Risk factors for hyperopia and myopia in preschool children the multi-ethnic pediatric eye disease and Baltimore pediatric eye disease studies

Abstract

Purpose: To describe the risk factors associated with hyperopia and myopia among children 6 to 72 months of age.

Design: Population-based cross-sectional study.

Participants: Population-based samples of 9970 children 6 to 72 months of age from Los Angeles County, California, and Baltimore, Maryland.

Methods: Participants were preschool African-American, Hispanic, and non-Hispanic white children (n = 9770) from Los Angeles, California, and Baltimore, Maryland. Parental questionnaires and a comprehensive eye examination were administered. Demographic, behavioral, and clinical risk factors associated with hyperopia (≥2.00 diopters [D]) and myopia (≤-1.00 D) were determined.

Main outcome measures: Odds ratios (ORs) for risk factors associated with myopia and hyperopia.

Results: Compared with non-Hispanic whites, African-American (OR, 6.0) and Hispanic (OR, 3.2) children were more likely to be myopic. Children 6 to 35 months of age were more likely to be myopic compared with those 60 to 72 months of age (OR, ≥1.7). Compared with African-American children, non-Hispanic white (OR, 1.63) and Hispanic (OR, 1.49) children were more likely to be hyperopic. Children whose parents had health insurance (OR, 1.5) and those with a history of maternal smoking during pregnancy (OR, 1.4) were more likely to have hyperopia. Astigmatism of 1.5 D or more at any axis was associated with myopia (OR, 4.37) and hyperopia (OR, 1.43).

Conclusions: Children in specific racial or ethnic groups and age groups are at higher risk of having myopia and hyperopia. Cessation of maternal smoking during pregnancy may reduce the risk of hyperopia in these children. Given that both myopia and hyperopia are risk factors for the development of amblyopia and strabismus, these risk factors should be considered when developing guidelines for screening and intervention in preschool children.

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

Figure 1

Participant flowchart highlighting those children who were included and excluded from the final analysis sample for both outcomes – myopia and hyperopia in both the Multi-Ethnic Pediatric Eye Disease Study and the Baltimore Pediatric Eye Disease Study.

Figure 2

Locally weighted regression line illustrating the independent association of the amount of maternal smoking during pregnancy and the estimated prevalence of hyperopia in both the Multi-Ethnic Pediatric Eye Disease Study and the Baltimore Pediatric Eye Disease Study. The estimated prevalence of hyperopia was obtained using a stepwise logistic regression procedure that adjusts for other potential risk factors.