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      Prevalence of refractive errors among the school-going children in East Sikkim

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          Abstract

          Purpose:

          Vision plays an important role in child's development for learning and communication. Uncorrected refractive error (URE) has become a major challenge to health care policy makers especially in school going children. We aim to report the prevalence of refractive error among the school students of the east district of Sikkim, India.

          Methods:

          A cross-sectional study was carried out among 15,954 school children under school health program of national program for control of blindness. The screening was conducted in 40 schools of east district which included primary, higher secondary, monastic and private schools.

          Results:

          The prevalence of refractive error was 6.7% among which myopia was the most common error present in 335 (31.1%) children, followed by astigmatism in 317 (29.4%) and the remaining 29 (2.6%) with hyperopia. The age group between 14-17 years had high prevalence of refractive error (9.2%). Females had slightly higher refractive error (6.93%) than males (5.9 %). Most backward classes were found to be highest suffering from refractive error (26.65%) and the least seen was found in schedule tribe (11.6%).

          Conclusion:

          The study provides a useful and baseline data about the refractive error amongst the school children of east Sikkim. A larger study needs to be conducted in all the schools of the state to get a clearer picture of RE and other eye related diseases to detect vision problem as early as possible.

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          Most cited references22

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          Global estimates of visual impairment: 2010.

          From the most recent data the magnitude of visual impairment and its causes in 2010 have been estimated, globally and by WHO region. The definitions of visual impairment are the current definitions of presenting vision in the International Classification of Diseases version 10. A systematic review was conducted of published and unpublished surveys from 2000 to the present. For countries without data on visual impairment, estimates were based on newly developed imputation methods that took into account country economic status as proxy. Surveys from 39 countries satisfied the inclusion criteria for this study. Globally, the number of people of all ages visually impaired is estimated to be 285 million, of whom 39 million are blind, with uncertainties of 10-20%. People 50 years and older represent 65% and 82% of visually impaired and blind, respectively. The major causes of visual impairment are uncorrected refractive errors (43%) followed by cataract (33%); the first cause of blindness is cataract (51%). This study indicates that visual impairment in 2010 is a major health issue that is unequally distributed among the WHO regions; the preventable causes are as high as 80% of the total global burden.
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            Refractive error in children in an urban population in New Delhi.

            To assess the prevalence of refractive error and related visual impairment in school-aged children in an urban population in New Delhi, India. Random selection of geographically defined clusters was used to identify a sample of children 5 to 15 years of age. From December 2000 through March 2001, children in 22 selected clusters were enumerated through a door-to-door survey and examined at a local facility. The examination included visual acuity measurements, ocular motility evaluation, retinoscopy and autorefraction under cycloplegia, and examination of the anterior segment, media, and fundus. Myopia was defined as spherical equivalent refractive error of at least -0.50 D and hyperopia as +2.00 D or more. Children with reduced vision and a sample of those with normal vision underwent independent replicate examinations for quality assurance in four of the clusters. A total of 7008 children from 3426 households were enumerated, and 6447 (92.0%) examined. The prevalence of uncorrected, baseline (presenting), and best corrected visual acuity of 20/40 or worse in the better eye was 6.4%, 4.9%, and 0.81%, respectively. Refractive error was the cause in 81.7% of eyes with vision impairment, amblyopia in 4.4%, retinal disorders in 4.7%, other causes in 3.3%, and unexplained causes in the remaining 5.9%. There was an age-related shift in refractive error from hyperopia in young children (15.6% in 5-year-olds) toward myopia in older children (10.8% in 15-year-olds). Overall, hyperopia was present in 7.7% of children and myopia in 7.4%. Hyperopia was associated with female gender. Myopia was more common in children of fathers with higher levels of education. Reduced vision because of uncorrected refractive error is a major public health problem in urban school-aged children in India. Cost-effective strategies are needed to eliminate this easily treated cause of vision impairment.
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              Global magnitude of visual impairment caused by uncorrected refractive errors in 2004.

              Estimates of the prevalence of visual impairment caused by uncorrected refractive errors in 2004 have been determined at regional and global levels for people aged 5 years and over from recent published and unpublished surveys. The estimates were based on the prevalence of visual acuity of less than 6/18 in the better eye with the currently available refractive correction that could be improved to equal to or better than 6/18 by refraction or pinhole. A total of 153 million people (range of uncertainty: 123 million to 184 million) are estimated to be visually impaired from uncorrected refractive errors, of whom eight million are blind. This cause of visual impairment has been overlooked in previous estimates that were based on best-corrected vision. Combined with the 161 million people visually impaired estimated in 2002 according to best-corrected vision, 314 million people are visually impaired from all causes: uncorrected refractive errors become the main cause of low vision and the second cause of blindness. Uncorrected refractive errors can hamper performance at school, reduce employability and productivity, and generally impair quality of life. Yet the correction of refractive errors with appropriate spectacles is among the most cost-effective interventions in eye health care. The results presented in this paper help to unearth a formerly hidden problem of public health dimensions and promote policy development and implementation, programmatic decision-making and corrective interventions, as well as stimulate research.
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                Author and article information

                Journal
                Indian J Ophthalmol
                Indian J Ophthalmol
                IJO
                Indian Journal of Ophthalmology
                Wolters Kluwer - Medknow (India )
                0301-4738
                1998-3689
                August 2021
                26 July 2021
                : 69
                : 8
                : 2018-2020
                Affiliations
                [1]Department of Ophthalmology, STNM Hospital, Gangtok, Sikkim, India
                [1 ]Department of Biochemistry, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim, India
                [2 ]Medical Student, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim, India
                Author notes
                Correspondence to: Dr. Karma L Bhutia, Sir Thutop Namgyal Memorial Hospital (STNM), Gangtok, Sikkim - 737 102, India. E-mail: drkarma07@ 123456gmail.com
                Article
                IJO-69-2018
                10.4103/ijo.IJO_112_21
                8482929
                34304168
                52b4bfd0-e306-429c-b3a9-30768fb2f5a2
                Copyright: © 2021 Indian Journal of Ophthalmology

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 13 January 2021
                : 07 March 2021
                : 07 June 2021
                Categories
                Original Article

                Ophthalmology & Optometry
                hyperopia,myopia,prevalence,refractive error,sikkim india
                Ophthalmology & Optometry
                hyperopia, myopia, prevalence, refractive error, sikkim india

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