1
|
Lai YH, Chang SJ. Efforts to improve the surgical outcome for exotropia and investigation of the insertion locations of the extraocular muscles. Kaohsiung J Med Sci 2023; 39:834-841. [PMID: 37341429 DOI: 10.1002/kjm2.12724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/16/2023] [Accepted: 05/31/2023] [Indexed: 06/22/2023] Open
Abstract
In our previous retrospective study, we found that using the strabismus surgery dosages established by western strabismus mentors tends to result in undercorrection of Taiwanese exotropia (XT) patients compared with those in western populations. We also discovered that the location of extraocular muscle (EOM) insertion could vary by ethnicity. In this study, using a generalized estimation equation model, we compared the XT surgery outcome between augmented and original strabismus surgery dosages in Taiwanese patients. We also conducted an observational study to investigate the horizontal EOM insertion location in a Taiwanese population and compared the data with Dr. Apt L.'s study. For Taiwanese XT patients, augmented surgical dosages resulted in significantly better outcome at 6 months and 1 year postoperatively compared with original surgical dosages (p = 0.003 and p < 0.001, respectively). The distance from the lateral recuts muscle (LR) insertion location to the limbus was significantly shorter in Taiwanese than in white Americans (6.5 vs. 6.9 mm, respectively, p = 0.0001). Furthermore, the medial rectus muscle and LR insertion locations differed significantly between males and females (p < 0.001 and p = 0.023, respectively). The patients' sex did not affect the surgery outcome. Augmented surgery doses modified from western strabismus mentors produce better surgery outcome for Taiwanese XT patients. Surgeons may require country-specific guidelines for strabismus surgery dosage. We also demonstrated a simple method for young ophthalmologists to establish their own normograms to improve their surgical success rate. Our study confirms that LR insertion locations differ between Taiwanese and White Americans.
Collapse
Affiliation(s)
- Yu-Hung Lai
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Ophthalmology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shun-Jen Chang
- Department of Kinesiology, Health and Leisure Studies, National University of Kaohsiung, Kaohsiung, Taiwan
| |
Collapse
|
2
|
Monika M, Durajczyk M. Evaluation of the Prevalence of Refractive Defects and Ocular Function in a Group of 1518 Children Aged 8 Years in Northwestern Poland-A Retrospective Study. J Clin Med 2023; 12:jcm12082880. [PMID: 37109217 PMCID: PMC10143658 DOI: 10.3390/jcm12082880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/04/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
PURPOSE To determine the prevalence of refractive errors in a group of 8-year-old school children in northwestern Poland. MATERIAL AND METHODS In 2017-2019, refractive errors were examined in a group of 1518 Caucasian children aged 8 years old with cycloplegia. Refraction was obtained with a hand-held autorefractor (Retinomax 3). The refractive error reading was expressed as the spherical equivalent (SE) as myopia (≤-0.5 D), emmetropia (>-0.5 D to ≤+0.5 D), mild hyperopia (>+0.5 D to ≤+2.0 D) and hyperopia (>+2.0 D), and astigmatism (≤-0.75 DC) and anisometropia (≥1.00 D). Data analysis was performed using Statistica 13.5 software and included Pearson's chi-squared and Mann-Whitney U tests. p-values of <0.05 were considered statistically significant. RESULTS Mild hyperopia was most common (37.6%), myopia was observed in 16.8% and astigmatism in 10.6% of participants. Pseudomyopia concerned up to 51.91% children. Girls were significantly more likely to have mild hyperopia (p = 0.0144) and were significantly more likely to wear glasses (p = 0.00093). CONCLUSIONS Screening children for refractive errors after cycloplegia is key for detecting accommodative spasm and refractive errors. The largest group of children presented with mild hyperopia, which is a physiological feature of refraction in 8-year-old children, but myopia and astigmatism were the most common refractive errors.
Collapse
Affiliation(s)
- Modrzejewska Monika
- Department of Ophthalmology, Pomeranian Medical University in Szczecin in Poland, Al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland
| | - Magdalena Durajczyk
- Department of Ophthalmology, Pomeranian Medical University in Szczecin in Poland, Al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland
| |
Collapse
|
3
|
Khouj G, Alharbi A, Alghamdi W, Alzahrani Y, Fallata A. Uncorrected Refractive Errors Among Children Attending Pediatric Ophthalmology Clinic at Security Forces Hospital, Makkah, Saudi Arabia. Cureus 2023; 15:e36234. [PMID: 37069875 PMCID: PMC10105575 DOI: 10.7759/cureus.36234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Refractive errors are globally one of the most prevalent ocular disorders among pediatrics. This study aimed to determine the pattern of uncorrected refractive errors among children attending pediatric ophthalmology clinics at Security Forces Hospital, Makkah, Saudi Arabia. METHODS This was a retrospective cohort clinic-based study including the records of children attending the pediatric ophthalmology clinic at Security Forces Hospital, Makkah, Saudi Arabia, between July 2021 and July 2022 who were diagnosed with refractive errors, ages between 4 and 14 years. RESULTS A total of 114 patients were included in the study while 26 patients with other ocular disorders were excluded from the study. The mean age of children included in the study was 9.1 ± 2.9. The most prevalent refractive errors were hyperopic astigmatism (64%), followed by myopic astigmatism (28.1%), then myopia (5.3%), and hyperopia (2.6%). The overall uncorrected refractive error of this study was estimated to be 36%. No significant association was found between the factors of age and gender on the type of refractive errors (P-value > 0.05). CONCLUSION The most prevalent pattern of uncorrected refractive errors among children attending pediatric ophthalmology clinics at Security Forces Hospital, Makkah, Saudi Arabia was hyperopic astigmatism followed by myopic astigmatism. No differences were found between different age groups and between genders on the type of refractive errors. Implementation of adequate vision screening programs for school-aged children is essential to detect uncorrected refractive errors at an early age.
Collapse
|
4
|
Shah R, Edgar DF, Evans BJW. Worsening vision at age 4-5 in England post-COVID: Evidence from a large database of vision screening data. Ophthalmic Physiol Opt 2023; 43:454-465. [PMID: 36866712 DOI: 10.1111/opo.13112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 03/04/2023]
Abstract
PURPOSE Myopia prevalence has increased in the UK at age 10-16y, but little is known about younger children. We hypothesise that if the 'myopia epidemic' is affecting young children, then there will be increasing rates of bilateral reduced unaided vision (V) at vision screenings of children 4-5 years of age. METHODS Retrospective anonymised data from computerised vision screening at age 4-5 years were analysed from serial cross-sectional data. Refractive error is not assessed in UK vision screening, so vision was investigated. Data were only included from schools that screened every year from 2015/16 to 2021/22. The criterion used was unaided monocular logMAR (automated letter-by-letter scoring) vision >0.20 in both the right and left eyes, so as to maximise the chances of detecting bilateral, moderate myopia rather than amblyopia. RESULTS Anonymised raw data were obtained for 359,634 screening episodes from 2075 schools. Once schools were excluded where data were not available for every year and data were cleaned, the final database comprised 110,076 episodes. The proportion (percentage and 95% CI) failing the criterion from 2015/16 to 2021/22 were 7.6 (7.2-8.0), 8.5 (8.1-8.9), 7.5 (7.1-7.9), 7.8 (7.4-8.2), 8.7 (8.1-9.2), 8.5 (7.9-9.0) and 9.3 (8.8-9.7), respectively. The slope of the regression line showed a trend for increasing rates of reduced bilateral unaided vision, consistent with increasing frequency of myopia (p = 0.06). A decreasing linear trendline was noted for children 'Under Professional Care'. CONCLUSIONS For children 4-5 years of age, there were signs of reduced vision over the last 7 years in England. Consideration of the most likely causes support the hypothesis of increasing myopia. The increase in screening failures highlights the importance of eye care in this young population.
Collapse
Affiliation(s)
- Rakhee Shah
- Institute of Optometry, London, UK.,Centre for Applied Vision Research, City, University of London, London, UK
| | - David F Edgar
- Institute of Optometry, London, UK.,Centre for Applied Vision Research, City, University of London, London, UK
| | - Bruce J W Evans
- Institute of Optometry, London, UK.,Centre for Applied Vision Research, City, University of London, London, UK
| |
Collapse
|
5
|
Hashemi H, Khabazkhoob M, Fayaz M, Emamian MH, Yekta A, Iribarren R, Fotouhi A. Refractive Errors and Their Associated Factors in Schoolchildren: A Structural Equation Modeling. Ophthalmic Epidemiol 2023; 30:46-56. [PMID: 35333680 DOI: 10.1080/09286586.2022.2048397] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To determine the prevalence of myopia and hyperopia in Shahroud schoolchildren and their risk factors. METHODS Optometric examinations including the measurement of uncorrected and corrected visual acuity as well as non-cycloplegic and cycloplegic refraction using retinoscopy were done for students. Generalized Structural Equation Modeling (GSEM) was used to determine direct and indirect effects of independent variables on myopia and hyperopia. RESULTS The data of 5581 students with a mean age of 9.24 ± 1.7 years were used in this study. The prevalence of myopia was 5.0% (95%CI: 4.3-5.7) and the prevalence of hyperopia was 4.8% (95%CI: 4.0 - 5.5) in all schoolchildren. According to the GSEM results, the odds of myopia in rural areas were 0.55 compared to urban areas. A one-unit increase in the ocular AL increased the odds of myopia by 4.91 times. The interaction of sex and age on myopia was significant such that in girls, the odds of myopia increased by 20% for every one-year increase in age while no significant change was seen in boys. A one-unit increase in the ocular AL decreased the odds of hyperopia by 0.49 times. Moreover, the interaction of outdoor activity hours and sex on the prevalence of hyperopia was significant such that increased outdoor activity reduced the odds of hyperopia in girls while no significant correlation was found in boys. CONCLUSION Myopia and hyperopia had moderate prevalence. Axial Length had the largest direct association on myopia and hyperopia. Age and outdoor activity had weak associations on refractive errors.
Collapse
Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Psychiatric Nursing and Management, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa Fayaz
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Abbasali Yekta
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
6
|
Danemayer J, Boggs D, Delgado Ramos V, Smith E, Kular A, Bhot W, Ramos-Barajas F, Polack S, Holloway C. Estimating need and coverage for five priority assistive products: a systematic review of global population-based research. BMJ Glob Health 2022; 7:bmjgh-2021-007662. [PMID: 35101862 PMCID: PMC8804659 DOI: 10.1136/bmjgh-2021-007662] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/10/2021] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION To improve access to assistive products (APs) globally, data must be available to inform evidence-based decision-making, policy development and evaluation, and market-shaping interventions. METHODS This systematic review was undertaken to identify studies presenting population-based estimates of need and coverage for five APs (hearing aids, limb prostheses, wheelchairs, glasses and personal digital assistants) grouped by four functional domains (hearing, mobility, vision and cognition). RESULTS Data including 656 AP access indicators were extracted from 207 studies, most of which (n=199, 96%) were cross-sectional, either collecting primary (n=167) or using secondary (n=32) data. There was considerable heterogeneity in assessment approaches used and how AP indicators were reported; over half (n=110) used a combination of clinical and self-reported assessment data. Of 35 studies reporting AP use out of all people with functional difficulty in the corresponding functional domains, the proportions ranged from 4.5% to 47.0% for hearing aids, from 0.9% to 17.6% for mobility devices, and from 0.1% to 86.6% for near and distance glasses. Studies reporting AP need indicators demonstrated >60% unmet need for each of the five APs in most settings. CONCLUSION Variation in definitions of indicators of AP access have likely led to overestimates/underestimates of need and coverage, particularly, where the relationship between functioning difficulty and the need for an AP is complex. This review demonstrates high unmet need for APs globally, due in part to disparate data across this sector, and emphasises the need to standardise AP data collection and reporting strategies to provide a comparable evidence base to improve access to APs.
Collapse
Affiliation(s)
- Jamie Danemayer
- Department of Computer Science, Global Disability Innovation Hub, University College London, London, UK
| | - Dorothy Boggs
- International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Emma Smith
- Department of Psychology, Assisted Living and Learning Institute, Maynooth University, Maynooth, Ireland
| | - Ariana Kular
- Department of Health Sciences, Mental Health and Wellbeing, University of Warwick, Warwick, UK
| | - William Bhot
- Department of Computer Science, Global Disability Innovation Hub, University College London, London, UK
| | - Felipe Ramos-Barajas
- Department of Computer Science, Global Disability Innovation Hub, University College London, London, UK
| | - Sarah Polack
- International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK
| | - Cathy Holloway
- Department of Computer Science, Global Disability Innovation Hub, University College London, London, UK
| |
Collapse
|
7
|
Sume BW, Seyoum G. Prevalence of refractive errors among school students in Ethiopia: A systematic review and meta-analysis. SAGE Open Med 2022. [DOI: 10.1177/20503121221127096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: Refractive errors are most common ocular disorders among children and adolescents. They remain as secondary causes of avoidable blindness in impoverished areas in Africa, most notably in Ethiopia. The problem worsens if it is not managed and addressed early. The aim of this systematic review and meta-analysis was to determine the prevalence of refractive errors among school students in Ethiopia. Methods: We searched international databases such as PubMed/Medline, Web of Science, CINAHL, Embase, Scopus, Cochrane Library, Google Scholar, and Science Direct for relevant articles. Data were extracted using Microsoft Excel and exported to Stata version 14.0 software for analysis. The Cochrane Q and I2 tests were used to assess heterogeneity. Funnel plot, Egger’s, and Begg’s tests were used to assess reporting bias. Random effect meta-analysis model was employed to estimate pooled prevalence of refractive errors. A regional subgroup analysis was carried out. Results: We reviewed 22 qualified studies with 23,355 study participants. The overall prevalence of refractive errors among school students was 7.36% (95% confidence interval = 6.05, 8.67). The prevalence of myopia, hyperopia, and astigmatism was 5.10% (95% confidence interval = 3.79, 6.40), 0.95% (95% confidence interval = 0.59, 1.31), and 0.01% (95% confidence interval = 0.01, 0.04), respectively. From subgroup analysis, the highest prevalence of refractive errors was reported in Amhara Region (9.18%, 95% confidence interval = 6.63, 11.74), followed by Southern Nations, Nationalities, and Peoples’ region (6.78%, 95% confidence interval = 4.65, 8.92) while the lowest prevalence of refractive errors was reported in Addis Ababa (3.93%, 95% confidence interval = 3.30, 4.56). Conclusion: In Ethiopia, the prevalence of refractive errors among school students is higher (7.36%) compared to what it was 5 years (7.05%) ago. Amhara Region has the highest prevalence of refractive errors among school students in Ethiopia with myopia being the most common type of refractive error.
Collapse
Affiliation(s)
- Bickes Wube Sume
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Girma Seyoum
- Department of Anatomy, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
8
|
Hu B, Liu Z, Zhao J, Zeng L, Hao G, Shui D, Mao K. The Global Prevalence of Amblyopia in Children: A Systematic Review and Meta-Analysis. Front Pediatr 2022; 10:819998. [PMID: 35601430 PMCID: PMC9114436 DOI: 10.3389/fped.2022.819998] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/15/2022] [Indexed: 01/15/2023] Open
Abstract
Epidemiological data about the prevalence of amblyopia around the world vary widely among regions and periods. This meta-analysis aimed to determine the global prevalence of amblyopia in children. PubMed, Embase, and the Cochrane Library were searched for prevalence studies published up to 5 November 2021. The outcome was the prevalence of amblyopia, analyzed as pooled estimates with 95% confidence intervals (CI). A total of 97 studies were included, including 4,645,274 children and 7,706 patients with amblyopia. The overall worldwide pooled prevalence of amblyopia was 1.36% (95%CI: 1.27-1.46%). The prevalence of amblyopia was higher in males (1.40%, 95%CI: 1.10-1.70%) than in females (1.24%, 95%CI: 0.94-1.54%) (OR = 0.885, 95%CI: 0.795-0.985, P = 0.025). The results of the meta-regression analysis showed that there were no significant associations between the prevalence of amblyopia and geographical area, publication year, age, sample size, and whether it was carried out in a developed or developing country (all P > 0.05). Begg's test (P = 0.065) and Egger's test (P < 0.001) showed that there was a significant publication bias in the prevalence of amblyopia. In conclusion, amblyopia is a significant vision problem worldwide, and public health strategies of early screening, treatment, and management are important.
Collapse
Affiliation(s)
- Budan Hu
- Department of Ophthalmology, The People's Hospital of Leshan, Leshan, China
| | - Zongshun Liu
- Department of Ophthalmology, The People's Hospital of Leshan, Leshan, China
| | - Jiao Zhao
- Department of Ophthalmology, The People's Hospital of Leshan, Leshan, China
| | - Li Zeng
- Department of Ophthalmology, The People's Hospital of Leshan, Leshan, China
| | - Gengsheng Hao
- Department of Ophthalmology, The People's Hospital of Leshan, Leshan, China
| | - Dan Shui
- Department of Ophthalmology, The People's Hospital of Leshan, Leshan, China
| | - Ke Mao
- Department of Ophthalmology, The People's Hospital of Leshan, Leshan, China
| |
Collapse
|
9
|
Current Challenges Supporting School-Aged Children with Vision Problems: A Rapid Review. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11209673] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Many children have undetected vision problems or insufficient visual information processing that may be a factor in lower academic outcomes. The aim of this paper is to contribute to a better understanding of the importance of vision screening for school-aged children, and to investigate the possibilities of how eye-tracking (ET) technologies can support this. While there are indications that these technologies can support vision screening, a broad understanding of how to apply them and by whom, and if it is possible to utilize them at schools, is lacking. We review interdisciplinary research on performing vision investigations, and discuss current challenges for technology support. The focus is on exploring the possibilities of ET technologies to better support screening and handling of vision disorders, especially by non-vision experts. The data orginate from a literature survey of peer-reviewed journals and conference articles complemented by secondary sources, following a rapid review methodology. We highlight current trends in supportive technologies for vision screening, and identify the involved stakeholders and the research studies that discuss how to develop more supportive ET technologies for vision screening and training by non-experts.
Collapse
|
10
|
Khoshhal F, Hashemi H, Hooshmand E, Saatchi M, Yekta A, Aghamirsalim M, Ostadimoghaddam H, Khabazkhoob M. The prevalence of refractive errors in the Middle East: a systematic review and meta-analysis. Int Ophthalmol 2020; 40:1571-1586. [PMID: 32107693 DOI: 10.1007/s10792-020-01316-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 02/10/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The purpose of the present study was to evaluate the prevalence of refractive errors in the Middle East region. METHODS In this meta-analysis, a structured strategy was applied to search databases PubMed, Web of Science, Scopus, and Google Scholar, databases as well as the reference lists of the selected articles to identify cross-sectional studies assessing the prevalence of refractive errors in the Middle East region until September 2019. The outcome measure was the prevalence of refractive errors, including myopia, hyperopia, and astigmatism, in two age groups of ≤ 15 years and > 15 years. The study results were combined using a random effects model at a confidence level of 95%. RESULTS The prevalence of myopia, hyperopia, and astigmatism was 4% (95% CI 4, 5), 8% (95% CI 6, 10), and 15% (95% CI 10, 19) in people less than or equal to 15 years and 30% (95% CI 25, 34), 21% (95% CI 15, 28), and 24% (95% CI 16, 31) in subjects over 15 years, respectively. The prevalence of myopia, hyperopia, and astigmatism was 3.5%, 12.4%, and 9.0% in male and 4.2%, 13.1%, and 9.9% in female subjects aged ≤ 15 years, respectively. In subjects aged > 15 years, the prevalence was 31.7%, 14.5%, and 31.5% in males and 31.9%, 11.2%, and 31% in females, respectively. CONCLUSION The prevalence of hyperopia is relatively high in Middle Eastern children, while the prevalence of myopia is higher in adults in this region. It seems that astigmatism is not a serious refractive problem in this region compared to the rest of the world.
Collapse
Affiliation(s)
- Fahimeh Khoshhal
- Department of Pediatrics, Dezful University of Medical Sciences, Dezful, Iran
| | - Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran.
| | - Elham Hooshmand
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Saatchi
- Department of Epidemiology, School of Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbasali Yekta
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Hadi Ostadimoghaddam
- Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
11
|
Fu Z, Hong H, Su Z, Lou B, Pan CW, Liu H. Global prevalence of amblyopia and disease burden projections through 2040: a systematic review and meta-analysis. Br J Ophthalmol 2019; 104:1164-1170. [DOI: 10.1136/bjophthalmol-2019-314759] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 10/17/2019] [Accepted: 10/21/2019] [Indexed: 12/11/2022]
Abstract
PurposeAmblyopia is a leading cause of vision impairment among children and young adults. Individual studies showed significant variations in the prevalence of amblyopia in different regions and age groups. This study is to estimate the global prevalence of amblyopia by pooling its prevalence from the previous studies and to project the number of people affected through 2040.MethodsWe performed a systematic review and meta-analysis on the prevalence of amblyopia using data published before 20 October 2018. We estimated the prevalence rate of amblyopia and its 95% CI globally and by subgroups (eg, region and age). The prevalence data were applied to United Nations World Population Prospects to derive the projected number with amblyopia through 2040.ResultsA meta-analysis of 60 studies (1 859 327 subjects) showed that the pooled prevalence rate of amblyopia was 1.44% (95% CI 1.17% to 1.78%). Prevalences in Europe (2.90%) and North America (2.41%) were higher than in Asia (1.09%) and Africa (0.72%). The highest prevalence was found in subjects over 20 years old (3.29%). There was no difference in the prevalence between genders. We estimated 99.2 (95% CI 71.7 to 146.1) million people with amblyopia in 2019 worldwide, increasing to 175.2 (95% CI 81.3 to 307.8) million by 2030 and 221.9 (95% CI 83.7 to 429.2) million by 2040.ConclusionsThe amblyopia is becoming a significant vision problem worldwide. It is of great importance to design and implement amblyopia screening, treatment and related public health strategies.
Collapse
|
12
|
Yang Y, Wang C, Gan Y, Jiang H, Fu W, Cao S, Lu Z. Maternal smoking during pregnancy and the risk of strabismus in offspring: a meta-analysis. Acta Ophthalmol 2019; 97:353-363. [PMID: 30402966 DOI: 10.1111/aos.13953] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 09/26/2018] [Indexed: 01/11/2023]
Abstract
The effect of maternal smoking during pregnancy on strabismus in offspring remains unclear. We conducted a meta-analysis to summarize epidemiological evidences on the association between maternal smoking during pregnancy and the risk of offspring strabismus. Eligible studies were searched from the PubMed, Ovid, Embase and CNKI databases up to May 2018. The qualities of included articles were assessed with the Newcastle-Ottawa Scale and the assessment scale recommended by the Agency for Healthcare Research and Quality. Odds ratios (ORs) corresponding with its 95% confidence intervals (CIs) were pooled to estimate the effects of maternal cigarette smoking on the risk of offspring strabismus. Subgroup analyses and meta-regression were performed to explore the potential sources of heterogeneity. The Begg's test and Egger's test were used to assess the publication bias. Eleven articles involving 4,833 patients with strabismus were included. The pooled OR showed that maternal smoking during pregnancy was significantly associated with strabismus in offspring (OR = 1.46, 95% CI = 1.32-1.60). Compared with less than 10 cigarettes per day (OR = 1.17, 95% CI = 1.06-1.29), maternal smoking 10 cigarettes or more per day during pregnancy significantly increased the risk of offspring strabismus (OR = 1.79, 95% CI = 1.39-2.31). The risk of developing esotropia and exotropia for smoking pregnant women, respectively, increased by 65% (OR = 1.65, 95% CI = 1.31-2.09 and OR = 1.65, 95% CI = 1.24-2.19) than those who did not smoke during pregnancy. Additionally, the increased risk of maternity smoking associated with offspring strabismus was stable across all subgroup analyses. Overall, maternal smoking during pregnancy was associated with a significantly increased risk of offspring strabismus and the result was persistent in subgroup analyses, suggesting the importance in changing smoking habit or smoking cessation for women who are pregnant or preparing to.
Collapse
Affiliation(s)
- Yudi Yang
- Department of Social Medicine and Health Management School of Public Health Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Chao Wang
- Department of Social Medicine and Health Management School of Public Health Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Yong Gan
- Department of Social Medicine and Health Management School of Public Health Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Heng Jiang
- Centre for Alcohol Policy Research School of Psychology and Public Health La Trobe University Melbourne Victoria Australia
- Centre for Health Equity Melbourne School of Population and Global Health the University of Melbourne Melbourne Victoria Australia
| | - Wenning Fu
- Department of Social Medicine and Health Management School of Public Health Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Shiyi Cao
- Department of Social Medicine and Health Management School of Public Health Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Zuxun Lu
- Department of Social Medicine and Health Management School of Public Health Tongji Medical College Huazhong University of Science and Technology Wuhan China
| |
Collapse
|
13
|
Ugurbas SC, Kucuk N, Isik I, Alpay A, Buyukuysal C, Ugurbas SH. Objective vision screening using PlusoptiX for children aged 3-11 years in rural Turkey. BMC Ophthalmol 2019; 19:73. [PMID: 30871506 PMCID: PMC6419461 DOI: 10.1186/s12886-019-1080-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 03/01/2019] [Indexed: 11/10/2022] Open
Abstract
Background This population based cross sectional study was conducted to detect amblyopia risk factors and myopia in a rural district of Northwestern Turkey by using PlusoptiX S12R (Photoscreener PlusoptiX Inc., Nuremberg, Germany). Methods Children from 38 rural schools in Caycuma district of Zonguldak Turkey underwent vision screening in their school using PlusoptiX S12 photoscreener. Data were analyzed using the factory default level 5 referral criteria targeting 80% sensitivity and 95% specificity. Referral, unable readings, and positive predictive value (PPV) were reported. Results Data from 2846 children were analyzed. Mean age was 7.9 years (±0.8) (range 36 months to 11 years). Three hundred ten (11%) were referred of whom 32% were read as ‘unable’. 150 children (48% of the referred) received a gold standard examination. Positive predictive value of PlusoptiX was 69%. PPV was 83% when unable readings were excluded. 93 children with amblyopia risk factors were identified. Only 26% (n = 25) had received glasses priorly. 49 children had amblyopia of whom 33 were newly diagnosed. Conclusions PlusoptiX showed a reasonable level of positive predictive value in community setting and the device could be a useful tool for vision screening in preschoolers and schoolers. We found most of the amblyogenic refractive errors were underdiagnosed in rural school children leading to a call for action on vision screening.
Collapse
Affiliation(s)
- Silay Canturk Ugurbas
- Department of Ophthalmology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Esenkoy-Kozlu, 67600, Zonguldak, Turkey.
| | - Numan Kucuk
- Department of Ophthalmology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Esenkoy-Kozlu, 67600, Zonguldak, Turkey
| | - Irem Isik
- Department of Ophthalmology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Esenkoy-Kozlu, 67600, Zonguldak, Turkey
| | - Atilla Alpay
- Department of Ophthalmology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Esenkoy-Kozlu, 67600, Zonguldak, Turkey
| | - Cagatay Buyukuysal
- Department of Biostatistics, Faculty of Medicine, Zonguldak Bulent Ecevit University, Esenkoy-Kozlu, Zonguldak, 67600, Turkey
| | - Suat Hayri Ugurbas
- Department of Ophthalmology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Esenkoy-Kozlu, 67600, Zonguldak, Turkey
| |
Collapse
|
14
|
Sabri K, Easterbrook B, Khosla N, Davis C, Farrokhyar F. Paediatric vision screening by non-healthcare volunteers: evidence based practices. BMC MEDICAL EDUCATION 2019; 19:65. [PMID: 30819159 PMCID: PMC6394097 DOI: 10.1186/s12909-019-1498-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 02/18/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND The purpose of this study was to test the sensitivity and specificity of eight undergraduate volunteer examiners conducting vision screening tests in a community setting, in order to determine if non-eye care professionals were able to be trained to an appropriate level of skill. METHODS Eight undergraduate volunteer examiners were trained to conduct vision screening tests to address a gap in pediatric community eye care. Phase I of the study was implemented in the pediatric ophthalmology clinic, and phase II was conducted in nine local schools. Phase I consisted of 40 h of training for each volunteer regarding specific vision tests. Phase II consisted of screening children at nine local schools. RESULTS A total of 690 children from nine local schools were screened by both the volunteer examiners and the optometrist during the course of this study. Volunteer examiners had a screening sensitivity of 0.80 (95%CI 0.66-0.90) and screening specificity of 0.75 (95%CI 0.71-0.78) when compared to the study optometrist. The overall accuracy of volunteer examiners was 75%. The resulting positive likelihood ratio was 3.24 (95%CI 2.6-3.9), indicating that a child with vision impairment was 3.2 times more likely to fail the vision test performed by the volunteer examiners compared to a child with no vision impairment. CONCLUSIONS Non-healthcare professionals can be trained to an acceptable degree of accuracy to perform vision screening tests on children, which may assist in mitigating existing gaps in paediatric eye care.
Collapse
Affiliation(s)
- K Sabri
- Division of Ophthalmology, Department of Surgery, McMaster University, 1200 Main Street West, 3V2, Hamilton, ON, L8N 3Z5, Canada.
- McMaster Pediatric Surgery Research Collaborative, Department of Surgery, McMaster University, 1200 Main Street West, Hamilton, ON, L8N 3Z5, Canada.
- McMaster Paediatric Eye Research Group, Department of Surgery, McMaster University, 1200 Main Street West, 3V2, Hamilton, ON, L8N 3Z5, Canada.
| | - B Easterbrook
- McMaster Pediatric Surgery Research Collaborative, Department of Surgery, McMaster University, 1200 Main Street West, Hamilton, ON, L8N 3Z5, Canada
| | - N Khosla
- Division of Ophthalmology, Department of Surgery, McMaster University, 1200 Main Street West, 3V2, Hamilton, ON, L8N 3Z5, Canada
| | - C Davis
- Hamilton-Wentworth Catholic District School Board, 90 Mulberry Street, P.O. Box 2012, Hamilton, ON, L8N 3R9, Canada
| | - F Farrokhyar
- Office of Surgical Research Services, Department of Surgery, McMaster University, 39 Charlton Avenue East, Hamilton, ON, L8N 1Y3, Canada
| |
Collapse
|
15
|
Metsing IT, Hansraj R, Jacobs W, Nel EW. Review of school vision screening guidelines. AFRICAN VISION AND EYE HEALTH 2018. [DOI: 10.4102/aveh.v77i1.444] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: Vision screenings are important in identifying visual anomalies likely to disrupt the physical, intellectual, social and emotional development of children. School health services globally include vision screenings, complementing a variety of associated screening services.Aim: This review article provides evidence for content, provision and efficacy of the vision screening services for children of school-going age and reports on the current practice of children’s vision screenings worldwide including in South Africa.Methods: Studies were identified from PubMed, Ebscohost and Science Direct with the search terms utilised during the selection of electronic articles and journals for the review. The target population includes children of school-going age from 6 to 19 years without previously known conditions associated with visual anomalies and learning-related problems. The quality of vision screening programmes and policies for the school-going age children in different countries were evaluated using Wilson and Jungner criteria.1Results: Vision screening programmes worldwide appear to support comprehensive vision screening methods among pre-schoolers (from birth to ≤ 6 years vs. children of school-going age). The development of vision screening procedures in some countries in the United States of America (USA) was found to be grounded on epidemiologic findings and principles. These may have contributed towards the formulation of national vision screening guidelines for pre-schoolers that supported the detection of amblyopia and its associated conditions such as strabismus, anisometropia and myopia. School-going children’s vision screenings are not supported worldwide as research has shown that there is lack of benefits for detecting other visual anomalies such as vergence and accommodative dysfunctions. This is despite evidence provided by the literature reviewed that an association exists between prevalent accommodation and vergence dysfunctions including poor ocular motilities and poor near-vision, among children of school-going age with poor academic performance.Conclusion: The guidelines worldwide support school vision screenings, especially for the pre-schoolers by the school health nurses, with other programs having considered the teachers, optometrists or orthoptists as the appropriate personnel to conduct the school vision screenings. There is still a need for the effectiveness of the school vision-screening programmes to be investigated related to the importance of detecting convergence and accommodative dysfunctions for the school going age children.
Collapse
|
16
|
Wallace DK, Repka MX, Lee KA, Melia M, Christiansen SP, Morse CL, Sprunger DT. Amblyopia Preferred Practice Pattern®. Ophthalmology 2018; 125:P105-P142. [DOI: 10.1016/j.ophtha.2017.10.008] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 10/03/2017] [Indexed: 10/18/2022] Open
|
17
|
Evidence for the need for vision screening of school children in Turkey. BMC Ophthalmol 2017; 17:230. [PMID: 29197362 PMCID: PMC5712108 DOI: 10.1186/s12886-017-0618-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 11/20/2017] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND In many countries, access to general health and eye care is related to an individual's socioeconomic status (SES). We aimed to examine the prevalence of oculo-visual disorders in children in Istanbul Turkey, drawn from schools at SES extremes but geographically nearby. METHODS Three school-based vision screenings (presenting distance visual acuity, cover test, eye assessment history, colour vision, gross stereopsis and non-cycloplegic autorefraction) were conducted on 81% of a potential 1014 primary-school children aged 4-10 years from two private (high SES) schools and a nearby government (low SES) school in central Istanbul. Prevalence of refractive errors and school-based differences were analysed using parametric statistics (ANOVA). The remaining oculo-visual aspects were compared using non-parametric tests. RESULTS Of the 823 children with mean age 6.7 ± 2.2 years, approximately 10% were referred for a full eye examination (8.2% and 16.3% of private/government schools respectively). Vision had not been previously examined in nearly 22% of private school children and 65% of government school children. Of all children, 94.5% were able to accurately identify the 6/9.5 [LogMAR 0.2] line of letters/shapes with each eye and 86.6% the 6/6 line [LogMAR 0], while 7.9% presented wearing spectacles, 3.8% had impaired colour vision, 1.5% had grossly impaired stereo-vision, 1.5% exhibited strabismus, 1.8% were suspected to have amblyopia and 0.5% had reduced acuity of likely organic origin. Of the 804 without strabismus, amblyopia or organic conditions, 6.0% were myopic ≤ - 0.50DS, 0.6% hyperopic ≥ + 2.00DS, 7.7% astigmatic ≥1.00 DC and 6.2% anisometropic ≥1.00DS. CONCLUSIONS The results highlight the need for general vision screenings for all children prior to school entry given the varied and different pattern of visual problems associated with lifestyle differences in two populations raised in the same urban locale but drawn from different socioeconomic backgrounds.
Collapse
|
18
|
Pediatric Eye Evaluations Preferred Practice Pattern®: I. Vision Screening in the Primary Care and Community Setting; II. Comprehensive Ophthalmic Examination. Ophthalmology 2017; 125:P184-P227. [PMID: 29108745 DOI: 10.1016/j.ophtha.2017.09.032] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 09/27/2017] [Indexed: 12/22/2022] Open
|
19
|
Global and regional estimates of prevalence of refractive errors: Systematic review and meta-analysis. J Curr Ophthalmol 2017; 30:3-22. [PMID: 29564404 PMCID: PMC5859285 DOI: 10.1016/j.joco.2017.08.009] [Citation(s) in RCA: 200] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 08/01/2017] [Accepted: 08/24/2017] [Indexed: 11/22/2022] Open
Abstract
Purpose The aim of the study was a systematic review of refractive errors across the world according to the WHO regions. Methods To extract articles on the prevalence of refractive errors for this meta-analysis, international databases were searched from 1990 to 2016. The results of the retrieved studies were merged using a random effect model and reported as estimated pool prevalence (EPP) with 95% confidence interval (CI). Results In children, the EPP of myopia, hyperopia, and astigmatism was 11.7% (95% CI: 10.5–13.0), 4.6% (95% CI: 3.9–5.2), and 14.9% (95% CI: 12.7–17.1), respectively. The EPP of myopia ranged from 4.9% (95% CI: 1.6–8.1) in South–East Asia to 18.2% (95% CI: 10.9–25.5) in the Western Pacific region, the EPP of hyperopia ranged from 2.2% (95% CI: 1.2–3.3) in South-East Asia to 14.3% (95% CI: 13.4–15.2) in the Americas, and the EPP of astigmatism ranged from 9.8% in South-East Asia to 27.2% in the Americas. In adults, the EPP of myopia, hyperopia, and astigmatism was 26.5% (95% CI: 23.4–29.6), 30.9% (95% CI: 26.2–35.6), and 40.4% (95% CI: 34.3–46.6), respectively. The EPP of myopia ranged from 16.2% (95% CI: 15.6–16.8) in the Americas to 32.9% (95% CI: 25.1–40.7) in South-East Asia, the EPP of hyperopia ranged from 23.1% (95% CI: 6.1%–40.2%) in Europe to 38.6% (95% CI: 22.4–54.8) in Africa and 37.2% (95% CI: 25.3–49) in the Americas, and the EPP of astigmatism ranged from 11.4% (95% CI: 2.1–20.7) in Africa to 45.6% (95% CI: 44.1–47.1) in the Americas and 44.8% (95% CI: 36.6–53.1) in South-East Asia. The results of meta-regression showed that the prevalence of myopia increased from 1993 (10.4%) to 2016 (34.2%) (P = 0.097). Conclusion This report showed that astigmatism was the most common refractive errors in children and adults followed by hyperopia and myopia. The highest prevalence of myopia and astigmatism was seen in South-East Asian adults. The highest prevalence of hyperopia in children and adults was seen in the Americas.
Collapse
|
20
|
Hashemi H, Nabovati P, Yekta A, Ostadimoghaddam H, Behnia B, Khabazkhoob M. The Prevalence of Strabismus, Heterophorias, and Their Associated Factors in Underserved Rural Areas of Iran. Strabismus 2017; 25:60-66. [DOI: 10.1080/09273972.2017.1317820] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Payam Nabovati
- Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Abbasali Yekta
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Ostadimoghaddam
- Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Bardia Behnia
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
21
|
Elflein HM, Fresenius S, Lamparter J, Pitz S, Pfeiffer N, Binder H, Wild P, Mirshahi A. The prevalence of amblyopia in Germany: data from the prospective, population-based Gutenberg Health Study. DEUTSCHES ARZTEBLATT INTERNATIONAL 2016; 112:338-44. [PMID: 26043421 DOI: 10.3238/arztebl.2015.0338] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 02/25/2015] [Accepted: 02/25/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Amblyopia is due to insufficient development of the visual system in early childhood and is a major source of lifelong impairment of visual acuity. Too little is known about the prevalence of amblyopia in Germany and the frequency of its various causes. METHODS The Gutenberg Health Study of the University of Mainz Faculty of Medicine is an ongoing population-based, prospective, monocentric cohort study with 15 010 participants aged 35 to 74. All participants are examined for the presence of ocular, cardiovascular, neoplastic, metabolic, immunologic, and mental diseases. 3227 participants aged 35 to 44 underwent ophthalmological examination from 2007 to 2012. Amblyopia was defined as impaired visual acuity in the absence of any organic pathology capable of explaining the condition, and in the presence of a known risk factor for amblyopia. RESULTS Amblyopia, when defined as a visual acuity less than or equal to 0.63, was present in 182 participants (5.6%, 95% confidence interval [CI] 4.9-6.5%), 120 of whom had a visual acuity less than or equal to 0.5 (3.7%, 95% CI 3.3-5.2%). A narrower definition of amblyopia requiring, in addition, an interocular difference in acuity of at least two lines yielded slightly lower prevalence figures: 5.0% (95% CI 4.2-5.8%) and 3.7% (95% CI 3.1-4.4%), respectively. The causes of amblyopia (visual acuity ≤ 0.63) were anisometropia (different refractive strengths of the two eyes) in 49% of participants, strabismus (a squint) in 23%, both of these factors in 17%, and visual deprivation in 2%. 3 patients (2%) had relative amblyopia due to a traumatic cataract sustained in early childhood. 7% of the participants with amblyopia had binocular amblyopia. CONCLUSION This study yielded a prevalence figure of 5.6% for amblyopia in Germany-a higher figure than in other, comparable population-based studies, which have generally yielded figures of ca. 3% for visual acuity ≤ 0.63. The distribution of the causes of amblyopia is similar across studies.
Collapse
Affiliation(s)
- Heike M Elflein
- Department of Ophthalmology at the University Medical Center of the Johannes Gutenberg University Mainz, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) at the University Medical Center of the Johannes Gutenberg University Mainz, Department of Germany Preventive Cardiology and Preventive Medicine, Center for Thrombosis and Hemostasis, German Center for Cardiovascular Disease (DZHK) at the University Medical Center of the Johannes Gutenberg University Mainz
| | | | | | | | | | | | | | | |
Collapse
|
22
|
Bušić M, Bjeloš M, Petrovečki M, Kuzmanović Elabjer B, Bosnar D, Ramić S, Miletić D, Andrijašević L, Kondža Krstonijević E, Jakovljević V, Bišćan Tvrdi A, Predović J, Kokot A, Bišćan F, Kovačević Ljubić M, Motušić Aras R. Zagreb Amblyopia Preschool Screening Study: near and distance visual acuity testing increase the diagnostic accuracy of screening for amblyopia. Croat Med J 2016; 57:29-41. [PMID: 26935612 PMCID: PMC4800325 DOI: 10.3325/cmj.2016.57.29] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM To present and evaluate a new screening protocol for amblyopia in preschool children. METHODS Zagreb Amblyopia Preschool Screening (ZAPS) study protocol performed screening for amblyopia by near and distance visual acuity (VA) testing of 15 648 children aged 48-54 months attending kindergartens in the City of Zagreb County between September 2011 and June 2014 using Lea Symbols in lines test. If VA in either eye was >0.1 logMAR, the child was re-tested, if failed at re-test, the child was referred to comprehensive eye examination at the Eye Clinic. RESULTS 78.04% of children passed the screening test. Estimated prevalence of amblyopia was 8.08%. Testability, sensitivity, and specificity of the ZAPS study protocol were 99.19%, 100.00%, and 96.68% respectively. CONCLUSION The ZAPS study used the most discriminative VA test with optotypes in line as they do not underestimate amblyopia. The estimated prevalence of amblyopia was considerably higher than reported elsewhere. To the best of our knowledge, the ZAPS study protocol reached the highest sensitivity and specificity when evaluating diagnostic accuracy of VA tests for screening. The pass level defined at ≤0.1 logMAR for 4-year-old children, using Lea Symbols in lines missed no amblyopia cases, advocating that both near and distance VA testing should be performed when screening for amblyopia.
Collapse
Affiliation(s)
| | - Mirjana Bjeloš
- Mirjana Bjeloš, University Eye Clinic, University Hospital "Sveti Duh", Sveti Duh 64, Zagreb, Croatia,
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Sabri K, Thornley P, Waltho D, Warren T, Laverty L, Husain S, Farrokhyar F, Higgins D. Assessing accuracy of non-eye care professionals as trainee vision screeners for children. Can J Ophthalmol 2016; 51:25-9. [PMID: 26874155 DOI: 10.1016/j.jcjo.2015.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 10/07/2015] [Accepted: 10/12/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To determine the level of agreement between non-eye care trainees and a trainer (ophthalmologist) in a vision screening program. DESIGN Prospective, observational study carried out in 3 phases (Phase I-III). PARTICIPANTS Study population included 1228 children, aged 6-14 years, at 5 elementary schools in the city of Hamilton. METHODS In Phase I, 1228 children were screened by the trainee screeners, of which 273 children failed the vision testing. Of these 273 children, 170 consented to enrolment into Phase II and were examined by an ophthalmologist, who confirmed that 105 of these children were true positives. On retesting (Phase III), the ophthalmologist passed 158 of the 163 randomly selected children who passed in Phase I. RESULTS Overall, trainee screeners had a sample sensitivity of 95.5% and sample specificity of 70.8% in detecting children who should fail vision screening. When we used the positive and negative prediction values obtained, 198 of the 1228 children had vision impairment-providing an estimated prevalence of 16.1%, or 161 children per 1000 population. CONCLUSIONS Non-eye care professionals can be trained to an acceptable degree of accuracy to perform certain vision screening tests on children. Such screening methods may be a useful approach to address existing gaps in provision of eye care for many Canadian children, thereby ensuring that all children receive timely vision screening.
Collapse
Affiliation(s)
- Kourosh Sabri
- Hamilton Health Sciences, Hamilton, Ont; McMaster University, Hamilton, Ont.
| | | | | | | | - Laura Laverty
- Public Health Services for the city of Hamilton, Hamilton, Ont
| | | | | | | |
Collapse
|
24
|
Yekta A, Hashemi H, Ostadimoghaddam H, Haghighi B, Shafiee H, Mehravaran S, Nabovati P, Asharlous A, Khabazkhoob M. Strabismus and Near Point of Convergence and Amblyopia in 4–6 Year-Old Children. Strabismus 2016; 24:113-9. [DOI: 10.1080/09273972.2016.1205103] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
25
|
Gokturk B, Topcu-Yilmaz P, Bozkurt B, Yildirim MS, Guner SN, Sayar EH, Reisli I. Ocular Findings in Children With 22q11.2 Deletion Syndrome. J Pediatr Ophthalmol Strabismus 2016; 53:218-22. [PMID: 27182748 DOI: 10.3928/01913913-20160427-01] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 03/02/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To identify the ocular features of children diagnosed as having 22q11.2 deletion syndrome in a Turkish population, which is the most common microdeletion syndrome with a wide range of facial and ocular abnormalities. METHODS Sixteen children aged between 4 months and 18 years with a microdeletion in chromosome 22q11.2 underwent a detailed ophthalmological examination including uncorrected and best corrected visual acuity testing, stereoscopic vision examination, biomicroscopic and indirect fundus examination, and ocular motility testing. RESULTS All patients had at least one ocular abnormality. The major abnormalities were eyelid abnormalities (eye hooding, narrow palpebral fissure, telecanthus, hypertelorism, sparse and thin eyebrows and eyelashes, blepharitis, and distichiasis), posterior embryotoxon, and tortuous retinal vessels in at least half of the patients. Other ophthalmological disorders were refractive errors, iris remnants, and strabismus. CONCLUSIONS The chromosome 22q11.2 deletion syndrome is associated with a wide range of ocular disorders, which necessitates a comprehensive eye examination for appropriate treatment and follow-up. Ocular findings sometimes can provide a clue to the diagnosis of 22q11.2 deletion. [J Pediatr Ophthalmol Strabismus. 2016;53(4):218-222].
Collapse
|
26
|
|
27
|
Yamamah GAN, Talaat Abdel Alim AA, Mostafa YSED, Ahmed RAAS, Mahmoud AM. Prevalence of Visual Impairment and Refractive Errors in Children of South Sinai, Egypt. Ophthalmic Epidemiol 2015. [DOI: 10.3109/09286586.2015.1056811] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
28
|
|
29
|
Hashemi H, Yekta A, Jafarzadehpur E, Ostadimoghaddam H, Eshrati B, Mohazzab-Torabi S, Khabazkhoob M, Soroush S. The Prevalence of Strabismus in 7-Year-Old Schoolchildren in Iran. Strabismus 2015; 23:1-7. [DOI: 10.3109/09273972.2014.999795] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|