Age-Specific Prevalence of Visual Impairment and Refractive Error in Children Aged 3–10 Years in Shanghai, China

We assessed changes in age-specific prevalence of refractive error at the time of starting school, by comparing preschool and school age cohorts in Shanghai, China. A cross-sectional study was done in Jiading District, Shanghai during November and December 2013. We randomly selected 7 kindergartens...

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Published in:Investigative ophthalmology & visual science Vol. 57; no. 14; p. 6188
Main Authors: Ma, Yingyan, Qu, Xiaomei, Zhu, Xiaofeng, Xu, Xun, Zhu, Jianfeng, Sankaridurg, Padmaja, Lin, Senlin, Lu, Lina, Zhao, Rong, Wang, Ling, Shi, Huijing, Tan, Hui, You, Xiaofang, Yuan, Hong, Sun, Sifei, Wang, Mingjin, He, Xiangui, Zou, Haidong, Congdon, Nathan
Format: Journal Article
Language:English
Published: United States 01.11.2016
Subjects:
Age Distribution
Age Factors
Child
Child, Preschool
China - epidemiology
Cross-Sectional Studies
Female
Humans
Male
Prevalence
Prognosis
Refraction, Ocular - physiology
Refractive Errors - epidemiology
Refractive Errors - physiopathology
Refractive Errors - rehabilitation
Risk Factors
Vision Tests
Visual Acuity
Visually Impaired Persons
ISSN:1552-5783, 1552-5783
Online Access:Get full text
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Summary:We assessed changes in age-specific prevalence of refractive error at the time of starting school, by comparing preschool and school age cohorts in Shanghai, China. A cross-sectional study was done in Jiading District, Shanghai during November and December 2013. We randomly selected 7 kindergartens and 7 primary schools, with probability proportionate to size. Chinese children (n = 8398) aged 3 to 10 years were enumerated, and 8267 (98.4%) were included. Children underwent distance visual acuity assessment and refraction measurement by cycloplegic autorefraction and subjective refraction. The prevalence of uncorrected visual acuity (UCVA), presenting visual acuity, and best-corrected visual acuity in the better eye of ≤20/40 was 19.8%, 15.5%, and 1.7%, respectively. Among those with UCVA ≤ 20/40, 93.2% could achieve visual acuity of ≥20/32 with refraction. Only 28.7% (n = 465) of children with UCVA in the better eye of ≤20/40 wore glasses. Prevalence of myopia (spherical equivalent ≤-0.5 diopters [D] in at least one eye) increased from 1.78% in 3-year-olds to 52.2% in 10-year-olds, while prevalence of hyperopia (spherical equivalent ≥+2.0 D) decreased from 17.8% among 3-year-olds to 2.6% by 10 years of age. After adjusting for age, attending elite "high-level" school was statistically associated with greater myopia prevalence. The prevalence of myopia was lower or comparable to that reported in other populations from age 3 to 5 years, but increased dramatically after 6 years, consistent with a strong environmental role of schooling on myopia development.
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ISSN:1552-5783
1552-5783
DOI:10.1167/iovs.16-20243