Vision outcomes of a vision screening program amongst schoolchildren in underserved, rural Zimba, Zambia

Authors: Joshua Huang, Jordan Huang, Jaxon Huang,  AndreaSteeves, Paul Huang, Katherine Huang, Stephen Huang, William Astle, John Huang, Peter Huang.

Author Disclosure Block: J. Huang: None. J. Huang: None. J. Huang: None. A. Steeves: None. P. Huang:
None. K. Huang: None. S. Huang: None. W. Astle: None. J. Huang: None. P. Huang: None.

Abstract Body:

Purpose: To investigate the prevalence of visual acuity impairment and externa leye abnormalities in school-aged children in Zimba, Zambia.

Study Design: Cross-sectional study

Methods: Vision screening was performed in children 5 to 18 years old (grades kindergarten to grade 9) between July-August 2019. The vision screening program involved the assessment of visual acuity, pupil size, colour vision, and reading vision. An external eye examination of the eyelids, orbit, cornea, and iris was also performed. Demographic data collected included patient age and gender. Screening failures were defined as any child presenting with a visual acuity of 20/40 or worse or ≥2-line interocular difference between eyes. Schoolchildren with abnormalities upon external eye examination were also classified as a screening failure. All screening failures were referred to the eye clinic for further assessment.

Results: A total of 676 schoolchildren underwent vision screening. 3.70% (25/676) of schoolchildren did not pass the vision screening program and were referred to the local ophthalmology clinic for further assessment. 1.33% (9/676) of schoolchildren did not pass the vision screening criterion for visual acuity. 2.4% (17/676) did not pass the vision screening criterion based on external eye examination. One student failed both visual acuity and external eye exams. Mild vision impairment (visual acuity between 20/40 to 20/60) was the most common amongst schoolchildren, comprising 55.56%(5/9) of visual acuity failures. Corneal/conjunctival scars were the most common external eye abnormalities amongst schoolchildren, comprising 47.06% (8/17) of external eye exam failures.

Conclusions: Our study is the first to report on visual acuity impairment and external eye abnormalities amongst schoolchildren in rural Zimba, Zambia. A total of 3.70% schoolchildren did not pass the vision screening program and were referred for further ophthalmic assessment. 1.33% of schoolchildren did not pass the vision screening criterion for visual acuity.2.4% did not pass the vision screening criterion based on external eye examination. Compared to other regions around the world with similar vision screening criterion, a low percentage of schoolchildren failed the visual screening program.