7-year-old Hamza was one of the low performing students of my class. He would never note down anything from the blackboard, could not read, and was way behind his grade level in all parameters. As a teacher, all of my efforts in conducting extra classes for him were going in vain. I had already been told by other teachers that he was a hopeless case.
Suspecting a case of weak eyesight, I urged his mother to get his eyes tested. After being pushed several times, the mother probably lied to me about having his eyes examined. She told me that the doctor said he had no eyesight issues. A year later, during an eye test camp set up in the school by Project Drishti, Hamza’s eyes were tested. It turned out he was incapable of seeing clearly due to one of the refractive errors, and that was the reason why he could not read from the blackboard. Hamza’s inability to see clearly was being mistaken as his inability to perform well academically.
Children are often not able to report weak eyesight. They try to adjust with their low vision by sitting closer to the board, holding a book closer, etc, but eventually give up on participating in tasks that involve concentration.
These students come across as trouble makers and are often subjected to punishment by teachers for not completing their work or not concentrating in class. Weak eyesight significantly affects a child’s ability to learn and their educational potential. It is estimated that 2-3 % of school children in rural areas in India have a refractive error. Another study showed that 7.4% of children in the age group of 5-15 years in urban areas had myopia (a type of refractive error).
Refractive errors of eyes occur when the shape of the eye is not able to bend light correctly. The most common refractive errors are –
- Myopia or nearsightedness – difficulty in seeing distant objects clearly
- Hyperopia or farsightedness – difficulty in seeing near objects clearly
- Astigmatism – impaired vision caused due to an irregularly curved cornea
- Presbyopia – difficulty in seeing due to ageing
Refractive errors can be corrected through the use of spectacles assigned after diagnosis. If not corrected on time, Refractive errors can lead to blindness. Refractive errors are the second most common reason for blindness in India after cataract. It accounts for 33.3% of cases of childhood blindness.
Hamza’s mother is not the only parent unconcerned about their child’s eyesight. A study by Signify, formerly known as Philips Lighting, covered 1,000 Indians and 300 ophthalmologists across the top 10 Indian cities. It revealed that while 68 % of Indian parents believe that their kid’s eyesight is essential for them to, only 46 % of them get their kid’s eyes tested regularly.
School Eye Screening program (SES) is a part of the National Program for Control of Blindness (NPCB) since 1994, which involves eye screening in schools for students studying in 5th to 10th standard. The program conducts one-day training for selected school teachers to conduct eye tests in their respective schools and provides them with an eye testing kit. Arrangements for spectacles are made by the District Health Society with local opticians to supply low-cost spectacles.
The program, though no doubt a crucial first step towards solving the problem, has several challenges. Many students suffering from refractive error start showing symptoms well before they enter 5th grade. Late diagnosis of the problem drags a child behind their grade level. The program does not cover those students who are out of school. The 2011 census showed that about 32 million children aged between 6-13 in India do not attend school.
The program’s success rests on the acceptance of and compliance with the usage of spectacles; however, studies from an India research report only 30% compliance to spectacle wear. The various barriers identified for non-compliance to spectacle wear include lack of parent engagement, discrimination by peers, negative attitudes of society towards those wearing spectacles leading to stereotypes, and poor quality of spectacle frame. Hence, there is a need to spread awareness regarding spectacle-wearing and increased parent involvement.
The worst-hit amongst all the children with a refractive error are the children coming from economically troubled households or having uneducated parents.
Lack of awareness and stereotypes prevents parents from getting their children regularly tested for any refractive error or pursing a solution for the same. During the pandemic, the rising screentime for children means more cases of weak eyesight. As the schools re-open post-pandemic, we need to ascertain that we are prioritizing, creating awareness about refractive errors, especially amongst the parents of students studying in low-income schools and government schools.