Prevalence of visual disorders in urban Palestinian children: a cross-sectional study

Abstract

BackgroundVision screening programmes for preschool children (aged 3–5 years) have been implemented for early detection and intervention of blinding visual disorders. In the occupied Palestinian territory, scientific data on visual disorders among preschool children are lacking. The aim of this study was to determine the prevalence of visual disorders in Palestinian preschool children living in urban areas. MethodsIn this cross-sectional study, preschools in Nablus city were selected using a cluster sampling randomised technique. All attending children aged 3–5 years were included in a vision screening after parental consent was obtained and a self-administered parental questionnaire was completed. The screening assessment included visual acuity, ocular alignment, depth perception, colour vision, non-cycloplegic retinoscopy, and ocular health. Children who failed the screening were referred for cycloplegic comprehensive eye examination. We used percentage and 95% CI to describe the prevalence, and the Pearson χ2 test was applied to determine any associations. A p value less than 0·05 was considered significant. An Institutional Review Board's ethical approval was obtained. Findings764 children from eight preschools were included in the vision screening. 127 children failed the screening test and proceeded to the comprehensive eye examination referral. The most prevalent visual disorders were refractive error (176 [29%] children), amblyopia (15 [4%]), colour vision deficiency (seven [1%]), strabismus (seven [1%]), and ocular health abnormalities (four [1%]). We found no variation in the prevalence of refractive errors by age (p=0·35) or sex (p=0·32). The leading causes for amblyopia were anisometropia (seven [1%] children), significant refractive error (six [1%]), and strabismus (two [<1%]). InterpretationRefractive error was the most prevalent visual disorder in Palestinian preschool children in Nablus. Both anisometropia and significant refractive errors were found to be the major causes of amblyopia. Although this study presented valuable information with respect to visual disorders among children at preschool age, the small sample size is a major limitation and the results cannot be extrapolated to the entire country. FundingNone.