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 Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 29  |  Issue : 4  |  Page : 1044-1047

Prevalence of refractive errors among primary school children in the rural areas of Menouf district, Egypt


1 Department of Family Medicine, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of Ophthalmology, Faculty of Medicine, Menoufia University, Menoufia, Egypt

Date of Submission09-Mar-2015
Date of Acceptance08-Jun-2015
Date of Web Publication21-Mar-2017

Correspondence Address:
Asmhan F Hamouda
Munshaat Soultan, Menoufia, 32511
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-2098.202535

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  Abstract 

Objective
The aim of this study was to determine the prevalence of refractive errors among primary school children in the rural areas of Menouf district, Egypt.
Background
Visual impairment among school children is a prevailing problem. Besides affecting children's attendance at school it reduces their ability to study thus leading to impairment of their academic achievements.
Participants and methods
The sample size was calculated to be 435 students, which was increased to 480 students. The students were selected among all the primary school children in the selected area through a systematic random sampling of the classes in the studied schools during the scholastic years 2013–2014. All students were interviewed and underwent assessment for visual acuity.
Results
The screening revealed that 116 students out of 480 (24%) had refractive errors. Of them, 22% patients had myopia and only 2% had hypermetropia.
The patients were found to be affected by watching television for long durations, in dim or yellow light, and at a distance less than the healthy recommended level.
Conclusion
Nearly one-fourth of the students were found to have refractive errors.

Keywords: hypermetropia, myopia, school children


How to cite this article:
Elkot MM, Wgdy FM, Hegazy NN, Hamouda AF. Prevalence of refractive errors among primary school children in the rural areas of Menouf district, Egypt. Menoufia Med J 2016;29:1044-7

How to cite this URL:
Elkot MM, Wgdy FM, Hegazy NN, Hamouda AF. Prevalence of refractive errors among primary school children in the rural areas of Menouf district, Egypt. Menoufia Med J [serial online] 2016 [cited 2020 May 31];29:1044-7. Available from: http://www.mmj.eg.net/text.asp?2016/29/4/1044/202535


  Introduction Top


School children in Menoufia governorate have many documented prevalent problems such as schistosomiasis [1].

Childhood visual impairment due to refractive errors is one of the most common problems among school children and is the second leading cause of treatable blindness [2]. Undetected or undercorrected refractive errors, particularly myopia, comprise a special problem among school children; it is characterized by poor vision and inability to read from the blackboard, which has a serious impact on a child's participation and learning in the class and thus on the child's education, career, and socioeconomic status [3]. In most cases, children's vision problems can be easily detected by simple vision tests (such as visual acuity screening) and can be corrected by timely and proper fitting of quality eye glasses [4]. Without appropriate optical correction, millions of children are losing educational opportunities [4].

Unfortunately, studies in a variety of developing countries state that 35–85% of individuals with refractive errors do not wear eye glasses and many of them have never been screened or examined [5].

Early detection of vision problems can have educational, behavioral, and quality of life benefits [6]. Correction of refractory errors and low vision is one of the priorities of global initiatives for vision 2020 [7].

In general, refractive errors can be easily corrected by the use of glasses. The main risk factor for refractive errors is social changes such as increase in near-intensive work, reading, and writing, and working on a computer [4].


  Objective Top


The aim of this study was to determine the prevalence of refractive errors among primary school children in the rural areas of Menouf district, Egypt.


  Participants and Methods Top


The sample size for the study was estimated to be 435 students by using Epi Info (Clifton Road Atlanta, GA, USA) for windows with an α error of 1%, which was then increased to 500 students to compensate for dropouts. A total of 480 students completed the study, with a dropout rate of 4%. This case–controlled, cross-sectional study was conducted in all the primary schools in Munshat Sultan village, Menouf district, Menoufia governorate, Egypt. One class from the first to the sixth grade was selected through systematic random sampling.

Human rights and ethical considerations were followed during the study with total confidentiality of any obtained data. The Ethical Committee of the Menoufia Faculty of Medicine for medical research formally approved the study. After explaining the aim of the study, a written consent form was obtained from the administrative authorities in the studied schools. All the students were interviewed and underwent visual assessment. They were interviewed using a sociodemographic data questionnaire [8]. This semistructured questionnaire was used to detect the presence of television or computer; distance of sitting; presence of proper light in the computer or television room, including the number of lamps in the room (more or less than three lamps in the room); and duration of watching. Students were examined using the broken Landolt's chart at a 6 m distance and children with low vision were referred to the Ophthalmology Department to differentiate between types of refractive errors.

The study was conducted during the period from October 2014 to November 2014.

Statistical analysis

The collected data were analyzed using SPSS, version 7.5. The prevalence of RE among the screened students was estimated. Pearson chi-squared test was applied and differences were considered significant at P< 0.05.


  Results Top


In the present study the mean age of the students with refractive errors was 9.9 ± 1.6 years, whereas the mean age of normal children was 10.7 ± 1.8 years. The mean age of the fathers of the children with refractive errors was 41 ± 6.04 years, whereas that of the fathers of normal children was 43.4 ± 6.02 years. The mean age of the mothers of the children with refractive errors was 35.7 ± 5.2 years, whereas that of the mothers of normal children was 38 ± 5.8 years.

About 21.1% of the mothers of the children with refractive errors were house wives, whereas about 78.9% of the mothers of normal children were house wives. About 29.7% of the fathers of the children with refractive errors were working professionals and about 70.3% of the normal children were working professionals. About 23.7% of the children with refractive errors were from rural areas, whereas 76.3% of the normal children were from rural areas, also about 24.7% of children with refractive errors were from urban areas ([Table 1]).
Table 1 Sociodemographic characteristics of the studied group

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There was a significant statistical difference between children with refractive errors and normal children regarding decrease in the distance from television up to 1 m and in the hours of watching by less than 2 h inadequate white light.

All the children who sit within 1 m from television had refractive errors. Nearly 77% of those watching television in inadequate or improper light and 81% of those watching it for more than 4 h had refractive errors ([Table 2]).
Table 2 Effect of television exposure among the studied group

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There was a statistically significant difference between children with refractive errors and normal children regarding the distance from the computer to less than 1 m, proper or white light, and sitting for more than 4 h.

About 31.4% of children who sit at a distance of less than 50 cm had visual errors; 58.6% of those sitting in inadequate or improper light and about 60.4% of those sitting for more than 4 h had refractive errors ([Table 3]).
Table 3 Effect of computer exposure among the studied group

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  Discussion Top


In the present study, the prevalence of refractive errors was found to be 24%. Myopic patients represented 22%, whereas only 2% had hypermetropia, which is in agreement with Megbelayin et al. [9], who noted in their studies that myopic spherical error is often the most common form of refractive error in school-age children.

This was in agreement with El-Bayoumy [10], who in their study conducted in Cairo, Egypt, found that the prevalence of refractive errors in school students aged 7–14 years to be nearly 22.1%.

The present study showed statistically significant differences between children with refractive errors and normal children as regards sitting in front of television, which was in agreement with a study by Ali et al. [11] in Pakistan, who showed evidence in the literature for strong relationship between short-distance television watching and the development of refractive errors, and also with the findings of a Singapore–China study conducted by Saw et al. [12].

The study showed statistically significant differences between children with refractive errors and normal children regarding the sitting distance from computer, adequate or white light, and less than 2 h of sitting.

This was in agreement with Seet et al. [13] in Singapore who showed a statistically significant difference between little or no computer or video game use and prolonged use.

This was in agreement with the findings of other studies, such as that by Elkington and Frank [14] who reported a strong correlation between studying in dim light at night and refractive errors.

This cannot be counted as a direct factor but an intermediate factor attributed to changing 'environmental conditions' and having higher education, and near work-related occupations involving computers.


  Conclusion Top


In conclusion, the prevalence of refractive errors in children in this study was 24%. In view of the observation that refractive errors were common and high in this study, there is a need for the Ministry of Education in Egypt to be involved in health education to increase awareness on refractive errors among children and also ensure easily accessible and affordable eye care services (including optical) in the local communities.

Furthermore, school screening programs should be established and follow-up for refractive errors involving children should be carried out to avert poor academic performances of children.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Bahbah M, El Shikhsalem W. Study of schistosomiasis among school children in Berket El Sab district, Menoufia Governorate. Menoufia Med J 2014; 27:239–243.  Back to cited text no. 1
    
2.
Alam H, Siddiqui MI, Jafri SI, Khan AS, Ahmed SI, Jafar M. Prevalence of refractive error in school children of Karachi. J Pak Med Assoc 2008; 58:322–325.  Back to cited text no. 2
    
3.
Taylor HR. Refractive errors: magnitude of the need. Community Eye Health 2000; 13:1–2.  Back to cited text no. 3
    
4.
WHO. Prevention of blindness and deafness. Available data on blindness, update 2006. Geneva: WHO; 2006. Available on: http://www.who.int/blindness/publications/global_data.pdf. [Last accessed 2014 May].  Back to cited text no. 4
    
5.
Ramke J, du Toit R, Palagyi A, Brian G, Naduvilath T. Correction of refractive error and presbyopia in Timor-Leste. Br J Ophthalmol 2007; 91:860–866.  Back to cited text no. 5
    
6.
Pokharel GP, Negrel AD, Munoz SR, Ellwein LB. Refractive error American Association of Pediatric Ophthalmology and Strabismus, and the American Academy of Ophthalmology. Policy statement: eye examination in infants, children and young adults by pediatricians. Pediatrics. 2003; 111:902–907.  Back to cited text no. 6
    
7.
Maul E, Barroso S, Munoz SR, Sperduto RD, Ellwein LB. Refractive error study in children: results from La Florida, Chile. Am J Ophthalmol 2000; 129:445–454.  Back to cited text no. 7
    
8.
El-Gilany A, El-Wehady A, El-Wasify M. Updating and validation of the socioeconomic status scale for health research in Egypt. East Mediterr Health J 2012; 18:962–968.  Back to cited text no. 8
    
9.
Megbelayin E, Nkanga GD, Kalu A. Pattern of refractive astigmatism in Nigerian high schools. Sky J Med Sci 2013; 1:1–6.  Back to cited text no. 9
    
10.
El-Bayoumy BM, Saad A, Choudhury AH. Prevalence of refractive error and low vision among schoolchildren in Cairo. East Mediterr Health J 2007; 13:575–579.  Back to cited text no. 10
    
11.
Ali A, Ahamad I, Ayub S. Prevalence of undetected refractive errors among school children. Biomedica 2007; 23:96–101.  Back to cited text no. 11
    
12.
Saw SM, Zhang MZ, Hong RZ, Fu ZF, Pang MH, Tan DT. Near-work activity, night-lights, and myopia in the Singapore–China study. Arch Ophthalmol 2002; 120:620–627.  Back to cited text no. 12
    
13.
Seet B, Wong TY, Tan DT, Saw SM, Balakrishnan V, Lee LK, Lim AS. Myopia in Singapore: taking a public health approach. Br J Ophthalmol 2001; 85:521–526.  Back to cited text no. 13
    
14.
Elkington AR, Frank HJ. Clinical optics. 2nd ed. Oxford: Blackwell Scientific Publications; 1991. pp. 95–98.  Back to cited text no. 14
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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