A survey of the Prevalence of Refractive Errors among Children in Lower Primary School in Kampla District.

Abstract

BACKGROUND: The prevalence of refractive errors in children in most developing countries is not known. WHO has initiated the refractive error study in children (RESC) program to try and address this problem in the vision 2020. The right to sight. In Uganda, like in many developing countries there is almost no established vision screening program for children on commencement of primary school, such that those with early onset of refractive errors will have many years of poor vision. THE AIMS AND OBJECTIVES of this study was to determine the prevalence of refractive errors among school children attending lower primary in Kampala district, determine the frequency of the various types of refractive errors and their relationship to sex and ethnicity. METHODOLOGY: This descriptive cross sectional study was carried out in Kampala district and a multi stage type of sampling was used to select the 700 participants aged between 6 and 9 years. A total of 623 children of them had a vision testing done on them at school using the same protocol. Of this 301 (48.3%) were males and 322 (51.7%) females – M: F ratio of approximately 1:1. Seventy five children had a detailed ocular examination including retinoscopy under cyclopegia and fundoscopy according to the set criteria of a visual acuity of < 6/9 and / or a squint in either or both eyes. RESULTS: There were 73 children with refractive errors, giving a prevalence rate of 11.6%. The 2 children who were emmetropic at retinoscopy had fundus abnormalities. Of the refractive errors, the commonest type was astigmatism constituting 52.0% followed by hypermetropia and myopia (37.0% and 11.o% respectively). On further analysis of the astigmatic type it was found that the commonest component was the hypermetropic subtype accounting for 42.1% followed by the mixed (31.6%) and myopic (26.3%). There was no significant sex and ethnic influence in the frequency and distribution of refractive errors in this study. CONCLUSION: From this study, there is a need to have a regular and simple vision testing in school children at least at commencement of school to detect those who may have early onset of refractive errors for referral. This needs a wider population based survey top establish the national figures for prevalence of refractive errors, covering wider age strata, in view of creating a national program for vision screening in schools.