Refractive Error Awareness among School Teachers in Tirukalukundram, Chengalpattu District- A Questionnaire based Study

Introduction

Refractive error is major cause for visual impairment and blindness in school children. Refractive error is a common eye disorder where light is not focussed accurately on the retina. To reduce rate of avoidable blindness, W.H.O made refractive error correction methods as a global initiative in Vision 2020- The Right to Sight 3 School going age is most prominent age where children face difficulties in visual problems [1]. Refractive errors are common among School children, due to change in society with increased and improper usage of audio-visual aids for education, communication and entertainment [2]. Proper eye care is necessary for School Students which helps to avoid visual problems and prevents from affecting their learning skills. Knowledge of Refractive error among School Teachers will determine the treatment options depending on type of Refractive error and power. Awareness of Refractive error helps in preventing the occurrence of visual impairment [3].

Literature Review

Burden of visual impairment due to uncorrected Refractive error is 53.1%⁷. Cross sectional study was conducted for adult population from September 2003 to April 2004 in Riyadh Saudi Arabia. Survey Questionnaire was distributed to 2500 random people. Results of this study depicted that 35% General public was not aware of visual problems. Therefore, on educating Refractive error awareness will help in reducing blindness and improves quality of vision [4].

In 2013 a descriptive survey was conducted using a structured questionnaire on 60 Primary School Teachers in Mysore, for early identification of Refractive error. Results of this study revealed that 80% School Teachers are aware of Refractive error but are not able to identify the visual problems [1].

A population-based study was conducted at Iran and Goa for determining awareness and attitude towards Refractive error correction methods in year of 2013 and 2018. Results reveal that 80% of population in these regions are not aware of Refractive error correction methods and also 25% of population did not know the difference between Ophthalmologist and Optometrist. This was due to lack of eye care services and are not educated by eye care authorities [3, 6]. A study was conducted in year of January 2017 for identifying awareness on healthy vision and eye screening on Private Schools of rural and urban areas of Noida. Workshop was arranged under advice of Department of Community Ophthalmology. Questionnaire was distributed, data was collected and analysed. Results reveal that 47% had no knowledge, 48% had no attitude and are not aware about steps of screening procedures which was due to lack of accessibility of eye care services [5, 6].

A cross sectional study was conducted young- adult population who were attending rural health centre of tertiary hospital age of 15-40. A self-structured questionnaire was distributed for gathering information on awareness on general population for refractive error and its correction methods. Results reveal that 23% are aware about Refractive error. Higher education groups are aware of visual problems so they depicted that education level will determine awareness.

A cross sectional population based survey with multistage cluster random sampling was taken and KAP questionnaire was distributed among adults. Results reveal that 74% are aware of Refractive error; 88% are aware of strabismus, so they depicted that awareness and knowledge of Refractive error and Strabismus was limited.

Annexure 1

Demographic Details

• Age: -----------------
• Gender: -----------------
• Educational Qualification: ----------------------------------
• Teaching Experience: ---------------------------------------

Result

The Present study included 460 (N=460) participants, 383 (84%) were Female and 73 (16%) were Male. As in Figure 1 Educational qualifications, 183 (40%) Undergraduates and 277 (60%) Postgraduates of School Teachers with mean age group (36.76 ± 8.67) years, mean teaching experience (21.70 ± 0.65) years. No Significant statistical association between Educational qualification and Knowledge (X2=1.981, p value=0.159) and Attitude (X2=1.077, p value=0.299) was found. Significant statistical association with gender and knowledge (X2=19.769, p value=0.011) was found, but not associated with attitude (X2=9.171, p value=0.328). Educational qualification was categorised as Undergraduate and Postgraduate. Using Median score cut off value was determined for Knowledge and Attitude using excel sheet and value received was 9 for knowledge and 12 for attitude. In this study both Undergraduates and Postgraduates have more attitudes on Refractive error but they have less knowledge about Refractive error. Values are mentioned in Table 2.

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Figure 1: Educational Qualification Participants. 183(40%) undergraduates and 277(60%) postgraduates Median Score was calculated in Figures 2,3 Undergraduates scoring involves (Good Knowledge20%, Poor Knowledge 80%, Good Attitude 96%, Poor Attitude 4%) and in Figures 4,5 Postgraduates scoring involves (Good Knowledge 23%, Poor Knowledge 77%, Good Attitude 49%, Poor Attitude 51%) Undergraduates and Postgraduates had more attitudes on Refractive error but they had less knowledge about Refractive error.

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Discussion

This study was cross sectional study to determine refractive error awareness among school teachers. This Prevalent study depicted 43% of school teachers had knowledge on Refractive error. This is lesser as compared to other studies Gondar city 54%10, Mysore 80%2, Andhra Pradesh 74%9, Visakhapatnam district 74%4 had knowledge on Refractive error. This lag in present study due to lack in eye care services, change in lifestyle and vision screening was not followed. Most of studies reveal that greater educational level, greater the awareness; in this present study Postgraduates had lesser knowledge could be due to lack of awareness. Knowledge level was found to be higher in Males and was more aware about Refractive error. This prevalent study depicted that 100% had attitude. It means behaviour towards eye care services on Refractive error. This is greater as compared to other studies North India 23%8, Gondar city 52%10, Vishakhapatnam 72%4. Awareness level of this prevalent study 56% compared to other studies Mysore 80%2, North India 23%8, Andhra Pradesh 74%9.

Conclusion

This present study concludes that awareness does not depend on Educational qualification. Awareness level is poor and steps need to be taken to prevent visual impairment. School Screening Camps needs to be conducted regularly which will improve Refractive error awareness level among School Teachers. Initiatives and recommendation of this study involves conducting School Screening Camps which creates and improves awareness level of School Teachers and provides benefit for Teachers as well as School Students. By taking this initiative majority of School Children will be protected from vision impairment by enhancing knowledge of School Teachers on Refractive error.

Conflict of Interest

No financial or commercial investments included in this study.

Limitations

This study had few limitations. Since it was a cross sectional study; an online based survey, Network accessibility was limited in our area so we had not covered some more interior village schools.

Acknowledgements

We thank to all School Teachers, Principal and Correspondents of Government and Private Schools for participating in this study.