Sains Malaysiana 38(6)(2009): 959–964

Penyebab Masalah Penglihatan di Kalangan Kanak-kanak Prasekolah

di Daerah Sitiawan, Perak, Malaysia

(Causes of Visual Impairment Among Pre-School Children in Sitiawan District, Perak, Malaysia)

Duratul Ain Hussin & Rokiah Omar*

Jabatan Optometri, Fakulti Sains Kesihatan Bersekutu, Universiti Kebangsaan Malaysia

Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia

Victor Feizal Knight

Institut Sukan Negara Malaysia

Bukit Jalil Seri Petaling, 57000 Kuala Lumpur, Malaysia

Diserahkan: 29 Ogos 2008 / Diterima: 23 Januari 2009

ABSTRAK

Masalah penglihatan boleh memberi impak yang serius terhadap perkembangan sosial dan mental kanak-kanak. Oleh itu, pengesanan masalah ini di peringkat awal adalah amat penting bagi memastikan prognosis yang lebih baik. Kajian ini bertujuan untuk mengenalpasti penyebab masalah penglihatan di kalangan kanak-kanak Prasekolah. Seramai 479 orang kanak-kanak tadika yang berumur 4-6 ± 0.69 tahun (min=5.3 tahun) di Sitiawan, Perak, Malaysia telah dipilih secara rawak. Mereka menjalani ujian akuiti visual, ujian katup, ujian Hirschberg, pemeriksaan eksternal okular dan oftalmoskopi. Kanak-kanak yang gagal saringan penglihatan telah dirujuk untuk pemeriksaan lanjutan. 52% kanak-kanak terdiri daripada lelaki dan selebihnya adalah kanak-kanak perempuan. Melayu merupakan kumpulan bangsa terbesar (59.9%), diikuti Cina (30.1%), India (9.6%) dan lain-lain (0.4%). Daripada 43 orang yang gagal saringan penglihatan, 32 (6.7% dari kumpulan subjek asal) orang disahkan mempunyai masalah penglihatan. Penyebab utama masalah penglihatan di kalangan kanak-kanak Prasekolah dalam kajian ini ialah ralat refraksi (4.8% dari keseluruhan subjek kajian) diikuti dengan ambliopia (1.0%), strabismus (1.0%) dan keabnormalan okular (0.8%). Maka, saringan penglihatan di kalangan kanak-kanak Prasekolah adalah amat penting untuk dilaksanakan kerana ia dapat mengesan masalah penglihatan di peringkat awal.

Kata kunci: Ambliopia; ralat refraksi; saringan penglihatan prasekolah

ABSTRACT

Visual impairment can seriouly impact on a child’s social and mental development. Therefore, early detection is important to ensure a better prognosis for them. The purpose of this study was to identify the cause of visual impairment among pre-school children. 479 kindergarten children aged 4-6 ± 0.69 years old (mean=5.3 years) in Sitiawan, Perak, Malaysia were randomly selected. They underwent visual acuity test, cover test, Hirschberg test, ocular external assessment and ophthalmoscopy. Children who failed the vision screening were referred for further assessment. 52% of the children were boys and the rest were girls. Malays represented the largest group (59.9%), followed by Chinese (30.1%), Indian (9.6%) and others (0.4%). Of those 43 children who failed the vision screening, 32 were confirmed having visual problem (6.7% of the total subjects). The main cause of visual impairment in this study population was refractive error (4.8% of the total subjects) followed by amblyopia (1.0%), strabismus (1.0%) and ocular abnormalities (0.8%). Hence, pre-school vision screening is very important and needs to be conducted as it can detect various visual problems at an early stage in pre-school children.

Keywords: Amblyopia; pre-school vision screening; refractive error

RUJUKAN

Bardisi, W.M. & Bin Sadiq, B.M. 2002. Vision Screening of Preschool Children in Jeddah, Saudi Arabia. Saudi Medical Journal 23(4): 445-449.

Barry, J.C., Reher, C. & Kanig, H.H. 2004. Factors Influencing the Detection of Visual Developmental Deficits in 3-year-old Kindergarten Children. Strabismus 12(4): 211-219.

Chung, K.M., Norhani, M., Peng, T.W. & Tan, L.L. 1996. Prevalence of Visual Disorders in Chinese Schoolchildren. Optometry and Vision Science 73(11): 695-700.

Fatanah, Samad, I. & Zainal. 2002. Blindness Prevention and Control Programme in Malaysia. Disease Control Division (NCD) 1(1): 18-21.

Garner, L.F., Norhani, M., Chung, K.M., Sharanjeet, K., Faudziah, A.M., Freeland, E. & Siti Nariman, S.M. 1987. Prevalence of Visual Disorders in Malay Schoolchildren. Sains Malaysiana 16: 339-346.

Goh, P.P., Abqariyah, Y., Pokharel, G.P. & Ellwein, L.B. 2005. Refractive Error and Visual Impairment in School-age Children in Gombak District, Malaysia. Ophthalmology 112(4): 678-685.

Hard, A.L., Sjodell, L., Borres, M.P., Zetterberg, I. & Sjostrand, J. 2002. Preschool Vision Screening in a Swedish City Region: Results After Alteration of Criteria for Referral to Eye Clinics. Acta Ophthalmologica Scandinavica 80(6): 608-611.

Holmes, J.M. & Clarke, M.P. 2006. Amblyopia. www.thelancet.com. 367: 1343-1351.

Ingrosso, A., Mancioppi, S. & Orsoni, J.G. 1995. Vision Screening of Preschool Xhildren in Italy. Ophthalmic Epidemiology 2 (1): 41-44.

Kvarnstršm, G., Jakobsson, P. & Lennerstrand, G. 2001. Visual Screening of Swedish Children: An Ophthalmological Evaluation. Acta Ophthalmologica Scandinavica 79(3): 240-244.

Lim, H.C., Quah, B.L., Balakrishnan, V., Lim, H.C., Tay, V. & Emmanuel, S.C. 2000. Vision Screening of 4-year-old Children in Singapore. Singapore Medical Journal 41(6): 271-278.

Lim, H.T., Yu, Y.S., Park, S.-H., Ahn, H., Kim, S., Lee, M., Jeong, J.-Y., Shin, K.H. & Koo, B.S. 2004. The Seoul Metropolitan Preschool Vision Screening Programme: Results from South Korea. British Journal of Ophthalmology 88: 929-933.

Maul, E., Barroso, S., Munoz, S.R., Sperduto, R.D. & Ellwein, L.B. 2000. Refractive Error Study in Children: Results from La Florida, Chile. American Journal of Ophthalmology 129 (4): 445-454.

Newman, D.K. & East, M.M. 1999. Preschool Vision Screening: Negative Predictive Valuefor Amblyopia. British Journal of Ophthalmology 83: 676-679.

Newman, D.K., Hitchcock, A., McCarthy, H., Keast-Butler, J. & Moore, A.T. 1996. Preschool Vision Screening: Outcome of Children Referred to the Hospital Eye Service. The British Journal Of Ophthalmology 80(12): 1077-1082.

Nor Sham Ahmad. 2004. Perkembangan Penglihatan Kanak-kanak Melayu Prasekolah di Lembah Klang. Tesis Sarjana Universiti Kebagsaan Malaysia.

Peters, H.B. 1984. The Orinda Study. Am. J. Optom. Physiol. Opt. 61: 361-363.

Pokharel, G.P., Negrel, A.D., Munoz, S.R. & Ellwein, L.B. 2000. Refractive Error Study in Children: Results from Mechi Zone, Nepal. American Journal of Ophthalmology 129(4): 436-444.

Press, L.J. & Moore, B.D. 1993. Clinical Pediatric Optometry. New York: Butterworth-Heinemann.

Robinson, B., Bobier, W.R., Martin, E. & Bryant, L. 1999. Measurement of the Validity of a Preschool Vision Screening Program. American Journal of Public Health 89: 193-198.

Snowdon, S.K. & Stewart-Brown, S.L. 1997. Preschool vision screening. Health Technology Assessment 1(8): i-iv, 1-83

Suttle, C.M., Wong, R., Anderton, P.J., Kim, H.J., Kim, J.D. & Lee, M. Y. 2003. A Survey of Pediatric Visual Assessment by Optometrists in New South Wales. Clinical & Experimental Optometry: Journal Of The Australian Optometrical Association 86(1): 19-33.

The Vision in Preschoolers Study Group. 2004. Comparison of Preschool Vision Screening Tests as Administered by Licensed eye care professionals in the Vision in Preschoolers Study. Ophthalmology 111: 637-650.

WHO. 1997. Global initiative for the elimination of avoidable blindness. Geneva: World Health Organization.

World Medical Association Declaration of Helsinki. 2004. Ethical Principles for Medical Research Involving Human Subjects Adopted by the 18th WMA General Assembly, Helsinki, Finland, June 1964

Zainal, M., Ismail, S. M., Ropilah, A.R., Elias, H., Arumugam, G., Alias, D., Fathilah, J., T O Lim, Ding, L.M. & Goh, P.P. 2002. Prevalence of blindness and low vision in Malaysian population: results from the National Eye Survey 1996. British Journal of Ophthalmology 86: 951-956.

*Pengarang untuk surat-menyurat; email: r_omar@medic.ukm.my