Refractive error and visual impairment in urban children in southern China
Refractive error and visual impairment in urban children in southern China
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DOI：
10.1167/iovs.03-1051
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发表时间：
2004-03-01
影响因子：
4.4
通讯作者：
Ellwein, LB
中科院分区：
文献类型：
--
作者：
He, MG;Zeng, JW;Ellwein, LB
目的。为了解中国南方某大都市学龄儿童屈光不正和视力损害的患病率。方法：随机抽取广州市5~15岁学龄儿童。2002年10月至2003年1月，在71所学校和19个社区设施对22个小组的儿童进行了逐户调查。检查内容包括视力、眼球运动功能、检影、睫状肌麻痹下的自体屈光，以及外眼、眼前段、中段和眼底的检查。结果：共调查4814户5053名儿童，检查4364名，占86.4%。裸眼、现有视力和最佳矫正视力20/40或更差的患病率分别为22.3%、10.3%和0.62%。视力下降的2335只眼中，屈光不正占94.9%，弱视占1.9%，其他占0.4%，原因不明占2.8%。1496例(34.3%)有眼球外段和前段异常，以轻度结膜异常为主。中膜和眼底异常32例(0.73%)。验光镜测量的近视(双眼至少相当于-0.50D的球镜)影响了73.1%的15岁儿童，78.4%的儿童患有自发性屈光。5岁儿童检影近视患病率为3.3%，自检近视患病率为5.7%。女性患近视的风险明显更高。验光镜测量的远视(+2.00D或以上)在5岁儿童中占16.7%，用自体屈光法测量的占17.0%。在这两种方法中，15岁青少年的远视患病率都低于1%。散光(柱镜大于或等于0.75D)在接受检影检查的儿童中占33.6%，在接受自体屈光检查的儿童中占42.7%。结论广州市学龄儿童因近视导致视力减退的患病率较高，是一个重要的公共卫生问题。这些儿童中有三分之一没有必要的矫正眼镜。需要有效的策略来消除这种容易治疗的严重视力障碍的原因。
PURPOSE. To assess the prevalence of refractive error and visual impairment in school-age children in a metropolitan area of southern China.METHODS. Random selection of geographically defined clusters was used to identify children 5 to 15 years of age in Guangzhou. Children in 22 clusters were enumerated through a door-to-door survey and examined in 71 schools and 19 community facilities from October 2002 to January 2003. The examination included visual acuity measurements, ocular motility evaluation, retinoscopy, and autorefraction under cycloplegia and examination of the external eye, anterior segment, media, and fundus.RESULTS. A total of 5053 children living in 4814 households were enumerated, and 4364 (86.4%) were examined. The prevalence of uncorrected, presenting, and best-corrected visual acuity 20/40 or worse in the better eye was 22.3%, 10.3%, and 0.62%, respectively. Refractive error was the cause in 94.9% of the 2335 eyes with reduced vision, amblyopia in 1.9%, other causes in 0.4%, and unexplained causes in the remaining 2.8%. External and anterior segment abnormalities were seen in 1496 (34.3%) children, mainly minor conjunctival abnormalities. Media and fundus abnormalities were observed in 32 (0.73%) children. Myopia (spherical equivalent of at least -0.50 D in either eye) measured with retinoscopy affected 73.1% of children 15 years of age, 78.4% with autorefraction. The prevalence of myopia was 3.3% in 5-year-olds with retinoscopy and 5.7% with autorefraction. Females had a significantly higher risk of myopia. Hyperopia (+2.00 D or more) measured with retinoscopy was present in 16.7% of 5-year-olds, 17.0% with autorefraction. The prevalence of hyperopia was below 1% in 15-year-olds, with both methods. Astigmatism (cylinder of greater than or equal to0.75 D) was present in 33.6% of children with retinoscopy and in 42.7% with autorefraction.CONCLUSIONS. The prevalence of reduced vision because of myopia is high in school-age children living in metropolitan Guangzhou, representing an important public health problem. One third of these children do not have the necessary corrective spectacles. Effective strategies are needed to eliminate this easily treated cause of significant visual impairment.