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Ophthalmology and Allied Sciences

Volume  3, Issue 2, Jul-Dec 2017, Pages 113-119
 

Original Article

Visual Functional Assessment in Children and Young Adults with Refractive Errors

L.K. Lali1, Tanuja Britto2, B. Antony Arokiadoss3, R. Shankar4

1Assistant Professor, Dept. of Ophthalmology, Government Medical College, Sivagangai, Sivaganga, Tamil Nadu 630562, India. 2HOD, Low Vision Department, 3Senior Consultant, Institute of Ophthalmology, Joseph Eye Hospital, Tiruchirappalli, Tamil Nadu 620001, India. 4Associate Professor, Dept. of Ophthalmology, Vinayaka Mission’s Kirupananda Variyar Medical College & Hospitals, Salem, Tamil Nadu 636308, India.

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DOI: http://dx.doi.org/10.21088/oas.2454.7816.3217.14

Abstract

Background: Normal visual functioning depends not only on patient’s visual acuity but also on many other parameters, such as the visual fields, perception of colour, contrast and visual skills. Clinically, objective measurements, such as those of acuity or the visual fields, provide an assessment of a patient’s visual status but do not reflect the degree of visual impairment that the patient experiences in his or her daily activities sufficiently. Impairment of vision affects the quality of life which is related to health, and affects the daily activities of life, including social activities. The efficacy of interventions should be validated by patient’s visual functions and by assessing visual or impact of visual impairment on daily activities. Aim: To evaluate visual functions and performance among children and young adults with refractive errors and to assess the effectiveness of ophthalmological interventions on visual functional improvement. Materials and Methods: The participants in this study comprised children and young adults with refractive errors, aged 530 years, attending the low Vision and paediatric ophthalmology department at Institute of Ophthalmology, Joseph Eye Hospital, Tiruchirappalli. Data relating to distant visual acuity, near visual acuity, ocular examination, refraction after cycloplegia, near vision, contrast sensitivity; colour vision, field of vision and functional visual assessment were collected and reviewed after refractive correction. Results: The comparison of visual functions and functional skills in children and young adults with refractive errors showed that individuals in low vision groups had reduced visual functions even with best corrected visual acuity than the individuals in normal vision group. There was a statistically significant difference in uncorrected visual acuity, best corrected visual acuity, colour vision, contrast sensitivity, stereopsis, near point of accommodation, near point of convergence etc. between Group 1(patients with vision 6/18) and Group II(patients with vision<6/18). Functional skills like reading speed, writing speed and mobility were also reduced in low vision groups that shows statistically significant difference between Group 1 and II and also had significant difference among subgroups of Group 1 and II. None of the patients had age appropriate functional skills in Group 1 and Group II. After using interventions (like optical and nonoptical aids) for 6 months, there was a statistically significant improvement in BCDV, functional skills between first visit and followup visit and had significant differences among subgroups. But none of the individuals in Group 1and II had age appropriate functional skills. Conclusion: The present study had shown that in spite of improved clinical and functional vision with interventions, at short term followup, the visual skills required, were not age appropriate, both at initial and at also followup visit. Hence, functional vision parameters should be monitored as a criterion to determine the quality of vision in those with refractive errors especially in the paediatric age group.

Keywords: Refractive Error; Visual Function; Paediatric and Young Adults. 


Corresponding Author : Associate Professor, Dept. of Ophthalmology, Vinayaka Mission’s Kirupananda Variyar Medical College & Hospitals, Salem, Tamil Nadu 636308, India.