Purchase this article with an account.
Kristina Tarczy-Hornoch, Rohit Varma, Susan A. Cotter, Roberta McKean-Cowdin, Mark S. Borchert, James M. Tielsch, David S. Friedman, Michael X. Repka, Joanne Katz, Multi-Ethnic Pediatric Eye Disease Study (MEPEDS)and Baltimore Pediatric Eye Disease Study (BPEDS); Risk Factors for Decreased Visual Acuity in Preschool Children: the Multi-Ethnic Pediatric Eye Disease Study and the Baltimore Pediatric Eye Disease Study. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6326.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To investigate risk factors associated with unilateral or bilateral decreased visual acuity in preschool children.
Population-based samples of 6504 children ages 30-72 months from California and Maryland were studied. Odds ratios (ORs) were determined for various risk factors associated with inter-ocular difference (IOD) in visual acuity (VA) of 2 or more lines with 20/32 or worse in the worse eye, or bilateral decreased VA worse than 20/40 or worse than 20/50 if younger than 48 months of age.
In multivariate logistic regression analysis, 2-line IOD with VA 20/32 or worse was independently associated with Hispanic ethnicity (OR 2.05); esotropia (OR 8.98); spherical equivalent (SE) anisometropia (ORs ranging from 1.5 for SE anisometropia 0.50 to <1.00 diopters (D), to 39.7 for ≥2.00 D); and aniso-astigmatism in J0 or J45 (ORs ranging from 1.4 for J0 or J45 differences of 0.25 to <0.50 D, to ≥5.3 for ≥1.00 D). Bilateral decreased VA was independently associated with lack of health insurance (OR 2.9); no breastfeeding (OR 2.0); astigmatism (OR 2.5 and 17.6 for astigmatism 1.00 to <2.00 D and ≥2.00 D); and SE hyperopia ≥4.00 D (OR 10.3).
Relatively low levels of anisometropia and esotropia are correctable risk factors for inter-ocular differences in visual acuity. Lack of breast feeding, astigmatism and high hyperopia are correctable risk factors for bilateral decreased visual acuity. Current guidelines for the screening and management of decreased visual acuity in preschool children with these risk factors should be reconsidered.
This PDF is available to Subscribers Only