Pattern of Refractive Error among the children attending Biratnagar Eye Hospital, Nepal

  • Pankaj Ray Adhikari Senior Optometrist Biratnagar Eye Hospital, Morang, Nepal
  • Sunil Kumar Chaudhary Opthalmic Officer, Biratnagar Eye Hospital, Morang, Nepal
  • Rajiv Ranjan Karn Research Officer, Eastern Regional Eye Care Programme, Nepal
  • Sanjay Kumar Singh Program Director, Eastern Regional Eye Care Programme, Nepal
Keywords: Amblyopia, Children, Eye Hospital, Nepal, Refractive error


Background: Uncorrected refractive error is the commonest cause of childhood blindness and visual impairment. It can easily be prevented by taking proper measures in time. Hyperopia, Myopia and Astigmatism are the common types of childhood refractive errors. To find out the pattern of Refractive error and amblyopia among the children attending the Pediatric Outpatient Department in Biratnagar Eye Hospital, Nepal.

Methodology: A cross-sectional study design was used. Inclusion criteria were children with refractive errors aged between 2-15 years attending pediatric OPD both from urban and rural areas of Eastern Nepal and neighbouring country India from October 2015 to March 2016. In these children pattern of refractive errors was determined. The data was entered into excel and analyzed by using SPSS 17. Chi-square test was used for categorical data.

Result: The prevalence of refractive error in  Biratnagar Eye Hospital was 6.2%. The commonest types of refractive error were Astigmatism (35.5%)     followed by Hyperopia (30.3%) and Myopia (28.1%). It was more common in rural areas (69%). Amblyopia was present in 38% of children having Refractive error.

Conclusion: The prevalence of refractive error and amblyopia in Biratnagar Eye Hospital was high,  astigmatism was the commonest type of refractive error and was found more in 11-15 year age groups mainly in a rural area.




Anstice, N. S., & Thompson, B. (2014). The measurement of visual acuity in children: an evidence‐based update. Clinical and Experimental Optometry, 97(1), 3-11.
Brilliant, L., Pokhrel, R., Grasset, N., Lepkowski, J., Kolstad, A., Hawks, W., . . . Shrestha, S. (1985). Epidemiology of blindness in Nepal. Bulletin of the World Health Organization, 63(2), 375.
EREC-P Annual Report, 2018
Fan, D. S., Lam, D. S., Lam, R. F., Lau, J. T., Chong, K. S., Cheung, E. Y., . . . Chew, S.-J. (2004). Prevalence, incidence, and progression of myopia of school children in Hong Kong. Investigative ophthalmology & visual science, 45(4), 1071-1075.
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.
Gupta, M., Rana, S. K., Mittal, S. K., & Sinha, R. (2016). Profile of amblyopia in school going (5-15 years) children at state level referral hospital in Uttarakhand. Journal of clinical and diagnostic research: JCDR, 10(11), SC09.
Gurung, H. B. (2003). Social demography of Nepal: census 2001: Himal Books.
Hashemi, H., Abbastabar, H., Yekta, A., Heydarian, S., & Khabazkhoob, M. (2017). The prevalence of uncorrected refractive errors in underserved rural areas. Journal of current ophthalmology, 29(4), 305-309.
IAPB, Vision Atlas 2017
Janti, S. S., Raja, A., Matheen, A., Charanya, C., & Pandurangan, R. (2014). A cross sectional study on prevalence of amblyopia in school going children. Journal of Evolution of Medical and Dental Sciences, 3(30), 8561-8565.
Karki, K., & Karki, M. (2004). Refractive error profile--a clinical study. Kathmandu University medical journal (KUMJ), 2(3), 208-212.
Karn R, IPD Patients satisfaction, Biranagar Eye Hospital, 2018
Karn R, Community Diagnosis Program on awareness on eye diseases.
Khawaja, A. P., Chan, M. P., Hayat, S., Broadway, D. C., Luben, R., Garway-Heath, D. F., . . . Wareham, N. J. (2013). The EPIC-Norfolk Eye Study: rationale, methods and a cross-sectional analysis of visual impairment in a population-based cohort. BMJ Open, 3(3), e002684.
Miranda, M. N. (1972). Residual accommodation: a comparison between cyclopentolate 1% and a combination of cyclopentolate 1% and tropicamide 1%. Archives of Ophthalmology, 87(5), 515-517.
Murthy, G., Gupta, S. K., Ellwein, L. B., Munoz, S. R., Pokharel, G. P., Sanga, L., & Bachani, D. (2002). Refractive error in children in an urban population in New Delhi. Investigative ophthalmology & visual science, 43(3), 623-631.
Nepal, B., Koirala, S., Adhikary, S., & Sharma, A. (2003). Ocular morbidity in schoolchildren in Kathmandu. British Journal of Ophthalmology, 87(5), 531-534.
Naidoo KS, Jaggernath J, Ramson P, Chinanayi F, Zhuwau T, Øverland L(2015). The prevalence of self- reported vision difficulty in economically disadvantaged regions of South Africa. Afr J Disabil. 2015 Jun 25,4(1):136
Pascolini, D., & Mariotti, S. P. (2012). Global estimates of visual impairment: 2010. British Journal of Ophthalmology, 96(5), 614-618.
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.
Rai, S. K., Thapa, H., Sharma, M., Dhakhwa, K., & Karki, R. (2012). The distribution of refractive errors among children attending Lumbini Eye Institute, Nepal. Nepalese Journal of Ophthalmology, 4(1), 90 -95.
Resnikoff, S., Pascolini, D., Etya'Ale, D., Kocur, I., Pararajasegaram, R., Pokharel, G. P., & Mariotti, S. P. (2004). Global data on visual impairment in the year 2002. Bulletin of the World Health Organiza tion, 82, 844-851.
Sapkota, K., Pirouzian, A., & Matta, N. (2013). Prevalence of amblyopia and patterns of refractive error in the amblyopic children of a tertiary eye care center of Nepal. Nepalese Journal of Ophthalmology, 5(1), 38 -44.
Shrestha, S., Bhat, K., Binu, V., Barthakur, R., Natarajan, M., & Subba, S. (2010). Pattern of refractive errors among the Nepalese population: a retrospective study. Nepalese Journal of Ophthalmology, 2(2), 87- 96.
Taludhar, S., & Dhakal, S. (2013). Refractive Error Profile in a Tertiary Centre in Western Nepal. Internation al Journal of Infection and Microbiology, 2(2), 59-63.
Tong, L., Saw, S.-M., Lin, Y., Chia, K.-S., Koh, D., & Tan, D. (2004). Incidence and progression of astigma tism in Singaporean children. Investigative ophthalmology & visual science, 45(11), 3914-3918.
Xiao, X., Liu, W., Zhao, W., Wang, Y., & Zhang, Y. (2011). Prevalence of astigmatism in 2023 children with amblyopia. Zhongguo dang dai er ke za zhi= Chinese journal of contemporary pediatrics, 13(6), 462- 465.
How to Cite
Adhikari, P., Chaudhary, S., Karn, R., & Singh, S. (2019). Pattern of Refractive Error among the children attending Biratnagar Eye Hospital, Nepal. International Journal of Perceptions in Public Health, 3(3), 66-73. Retrieved from