Prevalence of eye diseases and causes of visual impairment in school-aged children in Western China

Abstract

Background: The present study investigated the prevalence of refractive error, visual impairment, and eye diseases in school-aged children in western China.

Methods: The survey was done in a representative county (Yongchuan District, Chongqing Municipality) of western China. Cluster random sampling was used to select children aged 6 to 15 years. We conducted door-to-door surveys and eye examinations including optometry, stereoscopic vision test, eye position and eye movement, slit lamp examination of the anterior segment, retinoscopy, and fundus examination after cycloplegia with 1% cyclopentolate.

Results: Among 3469 children, data were available for 3079 (88.76%). The prevalences of eye diseases were, in descending order, refractive error (20.69%; 637/3079), conjunctivitis (11.76%; 362/3079), amblyopia (1.88%; 58/3079), color vision defect (0.52%; 16/3079), keratitis (0.36%; 11/3079), strabismus (0.29%; 9/3079), cataract (0.23%; 7/3079), pathologic myopia (0.19%; 6/3079), and ocular trauma (0.13%; 4/3079). The prevalence of corneal leucoma, corneal staphyloma, optic neuropathy, macular degeneration, and myelinated nerve fibers was 0.03% (1/3079) for each. The prevalence of visual impairment was 7.70% (237/3079), and the major causes of visual impairment were uncorrected refractive error (86.08%; 204/237), amblyopia (9.70%; 23/237), pathologic myopia (1.27%; 3/237), congenital cataract (0.42%; 1/237), and others (2.11%; 5/237).

Conclusions: Among school-aged children in a less developed area of western China, refractive error was the most prevalent eye disorder, and uncorrected refractive error was the main cause of visual impairment.

Figure.. Distribution of spherical equivalent refractive error in left eyes by age, as measured with cycloplegic retinoscopy. Boxes indicate the 25th to 75th percentiles of the age-specific distribution, ie, the interquartile range, and the bars inside the boxes represent the median. The whiskers extend to the lower and upper extremes, defined as the 25th percentile minus 1.5 times the interquartile range and the 75th percentile plus 1.5 times the interquartile range.