Bhutan School Sight Programme

It is well known that uncorrected refractive error is the leading cause of visual impairment and the most common eye disorder in children. Considering its high prevalence, socioeconomic impact and psychological effect, refractive error has gained priority as a public health challenge globally. Early diagnosis and appropriate refractive correction is among the most cost-effective interventions in eye health.

The geographic location and the ethnicity of the population, places Bhutan at a high risk zone for refractive error. However, we do not have any strategic planning and policies for refractive error services. This is due to lack of authentic data on visual impairment due to uncorrected refractive error or childhood blindness in Bhutan.

Therefore, with generous support from Lions Cubs International Foundation (LCIF) and Mission for Vision, Bhutan School Sight Programme was initiated in March 2019. The objective of this programme was two-fold. One to collect information with valid survey methodology to estimate visual impairment due to uncorrected refractive error in school going children of Bhutan. Two to provide vision screening and refraction services to all school going children (approximately 170,000) in Bhutan. Essilor has an agreement with the Bhutan government to provide 500,000 spectacles to all needy people of Bhutan. So, we made use of this opportunity and all the distribution of glasses was under Essilor’s support.

Till now we have completed the survey part using WHO Refractive Error in School Children (RESC) survey protocol. So, far 169,000 children have undergone for presenting and best corrected visual acuity assessment. The survey result shows that 14.5% of Bhutanese school going children have some degree of visual impairment. Uncorrected refractive error is responsible for almost 95% of total visual impairment in school children. The prevalence of visual impairment in school children due to refractive error was more in the higher age group, female gender, and in children of parents with higher education.. Glass coverage among the visually impaired is  very low. Most of the refractive error has some degree of astigmatism, needs cylindrical glasses, which makes glass distribution more complicated.

Now the available data proves the need and serves as crucial information to plan refractive error and optical dispensing services in Bhutan.