Vora Urmi, Khandekar Rajiv, Natrajan Sarvanan, Al-Hadrami Khalfan
Department of Non-Communicable Disease Control, Eye & Ear Health Care, Directorate General of Health Affairs, Ministry of Health (HQ), Muscat, Oman.
Middle East Afr J Ophthalmol. 2010 Oct;17(4):297-302. doi: 10.4103/0974-9233.71590.
We evaluated the refractive status and visual function of children with special needs (other handicap) in 2010 and compared them with healthy 1(st) grade school students in Oman.
This was a cohort study. Optometrists recorded vision using a logarithm of minimum angle of resolution (LogMAR) chart. Preferential looking method was used for testing 31 children. Cycloplegic refraction was performed on all children. Contrast sensitivity was tested using 2.5%, 10%, and 100% contrast charts. Ocular movement, alignment, and anterior segment were also assessed. A pediatrician reviewed the health records of all the children at the time of their enrollment in this study to determine if the child had been diagnosed with a systemic condition or syndromes. The visual functions were assessed by study investigators. We estimated the rates and the risk of different visual function defects in children with special needs.
The prevalence of refractive error in 70 children (4.7 ± 0.8 years) with special needs (group 1) and 175 normal healthy first grade students (group 2) were 58.5% and 2.9%, respectively. The risk of refractive error was significantly higher in children with special needs [relative risk, 48.1 (95% confidence interval, 17.54-131.8)]. Hyperopia (>1.00 D), myopia (≥ 1.00D) and astigmatism (≥ ±1.00 D) were found in 18.6%, 24.3%, and 27.1%, respectively, in group 1. Six children in this group had defective near vision. Sixteen (80%) children with Down syndrome had refractive error. Seven (50%) children with developmental disorder showed decreased contrast sensitivity.
Prevalence of uncorrected refractive error was much higher in children with special needs. Prevalence of strabismus, nystagmus, and reduced contrast sensitivity was also higher in children with special needs. Early vision screening, visual function assessment, correction of refractive error, and frequent follow-up are recommended.
我们于2010年评估了有特殊需求（其他残疾）儿童的屈光状态和视觉功能，并将他们与阿曼健康的一年级学生进行比较。
这是一项队列研究。验光师使用最小分辨角对数（LogMAR）视力表记录视力。对31名儿童采用优先注视法进行测试。对所有儿童进行睫状肌麻痹验光。使用2.5%、10%和100%对比度的视力表测试对比敏感度。还评估了眼球运动、眼位和眼前节。在本研究所有儿童入组时，由一名儿科医生查阅其健康记录，以确定该儿童是否被诊断患有全身性疾病或综合征。视觉功能由研究调查人员进行评估。我们估计了有特殊需求儿童中不同视觉功能缺陷的发生率和风险。
70名有特殊需求儿童（1组，年龄4.7±0.8岁）和175名正常健康一年级学生（2组）的屈光不正患病率分别为58.5%和2.9%。有特殊需求儿童的屈光不正风险显著更高[相对风险，48.1（95%置信区间，17.54 - 131.8）]。1组中远视（>1.00 D）、近视（≥1.00 D）和散光（≥±1.00 D）的发生率分别为18.6%、24.3%和27.1%。该组中有6名儿童近视力有缺陷。16名（80%）唐氏综合征儿童有屈光不正。7名（50%）发育障碍儿童对比敏感度下降。
有特殊需求儿童中未矫正屈光不正的患病率要高得多。有特殊需求儿童斜视、眼球震颤和对比敏感度降低的患病率也更高。建议进行早期视力筛查、视觉功能评估、屈光不正矫正和定期随访。
