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Screening Preschool Children for Visual Disorders: A Pilot Study

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Author(s): Suman Adhikari, BOptom | Nabin Paudel, BOptom | Prakash Adhikari, BOptom | Gauri Shankar Shrestha, MOptom | Jyoti Baba Shrestha, MD

Journal: Optometry & Visual Performance
ISSN 2325-3479

Volume: 1;
Issue: 6;
Start page: 202;
Date: 2013;
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Keywords: epidemiology | Nepal | preschool children | refractive error | vision screening

ABSTRACT
Purpose: Ocular and/or vision defects are one of the most common reasons for the referral of young children to the hospital. Vision disorders are the fourth most common disability of children and the leading cause of handicapping conditions in childhood. In preschool-age children, amblyopia and amblyogenic risk factors, such as strabismus and significant refractive errors, are the most prevalent and important visual disorders. The purpose of this pilot study was to determine the prevalence of visual disorders in preschool children in Kathmandu Valley, Nepal.Methods: Four hundred and eighty-four children attending eight preschools in Kathmandu Valley underwent detailed optometric examination. Visual acuity was assessed with either Sheridan Gardiner or Kay Picture chart monocularly. Binocularity was assessed with cover test and prism bar neutralisation. Refraction was carried out in all children. In most instances this was done without the use of a cycloplegic agent. Stereopsis was assessed with the Lang stereo test. Anterior and posterior segment abnormalities were assessed by using a pen light, hand-held slit lamp, and direct ophthalmoscope.Results: Refractive error was the most common visual disorder. Considering our criteria of refractive error for myopia ≥ 0.50 D, hyperopia ≥ 1.50 D, astigmatism ≥ 1.00 D, and anisometropia ≥ 1.00 D, the overall prevalence of refractive error in our study was 31.82%. The overall prevalence of myopia, hyperopia, and astigmatism was 24.17%, 2.48%, and 5.17%, respectively. Anisometropia was present in 1.65% of the participants, and 2%, 1.4%, and 0.2% had strabismus, amblyopia, and nystagmus, respectively.Conclusion: The relatively high prevalence of refractive error in our studied population needs more attention. The results suggest that there is a need for a large-scale community-based preschool screening program in Nepal so that affected children can be identified early and appropriate treatment can be started promptly.
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