Introduction: In line with the regional aim of eliminating rubella and congenital rubella syndrome (CRS), phased introduction of rubella-containing vaccines (RCV) in the Philippines’ routine immunization programme began in 2010. We estimated the burden of CRS in the country before widespread nationwide programmatic RCV use. Methods: We performed a retrospective chart review in four tertiary hospitals. Children born between 1 January 2009 and 31 December 2014 and identified as possible CRS cases based on the presence of one or more potential manifestations of CRS documented in hospital or clinic charts were reviewed. Cases that met the clinical case definition of CRS were classified as either confirmed (with laboratory confirmation) or probable (without laboratory confirmation). Cases that did not fulfil the criteria for either confirmed or probable CRS were excluded from the analysis. Results: We identified 18 confirmed and 201 probable cases in this review. Depending on the hospital, the estimated incidence of CRS ranged from 30 to 233 cases per 100 000 live births. The estimated national burden of CRS was 20 to 31 cases per 100 000 annually. Discussion: This is the first attempt to assess the national CRS burden using in-country hospital data in the Philippines. Prospective surveillance for CRS and further strengthening of the ongoing measles-rubella surveillance are necessary to establish accurate estimates of the burden of CRS and the impact of programmatic RCV use in the future.

Background: Quality of life questionnaires provide valuable information in assessing the effects of health interventions and public health campaigns. In the Philippines, we only have a few validated questionnaires targeted specifically for children. Objective: To translate to Filipino and validate the translated Impact of Vision Impairment for Children Questionnaire (IVI_C). Methods: This is a translation and validation study of the IVI_C. The IVI_C was translated following international guidelines of forward–translation and back-translation methods. After completion of the Filipino IVI_C version, pretesting was performed on school-aged children 8 to 18 years old through convenience sampling in the outpatient department and Pediatric Ophthalmology and Motility Clinic at Sentro Oftalmologico Jose Rizal, Philippine General Hospital from January 1 to August 31, 2018. Results: We included 130 participants in the study. The calculated Cronbach’s alpha coefficient of 0.88 for the translated Filipino version of the IVI_C suggested high reliability and internal consistency. Rasch analysis showed comparability of the Filipino translation to the original English version of the questionnaire. Conclusion Our study showed that the Filipino version of IVI_C questionnaire was of high reliability and validity.

Objective: To determine the visual outcome of amblyopia treatment and describe the relationship between age of onset and consult, compliance as measured by a patch diary, amblyopia subtype, and severity with the final visual outcome. Methods: Thirty-two consecutive, newly-diagnosed cases of amblyopia, aged 3-8 years on initial consult, with no history of prior amblyopia treatment, were included. Patching was done based on current AAO recommendations and patients were followed up monthly for 6 months. Treatment success was defined as best corrected visual acuity (BCVA) better than 20/30 (0.17LogMAR), or a 3-line improvement from baseline, or stable isoacuity for at least 3 months. Treatment failure was defined as no improvement of BCVA after 3 months of occlusion therapy or a regression of 2 lines. Descriptive and correlation statistics were performed comparing age of onset and consult, amblyopia subtype, severity, and compliance with the main outcome measure of BCVA at 6 months. Results: Sixteen (50%) attained treatment success. Patients seen earlier (age 2-5 years) had higher rates of success (75%) than those seen later (age 6-8 years) (35%). A moderately strong negative correlation (r=-0.48, p=0.01) existed between severity of amblyopia and final BCVA at 6 months. overall compliance to patching was 88±18%, with good compliance in the success group (92%) compared to fair compliance in the failure group (84%) and a moderate correlation between compliance and BCVA (r=0.37, p=0.05). Conclusion Treatment success was related to severity, compliance, and younger age of treatment. In the presence of good compliance, severity was a strong prognostic variable.
Amblyopia ; Compliance ; Sensory Deprivation ; Anisometropia

Objective: The objectives of this study were to translate into Filipino the Children’s Visual Function Questionnaire for children 3 years and above (CVFQ3plus), and to validate the translated CVFQ3plus to be used locally to assess the quality of life (QoL) of Filipino children aged 3 to 7 years old with visual impairment. Methods: Study Design: The study was a single-center, non-randomized translation and validation study. Translation: The CVFQ3plus translation into Filipino involved translation, reconciliation, pretesting, and small group discussion, based on the KIDSCREEN Group Translation and Validation procedures. Participants and Sampling: Convenience sampling was done to select the participants of the study. Participants were included in the study if they were parents or primary caregivers of children aged 3-7 years old who were noncompliant with treatment and/or those with non-treatable visual impairment defined as mild, moderate, severe unilateral, and severe bilateral. Procedure: All patients underwent complete ophthalmologic examination, including determination of the visual acuity using either the LEA chart or HOTV chart, prior to the administration of both the Filipino and English versions of the CVFQ3plus to their parents or caregivers. Participants were also asked to do a self-rating of their English proficiency, and their preferred version of the CVFQ. Statistical Analysis: Chronbach’s Alpha with a 95% confidence interval was used to determine the validity and internal consistency of the Filipino version of the CVFQ3plus questionnaire. Results: A total of 122 participants were included in the study. Chronbach’s Alpha score (α=0.86, CI=95%) for the translated Filipino version of the CVFQ3plus suggests high reliability and internal consistency, comparable to the original English version of the questionnaire. Conclusion This study was able to produce a highly reliable and internally consistent Filipino version of the CVFQ3plus.
Surveys and Questionnaires ; Quality of Life

Objective: The primary goal of this study was to determine the effect of visual impairment (VI) on the quality of life (QoL) in children aged 3-7 years. Methodology: This was a cross-sectional study involving 138 parents or caregivers of children aged 3-7 years from Pediatric Ophthalmology and General Ophthalmology Clinics of a tertiary government hospital. The Filipino version of the Children’s Visual Function Questionnaire (CVFQ3plus), an instrument that measures the impact of visual impairment on the QoL of children aged 3-7 years and their families, was used. It has 6 subscales: general health, general vision, competence, personality, family impact, and treatment. T-test was used to compare the total index QoL score and subscale scores between children with VI (n=69) and the control group (n=69). The multivariate regression model based on the total index QoL score in children with VI was used to assess the effect of other demographic factors. Results: Children with VI had significantly lower total index QoL score (p=0.02), general vision (p=0.04), competence (p=0.00), and personality (p=0.02) subscale scores than the control group. The visual acuity of children with VI had a significant effect on the total index QoL score (p=0.04). Demographic factors like patient’s age and sex, and parental age, sex and educational attainment had no effect on total index QoL score. Conclusion Visual impairment has a negative effect on the quality of life of Filipino children aged 3-7 years as shown by the use of the CVFQ3plus.
Vision Disorders ; Quality of Life ; Vision, Low

Objective: To determine the applicability of a modified criteria for initiating retinal examinations to screen for retinopathy of prematurity (ROP). Methods: All ROP charts of babies who had initial retinal examination to screen for ROP from January 1, 2005 to December 31, 2008 at the neonatal-intensivecare nursery and eye center of a tertiary hospital were reviewed. Date of birth, sex, age of gestation (AOG), birth weight (BW), postnatal age (PNA), postconceptional age (PCA), and ROP classification were recorded. Descriptive statistics and Student’s t-test were used to analyze the data. Results: A total of 690 eyes of 345 babies, 174 males and 171 females, were included in the study. At the initial retinal exam, the mean AOG was 31.39 ± 2.46 weeks; BW, 1,268.77± 317.12 grams; PNA, 4.56 ± 2.95 weeks; and PCA, 35.94 ± 3.26 weeks. Immature retinas in both eyes were seen in 175 (50.72%) babies, while 113 (32.75%) had ROP of any stage in both eyes and 51 (14.78%) had immature retina in one eye and ROP of any stage in the other eye. Among the 113 babies with ROP, 33 (29.2%) were assessed to have pre-threshold ROP. Conclusion This study supported the applicability of the modified criteria which are in agreement with the Joint Statements of the American Academy of Pediatrics, American Academy of Ophthalmology and American Association of Pediatric Ophthalmology and Strabismus, and the United Kingdom Royal College of Pediatrics and Child Health for initiating retinal exams to screen for ROP.
Retinopathy of Prematurity