METHODS: This cross-sectional, descriptive-analytical study used a purposive sampling technique. The list of facilities providing refraction services in the city of Malé was compiled through a desk review and finalized after verification by personnel from the Ministry of Health. The availability of human resources and infrastructure was measured using a pre-coded questionnaire that also listed barriers to service provision, followed by on-site observations and subsequent data analysis.
RESULTS: Three clinical ophthalmology departments within hospitals, two ophthalmology hospitals, and nine primary eye care centers were selected for this study. The private sector (n = 12, 85.7%) was the primary provider of refractive error services. All facilities possessed the essential equipment required for refraction. Only optometrists and ophthalmologists conducted refraction. Contact lens assessment and low vision services were not available at any facility. The number of refractions conducted in Malé annually was 145,392. Human resources and management-related factors were the major barriers to the provision of clinical refraction services (n = 21, 44.7%).
CONCLUSIONS: Accessibility to refractive error management and low vision services is needed in Malé to meet current population needs. Existing resources, including humans and equipment, require augmentation regarding service provision and enhancement. Knowledge of these barriers could lead to the upscaling of refraction services in Malé, Maldives by health policy makers.
METHODS: This prospective, interventional study was conducted on primary school children with dyslexia aged 8 - 11 years. The participants underwent comprehensive ophthalmic and optometric examinations and were categorized into groups A, B, and C, comprising primary school children at level 1 or 2. Groups A and B received combined VTM and MOE interventions for 12 and 24 weeks, respectively, and group C received MOE intervention alone. The reading performance was assessed at baseline and 12, 24, and 36 weeks post-intervention.
RESULTS: Both components of the reading performance improved significantly for school children at both levels in all study groups (all P < 0.05). However, the reading performance improvement was only approximately 28% in group C and 38% - 50% in groups A and B. In group A, students at level 1 showed significantly improved reading speed from baseline to 12 weeks post-VTM intervention and reading rate from baseline to 24 weeks post-VTM intervention (both P < 0.05). Students at level 2 showed significantly improved reading speed and rate from baseline to 12 and 24 weeks post-VTM intervention (all P < 0.05). In group B, students at both levels showed significantly improved reading speed and rate from baseline to 24 and 36 weeks post-VTM intervention (all P < 0.05). Students at level 2 showed significantly improved reading speed 12 weeks after cessation of intervention (at 36 weeks post-VTM intervention) compared to 24 weeks post-VTM intervention (P < 0.05). The improvement remaining stable 12 weeks after discontinuation of intervention indicated a sustained effect.
CONCLUSIONS: Combined or individual intervention improved the reading performance of school children with dyslexia at levels 1 and 2. However, combined intervention showed a better reading improvement effect. Improvement in the reading performance was maintained after discontinuation of the VTM intervention. Further interventional studies with a longer study period after discontinuation of this optical intervention are required to confirm the long-term sustainability of its positive effects on the reading performance of school children with dyslexia.
METHODS: This was a hospital-based cross-sectional study using a purposive sampling method. Children aged 4‒12 years who attended the Children's Unit at Gaza Ophthalmic Hospital, Gaza Strip, Palestine from September 2019 to July 2020, were examined. A comprehensive eye test was conducted for all participants. Those who failed the eye examinations and were diagnosed with refractive amblyopia were included in the study. Demographic data and amblyopic refractive error patterns were analyzed accordingly.
RESULTS: Of the 107 children, 72.9% were newly diagnosed with refractive amblyopia. The mean (standard deviation [SD]) of age of the children who participated was 7.85 (1.55) years. Approimately two-thirds of the patients were female (57.9%). Unilateral amblyopia was predominant in 60.7% of the cases. Moderate amblyopia was common (81.9%). A total of 149 amblyopic eyes were examined in total, with a mean (SD) (range) of best-corrected distance visual acuity and spherical equivalent of 0.45 (0.19) (0.2 to 1.3) logarithm of the minimum angle of resolution and + 0.76 (4.51) diopters (- 10.25 to + 11.50). Astigmatism was the most common amblyogenic factor (53.7%) among children with amblyopia.
CONCLUSIONS: The frequency of refractive amblyopia was 72.9%, and meridional amblyopia accounted for the highest percentage. Girls were more commonly affected than boys. The majority were in the 7-year-old age group. Most cases were unilateral with moderate refractive amblyopia. Our study yields insights into the patterns of refractive amblyopia among children in the Gaza Strip.