about socioeconomic status

1. CLINICOSOCIAL CASE
DANIEL YESUNATHAN - INTERN

2. DEMOGRAPHICS
 NAME : MEERABAI
 AGE/SEX : 72/F
 PLACE : VEPPAMPATTU, KANIYAMBADI
 OCCUPATION : HOMEMAKER

3. PRESENTING COMPLAINT
 LOSS OF VISION IN BOTH EYES × 1 MONTH

4. HISTORY OF PRESENT ILLNESS
 A 72 years old female, Mrs. Meerabai, came with a complaint of loss of vision on
both eyes for the past 1 month.
 She was apparently well till 2 years ago when she noticed decrease of vision in her
both eyes. It was insidious in onset, gradually progressive.
 She also complained of diplopia in the both eyes.
 There was no history of pain, redness, trauma, flashes, floaters or discharge.
 She don’t have a history of long term use of corticosteroids.
 She was seen in CHAD on 04/07/2022 and referred to Schell Eye Hospital

5. PAST HISTORY
 She is known hypertensive for past 3 months for which she is on
meds:
 Amlodipine 5mg HSOD
 Atenelol 50mg BD
 There was no history of DM, Thyroid disease.

6. FAMILY HISTORY
 She is a widow , with 2 sons and 1 daughter all got married .She
lives alone.
 No history or cataract or any other ophthalmologist pathology in
any of the family members.
 No other significant history in family

7. PERSONAL HISTORY
• Consumes a mixed diet
• No loss of weight or appetite
• Normal sleep pattern, bowel and bladder movements
• No h/o smoking or alcohol consumption

8. SOCIOECONOMIC STATUS
• Education: Primary school certificate
• Occupation: unemployed
• Income: 300/ month
• Score: 6 according to Modified Kuppuswamy
scale 2021 – Upper lower class

9. GENERAL EXAMINATION
• She was alert, conscious and oriented to time,
place and person
• Vital signs:
o PR: 70bpm, regular
o BP: 120/80 mmHg
o RR: 20 per minute
o Afebrile

10.  There was no pallor, icterus, cyanosis, clubbing, lymphadenopathy

11. EXAMINATION OF THE EYE
Visual acuity Right eye Left eye
Unaided vision P/L + P/L +
Vision with pinhole NIP NIP

12. Eyeball Right eye Left eye
Motility Full and normal in all
directions
Full and normal in all
directions
ROLAPS Negative Negative
Conjunctiva Normal Normal
EXAMINATION OF THE EYE

13. Eyeball Right eye Left eye
Cornea Arcus Senilis +
Dellen
Arcus Senilis +
Dellen
AC Depth Shallow Shallow
RADP no no
EXAMINATION OF THE EYE

14. DIAGNOSIS
 Right eye mature cataract
 Left eye mature cataract

15. SYSTEMIC REVIEW
• CVS: S1 S2 heard normal, no
murmurs
• RS: NVBS bilaterally
• CNS:No focal neurological deficits
• Abdomen: Soft, Non tender, No
organomegaly or free fluid

16. BARRIERS TO ACCESS HEALTH
CARE
Patient related -
• Fear of coming to hospital
• No support from sons.
• Unwillingness to accept having a disease.

17. WHAT ENABLED THE PATIENT TO
REACH EYE CARE SERVICE?
•Outreach service in Rural areas
CHAD
•Referral system

18. BARRIERS TO ACCESS HEALTH CARE
System related -
• Lack awareness of dieases
• Transportation access
• Distrust in public healthcare

19. STRATEGIES TO IMPROVE ACCESS TO
HEALTHCARE
o Provision of transport facilities
o More outreach programmes in different
places
o Increased awareness of disease progression