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Prevalence, causes and associations of amblyopia in year 1 students in Central China

The Anyang childhood eye study (ACES)

  • Pediatrics
  • Published:
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Abstract

Background

Earlier diagnosis and treatment of amblyopia are associated with improved visual outcomes. This study reports the prevalence of amblyopia and associated factors in year 1 primary school students in central China.

Methods

The school-based, cross-sectional study involved 3,112 year 1 primary school students . All the participants underwent a comprehensive eye examinations including cycloplegic refraction, cover test and ocular movement examinations. The unaided and best corrected visual acuity (BCVA) was recorded. Unilateral amblyopia was defined as a 2-line interocular difference with BCVA ≤ 20/32 (≥ logMar 0.2) in the worse eye and with coexisting anisometropia (≥ 1.00 D SE for hyperopia, ≥ 3.00 D SE for myopia, or ≥ 1.50 D for astigmatism), strabismus or past or present visual axis obstruction. Bilateral amblyopia was defined as BCVA in both eyes<20/40 (> logMar 0.3), with coexisting hyperopia ≥ 4 D SE, myopia ≤ −6 D SE, or astigmatism ≥ 2.5 D, or past or present visual axis obstruction.

Results

Out of the 3,112 eligible students, 2,893 (93.0 %) students completed the examinations. The average age of the students was 7.1 ± 0.4 (mean ± standard deviation SD) years old. The prevalence of amblyopia was 1.0 % (95 % confidence interval [CI], 0.6 %–1.3 %) with no difference between the sexes (P = 0.88). Of the 27 amblyopic students, unilateral amblyopia was found in 18 (66.7 %) students, and bilateral amblyopia in 9 (33.3 %) students. Of 18 unilateral amblyopia, 13 were anisometropic amblyopia, 4 were strabismus amblyopia, 1 was mixed amblyopia. Of 9 bilateral amblyopia, 7 were isoametropic amblyopia, 2 were stimulus deprivation. The mean corrected VA of the amblyopic eyes was 30.50 logMAR letters (Snellen VA equivalent 4/12.6), and the range was 5 to 45 logMAR letters (Snellen VA equivalent 4/40-4/6.3). Most amblyopic eyes (38.9 %) were significantly hyperopic (spherical equivalent ≥ +3.00 D); 25.0 % were myopic. In addition, 58 (2.1 %) students had a previous amblyopia history of amblyopia that was not corroborated in this study.

Conclusions

The study shows a relatively low prevalence of amblyopia (1.0 %) in year 1 students in central China. Amblyopia is usually caused by abnormal refractive error.

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Acknowledgments

The ACES was supported by the Major State Basic Research Development Program of China (“973” Program, 2011CB504601) of the Ministry of Science and Technology, the Major International (Regional) Joint Research Project (81120108007) of the National Natural Science Foundation of China. The authors thank the support they received from the Anyang city government in helping organize the survey.

Conflicts of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Lab, Capital Medical University, No. 1 Dongjiao Min Xiang, Dongcheng District, Beijing, 100730, China

    Jing Fu, Shi Ming Li, Si Yuan Li, Zhou Yang, Lei Li & Ning Li Wang

  2. Anyang Eye Hospital, Anyang City, Henan Province, China

    Jin Ling Li & He Li

  3. Department of Ophthalmology, The Second Hospital affiliated to Harbin Medical University, Harbin, Heilongjiang Province, China

    Bi Dan Zhu

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  1. Jing Fu
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Correspondence to Ning Li Wang.

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Fu, J., Li, S.M., Li, S.Y. et al. Prevalence, causes and associations of amblyopia in year 1 students in Central China. Graefes Arch Clin Exp Ophthalmol 252, 137–143 (2014). https://doi.org/10.1007/s00417-013-2451-z

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  • DOI: https://doi.org/10.1007/s00417-013-2451-z

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