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Prevalence of amblyopia and its association with refraction in Chinese preschool children aged 36–48 months
  1. Dan Huang1,
  2. Xuejuan Chen1,
  3. Hui Zhu1,
  4. Hui Ding2,
  5. Jing Bai2,
  6. Ji Chen2,
  7. Zhujun Fu3,
  8. Chen-Wei Pan4,
  9. Hu Liu1
  1. 1Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
  2. 2Department of Ophthalmology, Maternal and Child Healthcare Hospital of Yuhuatai District, Nanjing, Jiangsu, China
  3. 3Department of Ophthalmology, Nanjing Children’s Hospital, Nanjing, China
  4. 4Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
  1. Correspondence to Profosser Hu Liu, Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China; dr_liuhu66{at}


Purpose To determine the prevalence of amblyopia and its association with refraction in Chinese preschool children.

Methods The Yuhuatai Pediatric Eye Disease Study, a cross-sectional, population-based study, was conducted in children aged 36–48 months in Yuhuatai District, Nanjing, China, in 2015. Visual acuity was measured in 1695 eligible children.

Results Of the 1695 subjects, manifested amblyopia was detected in 25 children (1.47%, 95% CI 0.90% to 2.05%), including 11 and 14 with bilateral and unilateral amblyopia, respectively. Amblyopia prevalence did not differ by gender (p=0.77). Significant refractive errors were found in 22 (88.0%) of children with amblyopia, and strabismus was found in 6 (24.0%) children with amblyopia. In multivariate analysis, amblyopia was significantly associated with hyperopia (≥+2.00 dioptres (D); OR 8.81, 95% CI 3.27 to 23.69, p<0.0001), astigmatism (≥2.00 D; OR 17.90, 95% CI 6.78 to 47.21, p<0.0001) and anisometropia (≥2.00 D; OR 5.87, 95% CI 1.52 to 22.77, p<0.05).

Conclusions The prevalence of amblyopia in children 36–48 months old in Eastern China was 1.47%. The refractive error is a major risk factor for amblyopia.

  • amblyopia
  • children
  • refractive error

Statistics from


  • Contributors HL and XC designed the study. DH and XC wrote the main manuscript text. DH prepared tables 1–3. HZ prepared figure 1. DH, XC and C-WP performed data interpretation and analysis. DH, JB, JC and ZF performed the ocular examinations.

  • Funding This work is supported by the National Natural Science Foundation of China (Grant No 81400435 and No 81673198), the Natural Science Foundation of Jiangsu Province (Grant No BK20141027 and No BK20161595), and the Scientific Research Projects of Jiangsu Provincial Commission of Health and Family Planning (Grant No 285 H201507).

  • Competing interests None declared.

  • Patient consent Parental/guardian consent obtained.

  • Ethics approval The Ethics Committee of Nanjing Medical University.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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