July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Unmet Eye Care Needs Among a Syrian Pediatric Refugee Population

Author Affiliations & Notes
  • myrna lichter
    OPhthalmology, Saint Michael's Hospital, Toronto, Ontario, Canada
    Ophthalmology, University of Toronto, Toronto, Ontario, Canada
  • Footnotes
    Commercial Relationships   myrna lichter, None
  • Footnotes
    Support  Islamic Relief
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 4092. doi:
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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)

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Purpose : 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.

Methods : 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.

Results : 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%).

Conclusions : 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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