Abstract
Purpose: :
To compare the prevalence of amblyopia, strabismus, and significant refractive error among African American (AA), Asian , Hispanic, and Non-Hispanic White (NHW) 3- to 5-year-old children participating in Head Start (HS).
Methods: :
All children were participants in HS, a program providing comprehensive child development services to economically disadvantaged children and families, located in 5 areas of the country. Children classified as "special needs" (physical or mental disabilities) were excluded from VIP. After mandatory HS vision screening, all children who failed the HS screening and a sample of those who passed were selected for VIP. VIP-certified pediatric optometrists and ophthalmologists performed a standardized comprehensive ocular examination, including cycloplegic retinoscopy. Standard definitions were applied to identify amblyopia, strabismus, significant refractive error, and/or reduced visual acuity. Sampling fractions were used to calculate weights for estimation of prevalence rates, confidence intervals, and associated chi-square tests of homogeneity.
Results: :
Overall, 86.5% of those eligible and consenting to participate were examined in VIP. Examinations were performed on 2008 AA, 143 Asian, 870 Hispanic and 490 NHW children. Prevalence of amblyopia was similar among groups, ranging from 3.0% (Asian) to 5.3% (NHW), p=0.12. Prevalence of strabismus also was similar, ranging from 1.0% (Asian) to 4.4% (NHW), p=0.09. Prevalence of hyperopia varied by group, ranging from 5.6% (Asian) to 12.3% (NHW), p=0.001. Prevalence of anisometropia also varied by group, ranging from 2.7% (Asian) to 6.7% (Hispanic), p=0.04. Myopia was relatively uncommon in all groups (≤2%). Prevalence of astigmatism was similar among groups, ranging from 6.6% (NHW) to 11.1% (Hispanic), p=0.09.
Conclusions: :
Among Head Start children, the prevalence of amblyopia and strabismus is similar among the 4 racial and ethnic groups considered in this report. Prevalence of refractive error, specifically hyperopia and anisometropia, varied by group with Asians having the lowest rates.
Keywords: clinical (human) or epidemiologic studies: prevalence/incidence • amblyopia • strabismus