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Year : 2015 Month : February Volume : 4 Issue : 18 Page : 3134-3137

PATTERN OF REFRACTIVE ERRORS AMONG SCHOOL CHILDREN IN KURNOOL DISTRICT, ANDHRA PRADESH

G. Narendranath Reddy 1, K. Anjaneyulu2

1. Professor, Department of Ophthalmology, Government Regional Eye Hospital, Kurnool Medical College, Kurnool, Andhra Pradesh.
2. Assistant Professor, Department of Ophthalmology, Government Regional Eye Hospital, Kurnool Medical College, Kurnool, Andhra Pradesh.

CORRESPONDING AUTHOR

Dr. G. Narendranath Reddy,
Email : drgnreddy@rediffmail.com

ABSTRACT

CORRESPONDING AUTHOR:
Dr. G. Narendranath Reddy,
Professor of Ophthalmology,
H. No. 40/448-21 A,
Gipson Colony,
Kurnool-518001,
Andhra Pradesh.
E-mail: drgnreddy@rediffmail.com

ABSTRACT: The school children screened in the Kurnool district. The defective children were identified by the teacher, later examined by the ophthalmic team. Total 79,837 were screened, 42,047 were girls and 37790 were boys. The refractive errors in 1487 children were detected.  Myopia is the commonest refractive error and followed by hyper metropia, compound astigmatism.

KEYWORDS: refractive error, retinoscopy, myopia, hypermetropia, astigmatism, visual acuity.

INTRODUCTION: Visual impairment resulting from uncorrected refractive errors remain a significant public health problem worldwide.1 The significance of refractive error2 as a cause of visual impairment only recently assumed ascendancy following the re-conceptualization of visual impairment (blindness and low vision) using presenting visual acuity rather than best corrected visual acuity.3 Using presenting visual acuity (VA) allows for the estimation of the magnitude of visual impairment due to refractive errors. Blindness4 is defined in terms of visual acuity (VA) as, 3/60 in the better Seeing Eye and low vision as VA between 6/18 to 3/60 in the better Seeing Eye. An estimated 2.3 billion people worldwide have a refractive error and of these, only 1.8 billion have access to an eye examination and affordable refractive correction.5

The majority of the 500 million who do not have access to refractive error services live in developing countries and are mainly children. Undetected and uncorrected refractive errors are a particularly significant problem in school children.6 Poor vision and an inability to read material on the chalkboard due to refractive error can profoundly affect a child’s participation and learning in the classroom.6 It also has serious social implications for the child in school. Teachers who do not realize the plight of the child with respect to his/her visual status may unwittingly scold the child for being lazy and stupid and humiliate him/ her persistently. Unsympathetic schoolmates also taunt the child in the classroom as well as in the playground.7

These factors may combine to make the child drop out of school and be a victim of the attendant social problems associated with school drop-outs.8 Not infrequently, parents and siblings may undermine and discourage these unfortunate children. One report has documented the severe impact of poor vision on primary school children in Brazil. Specifically, the authors found that children with reduced vision had a 10% higher probability of dropping out of school, an 18% higher probability of repeating a grade and scored about 0.2 to 0.3 standard deviations lower on achievement test.9 This study did not, however, indicate whether the poor vision was due to refractive error or not. It does provide a peek into the impact of poor vision on academic achievement.7

To further understand the epidemiology of refractive errors among school children a uniform protocol has been developed.10 Several studies have been conducted in different parts of the world using this protocol.8-12

The latest global estimates of visual impairment suggests that among children aged 5–15 years, 12.8 million were visually impaired due to refractive errors representing a prevalence of 0.97% with higher prevalence reported in China and urban areas of south east Asia.13

PURPOSE: To assess the prevalence of refractive errors and visual impairment in school age children from 10 years to 17 years of age group in Kurnool district, Andhra Pradesh.

METHODS: The study was conducted in school children by using the snellen’s chart, subjective correction, cycloplegic refraction and ophthalmoscopic examination. The defective children identified by the teachers using the E chart keeping at a distance of 6 meters. The defective children examined by the ophthalmic team and prescribed the spectacles.

 

TOTAL No. of CHILDREN SCREENED

BOYS

GIRLS

TOTAL

37,790

42,047

79,837

Table 1: Total number of children screened

 

No. of children with

refractive error

Age wise

No. of children

with refractive error

Percentage

1487

10yrs

02

0.13%

 

11yrs

188

12.6%

 

12yrs

273

18.3%

 

13yrs

354

23.8%

 

14yrs

475

31.9%

 

15yrs

174

11.7%

 

16yrs

10

0.6%

 

17yrs

11

0.7%

Total

 

1487

 

Table  2: Number of  children with refractive error

 

No. of children with refractive errors

BOYS

PERCENTAGE

GIRLS

PERCENTAGE

TOTAL

557

37.5%

930

62.5%

1487

Table 3: Number of children with refractive error among different age group 

 

 

BOYS

PERCENTAGE

GIRLS

PERCENTAGE

 

 

 

 

 

10YRS

-

0%

2

100%

11YRS

87

47%

101

53%

12YRS

102

37%

171

63%

13YRS

127

36%

227

64%

14YRS

201

42%

274

58%

15YRS

67

39%

107

61%

16YRS

6

60%

4

40%

17YRS

4

36%

7

64%

Table 4: Gender wise distribution of refractive error

 

Refractive errors by Power wise

Percentage

-1.00DSPH to -2.00DSPH

1057

71%

-2.25DSPH to -3.00DSPH

95

06%

-3.25DSPH to -4.00DSPH

54

3.6%

-4.25DSPH & Above

226

15.1%

Simple Astigmatism

33

2.2%

Complicated Astigmatism

5

0.33%

Convex Powers +power

5

0.33%

Amblyopia

12

0.8%

Total

1487

 

Table 5: Distribution of refractive errors by power wise

 

RESULTS: Total numbers of school children screened in rural area of Kurnool district, A. P. were 79,837. The refractive error children were 1487 (1.8%), females were 930 (62.5%) and Males 557 (37%).The highest incidence of Myopia in age group of 14 years 475 (31.9%), hyperopia 5 (0.33%) and refractive concave (-) power from 1-00Dsph to 2-00 Dsph were the highest incidence 1057 (71%), amblyopia were 12 (0.8%).

CONCLUSION: Refractive error associated primarily with Myopia is a major cause of reduced vision with particularly high prevalence among school age children.  Eye Health education and screening may help to address the unmet need for refractive correction. To educate the parent is about the eye screening in school going children.

REFERENCES:

1.    Resnikoff S, Pascolini D, Mariotti SP, Pokharel GP. Global magnitude of visual impairment caused by uncorrected refractive errors in 2004. Bull World Health Org. 2008; 86: 63–70.
2.    Refractive Error Study in School children (RESC) Protocols and Manual of Procedures (Unpublished document).
3.    El-Bayoumy BM, Saad A, Choudhury AH. Prevalence of Refractive Error and Low Vision among School Children in Cairo. E Med Health J. 2007; 13(3): 575–579.
4.    WHO. Global Initiative for the Elimination of Avoidable Blindness. Geneva, World Health Organization, 1989 (Unpublished document WHO.PBL/97.61.
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