title: Do school classrooms meet the visual requirements of children and recommended vision standards?
abstract: BACKGROUND
  Visual demands of school children tend to vary with diverse classroom environments. The study aimed to evaluate the distance and near Visual Acuity (VA) demand in Indian school classrooms and their comparison with the recommended vision standards.
  
  
  METHODS
  The distance and near VA demands were assessed in 33 classrooms (grades 4 to 12) of eight schools. The VA threshold demand relied on the smallest size of distance and near visual task material and viewing distance. The logMAR equivalents of minimum VA demand at specific seating positions (desk) and among different grades were evaluated. The near threshold was converted into actual near VA demand by including the acuity reserve. The existing dimensions of chalkboard and classroom, gross area in a classroom per student and class size in all the measured classrooms were compared to the government recommended standards.
  
  
  RESULTS
  In 33 classrooms assessed (35±10 students per room), the average distance and near logMAR VA threshold demand was 0.31±0.17 and 0.44±0.14 respectively. The mean distance VA demand (minimum) in front desk position was 0.56±0.18 logMAR. Increased distance threshold demand (logMAR range -0.06, 0.19) was noted in 7 classrooms (21%). The mean VA demand in grades 4 to 8 and grades 9 to 12 was 0.35±0.16 and 0.24±0.16 logMAR respectively and the difference was not statistically significant (p = 0.055). The distance from board to front desk was greater than the recommended standard of 2.2m in 27 classrooms (82%). The other measured parameters were noted to be different from the proposed standards in majority of the classrooms.
  
  
  CONCLUSIONS
  The study suggests the inclusion of task demand assessment in school vision screening protocol to provide relevant guidance to school authorities. These findings can serve as evidence to accommodate children with mild to moderate visual impairment in the regular classrooms.
authors.affiliation: Medical Research Foundation, Sankara Nethralaya, Chennai, India.|Shanmugha Arts, Science, Technology & Research Academy (SASTRA) University, Thanjavur, India.|Elite School of Optometry, Chennai, India.
authors.forename: Kalpa
authors.initials: K
authors.lastname: Negiloni
authors.affiliation: Elite School of Optometry, Chennai, India.
authors.forename: Krishna Kumar
authors.initials: KK
authors.lastname: Ramani
authors.affiliation: Medical Research Foundation, Sankara Nethralaya, Chennai, India.
authors.forename: Rachapalle Reddi
authors.initials: RR
authors.lastname: Sudhir
mesh_terms: D000065:Accommodation, Ocular; D000293:Adolescent; D002648:Child; D006801:Humans; D007194:India; D012574:Schools; D014787:Vision Tests / Q000379:methods*; D014785:Vision, Ocular / Q000502:physiology*; D014792:Visual Acuity / Q000502:physiology*; D014796:Visual Perception