The prevalence of uncorrected refractive error in urban, suburban, exurban and rural primary school children in Indonesian population

Abstract

Uncorrected refractive error (URE) is a major health problem among school children. This study was aimed to determine the frequency and patterns of URE across 4 gradients of residential densities (urban, exurban, suburban and rural). This was a cross-sectional study of school children from 3 districts in Yogyakarta and 1 district near Yogyakarta, Indonesia. The information regarding age, sex, school and school grader were recorded. The Snellen's chart was used to measure the visual acuity and to perform the subjective refraction. The district was then divided into urban, suburban, exurban and rural area based on their location and population. In total, 410 school children were included in the analyses (urban=79, exurban=73, suburban=160 and rural=98 school children). Urban school children revealed the worst visual acuity (<0.001) and it was significant when compared with exurban and rural. The proportion of URE among urban, suburban, exurban and rural area were 10.1%, 12.3%, 3.8%, and 1%, respectively, and it was significant when compared to the proportion of ametropia and corrected refractive error across residential densities (=0.003). The risk of URE development in urban, suburban, exurban, and rural were 2.218 (95%CI: 0.914-5.385), 3.019 (95%CI: 1.266-7.197), 0.502 (95%CI: 0.195-1.293), and 0.130 (95%CI:0.017-0.972), respectively. Urban school children showed the worst visual acuity. The school children in urban and suburban residential area had 2 and 3 times higher risk of developing the URE.

Prevention of Progression in Myopia: A Systematic Review

“…Another important element for the development of myopia could be attributed to the residential area where children live. A cross-sectional study of school children in Indonesia revealed that the prevalence of uncorrected refractive error was 10.1%, 12.3%, 3.8%, and 1%, respectively among urban, suburban, exurban and rural area [53]. Thus, the higher prevalence among urban and suburban area could be explained with a lack of outdoor activities combined with a more intensive near work due to the higher education in comparison with rural areas.…”

The Prevalence of Visual Impairment and Refractive Errors among a Youth Population in Mozambique: Evidence of the Need for Intervention

“…Therefore, myopia was dominant in other studies, which may be associated with the fact that some studies used an autorefractor without cycloplegic, which overestimates the prevalence of myopia [12], and in others, refraction was performed only in schoolchildren with VA less than 6/6, which may underestimate the prevalence of hyperopia, as it does not always have a low VA.…”

“…The objective refraction was static (with a Keeller Professional Streak Retinoscope) without cycloplegic, and then the subjective refraction was performed. Due to the impossibility of using a cycloplegic, the use of an autorefractor was discarded as it could overestimate the prevalence of myopia in students with very active accommodation [12]. To evaluate the ocular structures, anterior and posterior segments, a point flashlight, magnifying loupe and a professional Keeler ophthalmoscope (for direct ophthalmoscopy) were used.…”

Prevalência De Baixa Acuidade Visual Em Crianças De Uma Escola Da Rede Pública De Ensino

“…Em estudos internacionais recentes, que realizaram a avaliação em crianças escolares, verificou-se a prevalência de 10,1% na população urbana da Indonésia (15) , 5,8%, na Etiópia (16) , e, em um estudo representativo realizado com crianças multiétnicas em escolas rurais da China (17) , cerca de 7,4% dos escolares apresentaram baixa AV, considerando a medida no melhor olho.…”