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Shibin Lin, Mingzhi Zhang, Yuqiang Huang, Kunliang Qiu, Bin Chen; Population Prevalence and Psychological Correlates of Strabismus among Urban and Rural School Children in Southern China. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1760.
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To determine the prevalence and psychological correlates of strabismus among urban and rural students in southern China.
A population-based, cross-sectional study in Shantou, China, enrolled 7537 students, aged 6 to 19 years. Comprehensive ophthalmologic examinations and orthoptic assessments were performed. Cover testing was performed at near and distance, and with spectacles if worn. Strabismus was defined as any heterotropia at near or distance on cover testing. All subjects in grade 3 and above were given a self-administered questionnaire concerning health-related behaviors. Logistic regression was used to model differences between orthophoric and strabismic children.
The prevalence of strabismus in children aged 6 to 19 years was 10.9%. The exotropia-esotropia ratio was 14.4:1. Intermittent exotropia was most common, with a prevalence of 7.98%. The overall strabismus prevalence was lower in urban than in rural areas (primary school, P<0.05; high school, P<0.05). In regression models, strabismus was associated with increasing age (P<0.05). Primary school students with strabismus were more likely to have sleep disturbance (P<0.05) and a recent history of anxiety (P<0.05) than orthophoric children. Middle and high school students with strabismus were more likely to have a history of injury (P<0.05), depression (P<0.05) and anxiety (P<0.05).
The prevalence of strabismus appears to be higher in China than has been reported for other populations, and the condition is associated with a significant burden of psychological disorders
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