Abstract

A STUDY ON PREVALENCE OF REFRACTIVE ERRORS, STRABISMUS AND AMBLYOPIA IN PAEDIATRIC AGE GROUP IN A TERTIARY CARE HOSPITAL

Author(s): Vinodhini K, Anuradha T. R, Vaishnavi J, Nazeem Farzana Ghouse

BACKGROUND Refractive errors are considered to be a preventable cause of blindness, leading to visual disabilities in children. As per WHO Vision 2020 initiative high priority is given for correction of refractive error as it is placed within the category of “childhood blindness”. Uncorrected refractive error can result in amblyopia or strabismus. The risk of developing amblyopia occurs if the children are not screened early for refractive errors and corrected on time. Most of the children with uncorrected refractive errors are asymptomatic and screening helps in early detection and timely intervention to avoid complications. Thus, the purpose of this study was to estimate the frequency and pattern of refractive errors, and to analyse associations between refractive error and different types of strabismus and amblyopia in paediatric age group <12 years who attended our Ophthalmology OPD at Govt. Stanley Medical College Hospital located in North Chennai. MATERIALS AND METHODS An observational, cross sectional study was done in paediatric age group <12 years who attended the Ophthalmology OPD in our Hospital during a 1-year period, after obtaining ethical committee clearance. Informed consent was taken from the childrens’ parent or guardian. All patients underwent a complete ophthalmic examination including a detailed history of ophthalmic problems, fundus examination, refraction, uncorrected visual acuity (UCVA), and best corrected visual acuity (BCVA). Keeping in view that accommodation may affect the result, cycloplegic refraction was done in all the children using 1% cyclopentolate. During routine ophthalmic examination of these children, the presence or absence of amblyopia and strabismus was also recorded. When strabismus was noted in children, squint evaluation was done. Based on the observations, they were grouped under the following heads: Myopia and Hypermetropia (mild/ moderate/ high), Astigmatism (mild/moderate/high). RESULTS Out of the 200 children, 128 (64%) were found to have refractive errors – astigmatism (49.2%) >hypermetropia (28.1%) >myopia (22.7%). 6 (4%) of them were found to have amblyopia and all of them presented late to us >7 years of age with mixed astigmatism, simple and compound hypermetropic astigmatism. 3 (2.3%) of the 128 children had strabismus – 2 esotropia and 1 exotropia, and they also presented at >7 years of age associated with hypermetropia and compound hypermetropic astigmatism. CONCLUSION Our study thus showed that Astigmatism was the most common refractive error among our study population and it was the most common association of amblyopia. Hypermetropia was found to be a common association of strabismus. Amblyopia and strabismus was found in children who presented to us late after 7 years of age. Hence our study on the whole signifies the need for early screening of children for refractive errors even from the pre-verbal age group to eliminate complications like amblyopia and strabismus.