Impaired visual acuity caused by uncorrected refractive errors and amblyopia in a German paediatric cohort

Abstract

Purpose This study describes the prevalence of visual impairment caused by uncorrected distance refractive error and the spectacle coverage in a large cohort of German children and adolescents. Furthermore, we determined the prevalence of amblyopia and amblyopia treatment. Methods Optometrists carried out visual acuity (VA) testing, non‐cycloplegic autorefraction, VA retesting with the refractive correction obtained by autorefraction, and if necessary subjective refraction and cover‐test in 1,874 subjects (901 girls/973 boys), aged 3 to 16 years. Additionally, a questionnaire on the history of previous eye care was completed. Results Distance visual impairment (VI) with VA worse than 6/18 Snellen in the better eye was present in 0.5% (95% confidence interval [95% CI]: 0.2% to 0.9%) of children. Logistic regression showed a significant positive association between VI and older age (OR = 1.21, P = 0.03). Gender differences were not found (P = 0.77). The spectacle coverage of all participants was 74.8% (95% CI: 65.2% to 82.8%). Amblyopia was found in 29 participants (1.5%; 95% CI: 1.0% to 2.2%) with no age or sex differences. The causes of unilateral amblyopia (27 cases, 93.1%) were anisometropia in 55.6% of children, strabismus in 25.9% and the combination of these factors in 18.5%. All children with bilateral amblyopia (2 cases, 6.9%) showed bilateral high ametropia. We observed 15 children with current amblyopia, who had been treated with occlusion therapy in the past (62.2%; 95% CI: 42.7% to 83.6%). Conclusions The prevalence of impaired VA caused by uncorrected refractive error and amblyopia is comparable with previous studies conducted in urban areas worldwide. Adding the measurement of refractive error to existing medical check‐ups, possibly using autorefraction, would be desirable.

The prevalence and causes of pediatric uncorrected refractive error: Pooled data from population studies for Global Burden of Disease (GBD) sub-regions

“…With regards to the high incidence rate of myopia in children in WPRO, we believe that the role of environment factors is more important than genetic and ethnic factors. The Refractive Error Study in Children (RESC) reported that the prevalence of myopia was higher in China, compared to Nepal, Chile, India, South Africa, and Malaysia consistent with other reports of high myopia rates among children of east [57,[75][76][77][78][79][80][81]. There might be three major factors for myopia formation and development by previous reports: the first is the excessive intensity of near vision work related to the pressure of more rigorous education system.…”

“…Further, we grouped fourteen studies from SEARO [51][52][53][54][55][56][57][58][59][60][61][62][63][64], and the pooled prevalence was 2.26 (95% CI: 0.85~6.01) [ Fig 8]. The heterogeneity of the estimates from the included studies was very high.…”

Habitual visual acuity and visual acuity threshold demands in Nigerian school classrooms

“…Previous studies have shown a prevalence of vision impairment among school children in Nigeria ranging from 1.2 to 6.9% 3 – 5 . Many conditions are known to cause vision impairment in children 6 , the leading cause identified as uncorrected refractive errors and amblyopia 6 – 8 .…”

Macular pigment optical density of hyperopic anisometropic amblyopic patients measured by fundus reflectometry

“…In amblyopia, the visual stimulus that enters the eye is not sufficiently clear, thus resulting in a below-normal best-corrected visual acuity (BCVA) in one or both eyes, with no organic eye lesion ( 1 ). The prevalence rates of amblyopia in children vary from 1 to 5% ( 2 , 3 ). To date, some studies have pointed out that there are pathological changes in the morphology and function of the visual pathway and visual center in amblyopic patients.…”