Refractive Error Study in Children: results from Mechi Zone, Nepal

Area of Science:

• Ophthalmology
• Public Health
• Pediatric Optometry

Background:

• Vision impairment and refractive errors pose significant public health challenges globally, particularly in school-aged populations.
• Understanding the prevalence and causes of visual deficits in children is crucial for implementing effective interventions and improving educational outcomes.

Purpose of the Study:

• To determine the prevalence of refractive errors and vision impairment among school-aged children (5-15 years) in the terai region of Eastern Nepal.
• To identify the primary causes of vision impairment in this population.

Main Methods:

• A cross-sectional study employing random cluster sampling of village-based households.
• Comprehensive eye examinations including visual acuity testing, cycloplegic retinoscopy, autorefraction, and ocular assessments were conducted.
• Quality assurance measures included replicate examinations for a subset of participants.

Main Results:

• Out of 5,067 children examined (91.7% participation rate), the prevalence of best visual acuity of 0.5 (20/40) or worse in at least one eye was 1.4%.
• Refractive error accounted for 56% of uncorrected reduced vision, with amblyopia and other/unexplained causes comprising the remainder.
• Low levels of myopia and hyperopia were observed, with hyperopia linked to female gender and myopia to older age.

Conclusions:

• Reduced vision is uncommon in Eastern Nepal's school-aged children, with correctable refractive error being the main contributor.
• The low prevalence suggests effective vision screening and correction programs may be beneficial.
• Longitudinal studies are warranted to track potential increases in myopia in subsequent birth cohorts.