so that by studying the sample, and understanding the properties or characteristics of the sample subjects, it would be possible to generalize the properties or characteristics to the population elements (Sekaran, 1999:268).

3.3 Data Collection Methods 1. Secondary Sources: All research inevitably involves the use of the book, pamphlet, periodical, and documentary materials in libraries. Obviously, no research project can be undertaken without this preliminary orientation. Nor should one be undertaken without

knowledge of the research that has already been done in the field (Goode & Hatt, 1952:103). The literature survey is simply a search through available data. After all, if someone else has already investigated one or more aspects of a topic, it doesnt make sense to spend money traveling the same path. Available literature (or secondary data) is in general abundance from various corporate, commercial, private, and governmental libraries, services, documents and publications (Weiers, 1984:67). Literature review is the documentation of a comprehensive review of the published and unpublished work from secondary sources of data in the areas of specific interest to the researcher (Sekaran, 1999:61). 2. Primary Sources: A structured questionnaire was prepared from the extensive literature survey. The questionnaire included the 30 questions regarding the problem and their causes. A 5-point Likert scale will be used to record the responses.

3.4 Tools for Data Analysis Science is a method of approach to the entire empirical world. It is a mode of analysis enabling the researcher to state the propositions in the form of 'if-then'. There are two types of questions about analysis which may be raised. One of them relates to the techniques of representing the data and the other to the methods of logically ordering them so that questions can be raised and answered (Goode &Hatt, 1952:343).

1. Descriptive Tools: Graphs, tables, and charts that display data so that they are easier to understand are all examples of descriptive statistics (Levin, 1984:4) therefore the researcher has used different tables and charts to represent descriptive data about the respondents as well as the variables used to analyze the attitude of the community.

2. Testing of Hypotheses: The researcher has also used inferential tools to test the hypotheses. Regression analysis (Multiple Regression & Stepwise-Regression)

References 1. Clisby C, Fowler MS, Hebb GS (2000). Outcome of treatment of visual problems in children with reading difficulties. Learning Difficulties Clinic, Royal Berks Hospital, Reading & University Laboratory of Physiology, Oxford. 2. Ferris FL and Tielsch JM (2004). Blindness and Visual Impairment: A Public Health Issue for the
Future as Well as Today. Arch Ophthalmol. 122; 451- 2.

3. Chung JY, Singh RP (2009). Preventive measures and screening for ophthalmic problems. In: Carey WD, ed. Cleveland Clinic: Current Clinical Medicine. 1st ed. Philadelphia, Pa: Saunders Elsevier; chap 201. 4. Olitsky SE, Hug D, Smith LP (2007). Disorders of vision. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier;:chap 620. 5. Sterns GK, McCormick GJ (2007). Ophthalmologic disorders. In: Duthie EH, Katz PR, Malone ML, eds. Practice of Geriatrics. 4th ed. Philadelphia, Pa: Saunders Elsevier;chap 24. 6. Babbie (1993) 256- 257. Babbie, Earl (1993). The practice of social research. 7th ed. Wordsworth Publishing Co. 7. Boyd, HW. Westfall, R. and Stasch, SF. (1977) Marketing research: Text and cases. 4th ed. Richard D. Irwin, Inc. 8. Goode & Hatt 1952: 103. Methods in social research, McGraw- Hill Kogakusha. 9. Sekaran, U. (1999). Research methods for business: A skill-building approach. 3rd ed. John. 10. Weiers, Ronald M. (1984) Marketing research. Prentice Hall Inc. Englewood Cliffs, New Jersey. 11. Levin, RI (1984) Statistics for management. 3rd ed. Prentice-Hall.

Annexure 1 Questionnaire
Topic

Study regarding the Visual Problems and their Causes:

A view-point of Eye Specialist Community
Dear Respondent! This questionnaire is purely for Academic purposes therefore your cooperation will help the Student-Scholar to fulfill the requirements for the degree of Masters in Sports and Physical Sciences.

FIDA MUHAMMAD
Candidate for Masters in Sports and Physical Sciences

Note. How far do you Agree/Disagree with the following Statements using 7-Point Scale? Strongly Disagree 1 Slightly Disagree 2 Neutral 3 Slightly Agree 4 Strongly Agree 5

Questions
1 2 3 4 5 6 In general, would you say your overall health is good? 1 2 2 2 2 2 2 3 3 3 3 3 3 4 4 4 4 4 4 5 5 5 5 5 5 At the present time, would you say your eyesight using both eyes 1 (with glasses or contact lenses, if you wear them)? How much of the time do you worry about your eyesight? 1 How much pain or discomfort have you had in and around your 1 eyes (for example, burning, itching, or aching)? How much difficulty do you have reading ordinary print in 1 newspapers? How much difficulty do you have doing work or hobbies that 1 require you to see well up close, such as cooking, sewing, fixing things around the house, or using hand tools? Because of your eyesight, how much difficulty do you have 1 finding something on a crowded shelf? How much difficulty do you have reading street signs or the names 1 of stores? Because of your eyesight, how much difficulty do you have going 1 down steps, stairs or curbs in dim light or at night?

7 8 9

2 2 2

3 3 3

4 4 4

5 5 5

10 11 12 13 14 15 16 17

Because of your eyesight, how much difficulty do you have 1 noticing objects off to the side while you are walking along? Because of your eyesight, how much difficulty do you have seeing 1 how people react to things you say? Because of your eyesight, how much difficulty do you have 1 picking out and matching your own clothes? Because of your eyesight, how much difficulty do you have 1 visiting with people in their homes, at parties or in restaurants? Because of your eyesight, how much difficulty do you have going 1 out to see movies, plays or sports events? Do you accomplish less than you would like because of your 1 vision? Are you limited in how long you can work or do other activities 1 because of your vision? How much does pain or discomfort in or around your eyes, for 1 example, burning, itching, or aching, keep you from doing what youd like to be doing? I stay home most of the time because of my eyesight. 1 I feel frustrated a lot of the time because of my eyesight. Have much less control over what I do, because of my eyesight. 1 1

2 2 2 2 2 2 2 2

3 3 3 3 3 3 3 3

4 4 4 4 4 4 4 4

5 5 5 5 5 5 5 5

18 19 20 21 22 23 24 25 26 27

2 2 2 2 2 2 2 2 2 2

3 3 3 3 3 3 3 3 3 3

4 4 4 4 4 4 4 4 4 4

5 5 5 5 5 5 5 5 5 5

Because of my eyesight, I have to rely too much on what other 1 people tell me. I need a lot of help from others because of my eyesight. 1

I worry about doing things that will embarrass me or others, 1 because of my eyesight. I am often irritable because of my eyesight. I dont go out of my home alone, because of my eyesight. 1 1

At the present time, would you say your eyesight using both eyes 1 (with glasses or contact lenses, if you wear them)? How much pain or discomfort have you had in and around your 1 eyes (for example, burning, itching or aching)?

28 29

How much difficulty do you have reading ordinary print in 1 newspapers? How much difficulty do you have doing work or hobbies that 1 require you to see well up close, such as cooking, sewing, fixing things around the house, or using hand tools? Because of your eyesight, how much difficulty do you have 1 finding something on a crowded shelf? Because of your eyesight, how much difficulty do you have going 1 down steps, stairs, or curbs in dim light or at night? Because of your eyesight, how much difficulty do you have 1 noticing objects off to the side while you are walking along? Because of your eyesight, how much difficulty do you have seeing 1 how people react to things you say? Because of your eyesight, how much difficulty do you have going 1 out to see movies, plays, or sports events? How much difficulty do you have driving at night? 1

2 2

3 3

4 4

5 5

30 31 32 33 34 35 36

2 2 2 2 2 2 2

3 3 3 3 3 3 3

4 4 4 4 4 4 4

5 5 5 5 5 5 5

37 38

How much difficulty do you have driving in difficult conditions, 1 such as in bad weather, during rush hour, on the freeway, or in the city traffic? Are you limited in how long you can work or do other activities 1 because of your vision? How much does pain or discomfort in or around your eyes, for 1 example, burning, itching or aching, keep you from doing what youd like to be doing? I feel frustrated a lot of the time because of my eyesight: 1 I have much less control over what I do, because of my eyesight: 1

2 2

3 3

4 4

5 5

39 40

2 2

3 3

4 4

5 5