Predictive Value of Headache for Screening of Refractive Errors in the Pediatric Age Group

Abstract

This article aims to study the predictive value of headache for screening of refractive errors in the pediatric age group. This is a cross-sectional study conducted in the outpatient setting of the Department of Ophthalmology of Lala Lajpat Rai Hospital, associated with Ganesh Shanker Vidyarthi Memorial Medical College, Kanpur (India), during a period of 1 year, including 5,398 children in the age group of 5 to 15 years. Data were collected using a predesigned, pretested questionnaire which included demographic data and chief complaints. All the subjects underwent visual acuity and refractive error testing. Visual acuity was conducted using Snellen's chart and Landolt's C chart. Thereafter, refractive testing was done under cycloplegia and corrective spectacles were prescribed to the patient. Data were analyzed using statistical package for social sciences version 16.0. Chi-square test was applied to analyze the discrete variables. Data were also used to calculate the sensitivity, specificity, positive predictive value, and negative predicative value of headache as a screening tool for the predicting refractive errors in children. Twelve percent of the total population attending the ophthalmic outpatient department belonged to the age group of 5 to 15 years. The male:female ratio was 1.3:1. Out of the total, 58.8% of the subjects had refractive errors. Myopia was the most common refractive error (46.4%) followed by astigmatism (31.3%) and then hyperopia (22.3%). Gender difference was significant (p < 0.01) in the myopic patients; there were more males with myopia than females. Visual acuity testing showed that more than 90% of the patients had visual acuity greater than 6/18 and ∼0.6% belonged to the legally blind category (<6/60). Headache was reported in 65.1% of the total patients. It was found that majority of subjects suffered from headache had myopia (45.8%) followed by astigmatism (29.5%) and hyperopia (24.6%). The sensitivity of headache as a predictor of refractive error was 79.2%, specificity was 54.9%, positive predictive value was 71.5%, and negative predicative value was 64.9%. Headache showed good sensitivity for detection of refractive error. We recommend screening of children presenting with headache for assessment of refractive errors.

Keywords

headache - refractive errors - pediatric age group - hyperopia

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