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J. Katz, L. Giordano, D. S. Friedman, M. X. Repka, J. Ibironke, P. Hawse, J. M. Tielsch; Prevalence of Refractive Errors Among Preschool Children in the Baltimore Pediatric Eye Disease Study. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1549.
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To determine the age-specific prevalence of refractive errors in White and African-American preschool age children.
The Baltimore Pediatric Eye Disease Study is a population-based evaluation of the prevalence of ocular disorders in children age 6 through 71 months in Baltimore, Maryland, United States. Among 4,132 children identified, 3,990 eligible children (97%) were enrolled and 2,546 children (62%) were examined. Cycloplegic autorefraction was attempted on all children using a handheld Nikon Retinomax K-Plus 2. An instrument-generated confidence level of 8, 9, or 10 was required for the measurement to be considered reliable. A maximum of three autorefraction attempts were made for each eye to achieve this confidence level. If a reliable autorefraction could not be obtained, a study-certified optometrist or ophthalmologist performed cycloplegic streak retinoscopy in a dim room with the child fixating at distance.
The mean right eye spherical equivalent was 1.49D (SD=1.23) in Whites and 0.71D (SD=1.35) in African Americans. Spherical equivalence did not decline with age. The prevalence of myopia of 1D or more in the eye with the lesser refractive error was 0.7% in Whites and 5.5% in African Americans. The prevalence of hyperopia of 3D or more was 8.9% in Whites and 4.4% in African Americans. A higher proportion of African Americans were emmetropic (>-1D to <+1D) than Whites (58% versus 36%). The prevalence of astigmatism was similar in Whites and African Americans. With-the-rule astigmatism of 1.5D or more in the eye with greater astigmatism (8.3% in Whites and 9.0% in African Americans) was more prevalent than oblique (0.7% in Whites and 1.0% in African Americans) or against-the-rule astigmatism (2.4% in Whites and 3.1% in African Americans).
Refractive errors are not prevalent in this population of urban preschool children. Hyperopia was more common than myopia, especially among White children. Emmetropia did not increase with age.
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