Eye and vision defects in under-five-year-old children in Oman: A public health intervention study

PURPOSE: To identify under-five-year-old children with vision or ocular defect in two provinces (Wilayats) of central Oman in 2006. STUDY DESIGN: Public health intervention study. MATERIALS AND METHODS: Ocular examination in Manah Wilayat was conducted by nursing staff of the primary health center (PHC) and in Mudhaiby Wilayat was conducted by a trainee Omani optometrist. Abnormal sized eyeball, strabismus, nystagmus and white pupil were recorded. Visual acuity was tested by LOGMAR chart with Lea's symbols in children >2 years of age and preferential viewing was assessed by Lea's grating paddle or 'Hiding Heidi' picture in children ≤2 years age. Data was analyzed using Statistical Package for Social Studies (SPSS 12). RESULT: Among 1,520 examined children, three children had absent eyeball bilaterally and three had unilaterally absent eyeball. Strabismus and nystagmus were detected in 44 (2.9%) and 18 (1.2%) children respectively. 'Hiding Heidi' test was normal in 530/537 (87%) of children. Distant vision reading was ≥0.32 in 386/448 (86.2%) eyes. Preferential looking test suggested that half of the children had defective vision (>2cpcm). Screening at '1-2 year' and '3-4 years' age group could significantly predict eye problems (P ≤ 0.001). CONCLUSION: Eye and vision screening of under-five kids helped in detection of eye problems in early stages. Instead of universal screening, high risk population or children of '3 to 4' years for vision and '1 to 2' years for ocular abnormalities is proposed The existing health services could not detect some children with eye problems and they were identified during such screening.