An observational study to evaluate the prevalence and pattern of refractive errors in children aged 3-17 years in Mumbai, India

Background: Refractive error is one of the most important causes of avoidable visual impairment. Early detection of refractive error in children is essential to avoid any permanent disability. The objective of the study was to determine the prevalence and pattern of refractive errors as per age, gender and educational standard in school children aged 3-17 years.Methods: This was an observational non-interventional study. 600 eyes of 300 participants in the age group of 3-17 years were evaluated. All underwent cycloplegic refraction followed by objective refraction. Participants were divided into 3 groups as follows 3-8 years, 9-12 years and 13-17 years and evaluation of type of refractive error was done age wise and gender wise.Results: The number of male and female participants was almost similar with a male:female ratio of 1.02:1. Refractive errors were most common in the age group of 9-12 years. The most common refractive error was astigmatism followed by myopia and hypermetropia. It was also found that majority of patients had bilateral refractive errors.Conclusions: The most common refractive error was astigmatism followed by myopia and hypermetropia. It was also found that majority of patients had bilateral refractive errors. The visual acuity in majority was 6/18 which according to WHO classification falls in Category 0 of Visual impairment in India.

Congenital and inherited ophthalmologic abnormalities.

OBJECTIVE: To identify genetic disorders associated with ophthalmologic abnormalities; type and frequency of various ophthalmologic abnormalities associated with selected genetic and inherited disorders; and devise a suitable classification for ophthalmologic abnormalities. METHODS: Pediatric cases referred with mental retardation, congenital malformations and suspected genetic and metabolic disorders were enrolled prospectively. Relevant clinical details (including an ophthalmologic examination) and investigations were recorded. RESULT: Of the 1308 patients enrolled, 679 (51.9%) had ophthalmologic abnormalities. 458 cases (67.45%) out of these 679 had mental retardation and 20 (2.94%) had neuroregression. Environmental (12.22%) and chromosomal anomalies (10.9%) were the largest etiological groups. Down syndrome was the commonest of the chromosomal anomalies and mongoloid slant and epicanthic folds were its commonest ophthalmologic features. Mucopolysaccharidoses (21.4%), Wilson disease (19.64%), oculocutaneous albinism (16.07%) and lipid storage disorders (14.29%) were the most common inborn errors of metabolism associated with ophthalmologic abnormalities. Of the 39 cases with Mendelian inheritance of disorders, autosomal dominant disorders (56.41%) were the commonest associated with ocular abnormalities. A simple anatomical classification has been devised for various ophthalmologic abnormalities encountered (wherein, positional and adnexal abnormalities were the commonest). CONCLUSION: Up to 50% of cases referred to the genetic services have ophthalmologic abnormalities. Conditions including chromosomal abnormalities, metabolic disorders, Mendelian syndromes and environmental factors are associated with ocular abnormalities. Anatomically, positional and adnexal abnormalities are the commonest.