Avaliação e triagem da acuidade visual em escolares da primeira infância / Evaluation and screening of visual acuity in early childhood schoolchildren

Resumo Objetivo: Identificar a prevalência de alterações visuais em crianças de cinco anos em escolas públicas de Curitiba-PR. Métodos: As escolas foram selecionadas aleatoriamente dentro do município de Curitiba. As crianças com cinco anos completos em 2017 foram avaliadas com a tabela de Snellen, através de distância mínima correta para nitidez de imagem e teste de Hirschberg. Os pais responderam um questionário sobre uso de telas, sintomas oculares e histórico familiar da criança. Os resultados das avaliações foram analisados estatisticamente considerando nível de significância p≤0,05. Resultados: Em uma população de 459 crianças triadas, 219 (47,7%) pertenciam ao sexo feminino e 240 (52,3%) masculino, sendo que do total, 100 foram encaminhadas para avaliação oftalmológica especializada. A partir da triagem observou-se a prevalência de miopia de 10,7%, hipermetropia de 17,6% e estrabismo de 0,9%. Houve relação entre genitores com miopia e filhos míopes (p<0,05). Dentre as queixas oftalmológicas predominaram cefaleia (30,4%) e franzir de testa (10%). Conclusão: A prevalência de alterações visuais encontrada foi de 21,8%. A relação entre distúrbios visuais e o histórico familiar se mostrou estatisticamente significativa. Entretanto, apenas o tempo médio em frente à televisão apresentou influência, dentre os hábitos de vida, sobre as alterações da AV (p=0,028). Queixas oftalmológicas apesar de frequentes, não apresentaram correlação expressiva com a diminuição da acuidade visual.

Abstract Objective: To identify the incidence of visual impairment in 5-year-old children in public schools from Curitiba-PR. Methods: A selection of schools has been choosen randomly from Curitiba. The children, with completed 5 years at end of 2017 have been evaluated using Snellen table, trough minimum distance for image sharpness and Hirschberg test. Parents answered a questionnaire about the use of screens, ocular symptoms and family history of the child. Significance levels were defines as begin p≤0,05. Results: The results have shown that four hundred fifty-nine children were screened. Two hundred nineteen are female (47,7%) and two hundred fourty (52,3%), male. From all screened patients, one hundred were refered to specialized oftalmic evaluation. After trial completing, has been attained a prevalence value of 10,7% for myopia, 17,6% of hyperopia and 0,9% of strabismus. Strong correlation between parents and children has been undiscovered (p<0,05). From listed oftalmic complaints, headache (30,4%) and frown (10%) where most prevalent. Conclusion: It has been attained that the prevalence of visual acuity is 21,8%. The relation between visual acuity alteration and familiar history has been shown to be significant related. On the other side, the average time in front of television has been shown the only habit that has correlation with visual acuity reduction (p=0,028). Vision complaints, although very frequent, doesn't translate into increased probability of visual acuity alteration.

Associação entre hiperopia e outros erros refrativos e visuais em crianças / Associations between hyperopia and others refractive and visual errors in children

RESUMO Objetivo: Investigar a associação da hipermetropia com ambliopia, estrabismo, anisometropia e astigmatismo. Métodos: A hiperopia foi classificada em Grupo 1: maior ou igual a +5.00D; Grupo 2: maior que +3.25D e menor que +5.00D, com diferença de equivalente esférico maior ou igual a 0.50D; Grupo 3: maior que +3.25D e menor que +5.00D, com diferença de equivalente esférico menor que 0.50D e Grupo 4: com equivalente esférico maior e igual a +2.00D. O Grupo controle pertencente ao equivalente esférico menor que +2.00D. Resultados: A presença de hipermetropia maior e igual a SE+2.00D foi significativamente associada à maior proporção de crianças com ambliopia (27,2 vs. 14,8%, OR = 2,150, p<0,001) e estrabismo (70,8 vs. 39,3%, OR = 3,758, p<0,0001. A presença de hipermetropia também foi significativamente associada à maior proporção de anisometropia nos grupos com hipermetropia maior e igual a SE+2.00 (29,1 vs. 9,9%, OR = 3,708, p<0,0001) e astigmatismo (24 vs. 9,9%, OR = 2,859 p<0,0001). Conclusão: A presença e magnitude da hipermetropia entre crianças foram associadas à maior proporção de erros refrativos e visuais, como estrabismo, ambliopia, astigmatismo e anisometropia.

RESUMO Objective: Evaluate ocular trauma cases related to falling in elderly patients e compare the prevalence and severity of the cases. Methods: A series of cases was made with 52 patients aging 60 or more within the period of 36 months presenting ocular trauma related to falling, whereas the prevalence between the gender, the need for hospitalization or surgery and subsequent visual deficit were evaluated, as well as the severity of the cases. Results: Thirty-three (63.5%) of 52 patients were from the female gender, over which 30.3% had need for surgery and 18.2% developed visual deficit and 19 (36.5%) were from the male gender where 42.1% needed surgery and 26.3% developed visual deficit. Conclusions: The study has shown a higher prevalence of cases in the female gender, although the severity was higher in the male gender.

Moderate hyperopia prevalence and associated factors among elementary school students / Prevalência de hipermetropia e fatores associados em escolares do ensino fundamental

Hyperopia is the most common refractive condition in childhood. There are few studies on moderate hyperopia and associated factors. This study aims to investigate the prevalence of moderate hyperopia and associated factors among school children. A cross-sectional study comprising 1,032 students attending 1st to 8th grades at two public schools was conducted in a Southern Brazilian urban area in 2012. Cycloplegia was used to examine both eyes and refractive error was measured through auto-refraction. A socioeconomic and cultural questionnaire was administered. Multivariable analysis was performed through Poisson regression. Moderate hyperopia prevalence was 13.4% (95% CI, 11.2-15.4) and 85% of these did not wear glasses. Age was inversely associated with moderate hyperopia, while female gender RP = 1.39 (95%CI, 1.02 - 1.90) and white skin RP = 1.66 (95%CI, 1.04 - 2.66) were risk factors for this outcome. This study makes progress in estimating mild and moderate hyperopia prevalence both by age range and specific age. It emphasizes how the lack of this condition being corrected in southern Brazil is a serious problem. It highlights the importance of detailing and characterizing the amount of time spent on close-range, long-range and outdoor activities.

A hipermetropia é o estado refrativo mais comum na infância. Este estudo objetiva investigar a prevalência de hipermetropia moderada e fatores associados entre escolares, tendo em vista haver poucos estudos sobre o assunto. Métodos: Estudo transversal com 1.032 crianças do 1º ao 8º anos de duas escolas públicas da zona urbana de uma cidade do sul do Brasil, no período de abril a dezembro de 2012. Ambos os olhos foram cicloplegiados e o erro refrativo foi medido através de autorrefração. Foi aplicado questionário socioeconômico e cultural. A análise multivariada foi realizada utilizando a regressão de Poisson. Resultados: A prevalência de hipermetropia moderada foi de 13,4% IC95% (11,2% - 15,4%) e 85% deles não usam óculos. Idade ficou inversamente associada com hipermetropia moderada enquanto sexo feminino OR=1,39 IC95% (1,02 - 1,90) e cor de pele branca OR=1,66 IC95% (1,04 - 2,66) foram fatores de risco para o desfecho. Conclusão: Este estudo avança na estimativa de prevalência de hipermetropia leve e moderada por faixa etária e por idade específica, enfatizando o grave problema da falta de correção no sul do Brasil. O estudo destaca a importância de detalhar e caracterizar a quantidade de tempo gasto em atividades de longe e de perto e ao ar livre.

Descripción de la función de sensibilidad al contraste en pacientes miopes e hipermétropes / Contrast sensitivity function in myopic and hyperopic patients

Objetivo: describir la Función de Sensibilidad al Contraste (FSC) en pacientes con miopía, astigmatismo miópico, hipermetropía y astigmatismo hipermetrópico. Diseño del estudio: serie de casos, descriptivo. Métodos: se incluyeron sujetos con miopía, astigmatismo miópico, hipermetropía y astigmatismo hipermetrópico, candidatos para cirugía refractiva y evaluados en la Unidad de Cirugía Refractiva de la Clínica de Oftalmología de Cali, con agudeza visual mejor corregida (AVMC) >=20/20, menores de 50 años de edad y sin antecedente de cirugía refractiva. La función sensibilidad al contraste se midió con el sistema OPTEC® 6500 (Stereo Optical Co, Inc., Chicago, USA) en frecuencias espaciales de 1.5, 3.0, 6.0, 12 y 18 ciclos/grado en condiciones fotópicas (85 cd/m2) y mesópicas (3 cd/m2). Se aplicaron las prueba no paramétrica de Wilcoxon y de Mann-Whitney para comparar diferencias entre la FSC entre los grupos de miopía/astigmatismo miópico e hipermetropía/astigmatismo hipermetrópico en las diferentes frecuencias espaciales. Resultados: se incluyeron 188 ojos de 95 sujetos con miopía y astigmatismo miópico (promedio de edad = 30,6 ± 7,6 años, 51% hombres) y 121 ojos de 64 sujetos con hipermetropía y astigmatismo hipermetrópico (promedio de edad = 43 ± 6,1 años, 62 % mujeres). La sensibilidad al contraste en los pacientes de ambos grupos fue mayor significativamente en condiciones fotópicas que en condiciones mesópicas, excepto en la frecuencia espacial de 3 ciclos/grado del grupo de miopía/astigmatismo miópico. Se encontró diferencia estadísticamente significativa del valor de la FSC entre los grupos de miopía/astigmatismo miópico e hipermetropía/astigmatismo hipermetrópico en condiciones fotópicas en casi todas las frecuencias espaciales, excepto en 3 ciclos/grado y en condiciones mesópicas en las frecuencias espaciales de 1.5, 3 y 6 ciclos/grado. Conclusiones: los valores de FSC son mayores en el grupo de pacientes con miopía y astigmatismo miópico que en los del grupo de hipermetropía y astigmatismo hipermetrópico. Estos valores podrían usarse como referencia en estos grupos de pacientes en nuestra población.

Purpose: to describe the contrast sensitivity function (CSF) in patients with myopia, hyperopia and astigmatism. Study design: descriptive case series study. Methods: subjects with myopia/myopic astigmatism and with hyperopia/hyperopic astigmatism looking for refractive surgery, and evaluated at the Unit of Refractive Surgery in the Clínica de Oftalmología de Cali were included. Their Best Spectacle Corrected Visual Acuity (BSCVA) was >=20/20, age less than 50 years and no previous refractive surgery. The CSF was measured using the OPTEC® 6500 (Stereo Optical Co, Inc, Chicago, USA) system for spatial frequencies 1.5, 3.0, 6.0, 12 and 18 cycles/degree in photopic (85 cd/m2) and mesopic (3 cd/m2) conditions. Statistical analysis was done using the Wilcoxon and Mann-Whitney tests for non-parametric samples, comparing the myopia/myopic astigmatism and the hyperopia /hyperopic astigmatism groups. Results: 188 eyes of 95 subjects with myopia/myopic astigmatism (age = 30,6 ± 7.6 years, 51% men) and 121 eyes of 64 subjects with hyperopia/hyperopic astigmatism (age = 43± 6.1 years, 62% women) were analyzed. The CSF was higher in both groups in photopic conditions except in 3 cycles per degree in myopia/myopic astigmatism group. Significant differences in the CSF were found between the two groups in photopic conditions excluding the 3 cycles per degree. In mesopic conditions diff erences were found for the spatial frequencies 1.5, 3 and 6 cycles per degree. Conclusions: The patients of the myopia/myopic astigmatism group had a contrast sensitivity function higher than those of hyperopia/hyperopic astigmatism group. These values could be used as reference for these patients in our population.

[Prevalence of refractive errors in different ages and gender, in patients examined in optometry clinic of rehabilitation of Shahid Beheshti Medical University in 2008/2009]

Since no study on the prevalence of refractive errors had been performed in this optometry clinic, this study was designed to determine the prevalence rate of refractive errors among the patients examined in this clinic in 2008/2009. In this cross-sectional study, the files of the patients examined in optometry clinic in 2008/2009 were reviewed. Variables included age, sex, rate and type of refractive errors and health of anterior and posterior eye segments. The prevalence rates of myopia, hypermetriopa, astigmatism and emmetropia were 11.83%, 15/38%, 45%, 27/34% respectively. The respective prevalence rates of refractive errors in men and women were: 10.3% and 13.1% for myopia, 16.7%, 15.1% for hypermetropia, 45.6% and 44.5% for astigmatism, and 27.4% and 27.3% for emmetropia. The mean ages of the patients with myopia, hypermetropia and astigmatism were 36.1 +/- 19.36, 41.27 +/- 22.06 and 32.16 +/- 20.98. Respectively Difference of the ratios of the patients with different ages suffering from refractive errors was significant [P<0.0001]. There was no significant difference in the male to female ratio in the patients with refractive errors [P<0.741]. This study showed that the prevalence rate of myopia increased up to the age of 20-30 years but that of hypermetropia decreased, and prevalence rates of myopia and hypermetropia in some age groups increased after the age of 40. In addition, the prevalence rates of refractive errors in different age groups were not similar and gender had no effect on the prevalence of refractive errors. These results are compatible with the results of other studies

Prevalence of refractive errors among pre-school children at King Abdulaziz Medical City, Riyadh, Saudi Arabia

Vision disorders are the fourth most common disability of children and the leading cause of handicapping conditions in childhood. The present study was undertaken to identify the prevalence and pattern of refractive errors among the school-entrant children at King Abdul Aziz Medical City [KAMC], Riyadh city - Kingdom of Saudi Arabia. The study population consisted of all the school-entrants [n = 1319], who attended the obligatory health examination for kindergarten and primary school entry during the period from March 2008 until October 2008. Every child was subjected to a 10min - visual acuity test [VAT] and autorefractive test applied by qualified optometrist. Children with a visual acuity of 20/28 or worse in one or both eyes, or with eye disorder [strabismus, nystagmus, ptosis and others] or abnormal ocular movement, were referred for a 45 min complete ophthalmic examination, which consists of: [1] Distance visual acuity [V/A], [2] cover - uncover test, and [3] non-cycloplpegic retinoscopy. Refractive error cut-off point was defined according to their spherical equivalent refractive error [SERE]. Out of the 1319 children, 60 children were diagnosed as having one or more refractive error, with an over-all prevalence of 4.5% [4.2% in boys and 4.9% in girls] with no sex difference. Prevalence of different refractive errors were as follows; Myopia [2.5%, 95%CI1.7:3.3%]

Estado refractivo en pacientes sometidos a facoemulsificación de catarata con situaciones especiales / Refractive state in patients with phacoemulsification of cataract in uncommon situations

BACKGROUND: We undertook this study to determine the refractive state in patients who underwent non-complicated phacoemulsification under unusual situations. METHODS: This was a clinical, open, transversal, prospective and comparative study. Patients had the following conditions: congenital cataracts, hyperopia, myopia, and emetropia with previous corneal transplantation or vitreous cavity filled with silicone oil. RESULTS: Thirty-six eyes were included in our study vs. control group (52 emetropic eyes). There was no statistical significance in spherical equivalent 6 weeks postoperatively, with 59% of patients within +1.00 D, 73% +2.00 D and 28% > +2.00 D. CONCLUSIONS: Refractive state was favorable with an average of 0.96 D +/- 6.27.

Prevalence and risk factors of refractive errors among school children in Mashhad, 2006-2007

To determine the prevalence of refractive condition and its risk factors among students in Mashhad. A total of 2510 students representing a cross-sectional of the population of Mashhad were sampled using random cluster sampling strategy. Primary and middle school students underwent cycloplegic refraction. The refractive errors of high school students were measured using non-cycloplegic autorefraction. Myopia was defined as spherical equivalent [SE] of -0.5 diopter [D] or more, and hyperopia was defined as SE of +0.5 diopter [D] or more, and astigmatism of 0.75 cylinder diopter or greater. Examination was carried out in the school using standardized testing protocols. 2150 students [group 1: 1163 primary and middle school, group 2: 947 high school students and 13 missed data] participated. The prevalence of refractive errors in the 1st group was: myopia=2.4%, hyperopia=87.9%, astigmatism=9.8% and anisometropia=3.0% [SE difference at least 1.00 D], and in the 2nd group myopia=24.1%, hyperopia=8.4%, astigmatism=11.8% and anisometropia=5.6%. There was significant difference in refractive errors between girls and boys [P<0.001]. In primary and middle school prevalence of myopia increased with age [OR=1.3 95% CI: 1.03 to 1.7 and P=0.013]. The prevalence of refractive errors among students in Mashhad is high. Effective detection and treatment of these refractive errors is expected to reduce the incidence of amblyopia and strabismus and also can prevent substantive effects on academic performance

Prevalence of undetected refractive errors among school children

In Pakistan 11.4% of the blindness is due to uncorrected refractive errors. This study was carried out in two schools of Lahore to find the prevalence of refractive errors among high school children. It was an institution - based, cross sectional study involving the use of structured questionnaire and visual examination of the students. A total of 540 children studying in class 6th to 10th were examined over a period of two weeks. Vision of all the children was checked. The children with visual acuity less than 6/12 in one or both eyes, underwent objective retinoscopy and subjective refraction. The results revealed that 107 out of 540 [19.8%] of the children had refractive errors. Myopia was the most common refractive error being 43% [46/107] of the total. Astigmatism, both simple as well as mixed / compound was 35.5% [38/107 while hypermetropia was least common i.e. 21.5% [23/107]. Strong correlation was found between a positive family history of wearing glasses, watching television closely, close study, studying in dim light and over indulgence in computer or video games. It is recommended that adequate preschool examination of the children be made mandatory and part of the admission policy of all the schools in Pakistan. In addition, there should be periodic examination of the school children at least on annual basis

Prevalence of refractive errors in students in Northeastern Brazil

OBJETIVO: Determinar a prevalência das ametropias em estudantes das redes pública e privada de Natal-RN. MÉTODOS: Foi realizada refratometria de 2.048 olhos de estudantes matriculados no ano letivo de 2001 e os dados avaliados com planilha do SPSS Data Editor 11. As ametropias foram divididas em: 1- de 0,1 até 0,99D (dioptria); 2- 1,0 até 2,99D; 3- 3,00 até 5,99D e 4- 6D ou maior. O astigmatismo foi reagrupado em I- a favor da regra (eixo entre 0 a 30 e 150 a 180 graus), II- contra a regra (eixo entre 60 e 120 graus) e III- oblíquo (eixo entre >30 e <60 e >120 e <150 graus). A faixa etária foi categorizada em 1- 5 a 10 anos, 2- 11 a 15 anos, 3- 16 a 20 anos, 4- 21anos ou mais. RESULTADOS: Dos erros refrativos, a hipermetropia foi o mais comum com 71%, em seguida astigmatismo, 34% e miopia, 13,3%. 48,5% dos míopes e 34,1% dos hipermétropes tinham astigmatismo. De acordo com as dioptrias, 58,1% dos míopes estão no grupo 1, 39% distribuídos entre os grupos 2 e 3. Os hipermétropes enquadram-se em sua maioria no grupo 1 (61,7%) e o astigmatismo no mesmo grupo com 70,6%. A associação dos eixos do astigmatismo dos dois olhos mostrou 95,2% com eixo a favor da regra nos dois olhos, diminuindo a porcentagem para os do eixo contra a regra (82,1%) e menor ainda para os do eixo oblíquo, apenas 50%. CONCLUSAO: Os resultados encontrados mostraram discordância com a maioria dos trabalhos internacionais, principalmente os orientais, que apontam a miopia como o erro refrativo mais comum e corrobora os nacionais, com a grande parte sendo hipermétropes.

Refractive errors in preterm babies.

Fifty preterm neonates were followed up at the age of 6 months and 1 year. In addition to developmental assessment, a complete ophthalmological examination was done on both visits. The largest (62%) gestational age group was of 34-36 weeks. At 6 months, none of the infants had normal vision. At 1 year of age, 64% of the babies had normal vision while incidence of myopia and hypermetropia was 16% and 20%, respectively. There was an inverse relationship noted between gestation and incidence of refractive errors. It was also noted that with decreasing weight, the incidence of myopia increased. Myopia was seen exclusively among infants of birth weight of 2000 g or less. Birth weight had a significant positive correlation with astigmatism. No correlation of asphyxia with refractive errors was observed. It is recommended that all preterm babies should have an ophthalmological examination at one year of age with follow up later on.

Incidence of glaucoma in a sample of population and their refraction

In this study 1334 subjects [391 males and 943 females] were examined, all were above 40 years of age. Of the total number examined 62 [4.7%] were glaucomatous, of which 55 [4.2%] had open angle glaucoma 7 [0.5%] had narrow angle glaucoma 29 [2.2%] were ocular hypertensives and the rest [93.l%] were found to be normal. In open angle glaucoma patients the ratio of males to females was 1: 1 and in narrow angle glaucoma patients 1: 2. Refraction in open angle glaucoma in patients was 1 [1.8%] hypermetrops, 9 [16.4%] emmetrops and 54 [81.8%] myopes. In narrow angle glaucoma patients: 4 [57.1%] hypermetrops 2 [28.6%] emmetrops and 1 [14.3%] low myope. So most of the open angle glaucoma patients were myopes [81.8%] and most of the narrow angle glaucoma patients were hypermetrops [57.1%]