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 Table of Contents  
DPU: INTERDISCIPLINARY CONFERENCE
Year : 2020  |  Volume : 7  |  Issue : 5  |  Page : 49-52

Visual acuity of school age children in selected schools of pimpri chinchwad metropolitan corporation: A cross sectional study


1 Department of Child Health Nursing, Dr. D. Y. Patil College of Nursing, Pimpri, Maharashtra, India
2 Dr. D. Y. Patil Vidyapeeth, Department of Opthalmology, Dr. D. Y. Patil Medical College and Hospital, Pune, Maharashtra, India

Date of Web Publication26-Feb-2020

Correspondence Address:
Priya Devarajan
Dr. D. Y. Patil College of Nursing, Pune, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdrr.jdrr_55_19

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  Abstract 


Background: Vision plays a vital role in the reading process. Refractive error leading to low vision is undiagnosed for long periods. The World Health Organization has grouped uncorrected refractive error with trachoma, ocular trauma, infectious diseases, and Vitamin A deficiency among the leading causes of blindness and vision impairment. Aims and Objectives: This study aims to assess the visual acuity of school-age children. Methods: We conducted a cross-sectional study, using a stratified random sampling technique with 225 samples. Snellen visual acuity chart was used to check visual acuity. Results: Nearly 83.6% of the school-age children had Grade I visual acuity, 16% of them had Grade II, and 0.4% of them had Grade III visual acuity. Almost 96.4% of the school-age children had Grade II (±−<3) refractive error and 3.6% of the school-age children had Grade I (no refractive error) refractive error. Conclusion: School screening is recommended for early detection and management of visual problem. Students, teachers, and parents must be educated about the early detection of refractive errors and its correction to prevent the progression of visual impairment.

Keywords: Refractive error, school-age children, visual acuity


How to cite this article:
Devarajan P, Maheshgowri R. Visual acuity of school age children in selected schools of pimpri chinchwad metropolitan corporation: A cross sectional study. J Dent Res Rev 2020;7, Suppl S2:49-52

How to cite this URL:
Devarajan P, Maheshgowri R. Visual acuity of school age children in selected schools of pimpri chinchwad metropolitan corporation: A cross sectional study. J Dent Res Rev [serial online] 2020 [cited 2020 Jul 3];7, Suppl S2:49-52. Available from: http://www.jdrr.org/text.asp?2020/7/5/49/278896

Editor: Dr. Sarika Chaturvedi





  Introduction Top


According to the 2010 estimates by the World Health Organization, nearly 285 million (4.24% of the total population) people of all ages worldwide are visually impaired and 39 million are blind. Furthermore, 90% of the world's visually impaired live in developing countries and 21.9% of the world's visually impaired are in India. Almost 18.9 million children under 15 years of age are visually impaired globally.[1],[2] In developing countries, 7%–31% of childhood blindness and visual impairment is avoidable, 10%–58% is treatable, and 3%–28% is preventable.[3]

In a study conducted on the effect of television (TV) watching on the vision of schoolchildren in semi-urban area of Kashmir, a total of 1128 children were examined. The percentage of male children was 42.73 and female children was 57.18. It was observed that children watching TV for <1 h had visual acuity of 6/6 in 42.4%, whereas children watching TV for 1–2 h, 2–3 h, and >3 h had lower visual acuity.[4]

Correction of refractive error and low vision is one of the priorities of global initiatives for Vision 2020. India is committed to reduce this burden of blindness by adopting the strategies advocated for Vision 2020 – The right to sight.[5]

The present study aims to assess the visual acuity of school-age children with the objectives of determining the visual acuity of school-age children and correlating the visual acuity of school-age children and selected demographic variables among the school-age children.


  Methods Top


A cross-sectional study with 225 samples using stratified random sampling technique was done to select the study participants. The researcher enlisted all the schools and then the stratas are assigned with a unique number. The age group of the children was 6–12 years with the inclusion criteria of school-age children who can read English/Marathi. Children who were present during the time of data collection, and exclusion criteria of School age children who were not willing to participate in the study and children from special schools. Approval from the institutional ethical committee was obtained. Written informed consent was taken from parents and assent was taken from children aged above 8 years.

The tool and technique used for the study were as follows: for Section I: demographic details including age, gender, class studying, father's and mother's occupation, and TV-viewing hours and for Section II: pro forma for checking visual acuity and Snellen visual acuity chart.

The final study was conducted from March 2016 to January 2017. Data collection was done on 225 students meeting the criteria for the study. Samples were obtained from H. A School of Pimpri-Chinchwad Municipal Corporation. The objectives of the study were discussed with the principal of the school, and official permission was obtained. Informed consent was obtained from the parents of children participating in the study. They were assured about the confidentiality of the data. Assent was obtained from the children aged above 8 years. The investigator collected demographic details followed by checking the visual acuity of each child with pro forma for checking visual acuity and Snellen visual acuity chart and for each sample. In a well-lighted room, Snellen chart was fixed on a wall at eye level. After interviewing the respondents, visual acuity was tested for far vision with Snellen chart at a distance of 6 m for each student, one at a time. Near vision was tested with Roman test-type chart kept at a distance of 30 cm from the eyes of the participants. One eye was tested first with the other eye covered with an eye shield. After 2 min, the other eye was tested similarly. Any other eye problems were also checked. The investigator took approximately 10–15 min to complete the procedure. Every time, the investigator met around ten samples personally in their school.


  Results and Description Top


Sample characteristics

  • Nearly 57.8% of the school-age children were aged 6–8 years, 20.9% of them were 8–10 years, and 21.3% of them were 10–12 years. Almost 63.6% of the children were female and 36.4% of the children were male
  • Nearly 41.8% of their fathers are in private service, 4.9% of their fathers in government service, 42.2% of them are doing self-business, 7.6% of the fathers are daily wages, 1.3% of them had no father, and 2.2% of their fathers are not working
  • Almost 12.9% of their mothers are in private service, 1.8% of their mothers are in government service, 6.7% of them are doing self-business, 13.3% of them are daily wages, and 65.3% of their mothers are not working
  • Nearly 13.3% of the children watch TV for <1 h, 50.2% of them watch TV for 1–2 h, 20.4% of them watch TV for 2–3 h, 14.2% of them watch TV for >3 h, and 1.8% of them did not watch TV
  • Overall 1.8% of them does not watch any channel, 55.1% of them watch cartoon, 1.3% of them watch educative channels, 16.4% of them watch entertainment channels, 0.9% of them watch sports channels, and 24.4% of them watch all channels.


Findings of visual acuity of school-age children

[Figure 1] shows that 83.6% of the school-age children had Grade I visual acuity, 16% of them had Grade II, and 0.4% of them had Grade III visual acuity.
Figure 1: Pie diagram showing the visual acuity of school-age children

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Refractive errors of school-age children

[Table 1] shows that refractive errors of school-age children showed that 188 children were having normal vision, 36 children were having myopia, and 1 child was having hypermetropia.
Table 1: Refractive errors of school-age children (n=225)

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Association between visual acuity among the school-age children and selected demographic variables

[Table 2] shows that the association between TV-viewing habits of the school-age children and selected demographic variables was assessed using Fisher's exact test. No significant relationship was obtained between the visual acuity and gender, occupation of the father, occupation of the mother, hours of watching TV in a day, and watching type of TV except the age of the mother. This indicates that visual acuity and age of mothers are dependent, but there is no significant relationship observed between visual acuity and gender, occupation of the father, occupation of the mother, hours of watching TV in a day, and watching type of TV by Fisher's exact test, which indicates that these factors are not dependent.
Table 2: Association between demographic variable and visual acuity (n=225)

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As P value corresponding to demographic variable age is small, the demographic variable of age (P = 0.013) was found to have a significant association with visual acuity among school-age children.


  Discussion Top


In the present study, 13.3% of the children watch TV for <1 h, 50.2% of them watch TV for 1–2 h, 20.4% of them watch TV for 2–3 h, 14.2% of them watch TV for >3 h, and 1.8% of them did not watch TV.

In a study conducted in Manipal, 74.2% of the children watch TV up to 2 h and 25.8% of the children watch >2 h. Nearly 92.4% of the children watch TV and 6.4% of the children does not watch TV at all. There is much different percentage in not watching TV, which may be due to the parents' disciplinary action so that children may have other options for playing or not having TV at home.[6]

In the present study, 83.6% of the school-age children had Grade I visual acuity (6/6), 16% of them had Grade II (6/9–6/24), and 0.4% of them had Grade III visual acuity (6/24–3/60).

Similarly, in a study conducted by Darge et al., the findings showed that 22 (5.8%) participants were visually impaired (VA ≤ 6/12 in either eye) and 356 (94.2%) of them were normal (VA > 6/12 in the worse eye).[7]

In the present study, refractive errors of school-age children showed that 188 children had normal vision, 36 children had myopia, and 1 child had hypermetropia, whereas a study conducted in Manipal shows that the prevalence of refractive error was 29.14%, and myopia was the most common refractive error constituting 27.15% and 1.3% of them with myopia and hypermetropia.[6]

The present study suggests that screening of schoolchildren for visual acuity and ocular problems should be done at regular intervals, and it should be one of the prime components of school health program. For this, school teachers should be oriented and trained in identifying common eye problems so that these children can be referred for prompt treatment. They should also impart awareness on ocular hygiene among schoolchildren. Limitation of this study was as this was a school-based study, nonschool-going children were left out from the sampling frame.

This study concludes that refractive error was a significant cause of visual impairment among schoolchildren. School screening is recommended for early detection and management. Students, teachers, and parents must be educated about the early detection of refractive errors and correction to prevent the progression of visual impairment.

Referral service has been done after preliminary examination of visual acuity and refractive error. Children who have Grade II and Grade III visual acuity had been referred to Dr. D. Y. Patil Hospital for refraction correction. Cycloplegic refraction was done on the children and they were prescribed for spectacle correction. Along with detail Ocular examination for other causes of ocular morbidities like Dry Eye, infectious disease, like conjunctivitis, trachoma, Vitamin A deficiency, Ocular Trauma, etc., has been treated for the same.

Recommendations

A complete eye and vision examination should be made compulsory for all children during the starting of the academic year and regularly throughout their school years for healthy eyes and adequate visual skills for successful academic achievement.

The importance of visual acuity examination should be discussed with the parents and caregivers. They must pay close attention to their children for academic performance.

Acknowledgment

We thank all the participants for their cooperation and school authorities for giving permission to conduct this study.

Financial support and sponsorship

This study was financially supported by D.Y. Patil Vidyapeeth, Pimpri, Pune.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Pararajasegaram R. VISION 2020-the right to sight: From strategies to action. Am J Ophthalmol 1999;128:359-60.  Back to cited text no. 1
    
2.
Pascolini D, Mariotti SP. Global estimates of visual impairment: 2010. Br J Ophthalmol 2012;96:614-8.  Back to cited text no. 2
    
3.
Kong L, Fry M, Al-Samarraie M, Gilbert C, Steinkuller PG. An update on progress and the changing epidemiology of causes of childhood blindness worldwide. J AAPOS 2012;16:501-7.  Back to cited text no. 3
    
4.
Mushtaq B, Hamid S, Shamas MN, Masoodi MA, Munshi IH, Mir R. Effect of television watching on vision of school children in semi urban area of Kashmir. Int J Res Med Sci 2014;2:672-6.  Back to cited text no. 4
    
5.
Thylefors B. A global initiative for the elimination of avoidable blindness. Community Eye Health 1998;11:1-3.  Back to cited text no. 5
    
6.
Sathish Kumar K, Akoijam BS. Prevalence of refractive error among school going children of Imphal, Manipur. Int J Med Science Public Health 2016;5:1363-8.  Back to cited text no. 6
    
7.
Darge HF, Shibru G, Mulugeta A, Dagnachew YM. The Prevalence of Visual Acuity Impairment among School Children at Arada Subcity Primary Schools in Addis Ababa, Ethiopia. Journal of Opthalmology 2017;1-7. https://doi.org/10.1155/2017/9326108  Back to cited text no. 7
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2]



 

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