Objective To estimate the distribution and predictors of some common visual problems (strabismus, amblyopia, hypermetropia,) within a population-based cohort of children at the age of 7 years.
Methods Children participating in a birth cohort study were examined by orthoptists who carried out cover/uncover, alternate cover, visual acuity and non-cycloplegic refraction tests. Prospectively collected data on potential risk factors were available from the study.
Results Data were available for 7825 7-year old children. 2.3% (95% CI 2.0% to 2.7%) had manifest strabismus, 3.6% (95% CI 3.3% to 4.1%) had past/present amblyopia and 4.8% (95% CI 4.4% to 5.3%) were hypermetropic. Children from the lowest occupational social class background were 1.82 (95% CI 1.03, 3.23) times more likely to be hypermetropic than children from the highest social class. Amblyopia (p = 0.089) and convergent strabismus (p =0.066) also tended to increase as social class decreased.
Conclusions Although strabismus has decreased in the UK, it and amblyopia remain common problems. Children from less advantaged backgrounds are more at risk of hypermetropia and to a lesser extent of amblyopia and convergent strabismus. Children's eye care services may need to take account of this socioeconomic gradient in prevalence to avoid inequity in access to care.