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February 25, 2010Investigative Ophthalmology & Visual Science236 citations

Prevalence of Refractive Error in Singaporean Chinese Children: The Strabismus, Amblyopia, and Refractive Error in Young Singaporean Children (STARS) Study

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MDMohamed DiraniYCYiong‐Huak ChanGGGus Gazzard

Key Points

  • To determine the prevalence of various refractive error types in children aged 6 to 72 months.
  • Conducted a population-based survey with door-to-door recruitment using disproportionate random sampling in 6-month age strata (N=3,009 examined; participation rate 72.3%).
  • Assessed cycloplegic autorefraction, ocular biometry, and logMAR visual acuity in children aged 6 to 72 months (mean age 41 months; right-eye cycloplegic data available for N=2,639).
  • Overall prevalence was 11.0% for myopia (spherical equivalent ≤ -0.50 D; high myopia 0.2%), 8.6% for astigmatism, 1.4% for hyperopia, and 0.6% for anisometropia, with a mean right-eye spherical equivalent of +0.69 D (SD 1.15).
  • Sex differences were non-significant for myopia prevalence (P = 0.91), while astigmatism prevalence increased significantly with age (P < 0.001), and myopia rates ranged from 20.2% in toddlers aged 24 to 35 months to 6.4% in children aged 60 to 72 months.

Abstract

PURPOSE: To determine the prevalence of refractive error types in Singaporean Chinese children aged 6 to 72 months. METHODS: The Strabismus, Amblyopia and Refractive Error in Singaporean Children (STARS) is a population-based study in southwest Singapore. Door-to-door recruitment of participants was used, with disproportionate random sampling in 6-month increments. Parental questionnaires were administered. Participant eye examinations included logMAR visual acuity, cycloplegic autorefraction, and ocular biometry. Overall and age-specific prevalences of myopia (spherical equivalence SE or= +3.00 D), astigmatism (cylinder >or= +1.50 D), and anisometropia (SE difference between each eye >or=2.00 D) were calculated. RESULTS: A total of 3009 children were examined (participation rate, 72.3%). Right eye (OD) cycloplegia data were available for 1375 boys and 1264 girls (mean age, 41 months). Mean OD SE was +0.69 D (SD 1.15). Overall myopia prevalence was 11.0% with no variance between the sexes (P = 0.91). The prevalence of high myopia (at least -6.00 D) was 0.2%. The prevalences of hyperopia, astigmatism, and anisometropia were 1.4%, 8.6%, and 0.6%, respectively. Most astigmatism (>95%) was with-the-rule (cylinder axes between 1 degrees and 15 degrees or 165 degrees and 180 degrees ). Myopia was present in 15.8%, 14.9%, 20.2%, 8.6%, 7.6%, and 6.4% of children aged 6 to 11, 12 to 23, 24 to 35, 36 to 47, 48 to 59, and 60 to 72 months, respectively. Prevalence increased with age for astigmatism (P < 0.001), but not for hyperopia or anisometropia (P = 0.55 and P = 0.37), respectively. CONCLUSIONS: The prevalences of myopia and astigmatism in young Singaporean Chinese children are high, but that of hyperopia is low. Age effects were observed for each refractive error category, but differences between the sexes were not significant. Age-related variation in myopia prevalence may be influenced by ocular development, environment, and/or testability.

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Cite This Study

Dirani et al. (2010) studied this question.

synapsesocial.com/papers/6a7cd0e1acf1bda3951e6df0https://doi.org/10.1167/iovs.09-3587
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