Visual impairment and unmet eye care needs among a Syrian pediatric refugee population in a Canadian city

Abstract

Objective: To assess the ocular health status of Syrian pediatric refugees in Canada and report the prevalence of vision impairment within this population.

Design: Cross-sectional descriptive study.

Participants: Syrian refugees 18 years old or younger.

Methods: Five clinic days were organized from July 2016 to November 2017 in Toronto, Ontario. A total of 274 patients were enrolled. Data collection involved surveys, vision screening, and ocular examinations. χ² was used for statistical analysis.

Results: The prevalence of uncorrected vision was 17.2% for distance, 4.7% for near, and 0.7% for both distance and near vision, including loss of vision. Of these, 95.3% had not visited an eye specialist in the past year, and 25.2% of parents were dissatisfied with their children's vision. The presenting visual acuity in the better-seeing eye was 20/50 or worse in 5.8% (95% confidence interval [CI] 3.6%-9.3%), and this did not correct with pinhole. This rate is 32 times (p < 0.01) higher than the prevalence rate in the average Canadian pediatric population (0.17%). Uncorrected refractive error prevalence was 26.3% (95% CI 21.2%-31.9%), with the most common etiology being myopia (19.7% CI 15.2%-24.9%). Myopia was 17.9 times (p < 0.0001) more prevalent among our Syrian refugee children compared with the average Canadian pediatric population (1.1%).

Conclusion: Syrian pediatric refugees residing in Canada have a high prevalence of vision problems. Comprehensive vision screening, improved access to eye clinics, and developing evidence-based guidelines may help address the unmet eye care needs of this vulnerable population.