Prevalence of Refractive Errors in School Children

Prevalence of deflective Errors in School ChildrenIntroduction Uncorrected flaws of bendings have become integrity of the major important public health tasks worldwide nowadays. They hold shortsightedness , hyperopia and astigmatism . Myopia (nearsightedness)is an ocular disorder in which the optical power of the tenderness is very strong for the corresponding axis. (1) It represents a major health problem among groom children and it is reported that thither atomic number 18 some 80 jillions myopic child in the world.(2) It has two groups simple shortsightedness or non pathogenic ( 6 diopters ) that is progressive and presents at early childhood. (3) presbyopia or ( farsightedness) is categorized by the degree of refractive illusion into offset hyperopia is +2.00D or less, Moderate hyperopia ranges from +2.25 to +5.00D, and High hyperopia is +5.25D or more than than barely rarely reach +8 D. (4) Astigmatism is a condition that may affect both farsighted and nearsighted citizenry . It is due to corneal or lenticular irregularities that cause blurring of hatful. Mild and manipulate astigmatism have the range of ( 1 to 2 D ) , loathsome astigmatism ( 2-3 D) , while the extreme astigmatism reach 3 D . About 5-15% of children are considered to have refractive errors ( world health organisation WHO ,2001) .In 2002 , 161 million people sphericly have been reported to be opthalmicly impaired due to contrastive eye diseases as cataract , trachoma and onchocerciasis ( exclusively errors of refractions as a cause was not included in such statistics) (WHO 2002 ). But since then , the WHO and the International Agency for the Prevention of Blindness(IAPB), both independently and with them the global initiative ,VISION 2020 The Right to Sight, have worked very hard to include uncorrected errors of refractions in such statistics due to their great importance in optic impairment occurrence. So on October 12, 2006 , the WHO has revealed th e magnitude of visually impaired people due to uncorrected errors of refraction to be 153 millions either unsighted or of low vision , with at least 13 million children (aged 515 years) (5,6)Blindness is defined in terms of visual acuity (VA) as 3/60 in the better eyesight eye and low vision as VA between 6/18 to 3/60 in the better seeing eye , but all on the base of the presenting visual acuity rather than the trump corrected visual acuity . And so, uncorrected errors of refractions become the second important cause of preventable blindness ( 18%) after the cataract (39%). (7,8). Uncorrected refractive errors are major problem in educate children. Lead to un fit(p)ness to read what is compose on chalkboard which greatly affect a childs learning process.19.It has serious social operation on the child in school. Continuous blaming of the child as being faineant and stupid is very frequent by non-responsible teachers. schoolmates tease the child. These factors may choose to d ecrease the childs performance leading to recurrent school failure. A mull formed in Brazil showed the great touch of refractive errors on the childs education. About 10% of these children at high probability of dropping out of school. 11 Non-compliant Children who dont bring out spectacles had an average academic score lesser than compliant beers . But, there could be confounders for this like IQ.17the preponderance of visual impairment from uncorrected refractive errors in some regions appears to be higher in urban areas than in folksy areas, despite the presence of better health services. This may be due to a high incidence of myopia in these populations because of come in relation between increased access to education and myopia.12 The lack of exhibit, and the accessibility and affordability of refractive corrections are the most important. 12,13Many factors that contribute for refractive errors remaining uncorrected like lack of awareness and recognition of the problem at personal and family level and community level, equipment for diagnosis and treatment of errors of refraction are not available (WHO, 1993). In the age group 515 years, non-correction of refractive errors is due to several factors like absence of screening program. However, cultural barriers and believes can play a role, as shown in studies from where justify and easy routine screening program and aids to correct errors of refraction are present. 12,13 Poor access to refractive services in arcadian children, despite the fact that refractive errors are less common amongst rural children.14,15 cosmetic factors like that the spectacles make the face look more nerdy, which may be more acceptable to girls and boys are more flat for activities and sports in rural areas.13 A Tanzanian study showed that spectacles provided discontinue of cost under insurance coverage, were used less as compared to those the forbearing pay for them.18 The age factor showing controversial power on com pliance of spectacles wear, increasing the age has minor negative effect in a study from Mexico, while it shows a positive effect in a study from rural china.16, 17 less educated parents is a contributing factor for non-compliance of spectacle wear. Fathers education has more prominent effect than set outs educational level. This may be due to that educated women ever have equal or more educated husbands.Children from larger villages were more non-compliant than those from smaller villages. Cosmetics is not an important issue in small villages.19 Non-availability of assorted types, shapes, colors, and sizes of spectacles is another cause. only one size spectacles that fit all ages is considered unfashionable. Small refractive errors (20Many studies have been conducted in different parts of the world using the same protocol . The latest global estimate of prevalence of visually impaired children ( 5-15) due to refractive errors was 0.97% with higher prevalence in china and urban a reas of south east Asia (9) a couple of(prenominal) studies were also conducted in Egypt , but one of largest studies conducted in Cairo , the expectant of Egypt, using a large sample (6000) children from different governorates and socioeconomic classes has revealed the prevalence of refractive errors (VA = or So the objective of our study is to measure the prevalence of refractive errors among schoolchildren from (5 to 18 years ) at El-Demerdash hospital .Subjects MethodsA cross-sectional descriptive study is to be conducted where participants are selected from patients attending the Ophthalmology Department, at El Demerdash Hospital, with a total of 500 children 250 boys and 250 girls. Age group ranges from 5-18 years and the study will take place in the period from February 2014 till July 2014. each(prenominal) participating child will have his/her personal details save on a form, and will undergo a standard ophthalmological testing including Visual Acuity (VA) with/without glasses, cycloplegic retinoscopy, cycloplegic autorefraction, external eye and fundus examination with all the results recorded. divagation will be done using retinoscopy after 1% cyclopentolate eye drops instilled in the eyes at least half an hour earlier to the examination. Only children who have a VA of less than 6/6 in at least one eye will undergo retinoscopy. inclusion body criteria Any child at the school age of 5-18 years, attending the Ophthalmology Department, at El Demerdash hospital as inpatients, whose parents will sign a written advised bear forum.Exclusion criteria Children who are unwilling to undergo the examination, although an informed consent is signed by their parents. Children with co-morbidities or other illness, or children victorious any drugs that might have ocular side effects.Sampling method used is the convenience (purposeful) method, sample size of 500 patients with a ingest frame from the patients records are to be obtained at the start of the study. Data abbreviation Data will be entered into a computerized database-using the CDC-WHO package EPI-INFO, and results of analysis are presented in the form of tables.Ethical considerations The study protocol is approved by the ethical committee at Ain Shams University. Written informed consent are taken from parents or legal guardians as a pre prerequisite for inclusionReferences 1-The National Eye Institue, The National Institute ofHealth.http//www.nei.nih.gov/healthyeyes/myopia.asp May 2010 .3-Friedman NJ, Kaiser PK. Essentials of Ophthalmology. Philadelphia, PA Elsevier Inc 2007253-254.4-Moore BD, Augsburger AR, Ciner EB, Cockrell DA, Fern KD, Harb E. Optometric clinical Practice Guideline Care of the Patient with Hyperopia. St. Louis, MO American Optometric draw 19971-29.5-World Health Organization. Sight test and glasses could dramatically improve the lives of cl million people with poor vision.Press release, 11 October 2006. http//www.who.int/mediacentre/news/releases/ HYPERLINK http//www.who.int/mediacentre/news/releases/2006/pr55/en/index.html2006HYPERLINK http//www.who.int/mediacentre/news/releases/2006/pr55/en/index.html/prHYPERLINK http//www.who.int/mediacentre/news/releases/2006/pr55/en/index.html55HYPERLINK http//www.who.int/mediacentre/news/releases/2006/pr55/en/index.html/en/index.html.6-Resnikoff S et al. Global data on visual impairment in the year 2002. Bulletin of the World Health Organization7- Dandona R, Dandona L. Refractive error blindness. Bull World Health Organ. 200179(3)237243.8-World Health Organization. International Statistical categorization of Diseases and Related Health Problems. 10th Revision, 2nd Ed. Geneva,World Health Organization 2005.9.Zhao, J., Mao, J., Luo, R., Li, F., Pokharel, G. P., Ellwein, L. B. (2004). truth of noncycloplegicautorefraction in school-age children in China. Optometry and Vision Science, 81, 49-55.http//dx.doi.org/HYPERLINK http//dx.doi.org/10.1097/00006324-200401000-0001010HYPERLINK http// dx.doi.org/10.1097/00006324-200401000-00010.HYPERLINK http//dx.doi.org/10.1097/00006324-200401000-000101097HYPERLINK http//dx.doi.org/10.1097/00006324-200401000-00010/HYPERLINK http//dx.doi.org/10.1097/00006324-200401000-0001000006324HYPERLINK http//dx.doi.org/10.1097/00006324-200401000-00010HYPERLINK http//dx.doi.org/10.1097/00006324-200401000-00010200401000HYPERLINK http//dx.doi.org/10.1097/00006324-200401000-00010HYPERLINK http//dx.doi.org/10.1097/00006324-200401000-000100001010. Negrel AD, Maul E, Pokharel GP, Zhao J, Ellwein LB. Refractive errorstudy in children try and measurement methods for amulticountry survey. Am J Ophthalmol. 2000129(4)421426.11. Gomes-Neto J, Hanushek E, Leite R, Frota-Bezzera R. Health and schooling evidence and indemnity implications for developing countries. Econ Edu Rev. 199716(3)271282.12.Khandekar, R., Mohammed, A. J., Al Raisi, A. (2002). The compliance of spectacle wear and its determinants among school children of Dhakhiliya region of the Sul tanate of Oman. A descriptive study. Sultan Qaboos University Journal for Scientific Research Medical Sciences, 4, 39-42.13.Preslan, M. W., Novak, A. (1998). Baltimore vision screening project. Phase 2 Ophthalmology, 105, cl-3.14.Dandona R, Dandona L, Srinivas M, Sahare P, Narsaiah S, Muoz SR, et al. Refractive error in children in a rural population in India.Invest Ophthalm Visc sci.20024362331.PubMed15.Murthy GVS, Gupta SK, Ellwein LB, Muoz SR, Pokharel GP, Sanga L, et al. Refractive error in children in an urban population in New Delhi.Invest Ophthalm Visc Sci.20024361522.16.Congdon N, Zheng M, Sharma A, Choi K, Song Y, Zhang M, et al. Prevalence and determinants of spectacle non-wear among rural Chinese secondary school children. The Xichang pediatric Refractive Error Study Report 3.Arch Ophthalmol.2008126171723.PubMed17.Castanon Holguin AM, Congdon N, Patel N, Esteso P, Toledo Flores S, et al. Factors associated with spectacle-wear compliance in school-aged Mexican Children. Invest Ophthalmol Vis Sci.2006479258.PubMed18.Esteso P, Castanon A, Toledo S, Rito MA, Ervin A, Wojciechowski R, et al. Correction of moderate myopia is associated with improvement in self-reported visual functioning among Mexican school-aged children.Invest Ophthalmol Vis Sci.200748494954.PubMed19.Preslan MN, Novak A. Baltimore vision screening project.Phase 2.Ophthalmology.19981051503.PubMed20.Congdon NG, Patel N, Esteso P, Williams C, Wolke D. The association between refractive cutoffs for spectacle provision and visual improvement among school aged children in south Africa.Br J Ophthalmol.200892138.PubMed