Prevalence of myopia and hyperopia in 6- to 72-month-old african american and Hispanic children: the multi-ethnic pediatric eye disease study

Abstract

Purpose: To determine the age-, gender-, and ethnicity-specific prevalence of myopia and hyperopia in African American and Hispanic children aged 6 to 72 months.

Design: Population-based cross-sectional study.

Participants: The Multi-Ethnic Pediatric Eye Disease Study is a population-based evaluation of the prevalence of vision disorders in children aged 6 to 72 months in Los Angeles County, California. Seventy-seven percent of eligible children completed a comprehensive eye examination. This report focuses on results from 2994 African American and 3030 Hispanic children.

Methods: Eligible children in 44 census tracts were identified during an in-home interview and scheduled for a comprehensive eye examination and in-clinic interview. Cycloplegic autorefraction was used to determine refractive error.

Main outcome measures: The proportion of children with spherical equivalent (SE) myopia </= -1.00 diopter (D) and SE hyperopia >/= +2.00 D in the worse eye. Prevalence of myopia and hyperopia is also reported using alternative threshold definitions.

Results: Prevalence of myopia was higher in African American (6.6%) compared with Hispanic children (3.7%; P<0.001). Hispanics showed a higher prevalence of hyperopia than African American children (26.9% vs. 20.8% respectively, P<0.001). The prevalence of myopia showed a significant decreasing trend with age (P<0.001). Hyperopia prevalence reached a low point at approximately 24 months of age but increased and remained higher than that thereafter. No significant gender differences were found in the prevalence of refractive error for either ethnic group.

Conclusions: We observed ethnicity-related differences in both hyperopia and myopia prevalence in preschool children. The age-related decrease in myopia prevalence in preschool children could reflect early emmetropization and contrasts with the increase in myopia prevalence known to occur in older school-aged children. The limits of emmetropization are evident, however, in the persistently elevated prevalence of hyperopia beyond 24 months of age.

Financial disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Figure 1

Prevalence of spherical equivalent refractive error of the worse eye stratified by level of refractive error, age and ethnic group in the Multi-ethnic Pediatric Eye Disease Study. Vertical axis shows the prevalence (%) of refractive error. Horizontal axis shows the spherical equivalent refractive error in 1 diopter intervals. AA: African American; H: Hispanic, mos: months; Numbers presented in legends show the age groups in months.

Figure 2

Comparison of frequency distributions of refractive error of the worse eye in youngest and oldest age group of African American and Hispanic children in the Multi-ethnic Pediatric Eye Disease Study. Panels A and B compare the frequency distributions of youngest and oldest age group within each ethnicity. Panels C and D compare the distributions of the youngest and oldest age groups between the two ethnic groups. Vertical axis shows prevalence (%) of refractive error; horizontal axis represents spherical equivalent refractive error in 1diopter (D) intervals. [,) shows a right open interval, for example [2,3) means an interval of spherical equivalent refractive error values equal to or greater than 2 D but less that 3 D. AA= African American; H= Hispanic.

Figure 3

Locally weighted regression line of estimated prevalence of myopia and hyperopia by months of age in African American and Hispanic children in Multi-Ethnic Pediatric Eye Disease Study. Vertical axis shows the estimated prevalence of spherical equivalent (SE) myopia<=−1diopters (D) and SE hyperopia>=+2D of the worse eye. Horizontal axis shows the age of children in months. Gray shading represent 95% confidence interval of the estimated prevalence.

Fig 4

Comparison of prevalence of myopia and hyperopia in 5 year old Hispanic and African American children in the Multi-Ethnic Pediatric Eye Disease Study (MEPEDS) in the United States and Hispanic children in Chile and African children in South Africa. Vertical axis shows the prevalence of myopia (upper graph) and hyperopia (lower graph) in the United States (Multi-ethnic Pediatric Eye Disease Study), South Africa (Naidoo et al) and Chile (Maul et al) . The prevalence of myopia and hyperopia for MEPEDS participants are presented using the definitions used in the study with the comparable race/ethnicity. Error bars represent the estimated standard error of the prevalence. AA: African American, Hisp: Hispanic.