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Ocular and vision defects in preschool children
Insights
Early childhood vision defects are common, affecting 7.1% of children by age five. While premature infants face higher risks initially, this risk diminishes by age five, with refractive errors becoming more prevalent.
Area of Science:
- Pediatric Ophthalmology
- Public Health
- Developmental Pediatrics
Background:
- Ocular and vision defects are frequent reasons for pediatric hospital referrals.
- A birth cohort study identified significant prevalence of vision defects in young children.
Purpose of the Study:
- To investigate the incidence and risk factors of ocular and vision defects in children up to five years old.
- To compare defect prevalence and characteristics between early (0-2 years) and later (2-5 years) childhood.
Main Methods:
- A survey of a birth cohort in a specific health district.
- Data collection on diagnoses of ocular and vision defects by the fifth birthday.
- Analysis of risk factors including birth weight and need for postnatal care.
Main Results:
- 7.1% of children had defects by age five; 2.1% by age two, and 5.1% between two and five.
- Low birthweight and special postnatal care children had higher risks and visual impairment before age two.
- These high-risk factors did not persist between ages two and five.
- Defect incidence in specialist eye clinics increased from 1.1% (0-2 years) to 1.7% (2-5 years), mainly due to refractive errors.
Conclusions:
- While certain factors increase early childhood vision defect risk, this elevated risk is not sustained past age two.
- Refractive errors are a primary driver of increased vision defect diagnoses in older toddlers and preschoolers.
- Ongoing surveillance and early detection remain crucial for managing pediatric vision health.
Abstract:
Ocular and/or vision defects are one of the commonest reasons for the referral of young children to hospital. In a survey of a birth cohort in one health district, 7.1% of children were diagnosed as having such defects by their fifth birthday; 2.1% were detected before the age of 2 years, and 5.1% between 2 and 5 years. Up to the age of 2 years, low birthweight children and those who require postnatal special care had a higher risk of having an ocular or vision defect diagnosed and were more likely to have serious visual impairment than other children. In contrast, between the ages of 2 and 5 years of age these high risk children showed no continuing increased risk of having a defect diagnosed, nor did they show any differences in the severity or type of vision defects compared with other children. Averaged over the years studied, the incidence of defects presenting to specialist eye clinics among all 2-5 year olds was 1.7%, higher than the 1.1% found for 0-2 year olds. This increase consisted primarily of children with refractive errors only.