Prevalence of ocular morbidity in preschool children in Pune, Maharashtra

Aim of the Study:This study aims to evaluate the prevalence and to make a comparison between the ocular morbidity pattern in school going children of urban and rural areas of West Uttar Pradesh.Materials and Methods:A school-based cross-sectional study design was adopted to examine children aged 5–15 years in randomly selected urban and rural schools of West Uttar Pradesh from June 2012 to August 2014. An optometrist did the vision and refraction, and a detailed ophthalmic examination was done by an ophthalmologist. Children needing further assessment were referred to a higher center. Interpretation and analysis of the data were done using Epi Info Software and t-test.Results:A total of 4838 students (2271 males and 2567 females) were screened. The prevalence of ocular morbidity was 29.35% (28.65% urban, 30.05% rural). Refractive error (17.36%) was the major cause of ocular morbidity followed by convergence insufficiency (2.79%), blepharitis (2.11%), Vitamin A deficiency (2.09%), allergic conjunctivitis (1.92%), bacterial conjunctivitis (0.95%), amblyopia (0.41%), stye (0.31%) and squint (0.27%). There was an increase in ocular morbidity with age, especially in refractive error and convergence insufficiency. On comparing urban and rural schools, Vitamin A deficiency showed a significantly higher prevalence (P < 0.05%) in the rural (3.03%) as compared to the urban sector (1.15%). The prevalence of visual impairment was 4.9/1000 children, and prevalence of blindness was 0.62/1000 children.Conclusion:This study was the first of its kind in West Uttar Pradesh, reporting a considerable high prevalence (29.35%) of pediatric ocular morbidity, which was more in rural as compared to the urban sector. Since most of this morbidity is either preventable or treatable, school screening forms an effective method to reduce this load.

PurposeChildhood ocular morbidity involves a spectrum of eye diseases that critically impact the mental development, future education and quality of life. However, there is limited evidence about the early detection and appropriate treatment of ocular morbidity in children <20 years. This study was aimed to assess the prevalence and make a comparison between the different types of ocular morbidity in children of both sexes in the age group of 6–17 years in the eastern India.MethodsA cross-sectional survey of ocular morbidity among children <17 years of age who presented at the Department of Ophthalmology, Kalinga Institute of Medical Sciences, Bhubaneswar, and Vision Care Center for Retina, Bhubaneswar, in the eastern India between January 2015 and March 2018 was accomplished. Demographic information, visual acuity, type of eye injury, refractive errors and other detailed ophthalmic examination were screened.ResultsA total of 633 children (age 6–17 years) were examined in this study. The majority of cases were observed in children of age 12–17 years, accounting for almost close to half of all the cases. The prevalence of ocular morbidity was 45.92% in males and 53.97% in females. The most common ocular morbidity in children encountered was refractive error (54.62%), followed by congenital abnormalities (9%), allergic conjunctivitis (8.52%) and traumatic eye injury (7.1%). There was an increase in ocular morbidity with age, especially the refractive error and congenital abnormalities.ConclusionA large number of ocular morbidity was observed in children of age <17 years. Since most of this morbidity was preventable or treatable, reasonable service for ocular morbidity and early age screening are effective methods to reduce this load. Moreover, health education for the prevention of childhood ocular morbidity and, at the same time, early presentation of children to ophthalmic hospitals for the treatment of eye disorders are essential.

BackgroundThis study aimed to investigate the difference between cycloplegic and noncycloplegic refraction and evaluate the pseudomyopia prevalence in Chinese preschool children during the outbreak of COVID-19.MethodsA cross-sectional study was conducted in the Tongzhou District of Beijing, China. Refractive error was measured under both noncycloplegic and cycloplegic conditions with autorefraction. The difference between noncycloplegic and cycloplegic spherical equivalent refraction (SER) and pseudomyopia prevalence were analyzed. Pseudomyopia was defined as SER ≤-0.50D in precycloplegic assessments and >-0.50D in post-cycloplegic assessments.ResultsOut of the 1487 participants who were enrolled in the study, 1471 individuals (98.92%) between the ages of 3–6 years completed all required procedures. A statistically significant difference in refraction was observed between noncycloplegic and cycloplegic measurements, the median of difference in spherical equivalent refraction (SER) of 0.88D (dioptre)(0.50,1.38). There was a high intraclass correlation (ICC) between these two methods for cylinders (ICC = 0.864; 95% CI, 0.850–0.877). The median DSE for myopia, emmetropia and hyperopia were 0.25D (0.00, 0.38),0.25D (0.06, 0.50) and 1.00D (0.62, 1.38), an hypermetropes showed considerably greater differences than myopes and emmetropes (Kruskal-Wallis test, H = 231.023, P = 0.000). Additionally, girls displayed a greater DSE than boys. Furthermore, when comparing against-the-rule (ATR) and oblique astigmatism, it was found that with-the-rule (WTR) astigmatism had the largest DSE. The study found varying prevalence rates of myopia, emmetropia, and hyperopia with and without cycloplegia, which were 1.90% vs. 10.06%, 11.49% vs. 50.31%, and 86.61% vs. 39.63%, respectively. Additionally, the overall prevalence of pseudomyopia was determined to be 8.29%. Participants with pseudomyopia had a significantly higher mean difference in SER (DSE) compared to non-pseudomyopic participants.ConclusionsCycloplegic refraction is more sensitive than a noncycloplegic one for measuring refractive error in preschool children. Pseudomyopia is prevalent in preschool children during the COVID-19 outbreak period. Our study indicates the possibility that cycloplegic refraction should be performed in preschool children routinely.

Respiratory morbidity, recurrent cough and/or wheeze and lung function abnormalities are common even outside infancy in preschool children born prematurely. Throughout the first 5 years of life, adverse neonatal events such as immaturity at birth and a requirement for prolonged respiratory support are significantly associated with positive symptom status. In the older preschool child, however, there is some evidence to suggest that other factors, such as a family history of atopy, may be equally important. The development of recurrent symptoms even at 4 years of age can be predicted accurately from the results of lung function measurements made in infancy, and hopefully such data will facilitate the introduction of effective intervention strategies. Lung function abnormalities are more marked in symptomatic patients and, in older children, seem to reflect increased airway responsiveness rather than having a significant relationship to adverse neonatal events. The hospital readmission rate for respiratory disorders, however, is certainly adversely affected by extremely low birthweight and neonatal chronic lung disease, as well as current symptom status. These data highlight that strategies to reduce extremely premature delivery and its consequences should favourably influence respiratory morbidity in preschool children.

Hartmann–Shack images taken from an archived collection of SureSight refractive measurements of pre-school children in Oxford County, Ontario, Canada were retrieved and re-analyzed. Higher-order aberrations were calculated over the age range of 3 to 6 years. These higher-order aberrations were compared with respect to magnitudes of ametropia. Subjects were classified as emmetropic (range −0.5 to + 0.5D), low hyperopic (+ 0.5 to +2D) and high hyperopic (+2D or more) based upon the resulting spherical equivalent. Higher-order aberrations were found to increase with higher levels of hyperopia (p < 0.01). The strongest effect was for children showing more than +2.00D of hyperopia. The correlation coefficients were small in all of the higher-order aberrations; however, they were significant (p < 0.01). These analyses indicate a weak association between refractive error and higher-order aberrations in pre-school children.

Abstract. Introduction. Dental diseases in preschool children do not appear to tend downward. According to the literature, the prevalence of dental decay and its complications in preschool children reaches 70%, dental abnormalities more than 80%, and periodontal diseases and oral mucosa diseases up to 98%. There are some data described in literature, regarding how family types affect the overall incidence in children. At the same time, the impact of family type on the children dental health has not been studied a lot so far. Taking this into account, this paper provides data on dental morbidity in preschool children living in nuclear and reconstituted families. The aim of the study is to examine the pattern of prevalence of major dental diseases in preschool children living in nuclear or reconstituted families. Materials and Methods. Preschool children of different ages and their parents took part in this study. During the study, we identified reconstituted and nuclear families, the children from which families constituted the subject of the study. In total, the study examined 1,929 children from 1,842 nuclear families and 166 children from 146 reconstituted children. Results and Discussions. The study found that the most important dental diseases occur in children of the earliest age, before 1 year of life. With the passage of time and the child’s growth, their dental morbidity progresses and reaches its peak among preschool children aged 4.6-6 years. Children living in reconstituted families were significantly more susceptible to the onset and progression of major dental diseases than those from nuclear families. Conclusions. The impact of family type on dental morbidity in preschool children should be considered while planning the prevention and medical examination programs, which will help identify dental diseases at an early stage, prevent the development of complications, and optimize health care costs for the treatment and prevention of dental diseases in preschool children

To determine the prevalence of ocular morbidity and refractive error among the children of the squatter settlements in Kathmandu. A cross-sectional study was carried out at five squatter settlement areas at Kathmandu, including 366 children younger than 16 years. Detailed eye examination included the visual acuity testing, cycloplegic refraction, binocular vision assessment, anterior segment examination, and posterior segment examination. Variations in age, sex, and ethnic distribution of the study population were analyzed through analysis of variance. Pearson χ test with Yate correction was used to analyze different types of ocular morbidity. Pearson correlation coefficient test was performed to correlate refractive error in the right eye and the left eye. Majority of children (28.9%) belonged to the age group 8 to 10 years, and most of them belonged to the Manohara settlement area (40.2%). Male-female ratio was 0.7. Uncorrected and best-corrected visual acuity of better than or equal to 6/9 in at least one eye was found in 87.9% and 99.0% children, respectively. Total ocular morbidity was observed in 33.7%. The common type of ocular morbidity was conjunctivitis (11.2%), refractive error (9.0%), and blepharitis (5.4%). Ocular morbidity was common in infants (57.9%; p = 0.043; odds ratio, 2.8) and 14- to 15-year-old children (52.8%; p = 0.002; odds ratio, 2.5). Ocular infection and refractive error represent the common ocular morbidity in children living in squatter settlements.

Background: School going children form an important group in which as ocular morbidity has a huge physical, psychological and socio-economic implications. Approximately one-third of blind persons in India are affected before 20 years of age, hence early detection of ocular morbidity and their management is very important. This study aims to highlight the prevalence of ocular morbidity in school going children of government and private schools of Haldwani. Materials and Methods: Government and private schools were selected by simple random sampling, sample size was calculated and a total of 1355 school children were included in the study. Data was collected with the questionnaire and detailed ophthalmic examination was done using appropriate charts and instruments. Data was analyzed using SPSS version 21. Results: Prevalence of ocular morbidity was found to be 23.3%. Refractive error was the most common ocular morbidity (15.6%) followed by colour blindness (2.4%) and vitamin A deficiency (1.1%). Prevalence of overall ocular morbidity and refractive errors were found significantly associated with age of the study participants. (p value < 0.05). Conclusion: A high prevalence of ocular morbidity among high-school children was observed. Refractive errors were the most common ocular disorders. Key words: Ocular morbidity, Prevalence, Blindness, School children, Refractive error

Background Myopia is a refractive error that is increasing dramatically all over the world. Early onset is associated with a significant visual burden later in life, but little is known about refractive errors in preschool children. The aim of this study was to assess prevalence of spectacle wear, visual acuity and refractive errors in young Dutch children and to make global comparisons. Methods We analyzed data of three prospective population-based studies: 99,660 3- to 5-year-olds undergoing vision screening at preventive child healthcare organizations, 6,934 6-year-olds from the Generation R study, and 2,974 7-year-olds from the RAMSES study. Visual acuity was measured with Landolt-C or LEA charts, spectacle wear was assessed, and refractive errors at age 6 and 7 were measured with cycloplegic refraction. Spectacle wear was compared with international studies. Results The prevalence of spectacle wear was 1.5%, 2.3%, 6.6%, 8.2% and 11.8% at 36, 45, 60, 72 and 84 months, respectively, with no major sex differences. Among children with spectacle wear at 72 months (N = 583) and 84 months (N = 351) 29.8% and 34.6% had myopia respectively, of which 21.1% and 21.6% combined with astigmatism, 19.6% and 6.8% had hyperopia, 37.2% and 11.1% hyperopia and astigmatism, and 12.5% and 33.3% astigmatism only. The prevalence of spectacle wear globally varied between 1.5% to 21%. Conclusions Spectacle wear in these European children started early in preschool and increased to substantial figures at school age. Among children with spectacle wear, &amp;gt;30% were already myopic, illustrating the urgency to implement myopia prevention strategies in child health centers. Key messages Early onset myopia is a public health issue. Of the 6- to 7-year-olds with spectacles 30-34% were already myopic. Monitoring of refractive errors and preventive lifestyle interventions are warranted.

To determine the sensitivity and specificity of noncycloplegic autorefraction for determining refractive status compared to cycloplegic autorefraction. The target population was noninstitutionalized citizens of all ages, residing in Tehran in 2002, selected through stratified cluster sampling. From 6497 eligible residents, 70.3% participated in the study, from August to November 2002. Here, we report data on 3501 people over the age of 5 years who had autorefraction with and without cycloplegia (two drops of cyclopentolate 1.0% 5 min apart, with autorefraction 25 min after the second drop). Overall, the sensitivity of noncycloplegic autorefraction for myopia was 99%, but the specificity was only 80.4%. In contrast, the sensitivity for hyperopia was only 47.9%, but the specificity was 99.4%. At all ages, noncycloplegic autorefraction overestimated myopia and underestimated hyperopia. Overestimation of myopia was highest in the 21-30 and 31-40 year groups. Underestimation of hyperopia was high up to the age of 50 (20-40%), but decreased with age, to about 8% after the age of 50, down to almost 0% after 70. The difference in mean spherical equivalent with and without cycloplegia fell from 0.71 dioptres (D) in the 5-10 age group to 0.14D in those over 70. Use of noncycloplegic autorefraction in epidemiological studies leads to considerable errors relative to cycloplegic measurements, except in those over 50-60. The difference between cycloplegic and noncycloplegic measurements varies with age and cycloplegic refractive category, and there is considerable individual variation, ruling out adjusting noncycloplegic measurements to obtain accurate cycloplegic refractions.

Background: Ocular morbidities in children can have a serious impact on development, education and quality of life in children hence require prompt attention. This study was conducted with an objective to determine the pattern of ocular morbidity in children less than 15 years of age presenting in the Outpatient Department (OPD) of MKCG Medical College, Berhampur.Methods: A hospital based cross-sectional study was carried out from August 2016 to January 2017 among 282 children. Data was collected by using a semi structured questionnaire after taking informed consent and analyzed.Results: Majority were in the age group of 10-14 years (55.3%). The common presenting symptoms were blurred vision (29.1%) and headache (7.8%). The common ocular morbidities reported were refractive error (34%), ocular infection (13.5%), ocular trauma (9.9%), allergic conjunctivitis (9.2%). Refractive error was more prevalent in children of aged 11-14 years and ocular trauma in 5-9 years compared to children of the other age group.Conclusions: Majority of ocular morbidities are preventable and treatable. So early attention through eye screening and intervention programme at the community level is recommended.

Early detection and treatment of amblyogenic conditions such as high refractive errors and anisometropia can help prevent the development of amblyopia. The traditional gold standard for the determination of refractive error in pre-school children is retinoscopy. Difficulties with retinoscopy in pre-school children have led to the development of autorefractors that can be free of operator bias and can be used by lay individuals. The Nikon Retinomax Plus handheld autorefractor has proven to be reliable for quick and accurate assessments of refractive errors in children. The Welch Allyn SureSight Vision Screener is a relatively new handheld autorefractor. The present study compares the results of measurements with the Retinomax Plus and the SureSight to the results of cycloplegic retinoscopy in pre-school children. Thirty-five children ranging in age from 3 to 5 years old were subjects. Any subjects with strabismus, amblyopia, nystagmus, or ocular disease were excluded. Refractive error was assessed 30 min after the application of a cycloplegic spray. Both autorefractors showed moderate agreement with cycloplegic retinoscopy results for measurement of spherical equivalent and cylinder power. In addition, the SureSight and the Retinomax Plus sphere and cylinder results showed moderate agreement with each other. Although the mean differences of the spherical equivalents determined were minimal, the 95% confidence intervals were large, which limits the value of the data obtained from each instrument. Even though the Retinomax Plus and the SureSight appear to agree with each other and with the results of cycloplegic retinoscopy for determining sphere and cylinder power, interpretation of the data should be considered as screening only because the actual magnitude of sphere and cylinder may vary from the actual magnitude. These results suggest that either device may be useful only as screening tools for assessing refractive error in pre-school children.

Aims: To assess the differences in ocular morbidity with/without visual impairment between rural and urban school-going children using a two-step screening strategy. Methods: Data obtained by a hospital team from school camps conducted between the 1st of February 2019 and the 31st of December 2019, in schools with a strength of at least 1,000 students were reviewed retrospectively. The differences in ocular pathologies between the rural and urban cohorts were evaluated. A P < 0.05 was considered significant. Results: Out of 25,132 students (nurban = 12,562; nrural = 12,570), 14.44% (nurban = 1,585; nrural = 2,044; P < 0.001) were selected for evaluation by the hospital team after a primary screening by their class teachers. A statistically significant difference was noted in the frequency of refractive errors (urban = 6.8%; rural = 6.0%; P = 0.01), allergic conjunctivitis (urban = 0.2%; rural = 0.05%; P = 0.001), and amblyopia (urban = 0.03%; rural = 0.12%; P = 0.009) between urban and rural children. Simple and compound myopic astigmatism were significantly more common in urban children (p < 0.001 and 0.03 respectively). There was no significant difference in the incidence of spectacle use (P = 0.11) between the two cohorts. A Cochran--Armitage trend test revealed a statistically significant increase in the proportion of myopia with age among the children evaluated by the hospital team (p < 0.001). Conclusion: Allergic eye disease and myopic astigmatism are commoner in urban children. Routine ophthalmic screening is required to identify uncorrected refractive errors and amblyopia, especially in rural school children.

Objectives: To determine childhood eye diseases in Sagamu and compare the findings with those of other centres. Method: This retrospective study covers a 3-year period (Jan 1999 – Dec 2001). Diagnoses were made by ophthalmology consultants after full examination of the eyes. A follow-up of the patients was done by ophthalmology residents Results: A total of 707 new paediatric cases presented at the ophthalmology outpatient clinic during the study period. This represents 22.51% of new cases (adults and children) presenting at the Olabisi Onabanjo University Teaching Hospital (OOUTH). The overall male-female ratio was 1.2:1. Conjunctivitis (45.97%) – in particular allergic conjunctivitis (78.76% of cases of conjunctivitis), followed by refractive error (24.61%), and trauma (11.32%) were the most common causes of ocular morbidity in children. Lid diseases (3.54%), corneal scar (2.83%) and neuro-ophthalmic diseases were found to be less common. Factors favouring allergic conjunctivitis are the agrarian occupation of the people and a dusty environment. Conclusion: The common causes of childhood ocular morbidity in Sagamu are comparable to the findings in studies conducted in some other centres. It was found that corneal scarring has reduced in children, probably due to a better awareness of measles immunization. Allergic conjunctivitis, however, has become an important cause of ocular morbidity in children. Refractive error was also found to be an important cause of ocular morbidity in this study as in other studies. This probably justifies its inclusion in the vision 2020 programme. Key Words: corneal scarring, allergic conjunctivitis, refractive error, ocular morbidity Nigerian Journal of Ophthalmology Vol.12 (1) 2004: 6-9

Many parents are concerned about their child's development. The purpose of this study is to determine whether parental concerns about overall development are associated with significant refractive errors among urban preschool children. A cross-sectional population-based study was conducted to evaluate the prevalence of ocular disorders in white and African American children aged 6 through 71 months in Baltimore, Maryland. A comprehensive eye examination with cycloplegic refraction was performed. Parental concerns about development were measured with the Parents' Evaluation of Developmental Status screening tool. Of 2546 eligible children 2381 (93.5%), completed the refraction and the parental interview. Parental concerns about development were present in 510 of the 2381 children evaluated [21.4%; 95% confidence intervals (CI): 9.8 to 23.1]. The adjusted odds ratios [OR] of parental concerns with hyperopia [≥3.00 diopters (D)] was 1.26 (95% CI: 0.90 to 1.74), with myopia (≥1.00 D) was 1.29 (95% CI: 0.83 to 2.03), with astigmatism (≥1.50 D) was 1.44 (95% CI: 1.08 to 1.93) irrespective of the type of astigmatism, and with anisometropia (≥2.00 D) was 2.61 (95% CI: 1.07 to 6.34). The odds of parental concerns about development significantly increased in children older than 36 months with hyperopia ≥3.00 D, astigmatism ≥1.50 D, or anisometropia ≥2.00 D. Parental concerns about general developmental problems were associated with some types of refractive error, astigmatism ≥1.50 D and anisometropia ≥2.00 D, in children aged 6 to 71 months. Parental concerns were also more likely in children older than 36 months with hypermetropia, astigmatism, or anisometropia. Parental concerns were not associated with myopia. Because of the potential consequences of uncorrected refractive errors, children whose parents have expressed concerns regarding development should be referred for an eye examination with cycloplegic refraction to rule out significant refractive errors.