Pattern of Ocular Morbidity among Children Referred Through a National Screening Program in a Tertiary Hospital in Northern India.

ABSTRACT

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.