title: Ophthalmologic abnormalities among students with cognitive impairment in eastern Taiwan: The special group with undetected visual impairment.
abstract: OBJECTIVE
  Students with cognitive impairment are at increased risk of suffering from visual impairment due to refractive errors and ocular disease, which can adversely influence learning and daily activities. The purpose of this study was to evaluate the ocular and visual status among students at the special education school in Hualien.
  
  
  METHODS
  All students at the National Hualien Special Education School were evaluated. Full eye examinations were conducted by a skilled ophthalmologist. The students' medical records and disability types were reviewed.
  
  
  RESULTS
  A total of 241 students, aged 7-18 years, were examined. Visual acuity could be assessed in 138 students. A total of 169/477 (35.4%) eyes were found to suffer from refractive errors, including 20 eyes with high myopia (≤-6.0 D) and 16 eyes with moderate hypermetropia (+3.0 D to +5.0 D). A total of 84/241 (34.8%) students needed spectacles to correct their vision, thus improving their daily activities and learning process, but only 15/241 (6.2%) students were wearing suitable corrective spectacles. A total of 55/241 students (22.8%) had ocular disorders, which influenced their visual function. The multiple disability group had a statistically significant higher prevalence of ocular disorders (32.9%) than the simple intellectual disability group (19.6%).
  
  
  CONCLUSIONS
  Students with cognitive impairment in eastern Taiwan have a high risk of visual impairment due to refractive errors and ocular disorders. Importantly, many students have unrecognized correctable refractive errors. Regular ophthalmic examination should be administered to address this issue and prevent further disability in this already handicapped group.
authors.affiliation: Department of Ophthalmology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
authors.forename: Wei-Shan
authors.initials: WS
authors.lastname: Tsao
authors.affiliation: Eye Health Promotion Center of Eastern Taiwan, Hualien, Taiwan.
authors.forename: Hsi-Pao
authors.initials: HP
authors.lastname: Hsieh
authors.affiliation: Eye Health Promotion Center of Eastern Taiwan, Hualien, Taiwan.
authors.forename: Yi-Ting
authors.initials: YT
authors.lastname: Chuang
authors.affiliation: Eye Health Promotion Center of Eastern Taiwan, Hualien, Taiwan; Department of Ophthalmology, Mennonite Christian Hospital, Hualien, Taiwan; Department of Ophthalmology and Visual Science, Tzu Chi University, Hualien, Taiwan. Electronic address: hsuhung@mch.org.tw.
authors.forename: Min-Muh
authors.initials: MM
authors.lastname: Sheu
mesh_terms: D000293:Adolescent; D002648:Child; D060825:Cognitive Dysfunction / Q000150:complications* / Q000503:physiopathology; D019988:Children with Disabilities / Q000523:psychology / Q000706:statistics & numerical data*; D004519:Education, Special / Q000706:statistics & numerical data; D005128:Eye Diseases / Q000453:epidemiology* / Q000209:etiology; D005139:Eyeglasses / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012030:Refractive Errors / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D014786:Vision Disorders / Q000453:epidemiology* / Q000209:etiology; D014792:Visual Acuity / Q000502:physiology
keywords: cognitive impairment; ocular disorder; refractive error; visual acuity