Status of Eye Health among School Children in South India – Sankara Nethralaya School Children Eye Examination Study (SN-SEES)

Narayanan, Anuradha; Krishnamurthy, Sruthi Sree; R, Krishna Kumar

doi:10.1080/09286586.2020.1849743

Cited by 12 publications

(8 citation statements)

References 18 publications

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“…VI prevalence estimates reported in school-based studies from India varied from 0.7% to 5.67% from 2011 to 2019. [ 14 16 24 25 26 ] In the current study, it was found to be 1.72% among school children aged between 4 and 15 years, which falls within the range of these school-based estimates. The difference within these estimates could be explained by variations in definitions, and the inclusion and exclusion criteria used in these studies.…”

Section: Discussionsupporting

confidence: 79%

“…[ 25 43 44 45 46 47 ] The overall myopia prevalence in this study was 2.17%, which is lower as compared to 13.1% that was reported in the North Indian Myopia study (NIM) in 2015, 7.5% reported in a meta-analysis in 2020, and 3.57% from 2011 to 2015 reported in the SN-SEES study in 2020 in India. [ 25 48 49 ] This study showed an increased prevalence of low myopia among school children and the prevalence of high myopia increased with age. This trend was also reported in China.…”

Section: Discussionmentioning

confidence: 71%

“…[ 40 ] Increased risk of VI among children in urban schools reported in the current study was also found in other parts of India. [ 17 25 ] Amongst those who were referred for SC/TC, 44.4% had VI and blindness, which reduced to 5.4% after refractive correction. Hence, this could be implied as a significant percentage of VI due to URE.…”

Section: Discussionmentioning

confidence: 99%

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Visual impairment and refractive errors in school children in Andhra Pradesh, India

Khanna

Prakash

Marmamula

et al. 2022

Indian Journal of Ophthalmology

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Purpose: Addressing childhood vision impairment (VI) is one of the main goals of the World Health Organization’s (WHO) combating blindness strategies. The primary aim of this study was to estimate the prevalence of VI, causes, and its risk factors in school children in Krishna district, Andhra Pradesh, India. Methods: Children aged 4–15 years were screened in schools using the 6/12 Snellen optotype by trained community eye health workers, and those who failed the test and those reported or found to have obvious eye conditions were referred to primary (VC), secondary (SC), or tertiary (TC) care centre appropriately, where they underwent a complete eye examination including cycloplegic refraction and fundus examination. Results: A total of 56,988 children were screened, of whom 51.18% were boys. The mean age was 9.69 ± 3.26 years (4–15 years). Overall, 2,802/56,988 (4.92%) children were referred to a VC, of which 632/56,988 (1.11%) required referral to SC/TC. PVA of <6/12 was found in 1.72% (95% confidence interval [CI]: 1.61–1.83). The prevalence of refractive error (corrected and uncorrected) was 2.38% (95% CI: 2.26–2.51) and myopia was 2.17% (95% CI: 2.05–2.29). In multivariable analysis, older children, those in urban schools, private schools, and children with a disability had an increased risk of VI and myopia. Additionally, the risk of myopia was higher among girls than boys. Of those referred and reached SC/TC, 73.64% were due to avoidable causes. Conclusion: Childhood VI prevalence was 1.72% in this region. Uncorrected refractive error (URE) was the major cause of VI in children. Older age, schools in urban locations, private schools, and the presence of disability were associated with the risk of VI among children.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 71%

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Visual impairment and refractive errors in school children in Andhra Pradesh, India

Khanna

Prakash

Marmamula

et al. 2022

Indian Journal of Ophthalmology

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“…[ 11 ] Another study from the same geographic location done between 2011 and 2015 among public schools showed the prevalence of ocular conditions of 1.46%. [ 21 ]…”

Section: Discussionmentioning

confidence: 99%

Profile of ocular conditions from school eye screening in Southern India

Chandrasekar

Rangavittal

Krishnamurthy

et al. 2022

Indian Journal of Ophthalmology

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Purpose: To profile the presentation of ocular conditions among school children aged 6 to 17 years from the south Indian state of Tamil Nadu. Methods: The study was conducted as part of a school eye health program in Kanchipuram district, Tamil Nadu that aimed to address the refractive needs of children (6–17 years) between July 2016 and June 2019. The study followed a three-phase protocol, which included visual acuity test, modified clinical test, color vision test, binocular vision assessment, objective and subjective refraction, dispensing spectacles, posterior segment evaluation using direct ophthalmoscopy, and referral to the base hospital. The demographics, clinical details, and ocular conditions (classified under 16 categories) were analyzed. Profiling and association of ocular conditions among different locations, types of schools, class grades, and gender were presented. Results: Data of 2,45,565 children were analyzed from 1,047 schools, of which 4,816 (1.96%) children were identified with ocular conditions other than refractive errors. The common reasons for referral were high myopia 901 (0.37%), strabismus 819 (0.33%), and amblyopia 691 (0.28%). Retinal problems (odds ratio [OR]: 1.65, 95% confidence interval [CI]: 1.22–2.22, P = 0.001) and strabismus (OR: 1.41, 95% CI: 1.21–1.65, P < 0.001) were the conditions prevalent in the rural location. Cataract and related conditions (OR: 5.73, 95% CI: 4.10–8.01, P < 0.001) and retinal problems (OR: 4.76, 95% CI: 3.37–6.72, P < 0.001) were common in children studying in public schools. Of the 16 categories, 13 conditions were seen among primary school children. Vernal keratoconjunctivitis (OR: 3.64 95% CI: 2.12–6.23 P < 0.001) was common among males. Conclusion: The study profiled ocular conditions among school children. Most ocular conditions warrant prolonged care and specialty eye care services. Ensuring the availability of such services and follow-up after school eye screening would safeguard the visual development of these children.

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“…Where ‘n’ is the sample size, P is expected prevalence, z is the 95 per cent confidence level ( z =1.96) and ‘d’ is the margin of error (corresponding to effect size) 20 . To make the data more robust, we assumed ‘d’ to be 1.2 per cent = 0.012, P = 20.55 per cent (the collective prevalence of 7 Indian studies: Prevalence of ophthalmic disorders in students of India) 21 - 27 . Hence, n = 1.96×1.96×0.205×(1-0.205)/(0.012) 2 = 4348.…”

Section: Methodsmentioning

confidence: 99%

Ocular morbidity among children (aged 6-18 yr) of the tribal area of Melghat, India: A community-based study

Satav,

Dani

et al. 2023

Indian Journal of Medical Research

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Background & objectives: Most of the ocular morbidities among school children are preventable or treatable. Melghat, a difficult to access, hilly, forest, tribal area with poorly developed infrastructure in the Amravati district of Maharashtra. Scarcity of ophthalmologists and low health-seeking behaviour of tribal people contributes to the high burden of ocular morbidity. Given the lack of published studies on the ocular morbidity among children in Melghat, outreach programmes are essential to diagnose and treat visual impairments promptly. The objective was to determine the prevalence of ocular morbidity among children in the tribal area of Melghat. Methods: A community-based observational study was carried out in the Chikhaldara and Dharni blocks of Melghat. Children from 15 tribal villages were screened for eye disorders by trained paramedics. Most of the children were examined by an ophthalmologist. We used Chi-square test for categorical variables. Results: A total of 4357 children aged between 6 and 18 yr were examined. Of these 2336 (53.6%) were females and 2021 (46.4%) were males. Out of 4357 children, 507 (11.63%) had an ocular morbidity. The prevalence of ocular morbidity and refractive error increased in the age group of 8-10 yr ( P <0.05 and <0.001, respectively). Refractive error was the most common ocular morbidity (n=339; 7.8%), followed by vitamin A deficiency (VAD) (n=120; 2.8%). Interpretation & conclusions: The prevalence of refractive error and VAD in this study was significantly higher than the rest of India and the world. For the prevention of childhood blindness, immediate intervention programme, including eye screening by trained paramedics, treatment by an ophthalmologist and prophylaxis, is crucial.

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Status of Eye Health among School Children in South India – Sankara Nethralaya School Children Eye Examination Study (SN-SEES)

Cited by 12 publications

References 18 publications

Visual impairment and refractive errors in school children in Andhra Pradesh, India

Visual impairment and refractive errors in school children in Andhra Pradesh, India

Profile of ocular conditions from school eye screening in Southern India

Ocular morbidity among children (aged 6-18 yr) of the tribal area of Melghat, India: A community-based study

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