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      Vision Screening, Vision Disorders, and Impacts of Hyperopia in Young Children: Outcomes of the Vision in Preschoolers (VIP) and Vision in Preschoolers – Hyperopia in Preschoolers (VIP-HIP) Studies

      Author(s): 1 , 2 , 3 , 4 , 5 , 6
      Publication date Created:
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      Journal: Asia-Pacific Journal of Ophthalmology
      Publisher: Ovid Technologies (Wolters Kluwer Health)

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          Abstract

          Abstract

          This review summarizes clinically relevant outcomes from the Vision in Preschoolers (VIP) and VIP–Hyperopia in Preschoolers (VIP-HIP) studies. In VIP, refraction tests (retinoscopy, Retinomax, SureSight) and Lea Symbols Visual Acuity performed best in identifying children with vision disorders. For lay screeners, Lea Symbols single, crowded visual acuity (VA) testing (VIP, 5-foot) was significantly better than linear, crowded testing (10-foot). Children unable to perform the tests (<2%) were more likely to have vision disorders than children who passed and should be referred for vision evaluation. Among racial/ethnic groups, the prevalence of amblyopia and strabismus was similar while that of hyperopia, astigmatism, and anisometropia varied. The presence of strabismus and significant refractive errors were risk factors for unilateral amblyopia, while bilateral astigmatism and bilateral hyperopia were risk factors for bilateral amblyopia. A greater risk of astigmatism was associated with Hispanic, African American, and Asian race, and myopic and hyperopic refractive error. The presence and severity of hyperopia were associated with higher rates of amblyopia, strabismus, and other associated refractive error. In the VIP-HIP study, compared to emmetropes, meaningful deficits in early literacy were observed in uncorrected hyperopic 4- and 5-year-olds [≥+4.0 diopter (D) or ≥+3.0 D to ≤+6.0 D associated with reduced near visual function (near VA 20/40 or worse; stereoacuity worse than 240”)]. Hyperopia with reduced near visual function also was associated with attention deficits. Compared to emmetropic children, VA (distance, near), accommodative accuracy, and stereoacuity were significantly reduced in moderate hyperopes, with the greatest risk in those with higher hyperopia. Increasing hyperopia was associated with decreasing visual function.

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          Prevalence of amblyopia and strabismus in white and African American children aged 6 through 71 months the Baltimore Pediatric Eye Disease Study.

          David Friedman, Michael X Repka, Joanne Katz … (2009)
          To determine the age-specific prevalence of strabismus in white and African American children aged 6 through 71 months and of amblyopia in white and African American children aged 30 through 71 months. Cross-sectional, population-based study. White and African American children aged 6 through 71 months in Baltimore, MD, United States. Among 4132 children identified, 3990 eligible children (97%) were enrolled and 2546 children (62%) were examined. Parents or guardians of eligible participants underwent an in-home interview and were scheduled for a detailed eye examination, including optotype visual acuity and measurement of ocular deviations. Strabismus was defined as a heterotropia at near or distance fixation. Amblyopia was assessed in those children aged 30 through 71 months who were able to perform optotype testing at 3 meters. The proportions of children aged 6 through 71 months with strabismus and of children aged 30 through 71 months with amblyopia. Manifest strabismus was found in 3.3% of white and 2.1% of African American children (relative prevalence [RP], 1.61; 95% confidence interval [CI], 0.97-2.66). Esotropia and exotropia each accounted for close to half of all strabismus in both groups. Only 1 case of strabismus was found among 84 white children 6 through 11 months of age. Rates were higher in children 60 through 71 months of age (5.8% for whites and 2.9% for African Americans [RP, 2.05; 95% CI, 0.79-5.27]). Amblyopia was present in 12 (1.8%) white and 7 (0.8%) African American children (RP, 2.23; 95% CI, 0.88-5.62). Only 1 child had bilateral amblyopia. Manifest strabismus affected 1 in 30 white and 1 in 47 African American preschool-aged children. The prevalence of amblyopia was <2% in both whites and African Americans. National population projections suggest that there are approximately 677,000 cases of manifest strabismus among children 6 through 71 months of age and 271 000 cases of amblyopia among children 30 through 71 months of age in the United States.
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            Prevalence of amblyopia or strabismus in asian and non-Hispanic white preschool children: multi-ethnic pediatric eye disease study.

            Kristina Tarczy-Hornoch, Mark Borchert, T. J. Kim … (2013)
            To determine the age- and race-specific prevalence of amblyopia in Asian and non-Hispanic white children aged 30 to 72 months and of strabismus in children aged 6 to 72 months. Cross-sectional survey. A population-based, multiethnic sample of children aged 6 to 72 months was identified in Los Angeles and Riverside counties in California to evaluate the prevalence of ocular conditions. A comprehensive eye examination and in-clinic interview were conducted with 80% of eligible children. The examination included evaluation of ocular alignment, refractive error, and ocular structures in children aged 6 to 72 months, as well as a determination of optotype visual acuity (VA) in children aged 30 to 72 months. The proportion of 6- to 72-month-old participants with strabismus and 30- to 72-month-olds with optotype VA deficits and amblyopia risk factors consistent with study definitions of amblyopia. Strabismus was found in 3.55% (95% confidence interval [CI], 2.68-4.60) of Asian children and 3.24% (95% CI, 2.40-4.26) of non-Hispanic white children, with a higher prevalence with each subsequent older age category from 6 to 72 months in both racial/ethnic groups (P=0.0003 and 0.02, respectively). Amblyopia was detected in 1.81% (95% CI, 1.06-2.89) of Asian and non-Hispanic white children; the prevalence of amblyopia was higher for each subsequent older age category among non-Hispanic white children (P=0.01) but showed no significant trend among Asian children (P=0.30). The prevalence of strabismus was similar in Asian and non-Hispanic white children and was found to be higher among older children from 6 to 72 months. The prevalence of amblyopia was the same in Asian and non-Hispanic white children; prevalence seemed to be higher among older non-Hispanic white children but was relatively stable by age in Asian children. These findings may help clinicians to better understand the patterns of strabismus and amblyopia and potentially inform planning for preschool vision screening programs. The author(s) have no proprietary or commercial interest in any materials discussed in this article. Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
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              Prevalence of amblyopia and strabismus in young singaporean chinese children.

              Jesse T Young, Tien-Yin Wong, Paul Mitchell … (2010)
              PURPOSE. To determine the prevalence of amblyopia and strabismus in young Singaporean Chinese children. METHODS. Enrolled in the study were 3009 Singaporean children, aged 6 to 72 months. All underwent complete eye examinations and cycloplegic refraction. Visual acuity (VA) was measured with a logMAR chart when possible and the Sheridan-Gardner test when not. Strabismus was defined as any manifest tropia. Unilateral amblyopia was defined as a 2-line difference between eyes with VA or =1.00 D for hyperopia, > or =3.00 D for myopia, and > or =1.50 D for astigmatism), strabismus, or past or present visual axis obstruction. Bilateral amblyopia was defined as VA in both eyes or =4.00 D, myopia or =2.50 D, or past or present visual axis obstruction. RESULTS. The amblyopia prevalence in children aged 30 to 72 months was 1.19% (95% confidence interval [CI], 0.73-1.83) with no age (P = 0.37) or sex (P = 0.22) differences. Unilateral amblyopia (0.83%) was twice as frequent as bilateral amblyopia (0.36%). The most frequent causes of amblyopia were refractive error (85%) and strabismus (15%); anisometropic astigmatism >1.50 D (42%) and isometropic astigmatism >2.50 D (29%) were frequent refractive errors. The prevalence of strabismus in children aged 6 to 72 months was 0.80% (95% CI, 0.51-1.19), with no sex (P = 0.52) or age (P = 0.08) effects. The exotropia-esotropia ratio was 7:1, with most exotropia being intermittent (63%). Of children with amblyopia, 15.0% had strabismus, whereas 12.5% of children with strabismus had amblyopia. CONCLUSIONS. The prevalence of amblyopia was similar, whereas the prevalence of strabismus was lower than in other populations.
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                Author and article information

                Journal
                Title: Asia-Pacific Journal of Ophthalmology
                Publisher: Ovid Technologies (Wolters Kluwer Health)
                ISSN (Electronic): 2162-0989
                Publication date Created: 2022
                Publication date (Electronic): January 2022
                Publication date (Electronic): January 18 2022
                Volume: 11
                Issue: 1
                Pages: 52-58
                Affiliations
                [1 ]The Ohio State University College of Optometry, Columbus, OH, US
                [2 ]Pennsylvania College of Optometry at Salus University, Elkins Park, PA, US
                [3 ]University of Pennsylvania, Philadelphia, PA, US
                [4 ]Indiana University School of Optometry, Bloomington, IN, US
                [5 ]New England College of Optometry, Boston, MA, US
                [6 ]University of California, Berkeley School of Optometry, Berkeley, CA, US.
                Article
                DOI: 10.1097/APO.0000000000000483
                PubMed ID: 35044337
                SO-VID: ee2aadaf-1e24-4988-acbb-74b19a8bc720
                Copyright © © 2022
                License:

                http://creativecommons.org/licenses/by-nc-nd/4.0

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