Abstract
Purpose: :
To report the age and ethnic specific distributions of refractive error in European Caucasian (EC) and East-Asian (EA) children using cumulative probability distributions (CPD) to describe percentage cut-offs for myopia and hyperopia and prevalence of myopia and hyperopia using AAPOS Vision Screening Committee standards.
Methods: :
SPEDS is a large population-based study of preschool children that examined (2473) children aged 6 months to 6 years. Comprehensive eye examinations were performed on each child, including cycloplegic refraction, following 2 drops of cyclopentolate 1.0%, 5 mins apart (0.5% for children aged 12 months), using auto-refraction (Canon RK-F1 or Retinomax) or by retinoscopy. Refractive status was classified by spherical equivalent (SE) of the right eye. Ethnicity was ascertained by questionnaire and assigned when both parents were of the one ethnicity.
Results: :
2176 children completed cycloplegic refraction and were included in this report. 1013(41%)were EC and 444(18%) were EA origin. Using CPD ≤5%, EC children had myopic refractions of 0.13,-0.25,-0.13,0.32,0.38,0.13D, in each of the respective age groups of 6-11, 12-23, 24-35, 36-47, 48-59, 60-72months. ≥95% of EC children in each of the respective age groups had a hyperopic refraction of 4.38,2.5,3.38,3.00,2.88,3.19D. In EC children, refractive distributions were statistically different at ages 6-11 and 36-59months from the reference age group 12-23months(p=,0.0018, 0.0421 respectively). Mean refraction by age in EA children were all significantly different. The distribution of refractive error in EC children had a mean of 1.46D(95%CI 0.99-1.96, kurtosis 17.8) and in EA 1.02D(95%CI 0.36-1.52, kurtosis 8.6) Using AAPOS criteria 4.2% of EC were hyperopic, 3.6% were myopic; while EA were 1.4% hyperopic and 5.7% myopic.
Conclusions: :
Cut-off’s using a large population based study of preschool-aged children have been defined for myopia and hyperopia which could potentially aid in referral criteria and screening settings. Important ethnic and age-variations in prevalence’s and distribution of refractive error compared to other population-based studies have been found.
Keywords: refractive error development • hyperopia • myopia