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Prevalence of refractive error among Chinese preschool children: The Changsha children eye study
Insights
This study found that refractive errors like myopia and hyperopia are prevalent in Chinese preschoolers, with myopia increasing slightly in 5-6 year olds. Older age and astigmatism are linked to myopia development, highlighting the need for early eye care.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Public Health
Background:
- Refractive errors are a significant global health concern, particularly in children.
- Understanding refractive error prevalence and characteristics in preschool populations is crucial for early intervention.
- The Changsha Children Eye Study (CCES) provides valuable data on the visual health of young Chinese children.
Purpose of the Study:
- To investigate the prevalence and characteristics of refractive errors in Chinese preschool children aged 1-6 years.
- To analyze the distribution of myopia, hyperopia, and astigmatism within this age group.
- To identify factors associated with the development of refractive errors in early childhood.
Main Methods:
- A population-based cross-sectional study involving 43,105 preschool children aged 1-6 years.
- Data collected from 18 community health service centers in Changsha.
- Refractive status assessed using a handheld child vision screener (Suowei).
Main Results:
- The prevalence of myopia (spherical equivalent ≤ -1.00 D) was 2.94%, hyperopia (SE ≥ +2.00 D) was 13.8%, and astigmatism (diopter of cylinder ≥ 1.50 D) was 17.6%.
- Refractive error magnitude decreased with age, indicating emmetropization.
- Myopia prevalence was lower in younger children (<5 years) and slightly increased in 5-6 year olds; older age and astigmatism were independent risk factors for myopia.
Conclusions:
- Refractive error distribution shifts from dispersed in younger children to more centralized in older ones.
- The slight increase in myopia prevalence at 5-6 years may signal early myopia development in school-aged children.
- Increased attention to the visual health of 5-6 year olds is recommended for early detection and management of refractive errors.
Purpose:
We aimed to investigate the refractive status and prevalence of refractive error, as well as its characteristics in Chinese preschool children aged 1-6 years old.
Methods:
A population-based cross-sectional study-Changsha Children Eye Study (CCES) was conducted. The prevalence of refractive errors among children aged 1-6 years old from 18 community health service centers was surveyed. A handheld child vision screener, Suowei, was used for examination.
Results:
A total of 43,105 preschool children were included. The mean spherical equivalent (SE) was 0.42 ± 1.05 D for the right eyes. The mean astigmatism (diopter of cylinder, DC) was -0.83 ± 1.02 D for the right eyes. The magnitude of refractive error was lower in older children, indicating the ongoing of the emmetropization during the 1-6-year-old children. The prevalence of myopia (SE ≤ -1.00 D), hyperopia (SE ≥ +2.00 D) and astigmatism (DC ≥1.50 D) was 2.94, 13.8 and 17.6%, respectively. The prevalence of myopia decreased with the increase of age between the six age groups (P < 0.001). The prevalence of hyperopia was lower in 5-6 years old, whereas, the prevalence of myopia was slightly higher at this period of time. With-the-rule (WTR) astigmatism (+ cylinder axis 90° ± 15°) was the most prevalent type of astigmatism than against-the-rule (ATR) astigmatism (+ cylinder axis 180° ± 15°) and oblique (OBL) astigmatism (X 2 = 209.5, P < 0.001). The binary logistic regression model showed that older age and suffering astigmatism were independently associated with the development of myopia. In addition, there was no significant gender difference in the prevalence of myopia, emmetropia, and hyperopia.
Conclusions:
Our population-based cross-sectional study investigated the prevalence of myopia, hyperopia, and astigmatism in preschool children aged 1-6 years old. The distribution of the refractive error was disperse in the younger group and gradually turned more centralized in older group. Similar to hyperopia, with age increased, the prevalence of myopia was lower in preschool children younger than 5 years old and then slightly increased at 5-6 years, which may indicate an early sign of myopia in school-age children. Therefore, we emphasize that more attention should be given to the children at this age.
