UCI EyeMobile for Children 2022-2023 School Year: Refractive Error and Amblyopia Prevalence

Abstract

Purpose : Uncorrected refractive errors (REs) and amblyopia lead to visual impairment with deleterious effects on quality of life and proper childhood development. Early detection and treatment by community vision care programs, such as the UCI EyeMobile for Children, have positive health and economic implications.

Methods : 5,074 children between the ages of 3 and 10 were screened at 153 locations, including preschools, head start programs, and elementary schools throughout Orange County (OC), California. Subsequently, 1,024 children presented for comprehensive eye examinations. A retrospective analysis of all examined children determined the prevalence and severity of REs and amblyopia and the spectacle prescription rate by age and by OC congressional districts. RE spherical equivalent (SE) was calculated as spherical plus half cylindrical error in diopter (D) units. Myopia and hyperopia were defined as |SE| ≥ 0.5D, with anisometropia as intraocular SE difference ≥ 1.00D. RE severity was categorized as: mild (0.50 – 1.75D), moderate (2.00 – 3.75D), moderately severe (4.00 – 5.75D), and severe (> 6.00D). The overall severity of RE was evaluated based on rate constant (k) determined by exponential distribution fit analysis. Propensity score matching analysis assessed the effect of median household income on RE and amblyopia frequency.

Results : Among the examined population, significant rates of RE and amblyopia were detected: myopia (24.4%), hyperopia (35.4%), astigmatism (71.8%), anisometropia (8.9%), amblyopia (7.0%), and amblyopia risk (14.4%). The majority (65.0%) received prescription spectacles from UCI EyeMobile, with around a third requiring a new or updated prescription. Children with or at risk of amblyopia had higher RE rates, with overall milder myopia (k = 2.17 vs 1.52), more severe hyperopia (k = 0.64 vs 1.30), and significantly more severe astigmatism, shifting to a gaussian distribution. The rates of REs, amblyopia, and spectacle prescriptions were uniform across OC districts. Household income was significantly associated with myopia (p=0.03) and amblyopia risk (p=0.002).

Conclusions : The UCI EyeMobile for Children serves as a vital vision care program, providing free vision screening, comprehensive eye examinations, and spectacles. A significant number of children required examination, leading to detection of high rates of RE and amblyopia, with subsequent provision of prescription spectacles.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.