Abstract
Background: The ability to read efficiently and comfortably is important in the intellectual development and academic performance of a child. Some children experience difficulties when reading due to symptoms related to near vision anomalies. Aim: To explore the feasibility of conducting a large study to determine the prevalence, distribution and characteristics of near vision anomalies in high school children in Empangeni, South Africa. Methods: The study was a cross sectional descriptive pilot study designed to provide preliminary data on prevalence, distribution and characteristics of near vision anomalies in a sample of high school-children in South Africa. Study participants comprised 65 Black children (30 males and 35 females), ages ranged between 13 and 19 years with a mean age and standard deviation of 17 ± 1.43 years. The visual functions evaluated and the techniques used included visual acuity (LogMAR acuity chart), refractive error (autorefractor and subjective refraction), heterophoria (von Graefe), near point of convergence (push-in-to-double), amplitude of accommodation (push-in-to-blur) accommodation facility (± 2 D flipper lenses), relative accommodation, accommodation response (monocular estimation method) and fusional vergences (step vergence with prism bars). Possible associations between symptoms and near vision anomalies were explored using a 20-point symptoms questionnaire. Results: Prevalence estimates were: Myopia 4.8%, hyperopia 1.6% and astigmatism 1.6%. For accommodative anomalies, 1.6% had accommodative insufficiency while 1.6% had accommodative infacility. For convergence anomalies, 3.2% had receded near point of convergence, 16% had low suspect convergence insufficiency, no participant had high suspect convergence insufficiency, 1.6% had definite convergence insufficiency and 3.2% had convergence excess. Female participants reported more symptoms than the males and the association between clinical measures and symptoms were not remarkable. Conclusion: Although the overall prevalence of near vision anomalies was low, convergence anomalies were found to be more prevalent than refractive and accommodative anomalies. Symptoms were not significantly associated with near vision anomalies. Overall, the pilot project reveals that it is feasible to conduct the study on a large scale with minor modifications. Identification and referrals for near vision anomalies are important steps towards diagnosis and treatment which will minimize discomfort with reading and subsequent poor performance which may be associated with such anomalies.
Highlights
The ability to read efficiently and comfortably is important in the intellectual development and academic performance of a child 1
The analysis revealed an inverse correlation between the following clinical signs and symptoms for the following questions; q13 (Do you have to re-read the same line of words when you read?) in relation to binocular accommodative facility (AF) with positive lenses (r = − 0.368, p
In relation to other studies, the 1.6% prevalence of hyperopia is comparable to findings from other studies which ranged from 1.24 to 1.81% 20-21, 23, the 4.8% prevalence of myopia is similar to the 4.05% reported by Niroula and Saha 22 but lower than the 2.9% reported by Naidoo et al 20
Summary
The ability to read efficiently and comfortably is important in the intellectual development and academic performance of a child 1. Optometrists see patients with complaints of blurred vision at near, diplopia, headaches, eye strain, watery eyes and ocular fatigue during reading. These symptoms, which are often related to near vision anomalies (NVAs) create discomfort and impair efficient near tasks including reading, writing or computer-based work 1-2. Most school vision screenings are inadequate as most eye tests performed focus on visual acuity and refractive errors[7] giving less emphasis to visual parameters related to NVAs. Near vision anomalies have various negative consequences . Aim: To explore the feasibility of conducting a large study to determine the prevalence, distribution and characteristics of near vision anomalies in high school children in Empangeni, South Africa. Possible associations between symptoms and near vision anomalies were explored using a
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