The prevalence of uncorrected refractive error in urban, suburban, exurban and rural primary school children in Indonesian population

Uncorrected refractive error（URE） is a major health problem among school children. This study was aimed to determine the frequency and patterns of URE across 4 gradients of residential densities（urban, exurban, suburban and rural）. This was a cross-sectional study of school children from 3 districts in Yogyakarta and 1 district near Yogyakarta, Indonesia. The information regarding age, sex, school and school grader were recorded. The Snellen＇s chart was used to measure the visual acuity and to perform the subjective refraction. The district was then divided into urban, suburban, exurban and rural area based on their location and population. In total, 410 school children were included in the analyses（urban=79, exurban=73, suburban=160 and rural=98 school children）. Urban school children revealed the worst visual acuity（P〈0.001） and it was significant when compared with exurban and rural. The proportion of URE among urban, suburban, exurban and rural area were 10.1%, 12.3%, 3.8%, and 1%, respectively, and it was significant when compared to the proportion of ametropia and corrected refractive error across residential densities（P=0.003）. The risk of URE development in urban, suburban, exurban, and rural were 2.218（95%CI： 0.914-5.385）, 3.019（95%CI： 1.266-7.197）, 0.502（95%CI： 0.195-1.293）, and 0.130（95%CI：0.017-0.972）, respectively. Urban school children showed the worst visual acuity. The school children in urban and suburban residential area had 2 and 3 times higher risk of developing the URE.

Cross-sectional investigation of visual impairing diseases in Shanghai blind children school

Background The control of blindness in children is a high priority within the VISION 2020 initiative. To determine the causes of severe visual impairment and blindness in children from Shanghai Blind Children School （SBCS） can provide useful information on childhood blindness in Shanghai. Methods A cross-sectional investigation of students in SBCS was conducted in May 2010. The World Health Organization/Prevention of Blindness （WHO/PBL） eye examination record system for children with low vision and blindness was used. The results were further compared with the findings of two previous investigation studies conducted in 1986 and 2004, respectively in SBCS. Results Of the 146 children observed, 80 children （54.8%） were blind （best corrected best visual acuity less than 0.05）, 27 children （18.5%） had severe visual impairment （best corrected visual acuity less than 0.1 but better than or equal to 0.05）, and 34 children （23.3%） had moderate visual impairment （best corrected visual acuity less than 0.3 but better than or equal to 0.1）. The major affected anatomic sites in the 107 children with severe visual impairment and blindness （SVI/BL） were retina （47.7%）, whole globe （16.8%）, optic nerve （13.1%） and lens （9.3%）. The leading causes of SVI/BL were retinopathy of prematurity （ROP, 25.2%）, followed by retinal dystrophy （15.9%）, optic nerve atrophy （9.3%） and microphthalmos （9.3%）. The two leading etiologic categories of SVI/BL were perinatal/neonatal （36.4%） and congenital/hereditary groups （29.0%）. The leading cause of moderate visual impairment was aphakia after cataract surgery （congenital cataract, 44.1%）. Compared with the findings in two previous investigations in SBCS, the proportion of ROP in visual impairing diseases increased, while the proportion of disorders of the lens （cataract and aphakia） significantly decreased.