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Profile of ocular conditions from school eye screening in Southern India
Ambika Chandrasekar1, Subhiksha Rangavittal1, Saara Krishnamurthy1
1Elite School of Optometry, Unit of Medical Research Foundation, Chennai, Tamil Nadu, India.
Insights
This study profiled common ocular conditions in Tamil Nadu school children, finding high myopia, strabismus, and amblyopia prevalent. Early detection and specialized care are crucial for preserving vision in affected children.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Public Health
Background:
- School-aged children represent a critical demographic for early detection of visual impairments.
- Ocular conditions in children can significantly impact their educational and developmental trajectory.
- A comprehensive understanding of ocular health in school populations is essential for targeted interventions.
Purpose of the Study:
- To systematically profile the spectrum of ocular conditions among school children aged 6 to 17 years in Tamil Nadu, India.
- To identify the prevalence and patterns of various eye diseases beyond refractive errors.
- To analyze the association of ocular conditions with demographic and school-related factors.
Main Methods:
- A large-scale school eye health program was conducted in Kanchipuram district, Tamil Nadu, from July 2016 to June 2019.
- A multi-phase protocol included visual acuity testing, clinical examinations, refraction, and ophthalmoscopy.
- Data from 245,565 children were analyzed, classifying ocular conditions into 16 categories.
Main Results:
- 1.96% of children (4,816) had ocular conditions other than refractive errors.
- High myopia (0.37%), strabismus (0.33%), and amblyopia (0.28%) were the most common referral reasons.
- Retinal problems and strabismus were more prevalent in rural areas; cataract and retinal issues were common in public schools; vernal keratoconjunctivitis was more frequent in males.
Conclusions:
- The study highlights the significant burden of various ocular conditions among school children in South India.
- Many identified conditions necessitate ongoing management and specialized ophthalmic care.
- Effective school eye screening programs must integrate robust follow-up mechanisms to ensure continuity of care and protect children's vision.
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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