Refractive errors in a large dataset of French children: the ANJO study

Abstract

Undetected refractive errors (REs) in children can lead to irreversible vision loss. This study aimed to show the proportions of REs in French children using cycloplegic refraction. Multicentre cross-sectional retrospective study including children with cycloplegic refraction and without associated ocular conditions from 2015 to 2018 in French eye clinics. The following data were collected: age, symptoms of eye strain, best-corrected visual acuity (BCVA), cycloplegic refraction. The analysis included 48,163 children (mean age: 7.75 years, range: 2 to 12 years). The proportion of each RE was as follows: emmetropia (− 0.50 < Spherical Equivalent (SE) ≤ + 2.0; 58.3%), hyperopia (+ 2.0 $$<$$ < SE $$\le$$ ≤ +5; 17.2%), myopia (− 6 $$\le$$ ≤ SE $$\le$$ ≤ − 0.50; 15.5%), high myopia (SE < − 6; 0.5%), high hyperopia (SE > + 5; 3.6%), mixed astigmatism (4.9%). Anisometropia (SE difference ≥ 1.5) was found in 5.0%. Functional amblyopia in children attending primary school (aged over 6 years) was encountered in 2.7%. Symptoms of eye strain were frequent (70%) but not specific to any RE. REs are frequently found in French children and may remain undetected in the absence of symptoms of eye strain. Few studies have investigated REs in children using cycloplegic refraction, which has been shown to be the gold standard for RE assessment.

A large-scale analysis of refractive errors in students attending public primary schools in Mexico

“…In Portugal, the prevalence rate was 6.1% among 749 students aged 3 to 16 years during the 2018–2019 academic year 37 . In France, the prevalence rate was 5.0% among 48,163 children 38 . Anisometropia at a child's first clinical examination has been associated with a high risk of amblyopia 39 , and so, these combined findings highlight the importance of preschool vision screening programs to identify and treat early cases of amblyopia.…”

“…Thus, the prevalence of high hyperopia (only 4.5% in 17,865 students) may have been underestimated (Table 5 ), although it was very similar to the global prevalence rate of 4.6% reported in the prepandemic, global systematic review and meta-analysis 3 . Furthermore, the previously mentioned analysis of refractive errors in 48,163 children in France used cycloplegic refraction and reported an even lower prevalence of high hyperopia at 3.6% 38 . Similarly, the prevalence of myopia (although quite low at 11.9%) may have been overestimated in this study due to the use of noncycloplegic refraction (Table 1 ).…”