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S. H. Sharbini, J. J. Wang, G. Burlutsky, K. A. Rose, P. Mitchell, Sydney Childhood Eye Study, Sydney Myopia Study; Parental Factors Associated With Strabismus in a Population-Based Sample of 12-Year Old Australian Children. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1807.
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© ARVO (1962-2015); The Authors (2016-present)
To examine the prevalence and associated factors of strabismus in a population-based random cluster sample of 12-year old students.
The Sydney Myopia Study randomly selected 21 secondary schools, stratified by socio-economic status (SES); 2353 children aged 12 years (75.3% response rate) were examined. Cycloplegic autorefraction, LogMAR visual acuity, cover tests (cover/uncover alternate, prism bar) at near and distance were performed. Medical and perinatal histories were obtained using parental questionnaires. Parental home-ownership was used to represent SES. Ethnicity was assigned only when both parents were from the same ethnic group.
Strabismus was detected in 63 children (2.7%), including 28 (44.4%) with esotropia and 35 (55.6%) with exotropia. There was no significant gender difference in the prevalence of strabismus (3.2% in girls; 2.2% in boys, p=0.1). There was also no ethnicity difference in the prevalence of strabismus (2.6 % in European Caucasian; 3.7% in East Asian and 2.1% in children with other ethnicities, p=0.4), nor in the prevalence of esotropia (1.4%, 0.85% and 0.84%, respectively) or exotropia (1.1%, 2.8% and 1.3%, respectively, p=0.1). Mean birthweight was not significantly different between children who had strabismus (3269 g, SD, 726.7) and those without (3352g, SD 563.2, p=0.4). Children with exotropia had slightly lower mean birthweight (3144g, SD 593.1), significantly different from that for children without strabismus, even after adjusting for ethnicity (p=0.048). The prevalence of strabismus was higher in children from low SES families (no home ownership, 4.2%) than those from higher SES families (2.4%, odds ratio, OR, 2.1, 95% confidence interval, CI 1.1-3.9) and in children with a history of maternal smoking (4.7%) than those without this exposure (2.5%, OR 2.1, 95% CI 1.0-4.4), after adjusting for ethnicity and birthweight. In a final model adjusting for birthweight, ethnicity, SES and history of maternal smoking, the associations between strabismus and low SES (OR 1.8, 95% CI 0.96-3.5) and maternal smoking history (OR 1.8, 95% CI 0.85-3.82) became marginally non-significant. Birthweight was no longer significant in the final model.
Our study shows that smoking by mothers during pregnancy and low familial SES may increase the likelihood of strabismus.
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