Prevalence and causes of low vision among urban and rural school children

Ritesh Verma, Manisha Rathi, C. S. Dhull, Sumit Sachdeva, Jitender Phogat


Background: The objective of this study is to determine the prevalence and the causes of low vision among school going children in and around Rohtak district of Haryana, India. Such information is important in planning for prevention of low vision and blindness strategies.

Methods: 2028 school children studying in class 1-5 were screened in the school premises. Visual acuity was assessed with Snellen’s chart and colour vision was tested with ishihara colour vision book. Those with vision <6/18 in both eyes were assessed at our tertiary care hospital to determine the cause of low vision.

Results: A total of 2028 children were enrolled in our study. 58 children were found to have uncorrected visual acuity less than 6/18 (functional low vision) in the better eye. Uncorrected refractive error was the most common cause of functional low vision (51.72%) among the 2028 children enrolled in our study followed by amblyopia (32.7%), cataract (5.1%), corneal opacity (5.1%), retinal dystrophy (5.1%), nystagmus (1.7%) and optic nerve glioma (1.7%).

Conclusions: The overall prevalence of low vision in our study is higher as compared to previous studies. A comparison between academic performances of children with low vision and rest of the children showed that children with low vision tend to perform poor academically. The prevalence of amblyopia was significantly higher in children from the rural background which emphasizes the importance of rural school screening programmes. It was found that amblyopia was significantly higher in females as compared to males in both rural and urban areas.


Amblyopia, Low vision, School health

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Gilbert CE, Ellwein LB. The Refractive Error Study in Children Study Group. Invest Ophthalmol Vis Sci. 2008;49(3):877-81.

Visual impairment and blindness. World Health Organisation 2014. Available at: http://www. Accessed on 18 August 2016.

Khanderkar R. Visual disabilities in children including childhood blindness. Middle East Afr J Ophthalmol. 2008;15:129-34.

Murthy GV, Gupta SK, Ellwein LB, Munoz SR: Refractive error in children in an Urban population in New Delhi: Invest Ophthalmol Vis Sci. 2002;43(3):623-31.

Frick KD, Foster A. The magnitude and cost of global blindness: An increasing problem that can be alleviated. Am J Ophthalmol. 2003;135:471–6.

Padhaye S, Khandekar R, Dharmadhikari S, Dole K, Gogate P, Deshpande M. Prevalence of uncorrected refractive error and other eye problems among urban and rural school children. Mid East Afr J Ophthalmol. 2009;16:69-70.

Limburg H, Kansara HT, Dsouza S. Results of school eye screening of 5.4 million children in India- A five year follow up study. Acta ophthalmol Scand. 1999;77:310-4.

Sudan A, Pandey A, Pandey S, Shrivastava P, Pandey K, Jain B. Effectiveness of using teachers to screen eyes of school children in Satna district of Madhya Pradesh, India. Indian J Ophthalmol. 2009;57:455-8.

Maul E, Barpsso S, Munoz SR, Sperduto RD, Ellwein LB. Refractive error study in children: Results from La Florida, Chile. Am J Opbthalmol. 2000;129:445-54.

Murthy GVS, Gupta SK, Ellwein LB, Muñoz SR, Pokharel GP, Sanga L, et al. Refractive error in children in an urban population in New Delhi. Invest Ophthalm Visc Sci. 2002;43:615-22.

Gupta R. A Clinical survey of the prevalence of Refractive Errors in School Going Children (5-15 years) around the suburban areas of Pune. AIOC Proceedings. 2005: 417–419.

Sethi S, Kartha GP. Prevalence of refractive errors among school children of Ahmedabad city. Ind Journ Com Med. 2000;25:181–3.

Matta S, Matta P, Gupta V, Dev A. Refractive errors among adolescents attending Ophthalmic OPD. Ind J Comm Med. 2006;31(2):114.

Yekta A, Fotouhi A, Hashemi H, Dehghani C, Ostadimoghaddam H, Heravian J et al. The Prevalence of Anisometropia, Amblyopia and Strabismus in Schoolchildren of Shiraz, Iran. Strabismus. 2010;18(3):104-10.

Fareed M, Anwar M, Afzal M. Prevalence and gene frequency of color vision impairments among children of six populations from North Indian region. Genes & Diseases. 2015;2(2):211-8.

Adam A, Puenpatom M, Davivongs V, Wangspa S. Anomaloscopic diagnosis of red- green blindness amongst Thais and Chinese. Hum Hered 1969;19:509-13.

Al-Aqtum MT, Al Qawasmeh MH. Prevalence of color blindness in young Jordanians. Ophthalmologica 2001;215:39-42.

Chia A, Gazzard G, Tong L, et al. Red-green colour blindness in Singaporean children. Clin Experiment Ophthalmol. 2008;36:464–7.