Optical Needs of Students with Low Vision in Integrated Schools of Nepal

PURPOSE: To identify the optical needs of students with low vision studying in the integrated schools for the blind in Nepal. METHODS: A total of 779 blind and vision-impaired students studying in 67 integrated schools for the blind across Nepal were examined using the World Health Organization/Prevention of Blindness Eye Examination Record for Children with Blindness and Low Vision. Glasses and low-vision devices were provided to the students with low vision who showed improvement in visual acuity up to a level that was considered sufficient for classroom learning. Follow-up on the use and maintenance of device provided was done after a year. RESULTS: Almost 78% of students studying in the integrated schools for the blind were not actually blind; they had low vision. Five students were found to be wrongly enrolled. Avoidable causes of blindness were responsible for 41% of all blindness. Among 224 students who had visual acuity 1/60 or better, distance vision could be improved in 18.7% whereas near vision could be improved in 41.1% students. Optical intervention provided improved vision in 48.2% of students who were learning braille. Only 34.8% students were found to be using the devices regularly after assessment 1 year later; the most common causes for nonuse were damage or misplacement of the device. CONCLUSIONS: A high proportion of students with low vision in integrated schools could benefit from optical intervention. A system of comprehensive eye examination at the time of school enrollment would allow students with low vision to use their available vision to the fullest, encourage print reading over braille, ensure appropriate placement, and promote timely adoption and proper usage of optical device.