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Prevalence, causes and risk factors of reduced VA and persistent reduced VA among preschool children in Eastern China
Author(s) -
Zhang Xiaohan,
Li Rui,
Wang Yue,
Zhao Xiaoyan,
Hao Qingfeng,
Tong Haohai,
Chen Ping,
Yu Yingqing,
Liu Hu
Publication year - 2020
Publication title -
ophthalmic and physiological optics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.147
H-Index - 66
eISSN - 1475-1313
pISSN - 0275-5408
DOI - 10.1111/opo.12692
Subject(s) - medicine , refractive error , visual acuity , population , pediatrics , breastfeeding , epidemiology , ophthalmology , environmental health
Aims To determine prevalence, causes, and risk factors of reduced uncorrected visual acuity (UCVA), reduced presenting visual acuity (PVA), and persistent reduced visual acuity (VA) among Chinese preschool children. Methods The longitudinal, population‐based Nanjing Eye Study (NES) was carried out. Children underwent baseline comprehensive ocular examinations in 2016 (at 48–60 months old) and the follow‐up ocular examinations in 2017. A comprehensive questionnaire about children and their families was completed by their legal guardians. For children having reduced PVA at baseline, a follow‐up questionnaire about potential factors concerning VA correction was completed. Reduced VA was defined as VA worse than 0.30 logMAR (Snellen equivalent 6/12, 20/40), and persistent reduced VA was defined as reduced PVA in both 2016 and 2017. Results Among 1448 participants with both eye examinations and questionnaires completed, prevalence of reduced UCVA, reduced PVA, and persistent reduced VA at age of 60–72 months were 5.94%, 3.04%, and 1.59% respectively. Causes for reduced PVA were refractive error (79.5%), amblyopia (18.2%), and amblyopia combined nystagmus (2.3%). Among 23 children having persistent reduced VA, causes of reduced PVA remained unchanged in 13 children and 4 children developed amblyopia from refractive error. Younger age (OR = 1.09 for each month decrease, p = 0.01) and non‐breastfeeding (OR = 2.08, p = 0.03) were risk factors for reduced UCVA. Younger children with reduced UCVA were at higher risk of having reduced PVA (OR = 1.18 for each month decrease, p = 0.04). Children with siblings (OR = 5.95, p = 0.02) were more likely to have persistent reduced VA. Conclusions Future vision health promotion strategies among preschool children should focus on early vision‐screening and timely refractive correction. Apart from children of non‐breastfeeding mothers, attention should also be paid to children with siblings.