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

Abstract

Background There are limited systematic reviews on the prevalence of uncorrected refractive errors in children. We aimed to summarize the prevalence and causes of pediatric uncorrected refractive error (URE) from studies in the Global Burden of Disease (GBD) sub-regions. Methods The pooled analysis used the individual participant data (ages less than 20 years old) from population-based studies around the world by regions. URE was defined as presenting VA < 6/18 and improving to ≥ 6/18 or ≥1 line on using a pinhole in either eye, with main causes of myopia, hyperopia or astigmatism. Each study provided data on any URE, myopia, hyperopia or astigmatism by age, gender, and ethnicity. Prevalence rates were directly age and gender standardized to the 2020 world population with all age groups. Estimates were calculated by study and sub-regions after pooling. Summary estimates included studies in which URE was assessed from a pinhole-corrected refraction in the better eye. Results The combined pooled data contained 302,513,219 patients including 8 963 URE cases individuals from 57 studies. Prevalence varied by age and GBD sub-regions and differed by gender. The age- and region-standardized prevalence of URE was 3.41 per 1000 (CI, 1.53~7.62) in Western Pacific region (12 studies), 2.26 per 1000 (CI, 0.85~6.01) in South-East Asia region (14 studies), 5.85 per 1000 (CI, 3.75~9.13) in Americans (11 studies) and 4.40 per 1000 (CI, 3.0~6.45) in Eastern Mediterranean region (13 studies). On the basis of these data, myopia was the first-leading cause in female children with 12~17 age group, with the prevalence rate 18.2 per 1000 (CI, 11.52~23.61). Astigmatism was detected in 27.2 per 1000 male children with 6~11 age group (CI: 19.12–30.68). Conclusions Prevalence of URE available data within these sub-regions are widely disparate. Myopia and astigmatism in young age children continue as the leading cause of URE worldwide. Providing appropriate refractive correction to those individuals whose vision can be improved is an important public health endeavor with implications for safety and quality of life.

Prevalence and associated factors of visual impairment among adults aged 40 and above in Southern Ethiopia, 2022

“…Uncorrected refractive error when the presenting visual acuity was less than 6/18, but improved to 6/18 or better with pinhole vision 31 .…”

“…Monocular moderate VI was defined as PVA < 6/18 to ≤ 6/60 in one eye and 6/6 to ≤ 6/18 in the other eye 31 .…”

“…Monocular blindness was defined as PVA < 3/60 to NLP in one eye and PVA 6/6 to 3/60 in the other eye 31 .…”

Ethnicity and refractive errors in Peruvian children aged 7–11 years: A five-year analysis of the Demographic and Health Survey

“…Another systematic review found that the age and region-standardised prevalence of uncorrected pediatric RE were 5.85 for every 1000 US children, 4.40 for every 1000 in the Eastern Mediterranean region, 3.41 for every 1000 in the Western Pacific region, and 2.26 for every 1000 in the Southeast Asian region. 17 While it has been suggested that environmental factors are responsible for these differences, it is likely that genetic and ethnic factors are more important. 6 …”

Validation of a Simple-to-Use, Affordable, Portable Wavefront Aberrometry-Based Auto Refractometer in a Paediatric Population

“…1 Globally growing rates of URE, especially in the paediatric population, necessitate a scalable vision screening strategy for diagnosis and timely management. 2 Early screening for RE is important as a child may not be able to express poor vision or a unilateral vision loss can be missed. Uncorrected or inaccurately corrected RE can lead to undesirable consequences, such as subnormal vision, amblyopia, asthenopia, binocular vision anomalies, and poor academic performance affecting the quality of life.…”