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Xuejuan Jiang, Kristina Tarczy-Hornoch, Susan A Cotter, Mina Torres, Rohit Varma; Dilated Eye Examination among Multi-ethnic Preschool Children. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3095.
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© ARVO (1962-2015); The Authors (2016-present)
To identify the prevalence of and factors associated with having had a previous dilated eye exam among multiethnic preschool children.
Data were obtained from the Multiethnic Pediatric Eye Disease Study, a population-based cross-sectional study of 9,197 African-American (AA), Hispanic (HW), Asian American (AS), and non-Hispanic white (NHW) children 6-72 months of age identified in Los Angeles. A parental interview and a detailed ocular exam were performed. Logistic regression was used to evaluate independent associations between dilated eye exam and demographic, behavioral, and clinical factors identified in the parental interview.
The prevalence of dilated eye exam was 6.3% among preschool children overall, ranging from 2.8% in 6-12 month-old children to 11.6% in 61-72 month-old children. In children with strabismus, only 38% had a previous dilated eye exam. The prevalence of dilated eye exam in strabismic children varied significantly by subtype of strabismus (p<0.001): 54% for esotropia and 23% for exotropia. In 4+ year-old children with amblyopia, only 29% had a previous dilated eye exam. The prevalence of dilated eye exam seemed to vary by race/ethnicity: 8.1% for NHW children, 4.9% for HWs, 6.3% for AAs, and 7.9% for ASs. However, in multivariate analysis of demographic, behavioral and clinical factors obtained from parental interview, a higher prevalence of dilated eye exam was not associated with race/ethnicity, and was independently associated with older age, having a gestational age of <33 weeks, having Down syndrome, having cerebral palsy, a family history of strabismus, and having vision insurance coverage. In children with strabismus, dilated eye exam prevalence was 74% for NHW children, 36% for HWs, 25% for AAs, and 37% for ASs. This variation remained significant after adjusting for strabismus subtype and the risk factors identified in the overall analysis. There was no racial/ethnic disparity after adjustment for other predictors in 4+ year-old children with amblyopia.
Dilated eye exam was relatively rare among preschool children, even among those with ocular disorders such as amblyopia and strabismus, and was limited to a small subset of children with unique characteristics. Interventions are needed to provide broad access to preventive eye care and treatment for preschool children, including evidence-based vision screening/examinations.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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