Refraction in the Pediatric Eye Examination

2022 ◽  
pp. 126-154
Author(s):  
Marilyn Vricella
Keyword(s):  
Refractive Error ◽  
Accurate Determination ◽  
Refractive Errors ◽  
Academic Problems ◽  
Advantages And Disadvantages ◽  
Common Causes ◽  
Eye Examination ◽  
Critical Components ◽  
Uncorrected Refractive Error

Accurate determination of refractive error is one of the most critical components of a pediatric eye examination. According to the National Eye Institute, refractive errors are the most common causes of correctable reduced vision in children. Children with uncorrected refractive error are more likely to have developmental delays, visual-related academic problems, and poor social skills or interactions. In addition to difficulty seeing, uncorrected refractive errors can contribute to developmental deficits of accommodation, binocular vision, and certain forms of strabismus, amblyopia, and perceptual function. The author provides the clinician an in-depth guide on how to determine the refractive error in pediatric patients. The chapter focuses on the specific techniques, advantages and disadvantages, equipment required, and step-by-step procedures for performing retinoscopy, objective refraction, and subjective refraction on children.

The prevalence and causes of visual impairment in Dariyah, a rural community in Saudi Arabia

2021 ◽  
Vol 80 (1) ◽  
Author(s):  
Waleed Alghamdi ◽  
Godwin O. Ovenseri-Ogbomo
Keyword(s):  
Saudi Arabia ◽  
Visual Impairment ◽  
Rural Community ◽  
Refractive Error ◽  
Population Based ◽  
Vision Impairment ◽  
Health Examination ◽  
Refractive Errors ◽  
Cross Sectional ◽  
Eye Examination

Background: Visual impairment is disproportionately distributed between rural and urban dwellers. Rural dwellers have limited access to the eye care services that are available in urban cities.Aim: The aim of this study was to determine the prevalence and causes of visual impairment in Dariyah, a rural community in the Qassim region, Saudi Arabia.Setting: This research comprised a population-based assessment of the vision and visual status of the inhabitants of Dariyah community.Methods: A cross-sectional descriptive study was conducted amongst the inhabitants of the community of Dariyah. A comprehensive eye examination consisting of visual acuity, ocular health examination, objective and subjective refraction was performed. The examinations were conducted by registered ophthalmologists and optometrists from the Qassim University. Vision impairments were categorised according to the International Classification of Diseases (ICD), Section 9D90, ‘Vision impairment including blindness’ (2018).Results: In all, 68 (24.5%) participants had vision impairment (using the better-seeing eye), with refractive errors being the main cause of vision impairment. Other causes of vision impairment included cataract (20, 7.2%), trichiasis (5, 1.8%) and glaucoma (2, 0.7%). Refractive errors were present in 193 (69.7%), with astigmatism being the commonest refractive error. About 60% of those with refractive errors presented without spectacles for correction, and 20% reported that they had never had an eye examination. Refractive errors could not be determined in 19 (6.9%) of the subjects because of conditions such as matured cataract and other ocular abnormalities.Conclusion: Uncorrected refractive error was found to be the leading cause of vision impairment in this rural community in Saudi Arabia.

scholarly journals PARENTS’ AWARENESS AND PERCEPTION OF CHILDREN’S REFRACTIVE ERROR. A QUALITATIVE STUDY

2020 ◽  
Vol 20 (3) ◽  
pp. 85-91
Author(s):  
Noof Ali Salim Al Ghailani ◽  
Babu Noushad ◽  
Faraz Khurshid ◽  
Galal Mohamed Ismail
Keyword(s):  
Qualitative Study ◽  
Health Belief Model ◽  
Refractive Error ◽  
Care Center ◽  
Health Belief ◽  
Refractive Errors ◽  
Structured Interviews ◽  
Eye Care ◽  
Belief Model ◽  
Uncorrected Refractive Error

Uncorrected refractive error is the leading cause of moderate and severe visual impairment across the globe. An important driver for early detection and management of refractive errors among children is appropriate parental awareness. This study aims to understand the awareness and perception among parents of children with refractive errors utilizing the conceptual framework of Health Belief Model. This qualitative study focused to conduct semi-structured interviews of parents who sought eye care for their children. Thirty-five parents who visited an eye care center for refractive error correction of their children between 5 to 15 years of age were purposively selected. The four constructs of the Health Belief Model (perceived susceptibility, perceived severity, perceived benefits and perceived barriers) were applied to prepare the interview guide. The voice records of participants were transcribed verbatim, coded and qualitatively analyzed to generate relevant themes. All participants were well aware of refractive errors and the implications of them on the visual and social development of children if they leave the errors untreated. However,there were varying perception about refractive error leading to serious consequences. The enanced quality of life with proper refractive correction prompted parents to seek timely eyecare for their children.   

scholarly journals Evaluation of Refractive Errors in Children

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 2249-2253
Author(s):  
Krithiga M ◽  
Xavier Jayaseelan C
Keyword(s):  
Refractive Error ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Common Type ◽  
Refractive Errors ◽  
Sectional Study ◽  
Cross Sectional ◽  
Medical College ◽  
Different Types ◽  
Eye Examination

The purpose of this study is to estimate the prevalence of refractive errors in children. Children of selected ages will be identified for visual acuity measurement, and primary eye examination will be performed. A cross-sectional study was conducted to evaluate the refractive errors in children in Saveetha medical college. A comprehensive eye examination was performed, and children with different types of refractive errors were found out. A total of 100 children were taken for the study. The sample size of the study is 100. Eye examination was performed, and refractive error was evaluated. The refractive errors that are most common in the affected age groups can be found out. The most common refractive error was found to be myopia, followed by hypermetropia and then astigmatism. This study helps to identify the most common type of error, and the causes can be found out. This is also helpful in the prevention of these errors. Early diagnosis will lead to proper and effective treatment. When these errors are left untreated, it can cause other severe effects in the eye. Awareness should be created among both the children and the parents about this problem, and the importance of regular eye examination can be stressed through this study.

scholarly journals Socio-economic differences in accessing NHS spectacles amongst children with differing refractive errors living in Scotland

Eye ◽  
2021 ◽  
Author(s):  
Stephanie Kearney ◽  
Niall C. Strang ◽  
Jim Lewsey ◽  
Augusto Azuara-Blanco ◽  
Sven Jonuscheit
Keyword(s):  
Refractive Error ◽  
Rural Areas ◽  
Reference Group ◽  
Information Services ◽  
Eye Disease ◽  
Refractive Errors ◽  
Factors Associated ◽  
Eye Examination ◽  
The Cost ◽  
Index Of Multiple Deprivation

Abstract Background/objectives Adults living in more deprived areas are less likely to attend an eye examination, resulting in greater visual impairment from undiagnosed eye disease and a widening of health inequalities. It is unknown if the introduction of free NHS eye examinations and help with spectacle costs has benefited children in Scotland. This study aimed to explore factors associated with accessing NHS spectacles including level of deprivation, refractive error, urbanity and age. Subjects/methods NHS-financed General Ophthalmic Services (GOS) 3 supplement the cost of spectacles for children under 16 years. Administrative data on the spectacle refraction dispensed were obtained from Information Services Division (ISD) for mainland Scotland, 2018, and categorised by: Emmetropes/low hyperopes (reference group), myopes and moderate/high hyperopes. Data were linked to the Scottish Index of Multiple Deprivation (SIMD) quintile. Results Data included 108, 043 GOS 3 claims. Greater deprivation was associated with greater GOS 3 claims p = 0.041. This was most evident in emmetropic/low hyperopic children and in moderate/high hyperopic children. GOS 3 claims in the myopes group increased with age across all SIMD and decreased with age in the moderate/high hyperope group (all p < 0.001). GOS 3 claims were not associated with urbanity for all Health Boards (p = 0.13). Conclusions Children in areas of greater deprivation and in more rural areas are not disadvantaged in accessing NHS spectacles. This did not vary by refractive error group. This suggests that health policy in Scotland is accessible to those from all deprivation levels and refractive errors.

scholarly journals Refractive Errors and Strabismus In Patients with Orofacial Clefts

2021 ◽  
Author(s):  
Camille Catarina Artuso ◽  
Ana Kelly Fernandes ◽  
Luisa Moreira Hopker ◽  
Ricardo Mokross Fernandes ◽  
Renato da Silva Freitas ◽  
...  
Keyword(s):  
Refractive Error ◽  
Medical Records ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Refractive Errors ◽  
Orofacial Clefts ◽  
Significant Difference ◽  
Eye Examination ◽  
The Mean ◽  
Isolated Cleft Palate

Abstract Purpose: To evaluate the prevalence of refractive errors and strabismus in patients with orofacial clefts. Methods: This retrospective study analyzed the medical records of 54 patients with orofacial clefts between August 2018 and March 2020. A complete eye examination was performed, including visual acuity assessment on a logMAR scale, anterior biomicroscopy, cycloplegic refraction, eye motility examination, and indirect ophthalmoscopy. Results: The mean age of the patients at presentation was 9.47 years. Twentythree (42.59%) patients had isolated cleft palate (CP), 10 (18.52%) had cleft lip (CL), and 21 (38.89%) had cleft lip and palate (CLP). The mean spherical equivalent was 1.30D (±1.56) in CL, 0.32D (±2.24) in CLP, and 0.62D (±3.76) in CP. The prevalence of refractive error, either spherical or cylinder >0.5 was 88%. The most common refractive error was hyperopia (60%), followed by astigmatism (54%) and myopia (16%). Overall, 52.63% of the patients were prescribed glasses. No statistically significant difference was observed between the groups with respect to the need for prescription of glasses (p=0.6753). There were 15 patients with some type of strabismus, and other ophthalmological changes were observed in 13 patients. Conclusion: In this population with orofacial clefts, the prevalence of refractive errors and strabismus was 88% and 22%, respectively.

scholarly journals Prevalence of Refractive Error and Need for Corrective Lenses in Medically Underserved Residents of Tijuana, Mexico

2019 ◽  
Author(s):  
John L. Ubels ◽  
Jonathan M. Ismond ◽  
Micah A. Timmermans ◽  
Arlene J. Hoogewerf
Keyword(s):  
Visual Acuity ◽  
Refractive Error ◽  
Access To Health Care ◽  
Refractive Errors ◽  
Eye Care ◽  
Source Program ◽  
Reading Glasses ◽  
Clinically Significant ◽  
Eye Exams ◽  
Uncorrected Refractive Error

AbstractPurposeThe population of Tijuana, Mexico is growing rapidly, with a current official population estimate of 1.7 million. Nearly 80,000 people migrate to Tijuana each year, resulting in the rise of neighborhoods with substandard housing, lack of services and inadequate access to health care, including eye care. This study describes refractive errors and the need for corrective lenses among participants attending free clinics in these neighborhoods where they received free eye exams and glasses during January 2016. Methods: This is a retrospective observational chart review of de-identified data collected from intake forms that were filled out for each participant at the clinics. Subjects were self-selected in response to announcements in the neighborhoods where clinics were conducted. Subjects with presenting uncorrected visual acuity 20/30 OU or worse were examined with an autorefractor to measure spherical refractive error. Either prescription or reading glasses were then distributed to participants who had refractive errors. Epi Info, an open source program provided by the CDC, was used to analyze demographic, visual acuity and refractive error data. Results: Presenting visual acuity was evaluated in 1209 people. Of these patients, 70% had a visual acuity of 20/30 or worse. Only 23% of these patients had glasses. Among the patients who were given refractions, 13% had clinically significant myopia (−0.75 D or worse in at least one eye). In participants 20 years old and younger, only 8% had clinically significant myopia. Clinically significant hyperopia (+0.75 D or worse in at least one eye) was detected in 25% of participants. Astigmatism (−1.5 D or worse in at least one eye) was present in 18% of participants. Prescription glasses were given to 542 participants and 396 of these people received their first glasses. Reading glasses were given to 386 people. Among students only 15% presented at the clinics with glasses, while it was determined that 56% of student participants needed glasses. Conclusion: The high levels of uncorrected refractive error in this study suggest limited access to affordable eye care in neighborhoods where clinics were conducted. Prevalence of myopia among adolescents and young adults is increasing in many parts of the world. In contrast, a relatively high prevalence of hyperopia was observed in this age group in Tijuana. The data demonstrate an urgent need for eye care and correction of refractive error in the study group.

scholarly journals Uncorrected refractive errors, presbyopia and spectacle coverage in Kamuli District, Uganda

2016 ◽  
Vol 75 (1) ◽  
Author(s):  
Naomi Nsubuga ◽  
Prasidh Ramson ◽  
Pirindha Govender ◽  
VingFai Chan ◽  
Mary Wepo ◽  
...  
Keyword(s):  
Refractive Error ◽  
Response Rate ◽  
Rapid Assessment ◽  
Cross Sectional Study ◽  
Refractive Errors ◽  
Sectional Study ◽  
Cross Sectional ◽  
Uncorrected Refractive Error ◽  
Age Range ◽  
Cluster Random Sampling

Background: Successful refractive error programmes arise from evidence that can be collected cost effectively and timely.Aim: To investigate the prevalence of uncorrected refractive error (URE), presbyopia and spectacle coverage in the Kamuli district, Uganda.Setting: The study was conducted in the Kamuli district in Uganda.Methods: The Rapid Assessment of Refractive Error (RARE) study design is a communitybased cross-sectional study using multistage cluster random sampling to gather information on refractive errors and presbyopia. Subjects aged 15 years and older were selected from the population in Kamuli district in Uganda. Vision impairment due to URE at distance and near and barriers to uptake of refractive error services were investigated.Results: Participants, N = 3281 (57.6% male), with an age range of 15–92 years were enumerated and the response rate was 100%. The prevalence of refractive errors was 4.6% (95% confidence interval [CI]: 3.7 – 5.5) and the spectacle coverage was 5.96% (95% CI 1.74% – 10.18%). The prevalence of uncorrected presbyopia was 50.3% (95% CI 47.6% – 53.0%) and the spectacle coverage was 0%. Thirty-three (or 1%) respondents were current spectacle users. One-hundred fourteen people (3.5%) had previously used spectacles; however, 50.9% of them discontinued spectacle use a year before the study because the spectacles were broken or scratched. The major barriers to spectacle uptake were accessibility of services and affordability of spectacles.Conclusion: The prevalence of URE and the barriers to uptake of refractive services will inform the implementation of refractive services in the study area. Key words: Uncorrected refractive errors; presbyopia and spectacle coverage

scholarly journals Prevalence of refractive errors, uncorrected refractive error, and presbyopia in adults in India: A systematic review

2019 ◽  
Vol 67 (5) ◽  
pp. 583 ◽  
Author(s):  
Sethu Sheeladevi ◽  
Bharani Seelam ◽  
PhanindraB Nukella ◽  
RishiR Borah ◽  
Rahul Ali ◽  
...  
Keyword(s):  
Systematic Review ◽  
Refractive Error ◽  
Refractive Errors ◽  
Uncorrected Refractive Error

scholarly journals The distribution of refractive errors among children attending Lumbini Eye Institute, Nepal

1970 ◽  
Vol 4 (1) ◽  
pp. 90-95 ◽  
Author(s):  
S KC Rai ◽  
HB Thapa ◽  
MK Sharma ◽  
K Dhakhwa ◽  
R Karki
Keyword(s):  
Refractive Error ◽  
Rural Areas ◽  
Refractive Errors ◽  
Age Group ◽  
Pediatric Ophthalmology ◽  
Statistical Software ◽  
Childhood Blindness ◽  
Number Of Children ◽  
Urban And Rural Areas ◽  
Uncorrected Refractive Error

Introduction: Uncorrected refractive error is an important cause of childhood blindness and visual impairment. Objective: To describe the patterns of refractive errors among children attending the outpatient clinic at the Department of Pediatric Ophthalmology, Lumbini Eye Institute, Bhairahawa, Nepal. Subjects and methods: Records of 133 children with refractive errors aged 5 - 15 years from both the urban and rural areas of Nepal and the adjacent territory of India attending the hospital between September and November 2010 were examined for patterns of refractive errors. The SPSS statistical software was used to perform data analysis. Results: The commonest type of refractive error among the children was astigmatism (47 %) followed by myopia (34 %) and hyperopia (15 %). The refractive error was more prevalent among children of both the genders of age group 11-15 years as compared to their younger counterparts (RR = 1.22, 95 % CI = 0.66 – 2.25). The refractive error was more common (70 %) in the rural than the urban children (26 %). The rural females had a higher (38 %) prevalence of myopia than urban females (18 %). Among the children with refractive errors, only 57 % were using spectacles at the initial presentation. Conclusions: Astigmatism is the commonest type of refractive error among the children of age 5 - 15 years followed by hypermetropia and myopia. Refractive error remains uncorrected in a significant number of children. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5858 NEPJOPH 2012; 4(1): 90-95

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