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myrna lichter; Unmet Eye Care Needs Among a Syrian Pediatric Refugee Population. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4092.
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© ARVO (1962-2015); The Authors (2016-present)
There is a lack of data on vision problems in a pediatric refugee population in North America. We performed a cross-sectional, descriptive study to assess the prevalence of visual impairment and unmet eye care needs of Syrian refugee children in Toronto.
Five single-day clinics were organized. Enrolment was offered to Syrian refugees registered with resettlement agencies, not for profit organizations, and/or private sponsorship groups. Through a structured interview, socio-demographics, medical history, subjective visual acuity, and access to eye care information was collected from the accompanying parent. Comprehensive visual screening, slit-lamp, dilated direct funduscopy, and refractions were performed. Visual acuity data was compared to Canadian prevalence data. χ2 tests was used for statistical analysis.
278 patients were examined. The median age was 8 years (interquartile range (IQR)= 5-11) and 52% were females. Most patients lived outside Syria as refugees for 1 to 5 years (75.5%) and were enrolled in elementary school or less (48.9%). The prevalence of reported uncorrected vision problems was 17.2% for distance vision, 4.7% for near vision, and 0.7% for close and distance/no vision. A majority had not visited an eye specialist in the past year (95.2%) and 25.2% of parents were dissatisfied with their children’s vision.The presenting visual acuity in the better-seeing eye was 20/50 or worse in 5.8% (95% CI, 3.6%- 9.3%). By using pin-hole correction, this improved to 5.5% (95% CI, 3.3%- 8.8%). Compared to the Canadian population (0.17%), Syrian refugee children were 32 times more likely to have 20/50 vision or worse (p < 0.01).The most common finding was refractive error in 25.9% (95% CI, 20.9%-31.5%). Six-year old Syrian children were 4 times more likely to suffer from myopia compared to their Canadian counterparts (26.1% v. 6.4%, p < 0.01). The prevalence of non-refractive error was 7.6% (95% CI, 4.7%-11.3%). The most frequent non-refractive errors were cataracts (1.8%), strabismus (1.8%), glaucoma (1.1%), and traumatic corneal scaring (0.07%).
This is the first study to assess ocular health in a pediatric refugee population in Canada. Syrian refugee children have a high prevalence of visual impairment, even when living within a system of universal healthcare. Vision-screening programs and accessible eye clinics may address this need.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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