Reduced Vision and Refractive Errors, Results from a School Vision Screening Program in Kanchanpur district of Far Western Nepal

Background At present there is no data available on reduced vision and refractive errors in school children of far western Nepal. So, school screening records were used to obtain data useful for planning of refractive services. Methods Data are provided from school screening conducted by Geta Eye Hospital during February/March 2008. The cases with complete data sets on visual acuity, refractive error and age were included and analyzed using computer software. Results Of 1165 children (mean age 11.6±2.5 years) examined, 98.8% (n= 1151) had uncorrected visual acuity of 6/9 and better in at least one eye whereas 1.2% (n= 14) had acuity 6/12 and worse in both eyes. Among them, either eye of 9 children improved to 6/9 and better with correction. However, visual acuity was 6/12 and worse in both eyes of 5 children even after correction. There were 24 children with refractive errors (myopia, 1.54%; n= 18 and hypermetropia, 0.51%; n=6) in at least one eye. The spherical equivalent refraction was not significantly different with age and gender. ConclusionsThe incidence of reduced vision and refractive errors among school children of this semi rural district were low.http://dx.doi.org/10.3126/kumj.v8i4.6233 Kathmandu Univ Med J 2010;8(4):370-4

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SPECTACLE-WEAR

The Professional Medical Journal ◽

10.29309/tpmj/18.4416 ◽

2018 ◽

Vol 25 (12) ◽

pp. 1852-1856

Author(s):

Rashid Riaz ◽

Mohammad Sher Zaman ◽

Rao Rashad Qamar

Keyword(s):

Primary School ◽

School Children ◽

Screening Program ◽

Compliance Rate ◽

Primary School Children ◽

Refractive Errors ◽

Limited Information ◽

Cross Sectional ◽

School Screening ◽

Pro Forma

Background: Refractive errors are the most common cause of avoidable visual impairment in children worldwide. Importance of school screening of refractive errors is one of the most important initiatives outlined in WHO Vision 2025 targets. Corrected refractive errors visually rehabilitate the school going children. But the benefit depends on the compliance of the spectacle wear by children. Purpose: To study the compliance of spectacle wear and to highlight the reasons of non compliance in school going children of Multan. Study Design: Cross-sectional descriptive study. Setting: Ophthalmology Department, Nishtar Medical University Multan, Pakistan. Period: Jan 2009 to Oct 2012. Materials and Methods: 631 students. Among them 187 males and 175 female students were prescribed spectacles for constant wear during school screening program. Each student was given a pro forma indicating name, age, gender, prescription and column of reasons of non compliance. After six months, we conducted a follow-up visit where these students were accessed about spectacle compliance and reasons of non compliance on the given feedback pro forma from teachers. The data was collected and analyzed by SPSS version 20. Results: The overall non-compliance rate of spectacle wear in primary school children was 35.91%. A significantly higher proportion of boys 119 (57.14%) were not wearing their spectacles compared to girls 175 (54.86%). Themain reasons for non compliance in primary school boys and girls were casual in wearing their spectacles, does not like to wear spectacles, break their spectacles frequently and some children feel spectacles are not needed or cause headache. Conclusions: Poor compliance of using spectacles was noted in our study among children with refractive errors with main reason for not using these spectacles was that they did not like to wear them. So there is need to adopt aggressive awareness campaign among teachers and parents to enhance their knowledge for better outcomes and visual improvement of the children. Screening of primary school children with refractive error was difficult task in Multan. Limited information was available on the magnitude of the compliance for spectacle wear and their reasons of noncompliance. This information is crucial for establishing a program and will strengthen the efforts for a better eye care in school children.

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

Dubai Medical Journal ◽

10.1159/000512521 ◽

2021 ◽

pp. 1-7

Author(s):

Salam Chettian Kandi ◽

Hayat Ahmad Khan

Keyword(s):

Visual Acuity ◽

Visual Field ◽

United Arab Emirates ◽

Refractive Error ◽

Screening Program ◽

Low Vision ◽

Refractive Errors ◽

Vision Screening ◽

Screening Programs ◽

School Based

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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Ophthalmic Screening of School Children in Ankara

European Journal of Ophthalmology ◽

10.1177/112067219500500307 ◽

1995 ◽

Vol 5 (3) ◽

pp. 181-186 ◽

Cited By ~ 12

Author(s):

M.E. Turaçli ◽

S.G. Aktan ◽

K. Dürük

Keyword(s):

School Children ◽

Urban Areas ◽

Primary Schools ◽

Screening Program ◽

Primary School Children ◽

Refractive Errors ◽

Normal Visual Acuity ◽

Good State ◽

State Schools ◽

Average State

Ophthalmic screening was done on 23,810 children visited at schools in different regions of Ankara. Children with below normal visual acuity were invited to the outpatient department and had a full routine ocular examination. Thirty-nine nursery and primary schools were selected, ten of them private, eleven average state schools, seven good state schools and eleven village schools. Among the 23,810 children, 3095 (13%) had various pathology; 1516 were girls, 1579 boys. Refractive errors were found in 85% of the children (2630). This equals 11% of the total screened population. Refractive errors were myopia 32%, hypermetropia 21%, astigmatism 47%. Strabismic children were 2.5%, and amblyopia was found in 1.1%. The purpose of the study was to assess the place of an ocular screening program in primary school children and to discuss the differences encountered in different urban areas.

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Prevalence and causes of visual impairment and blindness among school children in Muzaffarabad, Pakistan

International Journal of Scientific Reports ◽

10.18203/issn.2454-2156.intjscirep20181393 ◽

2018 ◽

Vol 4 (4) ◽

pp. 93

Author(s):

Abdul Rauf Awan ◽

Junaid Jamshed ◽

Muhammad Mushtaq Khan ◽

Zahid Latif

Keyword(s):

Visual Acuity ◽

Public Schools ◽

Visual Impairment ◽

Private Schools ◽

School Children ◽

School Health ◽

Vision Loss ◽

Screening Program ◽

Sampling Technique ◽

Cross Sectional

Background: Vision loss in childhood has serious implications in all stages of child’s growth and development. It poses social, educational and occupational challenges, with affected children being at greater risk of developing behavioral, psychological and emotional problems, lower self-esteem and poorer social integration. The aim of this study was to assess the prevalence and identify the causes of visual impairment and blindness in school children of UC Gojra, Muzaffarabad, Pakistan so that prevention strategies could be implemented.Methods: This was a school-based descriptive cross-sectional study conducted among public and private schools. A multi-stage stratified random sampling technique was used for selecting study participants aged 5-20 years from 24 schools in Muzaffarabad. The vision of school children was examined for visual acuity using standard Snellen chart. Those participants who had visual acuity of <6/18 in either eye underwent a more detailed ophthalmic examination to diagnose the causes of VI. An exploration of demographic variables was conducted using Chi-square test. Results: The mean age of participants was 10±2.83. The prevalence of visual impairment was 19.6% and 2.3% for severe visual impairment. The age group most affected by VI was 11-15 years (74.2%). There were increased chances of developing VI with advancing age of the participants. Males contributed 88.7% of the cases of VI while females contributed only 11.3%. The class category 5-6 had higher percentage of VI cases (32.7%). Public schools contributed 52.8% of the cases of VI while for private schools the corresponding percentage was 47.2%. The leading cause of VI was refractive error (89.3%) followed by amblyopia (5.0%). Other causes of VI included cataract (1.2%), corneal disease (1.8%), strabismus (1.8%) and nystagmus (0.6%).Conclusions: There is a need to implement school health policy on visual screening prior to admissions in schools and annual eye screening program for early detection and prompt treatment of eye problems among school children in Muzaffarabad.

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Topographically Guided Two-Step LASIK and Standard LASIK in the Correction of Refractive Errors after Penetrating Keratoplasty

European Journal of Ophthalmology ◽

10.1177/112067210901900404 ◽

2009 ◽

Vol 19 (4) ◽

pp. 535-543 ◽

Cited By ~ 4

Author(s):

Leopoldo Spadea ◽

Massimo Saviano ◽

Angela Di Gregorio ◽

Domenico Di Lodovico ◽

Fabio De Sanctis

Keyword(s):

Visual Acuity ◽

Penetrating Keratoplasty ◽

Laser In Situ Keratomileusis ◽

Refractive Errors ◽

Manifest Refraction ◽

Uncorrected Visual Acuity ◽

The Mean ◽

Group 2 ◽

Group 1

Purpose To evaluate in a long-term period the effectiveness and safety of topographically guided two-step laser in situ keratomileusis (LASIK) and standard LASIK technique in the correction of refractive errors after successful penetrating keratoplasty (PKP) for keratoconus. Methods At least 2 years after PKP and 6 months after removal of all sutures, 15 eyes of 15 patients (Group 1; mean manifest refraction spherical equivalent (MRSE) −7.23 D ± 3.42 SD) were submitted to standard LASIK and 15 eyes of 15 patients (Group 2; mean MRSE −4.37 D ± 1.97 SD) to a topographically guided two-step LASIK procedure (first the flap and at least 2 weeks later the laser ablation). In all cases, a superior hinged corneal flap (160 μm/9.5 mm) was created. Results After a follow-up of 36 months, in Group 1 the mean uncorrected visual acuity (UCVA) was 0.51 logarithm of the minimum angle of resolution (logMAR) ± 0.41 SD and the mean best-corrected visual acuity (BCVA) was 0.03 logMAR ± 0.05 SD, with a mean MRSE of −1.57 D ± 2.65 SD. In Group 2, the mean UCVA was 0.28 logMAR ± 0.24 SD and the mean BCVA was 0.01 logMAR ± 0.03 SD, with a mean MRSE of −0.07 D ± 1.00 SD. In both groups, no complications were observed. Conclusions After a long follow-up period, both topographically guided two-step LASIK and standard LASIK could be considered effective and safe tools in the correction of refractive errors after successful PKP for keratoconus.

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Impact of spectacles wear on uncorrected visual acuity among urban migrant primary school children in China: a cluster-randomised clinical trial

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-316213 ◽

2020 ◽

pp. bjophthalmol-2020-316213

Author(s):

Xinwu Zhang ◽

Ming Zhou ◽

Xiaochen Ma ◽

Hongmei Yi ◽

Haiqing Zhang ◽

...

Keyword(s):

Clinical Trial ◽

Visual Acuity ◽

School Children ◽

Randomised Clinical Trial ◽

Primary School Children ◽

Control Group ◽

Cluster Randomised ◽

Uncorrected Visual Acuity ◽

Chinese School ◽

Urban Migrant

ObjectiveTo estimate the effect of providing free spectacles on uncorrected visual acuity (VA) among urban migrant Chinese school children.DesignExploratory analysis from a parallel cluster-randomised clinical trial.MethodsAfter baseline survey and VA screening, eligible children were randomised by school to receive one of the two interventions: free glasses and a teacher incentive (tablet computer if ≥80% of children given glasses were wearing them on un-announced examination) (treatment group) or glasses prescription and letter to parents (control group). The primary outcome was uncorrected logarithm of the minimal angle of resolution (LogMAR) VA at study closeout, adjusted for baseline uncorrected VA.ResultsAmong 4376 randomly selected children, 728 (16.6%, mean age 10.9 years, 51.0% boys) at 94 schools failed VA screening and met eligibility criteria. Of these, 358 children (49.2%) at 47 schools were randomised to treatment and 370 children (50.8%) at 47 schools to control. Among these, 679 children (93.3%) completed follow-up and underwent analysis. Spectacle wear in the treatment and control groups was 68.3% and 29.3% (p<0.001), respectively. Uncorrected final VA for eyes of treatment children was significantly better than control children, adjusting only for baseline VA (difference of 0.039 LogMAR units, 95% CI: 0.008, 0.070, equivalent to 0.39 lines, p=0.014) or baseline VA and other baseline factors (0.040 LogMAR units, 95% CI 0.007 to 0.074, equivalent to 0.40 lines, p=0.020).ConclusionWe found no evidence that spectacles wear worsens children’s uncorrected VA among urban migrant Chinese school children.

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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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Corneal Stromal Opacities Accompanied by Hyperopia and Irregular Astigmatism: Two-Step Technology of the Clinical Rehabilitation

Ophthalmology in Russia ◽

10.18008/1816-5095-2018-2s-197-204 ◽

2018 ◽

Vol 15 (2S) ◽

pp. 197-204

Author(s):

I. A. Mushkova ◽

N. V. Maychuk ◽

R. A. Makarov ◽

G. M. Chernakova

Keyword(s):

Risk Factors ◽

Visual Acuity ◽

Retrospective Analysis ◽

Binocular Vision ◽

High Myopia ◽

Refractive Errors ◽

Color Test ◽

Uncorrected Visual Acuity ◽

Keratorefractive Surgery ◽

Irregular Astigmatism

Purpose: to identify risk factors for the development of asthenopic syndrome (AS) in patients with moderate to high myopia after keratorefractive surgery (KRS).Materials and methods. 122 patients (244 eyes) with medium and high myopia underwent a standard pre-operative examination of patients before KRS. The special methods of examinations were the study of reserves of relative accommodation (RRA) and the volume of absolute accommodation (VAA), and the accomodomography; the vision characteristics was determined on a four-point color test by E.B. Belostotsky, S.Y. Friedman at distances of 5.00 and 0.33 m, fusional reserves — with synoptophor. Patients survey was held with CISS questionnaire to detect the presence of AS.Results: There were no complications after KRS in all cases. Uncorrected visual acuity was the same or higher than maximal corrected before surgery in 1 week after KRS. Patents were divided into 2 groups according to results of CISS survey: 88% — without AS, 12% — with signs of AS. Retrospective analysis of pre-operative data of the patients with AS has shown that a combination of an absence of binocular vision with a pronounced decrease in fusion reserves, reserves of relative accommodation and volume of absolute accommodation is prognostically unfavorable factors in patients with myopia.Conclusion: All patients with moderate and high myopia have the refractive errors, there is no binocular vision in 12.3% patients. More significant errors of accommodation and binocular function were registered in patients with postoperative AS vs. patients without AS. Low fusion reserves and absence of binocular vision don’t allow to adopt for KRS results. This group of patients should be separated for pre-operative functional preparation.

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School-based epidemiology study of myopia in Tianjin, China

International Ophthalmology ◽

10.1007/s10792-020-01400-w ◽

2020 ◽

Vol 40 (9) ◽

pp. 2213-2222

Author(s):

Jiaxing Wang ◽

Ying Li ◽

Zhenyang Zhao ◽

Nan Wei ◽

Xiaoli Qi ◽

...

Keyword(s):

Visual Acuity ◽

Age Groups ◽

Dependent Manner ◽

Optimal Cutoff ◽

School Aged Children ◽

School Based ◽

Uncorrected Visual Acuity ◽

Spherical Equivalent Refraction ◽

Age Dependent ◽

The Relationship

Abstract Purpose To study the epidemiology of myopia in school-aged children in Tianjin and the relationship between visual acuity-based screening and refraction-based screening. Method This school-based prospective cohort study was performed on children from 42 elementary schools and 17 middle schools in Tianjin, China. Totally 14,551 children, ages ranging from 5 to 16 years, were included in this study. Uncorrected visual acuity (UCVA) was determined by logarithmic tumbling E chart. Non-cycloplegic photorefraction was examined by the Spot (v2.1.4) photoscreener. The relationship between the UCVA and refractive error was investigated for different age groups. Results The overall prevalence of myopia at this school based screen is 78.2%, ranged from 10% at age of 5 to 95% at age of 16. The most dramatic increase in prevalence is from age of 6 (14.8%) to age of 7 (38.5%). The overall prevalence of high myopia is 2.5%. UCVA is found corresponding to spherical equivalent refraction (SER) in a manner of normal distribution and is significantly affected by age. When using UCVA to estimate the prevalence of myopia, the overall sensitivity and specificity are 0.824 and 0.820, respectively. Age-dependent optimal cutoff points and 95% confident intervals of such estimation are reported. Conclusions Myopia is heavily affecting school-aged children in Tianjin, China. The refraction screening is preferable for myopia screening, whereas the UCVA screening results need to be interpreted in an age-dependent manner for myopia estimation.

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