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Prevalence of vision disorders by racial and ethnic group among children participating in head start
Gui-shuang Ying1, Maureen G Maguire1, Lynn A Cyert2
1Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania.
Insights
Vision disorders like amblyopia and strabismus were equally common across diverse preschool groups. However, significant refractive errors, including hyperopia and astigmatism, showed varying prevalence by race and ethnicity.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Public Health
Background:
- Vision disorders are common in preschoolers.
- Early detection and intervention are crucial for visual development.
- Understanding prevalence across racial/ethnic groups is vital for targeted screening.
Purpose of the Study:
- To compare the prevalence of amblyopia, strabismus, and significant refractive errors.
- To analyze these prevalences across five major racial/ethnic groups in U.S. preschoolers.
Main Methods:
- A multicenter, cross-sectional study of 4040 preschoolers (3-5 years) in Head Start programs.
- Comprehensive eye examinations by certified eye care professionals.
- Prevalence rates calculated using sampling weights for racial/ethnic comparisons.
Main Results:
- Amblyopia and strabismus prevalence were similar across all racial/ethnic groups.
- Significant hyperopia prevalence varied, highest in non-Hispanic whites (11.9%) and lowest in Asians (5.5%).
- Astigmatism and anisometropia prevalence varied, with highest rates in Hispanics (11.1% and 7.1%, respectively).
Conclusions:
- Amblyopia and strabismus prevalence did not differ significantly among the studied racial/ethnic groups.
- Refractive errors like hyperopia, astigmatism, and anisometropia showed significant variations across groups.
- Findings highlight the need for tailored approaches to refractive error screening in diverse preschool populations.
Objective:
To compare the prevalence of amblyopia, strabismus, and significant refractive error among African-American, American Indian, Asian, Hispanic, and non-Hispanic white preschoolers in the Vision In Preschoolers study.
Design:
Multicenter, cross-sectional study.
Participants:
Three- to 5-year old preschoolers (n=4040) in Head Start from 5 geographically disparate areas of the United States.
Methods:
All children who failed the mandatory Head Start screening and a sample of those who passed were enrolled. Study-certified pediatric optometrists and ophthalmologists performed comprehensive eye examinations including monocular distance visual acuity (VA), cover testing, and cycloplegic retinoscopy. Examination results were used to classify vision disorders, including amblyopia, strabismus, significant refractive errors, and unexplained reduced VA. Sampling weights were used to calculate prevalence rates, confidence intervals, and statistical tests for differences.
Main Outcome Measures:
Prevalence rates in each racial/ethnic group.
Results:
Overall, 86.5% of children invited to participate were examined, including 2072 African-American, 343 American Indian (323 from Oklahoma), 145 Asian, 796 Hispanic, and 481 non-Hispanic white children. The prevalence of any vision disorder was 21.4% and was similar across groups (P=0.40), ranging from 17.9% (American Indian) to 23.3% (Hispanic). Prevalence of amblyopia was similar among all groups (P=0.07), ranging from 3.0% (Asian) to 5.4% (non-Hispanic white). Prevalence of strabismus also was similar (P=0.12), ranging from 1.0% (Asian) to 4.6% (non-Hispanic white). Prevalence of hyperopia >3.25 diopter (D) varied (P=0.007), with the lowest rate in Asians (5.5%) and highest in non-Hispanic whites (11.9%). Prevalence of anisometropia varied (P=0.009), with the lowest rate in Asians (2.7%) and highest in Hispanics (7.1%). Myopia >2.00 D was relatively uncommon (<2.0%) in all groups with the lowest rate in American Indians (0.2%) and highest rate in Asians (1.9%). Prevalence of astigmatism >1.50 D varied (P=0.01), with the lowest rate among American Indians (4.3%) and highest among Hispanics (11.1%).
Conclusions:
Among Head Start preschool children, the prevalence of amblyopia and strabismus was similar among 5 racial/ethnic groups. Prevalence of significant refractive errors, specifically hyperopia, astigmatism, and anisometropia, varied by group, with the highest rate of hyperopia in non-Hispanic whites, and the highest rates of astigmatism and anisometropia in Hispanics.
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