Vision screening programme among school children--evaluation of the outcome in a selected urban locality.

To determine the profile of the visual acuity status, refractive error and other ocular morbidities and to asses the performance at different stages following a vision screening programme in school a retrospective analysis of the data obtained from the programme register for school vision screening programme conducted from April 2003 to March 2006 was done. The data was plotted age and genderwise. Statistical analysis was done to find out disease prevalence with 95% confidence Interval and Z-test was applied for comparison. There were 45,087 students for 239 primary and secondary schools who were examined; 1856 students (4.11%) found having visual acuity .5 or less in either or both eyes. Refractive error was evident in 4.03% students and was the aetiology of compromised vision in 98%. Myopia topped the list with the prevalence of 2.85%; 1733 students (3.84%) were provided with spectacles. Correction of refractive error improved the visual disability in 3.93% of students while amblyopia was found in 0.10%. Average student load per teacher for initial screening was 229. The vision screening programme in school helps to detect refractive error and other causes of compromised vision among large section of children between 5 and 15 years age group. Use of correct spectacles prevents amblyopia considerably. Constraints arising in the programme can be removed by proper planning.

A case report of unifocal Langerhans' cell histiocytosis or eosinophilic granuloma.

A case of unifocal Langerhans' cell histiocytosis or eosinophilic granuloma in a child is reported where the frontal, zygomatic and maxillary bones of the left orbital wall are affected. As eosinophilic granuloma is a rare disease and the involvement of maxillary bone in orbital eosinophilic granuloma is not well documented in the literature, this case is reported for its unusual involvement of 3 bones at a single site. The diagnosis was established by clinical, radiological and histological findings. As no other system or site was involved and considering the osseous involvement of multiple bones at one site, local radiotherapy was preferred as the mode of treatment. The patient responded favourably to radiotherapy with reduction of proptosis and tumour mass but there was no visual recovery. In the absence of universal agreement over the mode of treatment, the result emphasises the probable benign nature of the tumour and the need to withhold more aggressive treatment modalities for extensive multisystem involvements.