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Purpose: To obtain epidemiological data on children with ocular morbidity attending a nodal district early intervention center (DEIC). Methods: After parental consent, we recruited children with ocular morbidity. After detailed history and clinical evaluation, along with pediatric consultation and relevant neuro?radiological and ancillary investigation, information was entered in a pretested proforma: especially looking for perinatal morbidity, including developmental delay (DD). Visual acuity (VA) was assessed by age?appropriate means by an ophthalmic assistant trained to work with children with special needs. We diligently looked for strabismus and performed dilated ophthalmoscopy. Using JASP, we summarized data as means and proportions and reported 95% CIs. We explored the association of disability percentage with possible predictor variables using regression. Results: We enrolled 320 children, with a mean age of 34.43 ± 31.35 months; two?thirds were male; one?third belonged to lower socioeconomic status (36%), with most parents being illiterate. The mean presenting VA was 1.8 logMAR for both eyes, range: 0 to 3. Sixty?one percent were hyperopic and 27% were myopic. High refractive error, (>±6D) occurred in nine; anisometropia in one; strabismus in 149, mostly esotropia; congenital cataract in 25, whereas 63 had abnormal fundus. Seventy?six received a diagnosis of cerebral visual impairment (CVI). On multivariate linear regression (MLR), younger age, presence of DD, and CVI significantly predicted a higher disability percentage. Logistic regression revealed that statutory disability is likely associated with DD (odds ratio [OR]:13.43); whereas older age was protective (OR: 0.977). Conclusion: Our study suggests that in DEIC children with ocular morbidity, younger children, and the presence of DD significantly predict both greater disability and the likelihood of statutory levels
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Background: Ocular involvement is relatively common in malnourished children, and the consequences of malnutrition on the eye are frequently more severe during the formative years of life. This is a significant cause of avoidable blindness that has to be addressed with affordable methods. This study aims to determine the nature, extent, and seriousness of ocular manifestations in malnourished children and to evaluate the current prevalence given improving nutritional parameters through increased public awareness, education, and knowledge of vaccination and nutrition. Materials and Methods: This study was carried out in the department of ophthalmology of a tertiary eye care center for 1 year. Eye camps were held close by in urban shantytowns. We considered 518 kids between the ages of 6 months and 5 years who lived in those slums. The patient was subjected to a general, systemic, and ocular examination, including a vision and fundus examination. Results: A total of 100 children aged 6 months and 5 years (60 months) who were severely critically malnourished were enrolled and given an eye examination. In this study, 72% of very acutely malnourished children had ocular involvement. Conjunctival pallor was the most general observation in the anterior segment in 179 of the eyes (71.5% of the eyes). Retinal hemorrhage was the most pervasive posterior segment findings in 19 eyes (36.8%). Conclusion: This study is aimed to determine how frequently ocular symptoms occurred in malnourished children who visited tertiary eye care facilities. A vital target population that requires comprehensive screening to avoid vitamin A deficiency (VAD) and detect eye problems early is preschoolers. Every child should also receive an immunization and vitamin A prophylaxis. Low socioeconomic position, illiterate parents, and inadequate sanitation were determined to be the key risk factors for VAD.
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Background: According to the census of 2011, 13% of the Indian population was 60 years of age or older. As the geriatric population is the most vulnerable part of society, they are prone to all type of diseases including eye problems which are preventable or correctable but requires constant medical, financial, and social support. This study will find the magnitude of various ocular morbidities and their relationship with sociodemographic factors among geriatrics. Objective: 1. To find the magnitude of ocular morbidities among the elderly. 2. To study the relationship of different sociodemographic factors with ocular morbidities. 3. To estimate the average time spent for getting ophthalmic care at the outpatient department (OPD). Subjects and Methods: It was a hospital-based cross-sectional study conducted in the Ophthalmology OPD of Sriram Chandra Bhanja Medical College and Hospital, Cuttack, Odisha, from January to December 2016. A total of 1320 geriatric persons were enrolled during this period. Ethical clearance was obtained. Results: Out of the 1320 geriatric patients, 58.86% were in the age group of 60–69 years, 35.22% in 70–79 years, and 5.9% ?80 years with a mean age of 67.7 ± 6.7 years. Males accounted for 70.98% and females for 29.02%. Different ocular morbidities detected are cataract (59.2%), refractive error (18%), ocular injury (5.9%), diabetic retinopathy (3.9%), glaucoma and chronic dacryocystitis (3%), and foreign body in the eye (2%). The total waiting time in the ophthalmology OPD to get ophthalmic care was 7.8 ± 3.2 min. The total consultation time in the OPD was 75.59 ± 27.15 min. Conclusion: The most common cause of visual impairment/blindness in the geriatric age group are cataract and refractive errors which are treated/corrected free of cost at any government health facility under the National Programme for Control of Blindness. People should be aware of the causes, prevention modalities, and treatment of the causes of blindness.
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Purpose: To estimate prevalence of common ocular morbidities including color blindness among school?attending children of an urban foothill town of Uttarakhand State in Northern India. Methods: A cross?sectional study was conducted among school?going children of age group 6–16 years of standard I– XII. Schools were selected using population proportionate to the size sampling technique. Detailed ocular examination including color vision and unaided or aided visual acuity for various ocular morbidities was done. Data was entered into MS excel with statistical analysis using SPSS version 23 with significant P value <0.05. Results: In total, 13,492 students (mean age 10.9 ± 2.7 years) with almost equal male to female ratio were screened. Overall prevalence of ocular morbidity was 23.2%, with refractive error (18.5%) on top, followed by color blindness (2.2%). The later was observed more among males (3.0%) as compared to females (1.4%) with significantly higher odds, OR = 2.3 (1.7–2.9) (P < 0.001). Conclusion: Refractive error has been the most common ocular morbidity, followed by color blindness. Earliest detection can prevent permanent disability and disappointment among youngsters when rejected from entering certain professions due to color vision defect
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We wanted to determine the prevalence of ocular morbidity among school going children between ages of 6 and 16 yrs. in public schools of urban and rural areas of Kanpur city and study its pattern. METHODSA cross-sectional prospective study was done among a total of 2105 school going children (rural - 956 and urban -1149), 6-16 years of age in rural and urban areas of Kanpur city. A comprehensive ocular examination was done with the help of torch light, slit lamp and +90 D and direct ophthalmoscope to examine the anterior & posterior segment pathologies. RESULTSOcular morbidity in the rural population was 817 (no. of diagnosed cases) of which 43.30 % were in rural areas of which 63.52 % were males. 35.07 % were in urban areas of which 57.81 % were males. The most common type of ocular morbidity in rural population was refractive error (15.9 %), followed by vitamin A deficiency (12.86 %), blepharitis (5.43 %), squint (3.66 %), amblyopia (2.87 %), stye (2.40 %), ptosis (1.67%), colour blindness (1.15 %), and posterior segment pathologies (0.19 %).in urban areas, the most common cause was refractive error (26.19 %), followed by squint (2.78 %), amblyopia (1.91 %), vitamin A deficiency (1.91 %), blepharitis (1.83 %), colour blindness (1.21 %), stye (0.70 %), ptosis (0.35 %) and posterior segment pathologies (0.08 %). The difference was statistically extremely significant with p = 0.0001. CONCLUSIONSRefractive error was the most common ocular morbidity in both urban and rural areas, but Vitamin A deficiency and blepharitis were more common in rural areas. In rural areas malnutrition seems to be the major cause of ocular morbidity while more use of gadgets and less outdoor activity seems to play vital role in urban areas.
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Purpose: To estimate the prevalence of various ocular morbidities in school children (5–15 years) utilizing a comprehensive mobile eye unit in Central India. Methods: A prospective, cross-sectional, school-based observational study was carried out in Raipur, Chhattisgarh, India between December 2017 and September 2018. A total of 1557 eligible school-going children in the age group 5–15 years were evaluated. Random sampling was done to allocate schools (n = 29) and children from various urban and rural (836 vs 721) schools. The primary objective was to estimate the prevalence of ocular morbidities in school-going children in Raipur district, India. The secondary objective was to analyze whether geographical location (rural vs urban), age group, and gender led to any differences in ocular morbidity patterns. Results: The mean age of the study population was 10.3 ± 2.4 years. There were 691 (44.4%) boys and 866 (55.6%) girls. Ocular morbidity was present in a total of 331 (21.2%) children. Vitamin A deficiency was the most common cause of ocular morbidity, noted in 156 (10%) children, followed by refractive error (81, 5.2%). Myopia was significantly higher in urban school children (4.3%) compared to rural children (1.9%) (P = 0.002). The older age group had a higher prevalence (7.6%) of refractive error, especially myopia, compared to the younger age group (2.2%) (P < 0.001). Conclusion: Vitamin A deficiency prevalence was much higher indicating missed opportunities for vitamin A supplementation at a younger age. Refractive error was more prevalent in the urban population as well in the older age group (11–15 years), indicating a need for frequent eye screening.
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Childhood blindness is one of the priority targets of Vision 2020—Right To Sight due to its impact on the psychological and social growth of the child. An extensive search was performed to locate research papers on childhood blindness prevalence and its causes in the community based and blind schools, respectively, conducted from 1990 onward up to the present. Cross references were also manually searched along with expert consultation to enlarge the reference data. A total of five community-based studies on the prevalence including two refractive error studies conducted all over India in children less than 16 years were found. The causes of childhood blindness from the available blind school studies revealed that causes of childhood blindness have mainly shifted from corneal causes to whole globe abnormalities. This article highlights that though with the availability of proper healthcare facilities, the trend is changing for the causes but still a lot of effort in the form of timely neonatal eye care facilities, pediatric surgical services and proper refraction strategies is required.
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Aims/Objective:A community-based cross-sectionall comparative study was carried out to compare the pattern of ocular morbidity between residents in upland and riverine communities in Rivers State.Methods:The sample size was calculated using the formula for comparative studies, based on alpha of 0.05, beta of 0.20, the proportion of eye disorder of 40.4% from a community-based study in Rivers State. A minimum sample size of 84 per group was attained.Data on age, sex, visual acuity, cup-disc ratio, intra-ocular diagnosis were obtained using an interviewer-based pro forma. Collected data were entered into Microsoft Excel and exported to the United States Centers for Disease Control and Prevention(CDC) Epi Info version 7 software for statistical analysis. The Pearson's Chi square/Fisher's exact tests were used as appropriate to determine significant differences in demographic and eye examination findings between the two groups (riverine versus upland) while Chi-square homogeneity was performed to determine significant differences in the individual ocular diagnosis across the groups. Statistical significance was set at P≤0.05. Results:A total of eighty-six (86) participants per group were involved in the study, making a total of one hundred and seventy-two participants. The mean age was 37.9 (±18.1) and age range of 1-90years. Males comprised 30.2% of the sample population while females were 69.8%. The commonest causes of ocular morbidity in both communitieswere Refractive error. Allergic conjunctivitis and cataract were more common in the Riverine community compared to the upland one. Conclusion:Our study shows that the pattern of ocular morbidity may differ based on land surfaces. Ocular morbidity appears to be more prevalent in Riverine areas than upland.Government interventions and eye care service providers should take cognizance of this while planning intervention programs at the State and National levels
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Background: Ocular morbidity describes any eye disease regardless of resultant visual loss. India is plagued by ocular morbidities in school going children. Refractive error is considered to be the major cause of visual impairment. The objectives of the present study were to compare the pattern of ocular morbidity in urban and rural school children, to study the association of academic achievement with ocular morbidity in study population and to suggest appropriate recommendations for addressing the problem of ocular morbidity in school children.Methods: A cross sectional study was conducted in the 9 primary and 5 junior high schools of field practice areas of Rural Health Training Centre and Urban Health Training Centre respectively, under Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh from September 2005 to August 2006.Results: Prevalence of ocular morbidity in the present study was 23.3%. Maximum prevalence of 28.7% of ocular morbidity was seen in the age group of 14-16 years. Prevalence of ocular morbidity was found to be 100 (51.6%) in males and 64 (40.1%) in females. 29.3% of the 164 school children having ocular morbidity showed poor academic achievement compared to 18.7% of the 541 children not having ocular morbidity and the association was found to be statistically significant.Conclusions: Refractive error was one of the major causes of ocular morbidity among school going children but most of them were of mild degree. Ocular morbidity was found to affect the academic achievement of school going children.
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Background: Non communicable diseases have taken over previously life threatening infections in the demographic transition. As the burden of NCDs including diabetes is increasing at an alarming rate the complications related to these diseases are also increasing leading to huge morbidity. Likewise, blindness/ visual impairment due to diabetic retinopathy is now slowly and steadily replacing refractive errors and cataracts as a cause of morbidity.Methods: This cross sectional study was carried over a period of one year in an ophthalmic unit of a tertiary health care institute in which known diabetic patients were screened for diabetic retinopathy besides various modifiable and non-modifiable risk factors.Results: Overall prevalence of diabetic retinopathy in our study population was found to be 29.0%. Among various risk factors duration of diabetes, hypertension, HbA1C >6.5% and serum creatinine >1.1 mg/dl were found to be significantly associated with diabetic retinopathy.Conclusion: Regular screening for diabetic retinopathy besides prevention and strict control of risk factors is key to prevention and progression of blindness/ visual impairment due to diabetic retinopathy.
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Purpose: Childhood blindness is second to cataract in terms of blind person years; population-based prevalence of ocular morbidity among tribal children has not been studied. We conducted this study to determine the prevalence of ocular morbidity in tribal children age 15 years or younger in Jawadhi hills, southern India. Methods: A population-based cross-sectional study was conducted in four tribal villages where all children below 15 years of age were invited to participate in the study. After appropriate consent/assent, an optometrist assessed uncorrected vision refraction and best-corrected visual acuity using suitable techniques. A comprehensive ophthalmic examination was also done by an ophthalmologist to determine the presence of ocular morbidity. Children requiring cycloplegic refraction or further treatment were referred to the base hospital. Results: Among 260 children examined, the prevalence of ocular morbidity was 10.8% [95% confidence interval (CI): 6.3–13.7]. Vitamin A deficiency (VAD) was the foremost morbidity: 4.6% (95% CI 1.6–6.3) followed by refractive error (2.7%). Three (10.7%) children had more than one ocular morbidity. Nearly 1 in 10 tribal children suffer from ocular morbidity and 1 in 57 had low vision. Conclusion: VAD is a public health problem in this tribal region which requires immediate intervention with prophylaxis and treatment. Uncorrected refractive errors in school-age children also need to be attended.
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Background: About 30% of blind population of India loses their eyesight before the age of 20 years and many of them are under 5 when they become blind. Childhood blindness will have serious impact on development, education and quality of life. Therefore it is essential that ocular morbidity is detected and treated at an early stage.Methods: A cross-sectional study was conducted among 120 children aged 3-5 years attending 6 anganwadi centres of Hubballi taluk which were selected by stratified random sampling. Data was collected using pretested semi-structured questionnaire. Ocular examination was conducted to identify ocular morbidity. Test for visual acuity, colour blindness and refractive status was done using lea chart, ischihara charts and plusoptix mobile vision screener respectively. Nutrition status was assessed by clinical examination and anthropometry. Statistical analysis was done using SPSS package.Results: Out of 120 children 51.7% were male. Majority, 63.3% were residing in urban area and 40% belonged to class IV of modified B G Prasad classification of socio-economic status scale. The prevalence of ocular morbidity was found to be 20%. 15.8% of children had refractive error, 2.5% had vitamin A deficiency and 1.7% had squint. No statistically significant association was found between ocular morbidity and any risk factors.Conclusions: Refractive error was found to be the most common ocular morbidity among pre-school children. This if detected early can be corrected. Therefore it is important to screen for refractive error at the preschool age itself and to create awareness among parents and anganwadi teachers regarding common ocular symptoms.
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Introduction: Quantum of ocular morbidity in India especially in elderly has been increasingly high year over, probably due to their increasing population, higher longevity and unavailability of timely ophthalmic care as well as increasing life expectancy. Materials & Methods: The present study was thus designed to study the ocular morbidity profile of elderly people attending SGT Hospital, Gurugram. A hospital based cross-sectional study on ocular morbidities among elderly was conducted at Medical College Hospital, SGT University, Budhera, Gurugram, Haryana for a period of one year, from June 2017 to May 2018 after the institutional ethical clearance. A total of 1236 elderly patients fulfilling the inclusion criteria were enrolled, out of which 841 subjects were willing to participate in the study. All selected cases were subjected to history taking, personal interview, detailed ocular examination and necessary investigations as required. Data entry and analysis was done using Epi-info software. Results: Out of total 841 study participants, 433 (51.9%) were males and 408 (48.1%) were females with a male to female ratio of 1.06:1 with no statistical significant difference between the age groups and the gender. Refractive error was found to be the most common ocular morbidity among all the study participants followed by cataract, corneal opacity, retinopathies, glaucoma and ARMD. The other ocular morbidities were pterygium, dry eye, conjunctivitis, meibomitis, blindness, dacryocystitis, keratitis, endophthalmitis, entropion and blepharitis respectively. Thus It is required to define the priorities for eye care services based on the current population-based data.
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Background: The Rashtriya Bal Swasthya Karyakram (India) is directed towards achieving universal health coverage among children by early detection of diseases. Under the scheme, children are screened at the level of schools and community and are thereafter referred to tertiary centre. The purpose of study was to identify common causes of ocular morbidity in children screened and referred through this national screening program. Methods: Retrospective analysis of records of all children who presented to our centre with ocular problems over a period of one year (2015) was undertaken. Clinical diagnosis was recorded on a seven point scale based on major anatomical involvement. An analysis of causes of visual impairment was undertaken with a special emphasis on avoidable and treatable causes. Results: A total of 851 subjects presented with ocular problems (mean age 9.5±4.9 years); of them 819 were classified into seven major clinical groups and subgroups. Most common clinical group was that of strabismus (59.9%), followed by refractive errors (16.9%), lids related disorders (6.2%), orbit and adnexal developmental defects (4.6%), lenticular (3.3%), corneal and conjunctival (3.2%) and retinal disorders (2.1%). A total of 49.7% cases had avoidable or treatable causes of visual impairment. Conclusion: A national program with capacity to screen and ensure appropriate referral facilities resulted in intervention in many cases with avoidable and treatable causes of visual impairment. A varied pattern of ocular morbidity was found among the referred cases; our study could provide a platform for a target oriented approach towards planning and implementation of such screening programs.
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Background/Aims: Information on eye diseases in blind school children in Allahabad is rare and sketchy. A cross-sectional study was performed to identify causes of blindness (BL) in blind school children with an aim to gather information on ocular morbidity in the blind schools in Allahabad and in its vicinity. Study Design and Setting: A cross-sectional study was carried out in all the four blind schools in Allahabad and its vicinity. Materials and Methods: The students in the blind schools visited were included in the study and informed consents from parents were obtained. Relevant ocular history and basic ocular examinations were carried out on the students of the blind schools. Results: A total of 90 students were examined in four schools of the blind in Allahabad and in the vicinity. The main causes of severe visual impairment and BL in the better eye of students were microphthalmos (34.44%), corneal scar (22.23%), anophthalmos (14.45%), pseudophakia (6.67%), optic nerve atrophy (6.67%), buphthalmos/glaucoma (3.33%), cryptophthalmos (2.22%), staphyloma (2.22%), cataract (2.22%), retinal dystrophy (2.22%), aphakia (1.11%), coloboma (1.11%), retinal detachment (1.11%), etc. Of these, 22 (24.44%) students had preventable causes of BL and another 12 (13.33%) students had treatable causes of BL. Conclusion: It was found that hereditary diseases, corneal scar, glaucoma and cataract were the prominent causes of BL among the students of blind schools. Almost 38% of the students had preventable or treatable causes, indicating the need of genetical counseling and focused intervention.
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Background: Schoolchildren form an important target group as any ocular morbidity in this age group has huge physical, psychological and socio-economical implications. Considering the fact that one-third of India's blind lose their eyesight before the age of 20 years and many of them are under five years when they become blind, early detection and treatment of ocular morbidity among children is important. This study aims to highlight the prevalence of ocular morbidity in governmental schools in a sub-urbanized area of India. Research question of current study was to study the Effect of TV watching on vision in school children. Methods: Study area: Government schools in a sub-urbanized area of India. Sample size: 1128 school children from class 5th to 12th. Study design: A cross-sectional study was conducted and the study population comprised of school children who were examined in their schools and afterwards referred to the hospital if required. Data was gathered using a questionnaire, snellens charts and retinoscopes. Statistical analysis: simple proportion. Data was analysed statistically using SPSS software, version 14. Results: 1128 children were examined. Percentage of male children was 42.73% and females were 57.18%. Ocular abnormality was detected in 21.3% children with refractive errors contributing 18.26%, conjunctivitis-1.95%, blepheritis-0.62%, dacrocystitis-0.17%, stye-0.35%, color blindness-0%. It was also observed that children watching TV for less than 1 hour had visual acuity of 6/6 in 42.4%, whereas children watching TV for 1-2 hours, 2-3 hours and >3 hours had lower visual acuity. Conclusion: It was concluded that moderate to high prevalence of ocular morbidity among high school children is present in block Hazratbal. Finally, the aim of all blindness control programs should be to propagate awareness in the masses of eye care and to teach the essentials of ocular hygiene and eye healthcare.
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Eye diseases in childhood are important causes of medical consultation and it affects learning ability, adjustment in school and personality. To determine the pattern of ocular morbidity a cross-sectional observational study was conducted among 714 children, attending Ophthalmology department at a tertiary eye care center in Kolkata, West Bengal. All the children less than 15 years of age, attending in Unit II outpatient department were selected by complete enumeration method for duration of one year (January-December 2010). Distribution of association was analyzed by Chi-square test and difference between two proportions was calculated by z test for proportions. The common ocular morbidity were refractive errors (23.67%) followed by allergic conjunctivitis (17.23%), infection of the eye and adnexa (15.13%), ocular trauma (12.74%), and congenital eye diseases (13.59%). Majority of ocular morbidity is treatable and need early attention through eye screening cum intervention program beginning right from the childhood.
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Background: Data on eye diseases among non-schooling children is very rare. Considering the fact those 19 million visually impaired children, 12 million children are due to refractive errors while 1.4 million are irreversibly blind for the rest of their lives. Early detection and treatment of ocular morbidity among children is important. Objective: To estimate the prevalence of ocular morbidity among urban-slums, non-schooling children of age 0-15 years. Methods: A cross sectional community based study was carried out in five slum areas of urban health training center, Asarwa, adopted by Dept. of Community Medicine to cover non-schooling children of below 15 years of age, from November 2010 to December 2010. Information was collected on a pretested semi structured proforma. An ophthalmologist from Regional Institute of Ophthalmology (RIO) did visual acuity and detailed ophthalmic examination. Data was analyzed with appropriate statistical tests like simple proportions and chi-square (x2) test. Result: Total 391 (14.2%) children in urban –slums community, who were not going to school, were included. Prevalence of ocular morbidity was 21.2%, Trachoma 4.9%, vitamin A deficiency 3.6 %, conjunctivitis 3.3%, refractive errors 3.3% squint 2.5% & color blindness 1.0%. Overall prevalence of ocular morbidity in government hospital and non-schoolings did not show any statistical significant difference. Conclusion: A high prevalence of ocular morbidity among non-schooling children was observed. School health services should be further expanded as child health check-up for the benefit of non-schooling children as well.