Sapkota Yuddha D, Adhikari Bishwa Nath, Pokharel Gopal P, Poudyal Bimal K, Ellwein Leon B
Nepal Netra Jyoti Sangh, Tripureshwor, Kathmandu, Nepal.
Ophthalmic Epidemiol. 2008 Jan-Feb;15(1):17-23. doi: 10.1080/09286580701772011.
Assess visual impairment in school children of upper-middle socioeconomic status in Kathmandu for comparison with rural Jhapa District.
Random selection of classes from secondary private schools in Kathmandu was used to identify the study sample. Children in 130 classes at 43 schools were enumerated using school records and examined between January-May 2006. Examinations included visual acuity testing, ocular motility evaluation, cycloplegic refraction, and examination of the external eye, anterior segment, media, and fundus. The principal cause was determined for eyes with uncorrected visual acuity < or = 20/40.
A total of 4,501 children in grades 5-9 were enumerated; 4282 (95.1%) were examined. The prevalence of uncorrected, presenting, and best-corrected visual impairment (< or = 20/40) in the better eye was 18.6%, 9.1%, and 0.86%, respectively. Refractive error was a cause in 93.3% of children with uncorrected visual impairment, amblyopia 1.8%, retinal disorders 1.3%, other causes 0.3%, and unexplained causes 4.4%. Among children correctable in at least one eye, 46.3% presented without the necessary spectacles. Visual impairment with myopia (-0.50 diopters) ranged from 10.9% in 10 year-olds to 27.3% in 15 year-olds, compared to 0.5%-3.0% in rural Jhapa District. Myopic visual impairment was associated with grade level, female gender, parental education, parental spectacle usage, and Mongol ethnicity.
Visual impairment with myopia among upper-middle socioeconomic school children in Kathmandu is higher than that in rural Nepal, and a public health problem because nearly half are without corrective spectacles. Effective strategies are needed to eliminate this easily treatable cause of visual impairment.
评估加德满都社会经济地位中上等的学童的视力损害情况，以便与贾帕县农村地区进行比较。
从加德满都的私立中学随机选取班级来确定研究样本。利用学校记录对43所学校130个班级的儿童进行清点，并于2006年1月至5月期间对他们进行检查。检查包括视力测试、眼球运动评估、散瞳验光以及对外眼、眼前段、眼内介质和眼底的检查。确定视力未矫正低于或等于20/40的眼睛的主要病因。
共清点了4501名五至九年级的儿童；4282名（95.1%）接受了检查。较好眼的视力未矫正、现有视力和最佳矫正视力损害（低于或等于20/40）的患病率分别为18.6%、9.1%和0.86%。屈光不正导致93.3%视力未矫正的儿童视力损害，弱视占1.8%，视网膜疾病占1.3%，其他原因占0.3%，不明原因占4.4%。在至少一只眼睛可矫正的儿童中，46.3%未佩戴必要的眼镜。近视性视力损害（-0.50屈光度）在10岁儿童中为10.9%，在15岁儿童中为27.3%，而贾帕县农村地区为0.5%-3.0%。近视性视力损害与年级、女性性别、父母教育程度、父母眼镜使用情况和蒙古族血统有关。
加德满都社会经济地位中上等的学童中近视性视力损害高于尼泊尔农村地区，这是一个公共卫生问题，因为近一半的儿童没有矫正眼镜。需要采取有效策略来消除这种易于治疗的视力损害原因。
