Comparison of refractive error and visual impairment between Native Iban and Malay in a formal government school vision loss prevention programme.
2012
Background: The epidemiological study of vision problems is important
for developing national strategies for the prevention of visual
impairment. There was a lack of information regarding vision problems
among school children in East Malaysia. The purpose of this study was
to compare the refractive errors and degrees of visual impairment
between Native Iban and Malay school children who participated in a
formal government vision loss prevention programme conducted in a rural
area of Betong Division, Malaysia. Methods: In total, 293 Native Iban
and Malay school children (Standard 1, Standard 6, and Form 3) received
refractive assessments by an optometrist after failing tests in the
formal government school vision screening programme in 2008. A
criterion for referral was a visual acuity of 6/9 or worse in either
eye. Assessments of the refractive errors of the children were
performed using dry retinoscopy and subjective refraction techniques at
community clinics. Results: The overall prevalences of refractive error
and visual impairment among the sampled populations were 47.7% and
3.5%, respectively. Approximately 97.1% of reported cases were myopia.
The Malay sample population was found to be more myopic than the Native
Iban population (U = 8240.50, P < 0.05, r = 0.14), but no
significant association was found between myopia and ethnicity (χ2
= 2.66, P > 0.05). Both Native Iban and Malay children in education
levels higher than Standard 1 were more likely to have myopia (P <
0.05). Myopia was found to be more likely to affect females than males
at a statistically significant level among Native Iban children
(χ2 [1.N = 170] = 6.279, P < 0.05, odds ratio = 2.327, 95% CI =
1.184–4.575). There was no statistically significant association
between visual impairment and ethnicity (χ2 = 1.60, P > 0.05).
Approximately 94.1% of children with refractive errors suffered from
having either the wrong prescription (7.8%) or having uncorrected
refractive errors (92.2%). Conclusion: The Native Iban population was
found to be less myopic than the Malay population despite having a
similar frequency of myopia. The proportion of children with myopia
increased with the level of education in both ethnicities. A high
percentage of untreated refractive error problems among Native Iban and
Malay children in the Betong Division indicates that there is a need
for government intervention for the purpose of economic and healthcare
improvements.
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