PREVALENCE OF REFRACTIVE ERRORS AND THE FACTORS RELATED TO IT AMONG MADRASSA STUDENTS IN DISTRICT SIALKOT

Introduction: Refractive errors comprise visual impairment arising from inability of eye to focus light on retina. Refractive errors include myopia, hyperopia, astigmatism and presbyopia. Many factors like age, family history, distance while watching screen and reading and illumination during activities contribute towards refractive error. Globally, uncorrected refractive errors contribute towards 43% of visual impairment with more than 12 million children aged between 5 to 15 years. Globally estimated pool prevalence of myopia, hyperopia and astigmatism in children was 11.7%,4.6% and 14.9% respectively. In a country like Pakistan, not much study has been undertaken regarding refractive errors and madrassa are already deprived of school health services. With this background, the following study was charted up with following objectives: Objectives: The objectives were to study the prevalence of refractive errors among Madrassa students aged 5 to 15 years in Sialkot and and to study the factors related to it. Materials and methods: A descriptive cross sectional, study was conducted in Shahabia Madrassa, located in District Sialkot. 168 boys were selected randomly and examined by an ophthalmology team for RE. Data was collected on the pre-tested questionnaire and a checklist was used to observe variables like reading distance and room illumination. Data was entered and analyzed on SPSS 20. Prevalence was calculated in percentages and quantitative factors like age was expressed in mean, median and standard deviation, Chi square test was used as a test of significance and p value <= 0.05 was taken as significant. Results: Mean age of boys was 12.3 years with SD +/- 1.8 Median being 12years. 31.5%(53/168) of students had errors of refraction., out of which 26(49.1%) were diagnosed. 43/53 students (81.1%) were myopic,4/ 53 students (7.6%) were hyperopic and 6/ 53 (11.3%) were astigmatic. 31 /78 boys (31.7%) were >= 13 years and 22/90 boys (24.4%) were <13 years had refractive error. Out of 53 with refractive error, 52/114 boys (45.6%) had reading distance of < 25cm and 1/53 boys had (1.9%) >= 25 cm. 37/90 boys (41%) had positive family history and 16/78 boys (20%) with negative family history were also having refractive error. 11/66 (16.7%) had sufficient illumination for activities. 9/59(15.3 %) boys with < 1 year of madrassa schooling and 44/65(40.4%) with > 1 year of madrassa schooling had refractive errors. Symptoms like irritation of eyes, blurring of vision and double vision were found to be significantly related (p values :0.005, 0.000, 0.013 respectively). Factors like age, years of madrassa schooling, illumination in indoor activities, distance while using screen, were found to be significant (p value was <= 0.05). Conclusion: Refractive errors had a prevalence of 31.5% in madrassa students and half of them(49.1%) were diagnosed. Myopia (81.1%) being the commonest was followed by astigmatism(11.3%) and Hyperopia(7.6%). Refractive errors were common in children with positive family history and age of >= 13 years. Years of madrassa schooling >= 1 had a positive relation with refractive errors. Mother education and occupation had a protective effect against the prevalence. Additionally, insufficient illumination, screen and reading distance (<25 cm) while reading and using screen were found to be significantly related. Symptoms such as blurring of vision, eyes irritation and diplopia were also significantly related. The study results show lack of screening among madrassa students and poor School Health Services. There is a need of awareness and education regarding student's health and measures should be taken accordingly to uplift health status of students who are already attending marginalized parallel education system.