Abstract
Purpose: :
Although globally uncorrected refractive error is reported to be the most common cause of visual impairment in school-age children, little is known about the extent of uncorrected refractive error in the United Kingdom where vision screening occurs at school entry. We investigated the prevalence of uncorrected refractive error in school-children living in a large metropolitan area of central England.
Methods: :
This was a cross-sectional study of children aged 6-7 years and 12-13 years who were recruited from a stratified (based on socioeconomic status) random sample of schools in Birmingham, England. Participants were tested at school with assent from the child and consent from their parent/guardian. Measurements of LogMAR vision, visual acuity and cycloplegic open-field autorefraction were taken. For the purposes of this study the refractive definitions used were: myopia ≤-0.50D spherical equivalent refraction (SER), hyperopia ≥+2.00D SER and astigmatism ≥1.00DC in either eye. History of spectacle wear and previous vision screening were recorded.
Results: :
Data were available for 648 children, n=352 for 6-7-year-olds and n=296 for 12-13-year-olds. For children with no history of current spectacle wear, uncorrected myopia was found in 10.1% (95% CIs 6.7-13.6) 12 -13 year olds and 6.9% (95% CIs 4.1-9.8) 6-7 year olds; uncorrected hyperopia was found in 2.7% (95% CIs 0.6-4.1) 12 -13 year olds and 8.3% (95% CIs 5.2-11.4) 6-7 year olds. Uncorrected astigmatism was found in 10.5% (95% CIs 7.0-14.0) 12 -13 year olds and 10.3% (95% CIs 6.8-13.7) 6-7 year olds. The prevalence of uncorrected ametropia did not vary significantly with socioeconomic status or ethnicity.
Conclusions: :
It appears that uncorrected refractive error is a significant problem for at least 30% of school children in England. Despite the free and universal access to child eye care available in the UK through the National Health Service, the findings indicate that a general lack of eye care awareness exists in this population and is not specific to socioeconomic status or ethnicity.
Keywords: myopia • hyperopia • clinical (human) or epidemiologic studies: health care delivery/economics/manpower