Bakar Nurul Farhana Abu, Chen Ai-Hong, Noor Abdul Rahim Md, Goh Pik-Pin
Department of Optometry, 17th Floor, Faculty of Health Sciences, Universiti Teknologi MARA Puncak Alam Campus, 42300 Puncak Alam, Selangor, Malaysia.
Malays J Med Sci. 2012 Apr;19(2):48-55.
The epidemiological study of vision problems is important for developing national strategies for the prevention of visual impairment. There was a lack of information regarding vision problems among school children in East Malaysia. The purpose of this study was to compare the refractive errors and degrees of visual impairment between Native Iban and Malay school children who participated in a formal government vision loss prevention programme conducted in a rural area of Betong Division, Malaysia.
In total, 293 Native Iban and Malay school children (Standard 1, Standard 6, and Form 3) received refractive assessments by an optometrist after failing tests in the formal government school vision screening programme in 2008. A criterion for referral was a visual acuity of 6/9 or worse in either eye. Assessments of the refractive errors of the children were performed using dry retinoscopy and subjective refraction techniques at community clinics.
The overall prevalences of refractive error and visual impairment among the sampled populations were 47.7% and 3.5%, respectively. Approximately 97.1% of reported cases were myopia. The Malay sample population was found to be more myopic than the Native Iban population (U = 8240.50, P < 0.05, r = 0.14), but no significant association was found between myopia and ethnicity (χ(2) = 2.66, P > 0.05). Both Native Iban and Malay children in education levels higher than Standard 1 were more likely to have myopia (P < 0.05). Myopia was found to be more likely to affect females than males at a statistically significant level among Native Iban children (χ(2) [1.N = 170] = 6.279, P < 0.05, odds ratio = 2.327, 95% CI = 1.184-4.575). There was no statistically significant association between visual impairment and ethnicity (χ(2) = 1.60, P > 0.05). Approximately 94.1% of children with refractive errors suffered from having either the wrong prescription (7.8%) or having uncorrected refractive errors (92.2%).
The Native Iban population was found to be less myopic than the Malay population despite having a similar frequency of myopia. The proportion of children with myopia increased with the level of education in both ethnicities. A high percentage of untreated refractive error problems among Native Iban and Malay children in the Betong Division indicates that there is a need for government intervention for the purpose of economic and healthcare improvements.
视力问题的流行病学研究对于制定预防视力损害的国家战略至关重要。马来西亚东部学童的视力问题相关信息匮乏。本研究旨在比较参与马来西亚贝东分区农村地区正式政府视力丧失预防计划的伊班族和马来族学童的屈光不正和视力损害程度。
2008年，共有293名伊班族和马来族学童（一年级、六年级和三年级）在正式的政府学校视力筛查计划中测试未通过后，由验光师进行了屈光评估。转诊标准是任何一只眼睛的视力为6/9或更差。在社区诊所使用干式视网膜检影法和主观验光技术对儿童的屈光不正进行评估。
抽样人群中屈光不正和视力损害的总体患病率分别为47.7%和3.5%。报告病例中约97.1%为近视。发现马来族抽样人群比伊班族人群近视程度更高（U = 8240.50，P < 0.05，r = 0.14），但近视与种族之间未发现显著关联（χ(2) = 2.66，P > 0.05）。教育水平高于一年级的伊班族和马来族儿童都更易患近视（P < 0.05）。在伊班族儿童中，近视在统计学上更易影响女性而非男性（χ(2) [1.N = 170] = 6.279，P < 0.05，优势比 = 2.327，95% CI = 1.184 - 4.575）。视力损害与种族之间无统计学显著关联（χ(2) = 1.60，P > 0.05）。约94.1%的屈光不正儿童存在配镜错误（7.8%）或未矫正的屈光不正（92.2%）。
尽管近视发生率相似，但发现伊班族人群的近视程度低于马来族人群。两个种族中近视儿童的比例均随教育水平升高而增加。贝东分区伊班族和马来族儿童中未治疗的屈光不正问题比例较高，表明需要政府干预以改善经济和医疗保健状况。
