June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Current Visual Acuity and Refractive Errors among Indigenous Children in Northern Canada
Author Affiliations & Notes
  • Kourosh Sabri
    McMaster Children's Hospital, Hamilton, Ontario, Canada
    McMaster University, Hamilton, Ontario, Canada
  • Yasmin Jindani
    McMaster University, Hamilton, Ontario, Canada
  • Melanie De Melo
    McMaster University, Hamilton, Ontario, Canada
  • Elaine Innes
    Weeneebayko Area Health Authority, Moose Factory, Ontario, Canada
  • Sandra Kioke
    Weeneebayko Area Health Authority, Moose Factory, Ontario, Canada
  • Footnotes
    Commercial Relationships   Kourosh Sabri None; Yasmin Jindani None; Melanie De Melo None; Elaine Innes None; Sandra Kioke None
  • Footnotes
    Support  The project is funded by the Jordan’s Principal branch of the Federal Ministry of Indigenous Services Canada.
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 3368 – A0155. doi:
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      Kourosh Sabri, Yasmin Jindani, Melanie De Melo, Elaine Innes, Sandra Kioke; Current Visual Acuity and Refractive Errors among Indigenous Children in Northern Canada. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3368 – A0155.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : The health inequalities that exist between Indigenous and non-Indigenous Canadians begin in childhood and diverge further from this foundational developmental period. Indigenous children are at high risk for visual impairment (VI) due to limited access to vision care services with a risk of blindness six times greater than non-Indigenous children. These communities consist of a large youth demographic with 28% under the age of fourteen. This study provides data on prevalence and causes of VI in Indigenous children living in remote northern Ontario, Canada.

Methods : This cross-sectional study included 259 Indigenous children aged 8 months to 18 years living in remote northern communities along James Bay, Ontario served by the Weeneebayko Area Health Authority. All children underwent at least one complete eye examination between November 2020 and November 2021, including cycloplegic refraction.

Results : Of the 259 children examined (age range 0.67 to 18 years, mean 10.3, median 9.0 years) the main cause of treatable or avoidable VI was uncorrected refractive error. Of the examined children, 203 (78%) had refractive errors, of which, 156 (77%) did not use correction. Visual acuity (VA) was measured in 518 eyes of 259 subjects and ranged from 20/15 to counting fingers (CF). Of the 203 children with refractive error, 69 (34%) experienced mild VI, (VA worse than 20/40 up to 20/60 in the better-seeing eye), 55 (27%) experienced moderate VI, (VA worse than 20/60 up to 20/200 in the better-seeing eye) and 12 (6%) children experienced severe VI, ( VA worse than 20/200 in the better seeing-eye). The overall prevalence of myopia was 33% (85) (range -0.5DS up to -7.0DS of eyes examined, mean -2.3DS, median -2.0DS) and of hyperopia was 29% (76) (range +0.5DS up to +7.0DS of eyes examined, mean +1.8DS, median +1.5DS). Astigmatism was evident in 66% (171) (range -0.5DC up to -5.5DC of eyes examined, mean -2.0DC, median -1.8DC). Of the 259 children, 107 (41%) had never previously received an eye examination.

Conclusions : These findings suggest high rates of uncorrected refractive error, particularly astigmatism, resulting in poor vision among Indigenous children. There is an urgent need to address the gap in the delivery of eye care to Indigenous Canadians.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.


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