Clinical Profile of Refractive Errors Associated with Screen Time in Children Aged 5-15 Years in a Tertiary Care Hospital of Southern India during COVID Pandemic: A Prospective Study
Dr. NVN Prasanna Bharathi,
E-507, Fresh Living Apartments, Madhapur, Hyderabad, Telangana, India.
Introduction: Refractive errors cannot be prevented, but it is important to detect them early to improve the quality of life and prevention of blindness. Refractive errors screening in children during Coronavirus disease-2019 (COVID-19) pandemic was difficult task as they were high-risk group. Increased near activity due to online classes and smart devices usage may increase the uncorrected refractive errors. The study emphasises on the refractive errors screening during COVID pandemic.
Aim: To study the clinical profile of refractive errors of the children aged 5-15 years in a tertiary care hospital in COVID pandemic in association with screen time, outdoor activity, type of gadget, amblyopia and educational status of mother.
Materials and Methods: This was a hospital based prospective analytical study conducted in children 5-15 years attending the Ophthalmology Outpatient Department of ESIC Medical College and Hospital, Telangana, India, from May to October 2021. Children were screened for refractive errors and compared with the refractive errors data of different children of same age referred from Paediatric Outpatient Department and who attended to Ophthalmology Outpatient Department for regular eye checkup in prepandemic time. Unaided visual acuity of all children were measured with the help of Snellen’s chart. Children with refractive errors underwent cycloplegic retinoscopy followed by postmydriatic test. Screen time and outdoor activity duration were recorded. Interpretation and analysis of obtained results was carried out using Statistical Package for Social Sciences version 22.0 for descriptive statistics. Non parametric tests like Pearson Chi-square test were used to express the qualitative data. Data with p-value less than 0.05 was considered statistically significant.
Results: A total of 790 children were screened out of which 358 (45.3%) presented with refractive error when compared with the prepandemic prevalence 276 (34.9%) out of 790 children screened, presented with the refractive error. A total of 118 (33%) of the children presented with increased blink rate associated with increased screen time and dry eye. Rate of progression of more than 1D was observed in 44 (12.29%) of which myopia 28 (7.8%), astigmatism 10 (2.7%) and hypermetropia 6 (1.6%) in six months. A total of 286 (79.8%) children presented with myopia and 24 (6.7%) presented with hypermetropia, 48 (13.4%) presented with astigmatism. A total of 258 (72.06%) presented with screen time for four to seven hours and 32 (8.9%) children presented with amblyopia.
Conclusion: Refractive errors increased due to smart classes in schools or use of laptops, television viewing, computers or mobiles. Hence, this reinforces the need to screen all the school going children and children with the history of gadgets use.