Abstract
Purpose :
To determine prevalence and causes of reduced vision in children by age in metropolitan Sydney .
Methods :
Cross-sectional analysis included 5 cohorts; 3-5 years (n=986) in the Sydney Paediatric Eye Disease Study (SPEDS), 6 years (n=1739) and 12 year olds (n=2345) in the Sydney Myopia Study (SMS) and its five year follow-up at 12 years (n=1111) and 17 years (n=1649) in the Sydney Adolescent Vascular and Eye disease Study (SAVES). A longitudinal analysis of incident cases of reduced vision between SMS baseline and SAVES follow-up only included children assessed in both studies. All children had a comprehensive ocular examination, including visual acuity (VA) with and without refractive correction. Reduced uncorrected VA was defined as <6/12. Ethics approval was obtained from the Human Research Ethics Committee at University of Sydney, New South Wales Department of Education and Training, and the Catholic Education Office. The studies adhered to the tenets of the Declaration of Helsinki.
Results :
The overall prevalence of reduced vision based on unaided VA increased with age from 4.5% in 3-5 year olds to 17.7% in 17 year olds (p<.001). The proportion of reduced vision caused by refractive error, amblyopia, strabismus and pathology also varied between cohorts. In the younger cohorts, amblyopia accounted for 21% of 3-5 year olds and 28% of 6 year olds with reduced vision. There was a substantial decline in reduced vision attributable to amblyopia in the older children, in whom refractive error was increasingly implicated. Myopia contributed to 18% of children with reduced vision in both the 3-5 and 6 year olds. This increased to ≥80% in children aged 12 and 17 years. The incidence rate of reduced VA was 13.5/1000 children per year between age 6 at baseline and 12 years at follow-up, and 11.6/1000 children per year between age 12 at baseline to 17 years at follow-up. This increase in incidence was largely caused by the onset of myopia. In those children with uncorrected reduced VA, only 52% of 12 year olds and 73% of 17 year olds wore glasses.
Conclusions :
Amblyopia caused reduced vision at a proportionally higher rate in younger children which supports preschool screening. Even within a well-serviced area such as metropolitan Sydney, further public education is required to promote understanding of myopia and visual impairment in adolescence and promote wearing of glasses.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.