Prevalence of uncorrected refractive error and other eye problems among urban and rural school children.
BACKGROUND
Uncorrected refractive error is an avoidable cause of visual impairment.


OBJECTIVE
To compare the magnitude and determinants of uncorrected refractive error, such as age, sex, family history of refractive error and use of spectacles among school children 6-15 years old in urban and rural Maharashtra, India.


METHODS
This was a review of school-based vision screening conducted in 2004-2005.


METHODS
Optometrists assessed visual acuity, amblyopia and strabismus in rural children. Teachers assessed visual acuity and then optometrists confirmed their findings in urban schools. Ophthalmologists screened for ocular pathology. Data of uncorrected refractive error, amblyopia, strabismus and blinding eye diseases was analyzed to compare the prevalence and risk factors among children of rural and urban areas.


RESULTS
We examined 5,021 children of 8 urban clusters and 7,401 children of 28 rural clusters. The cluster-weighted prevalence of uncorrected refractive error in urban and rural children was 5.46% (95% CI, 5.44-5.48) and 2.63% (95% CI, 2.62-2.64), respectively. The prevalence of myopia, hypermetropia and astigmatism in urban children was 3.16%, 1.06% and 0.16%, respectively. In rural children, the prevalence of myopia, hypermetropia and astigmatism was 1.45%, 0.39% and 0.21%, respectively. The prevalence of amblyopia was 0.8% in urban and 0.2% in rural children. Thirteen to 15 years old children attending urban schools were most likely to have uncorrected myopia.


CONCLUSIONS
The prevalence of uncorrected refractive error, especially myopia, was higher in urban children. Causes of higher prevalence and barriers to refractive error correction services should be identified and addressed. Eye screening of school children is recommended. However, the approach used may be different for urban and rural school children.
Department of Community Ophthalmology, HV Desai Eye Hospital, Pune, India.
Amruta S
AS
Padhye
Rajiv
R
Khandekar
Sheetal
S
Dharmadhikari
Kuldeep
K
Dole
Parikshit
P
Gogate
Madan
M
Deshpande