Journal Highlights
American Journal of Ophthalmology, February 2020
Download PDF
Between 2012 and 2017, preschool-aged children were screened with an autorefractor in the Preschool Vision Program at the University of California, Los Angeles. In a summary of the five-year findings, Margines et al. noted that astigmatism was the most common refractive error (present in 53%); the frequency was highest among Latino children, who also had poorer uncorrected and corrected visual acuity. Amblyopia occurred in 1% of the study population. Nearly 8% of screened children received eyeglasses.
Of the 79,451 children who met eligibility criteria, 18% failed the initial screening and were offered another screening on a subsequent day. If specific criteria were met for myopia, hyperopia, astigmatism, or anisometropia, a full cycloplegic exam was conducted.
Only 56% of those who failed the screening returned for examination. Of those who did, 84% (n = 6,779) received the cycloplegic exam. Among these children, nearly 87% (n = 5,883) were found to need eyeglasses; another 7.3% (n = 498) received glasses from being in the care of an optometrist or ophthalmologist. Because exam results were similar for each child’s eyes, only the right-eye data were analyzed.
Among children with cycloplegic exams, hyperopia was found in 61%, myopia in 20%, and astigmatism in 93%. Astigmatism rates were highest among Latino children. An astigmatism cutoff of ≥1.50 D in either eye predicted the need for glasses in 93%; a cutoff of ≥1.50 D in both eyes increased the predictive value to 96%.
Refractive amblyopia was noted in 780 children (1% of those screened; 11.5% of those examined); 211 (27%) of them were bilateral amblyopes. Refractive errors varied significantly by age and ethnicity. The mean spherical equivalent (SE) for 3-year-olds was much lower than that of 4- and 5-year-olds (0.94, 1.2, and 1.2 D, respectively). The mean SE was 0.83 D for Asians, 1.0 D for blacks. 1.1 D for Latinos, and 2.1 D for whites.
According to the authors, this study represents the largest published sample of vision-screening results for preschoolers, and it provides further in-sight into the prevalence of common refractive errors and their link to race/ethnicity. The data can “inform screening criteria to more accurately identify children who need intervention to prevent permanent vision loss,” said the authors.
The original article can be found here.