DOI: https://doi.org/10.22141/2309-8147.3.2.2015.173032

THE STATE OF OPHTHALMOLOGICAL HEALTH: RISK FACTORS AND A METHOD FOR PREDICTING IMPAIRMENT IN SCHOOLCHILDREN IN KYIV, UKRAINE

N. Orlova, A. Kostetska

Abstract


The ability to predict vision pathology plays an important role in the primary prevention of visual impairment among schoolchildren. The results of a complex and integrated socio-medical data analysis in Kyiv, Ukraine, indicates a progressive deterioration of ocular health among schoolchildren, an inadequacy of the existing health system to provide outpatient eye care for schoolchildren, and the system’s non-compliance with WHO guidelines. This serves as the rationale for a scientifi c basis and development, as a set of measures for optimizing the prevention of visual impairment of schoolchildren.
Study Objective: To undertake a comprehensive assessment of the opthamological health of schoolchildren in Kyiv, Ukraine, and to develop a method for predicting individual vision pathology among children of school age.
Data and Methods: We conducted a retrospective epidemiological case-control study. The sample included 482 students of secondary schools in Kyiv, Ukraine, aged 10–12 years. We identifi ed 183 cases of acquired myopia (H52.1) and spasm of accommodation (H52.5) among children of school age; while 299 children were identifi ed as control group without any visual impairment. We assess the risk of visual impairment by presenting odds ratios (OR) and corresponding confi dence intervals (CI) for various predictors. As the result of specially conducted examination of 403 students of Kyiv, it was found that more than a third (36,5±2,4%) students have ophthalmic pathology, resulting in impaired vision. Most students were diagnosed with mild myopia (15,3±1,8 %) and medium (5,4±1,1 %) extent, and spasm of accommodation (9,4±1,5%).The occurrence of ophthalmic pathology increases in direct proportion to the age of children with 7,8±2,1% among fi rst graders to 63,6±4,8% among high school graduates (8 times). Such dynamics is caused, fi rst of all, by increase of the frequency of spasm of accommodation and mild myopia.
Results: On the basis of the «sequential analysis of Wald» procedure we developed a table with predicted estimates to determine the individual risk of visual impairment in schoolchildren.
Conclusions: The proposed method allows to screen schoolchildren at risk of developing visual impairment at the primary health care level, to form groups of prevention, to differentiate volumes eye care and is an instrument to improve the system of protection of students.


Keywords


ophthalmology care, schoolchildren, visual impairment, risk factors, individual risk prediction

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