Purpose: Uncorrected refractive error including myopia is one of the visual disorders that could affect the normal vision development early in childhood and lead to the development of amblyopia, which is one of the most common causes of unilateral vision loss. Early detection and intervention of ocular problems are essential to prevent the negative long-terms outcomes including loss of educational and employment opportunities, loss of economic gain and impaired quality of life, that are associated with visual impairment in early childhood. In Palestine, visual assessment is incorporated in school health programs only and targets first, seventh and eighth grade school children. This is despite the fact that treatment of visual disorders is known to be more effective if detection is before the age of 5 years. The purpose of this study is to determine the prevalence of visual disorders among Palestinian preschool children.
Methods: A cross-sectional study was conducted and a vision screening program that was based on a combination of clinical assessments from the Modified Clinical Technique (MCT) and Vision In Preschoolers (VIP) was conducted to assess visual acuity, refractive error, ocular alignment, depth perception, color vision and ocular health. Children who failed the screening were referred for comprehensive eye examination.
Results: A total number of 764 children underwent the vision screening. Out of the 290 children who failed the vision screening, 127 children responded to the referral call for comprehensive eye examinations. Refractive error was the most prevalent visual disorder with a prevalence of (29.02%) where myopia and myopic astigmatism had a prevalence of 0.35% and 1.04%, followed by amblyopia (4.10%), color vision deficiency (1.24%), strabismus (1.24%), and ocular health abnormalities (0.70%). Anisometropia was the first leading cause for amblyopia (P=0.001), followed by significant refractive error and strabismus (P=0.002).
Conclusion: Effective and evidence-based national vision screening program must be implemented and adopted by the Palestinian Ministries of Health and Education in accordance with the Vision 2020 initiative of disease control and preventative eye care in an effort to control childhood blindness and vision impairment. Awareness campaigns at family, community and public health levels will be integral to any screening program to ensure that children are receiving proper ocular evaluations by eye care professionals following initial screening referrals.
Key words: Vision screening, Early detection, Visual Abnormalities, Refractive Errors, Myopia