Use Of Spectacles Research Articles

Use of Ready-Made Spectacles to Meet Visual Needs in a Low-Resource Adult Population

In affluent societies, distance and near vision problems are typically corrected with custom-made eyeglasses. Many persons in less affluent areas do not have the resources for such. The purpose of this study was to assess the use of less expensive ready-made (RM) bifocals and readers to correct distance and near refractive error and presbyopia in an outreach clinic in Nicaragua. This is a retrospective review of records of all patients older than 34 years who presented for an eye examination in an outreach clinic in Granada, Nicaragua, in 2010. A visual satisfaction questionnaire had been administered to patients before they were examined and after RM plus sphere bifocals or plus sphere reading spectacles were dispensed. The main outcome measures included pre- and post-distance and near visual acuities, vision satisfaction and difficulty ratings, and perceived cost and willingness to pay for replacement rating. Ready-made plus sphere spectacles (bifocals or single-vision readers) were dispensed to 95.4% of those examined. The remaining 4.6% required custom prescriptions because of astigmatism, myopia, or anisometropia. The RM bifocals were very well accepted, with high visual satisfaction ratings with the bifocals improving from a presenting value of 11 to 89.4% at distance and from 6.6 to 89.4% at near. Percentage of patients achieving visual acuity of 20/40 or better improved from 60 to 84.5% at distance and from 44 to 97% at near. Percentage achieving functionally good near vision (20/40 or better) improved from 38 to 97% with RM readers. Patients reporting highest satisfaction with near vision improved from 6.3 to 86.6%. Patients indicated that, on average, they would be willing to pay US$18.39 to replace the bifocals and US$16.67 to replace the readers. Ready-made bifocals and RM single-vision readers may be an acceptable and affordable alternative for many patients with hyperopia and/or presbyopia where access to custom-made eyeglasses is difficult.

Decreasing Uncorrected Refractive Error in the Classroom Through a Multifactorial Pilot Intervention

The study assessed the effectiveness of a pilot intervention to promote the use of eyeglasses in one school in California. The intervention used a one-group pretest, posttest design. Between January and June 2011, during the intervention, all first- and second-grade children received eye evaluations and the children with refractive error received two pairs of attractive eyeglasses. Parents received eye care education. Teachers monitored the use of eyeglasses in the classroom. Prior to the intervention in January 2011, 1 of the 15 children with refractive error (6.7%) wore eyeglasses in the classroom and the remaining 14 (93.3%) lacked eyeglasses altogether; 6 months following the end of the intervention in December 2011, 11 of the 15 children (73.3%) wore eyeglasses in the classroom and the remaining 4 (26.7%) did not (p = .002). The multifactorial intervention increased the use of eyeglasses in the classroom even months after the end of the summer vacation.

A review on the use of corneal inlays for the treatment of presbyopia

This article explores current treatments for presbyopia and the recent advances in technology, which have renewed interest in the use of corneal implants. Currently, the safest method to correct presbyopia is the use of spectacles or prescription contact lenses, but for some people there is a need for an alternative.

One-Year Safety and Efficacy Results of a Hydrogel Inlay to Improve Near Vision in Patients With Emmetropic Presbyopia

To conduct a feasibility study of the safety and efficacy of a corneal contouring inlay as a treatment for emmetropic presbyopia. The Raindrop corneal inlay (ReVision Optics, Inc., Lake Forest, CA) was implanted on the corneal stromal bed beneath a keratotomy flap in 20 nondominant eyes of 20 patients. The implant is designed to cause a change in the curvature of the overlying cornea, with a subsequent multifocal change in refractive power. Efficacy outcome was defined as at least 75% of eyes with uncorrected near visual acuity of 0.3 logMAR (20/40 Snellen) or better at 6 months. Main safety outcomes were retention of preoperative best-corrected distance visual acuity and reports of adverse events. Other outcome measures included contrast sensitivity; near, intermediate, and distance visual acuities; patient satisfaction; spectacle use; and complications. All implanted eyes achieved uncorrected near visual acuity of 0.3 logMAR (20/40 Snellen) or better by the 1-week postoperative examination and remained so throughout the 1-year follow-up period, also averaging less than 0.1 logMAR (20/25 Snellen) monocularly and binocularly throughout that period. Mean binocular uncorrected distance visual acuity remained within 0.02 logMAR of the preoperative mean throughout the study. One patient who was dissatisfied with the resulting vision underwent explantation. At 1 year, 16 of 19 patients seldom or never wore glasses and all 19 were satisfied or very satisfied with their overall vision. The hydrogel corneal inlay improved uncorrected near and intermediate visual acuity in patients with emmetropic presbyopia, with high patient satisfaction and little effect on distance visual acuity.

Función visual sin corrección óptica tras cirugía de cataratas

PurposeTo study the relationship between refraction after cataract surgery and the use of spectacles in patients older than 65 years. MethodsRetrospective case control study. The study included 40 retired subjects older than 65 years-old who fulfilled our inclusion criteria. Clinical ophthalmic and optical information was collected, and patients were requested to complete a validated questionnaire of visual function (VF14) and a test of independence of spectacles. The difference between VF14 test results with and without glasses (difVF14) was calculated. ResultsThe study included 16 men and 24 women, with a mean age of 74 years. There was a significant correlation between difVF14 and postoperative refraction, with lower difVF14 values associated with postsurgical refraction in the range −0.50 to −1.00 D (OD 0.479 [95% CI; 0.286-0.804]). The questionnaire of independency of lenses did not show significant correlation with postoperative refraction. ConclusionsPatients with postsurgical refraction between −0.50 and −1.00 diopters displayed better visual function without glasses than those with refraction out of that range.Neutral distant refraction and positive lenses for near vision might not be the ideal solution for every patient. Postsurgical refraction should be individualized for each patient according to their personal preferences, in order to achieve the best visual function and the best vision-related quality of life.

Study to assess the psychosocial aspects of refractive errors and effectiveness of health education in correcting stigmas related to spectacle use in high-school students of rural India

Background: Refractive error is the most common cause of blindness which can be corrected easily using simple modality like spectacles but because of ignorance, stigmas and cost related issues it is underutilized. Aims & Objective: Study to assess the psychosocial aspects of refractive error and effectiveness of health education in correcting stigmas related to spectacle use in high-school students of rural India. Material and Methods: This was a cross sectional study in which total of 255 high school students from a school near Bhopal were included. The responses were recorded on a pre-designed and pre-tested questionnaire. The health education was provided to all the participants and they were reassessed after one month using same questionnaire. The researcher used the STATA version 12.1 for data entry and analysis. Results: Amongst total of 255 students, 165 were males and 90 were females. During initial phase most of the respondents believed that common reasons for low vision were nutritional deficiency (68%) and bad eye care (56%). The respondents refused to use spectacles at all if needed as spectacles are cosmetically unacceptable (62%) , fear of rejection from opposite sex (54%) and likely teasing from colleagues (36%).Following health education there were statistically significant changes in the knowledge, attitude and care seeking behaviour of spectacle use. Only two parameters i.e. cosmetic acceptance of spectacles and that traditional methods were more than spectacles did not changed significantly. Conclusion: Prevalent stigmas regarding spectacle use among students of rural India were effectively corrected with health education.

Infection control practices in dental school: A patient perspective from Saudi Arabia.

Background:Routine use of gloves, masks and spectacles are important in infection control. Aim of this study was to assess the knowledge and attitudes of infection control measures among the patients attending clinics of Riyadh Colleges of Dentistry and Pharmacy (RCsDP) in Saudi Arabia.Material and Methods:It was a cross-sectional descriptive study of a convenient sample of dental patients attending dental clinics of RCsDP. A structured, close ended, self-administered questionnaire was distributed to 350 patients and a response rate of 86% was obtained. Questionnaireconsisted of series of queries related to knowledge and attitudes of patients towards infection control measures. Data analysis included frequency distribution tables, Mann-Whitney and Kruskal-Wallis tests. Level of significance was set at P < 0.05.Results:Final study sample included 301 patients (147 males and 154 females). Almost 99%, 93.7% and 82.7% of the patients agreed that dentist should wear gloves, face mask and spectacles while providing treatment. However, 60.1%, 30% of the patients said that HIV and hepatitis-B infections can spread in dental clinics. Half of the patients felt that they were likely to contract AIDS and 77.7% refused to attend clinics if they knew that AIDS and Hepatitis-B patients treated there. Only 25.2% said that autoclave is the best method of sterilization. A significantly higher knowledge of infection control was observed among the previous dental visitors compared to the first time visitors to the dental clinics (P < 0.05).Conclusions:Patients revealed adequate knowledge towards the use of gloves, face mask and spectacles by dentist. However, their knowledge regarding the spread of Hepatitis-B, HIV infection and use of autoclave was poor. Previous visitor of dental clinics showed higher knowledge of infection control as compared to the first time visitors. Many patients expressed their negative attitudes towards dental care due to AIDS and Hepatitis-B concerns.

Changing trends in the prevalence of visual impairment, uncorrected refractive errors and use of spectacles in Mahbubnagar district in South India

Background/Aim:The Andhra Pradesh Eye disease Study (APEDS) was a conventional cross-sectional study conducted in four locations during 1996-2000. Ten years later, a Rapid Assessment of Refractive Errors (RARE) survey was conducted in one of the geographical regions. The prevalence of visual impairment (VI), uncorrected refractive error (URE), spectacles use obtained from both the surveys was compared.Settings and Design:Rural settings; cross-sectional studies.Materials and Methods:In both the surveys, distance visual acuity (VA) was assessed using a logMAR chart. Pinhole VA was assessed if presenting VA was <20/20 in APEDS and <20/40 in RARE. VI was defined as presenting VA <20/40 in the better eye. URE was defined as presenting VA <20/40 and improving to ≥20/40 with a pinhole.Statistical Analysis Used:Performed using Statistical Package for Social Sciences (SPSS). Chi square tests and t-test were used.Results and Conclusions:The results from a RARE survey with 3,095 subjects were compared with an APEDS dataset that had 1,232 subjects in the same age group of 15-49 years. The prevalence of VI has decreased from 9.5% (95% CI, 7.7-11.1) in APEDS to 2.7% (95% CI, 2.1-3.3) in RARE. Similarly, the prevalence of URE in the better eye decreased from 5.8% (95% CI, 4.5-7.1) to 2.3% (95% CI, 1.8-2.8). The usage of spectacles increased from 6.6% (95% CI, 5.2-8.0) to 9.7% (95% CI, 8.7-10.7). There is a decreasing trend in the prevalence of VI and URE in Mahbubnagar district in Andhra Pradesh over a decade.

Spectacle Coverage and Spectacles Use among Elderly Population in Residential Care in the South Indian State of Andhra Pradesh

Background. There is limited research conducted on uncorrected refractive errors, presbyopia, and spectacles use among the elderly population in residential care in developing countries such as India. We conducted a cross-sectional study among elderly in residential care to assess the spectacle coverage and spectacles usage in the south Indian state of Andhra Pradesh. Methods. All 524 residents in the 26 “homes for aged” institutions in the district were enumerated. Eye examination was performed that included visual acuity (VA) assessment for distant and near vision. A questionnaire was used to collect information on spectacles use. Results. 494/524 individuals were examined, 78% were women, and 72% had no education. The mean age of participants was 70 years. The spectacle coverage for refractive errors was 35.1% and 23.9% for presbyopia. The prevalence of current use and past use of spectacles was 38.5% (95% CI: 34.2–42.8; n = 190) and 17.2% (95% CI: 13.9–42.8), respectively. Conclusions. There is low spectacle coverage for both refractive errors and presbyopia among elderly individuals in residential care in the south Indian state of Andhra Pradesh. Appropriate service delivery systems should be developed to reach out this vulnerable group of seniors on a priority basis.

Screening for visual impairment: Outcome among school children in a rural area of Delhi - Suggestions to improve compliance

Dear Editor, I read with interest an article by Rustagi, et al. on Screening for visual impairment: Outcome among school children in a rural area of Delhi.[1] I congratulate the authors for bringing out myths about the non-use of glasses, but am concerned about the non-compliance of the study subjects and have a few suggestions. The authors should have obtained consent from the parents before the initial examination was done. Identifying the students with visual acuity <20/30 and then obtaining consent from the parents for a refraction test consumed time and built up the non-compliance. This was evident from the fact that 18 students (25.0%) stated that they had forgotten to get the consent form signed and five (6.9%) stated that they had lost the consent forms. Parental involvement from the beginning of the study, for education regarding ocular problems and importance of spectacle use would have helped to improve the compliance. An ophthalmologist's help from the beginning, for performing refraction, would also have helped, as students need not have been referred for refraction to some other place. Ten (0.9%) children had visual acuity <20/200 in the better eye (visual acuity equivalent to blindness, according to the definition of blindness by the National Program for Control of Blindness in India). What was the visual status of these children? I think the authors should have studied the other causes of visual impairment (the first objective of the study) in such a big screening program.

Addressing refractive error visual impairment: volunteer organisations' alignment with Vision 2020 and public health principles

Background: Eye care professionals have been making short visits to developing countries for decades in an effort to reduce visual impairment caused by refractive error. A 2006 survey revealed that volunteer organisations were not working within the Vision 2020 framework. Recommendations were made for volunteer organisations that would better align their work with accepted Vision 2020 and public health principles.Methods: This study re‐evaluates the alignment of volunteer organisations with Vision 2020 and public health principles. To determine their philosophies and methods, a web‐based survey was sent to 89 volunteer organisations identified from an internet search.Results: The response rate was 48 per cent. Many (70.7 per cent) organisations exclusively mention direct service provision in their statement of purpose, often provided by student volunteers (75.6 per cent). A few (19.5 per cent) provide short training in refraction, not necessarily following best principles. The majority (82.1 per cent) dispenses recycled spectacles and many use medications not on national essential drug lists. Few attempt to follow aid effectiveness principles with only 26.8 per cent stating they follow Vision 2020 country plans. Overall, as in 2006, the work of these organisations is largely not in alignment with Vision 2020 and public health principles.Conclusion: Organisations interested in decreasing visual impairment due to refractive error in the developing world are encouraged to transition to organisations that not only recognise but also implement public health principles. This should include reprioritisation of their work to developing human resources and infrastructure, determining the burden and causes of disease, assisting in the training of mid‐level personnel and providing professional and community education, collaborating via partnerships, discontinuing the use of recycled spectacles and inappropriate medications, and evaluating their outcomes. Following these recommendations as well as creating a better alignment with public health principles in general will increase the likelihood that their programs will be effective in decreasing visual impairment due to refractive error in the developing world.

Social inequality in health among women in Campinas, São Paulo State, Brazil

The aim of this was study was to assess social inequalities in health status and use of health services according to level of schooling in women. This was a cross-sectional population-based study with a sample of 508 women from 20 to 59 years of age living in Campinas, São Paulo State, Brazil (ISA-Camp 2008). Women with less schooling showed higher prevalence of hypertension, circulatory problems, headache, dizziness, obesity, common mental disorders, worse self-rated health, use of dental prosthesis, and visual impairment, but lower prevalence for use of eyeglasses. There were no differences between the two schooling strata in prevalence of medical visits in the previous two weeks, use of medicines in the three previous days, Pap smear, breast self-examination, clinical breast examination, hospitalizations and surgeries in the previous year, and rubella vaccination any time in life. The only significant differences were in use of dental services and mammograms. The results show social inequalities in various health indicators and equity in access to various components of the health services.

A comparative study of visual function of young myopic adults wearing contact lenses vs. spectacles

To evaluate the impact of contact lenses wear vs. spectacles wear on visual function of young adults with mild to moderate myopia. 57 students (27 male and 30 female) with a mean age of 23 years old participated in the study. Their mean best corrected visual acuity was 10/10 binocularly, all suffered from mild to moderate myopia (-3.75 sph/SD 1.25 sph) and they were both contact lenses and spectacles wearers. The VF-14 questionnaire was administered to assess the contact lenses wear vs. spectacles wear impact score on general daily living among the young individuals. It was used translated in Greek after following the 'translation-back translation' procedure. The mean VF-14 score among spectacles and contact lenses wearers was 100 and 86.78 (SD 4.08) respectively. Although there was a significant difference between the two groups (p<0.05), both scores were related to a satisfactory functional vision for daily living. The contact lenses wearers were facing difficulty especially while driving at night, seeing steps, as well as doing fine handwork (i.e. sewing, knitting or carpentry). The use of both spectacles and contact lenses provides satisfactory visual functioning for daily activities in young individuals suffering from mild to moderate myopia. However, there is a spectacles' wear superiority in personal satisfaction when compared to contact lenses.

Visual Outcomes and Patient Satisfaction After Presbyopic Lens Exchange With a Diffractive Multifocal Intraocular Lens

To investigate the visual outcomes, severity of symptoms, and patient satisfaction after refractive lens exchange (RLE) with a diffractive multifocal intraocular lens (IOL). A nonrandomized, unmasked, retrospective chart review study was performed. Patients who underwent RLE with ZMA00 (Abbott Laboratories) were identified from a hospital database. Eyes with preoperative uncorrected distance visual acuity or corrected distance visual acuity 20/20 or better were included. The study cohort comprised 45 eyes from 29 patients. Monocular uncorrected and distance-corrected visual acuity at distance, 67 cm, and 30 cm were measured 6 months postoperatively. A patient questionnaire assessing visual symptoms (halo, night glare, and starburst) and satisfaction with visual performance was administered. Six months postoperatively, mean uncorrected visual acuity (logMAR) was -0.10±0.13, 0.43±0.25 at 67 m (intermediate), and 0.18±0.05 at 30 m (near). Mean distance-corrected visual acuity at these distances was -0.02±0.06, 0.40±0.21, and 0.17±0.02, respectively. Twenty-seven patients completed the questionnaire. Patients reported postoperative halos (78%), night glare (26%), and starbursts (48%). All bilateral RLE patients were spectacle-free at all distances, whereas 50% of unilateral RLE patients required spectacles postoperatively. Bilateral RLE patients with habitual spectacle use preoperatively were the most satisfied with their postoperative visual performance. Refractive lens exchange with the ZMA00 is an option for presbyopic correction; however, significant glare, halo, and starburst issues are subjectively reported.

Visual Function after Correction of Distance Refractive Error with Ready-made and Custom Spectacles: A Randomized Clinical Trial

To evaluate patient-reported outcome measures with the use of ready-made spectacles (RMS) and custom spectacles (CS) in an adult population in India with uncorrected refractive error (URE). Prospective, double-masked, randomized trial with 1-month follow-up. A total of 363 adults aged 18 to 45 years with ≥1 diopter (D) of URE (RMS, n = 183; CS, n = 180). All participants received complete refraction and were randomized to receive CS (full sphero-cylindrical correction) or RMS based on the spherical equivalent for the eye with lower refractive error but limited to the powers in the RMS inventory. Visual function and quality of life (VFQoL) instrument and participant satisfaction. Rasch scores for VFQoL increased from 1.14 to 4.37 logits in the RMS group and from 1.11 to 4.72 logits in the CS group: respective mean changes of 3.23 (95% confidence interval [CI], 2.90-3.56) vs. 3.61 (95% CI, 3.34-3.88), respectively. Mean patient satisfaction also increased by 1.83 points (95% CI, 1.60-2.06) on a 5-point Likert scale in the RMS group and by 2.04 points (95% CI, 1.83-2.24) in the CS group. In bivariate analyses, CS was not associated with increased VFQoL or patient satisfaction compared with the RMS group. In the full multivariable linear regression, the CS group had greater improvement when compared with those receiving RMS (+0.45 logits; 95% CI, 0.02-0.88), and subjects with astigmatism >2.00 D had significantly less improvement (-0.99 logits; 95% CI, -1.68 to -0.30) after controlling for demographic and vision-related characteristics. In multivariable analysis, increased change in patient satisfaction was related to demographic and optical characteristics, but not spectacle group. Ready-made spectacles produce large but slightly smaller improvements in VFQoL and similar satisfaction with vision at 1-month follow-up when compared with CS. Ready-made spectacles are suitable for the majority of individuals with URE in our study population, although those with high degrees of astigmatism may benefit from a trial of CS. This study provides further evidence for the use of RMS in settings where CS are unavailable or unaffordable, or refractive services are inaccessible to those in need.

Prevalence and Correction of Near Vision Impairment at Seven Sites in China, India, Nepal, Niger, South Africa, and the United States

To estimate the prevalence of near vision impairment and use of corrective spectacles among middle-aged and older adults in different settings and ethnic groups. Population-based, cross-sectional study. People aged ≥ 35 years were randomly selected with cluster sampling in 4 rural settings in Shunyi (China), Kaski (Nepal), Madurai (India), and Dosso (Niger); 1 semi-urban area in Durban (South Africa); and 2 urban settings in Guangzhou (China) and Los Angeles (USA). Near visual acuity (VA), with and without presenting near correction, was measured at 40 cm using a logMAR near vision tumbling E chart. Subjects with uncorrected binocular near VA ≤ 20/40 were tested with plus spheres to obtain the best-corrected binocular VA. A total of 17 734 persons aged ≥ 35 years were enumerated and 14 805 (83.5%) were examined. The age- and sex-standardized prevalence of uncorrected near vision impairment (VA ≤ 20/40) ranged from 49% in Dosso to 60% in Shunyi and Guangzhou, 65% in Kaski and Los Angeles, and 83% in Madurai and Durban. The prevalence of near vision impairment based on best-corrected visual acuity was less than 10% in Guangzhou, Kaski, Durban, and Los Angeles, but as high as 23% in Madurai. In multiple logistic regression models, uncorrected near vision impairment was associated with older age (odds ratio [OR] = 1.14, P < .001) and female sex (OR = 1.12, P = .027), but not with educational level (OR = 1.01, P = .812). Over 90% of people in need of near refractive correction in rural settings did not have the necessary spectacles. These rates were 40% in urban settings. By 50 years of age, the majority of people suffer from near vision impairment, most of which can be corrected optically. Over 90% of those in need of near refractive correction in rural settings do not have the necessary spectacles.

Real Cost of Recycled Spectacles

Purpose. Many programs aimed at mitigating the problem of uncorrected refractive error and the resulting avoidable blindness use recycled (donated) spectacles as a seemingly inexpensive expedient. This article analyses the costs and benefits of recycled spectacles and compares them with alternative methodologies. Although well intentioned, it is argued that recycled spectacles will neither suit many of those affected by uncorrected refractive error nor provide a cost saving solution to the problem. Although this is not the first argument against the use of recycled spectacles, there has been no accurate costing of their delivery. This article assesses the real cost of delivery of recycled spectacles. Methods. The useable quantity of recycled spectacles was determined by examining two separate batches of donated spectacles. These data were used in the calculation of the cost of delivery. The metric used for comparison was only cost (i.e., it was a cost minimization analysis) because it was deemed that recycled spectacles and ready-made spectacles were the same mode of correction fundamentally. Results. Only 7% of the 275 recycled spectacles analyzed were suitable for use. The relatively small proportion of useable spectacles contributed to the high societal cost of delivering recycled spectacles, which was found to be U.S.$20.49, more than twice the cost of supplying ready-made spectacles. Conclusions. Recycled spectacles are not a cost-saving method of correcting refractive error and should be discouraged as a strategy for eliminating uncorrected refractive error in developing countries.

Accuracy of referrals from an orthoptic vision screening program for 3- to 4-year-old preschool children

To determine the accuracy of orthoptist referrals from a preschool-based vision screening program for children 3-4 years of age and to report the outcomes of referred children. This was a retrospective review of records of participants in the preschool vision screening program in the Walsall, United Kingdom, area for the 2006-2007 school year. Screening examinations were performed by orthoptists and included assessment of visual acuity, ocular alignment, ocular motility, and stereoacuity. For the 2006-2007 school year, 2,830 of 3,623 children (78%) were screened, Of these, 413 were referred to the Hospital Eye Service. Comparison of the screening results and the Hospital Eye Service examination revealed that recorded visual acuities were similar in 81% of subjects and ocular alignment in 94%. Visual acuity was 6/9 or better at the hospital examination in 87% of referred children, with 46% requiring spectacle use only; 17% of referrals were diagnosed with amblyopia. Although the Walsall vision screening program diverged from UK national guidelines by testing at an earlier age, there was no evidence that earlier screening led to a large number of incorrect referrals, and early screening may allow for better outcomes. Sensitivity of screening was not tested, and orthoptist screening in the United Kingdom is likely to be more accurate in this age group than nonspecialist or lay screening that is performed in many other areas.

Screening for visual impairment: Outcome among schoolchildren in a rural area of Delhi

Background:Uncorrected refractive errors are the main cause of vision impairment in school-aged children. The current study focuses on the effectiveness of school eye screening in correcting refractive errors.Objectives:1. To study the magnitude of visual impairment among school children. 2. To assess the compliance of students for refraction testing, procurement and use of spectacles.Materials and Methods:An intervention study was conducted in schools of the north- west district of Delhi, in the rural field practice area of a medical college. Students studying in five government schools in the field practice area were chosen as the study subjects.Results:Out of 1123 students enrolled, 1075 (95.7%) students were screened for refractive errors. Low vision (visual acuity < 20/60) in the better eye was observed in 31 (2.9%) children and blindness (visual acuity <20/200) in 10 (0.9%) children. Compliance with referral for refraction was very low as only 51 (41.5%) out of 123 students could be tested for refraction. Out of 48 students, 34 (70.8%) procured spectacles from family resources but its regular use was found among only 10 (29.4%) students. The poor compliance among students stems out of various myths and perceptions regarding use of spectacles prevalent in the community.Conclusion:Refractive error is an important cause of avoidable blindness among rural school children. Behavior change communication among rural masses by spreading awareness about eye health and conducting operational research at school and community level to involve parent's teachers associations and senior students to motivate students for use of spectacles may improve utilization of existing eye health services in rural areas.

Ophthalmic manifestations of children with Down syndrome in Port Harcourt, Nigeria

AimThe aim of this study was to provide a profile of oculo-visual anomalies in children with Down syndrome (DS) in Port Harcourt, Nigeria.MethodsThis comparative study assessed the visual functions of 120 children (42 DS and 78 developmentally normal children). The visual functions evaluated and the techniques used were: visual acuity (Snellen illiterate chart and Lea picture charts), refraction (static retinoscopy with cyclopegia), ocular alignment (cover test), near point of convergence (pen and rule), and external examinations and fundoscopy.ResultsA total of 42 children with DS (22 males, 20 females, mean age 11.43 ± 6.041 years) and control group of 78 normal children (36 females, 42 males) with mean age 6.63 ± 1.98 years were examined. Of the 42 DS children, visual acuity was less than 6/18 in eight and one of the DS and control groups, respectively. Visual acuity could not be checked conventionally in eleven participants from the DS group due to poor response. The main findings were: DS compared to control group showed refractive errors of 76.2% (half of which was from myopia) vs 14.1% (only 10% due to myopia). There was a statistically significant difference in total refractive errors between the Down syndrome group and the control group (P = 0.001, χ2 = 18.29). Strabismus was 9.5% (75% esotropia) vs 0%, and there was a statistically significant difference (P = 0.001, χ2 = 5.01), nystagmus was 4.8% v 0%, conjunctivitis 19.05% vs 8.97%, and keratitis 7.14% vs 0%, which was statistically significant (P = 0.05, χ2 = 2.90).ConclusionRefractive errors were prevalent in a sample of children with DS in Port Harcourt, Nigeria, whereas the prevalence of ocular diseases was low when compared to age-matched control participants. This study highlights the need for ophthalmic care in children with DS. Routine eye care such as the use of spectacles when necessary is recommended for people with DS at all ages to improve their educational and social needs as well as overall quality of life.