Visual impairment and amblyopia in Malaysian pre-school children - The SEGPAEDS study
Min, Fiona Chew Lee
Thavaratnam, Lakana Kumar
Shukor, Intan Nor Chahaya Bt
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Min, F.C.L., Thavaratnam, L.K., Shukor, I.N.C.B., Ramasamy, S., Rahmat, J., Reidpath, D.D., Allotey, P. and Alagaratnam, J. (2018) ‘Visual impairment and amblyopia in Malaysian pre-school children - The SEGPAEDS study’, Medical Journal of Malaysia, 73(1).
Introduction: Little is known regarding the extent of visual impairment amongst pre-school children in Malaysia. Objective: To determine the prevalence of visual impairment and amblyopia in Malaysian preschool children. Methodology: A cross-sectional, population-based study was conducted on children aged four to six years from 51 participating kindergartens in the district of Segamat, Johor, Malaysia from 20 March 2016 to 6 April 2016. All subjects had initial eye screening consisting of LogMar visual acuity, orthoptics examination and Spot vision screener assessment. Subjects who failed the initial eye screening were invited for a formal eye assessment consisting of cycloplegic refraction and a comprehensive ocular examination. Definitions of visual impairment and amblyopia were based on the Multi-Ethnic Pediatric Eye Disease Study criteria. Results: A total of 1287 children were recruited. Mean subject age was 5.03 (SD:0.77) and males represented 52.3% of subjects. Subjects by ethnicity were Malay (54.8%), Chinese (27.7%), Indian (15.6%) and Orang Asli (1.9%). Formal eye assessment was required for 221 subjects and 88.8% required ophthalmic intervention. Refractive error, representing 95.4% of diagnosed ocular disorders, comprised of astigmatism (84%), myopia (9%) and hypermetropia (6.9%). With-the-rule astigmatism was present in 93.4% of the subjects with astigmatism. Visual impairment was present in 12.5% of our subjects, with 61% having bilateral visual impairment. Of the subjects with visual impairment, 59.1% had moderate visual impairment. The prevalence of amblyopia was 7.53%, and 66% of the amblyopic subjects had bilateral amblyopia. Conclusion: Our study highlights an urgent need for initiation of preschool vision screening in Malaysia.