Medical hypothesis, discovery & innovation in optometry

Abstract

Background: The prevalence of hearing impairment in Nepal is 16.5%, affecting approximately 2.71 million people. Deaf children are visually dependent, and even a mild refractive error may cause visual discomfort. The goal of this study was to determine the need for vision screenings in schools for the hearing impaired in Biratnagar, Nepal.
Methods: A cross-sectional study was conducted with permission from Birat Deaf Secondary School, Biratnagar, Nepal. A total of 130 hearing-impaired students were examined. Non-invasive, comprehensive optometric examinations were performed to detect visual disorders. When a more detailed evaluation was needed, the students were referred to the Pediatric Ophthalmology Department, Biratnagar Eye Hospital Biratnagar, Nepal.
Results: Of the 130 hearing-impaired students, 58 (44.6%) were male and 72 (55.4%) were female. The mean ± standard deviation of age was 16.03 ± 3.8 years (range 6–25 years). Twenty-one (16.1%) students had refractive errors: 13 (10%) had myopia, 7 (5.4%) had hyperopia, and 1 (0.8%) had anisometropia. In the cover test, 88 (67.7%) had orthophoria, 19 (14.6%) had exophoria, 11 (8.5%) had esophoria, 5 (3.85%) had exotropia, and 3 (2.3%) had esotropia. Cover tests were not performed in 4 (3.1%) students, as they were unable to fixate due to nystagmus or decreased vision. On ocular examination, 20 (15.3%) students had anterior segment abnormalities, including lid abnormality, conjunctivitis, Bitot’s spots, pterygium, corneal opacity, and lenticular opacity. Posterior segment or retinal abnormalities were found in four students with one having Usher syndrome. Color vision defects, nystagmus, and amblyopia were found in 8 (6.1%), 2 (1.5 %), and 1 (0.8%), respectively.
Conclusions: The findings of the present study reflect the need of periodic vision screenings in schools for the hearing impaired in Nepal. These children are at a high risk of vision impairment.