Epidemiological Findings of Refractive Errors and Amblyopia among the Schoolchildren in Hatta Region of the United Arab Emirates

Introduction: Uncorrected refractive errors and amblyopia pose a major problem affecting schoolchildren. We had previously observed that many schoolchildren in the Hatta region presented to the ophthalmology clinic with uncorrected refractive errors and amblyopia, which led us to undertake this research. As per the WHO, the term “visual impairment” can be “low vision” or “blindness.” Based on the presenting vision, “low vision” is defined for children who have vision of <6/18 to 3/60 or having visual field loss to <20° in the better-seeing eye. Children defined to have “blindness” have presenting vision of <3/60 or corresponding visual field of <10°. Purpose: To estimate the magnitude of uncorrected refractive errors and amblyopia among the schoolchildren aged 6–19 years and to assess the efficacy of school-based refractive error screening programs in the Hatta region of the United Arab Emirates. Methods: An epidemiological, cross-sectional, descriptive study was conducted on the entire student population studying in the government schools of the region. Those who failed the Snellen visual acuity chart test and those who were wearing spectacles were evaluated comprehensively by the researcher in the Department of Ophthalmology of the Hatta Hospital. Data were entered in the Refractive Error Study in School Children (RESC) eye examination form recommended by the WHO, and were later transferred to Excel sheets and analyzed by SPSS. Results: 1,591 students were screened and evaluated from the end of 2016 to mid-2017. About 21.37% (n = 340) had impaired vision with 20.9% (n = 333) refractive errors, of which 58% were uncorrected. Among the refractive error group, 19% (64 subjects) had amblyopia (4% of total students). The incidence of low vision was 9.5% and blindness was 0.38%. Low vision was found to be 9.5% and blindness 0.38%, taking in to account presenting visual acuity rather than best-corrected visual acuity for defining low vision and blindness. Conclusion: A significant number of students were detected to have uncorrected refractive errors among the vision impaired group (59%, n = 197) despite a school-based vision screening program in place. Seventy-eight percent of the amblyopia cases (n = 50) were found to be in the 11–19 years age group. Noncompliance with optical corrections was the reason for the high number of cases. A rigorous vision screening program and refractive services, complimented with awareness among parents and teachers, are recommended.

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Is Prematurity a Risk Factor for Refractive Errors in Children? Results from School Vision Screening Program

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2020/493 ◽

2020 ◽

Vol 7 (42) ◽

pp. 2380-2383

Author(s):

Kajal Seema Sukumaran ◽

Jayalekshmi Thankamma ◽

Prasenna Meleaveetil ◽

Kavitha Syamala

Keyword(s):

Visual Acuity ◽

Risk Factor ◽

Preterm Infants ◽

Gestational Age ◽

Screening Program ◽

Refractive Errors ◽

Vision Screening ◽

School Vision ◽

Preterm Group

BACKGROUND The prevalence of refractive errors is reported to be higher in children born preterm. Factors like gestational age, birth weight and retinopathy of prematurity status have a significant impact on the refractive development in preterm infants. Population based long term follow up studies on the refractive status in preterm infants are limited. We designed this study to assess whether prematurity is a risk factor for refractive errors in children. METHODS This study was conducted among children aged 5 - 16 years who participated in the school vision screening program over a period of one year. All children underwent detailed ocular examination including measurement of best corrected visual acuity, cycloplegic refraction and fundoscopy. Visual acuity was assessed using an internally illuminated Snellen’s chart at 6 meters. Objective refraction by streak retinoscopy after instilling 1 % cyclopentolate eye drops was done in all children with visual acuity ≤ 6 / 9. Children were divided into two groups based on their gestational age at birth - preterm group and full-term group. Preterm birth was defined as childbirth before 37 completed weeks of gestation. Children were enrolled in the study only if the hospital birth document showing gestational age and birth weight was available. Children with co-existing organic disease affecting the eye contributing to the diminished visual acuity such as congenital cataract, glaucoma, and corneal opacities were excluded from the study. Those who had undergone any ocular surgery were also excluded. RESULTS One thousand two hundred and ninety-five children were enrolled in the study of which 700 (54.1 %) were boys and 595 (45.9 %) were girls. Median age of the enrolled children was 12 years. The number of pre-term births was 287 (22.2 %). Of the 1295 students screened, 273 (21 %) had refractive errors. Among the children with refractive errors, astigmatism was the most common refractive error (10.6 %), followed by myopia (8.5 %) and hypermetropia (1.9 %). Refractive errors were statistically more prevalent in preterm group (34.1 %), when compared with term born children (17.3 %), p = < 0.001. Compared to the term born children, preterm group had significantly higher prevalence of myopia; 16.4 % vs 6.3 % (p = < 0.001) and astigmatism; 15.3 % vs 9.3% (p = 0.003). There was no statistically significant difference in the prevalence of hypermetropia among the two groups; 2.4 vs. 1.8 (p = 0.477). CONCLUSIONS There is strong association between prematurity and refractive errors. These findings prompt long term monitoring of the refractive and visual outcome in preterm infants for diagnosing refractive errors at the earliest. This helps to prevent the consequent amblyopia and the ensuing permanent visual function deficits. KEYWORDS Prematurity, Refractive Error, Myopia, Hypermetropia, Astigmatism

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Pediatric Ophthalmic Diagnoses at the Yaounde Central Hospital

Journal of Ophthalmology & Clinical Research ◽

10.33140/jocr/02/01/00002 ◽

2018 ◽

Vol 2 (1) ◽

Keyword(s):

Visual Acuity ◽

Descriptive Study ◽

Refractive Errors ◽

Central Hospital ◽

Screening Programs ◽

School Aged Children ◽

School Based ◽

Distant Visual Acuity ◽

The Mean

Background: Ophthalmic disorders in children can seriously impact development, vision, education and quality of life. The aim of this study was to determine the pattern of ophthalmic diagnoses of children seen at the Yaoundé Central Hospital. Methods: A prospective descriptive study was carried out over a 3 months period (February 2 to April 30 2016). Children aged 0 to 15 years, were included after informed consent was obtained from their parents. Variables studied include age, sex, presenting complaint, visual acuity (in school aged children) and the diagnosis. Blindness was defined as corrected distant visual acuity of <1/20. Results: During the study period, 393 children were seen. We included 301 in this study, amongst whom 153 (50.8%) girls and 148 (49.2%) boys. The mean age was 7.8 ± 4.2 years. The most frequent presenting complaints were pruritus (12.8%), pain (11.3%) and decreased visual acuity (10.7%). Refractive errors (40.2%), conjunctivitis (33.9%) and strabismus (8.6%) were the most frequent diagnoses. Monocular blindness was present in 2.3% of cases (n=7). Conclusion: Refractive error was the most frequent childhood ophthalmic diagnosis in this study. We recommend the putting in place of school-based screening programs.

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Outcomes of an Elementary School-Based Vision Screening Program in North Carolina

The Journal of School Nursing ◽

10.1177/1059840511424413 ◽

2011 ◽

Vol 28 (1) ◽

pp. 24-30 ◽

Cited By ~ 12

Author(s):

Alex R. Kemper ◽

Anya Helfrich ◽

Jennifer Talbot ◽

Nita Patel

Keyword(s):

North Carolina ◽

Screening Program ◽

School Nurses ◽

Vision Screening ◽

Screening Programs ◽

School Year ◽

School Based ◽

Eye Examination ◽

The Impact

School nurses can play a key role in the detection of significant refractive error. The purpose of this study was to assess the impact of a statewide school nurse vision screening program by evaluating the outcomes of screening among first, third, and fifth graders in 10 schools in North Carolina during the 2009–2010 school year. Of the 2,726 children who were screened, 7.7% ( n = 209) were abnormal, of which 89% ( n = 186) were placed into a comprehensive database for follow-up. No documentation of any follow-up was available for 35% ( n = 65) of these children. Of the 106 with complete eye examination data available, 54.7% ( n = 58) had myopia, 22.6% ( n = 24) had hyperopia, 11.3% ( n = 12) had astigmatism, 1.9% ( n = 2) had anisometropia, and 9.4% ( n = 10) were normal. Even with incomplete follow-up, this screening activity led to identification of 3 cases for every 100 children screened, underscoring the importance of high-quality school-based vision screening programs.

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Establishing a school-based vision screening program in Myanmar: a qualitative study on the perspectives of school children with refractive error, teachers, optometrists and ophthalmologists

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20210781 ◽

2021 ◽

Vol 8 (3) ◽

pp. 1052

Author(s):

Soe Min Oo ◽

Myo Mon Mon ◽

Khaing Lay Mon

Keyword(s):

Qualitative Study ◽

School Children ◽

Refractive Error ◽

Service Providers ◽

Screening Program ◽

Care Program ◽

World Health ◽

Vision Screening ◽

School Based ◽

Vision Care

Background: Refractive error (RE) is one of the global leading causes of vision impairment among children. The World Health Organization outlined the school-based vision care program aided by school teachers as one solution. In Myanmar, although the prevalence of RE among school children is expected at about two million, a regular eye check-up program has not been established. This study aimed to explore the barriers, feasibility, and limitations of the children with RE and service providers to establish a program.Methods: This qualitative study was conducted in eight public schools,that have been involved in the pilot school-based vision screening program, in Yangon. Focus group discussions with school children and teachers from these schools, key informant interviews with optometrists and ophthalmologists, involved in the program, and working at Yangon Eye Hospital and North Okala General Hospital, were carried out from January to August 2020. Qualitative data analysis was manually performed using the grounded theory according to the pre-defined themes.Results: Almost all school children showed positive perspectives but they expressed their psychosocial barriers of the cost, time, and care given by their parents on the next vision examination. All teachers mentioned optimism to be volunteers. The optometrist and ophthalmologists revealed the feasibility to establish the program despite having limitations in human resources, logistic requirements, and low awareness level on visual impairment of the children by parents.Conclusions: This study highlighted that a school-based vision care program can be initiated in Myanmar despite having some barriers and limitations.

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Eye-glasses wear compliance following school-based visual acuity screening in Nepal: a comparative study

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v12i1.25736 ◽

2020 ◽

Vol 12 (1) ◽

pp. 91-98

Author(s):

Hari Bahadur Thapa ◽

Salma KC Rai ◽

Saraswati Khadka Thapa ◽

Anadi Khatri ◽

Ken Bassett

Keyword(s):

Visual Acuity ◽

Public Schools ◽

Screening Program ◽

Intervention Group ◽

Educational Status ◽

Screening Programs ◽

School Based ◽

Significant Difference ◽

Private And Public

Introduction: Eye-glasses wear compliance is found to be low among children in school-based eye screening programs who are provided spectacles free of charge. Methods: Thirty-six schools from school visual acuity screening program in Nepal were randomly selected to receive no follow-up (standard) or follow-up by an optometry team at 3 months. In the intervention group (that received the follow-up), ophthalmic personal made unannounced visits to the schools at 3 months to determine spectacle compliance .Direct examination to determine compliance with spectacle wear 6 months was done. The primary reason for noncompliance from a list of possibilities was identified using a questionnaire. Results: Among 297 (145 control and 152 intervention) students that received glasses in the 36 schools, 128/152 (84%) were available for examination at 3 months in the intervention group. A total of 216/297 (73%) students were available for examination at 6 months (73 % and 72% of the control and intervention groups, respectively). Within the intervention group, 51% of children at 3 months and 57% at 6 months were wearing glasses during the unannounced visits. The main source of refractive error was myopia. Out of 66 children with astigmatism, 24 (36%) were wearing glasses. There was no statistically significant difference in compliance (p=0.85) between private and public schools, but compliance correlated better with the educational status of careers. Conclusion: A follow-up visit to the school by eye care personnel did not improve spectacle wear compliance among children .Other factors may also be responsible for poor compliance.

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PREVALENCE OF REFRACTIVE ERRORS IN ADOLESCENTS IN OUT- PATIENT ATTENDEES OF THE PREVENTIVE OPHTHALMOLOGY CLINIC OF COMMUNITY MEDICINE, S K I M S, KASHMIR, INDIA

Journal of Health and Allied Sciences NU ◽

10.1055/s-0040-1703627 ◽

2013 ◽

Vol 03 (01) ◽

pp. 17-20

Author(s):

Jabeen Rohul ◽

Aakifa Maqbool ◽

Syed Arshad Hussain ◽

Hamid Shamila ◽

Fazli Anjum ◽

...

Keyword(s):

Early Detection ◽

Refractive Error ◽

Social Problems ◽

Low Vision ◽

Community Medicine ◽

Refractive Errors ◽

High Prevalence ◽

Males And Females ◽

The Mean ◽

Eye Clinic

AbstractBlindness is one of the most significant social problems in India with uncorrected refractive errors as the second major cause accounting for 19.7% of blindness and low vision.All adolescents (12-18 years) attending the eye clinic from Jan 2007-Jan 2009 for any eye ailment were examined and screened for refractive error using Snellen's chart.Out of total 930 adolescents, 508(54.62%) of adolescents had refractive errors. Of the total males and females examined 57.43% and 52.12% respectively had refractive errors. The mean age of presentation was 14.3 years. Most of the adolescents presented with myopia 257(50.59%) followed by astigmatism (35.23%) and hypermetropia (14.17%).High prevalence of refractive errors warrants early detection and treatment.

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Community-Based Hearing and Vision Screening in Schools in Low-Income Communities Using Mobile Health Technologies

Language Speech and Hearing Services in Schools ◽

10.1044/2020_lshss-20-00089 ◽

2021 ◽

pp. 1-13

Author(s):

Michelle Manus ◽

Jeannie van der Linde ◽

Hannah Kuper ◽

Renate Olinger ◽

De Wet Swanepoel

Keyword(s):

South Africa ◽

Visual Acuity ◽

Mobile Health ◽

Low Income ◽

Vision Loss ◽

Health Workers ◽

Screening Program ◽

Hearing Screening ◽

Vision Screening ◽

Health Technologies

Introduction Globally, more than 50 million children have hearing or vision loss. Most of these sensory losses are identified late due to a lack of systematic screening, making treatment and rehabilitation less effective. Mobile health (mHealth), which is the use of smartphones or wireless devices in health care, can improve access to screening services. mHealth technologies allow lay health workers (LHWs) to provide hearing and vision screening in communities. Purpose The aim of the study was to evaluate a hearing and vision school screening program facilitated by LHWs using smartphone applications in a low-income community in South Africa. Method Three LHWs were trained to provide dual sensory screening using smartphone-based applications. The hearScreen app with calibrated headphones was used to conduct screening audiometry, and the Peek Acuity app was used for visual acuity screening. Schools were selected from low-income communities (Gauteng, South Africa), and children aged between 4 and 9 years received hearing and vision screening. Screening outcomes, associated variables, and program costs were evaluated. Results A total of 4,888 and 4,933 participants received hearing and vision screening, respectively. Overall, 1.6% of participants failed the hearing screening, and 3.6% failed visual acuity screening. Logistic regression showed that female participants were more likely to pass hearing screening ( OR = 1.61, 95% CI [1.11, 2.54]), while older children were less likely to pass visual acuity screening ( OR = 0.87, 95% CI [0.79, 0.96]). A third (32.5%) of referred cases followed up for air-conduction threshold audiometry, and one in four (25.1%) followed up for diagnostic vision testing. A high proportion of these cases were confirmed to have hearing (73.1%, 19/26) or vision loss (57.8%, 26/45). Conclusions mHealth technologies can enable LHWs to identify school-age children with hearing and/or vision loss in low-income communities. This approach allows for low-cost, scalable models for early detection of sensory losses that can affect academic performance.

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Remote vision testing: Validation of a simple home-printable vision screening test for telemedicine

10.1101/2020.09.01.20131698 ◽

2020 ◽

Author(s):

Michael D Crossland ◽

Tessa M Dekker ◽

Joanne Hancox ◽

Matteo Lisi ◽

Thomas A Wemyss ◽

...

Keyword(s):

Visual Acuity ◽

Confidence Interval ◽

Visual Impairment ◽

Low Vision ◽

Clinical Test ◽

Vision Screening ◽

Tertiary Centre ◽

Wide Range ◽

And Control ◽

Acuity Test

Objectives: to develop and validate a simple paper vision test (the Home Acuity Test or HAT) for ophthalmology telemedicine appointments, which can be used by people who are digitally excluded. Design: Bland Altman analysis of the HAT chart, compared to the last measured visual acuity on a standard clinical test. Setting: Routine outpatient ophthalmology telemedicine clinics in a tertiary centre. Participants: 50 control subjects with no eye disease and 100 consecutive adult ophthalmology outpatients from strabismus and low vision telemedicine clinics. Participants were excluded if they reported subjective changes in their vision. Main outcome measures: For control participants, test/retest variability of the HAT and agreement with standard logMAR visual acuity measurement. For ophthalmology outpatients, agreement with the last recorded clinic visual acuity and with ICD11 visual impairment category. Results: For control participants, HAT test/retest variability was -0.012 logMAR (95% CI: -0.25 to 0.11 logMAR). Agreement with standard vision charts was -0.14 logMAR, with a 95% confidence interval of -0.39 to +0.12 logMAR (figure 3). For ophthalmology outpatients, agreement in visual acuity was -0.10 logMAR (one line on a conventional logMAR sight chart), with the HAT indicating poorer vision than the previous clinic test. The 95% confidence interval for difference was -0.44 to +0.24 logMAR. Agreement in visual impairment category was good for patients (Cohen's K test, K = 0.77 (95% CI, 0.74 to 0.81), and control participants (Cohen's K test, K = 0.88 (95% CI, 0.88 to 0.88). Conclusions The HAT can be used to measure vision by telephone for a wide range of ophthalmology outpatients with diverse conditions, including those who are severely visually impaired. Test/retest variability is low and agreement in visual impairment category is good.

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