In a new study from LVPEI, Dr. Rohit Khanna, Winston Prakash, Dr. Srinivas Marmamula, and others report the current prevalence and risk factors of vision impairment among schoolchildren in Telangana.
Most learning is done by seeing. Good vision is crucial for taking notes from the blackboard, from a screen, or for reading a book. Undiagnosed vision impairment (VI) can hamstring a child’s scholastic progress, their intellectual growth, and their career prospects, leading to low employability and wages. So, an early diagnosis of VI in children can help them receive timely intervention and improve their prospects. Population-level screening for common eye conditions in children is the ideal strategy to achieve such positive outcomes. Those identified with VI can then be followed up with proper treatment.
School vision screening programs are a cost-effective approach to achieving large-scale VI screening among children. LVPEI’s Initiative for Screening Children for Refractive Errors and other Eye health Needs (I-SCREEN), for example, focuses on school screenings in the southern Indian states of Andhra Pradesh and Telangana. A study from last year estimated the prevalence of VI among schoolchildren in rural and urban areas of Krishna district in Andhra Pradesh to be 1.72%. The last recorded data on VI prevalence among schoolchildren (7.1%) in Telangana is 14 years old and covered only Hyderabad, the state capital.
In a new study published in the Indian Journal Ophthalmology, Dr. Rohit Khanna, Winston Prakash, Dr. Srinivas Marmamula, and others from LVPEI provide updated estimates for the prevalence of VI and ocular morbidity among schoolchildren in Telangana. Unlike the previous study, a total of 774,184 schoolchildren (boys: 51.5%) aged 4–15 years were screened for this study. The study found that almost 9,000 schoolchildren in Telangana were visually impaired, with an average prevalence of 1.16%—similar to Andhra Pradesh. However, the study found that prevalence of VI among schoolchildren in Hyderabad (2.24%) was nearly twice the average of the other three rural districts. However, the study found that the prevalence of VI among schoolchildren in Hyderabad (2.24%) was nearly twice the average of the other three rural districts. The updated data indicates a threefold decrease in the prevalence of VI in the city in the last 14 years.
Age and disability were major risk factors that correlated with the likelihood of VI among children. Older schoolchildren (11–15 years) had nearly six times the risk of visual impairment compared to younger children (4–5 years). A physical or mental handicap also had a fivefold increase in the risk of VI. A girl child had a 30% higher risk compared to a male child. Refractive errors, like myopia, accounted for 74% of VI, and spectacles provision saw a four-fold reduction in the prevalence of VI. The study also noted the lingering presence of vitamin A deficiency in the sample.
‘Unlike adults, a child cannot properly comprehend or communicate their vision problems, which makes most childhood vision problems-especially in rural areas-go unnoticed,’ concludes Winston D. Prakash, research optometrist at LVPEI and the first author of the paper. ‘That is why school-level vision screening programs are needed to safeguard the sight of this vulnerable demographic.’
Citation
Prakash WD, Marmamula S, Mettla AL, Keeffe J, Khanna RC. Variations in the prevalence of vision impairment across regions among school children in Telangana State, South India. Indian J Ophthalmol. 2023 Oct;71(10):3322-3327
Photo credit: Winston Prakash, LVPEI
