title: Visual acuity and refractive status of Omani students with refractive error in grades 1, 4 and 7: A retrospective cohort study.
abstract: BACKGROUND
  The visual and refractive status were assessed for grade 7 students in seven governorates in Oman. The health records were reviewed to assess the rationale for their previous school-based vision screening.
  
  
  METHODS
  A representative sample of 7(th) grade students with a refractive error (RE) was examined by optometrists in 2012. Their compliance with spectacle wear was also reviewed. Each student's vision and refractive status in grades 1 and 4 were compared with the status in grade 7. Each student's use of eye care services between grade 4 and 7 was evaluated to determine the uptake of existing eye services for vision problems.
  
  
  RESULTS
  This study had 286, 7(th) grade students with RE (myopia [94%], hyperopia [4%] and astigmatism [>1D] [2%]). The types of RE between genders in each grade were not significant (P > 0.05). During their vision screening when they were in grade 4, 5 of 13 moderate myopes (>-2D to - 6D) and 3 of 4 high myopes (>-6D) were detected and managed. Ten students with moderate and high myopia were already using spectacles before they were screened in grade 7. The compliance for spectacle wear was 62% in grade 7. Between grades, 4 and 7, 140 (49%) students did not visit eye clinics or an optician.
  
  
  CONCLUSIONS
  Refractive services in grade 4 were an additional initiative from the eye health care systems in Oman to the actual World Health Organization recommendations of conducting vision screening and RE corrections at grade 7 and 10. However, this was not proved to be significantly effective in early detection, and even the uptake of eye care services by school children was also low.
authors.affiliation: Department of Primary Health, Eye Health Care, Ministry of Health, Oman.
authors.forename: Saleh
authors.initials: S
authors.lastname: Al Harby
authors.affiliation: Imam Mohammed Bin Saud Islamic University, College of Medicine, Riyadh, Saudi Arabia.
authors.forename: Tariq
authors.initials: T
authors.lastname: Al-Asbali
authors.affiliation: Department of Research, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Khandekar
keywords: Barriers for service uptake; childhood blindness; compliance; refractive error; school health; spectacle wear; vision screening