The Kariapatti pediatric eye evaluation project: baseline ophthalmic data of children aged 15 years or younger in Southern India.
OBJECTIVE
To estimate the prevalence of ocular morbidity among children of rural southern India before developing a service delivery model for community-based pediatric eye care.


METHODS
Population-based cross sectional study.


METHODS
Trained field-workers performed door-to-door enumeration in 74 randomly selected villages of the Kariapatti block in southern India to identify children aged 15 years or younger and performed visual acuity measurements using Cambridge crowded cards and external eye examination with torchlight. Pediatric ophthalmologists further examined subjects with ocular problems identified by the field-worker. The clinical team performed repeat visual acuity measurements with Cambridge crowded cards, refraction, slit-lamp anterior segment examinations, and dilated posterior segment examinations at the screening site. The ophthalmologist identified and recorded one major cause for each visually impaired eye.


RESULTS
Field-workers screened 10605 (94.6%) of 11206 children enumerated, and identified 1441 (13.6%) children as requiring further clinical examination. An additional 449 children identified as normal by the field-worker were randomly chosen for repeat examinations at the screening sites. In all, 1578 (83.5%) of these 1890 children were examined at the screening site. According to World Health Organization criteria, 6.2 of 10000 children were blind; 42.9% of this blindness was potentially avoidable. Refractive errors (0.55%, 95% confidence interval: 0.41, 0.69) and strabismus (0.43%, 95% confidence interval: 0.30, 0.55) were the major ocular morbidity in this population.


CONCLUSIONS
Developing an appropriate service delivery model for this region will require a balance between the relatively low prevalence of morbidity and blindness and the need for service in this population.
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003150:Community Health Workers / Q000458:organization & administration; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000458:organization & administration; D005128:Eye Diseases / Q000453:epidemiology*; D005260:Female; D006266:Health Education; D006302:Health Services Research / Q000458:organization & administration; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D015995:Prevalence; D011897:Random Allocation; D015351:Vision Screening; D019987:Persons with Visual Disabilities / Q000706:statistics & numerical data*