Prevalence of visual impairment in school-going children among the rural and urban setups in the Udupi district of Karnataka, India: A cross-sectional study

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Abstract

AIM:

The aim of this study is to estimate the prevalence of visual impairment among school-going children in Udupi district, Karnataka.

MATERIALS AND METHODS:

A cross-sectional study across eleven schools from both urban and rural parts of Udupi taluk was conducted to report the magnitude of visual impairment among the schoolchildren. Complex survey design was used in allocating the sample size through stratification and clustering. Totally 1784 schoolchildren between the age groups of 5 and 15 years participated in the study. Presenting visual acuity and objective refraction was measured using computerized logMAR acuity charts and Plusoptix A09 photorefractor, respectively. Manifest ocular deviation or squint was also recorded.

RESULTS:

The mean age of the students was found to be 10.62 ± 2.72 years. The prevalence of visual impairment, i.e., visual acuity worse than or equal to 20/40 in the better eye was found to be 4.32% (95% confidence interval: 3.38%, 5.26%). The prevalence rate was significantly higher among students from urban area (5.6%) compared to those from rural area (3.6%) ( P = 0.011).

CONCLUSION:

Visual impairment was found to be 4.32% in the school-going population of Udupi district. Effective and user-friendly devices aided the visual deficit screening including refractive error and squint.

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Most cited references 21

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Refractive error in children in an urban population in New Delhi.

L Sanga, Damodar Bachani, Neha A Gupta … (2002)

To assess the prevalence of refractive error and related visual impairment in school-aged children in an urban population in New Delhi, India. Random selection of geographically defined clusters was used to identify a sample of children 5 to 15 years of age. From December 2000 through March 2001, children in 22 selected clusters were enumerated through a door-to-door survey and examined at a local facility. The examination included visual acuity measurements, ocular motility evaluation, retinoscopy and autorefraction under cycloplegia, and examination of the anterior segment, media, and fundus. Myopia was defined as spherical equivalent refractive error of at least -0.50 D and hyperopia as +2.00 D or more. Children with reduced vision and a sample of those with normal vision underwent independent replicate examinations for quality assurance in four of the clusters. A total of 7008 children from 3426 households were enumerated, and 6447 (92.0%) examined. The prevalence of uncorrected, baseline (presenting), and best corrected visual acuity of 20/40 or worse in the better eye was 6.4%, 4.9%, and 0.81%, respectively. Refractive error was the cause in 81.7% of eyes with vision impairment, amblyopia in 4.4%, retinal disorders in 4.7%, other causes in 3.3%, and unexplained causes in the remaining 5.9%. There was an age-related shift in refractive error from hyperopia in young children (15.6% in 5-year-olds) toward myopia in older children (10.8% in 15-year-olds). Overall, hyperopia was present in 7.7% of children and myopia in 7.4%. Hyperopia was associated with female gender. Myopia was more common in children of fathers with higher levels of education. Reduced vision because of uncorrected refractive error is a major public health problem in urban school-aged children in India. Cost-effective strategies are needed to eliminate this easily treated cause of vision impairment.

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Refractive error in children in a rural population in India.

Lalit Dandona, Shyam M. Srinivas, Saggam Narsaiah … (2002)

To assess the prevalence of refractive error and related visual impairment in school-aged children in the rural population of the Mahabubnagar district in the southern Indian state of Andhra Pradesh. Random selection of village-based clusters was used to identify a sample of children 7 to 15 years of age. From April 2000 through February 2001, children in the 25 selected clusters were enumerated in a door-to-door survey and examined at a rural eye center in the district. The examination included visual acuity measurements, ocular motility evaluation, retinoscopy and autorefraction under cycloplegia, and examination of the anterior segment, media, and fundus. Myopia was defined as spherical equivalent refractive error of at least -0.50 D and hyperopia as +2.00 D or more. Children with reduced vision and a sample of those with normal vision underwent independent replicate examinations for quality assurance in seven clusters. A total of 4414 children from 4876 households was enumerated, and 4074 (92.3%) were examined. The prevalence of uncorrected, baseline (presenting), and best corrected visual acuity of 20/40 or worse in the better eye was 2.7%, 2.6%, and 0.78%, respectively. Refractive error was the cause in 61% of eyes with vision impairment, amblyopia in 12%, other causes in 15%, and unexplained causes in the remaining 13%. A gradual shift toward less-positive values of refractive error occurred with increasing age in both boys and girls. Myopia in one or both eyes was present in 4.1% of the children. Myopia risk was associated with female gender and having a father with a higher level of schooling. Higher risk of myopia in children of older age was of borderline statistical significance (P = 0.069). Hyperopia in at least one eye was present in 0.8% of children, with no significant predictors. Refractive error was the main cause of visual impairment in children aged between 7 and 15 years in rural India. There was a benefit of spectacles in 70% of those who had visual acuity of 20/40 or worse in the better eye at baseline examination. Because visual impairment can have a significant impact on a child's life in terms of education and development, it is important that effective strategies be developed to eliminate this easily treated cause of visual impairment.

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Prevalence of Uncorrected Refractive Error and Other Eye Problems Among Urban and Rural School Children

Amruta Padhye, Rajiv Khandekar, Sheetal Dharmadhikari … (2009)

Background: Uncorrected refractive error is an avoidable cause of visual impairment. Aim: To compare the magnitude and determinants of uncorrected refractive error, such as age, sex, family history of refractive error and use of spectacles among school children 6-15 years old in urban and rural Maharashtra, India. Study Design: This was a review of school-based vision screening conducted in 2004-2005. Materials and Methods: Optometrists assessed visual acuity, amblyopia and strabismus in rural children. Teachers assessed visual acuity and then optometrists confirmed their findings in urban schools. Ophthalmologists screened for ocular pathology. Data of uncorrected refractive error, amblyopia, strabismus and blinding eye diseases was analyzed to compare the prevalence and risk factors among children of rural and urban areas. Results: We examined 5,021 children of 8 urban clusters and 7,401 children of 28 rural clusters. The cluster-weighted prevalence of uncorrected refractive error in urban and rural children was 5.46% (95% CI, 5.44-5.48) and 2.63% (95% CI, 2.62-2.64), respectively. The prevalence of myopia, hypermetropia and astigmatism in urban children was 3.16%, 1.06% and 0.16%, respectively. In rural children, the prevalence of myopia, hypermetropia and astigmatism was 1.45%, 0.39% and 0.21%, respectively. The prevalence of amblyopia was 0.8% in urban and 0.2% in rural children. Thirteen to 15 years old children attending urban schools were most likely to have uncorrected myopia. Conclusion: The prevalence of uncorrected refractive error, especially myopia, was higher in urban children. Causes of higher prevalence and barriers to refractive error correction services should be identified and addressed. Eye screening of school children is recommended. However, the approach used may be different for urban and rural school children.

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Author and article information

Journal

Journal ID (nlm-ta): Oman J Ophthalmol

Journal ID (iso-abbrev): Oman J Ophthalmol

Journal ID (publisher-id): OJO

Title: Oman Journal of Ophthalmology

Publisher: Wolters Kluwer - Medknow (India )

ISSN (Print): 0974-620X

ISSN (Electronic): 0974-7842

Publication date Collection: Sep-Dec 2019

Publication date (Electronic): 11 October 2019

Volume: 12

Issue: 3

Pages: 145-149

Affiliations

[1] Department of Optometry, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education, Manipal, Karnataka, India

[1 ] Department of Public Health, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India

[2 ] Department of Community Medicine, Melaka-Manipal Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India

Author notes

Address for correspondence: Dr. Ramesh S. Ve, Department of Optometry, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal - 576 104, Karnataka, India. E-mail: ramesh.sve@ 123456manipal.edu

Article

Publisher ID: OJO-12-145

DOI: 10.4103/ojo.OJO_190_2018

PMC ID: 6826605

PubMed ID: 31902987

SO-VID: 8fa0a586-3b0e-470c-96f0-a8ef6492f042

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This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Prevalence of visual impairment in school-going children among the rural and urban setups in the Udupi district of Karnataka, India: A cross-sectional study

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MATERIALS AND METHODS:

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Clinical Virtual Research Center Journal of Ophthalmology

Most cited references 21

Refractive error in children in an urban population in New Delhi.

Refractive error in children in a rural population in India.

Prevalence of Uncorrected Refractive Error and Other Eye Problems Among Urban and Rural School Children

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