The prevalence of visual impairment in school children of upper-middle socioeconomic status in Kathmandu.
OBJECTIVE
Assess visual impairment in school children of upper-middle socioeconomic status in Kathmandu for comparison with rural Jhapa District.


METHODS
Random selection of classes from secondary private schools in Kathmandu was used to identify the study sample. Children in 130 classes at 43 schools were enumerated using school records and examined between January-May 2006. Examinations included visual acuity testing, ocular motility evaluation, cycloplegic refraction, and examination of the external eye, anterior segment, media, and fundus. The principal cause was determined for eyes with uncorrected visual acuity < or = 20/40.


RESULTS
A total of 4,501 children in grades 5-9 were enumerated; 4282 (95.1%) were examined. The prevalence of uncorrected, presenting, and best-corrected visual impairment (< or = 20/40) in the better eye was 18.6%, 9.1%, and 0.86%, respectively. Refractive error was a cause in 93.3% of children with uncorrected visual impairment, amblyopia 1.8%, retinal disorders 1.3%, other causes 0.3%, and unexplained causes 4.4%. Among children correctable in at least one eye, 46.3% presented without the necessary spectacles. Visual impairment with myopia (-0.50 diopters) ranged from 10.9% in 10 year-olds to 27.3% in 15 year-olds, compared to 0.5%-3.0% in rural Jhapa District. Myopic visual impairment was associated with grade level, female gender, parental education, parental spectacle usage, and Mongol ethnicity.


CONCLUSIONS
Visual impairment with myopia among upper-middle socioeconomic school children in Kathmandu is higher than that in rural Nepal, and a public health problem because nearly half are without corrective spectacles. Effective strategies are needed to eliminate this easily treatable cause of visual impairment.
Sapkota
Yuddha D
YD
Nepal Netra Jyoti Sangh, Tripureshwor, Kathmandu, Nepal.
Adhikari
Bishwa Nath
BN
Pokharel
Gopal P
GP
Poudyal
Bimal K
BK
Ellwein
Leon B
LB
D000293:Adolescent; D002648:Child; D005139:Eyeglasses / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D009390:Nepal / Q000453:epidemiology; D015995:Prevalence; D012030:Refractive Errors / Q000453:epidemiology*; D012923:Social Class; D014786:Vision Disorders / Q000453:epidemiology*; D014792:Visual Acuity; D019987:Persons with Visual Disabilities / Q000706:statistics & numerical data*