Elsevier

Ophthalmology

Volume 113, Issue 9, September 2006, Pages 1567-1573
Ophthalmology

Original Article
Refractive Error and Patterns of Spectacle Use in 12-Year-Old Australian Children

https://doi.org/10.1016/j.ophtha.2006.02.066Get rights and content

Purpose

To document the prevalence of visual impairment resulting from refractive error and to describe patterns of spectacle use in a representative sample of 12-year-old Australian school children.

Design

Population-based cross-sectional study.

Participants

Two thousand three hundred fifty-three predominantly 12-year-old children examined from 2004 through 2005.

Methods

Logarithm of the minimum angle of resolution (logMAR) visual acuity (VA) was measured unaided and with spectacles if worn. Subjective refraction, cycloplegic autorefraction (with cyclopentolate), and detailed dilated fundus examination were performed.

Main Outcome Measures

Myopia was defined as spherical equivalent (SE) refraction ≤−0.50 diopters (D), hyperopia as SE refraction ≥2.0 D, and astigmatism as cylinder ≥1.0 D. Uncorrected visual impairment was defined using unaided VA, and presenting visual impairment was defined using spectacle-corrected VA, if worn. Visual impairment was defined as VA <20/40 (<40 logMAR letters) for both better and worse eyes. Spectacle need was defined as uncorrected visual impairment in the better eye, improving by at least 2 lines with refraction, and undercorrection as presenting impairment in the better eye, improving by at least 2 lines with refraction.

Results

Uncorrected and presenting visual impairment in at least 1 eye because of refractive error was found in 10.4% and 3.7%, respectively. Spectacle use was reported by 448 children (19.0%); 204 (46.3%) had myopia, 48 (10.9%) had hyperopia, and 96 (21.8%) had astigmatism in at least 1 eye; 38.3% had no significant refractive error in either eye. Eight children were in need of spectacles and 37 children (8.3% of spectacle users) were undercorrected. Nonrefractive spectacle users were more likely to report eyestrain and headache or to have had learning difficulty at school (P<0.0001).

Conclusions

This study documents a relatively low prevalence of undercorrected refractive error in a population of Australian children. Nonrefractive prescription of spectacles is common.

Section snippets

Population

The Sydney Myopia Study is a population-based survey of eye health in school children (predominantly aged 6 or 12 years), resident in the metropolitan area of Sydney, Australia. This project forms part of the Sydney Childhood Eye Study, which examines childhood eye conditions across a range of ages. Methods used to identify and select the target sample, as well as a description of this sample and study procedures, have been reported.16 In brief, schools in the study area were stratified by

Participants

Of 3144 eligible children, 2367 children (response rate, 75.3%) were given parental permission to participate and had questionnaire data provided by parents. Of the 2367 children with a positive response, 14 were not examined because they were absent from school during the examination period. The mean age of participants was 12.7 years (range, 11.1–14.4 years); 49.4% of children were female. Basic sociodemographic data on the study participants are presented in Table 1.

Prevalence of Visual Impairment Resulting from Refractive Errors

Uncorrected visual

Discussion

To our knowledge, this is the first population-based study to document refractive error correction and associated factors in a predominantly Caucasian population of children, while having sufficient power to document differences with children of other ethnicities. The burden of refractive visual impairment in our sample (10.4%) was comparable with recent estimates of 11.2% and 9.8% from a rural Chinese district4 and an urban Chilean sample,9 respectively. It was less than that of 2 urban

References (28)

  • R. Dandona et al.

    Refractive error in children in a rural population in India

    Invest Ophthalmol Vis Sci

    (2002)
  • G.V. Murthy et al.

    Refractive error in children in an urban population in New Delhi

    Invest Ophthalmol Vis Sci

    (2002)
  • K.S. Naidoo et al.

    Refractive error and visual impairment in African children in South Africa

    Invest Ophthalmol Vis Sci

    (2003)
  • M. He et al.

    Need and challenges of refractive correction in urban Chinese school children

    Optom Vis Sci

    (2005)

    • Cited by (0)

    Manuscript no. 2005-1241.

    The Sydney Myopia Study is supported by the National Health & Medical Research Council, Canberra, Australia (grant no.: 253732); Westmead Millennium Institute, University of Sydney; and Vision Co-operative Research Centre, University of New South Wales, Sydney, Australia.

    The authors have no proprietary interests in the article.

    View full text
    Copyright © 2006 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.