Prevalence of Visual Impairment and Refractive Errors in Children of South Sinai, Egypt

Purpose: To assess the prevalence and causes of visual impairment in children of South Sinai, and to evaluate outcomes of rehabilitation programs. Methods: Population-based, cross-sectional analysis of 2070 healthy school children screened for visual impairment from 2009 through 2010 in cities of South Sinai and their surrounding Bedouin settlements. Visual acuity (VA) was tested using Snellen charts followed by cycloplegic autorefractometry for cases with presenting VA <= 6/9. Appropriate eyeglasses were prescribed and VA re-evaluated. Results: This study included 1047 boys and 1023 girls, mean age 10.7 +/- 3.1 years. Visual impairment (uncorrected VA <= 6/9) was detected in 29.4% of children, while 2.0% had moderate severe visual impairment (uncorrected VA <= 6/24). There were statistically significant differences in prevalence of visual impairment between the studied cities (p <0.05), with the highest prevalence in Abu Redis. Prevalence of visual impairment was significantly higher among girls (p <0.05) and those with positive consanguinity (p <0.05). Bedouin children showed significantly lower prevalences of visual impairment. Only age was a reliable predictor of visual impairment (odds ratio 0.94, p <0.0001). Ophthalmic examination revealed other disorders, e.g. dry eye (4.74%), squint (2.37%), exophthalmos (1.58%) and ptosis (0.79%). VA significantly improved in children who received spectacles (p <0.001). Conclusion: A total of 29.4% of South Sinai children had some form of visual impairment, 90.32% of which comprised refractive errors (mainly astigmatism) which were significantly corrected with eyeglasses. VA screening and correction of refractive errors are of the utmost importance for ensuring better visual outcomes and improved school performance.