Visual Impairment In Children Research Articles

Visual Behaviours (ViBes) in Cerebral Visual Impairment: Validating a Descriptive Tool to Support Diagnosis and Monitoring.

Cerebral visual impairment (CVI) is the most common cause of visual impairment in children in the UK. Diagnosis is based on identification of visual behaviours (ViBes) relating to visual dysfunction. Examination techniques and inventories have been developed to elicit these in children with a developmental age of two years or more. The absence of a structured approach to recording visual behaviours in children with complex needs is a barrier to diagnosis. The aim of the study was to develop a matrix of visual behaviours seen in pre-verbal and pre-motor children with visual impairment and establish its content validity and inter-rater reliability. ViBe content validation:: Visual behaviour descriptors relating to visual function were collated and categorised by expert consensus of vision professionals into a matrix composed of three functions (attention, field/fixation, motor response) and five levels (0 = no awareness; 1 = visual awareness; 2 = visual attention; 3 = visual detection; 4 = visual understanding).ViBe inter-rater reliability:: The participants (two orthoptists, an optometrist, an ophthalmologist and two qualified teachers of the visually impaired) used the ViBe matrix to independently score each of 17 short video clips of children demonstrating visual behaviours seen in CVI. The ViBe matrix will be presented. Cohen's kappa for the matrix was 0.67, demonstrating moderate-to-strong inter-rater reliability. The development of standardised descriptors can support clinicians and teachers in identifying areas of concern for children with complex needs. In addition, the ViBe matrix could be utilised in research, clinical and diagnostic reports to clearly communicate the areas of visual dysfunction and track progress resulting from interventions. The absence of a structured approach to recording visual behaviours in children with complex needs is a barrier to diagnosis.The ViBe matrix offers descriptors relating to visual behaviours and has demonstrated acceptable inter-rater reliability.The tool may support the identification and diagnosis of cerebral visual impairment in a population of children who cannot access standard testing.

Physiological and hygienic assessment of the use of gadgets by students living in cities

Total computerization of all types of students» activities contributes to the negative impact on the organ of vision. And the use of digital devices in everyday life only exacerbates the widespread myopia. In modern society, visual impairments in children are among the urgent medical and social problems. The purpose of this work is to give a hygienic assessment of the effect of gadgets on the visual functions of schoolchildren and students. To achieve this goal, a sociological study was conducted by means of a group indirect survey. A questionnaire was developed, which included 13 questions. The survey was conducted in an online format. The object of the study were students of different levels of education. Students of grades 5 and 11 of schools in Perm Krai and Bashkortostan (122 people) and 102 students of the 6th year of medical universities in Perm and Ufa were interviewed. Access to the electronic questionnaire on the Google Forms platform was provided after obtaining voluntary consent. Comparison of the studied groups among themselves showed that the number of people with myopia significantly increases with age: from 63.4 to 78.4 % (p = 0.02). At the same time, students are more likely to use glasses on a regular basis (56 %; p = 0.0009). Assessment of the manifestation of «visual» symptoms revealed that with age, students make the main complaints about «image blurring» — 71.6 % (p = 0.03). Popular digital devices among all categories of respondents are a cell phone and a laptop. At the same time, 11th grade students and students use the laptop more often. Younger schoolchildren use them most often for games, high school students and students — for communication with peers and information retrieval. Most of the respondents spend more than two hours a day using gadgets. Medical students and 11th grade students spend more than 4 hours a day on this (p = 0.01).

Flashbulb Memories in the Communication of the Diagnosis of Visual Impairment: The Effect of Context and Content.

The diagnosis of a child's visual impairment is remembered vividly and intensely by their parents. However, the way in which the diagnosis is communicated may affect the development and persistence of this memory. The aim of this study is to analyze the circumstances in which the first news of the diagnosis of visual impairment in children is given and whether the memory of this event persists over time leading to a flashbulb memory. A longitudinal study was carried out with the participation of 38 mothers. Data were collected on sociodemographics, clinical variables, circumstances surrounding the communication of the diagnosis, and the degree of agreement of the information in the two phases of the research. The diagnosis was, on the whole, given to both parents at the same time, in medical language and with little tact, generally in the office of an ophthalmologist. The mothers would have preferred to have received the news in a different way, and the existence of a flashbulb memory is confirmed, more dependent on the context in which the diagnosis was given and its content than on sociodemographic and clinical factors. The way in which the first news of such a diagnosis is given plays a significant role in how it is remembered. Therefore, an improvement in medical practice regarding the communication of such diagnoses is recommended.

Hearing and Visual Impairment in Children with Cerebral Palsy, A Study in Tertiary Level Hospital in Bangladesh

Background: Cerebral palsy (CP) is a diagnostic term used to describe a group of motor syndromes resulting from disorders of early brain development. CP remains unexplained in most cases and is typically diagnosed outside the neonatal period. Visual impairment decreases the quality of life and hearing impairment hampers linguistic development. This study aimed to observe the visual and hearing impairment of children with cerebral palsy associated with developmental disabilities. Material Methods: This is a cross-sectional observational descriptive study carried out in the department of Paediatric Neurology CMH Dhaka from March 2018 to February 2022. The participants (N=120) were from birth to 12 years of age. Detailed information was obtained in each case according to protocol. The pediatric neurologist based on the study definition crosschecked the diagnosis. The hearing assessment was done with the help of an Otolaryngologist in the department of Otolaryngology and the ophthalmological evaluation was done with the help of an ophthalmologist of the department of ophthalmology of CMH Dhaka. Hearing impairment, Ophthalmological motor disturbance, and developmental disabilities were correlated. A convenience sampling technique was used in this study. Relevant data were collected from hospital records. All the information was recorded in the fixed protocol. Collected data were classified, edited, coded, and entered into the computer for statistical analysis by using SPSS 2021. Results: In this study, among the 120 children with CP, the mean age of the study was 5.57(SD±3.89) age range of 2-12 years Males were 82(68%) and females were 38(32%), male-female ratio (sex M: F 2.15: 1). Spastic quadriplegia constitutes the predominant group 59(49%), followed by Spastic diplegia 21(18%), Spastic hemiplegia 20(17.5%), dyskinetic CP 09(8%), 7(6%) were mixed CP and 4(3%) were hypotonic CP. Hearing impairment was found in 87 (72%) cases and visual impairment was detected in 92(76%). Among them, the child with Spastic Quadriplegic (83%) and diplegic CP (62%) children had a hearing impairment. Regarding vision, no fix and follow were observed in 69(57%) cases. Among the studied CP child (n=120) 16 children (13.33%) had normal eye finding and 104 (86%) had abnormal eye findings. Refractive error (32.5%) and Squint (19%) were the most common ocular defect among studied patients. Other ocular defect were nystagmus(10%), optic atrophy(12.5%), microphthalmia(10%), corneal opacity(3%), optic hypoplasia(4.1%), cataract(2.5%), pigmentary retinopathy(5%), retro-lental fibroplasias(3.3%) and ptosis(2.5%). In children with hypotonic (athetoid) and mixed CP, almost all (11 of 11) children had visual impairment. Spastic quadriplegic CP children (80%) and Spastic diplegic CP children (90%) had one or more domains of visual impairment. Conclusion: Cerebral Palsy is a non-progressive various form of neurological disorder in children. Early visual screening and hearing assessment can help CP children to minimize mental retardation, learning difficulties, and speech delay.

Comparative efficacies of 13 surgical interventions for primary congenital glaucoma in children: a network meta-analysis of randomized clinical trials.

Timely and proper intraocular pressure (IOP) management is vital to the prevention of visual impairment in children with primary congenital glaucoma (PCG). Although various surgical interventions have been proposed, no well-founded evidence exists on their comparative efficacies. We aimed to compare the efficacies of surgical interventions for PCG. We searched relevant sources up to 4 April 2022. Randomized controlled trials (RCTs) entailing surgical interventions for PCG in children were identified. A network meta-analysis (NMA) was performed, comparing 13 surgical interventions: Conventional partial trabeculotomy ([CPT] control), 240-degree trabeculotomy, Illuminated microcatheter-assisted circumferential trabeculotomy (IMCT), Viscocanalostomy, Visco-circumferential-suture-trabeculotomy, Goniotomy, Laser goniotomy, Kahook dual blade ab-interno trabeculectomy, Trabeculectomy with mitomycin C, Trabeculectomy with modified scleral bed, Deep sclerectomy, Combined trabeculectomy-trabeculotomy with mitomycin C, and Baerveldt implant. The main outcomes were mean IOP reduction and surgical success rate at postoperative 6 months. The mean differences (MDs) or odds ratios (ORs) were analyzed by a random-effects model, and the efficacies were ranked by P -score. We appraised the RCTs using the Cochrane risk-of-bias (ROB) tool (PROSPERO: CRD42022313954). Sixteen RCTs were eligible for NMA, including 710 eyes of 485 participants and 13 surgical interventions, which formed a network of 14 nodes comprising both single interventions and intervention combinations. IMCT was superior to CPT in both IOP reduction [MD (95% CI): -3.10 (-5.50 to -0.69)] and surgical success rate [OR (95% CI): 4.38 (1.61-11.96)]. The MD and OR comparing the other surgical interventions and intervention combinations with CPT were not statistically significant. The P -scores ranked IMCT as the most efficacious surgical intervention in terms of success rate ( P -score =0.777). Overall, the trials had a low-to-moderate ROB. This NMA indicated that IMCT is more effective than CPT and might be the most efficacious of the 13 surgical interventions for management of PCG.

Considerations in Building a School-Based Vision Program.

The burden of childhood visual impairment and disparities in access to pediatric vision care remain pressing issues in the United States. School-based vision programs (SBVPs) serve as one approach to advancing health equity. Operating at the intersection of schools and healthcare, SBVPs can increase access to pediatric vision services, improve academic performance, and facilitate referrals to community vision care providers. To maximize their impact, SBVPs must tailor their services to the individual needs and resources of local school communities. School nurses, who have strong ties to school health care services and the school community, are trusted partners in building SBVPs. This article aims to facilitate SBVP development, implementation, and sustainability processes by offering guidance for school nurses and other stakeholders who aim to build a SBVP, support local programs, or learn more about how SBVPs operate.

The Visual Rehabilitation of Bilateral Posterior Lens Luxation In Children: A Case Report

Introduction: Dislocated lens can be subluxated (partial) or luxated (complete), which can cause visual impairment in children. Conservative visual rehabilitation is an option for luxated lens treatment. Purpose: This study reports the possibility for visual rehabilitation of bilateral of bilateral luxated lens in children. Case Report: A 3-year-old boy came to the outpatient clinic of Dr. Saiful Anwar General Hospital with complaints of blurred vision on both eyes. The child would always bring objects close to his eyes since the past year. There was no history of ocular injury nor development disorder. Uncorrected visual acuities with LEA symbol on both right and left eyes were 6/114. The best-corrected visual acuity (BCVA) of the right eye was 6/45 and left eye was 6/9 with both S+11.00. Iridodonesis and aphakic lenses were found during slit-lamp examination of both eyes. The intraocular pressures were 14.2 mmHg on the right eye and 17.3 mmHg on the left eye. The lenses were seen in the vitreous cavities during funduscopy and ultrasonography examination. After 1 month of using spectacles, the BCVA of the right eye was 6/18 and that of the left eye was 6/18 with the binocular BCVA was 6/15. Lensectomy with pars plana vitrectomy was planned to prevent complication. Conclusion: Conservative visual rehabilitation is important to prevent amblyopia in children with luxated lenses and surgical treatment is needed to prevent complication. In this patient, aphakic spectacles were given for visual rehabilitation pending operative treatment.

‘Listen, learn, help’: Parental views on specialist vision impairment provision in the United Kingdom

The presence of childhood vision impairment has cascading effects on educational provision and global development across cognitive, physical, and mental health domains. Effective, appropriate, and targeted support in education is legislated across the United Kingdom, influenced by the ‘access to learning, learning to access’ model. Despite reasonable adjustment and specialist provision legislature, anecdotal parental reports suggest inconsistent and insufficient provision culminating in poor physical and mental health outcomes for school-aged children and young people with vision impairment in the United Kingdom. This pilot study aimed to evaluate the perceived effectiveness of provisional arrangement/specialist support from a parental viewpoint. We examined the questionnaire responses of parents/caregivers of children and young people with vision impairment to harness their views regarding provisional entitlement. An online questionnaire was developed in collaboration with parents/caregivers of children with vision impairment who identified a distinct need for research in this field. Forty-six parents/caregivers completed the questionnaire. Most parents reported their child accessing specialised provision; however, frequency of provision and qualification of staff administering provision was inconsistent. Parents reported that available provision more negatively impacted their child’s mental health, and resultingly, most parents lacked confidence in the arrangements their child received. We concluded that parental perception of provisional arrangements is seemingly influenced by the quality of the team supporting their child in educational domains. Future work triangulating parental views with that of the children receiving the support, and support staff, is needed for corroboration.

Visual search and childhood vision impairment: A GAMLSS-oriented multiverse analysis approach

The aim of this report was to analyze reaction times and accuracy in children with a vision impairment performing a feature-based visual search task using a multiverse statistical approach. The search task consisted of set sizes 4, 16, and 24, consisting of distractors (circle) and a target (ellipse) that were presented randomly to school-aged individuals with or without a vision impairment. Interactions and main effects of key variables relating to reaction times and accuracy were analyzed via a novel statistical method blending GAMLSS (generalized additive models for location, scale, and shape) and distributional regression trees. Reaction times for the target-present and target-absent conditions were significantly slower in the vision impairment group with increasing set sizes (p < .001). Female participants were significantly slower than were males for set sizes 16 and 24 in the target-absent condition (p < .001), with male participants being significantly slower than females in the target-present condition (p < .001). Accuracy was only significantly worse (p = .03) for participants less than 14 years of age for the target-absent condition with set sizes 16 and 24. There was a positive association between binocular visual acuity and search time (p < .001). The application of GAMLSS with distributional regression trees to the analysis of visual search data may provide further insights into underlying factors affecting search performance in case-control studies where psychological or physical differences may influence visual search outcomes.

Outcome of Visual Acuity Rehabilitation of Low Vision in Children after Congenital Cataract Surgery: A Case Series

Congenital cataract is the major cause of treatable visual impairment in children. The first 6 weeks of children’s age is the critical period for visual experience. Based on this, it is suggested that surgery in congenital cataract cases should be performed as soon as possible. The visual outcome after cataract surgery depends on the surgeon, the age of the children, and other visual conditions. Management of the visual rehabilitation in this case is very challenging. Most of the problem after congenital cataract surgery is amblyopia. The purpose of this paper is to report the visual acuity outcome after visual rehabilitation of children who had been performed cataract surgery. This case is a case series of the visual acuity outcome of children who had been performed bilateral cataract congenital surgery in dr Syaiful Anwar Hospital, Malang, Indonesia . The data was obtained from medical record and we compared the visual acuity before and after visual rehabilitation and the outcome based on their timing when they were performed the surgery and the visual acuity correction was obtained. There were 5 cases; 4 cases was bilateral aphakia because of microcornea and 1 case was bilateral pseudophakia with high myopia. Their ages ranged fom 20 months – 12 year old. Most of the children got spectacle for their visual acuity rehabilitation and the power of pectacle lens was based on streak retinoscopy. The aphakia and pseudophakia children obtained better visual acuity after visual rehabilitation. The younger the age in which they underwent surgery and the earlier they got visual correction after cataract surgery the better their visual acuity outcome will be. The success of visual rehabilitation depends on ocular condition, age, the visual rehabilitation technique and the compliance of the patients and the parents.

“Even though a lot of kids have it, not a lot of people have knowledge of it”: A qualitative study exploring the perspectives of parents of children with cerebral/cortical visual impairment

BackgroundCerebral/Cortical Visual Impairment (CVI) is the leading cause of visual impairment in children and can negatively impact participation in daily activities. Methods and procedureThis qualitative study used virtual focus groups and an online questionnaire to understand the perspectives of families with children who have CVI. Constant comparison analysis was used to analyze focus group transcripts and extract themes. The PEDI-CAT and an online questionnaire were administered to characterize the study population. Outcomes and resultsFour themes were identified: (1) Awareness of CVI and its effect on the child and family, (2) Parent experiences, (3) Child factors and functional implications, and (4) Supports that enhance child development/vision. Conclusions and implicationsFindings from this study highlight the substantial impact that lack of CVI awareness had on parent experiences. Lack of awareness led to late diagnosis, missed intervention opportunities, and caregiver burden. Due to insufficient resources, parents had to educate themselves and service providers about CVI and advocate for their child’s needs. Healthcare and educational providers who work with pediatric neurodevelopmental populations must be knowledgeable about clinical features of CVI, task and environmental adaptations to support vision and implementation of family-centered care.

Genome-wide screening reveals the genetic basis of mammalian embryonic eye development

BackgroundMicrophthalmia, anophthalmia, and coloboma (MAC) spectrum disease encompasses a group of eye malformations which play a role in childhood visual impairment. Although the predominant cause of eye malformations is known to be heritable in nature, with 80% of cases displaying loss-of-function mutations in the ocular developmental genes OTX2 or SOX2, the genetic abnormalities underlying the remaining cases of MAC are incompletely understood. This study intended to identify the novel genes and pathways required for early eye development. Additionally, pathways involved in eye formation during embryogenesis are also incompletely understood. This study aims to identify the novel genes and pathways required for early eye development through systematic forward screening of the mammalian genome.ResultsQuery of the International Mouse Phenotyping Consortium (IMPC) database (data release 17.0, August 01, 2022) identified 74 unique knockout lines (genes) with genetically associated eye defects in mouse embryos. The vast majority of eye abnormalities were small or absent eyes, findings most relevant to MAC spectrum disease in humans. A literature search showed that 27 of the 74 lines had previously published knockout mouse models, of which only 15 had ocular defects identified in the original publications. These 12 previously published gene knockouts with no reported ocular abnormalities and the 47 unpublished knockouts with ocular abnormalities identified by the IMPC represent 59 genes not previously associated with early eye development in mice. Of these 59, we identified 19 genes with a reported human eye phenotype. Overall, mining of the IMPC data yielded 40 previously unimplicated genes linked to mammalian eye development. Bioinformatic analysis showed that several of the IMPC genes colocalized to several protein anabolic and pluripotency pathways in early eye development. Of note, our analysis suggests that the serine-glycine pathway producing glycine, a mitochondrial one-carbon donator to folate one-carbon metabolism (FOCM), is essential for eye formation.ConclusionsUsing genome-wide phenotype screening of single-gene knockout mouse lines, STRING analysis, and bioinformatic methods, this study identified genes heretofore unassociated with MAC phenotypes providing models to research novel molecular and cellular mechanisms involved in eye development. These findings have the potential to hasten the diagnosis and treatment of this congenital blinding disease.

Systematic review and meta-analysis of childhood visual impairment in the Eastern Mediterranean Region.

Childhood visual impairment has a significant effect on social life, educational performance, and professional choices, and can lead to poverty. To review the prevalence and causes of visual impairment among children aged 5-17 years in the Eastern Mediterranean Region (EMR). This study was conducted in 2021 using the Preferred Reporting Items for Systematic reviews and Meta- Analyses (PRISMA) method. We searched Google Scholar, PubMed, Web of Science, Scopus, Index Medicus for the Eastern Mediterranean Region, and Medline for studies published between January 2000 and April 2020. The articles included were epidemiological studies of prevalence and causes of childhood visual impairment published in peer-reviewed journals. Of the 12 705 articles screened, 23 from 9 countries met the inclusion criteria. The pooled prevalence of uncorrected, presenting, and best-corrected childhood visual impairment was 11.57%, 8.34% and 1.21%, respectively. The most common causes of childhood visual impairment were refractive error (51.89%), amblyopia (11.15%), retinal disorders (3.90%), corneal opacity (3.0%), and cataract (1.88%). There was a highly significant heterogeneity between the studies (P < 0.0001). The prevalence of visual impairment among children in the EMR was high, and the leading causes were uncorrected refractive error and amblyopia, which were avoidable. Access to eyecare services may help improve early diagnosis and treatment of preventable causes of childhood visual impairment.

Favism: Clinical Features at Different Ages.

Favism is a hemolytic disease due to the ingestion of fava beans in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency. There is wide inter- and intra-individual variability in the development of hemolytic crisis, and several factors influence it: quantity, quality, ripeness of fava beans, and age of onset. In this narrative review of case reports and case series, we reported the predisposing factors and clinical features for four different age groups classified as follows: pregnant women and infants (i.e., exclusively breastfed children); children, from weaned to 11 years; preadolescents and adolescents, from 11 to 18 years; and adults (18 years and older). Some symptoms developed only in specific age groups: death in infants; visual impairment in children; systolic murmur in infants, children, and adolescents; and renal failure in adults. In youngest children or pregnant women the severity is the highest. Some other symptoms were present in all: jaundice, increased bilirubin, splenomegaly, hepatomegaly, discolored urine, tachycardia, pallor, abdominal pain, malaise, vomit, nausea, and dizziness. Laboratory findings are characterized by anemia, reticulocytosis, elevated bilirubin level, and sometimes urinary urobilinogen and methemoglobinemia. In most cases the symptomatology is self-limited and does not release sequelae, but hospitalization and transfusion are often required.

Prevalence and causes of visual impairment and blindness among primary schoolchildren in Herat, Afghanistan

Childhood visual impairment and blindness (VI&amp;B) significantly affects socioeconomic status and health of an individual in adult age. The prevalence and etiology of VI&amp;B in children varies considerably around the world and across different studies. This study aims to identify the prevalence and causes of VI&amp;B among schoolchildren in Herat, Afghanistan. This school-based cross-sectional study was conducted through a stratified cluster sampling on schoolchildren of both sexes aged between 7 and 15 years, between September and December 2021. Visual acuity of study participants was assessed using standard Snellen chart. Participants with VI&amp;B were further assessed for identification of etiology. Data was analyzed in IBM SPSS Statistics (version 27). A total of 8930 schoolchildren, comprising 4366 (48.9%) boys and 4564 (51.1%) girls with a mean age of 10.1 ± 2.3 years were examined. The prevalence of VI&amp;B in the worst eye was 5.2% (5.0% VI and 0.2% blindness). Of the 4366 boys in this study, 228 (5.2%) had VI, while 17 (0.4%) had blindness, while of the 4564 girls in this study, 211 (4.6%) had VI and 4 (0.1%) had blindness in the worst eye. Refractive error was the principle cause of VI&amp;B in 334 (72.6% of the visually-impaired and 3.6% of the overall sample population). This is the first comprehensive study that reports the prevalence and causes of VI&amp;B in schoolchildren in Afghanistan. The prevalence of VI&amp;B among participants was high in Herat, and the principle cause was uncorrected refractive error.

Does the Current Global Health Agenda Lack Vision?

<h3>Key Messages</h3> Despite the successes of the VISION 2020 global initiative, large economic and societal consequences still exist across the life span from vision impairment and blindness, which have not yet been addressed by the global health community. There remains a lack of reliable global data on vision health, especially in the case of childhood blindness and vision impairment. Historically, vision has been poorly represented in global health budgeting and finance, which objectively reflects its lack of prioritization on the overall global health agenda. We need greater investment in cost-effective strategies to prevent and treat a rapidly increasing global burden of ocular disease because of an aging and changing population.

Distribution and causes of blindness and severe visual impairment in children at a tertiary referral centre in Rwanda

AimTo determine the prevalence and the causes of severe visual impairment and blindness (SVI/BL) in children at a tertiary referral centre in Rwanda.MethodsIn this retrospective study, files of all patients...

Prevalence and Factors Associated with Visual Impairment in Children: Protocol for a Systematic Review and Meta-Analysis

Prevalence and Factors Associated with Visual Impairment in Children: Protocol for a Systematic Review and Meta-Analysis

Evaluation of babies with retinopathy of prematurity following intravitreal bevacizumab administration.

In Turkiye, the increased likelihood of survival of small premature babies has resulted in a higher incidence of retinopathy of prematurity (ROP), which causes severe visual impairment in childhood. Early diagnosis and timely and proper treatment of ROP can prevent vision loss. This paper discusses cases of ROP treated with bevacizumab. Patients treated with bevacizumab for ROP were evaluated retrospectively. Systolic and diastolic blood pressure values were recorded 1 day before and 2 weeks after bevacizumab administration. The Bayley III test, hearing test, eye examination, and neurological evaluation were performed. The mean composite Bayley III test scores for cognition, language, motor, social-emotional, and adaptive domains in 10 patients who received bevacizumab for ROP were 75±10.8, 73.4±15.4, 71.2±10.2, 88±23.7, and 65.4±13.8, respectively. The mean values of the day before the injection and the values of the 14 days after the injection were compared, it was seen that there was a significant increase in systolic blood pressure values, especially at the end of 1st day and 1st week after the surgery. Neurological examination results were abnormal in 50% of the cases. Vision problems were detected in 40% of the cases. About 30% of the babies failed the hearing test. Caution needs attention in the care of neonates until further studies of the long-term benefits and effects of bevacizumab therapy are completed.

Type of Refractive Errors among School Going Children from District Kathua, Jammu, India

Introduction: Worldwide refractive error remains one of the most common causes of visual impairment in children. Uncorrected refractive error can lead to long term effect on acadaemic progression and employment opportunities. The study was conducted in remote area of district of Kathua, Jammu, India. Aim: To estimate type of refractive error among children and its association with demographic characters. Materials and Methods: The descriptive, cross-sectional, observational, hospital-based study was carried out in Out Patient Department (OPD) of Ophthalmology, Government Medical College, Kathua. The study of population included 351 children of age 5-16 years with complaint of diminution of vision. Examination included visual acuity recording, slit lamp, fundus examination and dilated retinoscopy. Inferential statistics was calculated using Open Epi version 3.01. Results: Out of 1582 children, 351(22.18%) children had refractive error. Their mean age was 12.52±2.87 years. The refractive errors were more common in the age group 13-16 years (61.5%), followed by 9-12 years (29.9%), and 5-8 years (8.51%). Refractive errors were more in males (56.12%) as compared to females (43.87%); 247(70.37%) children had refractive error in both the eyes, whereas 104(29.6%) had it in one eye. Astigmatism was most common (50.14%) followed by myopia (40.45%), hypermetropia (7.4%) and amblyopia (1.99%). Maximum astigmatism was seen in 13-16 years (56.25%) followed by 9-12 years (34.09%) and least in 5-8 years (9.65%). Conclusion: A high percentage of refractive errors in the study indicate that school health services should be strengthened and implemented effectively