Comparison of ocular pathologies between children attending rural and urban schools in south india: A retrospective analysis

Abstract

Aims: To assess the differences in ocular morbidity with/without visual impairment between rural and urban school-going children using a two-step screening strategy. Methods: Data obtained by a hospital team from school camps conducted between the 1st of February 2019 and the 31st of December 2019, in schools with a strength of at least 1,000 students were reviewed retrospectively. The differences in ocular pathologies between the rural and urban cohorts were evaluated. A P < 0.05 was considered significant. Results: Out of 25,132 students (nurban = 12,562; nrural = 12,570), 14.44% (nurban = 1,585; nrural = 2,044; P < 0.001) were selected for evaluation by the hospital team after a primary screening by their class teachers. A statistically significant difference was noted in the frequency of refractive errors (urban = 6.8%; rural = 6.0%; P = 0.01), allergic conjunctivitis (urban = 0.2%; rural = 0.05%; P = 0.001), and amblyopia (urban = 0.03%; rural = 0.12%; P = 0.009) between urban and rural children. Simple and compound myopic astigmatism were significantly more common in urban children (p < 0.001 and 0.03 respectively). There was no significant difference in the incidence of spectacle use (P = 0.11) between the two cohorts. A Cochran--Armitage trend test revealed a statistically significant increase in the proportion of myopia with age among the children evaluated by the hospital team (p < 0.001). Conclusion: Allergic eye disease and myopic astigmatism are commoner in urban children. Routine ophthalmic screening is required to identify uncorrected refractive errors and amblyopia, especially in rural school children.

Keywords

• allergic eye disease
• astigmatism
• refractive error
• rural versus urban children
• school screening