Najwa Munirah, Refractive Error Findings in Students Who Failed School-Based Vision Screenings at Hospital Sandakan (HDOK), Sabah.

RESEARCH POSTER PRESENTATION DESIGN © 2022 www.PosterPresentations.com Uncorrected refractive error is the predominant cause of reduced vision in children1 . It can affect their daily life, including difficulty in studying and if it is left untreated at an early age, it not only causes amblyopia but also other problems in the future. Based on National Eye Survey (NESSII) that was conducted in 2018, it was reported that Sabah has one of the highest prevalence of visual impairment due to poor access to ophthalmological services3 . Thus, this study is carried out to investigate the common types of refractive error(RE) among students who are referred to HDOK by Health School Service Unit (UPKS). The knowledge of the prevalence refractive error would be helpful in planning of public health strategy. Muhammad Iqbal Basri 1 , Nur Hafizah Mat Jalil 1 , Najwa Munirah Mohd Yussoff 1 , Norina Abd Ghafor 1* 1 Ophthalmology Department, Hospital Duchess of Kent (HDOK) Refractive Error Findings in Students Who Failed School-Based Vision Screenings at Hospital Sandakan (HDOK), Sabah. INTRODUCTION METHODOLOGY CONCLUSIONS OBJECTIVES REFERENCES ACKNOWLEGDEMENT A total of 228 students were analyzed in this study. • Almost 2/3 of the students had clinically significant refractive error and any refractive error with suburban community had higher risk of acquiring myopia. • The detection of refractive error and prescription for glasses provided by the vision program helped a significant percentage of students who might not have accessibility to it. • Thus, this demonstrated that the screening program by UPKS had a significant impact on identifying students with vision problems. • Regular eye screening would also lead to increase awareness of myopia in school age children and may increase the proportion of children seeking care appropriately. • An improved eye care delivery system and public health policies are required in the future. 1. Maul E., Barroso S., Munoz S.R., Sperduto R.D., Ellwein L.B., 2000. Refractive error study in children: results from La Florida, Chile. AM. J. Ophthalmol. 129, 445–454. 2. Guo X, Angeline M.N., Hursuong V, et al (2021). Refractive Error Findings in Students Who Failed Schoolbased Vision Screening. Ophthalmic Epidemiology. https://doi: 10.1080/09286586.2021.1954664. 3. Chew F.L.M, Salowi M.A, Mustari Z, et al. Estimates of visual impairment and its causes from the National Eye Survey in Malaysia (NESII). Plos one. 2018 ;13(6):e0198799. DOI: 10.1371/journal.pone.0198799. PMID: 29944677; PMCID: PMC6019397. • To find out the general types of refractive status among students in Sandakan Division. • To determine the risk factors associated with the refractive error among students in Sandakan Division. We gratefully acknowledge the contributions of the individuals of Health School Service Unit (UPKS). Figure 2: Proportions of students with myopia, hyperopia, astigmatism & anisometropia by age. A student may be classified as having more than one type of refractive error. Clinically Significant Refractive error n (%) Type of Refractive error n (%) Yes No Myopia Hyperopia Astigmatism Aniso Suburban Standard 1 31 (73.8) 11 (26.2) 27 (64.3) 5 (11.9) 30 (71.4) 8 (19.4) Standard 6 57 (85.1) 10 (14.9) 47 (70.1) 6 (9) 26 (38.8) 23 (34.3) Form 3 38 (97.4) 1 (2.6) 36 (92.3) 0 (0) 14 (35.9) 13 (33.3) Total 126 (85.1) 22 (14.9) 110 (74.3) 11 (7.4) 70 (47.2) 44 (29.7) Rural Standard 1 14 (38.9) 22 (61.1) 12 (33.3) 5 (13.9) 14 (38.9) 4 (11.1) Standard 6 22 (50) 22 (50) 20 (45.5) 4 (9.1) 13 (29.5) 6 (13.6) Total 36 (45.0) 44 (55.0) 32 (40) 9 (11.2) 27 (33.8) 10 (12.5) RESULTS Figure 1: Demographic gender and locality of students. Figure 3: Proportions of students with clinically significant refractive error in different localities. Table 1 : Comparison of students in different localities (suburban & rural areas) with clinically significant refractive error & the types of refractive error. 0 10 20 30 40 50 60 70 Male (n) Female (n) Suburban (n) Rural (n) Standard 1 45 33 45 36 Standard 6 57 54 67 44 Form 3 14 25 39 0 Number of students Demographic Gender & Locality of the Students • Clinically significant refractive error and any refractive error were found in 162 (71.1%) and 174 (76.3%) students respectively. • The most prevalent type of refractive error found is myopia; 142 (62.3%) followed by astigmatism; 97 (42.5%), anisometropia; 54 (23.7%) and lastly is hyperopia; 20 (8.8%). • Myopia reported more in Form 3 (89.3%) students compared to the lower age group. • Based on Table 1, suburban district showed a higher incidence of myopia, which is 74 (67.9%) students than rural area which is 32 (40%) students. • Clinically significant refractive error also increased with the increment of age as demonstrated in Figure 3. But the significant increment (p<0.05) only reported for students living in suburban area. • However, students in the same age group in Standard 1 and Standard 6 showed significant differences in clinically significant refractive error in different areas; (p<0.05) & (p<0.001) respectively. • As there had been no screening for Form 3 students in the rural area, there was no comparison between the same age group for Form 3 and the two locations. 0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 80.00% 90.00% 100.00% MYOPIA HYPEROPIA ASTIGMATISM ANISOMETROPIA Proportions of students with any refractive error by age. Standard 1 (7 years old) Standard 6 (12 years old) Form 3 (15 years old) Cross-sectional analysis Procedures: 1) Visual Acuity Assessment 2) Refraction 3) BV Assessment Students were divided into : 1) Age : Standard 1 (7 years old), Standard 6 (12 years old), Form 3 (15 years old). 2) Locality: Suburban (Sandakan) & Rural (Kinabatangan, Telupid, Beluran, Tongod). Criteria: Any refractive error was identified when there is at least -0.50 diopter (D) sphere equivalent (SE) myopia, +0.50D SE hyperopia, -1.00D astigmatism or 1.00D anisometropia in the right eye. Clinically significant refractive error is defined as decreased VA; 6/12 or less & myopia ≥-0.75D SE, hyperopia without esodeviation ≥+2.00D SE, hyperopia with esodeviation≥+1.00D or astigmatism≥ 1.50D. The data was analyzed using IBM SPSS Statistics version 28. 73.80% 85.10% 97.40% 38.90% 50% STANDARD 1 STANDARD 6 FORM 3 Proportions of students with clinically significant refractive error in different localites. Suburban Rural