Refractive Error and Amblyogenic Risk Factors in Pre-School Children




Aryal, Subhash
Aiken, Julia
Galvan, Coulter
Zielke, Cameron
Mozdbar, Sima


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Amblyopia is the most common cause of vision loss in children and is defined as reduced visual acuity in the absence of ocular pathology. Early detection and treatment of children identified as having amblyogenic risk factors, including high refractive error, is imperative in reducing long-term visual impairment. This study determines the prevalence of refractive errors and amblyogenic risk factors in children aged 3-5 years and attending Fort Worth, Texas schools. Researchers performed vision screenings in 20 elementary schools. The sample was delimited to children 5 years and younger (N=1,769). Binomial variables indicating refractive errors (hyperopia, myopia, astigmatism and anisometropia) were created to execute frequencies and Chi-Square tests amongst race/ethnicity and gender. Participants were also stratified by presence of any amblyogenic risk factors. Those with at least one refractive error accounted for 32% of the sample. Nearly 1% (n=22) had an amblyogenic risk factor. No significant presence of refractive errors by gender were present, but significance appeared amongst Hispanic (p< .0001), Black (p< .0001), and Asian (p< .0460) children. Hispanic and Black children had 3.445 (95%, CI=2.418-4.909) and 2.912 (95%, CI=1.947-4.357) higher odds, respectively, of having a refractive error than their White counterparts. Significant differences in refractive errors by race and ethnicity align with findings in previous studies. The prevalence of uncorrected refractive errors indicates a potential for learning difficulties and developmental challenges. These findings support the importance of routine vision screening and the need for community-targeted education regarding comprehensive eye examinations.