Refractive Error Study in Children: Results from La Florida, Chile
Refractive Error Study in Children: Results from La Florida, Chile
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DOI：
10.1016/s0002-9394(99)00454-7
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发表时间：
2000-04-01
影响因子：
4.2
通讯作者：
Ellwein, LB
中科院分区：
文献类型：
--
作者：
Maul, E;Barroso, S;Ellwein, LB
目的：评估智利圣地亚哥郊区（拉佛罗里达）学龄儿童屈光不正和视力损害的患病率。
方法：采用随机选择地理区域集群的方法来确定5至15岁儿童的代表性样本。通过挨家挨户的调查对26个选定集群中的儿童进行统计，并邀请他们到社区卫生诊所接受检查。1998年4月至8月进行了视力测量、睫状肌麻痹视网膜检影、睫状肌麻痹自动验光、眼球运动评估以及外眼、眼前节、眼介质和眼底检查。对所有视力下降的儿童以及部分视力正常的儿童进行了独立重复检查，以对6个集群进行质量保证监测。
结果：对来自3830户家庭的共6998名儿童进行了统计，其中5303名儿童（75.8%）接受了检查。至少一只眼未矫正、初始及最佳视力为0.50（20/40）或更差的患病率分别为15.8%、14.7%和7.4%；3.3%的儿童双眼最佳视力为0.50或更差。在1285只视力下降的眼中，屈光不正为病因的占56.3%，弱视占6.5%，其他病因占4.3%，其余32.9%病因不明。5岁儿童中任一眼近视 -0.50屈光度或更低的占3.4%，到15岁时男性增加到19.4%，女性增加到14.7%。在相同年龄范围内，男性远视2.00屈光度或更高的比例从22.7%下降到7.1%，女性从26.3%下降到8.9%。女性远视的风险明显高于男性。
结论：屈光不正（主要与近视相关）是拉佛罗里达学龄儿童视力下降的主要原因。超过7%的儿童可从佩戴合适眼镜中受益。需要努力使现有的为学童提供免费眼镜的项目更有效。还需要进一步研究以确定近视的上升趋势是否在15岁之后仍持续。（《美国眼科杂志》2000年；129:445 - 454。©2000爱思唯尔科学公司。保留所有权利。）
PURPOSE: To assess the prevalence of refractive errors and vision impairment in school-age children in a suburban area (La Florida) of Santiago, Chile.METHODS: Random selection of geographically defined clusters was used to identify a representative sample of children 5 to 15 years of age. Children in the 26 selected clusters were enumerated through a door to-door survey and invited to report to a community health clinic for examination. Visual acuity measurements, cycloplegic retinoscopy, cycloplegic autorefraction, ocular motility evaluation, and examination of the external eye, anterior segment, media, and fundus were done from April through August 1998. Independent replicate examinations of all children with reduced vision and a sample of those with normal vision were done for quality assurance monitoring in six clusters.RESULTS: A total of 6,998 children from 3,830 households were enumerated, and 5,303 children (75.8%) were examined, The prevalence of uncorrected, presenting, and best visual acuity 0.50 (20/40) or worse in at least one eye was 15.8%, 14.7%, and 7.4%, respectively; 3.3% had best visual acuity 0.50 or worse in both eyes. Refractive error was the cause in 56.3% of the 1,285 eyes with reduced vision, amblyopia in 6.5%, other causes in 4.3%, with unexplained causes in the remaining 32.9%. Myopia -0.50 diopter or less in either eye was present in 3.4% of 5-year-old children, increasing to 19.4% in males and 14.7% in females by age 15. Over this same age range, hyperopia 2.00 diopters or greater decreased from 22.7% to 7.1% in males and from 26.3% to 8.9% in females. Females had a significantly higher risk of hyperopia than males.CONCLUSIONS: Refractive error, associated primarily with myopia, is a major cause of reduced vision in school-age children in La Florida. More than 7% of children could benefit from the provision of proper spectacles. Efforts are needed to make existing programs that provide free spectacles for school children more effective. Further studies are needed to determine whether the upward trend in myopia continues far beyond 15 years of age. (Am J Ophthalmol 2000;129:445-454. (C) 2000 by Elsevier Science Inc. All rights reserved.).