Tribal Odisha Eye Disease Study (TOES) # 7. Prevalence of refractive error in children in tribal Odisha (India) school screening

PURPOSE: To describe the prevalence of refractive error in school children in a tribal district, Rayagada, Odisha state, India. METHODS: In a cross-sectional school eye health study, the students with diminished vision and other ocular abnormalities were referred for a further eye examination to the vision technicians after initial screening by the trained school teachers. The examination by vision technicians consisted of an external eye examination, photorefraction using a Spot screener and subjective correction. Those not improving with subjective correction were referred to the ophthalmologist for further examination. RESULTS: The school teachers measured vision in 153,107 children; 5,990 students reached a vision technician. There was a near equal number of boys (50.06%) and girls (49.94%). The average age was 10.5 ± 2.63 (range: 5–15) years. The prevalence of refractive error was 9.7% (95% [CI]; 9.0–10.5%) in the vision technician-examined children. Myopia (4.9%) and astigmatism (5.4%) were more common than hyperopia (0.2%). The presenting visual acuity (PVA) was worse in children with hypermetropia (PVA 20/100-20/200 in 40% of children). Spherical equivalent of refractive error did not have a good correlation with age (R(2) = 1.3); but increasing age was associated with increased risk of myopia (odds ratio 1.14; 95% CI 1.09–1.20; P < 0.001). CONCLUSION: The quantum of refractive error was close to other similar studies in India but the prevalence of myopia was relatively less.