Requirements for optical services in children with microphthalmos, coloboma and microcornea in Southern India

Purpose The aim of the study was (1) to determine the need for spectacles i n children in Southern India with coloboma, microphthalmos and microcornea, (2) to describe their refractive errors and (3) to assess their needs for low vision aids (LVAs). Methods Children with congenital eye anomalies were recruited from special education for the blind, schools for the mentally handicapped, community-ba sed rehabilitation programmes and hospital records in Andhra Pradesh, India . All those with at least light perception vision (PL) in one eye and who h ad navigational vision were refracted. Those whose distance vision in their better eye improved with refraction were prescribed spectacles. Those unab le to read N10 were assessed for LVAs for near. Those with distance visual acuity of < 6/18 in the better eye were assessed for telescopes to aid dist ance vision. Results Ninety-nine children with coloboma, microcornea or microphthalmos h ad functional vision. Eight unilateral cases were excluded. Ninety-one bila teral cases were refracted and assessed for LVAs. The vision in 52 children (57%) improved in the better-seeing eye by 1 or more lines of Snellen acui ty with spectacles. Spectacles were prescribed most frequently for myopia a ssociated with choroidal coloboma. After refraction, all 19 children with a visual acuity of 6/18 or better could read N10, and 43 of the 72 children (60%) with a visual acuity of <6/18 to PL with functional vision could read N10 unaided, or with distance correction. A further 6 (8%) reached this le vel with magnifiers. Thirteen children (18%) were given telescopes. Conclusion Children with congenital anomalies of the eye and functional vis ion benefit from refraction and low vision services.