DISTRIBUTION OF AMETROPIA AMONG PRIMARY SCHOOL CHILDREN IN ETCHE LOCAL GOVERNMENT AREA RIVERS STATE NIGERIA.

DISTRIBUTION OF AMETROPIA AMONG PRIMARY SCHOOL CHILDREN IN ETCHE LOCAL GOVERNMENT AREA RIVERS STATE, NIGERIA. BY NWAOBILOR GIFT MADUABUCHI 2017/110211/REGULAR A THESIS WORK SUBMITTED TO THE DEPARTMENT OF OPTOMETRY, FACULTY OF HEALTH SCIENCES, ABIA STATE UNIVERSITY, UTURU. IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE AWARD OF DOCTOR OF OPTOMETRY (OD) DEGREE July, 2024. I DECLARATION I, Nwaobilor Gift Maduabuchi, an undergraduate of the Department of Optometry with Matric No: 2017/110211/regular, do hereby declare on my honor, that this Thesis has not been previously presented, either wholly or in part for the award of any other Degree, Diploma or Certificate or Publication in any University, other Higher Institution or elsewhere. …………………………. Nwaobilor Gift Maduabuchi Mat No: 2017/110211/regular ii CERTIFICATION We certify that this work titled, “ Distribution of Ametropia among primary school children in Etche local Government area Rivers State, Nigeria” was carried out by Nwaobilor Gift Maduabuchi(2017/110211/regular) and was approved by the Department of Optometry, faculty of Health Sciences, Abia State University, Uturu. However, we affirm that the student, Nwaobilor Gift Maduabuchi, bears full responsibility for the contents of this work. ………………….. ………… DR. U.C. CHIJIOKE Date Thesis supervisor ……………………. ….. ……… PROF. (MRS) O.U. AMAECHI. Date Chairman, Thesis committee …………………………. …………… DR. A.U OMAKA Date Head, Department of Optometry …………………………. …………… PROF. C.O TIMOTHY. Date Dean, Faculty of Health Sciences …………………………. ………… External Examiner. Date iii DEDICATION This work is dedicated to my beloved parents, Mr. And Mrs. Nwaobilor Emeka Gabriel for their endless love, support and encouragement towards the completion of this program. I equally dedicate this work to my Dad, Dr. Anele Ernest akachukwu for all his support on my quest for knowledge and success in life. iv ACKNOWLEDGEMENTS I am extremely thankful to my supervisor, Dr. Okore Nnamdi Elem not just because it is common to acknowledge a thesis supervisor, but because of His outstanding efforts, invaluable suggestions and constructive criticisms towards the success of this study, may God bless you Sir. My appreciation also goes to the Head of Department, Dr. Udo Ubani, may God bless you immensely. I will like to reserve in memory lane My all my lecturers in the Department of Optometry who include, Prof. E.U. Ikonne, Prof. O.C. Ahuana, Dr. Timothy, Dr. Omaka, Dr. (Mrs.) Ogbogu, Dr. (Mrs.) Ezeigbo, Dr. Anonaba, Dr Ndukuba, Dr. Onyekwere, Dr. Ebere, Dr. Izuchukwu and Dr. Okore; may God bless you all. A profound sense of gratitude binds me to my parents, Elder and Elder (Mrs) Moses Ugbu Aki for the spiritual support, financial support, love and inspiration to reach my dreams. Accomplishing this would hopefully make you proud of me as much as I am proud of having you as my parent. I love you Dad and Mum. To my siblings, Godson, Chinedu, Amarachi and Chioma, Thank you all for the things you all have done for me. I know you all will be proud of me in doing this accomplishment. You all are truly the best siblings a sister could ever have. My special appreciation goes to my friends, Emmanuel, Yvonne, Doris, Pst. Daniel, Pee Chi, Kendra Pal, Victoria, Ify Okoh, Nmesoma, Kay Jay, thanks for always being there for me. It is my pleasure to acknowledge the roles of living world family, Absu who were instrumental for my stay in the course of this programme Worthy of Thanks is my Mentor, Dr.(Mrs) Jane Eligwedire for her guidance and inspiration towards the success of this study. Furthermore I wish to thank my Husband Mr. Odmodum Eke for his immeasurable moral and spiritual support during this study. Finally, in humility, I wish to express my profound gratitude to God Almighty for granting me the opportunity to reach this height today and for His unending grace that sustained me through this academic journey Vi TABLE OF CONTENTS TITLE PAGE. i DECLARATION. ii CERTIFICATION. iii DEDICATION. iv ACKNOWLEDGEMENTS. V TABLE OF CONTENTS. vi LIST OF TABLES. xi LIST OF FIGURES. xii ABSTRACT. xiii CHAPTER ONE: INTRODUCTION 1.1 Background information. 1 1.2 Statement of Problem 2 1.3 Aim and Objectives of the Study. 3 1.4 Scope of the Study 4 1.5 Significance of Study 4 1.6 Research Questions 5 1.7 Research Hypothesis 5 Vii CHAPTER TWO: LITERATURE REVIEW 2.1 Introduction. 7 2.2 Conceptual Framework/Historical Survey 2.2.2 Myopia. 8 2.2.3 Hyperopia 10 2.3.2.3 Astigmatism. 12 2.3 Empirical Framework 20 2.3.1 Pattern of Refractive Error in Primary School Children 2.3.2 Prevalence and Pattern of Refractive Errors among Primary school Children in AL Hassa, Saudi Arabia 2.3.3 Prevalence and Pattern of Refractive Errors and Visual Impairment among School Children: the Lhasa Childhood Eye Study. 2.3.4 Prevalence and Pattern of Refractive Errors among Primary School Children in Malamulele community of Limpopo province, South Africa 2.3.5 Refractive Error and Visual Impairment in Primary School Children in Onitsha, Anambra State, Nigeria. viii 2.3.6 Refractive Error among School Children in Jhapa, Nepal 2.3.7 Pattern of Refractive Error in Primary School Children in Dehradun City of Uttrahand 2.4 Summary of Literature CHAPTER THREE: MATERIALS AND METHODS 3.1 Study Area 3.2 Study Design 3.3 Study Population 3.4 Sample and Sampling Technique 3.5 Research Instruments 3.6 Validation and Reliability of the Instrument 3.7 Data Collection Procedures 3.8Data Analysis Technique 3.9 Ethical Consideration CHAPTER FOUR: RESULTS AND ANALYSIS OF DATA 4.1 Data Presentation Ix 4.2 Testing of Hypothesis CHAPTER FIVE: DISCUSSION 5.1 Discussion 5.2 Conclusion 5.3 Implication of the Findings 5.4 Limitations of the Findings 5.5Suggestions for Further Studies 5.4 Suggestions for Further Studies References Appendices x LIST OF TABLES TABLE 1 Frequency Table of Gender Distribution TABLE 2: Frequency Table of Age Distribution TABLE 3: Frequency distribution of the Refractive Errors TABLE 4: Frequency distribution of the Left eye TABLE 5: Frequency distribution of the Right eye TABLE 6: Cross tabulation summary table showing the Subjects Gender and Refractive Error TABLE 7:Chi-Square Result Test TABLE 8: Symmetric measures result table showing Phi and Cramer,s p-value from the analysis TABLE 9: Refractive Error and Age Cross Tabulation TABLE 10: Chi-square test results TABLE 11: Symmetric measures result table showing Phi and Cramer,s p-value from the analysis xi ABSTRACT Uncorrected refractive error has been a major source of poor academic performance amongst school children. This research was carried out to determine the distribution of refractive errors among primary school children in Etche local Government area. The research was centered at okehi community primary school, The subjects were 102 students, 64 females (62.7%) and 38 males (37.3%) with an age range of 6-9 years old. Visual acuity and external examination was done to eliminate any form of pathology and which subjective refraction was done for each eye. Objective refraction was obtained using retinoscopy and subjective refraction was done and determined for the two eyes. A total of 102 students were examined of which 64 females (62.7%) and 38 males (37.3%) were seen. A number of 19 pupils (18.6%) were aged 6 years, 35 pupils (34.3%) were aged 7 years, a total of 19 pupils (18.6%) were aged 8 years while 29 pupils (28.4) were aged 9 years. A total number of 27 pupils (26.5%) presented with hyperopia, 19 pupils (18.6%) had myopia and 15 (14.7%) were emmetropes. Hyperopia was the most prevalent refractive error found in this study. It was concluded that refractive errors were independent of the gender (p