Impact of Visual Impairment on Children’s Mental Health

A study conducted at Orbis International found that providing appropriate eye care and spectacles improved children’s mental health and academic performance, filled important research gaps, and provided essential guidance for future interventions and research. It is concluded that

Visual impairment and blindness affect 2.2 billion people worldwide, including 19 million children. For these children, visual impairment can have a significant impact on their lives, including their educational attainment and mental health.

Two studies, conducted in collaboration with eye care non-profit Orbis International, found that providing children with free glasses improved their ability to learn in school and addressed children’s visual impairments. concluded that it can reduce depression and anxiety. Both studies fill important research gaps and provide essential guidance for future interventions and research.

glasses and child education

First study published in BMJMorewas conducted in rural western China, where only 15% of children who need glasses have glasses.

This study was a cluster randomized controlled trial (RCT), using double masks and selecting one school per township to minimize cross-arm contamination. Elementary schools in two of his neighboring provinces, Gansu and Shaanxi, were considered targets. The regions sampled included low- and middle-income towns in each state.

A total of 252 schools were selected. One in each township, one in her fourth grade and one in her fifth grade class from each school he chose. Children in these selected classes are eligible to participate in the study if their uncorrected visual acuity (UCVA) is 6/12 her in one eye and can be improved to 6/12 her in both eyes by wearing spectacles. had.

The researchers began by providing questionnaires to children, parents, and math teachers. The questionnaire to the children asked about their vision and personal information. Surveys of parents and teachers asked about wealth and blackboard use, respectively.

Each child’s visual acuity was assessed at the beginning of the study. Autoreflection with subjective refinement was then performed on children with UCVA less than 6/12 of hers. Mathematics scores were assessed at the beginning and end of the study using separate timed and proctored exams appropriate for each grade. Eyeglass wear was assessed by direct examination and self-report means at the end of the study.

Schools were randomized to receive one of three interventions: free eyeglasses, free eyeglass vouchers, or prescription (control group). Children in the voucher and control groups received free glasses at the end of the study if desired, but were not initially informed of this.

Schools were further randomly assigned to two groups. Schools with education that encourages wearing glasses (watching videos, receiving brochures, classroom discussions, etc.) and schools without education.

All information was created to show that myopia is common in China, that glasses are the safest and most effective treatment, and that wearing glasses does not harm children’s eyes. rice field.

Ultimately, 3,177 children from 251 schools were eligible to participate in the study. Only 15% of the eligible children were already wearing glasses. At the end of the study, 41% of her children in the free glasses group were observed wearing glasses, with 68% self-reported wearing them. In contrast, 26% were observed and 37% self-reported wear in the control group.

By providing free glasses to the children, they improved their math test scores, equivalent to half a semester’s worth of extra classes. The improvement was particularly pronounced when more than half of the instruction utilized the blackboard (these children were mostly short-sighted and had particular weaknesses when reading from a distant blackboard as opposed to textbooks on their desks). It was at a disadvantage, so it is a plausible result).

Providing free glasses influenced test scores more than parental education or family wealth. This effect was seen even when compliance was imperfect (around 40% in this case), but further encouragement to wear spectacles is expected to increase the effect.

This study provides a rationale for cost-effective government programs to provide free glasses to school children. The low cost of buying glasses in bulk has increased the affordability of government programs, and as a result of this study, pilot his programs to provide free glasses to children have been launched in Gansu and Shaanxi provinces. . This research was also the catalyst for his 2018 China National Myopia Control Program launched by none other than Xi Jinping.

Visual impairment and mental health

A second study published in Ophthalmologyshowed that visually impaired children had higher rates of depression and anxiety than non-visually impaired children.

Specifically, myopic children score higher on depression and anxiety, while children with other causes of visual impairment score higher on anxiety. Additionally, children who underwent corrective squint surgery were shown to have improved symptoms of depression and anxiety.

This study provides clear evidence that governments can be guided to act on children’s vision. In particular, it relates to the provision of glasses and insurance for corrective strabismus surgery, which would otherwise be prohibitively expensive.

Depression and anxiety pose a greater risk to children if not identified and corrected early. Children also have a much higher lifetime burden in terms of years affected by these conditions.

The Orbis study believes that the mental health of children with visual impairments may be adversely affected as they tend to participate less in physical activity, perform poorly academically and are socially isolated. It is

Moreover, negative attitudes toward strabismus appear to emerge as early as age 6, and early detection and treatment can have a serious impact on a child’s mental health.

This study reports on a systematic review and meta-analysis to investigate visual impairment, ocular morbidity, and whether their treatment is associated with mental health problems in children, particularly depression and anxiety. doing.

The study analyzed 36 articles from 9 different databases. These articles analyzed studies of children and young adults undergoing ophthalmologic interventions and analyzed mental health findings in adults with visual impairment (visual acuity <6/12) or ocular morbidity during childhood. I provided a summary of the story.

In addition, the study evaluated 23 observational studies on depression and anxiety, 8 observational studies on strabismus, and 7 intervention studies. Overall, approximately 700,000 participants were enrolled in these studies. Of the 36 studies, 22 were from low- to middle-income countries, 9 of which focused on myopia in China.

Although many studies have focused on the impact of visual impairment on depression and anxiety in adults, few studies have investigated the mental health of children with visual impairment, and to date there has been no such comprehensive study. has never been reviewed in such a way.

This research has significant implications for healthcare planners when allocating resources and designing interventions to control visual impairment. For example, in some countries, squint surgery is considered a cosmetic procedure and is not covered by insurance, leaving families to pay for it out-of-pocket. These barriers may discourage patients of lower socioeconomic status from seeking treatment, keeping the mental health benefits of corrective surgery out of reach.

More accessible eye care treatments improve children’s mental health and overall well-being.

Research use

These studies provide important information about the impact of avoidable visual impairment and blindness on children’s educational outcomes and mental health.

Uncorrected refractive errors continue to be the leading cause of vision loss worldwide. The inability to see clearly and the documented impact of visual impairment on educational performance, especially in a highly pressured educational environment such as China, affects more than half of children between the ages of 6 and 18. have myopia, which can cause anxiety and depression.

Ultimately, the results of both studies will provide policy makers and health planners with important information regarding intervention design and resource allocation. It highlights the negative effects of visual impairment and the positive effects of treatment.

Nathan Congdon is Research Director at Orbis International.
Emily Rich (MPH) is a recent graduate from Queen’s University Belfast, Belfast, Northern Ireland and is currently a member of the Volunteer Department at Orbis International.She can be contacted at [email protected]

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