RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES - rguhs

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES BENGALURU, KARNATAKA
PROFORMA FOR REGISTERATION OF SUBJECTS FOR
DISSERTATION
| | | |
|1 |NAME OF CANDIDATE |MS. ASHWINI BLOSSOM |
| | | |
|2 |NAME OF THE |K. R. COLLEGE OF NURSING, |
| |INSTITUTION AND |PROPERTY NO.59, 25/4/ 74, KATHA NO. |
| |ADDRESS |1935, C& M COMPLEX, OMKAR |
| | |LAYOUT, UTTARAHALLI- KENGERI |
| | |MAIN ROAD, BANGALORE-60. |
|30 |COURSE STUDY AND |I YEAR M.SC. NURSING |
| |SUBJECT |CHILD HEALTH NURSING |
|4 |DATE OF ADMISSION TO |25-7-2011 |
| |COURSE | |
| | |"KNOWLEDGE OF TEACHERS REGARDING |
|5 |TITLE OF THE TOPIC |IDENTIFICATION OF VISION PROBLEMS IN|
| | |SCHOOL AGE CHILDREN IN SELECTED |
| | |SCHOOLS OF BENGALURU CITY WITH A |
| | |VIEW TO DEVELOP AN INFORMATION |
| | |BOOKLET" |
6. BRIEF RESUME OF THE INTENDED WORK INTRODUCTION
"Children are the keys of paradise" - Eric Hoffer.
Children are wealth of tomorrow. Children are the major consumers of health
care. In India about 35% of total population are children below 15 years of
age. Children always need special care to survive and thrive. School age
years are a time of continued maturation of child's physical, social,
psychological characteristics. The school age child values school
attendance and school activities. Children spend a lot of time in
recreational activities that require good vision. Good vision is a key to
success. Visual skills are needed for the school success. New research
estimates that a million children have an undetected vision problems, while
almost 70% of schools do not have any eye screening, which was described as
"an absolute public health disgrace" by Bob Hughes.1
Early identification of vision problems among school children is very
important. An important part of all screening process is following up on
referrals to be certain that school children receive diagnostic care they
need. Eye examination for children are extremely important, because 5 to 10
% of pre schoolers and 25% of school-aged children have vision problems.
Early identification of a child's vision problem can be crucial because
children often are more responsive to treatment. Children who need
eyeglasses should be examined annually or as recommended by their
optometrist or ophthalmologist. Early eye exams are also important because
children need the 1
following basic skills related to good eyesight for learning that includes
near vision, distance vision, binocular vision (two eyes), coordination Eye
movement skills, focusing skills, peripheral awareness, hand eye co-
ordination.2
According to National Institute of Health release data from largest
paediatric eye study about 4 per cent pre-schoolers had Myopia, 21 per cent
had hyperopia, 10 per cent had astigmatism, 2 per cent had strabismus and 5
per cent had amblyopia, 9 per cent of children from 5-6 years. Ethnicity
was also associated with risk of refractive errors. Myopia was more common
among African -American children (6 per cent), compared to Hispanic (3 per
cent), non Hispanic white children (1 per cent). But African American
children (17 per cent) compared to Hispanic. A child grows and matures over
80 per cent of what they learn is processed through their eyes. However
most people have limited understanding of what good vision means.3
In India it is estimated that around 2-5% of school children have vision
problems. In Bengaluru it is estimated that around 20% of school children
have vision problems. It is estimated that nearly 25 per cent of school age
children have vision problems. Despite the social, economic and health care
advances which have occurred in our society, many preschool and school age
children are not receiving adequate professional eye care. Only 1/3rd of
all children have had an eye exam or visual screening prior to entering
school. The American Optometric Association believes that a vision
assessment conducted as a part of school vision screening in the public or
private schools cannot substitute for regular professional care.4
The warning signs of vision problems in kids are "Refractive errors" which
is the most common cause of vision problems among school age children.
Parents as well 2
as the teachers should be aware of these signs that a child needs
correction that includes consistently sitting too close to television,
holding book too close, using a finger to guide his eye, squinting or
tilting the head to see better, frequent eye rubbing, sensitivity to light
and excessive tearing, closing one eye to read, watch television, avoiding
activities that require a near vision such as participating in sports or
recreational activities, receiving low grades than usual.5
Vision screening in schools are important and can help to detect eye
conditions. Children need to receive an eye examination by an eye doctor in
clinical setting to detect issues with distance vision, close vision,
colour detection and binocular vision. The tools used for screening are
Snellen's letters and number chart for school children. The school health
committee (1906) assessed the standard of heath and suggested ways and
means to improve them and also suggests that basic eye health services
should be provided in schools. 6
The treatment of visual system conditions includes optical surgery,
behavioural modification, neuro motor or sensory integration exercises or
combination of the above. In neurological or developmental problems
prescribing exercises or lens to train the eye muscles or other therapies
to stimulate the nerves to operate normally are done. Vision therapy is
perhaps the best kept secret in vision care. It includes the use of lenses,
prisms, filters, computerised visual activities, non computerised viewing
instruments. Another name often associated with vision therapy is
'orthoptics'. This term which literally means "straightening the eyes", the
purpose of cosmetically straightening the eyes that are misaligned due to
strabismus. It improves accuracy of eye movements used during reading and
also near and far focussing
3
skills can be improved.7
Teachers have to identify school children who struggle to read and complete
assignments, or who become disinterested in and avoid reading. Eyestrain,
blurring, headaches, double vision, loss of place, failure to recognize
letters or simple words, omissions and transpositions, difficulty copying
from the desk or chalkboard and inability to sustain attention while
reading are common symptoms of such vision disorders. When these vision
disorders are detected early, they are usually treatable, often with
significant gains in classroom performance.9
Teachers are very close to the children, who observe them and spend a lot
of time with them. Teachers are the first to come across any deviation or
problem in children. So it is necessary for teachers to identify and have
knowledge regarding vision problems, their signs and symptoms and
treatment. Special clinics should be arranged in schools for the treatment
and follow up service.
6.1. NEED FOR THE STUDY
Childhood has become a separate phase of life, which society has
characterised by schooling. Child is not considered as a miniature adult.
Children's sight are protected by laws and customs. Each year thousands of
students suffer from undetected visual problems that can make school and
life difficult. Many are misdiagnosed as having hearing difficulty or
Attention Deficit Disorder. Children with poor visual skills may struggle
to read, have short attention span, develop low self esteem and have doors
closed to many future careers because of poor visual skills. If a child's
vision is lost or changes, growth and development can be delayed.10
4
The global prevalence of refractive errors have been estimated from 500
million to
2.3 billion. Around 15.3 million over 5 years of age are visually impaired,
as a result of uncorrected refractive errors of whom 8 million are blind.
Some 12.8 million in the age group 5-15 years are visually impaired from
uncorrected and inadequately corrective refractive errors. Worldwide
estimation of prevalence of visually impaired in 2011, blind children of 14
years is 4per cent and blind children from age group of 0-14 years are 1.4
million. In India, it is estimated that 5.1% of children in schools had a
visual acuity of 6/12 in the better eye. WHO estimated about 119 million
children are visually impaired, among these 12 million children are
visually impaired due to refractive errors.11
The eye chart cannot test many other important visual skills that children
need to succeed in today's modern world, especially at school, for example
eye chart cannot check how well children team and co-ordinate their eyes at
close distances required for rea