UNMET NEED FOR EYE CARE AND SPECTACLE COVERAGE AMONG SCHOOL CHILDREN IN CENTRAL INDIA

Abstract

Background: Uncorrected refractive error is a leading cause of avoidable visual impairment in children and remains a major contributor to unmet eye care needs in low and middle income countries. Spectacle coverage and unmet need are practical measures to monitor progress towards universal eye health. We aim to assess unmet need for spectacles, spectacle coverage and (eREC) effective refractive error coverage among government school children in rural central India, and to examine their association with socio demographic factors.

Methods: A cross-sectional study was performed on 500 children aged 7-14 years in rural government schools. Distance vision was evaluated using the Snellen E Chart. Children who had presenting visual acuity worse than 6/9 in one or both eyes were further evaluated with pinhole and referred for refraction if vision improved. Refractive error refers to difficulty seeing at a distance and its various classifications are defined in recent global recommendations.

Results: Refractive error was present in 28 of 500 children (5.6%) in present study. Of the children needing distance correction, 8 corresponded to need with adequately correcting spectacles, 2 undermet need with inadequate spectacles and 18 unmet need without spectacles. Overall, there was an unmet + undermet need of 4.0% in the total population. Both spectacle compensation and eREC stood at 28.6%. The older children, girls and family with lower socio-economic strata had higher needs and unmet needs.

Conclusions: A considerable number of children with refractive error remained uncorrected or inadequately corrected, resulting in low spectacle coverage. Standardized use of spectacle coverage and eREC usage can enable programmes to identify gaps and measure effectiveness of school eye health programmes aimed at improving access and quality of refractive care.