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Refractive error among urban preschool children in Xuzhou, China
Xiaojuan Wang1, Dan Liu1, Ruifang Feng1
1Xuzhou Eye Institute Xuzhou 221000, China ; The First Peoples' Hospital of Xuzhou 221000 China.
Insights
Refractive errors in Xuzhou preschool children show hyperopia is most common at 14.3%, with myopia at 0.9%. Refractive status remained stable across age groups in this urban Chinese population.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Public Health
Background:
- Refractive errors are a significant global health concern.
- Prevalence data for refractive errors in preschool children in Xuzhou, China, were previously unavailable.
- Understanding refractive error distribution is crucial for early intervention and vision care planning.
Purpose of the Study:
- To determine the prevalence of refractive errors, including myopia, hyperopia, astigmatism, and anisometropia, in urban preschool children in Xuzhou, China.
- To analyze the distribution of refractive errors based on age and categorize different types of astigmatism.
- To assess the stability of refractive status in this pediatric population.
Main Methods:
- A cross-sectional study involving 2255 preschool children from twelve randomly selected kindergartens in Xuzhou.
- Comprehensive eye examinations including visual acuity, cover-uncover test, cycloplegic refraction (streak retinoscopy), slit-lamp examination, and funduscopy.
- Standardized definitions for emmetropia, myopia, hyperopia, astigmatism, and anisometropia based on spherical equivalent (SE) and cylindrical error.
Main Results:
- The majority of children (86.6%) were emmetropic. The overall prevalence of myopia was 0.9% and hyperopia was 14.3%.
- Hyperopia was the most common refractive error (14.3%), followed by astigmatism (8.8%), anisometropia (3.2%), and myopia (0.9%).
- Mean spherical equivalent (SE) for the right eyes was +1.14 ± 0.95 D, showing no significant decline with age. Mean astigmatism was 0.87 ± 0.62 D, with With-the-rule astigmatism being most prevalent (93.8%).
Conclusions:
- Refractive status in urban Xuzhou preschool children is generally stable, with hyperopia being the predominant refractive error.
- The study found no evidence of a myopic refractive shift within the studied age range.
- These findings provide essential baseline data for vision screening programs and public health initiatives for preschool children in the region.
Abstract:
The prevalence of refractive errors in urban preschool children in Xuzhou, China remains unknown. Children attending twelve randomly selected kindergartens participated in this study. Visual acuity, ocular alignment, cover-uncover test, cycloplegic refraction, slit-lamp and funduscopy were performed under a standardized testing environment. Cycloplegic streak retinoscopy was performed for all subjects. The mean spherical equivalent (SE) refractive error was the main outcome measure. Emmetropia was defined as refractive status between +1.75 diopters (D) and -0.75D. Myopia, hyperopia, astigmatism and anisometropia were defined as SE < -0.50D, SE > +2.0 D, cylindrical error > 1.0 D and SE difference ≥ 1 D between fellow eyes, respectively. Out of 2349 eligible children, 2255 (96%) children completed a refractive examination. Of the 2255 children, the mean SE of right eyes was +1.14 ± 0.95 diopters (D). Mean SE of the right eyes did not decline with age (r = -0.01; P = 0.56). The majority (86.6%) of children were emmetropia. The prevalence of myopia and hyperopia was 0.9% and 14.3%, respectively. The mean astigmatism for the right eyes was 0.87 ± 0.62 D. The prevalence of With-the-rule, against the rule and oblique astigmatism was 93.8%, 4.7% and 1.5%, respectively. The mean anisometropia between two eyes was 0.14 ± 0.38 D. The most common type of refractive error was hyperopia (14.3%), followed by astigmatism (8.8%), anisometropia (3.2%), and myopia (0.9%). The refractive status in this population of urban Xuzhou preschool children was stable and there was no evidence of a myopic refractive shift over this age range in our cross-sectional study.
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