Prevalence of Visual Impairment in African-American and Hispanic Children Aged 30 to 72 Months: The Multi-Ethnic Pediatric Eye Disease Study

Abstract

Purpose: : To determine the age- and ethnicity-specific prevalence of visual impairment in African-American and Hispanic children aged 30 to 72 months.

Methods: : In a population-based sample of children aged 30 to 72 months in Los Angeles County, California, visual acuity (VA) was measured using the Amblyopia Treatment Study HOTV VA testing protocol with the Electronic Visual Acuity tester. Visual impairment (VI) was defined as VA worse than 20/40 in children >=48 months and worse than 20/50 in children 30-47 months. Those with VI at presentation (with current glasses if worn) were retested with correction the same day after cycloplegic refraction. Children who still had VI were scheduled for a retest on another day, as were those unable to do the test initially. Chi-square testing was used for prevalence comparisons.

Results: : 1690 Hispanic and 1663 African-American children >=30 months of age were tested. The prevalence of VI in the better-seeing eye according to best-recorded VA was the same (1.4%) in Hispanic and African-American children. Prevalence varied significantly with age in both Hispanic and African-American children (p=0.004 and 0.03, respectively). Only 0.6% of children 60-72 months had VI, compared to 4.1% of children 30-35 months old, in whom poor attention was often the only identifiable cause of apparent VI. VI in the worse-seeing eye according to best-recorded VA was seen in 3.6% of Hispanic children and 3.1% of African-American children (p=0.4). Presenting VA was impaired in the better eye of 2.4% of Hispanics and 2.6% of African-Americans (p=0.71); it was impaired in the worse eye slightly more often in Hispanic children (9.5%) than African-American children (7.4%) (p=0.03).

Conclusions: : The prevalence of VI is similar in Hispanic and African-American preschool children. Presenting VA is more often impaired than best-recorded VA, due to uncorrected refractive error and improved test performance with retesting. Apparent VI is more common in younger children than in older children, probably because of limited attention and cooperation in some young children leading to poor performance on visual acuity testing.

Keywords: clinical (human) or epidemiologic studies: prevalence/incidence • visual acuity