Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 9  |  Issue : 4  |  Page : 451-454  

Awareness of childhood blindness in parents attending Paediatrics Ophthalmology outpatient department


1 Department of Ophthalmology, Dr. D. Y. Patil Medical College, Hospital and Research Center, Pimpri, Pune, Maharashtra, India
2 Department of Pathology, Dr. D. Y. Patil Medical College, Hospital and Research Center, Pimpri, Pune, Maharashtra, India

Date of Web Publication12-Jul-2016

Correspondence Address:
Banyameen Iqbal
Department of Pathology, Dr. D. Y. Patil Medical College, Hospital and Research Center, Pimpri, Pune, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-2870.186057

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  Abstract 


Background: Blindness is defined by World Health Organisation as having a visual acuity of <3/60 in the better eye. Thirty-seven million people are blind worldwide. One million and four hundred thousand are children. The causes of blindness in children vary according to region and socioeconomic development. The aim of our study is to identify a range of potential issues relating to parental awareness and perceptions of common eye diseases affecting children. Materials and Methods: The type of study was population-based, prospective, cross-sectional study conducted on parents of 200 children ranging from 0 to 16 years of age, attending Paediatric Ophthalmology clinic during the month of August and September 2014. This was an open-ended questionnaire-based study and only the participants who consented were enrolled in the study. Results: The most common eye problem detected among 200 of children was refractive errors. The incidence of refractive errors was found to be 103 out of 200 (51.5%). This is followed by 71 (35.5%) cases of squint/strabismus. Of 200 parents, 150 (75%) think the present eye condition of their child will reduce the eyesight. However, they did not know about the nature of the eye problem. Forty-four (22%) parents did not know anything about the eye condition of their child. Seventy (35%) parents were apprehensive about the use of spectacles in the children suffering from refractive errors. One hundred and six (53%) parents came to know about the eye problem of their child from the teacher of the child and 63 (31.5%) parents got information from their family doctor. Conclusions: As the number of mothers attending the eye department with the child is high, so there is more need of educating the mothers about the eye conditions of the child. Education and socioeconomic conditions affect the knowledge and awareness level of the parents regarding eye problems. Most of the children attending outpatient department were found to be in the age group of 5-8 years. This may point toward factors like dietary deficiency of Vitamin A and other important nutrients. Commonest eye problem was of refractive errors among children.

Keywords: Blindness, parental awareness, refractive errors, vision


How to cite this article:
Paranjpe R, Mushtaq I, Thakre A, Sharma A, Dutta D, Iqbal B. Awareness of childhood blindness in parents attending Paediatrics Ophthalmology outpatient department. Med J DY Patil Univ 2016;9:451-4

How to cite this URL:
Paranjpe R, Mushtaq I, Thakre A, Sharma A, Dutta D, Iqbal B. Awareness of childhood blindness in parents attending Paediatrics Ophthalmology outpatient department. Med J DY Patil Univ [serial online] 2016 [cited 2024 Mar 29];9:451-4. Available from: https://journals.lww.com/mjdy/pages/default.aspx/text.asp?2016/9/4/451/186057




  Introduction Top


Blindness is defined by World Health Organisation (WHO) as having a visual acuity of <3/60 in the better eye. Thirty-seven million people are blind worldwide. One million and four hundred thousand are children.[1] Then why are we so concerned with childhood blindness?First, because 57% of childhood blindness is avoidable hence this means that if serious measures are taken to treat these children we are avoiding many children from being totally blind, for example, early treatment of refractive errors, congenital/developmental cataract, squint, congenital glaucoma, keratoconus, retinopathy of prematurity [2] can reduce significant morbidity in children. Second, concentrating on childhood blindness means that we are reducing blind years in adults because children who are born blind and survive have a lifetime of blindness ahead of them. Third, conditions associated with blindness in children are also the cause of child mortality, for instance, congenital rubella syndrome, Vitamin A deficiency, and more. Fifty percent of children that are blind usually die within 2 years of being blind.

The causes of blindness in children vary according to the region and socioeconomic development.[3] The aim of our study is to identify a range of potential issues relating to parental awareness and perceptions of common eye diseases affecting children.

Childhood blindness is one of the priorities in Vision 2020: The right to sight [4] A WHO initiative that tries to eliminate avoidable blindness by the year 2020.

However, not many studies have been conducted regarding this topic; our study aims to fill the lacunae concerning the topic.


  Materials and Methods Top


The type of study was population-based, prospective, cross-sectional study conducted on parents of 200 children of 0-16 years of age group, attending Paediatric Ophthalmology Clinic in a Tertiary Care Hospital in Western Maharashtra. The method which was used in our study to assess parental awareness and knowledge was by means of an open-ended questionnaire.[4] The questionnaire was generated from similar studies found in the literature. Validation of questionnaire was carried out by doing pilot study, and final draft was created. The questionnaire so finalized was put before the Ethical Committee of our institute for their clearance. A detailed consent form was also attached with the questionnaire in the local language and only the participants who consented were enrolled in the study. All parents or usual caregivers of children, who had been diagnosed with an ophthalmic disorder at least 1 year earlier and were attending ophthalmology outpatient clinic were surveyed for the month of August and September 2014. All the case notes were reviewed, and all the available clinical, and sociodemographic data necessary for evaluation of parental understanding were recorded. This data were subsequently linked to information from parental questionnaires by a unique study identification number assigned to each child. For the convenience of the parents, we had converted the questionnaire into local languages such as Hindi and Marathi. For the people who were illiterate, they were provided with helpers like nurses to fill their questionnaire. The data were entered in Microsoft XL ® spreadsheet after ensuring completeness of the filled forms. If any missing data were noticed, the participant was contacted at the earliest and the details were rechecked. Analysis was done using the Statistical Package for Social Sciences (SPSS 10.0.5; SPSS Inc., Chicago, USA). No intervention of any form was done during the study except the questionnaire.


  Results Top


A study conducted on parents/caregivers of 200 children in Paediatric Ophthalmology Department shows following results. Among 200 parents/caregivers, 49% are mothers and 35% are fathers [Figure 1]. Among 200 parents/caregivers 54% reached up to secondary education [Table 1]. Among the parents, most commonly housewives accompanied their children in Paediatric Ophthalmology outpatient department (OPD) with the highest percentage of 42% [Figure 2]. The mean age of children attending Paediatric Ophthalmology OPD was 6.6 years with standard deviation of 3.20 years [Figure 3]. High incidence of 18% is seen in 8 years of children followed by 12% incidence of 5 years of age. Most common eye problem found among these children is refractive errors with high incidence of 51.5%. According to the comments given by parents in the extra information box, about 35% parents were apprehensive about the use of spectacles in their children with refractive errors [Figure 4]. Refractive errors and strabismus (squint) are top two eye problems detected among children. About 25% parents think that squint will cause less chances of marriage due to cosmetic reasons especially in girls, which is why they want to treat this condition. Seventy-five percent of parents think the eye problem will reduce the eyesight of their child but were completely unaware of the nature of disease and 22% of them did not know about the condition [Figure 5]. Parents got the information about the eye condition of their child most commonly from the teacher of the child (53%) followed by the family doctor (31%), and only 4% got the information from mass media [Figure 6].
Figure 1: Relation of parents/caregivers with children

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Table 1: Educational level of parents/caregivers

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Figure 2: Figure showing occupation wise distribution of attendants accompanying children

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Figure 3: Bar diagram showing age of children attending paediatric ophthalmology clinic

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Figure 4: Most common eye problem in children

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Figure 5: Pie daigram showing parental awareness about eye problems

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Figure 6: Pie diagram showing source of information about eye problems

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  Discussion Top


Of 200 parents of the children attended Paediatric Ophthalmology OPD 49% were mothers 35% were fathers, and 16% were other relatives (such as uncle, aunt, sister, brother, grandfather, and grandmother). It was seen that mothers were accompanying children more to the OPD clinics so there is a need to educate mothers so that they can help in early detection of the disease.

The education level of most of the parents was not very high. Only 54% reached up to secondary school education, 18% studied till 12th class, and 8.5% were graduates. A study conducted by Muhit MA et al showed about 75% of parents had education up to primary level, and only 3.7% of them had graduation degree and above.[5] Hence, it is seen that lack of education is a major deterrent in identifying eye diseases and education can play a major role in generating awareness about eye diseases.

Among the parents, most commonly mothers accompanied their child to OPD and most of them were housewives (41.5%), 24% were semi-skilled workers, 16.5% were unskilled, and only 4% were skilled workers. Twelve percent parents were indulged in professional works like business, teaching, etc. Hence, socioeconomic profile of the parents is also responsible for early detection and awareness of eye problems in children.

Eight years age group children were highest in incidence in OPD. There were 18% children of 8 years of age, 16% children of 5 years of age and 15% of 6 years of age. The mean age calculated was 6.6 years. The age variation ranges from 1 year to 13 years.

The most common eye problem affecting children was refractive errors. The incidence of refractive errors was found to be 103 out of 200 (51.5%), which is comparable to the study of Dandona et al., in which over a 1000 school children were enrolled.[6] This was followed by 71 (35.5%) cases of squint/strabismus. One hundred and ninety-four children did not have other medical conditions. There were only three cases of a cough, two cases of breathing problem and one case of epilepsy along with eye problem.

Out of 200 parents, 75% think the present eye condition of their child will reduce the eyesight. However, they did not know about the nature of the eye problem. Twenty-two percent did not know anything about the eye condition of their child. Thirty-five percent parents were apprehensive about the use of spectacles in the children suffering from refractive errors which is comparable with the results of previous studies done by Gogate et al.[7] Twenty-five percent parents brought their children for the treatment of squint because along with the reduce eyesight they also think this condition will cause a problem in the marriage of their child in future. Fifty-three percent parents came to know about the eye problem of their child from the teacher of the child. The findings of our study are almost comparable to the study conducted by Kalikivayi et al. in which teachers were mainly responsible for detecting visual problems initially.[8] 31.5% of parents got information from their family doctor. This indicates that most of the parents are ignorant about the eye condition of their children at home. Hence, parents should be taught about the symptoms of the refractive errors, and they should be encouraged for the use of spectacles. Surprisingly, in this era of mass media like TV, magazines, newspapers, etc., very few parents (4%) got information about the eye problems of their children through it. Mass media has to play an important role in making awareness about this problem by running continuous advertisements, health programs, lectures, etc.


  Conclusions Top


As the number of mothers attending the eye clinics with their children is high, there is a need of educating the mothers about the eye conditions of their children. Early detection will help in prevention of global blindness. The maximum literacy level of the parents ranges between 6th and 10th classes. It concludes that education affects the knowledge and awareness level of the parents. Most of the parents are semi-skilled workers hence socioeconomic conditions also affect the health of the child. Most of the children attending OPD were found to be in the age group of 5-8 years. This may point toward factors such as dietary deficiency of Vitamin A and other important nutrients. This finding also indicates that till this age of 5-8 years, parents do not come to know about the eye problem of their child. Commonest eye problem was of refractive errors among children. This may be probably due to educational stress they face in school. Furthermore, increasing use of entertainment media such as televisions and computers are becoming a major contributory factor in the causation of refractive errors.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Preventing Blindness in Children: Report of a WHO/IAPB Scientific Meeting. Geneva: World Health Organization; 2000.  Back to cited text no. 1
    
2.
Rahi JS, Sripathi S, Gilbert CE, Foster A. Childhood blindness in India: Causes in 1318 blind school students in nine states. Eye (Lond) 1995;9 (Pt 5):545-50.  Back to cited text no. 2
    
3.
Nirmalan PK, Sheeladevi S, Tamilselvi V, Victor AC, Vijayalakshmi P, Rahmathullah L. Perceptions of eye diseases and eye care needs of children among parents in rural South India: The Kariapatti Pediatric Eye Evaluation Project (KEEP). Indian J Ophthalmol 2004;52:163-7.  Back to cited text no. 3
[PUBMED]  Medknow Journal  
4.
Global Initiative for the Elimination of Avoidable Blindness. Geneva: World Health Organization; 1998.  Back to cited text no. 4
    
5.
Muhit MA, Shahjahan M, Hassan A, Wazed A, Ahmed N. Parental knowledge, attitude and practice related to blindness of children in some selected Upazilla of Bangladesh. Mymensingh Med J 2011;20:671-9.  Back to cited text no. 5
    
6.
Dandona R, Dandona L, Srinivas M, Sahare P, Narsaiah S, Muñoz SR, et al. Refractive error in children in a rural population in India. Invest Ophthalmol Vis Sci 2002;43: 615-22.  Back to cited text no. 6
    
7.
Gogate P, Mukhopadhyaya D, Mahadik A, Naduvilath TJ, Sane S, Shinde A, et al. Spectacle compliance amongst rural secondary school children in Pune district, India. Indian J Ophthalmol 2013;61:8-12.  Back to cited text no. 7
[PUBMED]  Medknow Journal  
8.
Kalikivayi V, Naduvilath TJ, Bansal AK, Dandona L. Visual impairment in school children in southern India. Indian J Ophthalmol 1997;45:129-34.  Back to cited text no. 8
[PUBMED]  Medknow Journal  


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]
 
 
    Tables

  [Table 1]


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