Vision status of children aged 7–15 years referred from school vision screening in Norway during 2003–2013: a retrospective study

Abstract

Background Undetected vision problems is an important cause of reduced academic achievement, performance in everyday life and self-esteem. This receives little attention in national health care services in Norway even though most of these vision problems are easily correctable. There are no published data on how many Norwegian schoolchildren are affected by correctable vision problems . This study aims to determine the vision status in primary and secondary schoolchildren referred from vision screening during the 10 year period of 2003–2013. Methods Of the 1126 children (15%) aged 7–15 years referred to the university eye clinic by the school screening program, all 782 who attended the eye clinic were included in the study. Patient records were retrospectively reviewed with regard to symptoms, refractive error, best corrected visual acuity (BCVA) of logMAR, binocular vision, ocular health and management outcomes. Results Previously undetected vision problems were confirmed in 650 (83%) of the children. The most frequent outcomes were glasses (346) or follow-up (209), but types of treatment modalities varied with age. Mean refractive errors were hyperopic for all age groups but reduced with age (ANOVA, p < 0.001). Overall, 51% were hyperopic, 32% emmetropic and 17% myopic. Refractive errors did not change across the decade (linear regression, all p > 0.05). Mean logMAR BCVAs were better than 0.0 and improved with age (ANOVA, p < 0.001) . The most prevalent symptoms were headaches (171), near vision problems (149) and reduced distance vision (107). Conclusions The vision screening identified children with previously undetected visual problems. This study shows that the types of visual problems varied with age and that most problems could be solved with glasses. Our results stress the importance of regular eye examinations and that vision examinations should be included in primary health care services. Furthermore, there is a need for raised awareness among parents and teaching staff regarding vision problems in children.

Headache and musculoskeletal pain in school children are associated with uncorrected vision problems and need for glasses: a case–control study

“…The eye and physical examination revealed that headaches and trigger points were also common in the control group, however, these children had not been in contact with health care personnel. Further, the results showed associations between symptoms and need for new glasses in 40% of the control group, in line with previous studies showing that 10–40% of school children need glasses to obtain satisfactory vision 30 , 46 – 48 . That the eye examination also revealed symptoms in the control group, supports that children often are unaware of symptoms of uncorrected vision problems.…”

“…Normal NPC was defined as ≤ 10 cm, AA as > 9 D, and AC/A ratio as 4:1 ± 2 pd. Normal values are in line with previous studies 46 , 48 , 57 , 58 . Glasses for uncorrected refractive errors were recommended when the child had (1) moderate to high hyperopia, (2) mild hyperopia and ≥ 2 positive symptoms, (3) myopia, (4) reduced binocular function and ≥ 2 positive symptoms, (5) best-corrected visual acuity improvement of − 0.1 logMAR or more, or a combination of these.…”

“…Particularly mild hyperopia, near vision problems and headaches may be difficult for a child to understand and complain about, and are often only identified by a thorough eye examination, when tested or asked specifically. It is a risk that the children found to have vision problems in this study, would have remained undiagnosed and uncorrected 30 , 46 – 48 . It is well known that children may have difficulties expressing and understanding symptoms of pain and discomfort, which our study also indicates 76 .…”

“…Indications in the literature are that correcting vision problems (glasses/contact lenses) can treat headaches in children and adults 44 , 45 . Further, in Nordic school children, as many as 40% need glasses to obtain satisfactory vision during near tasks (book/tablet/computer) or far tasks (blackboard) 30 , 46 – 48 .…”

A Serial Cross-Sectional Analysis of the Prevalence, Risk Factors and Geographic Variations of Reduced Visual Acuity in Primary and Secondary Students from 2000 to 2017 in Hong Kong

“…In mainland China, refractive errors accounted for 85% to 98% of reduced VA in Beijing, Chongqing, Xinjiang, Yunnan, Guangdong and Shanghai [4][5][6][7][8][9][10]. One common cause of refractive errors among schoolchildren was myopia, accounting for 25% to 75% of refractive errors in Saudi Arabia, Nepal, India, Norway and Mexico [11][12][13][14][15]. Myopia accounted for 53% to 67% of refractive errors in Shanghai, Chongqing and Beijing of China [7,9,16].…”