Uncorrected ametropia in children with limited access to ocular health care.

Abstract

Introduction: The primary objective of this study is to describe the refractive needs of vulnerable children according to their social security status. The secondary objective of this study is to describe the types of ametropia in this population of children with limited access to ocular health care.

Methods: Children with limited access to ocular health care were recruited. Their social security status was assessed as well as their need for optical correction. Children received an orthoptic and ophthalmological examination. The ametropia thresholds requiring optical correction were defined as follows: hyperopia if spherical equivalent (SE) ≥ 3D before 6 years, ≥ 2.25 D between 6 and 12 years, ≥ 1.5 D from 12 years onwards; myopia if SE ≤ 0.5 D; astigmatism if cylinder C ≥ 1D; anisometropia if sphere difference between both eyes ≥ 1D.

Results: Out of 83 planned patients, 60 children turned up. 51 files for children aged 1 to 14 years old were analysed. 63.2 % of children without social security required an optical correction, compared with 65.6 % of children receiving State Medical Aid (SMA) and 66.7 % of children receiving Universal Health Protection (UHP). Out of 102 eyes, SE was hypermetropic in 56.9 % of cases, myopic in 21.6 % of cases; astigmatism was present in 60.8 % of cases. Anisometropia was assessed in 27.5 % of cases. 33 children out of 51 (64.7 %) required correction with glasses.

Discussion and conclusion: Children benefiting from SMA or UHP have similar refractive needs than children without social security, and probably greater than those of the general population. In our population there is two-thirds of patients with ametropia requiring optical correction; most of these children did not initially wear glasses, which suggests that access to ophthalmic and optical care is more difficult for vulnerable children.