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Brinda Muthusamy, Biswajit Dey, Veena Kannusamy, Fredrick Moutappa, Hee-Jung Park; Sibling Motivation Cards - New Screening Initiative in South India for Pediatric Eye Disease. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6780.
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In a developing country like India, early identification and prompt treatment of ocular diseases is a big challenge especially among the pediatric population. The most common treatable ocular causes of childhood visual impairment are refractive errors, strabismus, congenital cataract, and amblyopia. These conditions have a genetic basis and are more common among families of an affected individual. To improve screening efficiency, we devised "Sibling Motivation Cards" (SMC) to target first-degree relatives of affected individuals. We describe a pilot study to evaluate the use of this screening tool.
The pilot initiative was carried out at Aravind Eye Hospital, Pondicherry in South India. Over a 5 month period, a sample of children aged 5 to 17 years diagnosed with refractive errors, strabismus, amblyopia, or pediatric cataract was offered a SMC. The parents were counseled on the importance of having the siblings screened for ocular disease. They were given an appointment to attend the base hospital for a comprehensive ophthalmologic evaluation performed by an orthoptist and a pediatric ophthalmologist. Glasses were provided on-site and treatment offered when necessary.
Over the study period, 177 SMCs were given to the parents of children initially screened (probands). Of the probands, 142 (80.2%) had refractive errors, 16 (9.0%) had strabismus, 10 (5.6%) had cataract and 9 (5.1%) had amblyopia. Of the 177 SMCs given, 69 siblings (39.0%) turned up for evaluation. Of these, 37 (53.6%) had ocular defects. 35 (50.7%) had refractive errors and 1 each (1.5%) had strabismus and cataract. Out of the 35 siblings having refractive errors, 1 (2.9%) had hyperopia, 10 (28.6%) had myopia, 19(54.3%) had compound myopic astigmatism, and 5 (14.3%) had simple myopic astigmatism.
Siblings of children with visual impairment had a higher rate of pediatric eye disease than the general population. By screening siblings of probands, we identified 53% of the siblings with treatable pediatric eye diseases who may not have been identified otherwise. Targeting scarce resources to this higher risk population can improve screening efforts.
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