1. ARAVIND EYE CARE SYSTEM Aravind Eye Hospital & Postgraduate Institute of Ophthalmology ARAVIND EYE CARE SYSTEM Aravind Eye Hospital & Postgraduate Institute of Ophthalmology DEPARTMENT OF COUNSELLING Refractive Error

2.  It is a common eye problem  It is the second next common cause of preventable blindness  The symptoms may be missed as children, are unaware of their problem  It is generally reported by the school teacher by observing the child behavior in the classroom Cont… Refractive Error

3.  (4 – 5) % of the children have some refractive error  Many children fail to have an ophthalmic consultation as parents may be ignorant of the problem or hesitant out of fear, that glasses, it worn at a young age may become permanent Picture of Myopia, Hypermetropia, Astigmatism

4. MyopiaDefinition:  Normally light entering the eye gets focused on the retina  When the light gets focused in front of the retina it is called myopia  It is also called near sightedness

5. Symptoms:  Child is unable to see letters on the blackboard  Child keeps books very close to eyes while reading  Child sits too close to the television  Child squeezes eyes while trying to see distant objects Cont…

6. Treatment:  Use of spectacles (minus lenses) to provide clear vision thus enabling the child to see distant objects clearly  Contact lens, can be used after the age of 15-16 years

7. Hypermetropia Definition: It is condition where light entering the eyes come to a focus behind the retina. It is also known as far sightedness and is less common than myopia Symptoms:   Child has difficulty in reading, both at distance and near   Eye strain and head ache while trying to read   Squint Picture Cont…

8. Hypermetropia

9. Treatment:  Use of spectacle (plus lenses) – to provide clear vision  Contact lens-could be tried in some cases after the age of 15 – 16 years Picture

10. Astigmatism  It is an eye condition where the light entering the eye does not come to a point focus on retina  Some light rays get focused behind and some in front  Hence, the cannot see a sharp and clear image Cont…

11. Symptoms:  Blurred vision for distance and for near  Squeezing of eyes while trying to see fine objects or letters  Frequent headache Treatment:  Use of glasses  Contact lens

12. Role of counsellor  Explain the parents about the visual defect (Myopia / Hypermetropia / Astigmatism) in detail using an eye model  Encourage child to wear glasses regularly  Explain that wearing glasses will improve child’s vision, and hence child’s concentration and academic performance too  Advise yearly checkup Cont…

13.  Advise maintenance of glasses (Cleaning & handling)  Advice examination of family members ( specially in myopia)  To report immediately if child has complaints of floaters, flashes or diminution of vision  Explain that refractive error will keep on changing, hence regular follow up is necessary  Explain that any kind of diet and medicines will not change the refractive error

14.  To request school teacher to ensure that child uses glasses regularly  Encourage and motivate child and parents and tell them not to get discouraged by other’s comments  The counsellor should spend adequate time with the child and family to emphasize and reinforce the importance of wearing glasses  She should modify her style of counselling, using visual aids and analogues to convince both the child and the parents.