The Visual and Refractive Status in One Sample Population of ‘Orang Asli’(Indigenous) Children in Hulu Langat, Selangor

Bangladesh Journal of Medical Science Vol. 19 No. 04 October’20 Original article The Visual and Refractive Status in One Sample Population of ‘Orang Asli’(Indigenous) Children in Hulu Langat, Selangor Fairuz MN, Noor Farasuhana MF, Mohd Zaki AI, Noorsuhaila S Abstract: Background: The aim of this study is to assess the visual and refractive status among ‘Orang Asli’ (indigenous) children in Kampung Sungai Lalang, Semenyih, Selangor. Uncorrected refractive error is a major burden among children around the world. It results in a significant number of problems among this high-risk group including educational loss, low productivity and impaired quality of life. Besides that, there are lacking information regarding vision problems among aborigine children or ‘Orang Asli’ in Malaysia. This study was undertaken to determine the prevalence of refractive error, and the association of the refractive error and visual acuity with age among ‘Orang Asli’ children. Methods: A cross sectional study was conducted on ‘Orang Asli’ children (n=43) where 51.2% were male and 48.8% were female. Visual acuity and refraction assessment were done on every child using Refractive Error Study in School Children (RESC) protocol. Results: The prevalence of refractive error was simple myopia (1.2%), simple hyperopia (18.6%), compound myopic astigmatism (7.0%), and mixed astigmatism (73.3%) respectively. The visual acuity measurement shows that the majority of subjects achieved 6/6 represented by 88.4% of the right eye and 86% of the left eye. There is no association between refractive error and age (P>0.05). Conclusion: This study concludes that there is a high prevalence of hyperopia among ‘Orang Asli’ children and There is no association of refractive error with age and gender. Therefore, there is a need to create better awareness programs among the parents about the importance of eye examination to their children. Keywords: Refractive status; ‘Orang Asli’ (Indigenous); visual acuity Bangladesh Journal of Medical Science Vol. 19 No. 04 October’20. Page : 609-613 DOI: https://doi.org/10.3329/bjms.v19i4.46614 Introduction Studies on vision problems and refractive errors status are essential for developing national strategies for the prevention of visual impairment.1 There was a lack of information regarding vision problems among aborigine children or ‘Orang Asli’in Malaysia. ‘Orang Asli’ are the indigenous inhabitants or known as original peoples of Peninsular Malaysia. They constitute a minority group in the population making up approximately 0.6% of the total population (28.2 million in 2016). Studied by Dandona et al2 found that prevalence of myopia in suburban and rural 1. 2. 3. 4. regions to be 5% and 2.5% respectively. School children are the high risk group of having myopia because uncorrected refractive errors can adversely affect their learning disabilities and mental development.3Children usually not be aware of defective vision problems and hence may not complain.4 Commonly they might adopt ways like sitting close to the whiteboard, holding books closer to eyes and even by avoiding work requiring visual concentration to accommodate to poor vision. Hence awareness of refractive error and its risk factors, early diagnosis and treatment are required to prevent Fairuz MN, Lecturer, Department of Optometry and Vision Science, Faculty of Health and Life Sciences, Management and Science University, Malaysia. Noor Farasuhana MF, Optometry Student, Department of Optometry and Vision Science, Faculty of Health and Life Sciences, Management and Science University, Malaysia. Mohd Zaki AI, Associate Professor, Department of Optometry and Vision Science, Faculty of Health and Life Sciences, Management and Science University, Malaysia. Noorsuhaila S, Resident Optometrist, Noorsuhaila Optometrist, Puncak Alam, Selangor, Malaysia. Correspondence to: Lecturer, Department of Optometry and Vision Science, Faculty of Health and Life Sciences, Management and Science University, Malaysia Fairuz MN, Email : 609 The Visual and Refractive Status in One Sample Population of ‘Orang Asli’(Indigenous) Children in Hulu Langat, Selangor further disability.5The lack of appropriate preschool vision screening continuously to contribute to an unacceptable prevalence of permanent visual loss from vision disorders and amblyopia one of the most of which is reversible if detected and treated early.6 Since the colonial era, many surveys and studies have been conducted on the medical and health aspects of the ‘Orang Asli’. Many studies show evidence of poor health and nutritional status of ‘Orang Asli’ population have been documented over the decades7but not for vision problems. It could be a high relationship between vision problems and refractive errors among ‘Orang Asli’ children population. In order to reduce the prevalence of avoidable visual impairment and blindness caused by refractive error, epidemiological information on refractive error and other vision problems are needed.8There is lacking data about the aborigine regarding ocular health and vision status. By conducting the study, eye health screenings at ‘Orang Asli’ settlement provide an opportunity for them to get access to proper eye examination as they did not have easy and modern access to health checkup The importance of this study is to rule out visual and refractive error status of the ‘Orang Asli’ children in one sample population for the earlier intervention. Materials and methods The objective of this cross sectional study are to determine the current visual acuity status and refractive status and to identify the association between sociodemographic (age and gender) with refractive error in one sample of population of ‘Orang Asli’ children in Hulu Langat, Selangor. This study was conducted at the ‘Orang Asli’ settlement in Kampung Sungai Lalang, Semenyih, Selangor. The total population of ‘Orang Asli’ in Kampung Sungai Lalang, Semenyih is 214. Participants were randomly selected from the children registered for the vision screening. Selection criteria involving male and female children, age 4 to 12 years old, reliable response and no abnormalities detected during ocular health assessment. Children who were detected with the ocular disease or binocular vision problem were excluded. The sample size was determined by using the following population proportion formula: n = N*X / (X + N – 1), where, X = Zα/22*p*(1-p) / MOE2 n = 214(88.5)/(88.5+214-1) X = 1.962 x 0.64 (1-0.64)/0.12 n = 63 subjects. 610 The original Refractive Error Study in School Children (RESC) protocol was relied upon in designing the examination protocol for ‘Orang Asli’ children.9The examination protocol for ‘Orang Asli’ children was simplified to ensure the understanding of the subjects on the procedure of examination and the cooperation from the subjects will be easy. The examination involved a visual acuity test at 3-meter for distance and 40-cm for near using LEA distance and (...truncated)