Vision screening in school children from low-income areas of Sao Paulo city: Frequency and causes of visual impairment and blindness

Abstract

Objective: The purpose of this study was to investigate frequency and causes of visual impairment in school-aged children from low-income areas of Sao Paulo evaluated by the “Ver na Escola” project, an initiative from São Paulo city government in partnership with a local non-governmental organization, launched aiming to offer free-of-charge visual screening and treatment to children enrolled in public schools. Methods: Vision screening included presenting VA, ocular motility, and automated dynamic refraction assessment. Children referred for the ophthalmologist were submitted to automated and subjective static refraction, best-corrected VA, slit lamp, and fundus examination. Results: A total of 17972 children were included in the study. Our findings show a frequency of visual impairment and blindness of 14.6% considering presenting VA decreasing to 1.3% after appropriate refractive correction. The main causes of visual impairment and blindness were uncorrected refractive errors (96.77%), amblyopia (0.88%), and retinal abnormalities (0.37%). Conclusion: The frequency of visual impairment and blindness in the population under study was 14.6% mainly due to uncorrected refractive errors. These results support the need for expanded and perennial refractive services through school-based programs associated with provision of spectacles. These initiatives should be sustainable and pursued by health and school authorities to provision of screening and eye care for those in need.