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G. V. S. Murthy, Sanjeev K. Gupta, Leon B. Ellwein, Sergio R. Muñoz, Gopal P. Pokharel, Lalit Sanga, Damodar Bachani; Refractive Error in Children in an Urban Population in New Delhi. Invest. Ophthalmol. Vis. Sci. 2002;43(3):623-631.
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purpose. To assess the prevalence of refractive error and related visual
impairment in school-aged children in an urban population in New Delhi,
methods. Random selection of geographically defined clusters was used to
identify a sample of children 5 to 15 years of age. From December 2000
through March 2001, children in 22 selected clusters were enumerated
through a door-to-door survey and examined at a local facility. The
examination included visual acuity measurements, ocular motility
evaluation, retinoscopy and autorefraction under cycloplegia, and
examination of the anterior segment, media, and fundus. Myopia was
defined as spherical equivalent refractive error of at least −0.50 D
and hyperopia as +2.00 D or more. Children with reduced vision and a
sample of those with normal vision underwent independent replicate
examinations for quality assurance in four of the clusters.
results. A total of 7008 children from 3426 households were enumerated, and 6447
(92.0%) examined. The prevalence of uncorrected, baseline
(presenting), and best corrected visual acuity of 20/40 or worse in the
better eye was 6.4%, 4.9%, and 0.81%, respectively. Refractive error
was the cause in 81.7% of eyes with vision impairment, amblyopia in
4.4%, retinal disorders in 4.7%, other causes in 3.3%, and
unexplained causes in the remaining 5.9%. There was an age-related
shift in refractive error from hyperopia in young children (15.6% in
5-year-olds) toward myopia in older children (10.8% in 15-year-olds).
Overall, hyperopia was present in 7.7% of children and myopia in
7.4%. Hyperopia was associated with female gender. Myopia was more
common in children of fathers with higher levels of education.
conclusions. Reduced vision because of uncorrected refractive error is a major
public health problem in urban school-aged children in India.
Cost-effective strategies are needed to eliminate this easily treated
cause of vision impairment.
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