SYNOPSIS

Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore

“OCULAR MORBIDITY IN SCHOOl CHILDREN”

Name of the candidate : Dr.Archana M V

Guide : Dr. K Varadaraj Shenoy

Course and Subject : M.D. (Paediatrics)

.

Department of Paediatrics,

Father Muller Medical College Hospital

Kankanady, Mangalore – 575002.

August – 2011

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA, BANGALORE

ANNEXURE – II

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1. / Name of the Candidate and Address / DR.ARchANA M v
post Graduate Resident
Dept of Paediatrics
Father muller medical college
Kankanady
Mangalore – 575002
2. / Name of the Institution / Father muller medical college
Kankanady
Mangalore – 575002
3. / Course of study and subject / MD (Paediatrics)
4. / Date of admission to Course / 31-05-2011
5. / TITLE OF THE TOPIC:
“OCULAR MORBIDITY IN SCHOOL CHILDREN”
6. / BRIEF RESUME OF THE INTENDED WORK:
6.1 NEED FOR THE STUDY:
Many ocular diseases have their origin in childhood.30% of India’s blind lose sight before the age of 20 and many of them are under five when they become blind1. About 6-7 percent of children aged 10-14 years have problem with their eye sight2. VISION 2020 initiative to eliminate avoidable blindness has given high priority to correction of refractive error and has placed it within the category of childhood blindness. Visual impairment in a child can affect performance in school, personality development and future career oppourtunities.
Refractive error is the most common cause of visual impairment around the world and second leading cause of treatable blindness. Most children with uncorrected refractive error are asymptomatic and hence periodic visual screening and primary eye care reduces the prevalence of refractive error. Apart from refractive error other ocular morbidity like strabismus, stye, blepharitis, conjunctivitis, xerophthalmia, corneal opacity are also prevalent among school children5-6.
There are no such studies conducted in Mangalore city that gives information regarding prevalence of ocular morbidity in school children. Rationale behind conducting this study is to provide data on the prevalence and cause of visual impairment, other ocular morbidity in school children in Mangalore city, which is needed for early detection of refractive error and providing curative services for other ocular morbidity in children.
6.2 REVIEW OF LITERATURE
Amruta S Panhye and associates3 in their study on prevalence of uncorrected refractive error and other eye problems among urban and rural school children, found the prevalence of uncorrected refractive error in urban children was 5.46% and rural children was 2.63%, they concluded that the prevalence of uncorrected refractive error, especially myopia was higher in urban school children.
Nazia Uzma and colleagues4 in their clinical survey of prevalence of refractive error and eye disease in urban and rural school children, found the prevalence of uncorrected refractive error to be 9.8% in urban and 6.6% in rural children. The study emphasized the need for eye care to be included in school health check-up program.
Rajesh Kumar and his associates5 in their study the prevalence of ocular morbidity found to be 24.6%. Commonest cause being uncorrected refractive error (5.4%) followed by conjunctivitis (4.6%), trachoma(4.3%), xerophthalmia(4.1%), stye(1.3%). They also found that the prevalence of ocular morbidity increases with age and concluded that majority of ocular diseases observed were either preventable or treatable.
Madhu Gupta and colleagues6 conducted study on ocular morbidity prevalence among school children observed prevalence of ocular morbidity was 31.6%. Leading cause being refractive error followed by squint, color blindness, vitamin A deficiency.
G.V.S Murthy and co-workers7 conducted study to assess the prevalence of refractive error and related visual impairments in school children, found the prevalence of uncorrected refractive error was 6.4%. Refractive error was the leading cause of vision impairment in 81.7% of eye with vision impairment followed by amblyopia (4.4%) and retinal disorder (4.7%).
6.3 OBJECTIVES OF THE STUDY:
1)  Prevalence of refractive error in school children
2)  Prevalence of other ocular morbidity in school children
3)  Predictors of refractive error in school children and correlation of refractive error with selected family and patient criteria.
7. /
MATERIAL AND METHODS
7.1  SOURCE OF DATA :
2300 School children between 6 to 15 years of age studying in government and private schools in Mangalore. Schools will be selected by simple random sampling.
Type of study- population based descriptive cross sectional study.
7.2 METHOD OF COLLECTION OF DATA:
All study subjects will be given pretested and structured proforma to be completed by parents at home regarding socio demographic status and previous ocular history. Visual acuity will be tested using Snellen’s chart or E chart at 6meter distance. Visual acuity less than 6/12 in either eye or both will be declared as visual impairment. Pinhole vision testing is done to differentiate refractive error from posterior chamber pathology (The visual acuity improves with pinhole if there is refractive error but it remains the same in posterior chamber pathology).Ishihara’s chart will be used to detect color blindness .Ocular motility in six cardinal directions will be done to rule out paralytic squint. Hirschberg’s test will be done to detect strabismus and cover uncover test will be done to identify latent strabismus. Simple torch light examination will be done to detect any anterior segment pathology.
Statistical analysis:
Collected data analysed by frequency, percentage, odd’s ratio, Chi square test.
Inclusion criteria:
1. School children aged 6-15years
Exclusion Criteria:
1. School children with posterior segment pathology
2. Children who are unable to read Snellen’s chart or E chart
7.3 Does the study require any investigations or interventions to be conducted on patients or other human of animals? If so please describe briefy.
No
7.4 Has the ethical clearance been obtained from your institution in case of
7.3?
Yes
8. / LIST OF REFERENCES:
1)  Danish Assistance to National Programme for Control of Blindness. New Delhi:vision screening in school children. Training module 1.
2)  WHO (1995). The World Health Report 1995. Report of director general WHO
3)  Padhye A S, Khandeker R, Dharmadikari S, Dole K, Gogate R Deshpande M. Prevalence of uncorrected refractive error and other eye problem among urban and rural school children. Middle East African Journal of Ophthalmology.2009Apr-June;16(2):69-74
4)  Umnaz N, Kumar B S, Salar B M et al. A comparative clinical survey of the prevalence of refractive error and eye diseases in urban and rural school children. Can J Ophthalmol 2009;44(3):328-333
5)  Kumar R, Dabas P, Mehra M, Ingle G K, Saha R and Kamalesh. Ocular morbidity among primary school children in Delhi. Health and population-perspective and issues.2007;30(3): 222-229
6)  Gupta M, Gupta B P, Cauhan A, Bhardwaj A. Ocular morbidity prevalence among school children in Shimla. Indian Journal of Ophthalmology.2009 Mar-Apr;57(2):133-138.
7)  Murthy G V S, Gupta S K, Ellwein L B. Refractive error in children in an urban population in New Delhi. Investigative ophthalmology and visual science.2002 March;43(3):623-631
9. / SIGNATURE OF THE CANDIDATE:
10. / REMARKS OF THE GUIDE:
11. / NAME AND DESIGNATION OF THE
11.1 GUIDE: / Dr. K. Varadaraj Shenoy
Prof and HOD, Dept of Paediatrics
Fr. Muller Medical College
Kankanady,
Mangalore – 575002
11.2 SIGNATURE :
11.3 CO-GUIDE: / Dr. Francis E A Rodrigues
Prof and HOD,
Dept of ophthalmology
Fr. Muller Medical College
Kankanady,
Mangalore – 575002
11.4 SIGNATURE:
11.5 HEAD OF THE DEPARTMENT: / Dr. K. Varadaraj Shenoy
Prof and HOD, Dept of Paediatrics
Fr. Muller Medical College
Kankanady,
Mangalore – 575002
11.6 SIGNATURE:
12. / 12.1REMARKS OF THE CHAIRMAN & PRINCIPAL:
12.2 SIGNATURE: