The prevalence of amblyopia in 7–9-year-old schoolchildren in Mashhad
Medical Hypothesis, Discovery & Innovation in Optometry,
Vol. 2 No. 1 (2021),
16 June 2021
AbstractBackground: To determine the prevalence of amblyopia in schoolchildren aged 7–9 years old in Mashhad, Iran.
Methods: This was a cross-sectional, community-based study with schoolchildren aged 7–9 years old. We randomly selected 20 of 189 elementary schools (three schools per district; 10 male-segregated and 10 female-segregated schools) from a proportional combination of public schools across Mashhad. Basic vision exams were performed. If amblyopia was suspected, children underwent supplementary vision exams. The diagnostic criterion for amblyopia was a best corrected visual acuity (BCVA) in one or both eyes equal to or worse than 20/40 or an interocular difference of more than two lines in BCVA without any significant organic pathology.
Results: A total of 2831 children were included in the study. All children were examined comprehensively by an optometrist, and amblyopia was detected in 49/2831 (1.7% [95% CI, 1.22?2.18]). Of the 49 children with amblyopia, 20 (40.8%) were amblyopic in the right eye, 9 (18.4%) in the left eye, and 20 (40.8%) in both eyes. Twenty-four (49%) were first graders, 15 (30.6%) were second graders, and 10 (20.4%) were third graders. The most prevalent subtype of amblyopia was anisometropic amblyopia (57.1%, [95% CI, 43.24?70.96]).
Conclusions: Considering the prevalence of amblyopia among schoolchildren aged 7–9 years old (1.7%), timely detection of amblyopia through preschool screening programs is essential for early treatment or prevention of further visual impairment during childhood.
How to cite this article: Shahpary S, Ramin S, Azimi A, Heyrani M. The prevalence of amblyopia in 7-9-year-old schoolchildren in Mashhad. Med Hypothesis Discov Innov Optom.2021 Spring; 2(1): 18-23. DOI: https://doi.org/10.51329/mehdioptometry121
- elementary school
- preschool children
- diagnostic screening program
Brown SA, Weih LM, Fu CL, Dimitrov P, Taylor HR, McCarty CA. Prevalence of amblyopia and associated refractive errors in an adult population in Victoria, Australia. Ophthalmic Epidemiology. 2000;7(4):249-58. doi: 10.1076/0928-6586(200012)741-yft249 pmid:11262672
Mostafaie A, Ghojazadeh M, Hosseinifard H, Manaflouyan H, Farhadi F, Taheri N, et al. A systematic review of Amblyopia prevalence among the children of the world. Rom J Ophthalmol. 2020;64(4):342-55. doi: 10.22336/rjo.2020.56 pmid: 33367172
Jamali P, Fotouhi A, Hashemi H, Younesian M, Jafari A. Refractive errors and amblyopia in children entering school: Shahrood, Iran. Optom Vis Sci. 2009;86(4):364-9. doi: 10.1097/OPX.0b013e3181993f42 pmid: 19289975
Xiao O, Morgan IG, Ellwein LB, He M, Refractive Error Study in Children Study G. Prevalence of Amblyopia in School-Aged Children and Variations by Age, Gender, and Ethnicity in a Multi-Country Refractive Error Study. Ophthalmology. 2015;122(9):1924-31. doi: 10.1016/j.ophtha.2015.05.034 pmid: 26278861
Faghihi M, Ostadimoghaddam H, Yekta AA. Amblyopia and strabismus in Iranian schoolchildren, Mashhad. Strabismus. 2011;19(4):147-52. doi: 10.3109/09273972.2011.622341 pmid: 22107119
Yekta A, Fotouhi A, Hashemi H, Dehghani C, Ostadimoghaddam H, Heravian J, et al. The prevalence of anisometropia, amblyopia and strabismus in schoolchildren of Shiraz, Iran. Strabismus. 2010;18(3):104-10. doi: 10.3109/09273972.2010.502957 pmid: 20843187
Hashemi H, Yekta A, Jafarzadehpur E, Nirouzad F, Ostadimoghaddam H, Eshrati B, et al. The prevalence of amblyopia in 7-year-old schoolchildren in Iran. Strabismus. 2014;22(4):152-7. doi: 10.3109/09273972.2014.971824 pmid: 25335186
Barrett BT, Bradley A, Candy TR. The relationship between anisometropia and amblyopia. Prog Retin Eye Res. 2013;36:120-58. doi: 10.1016/j.preteyeres.2013.05.001 pmid: 23773832
Lim HT, Yu YS, Park SH, Ahn H, Kim S, Lee M, et al. The Seoul Metropolitan Preschool Vision Screening Programme: results from South Korea. Br J Ophthalmol. 2004;88(7):929-33. doi: 10.1136/bjo.2003.029066 pmid: 15205240
Carlton J, Karnon J, Czoski-Murray C, Smith KJ, Marr J. The clinical effectiveness and cost-effectiveness of screening programmes for amblyopia and strabismus in children up to the age of 4-5 years: a systematic review and economic evaluation. Health Technol Assess. 2008;12(25):iii, xi-194. doi: 10.3310/hta12250 pmid: 18513466
Benetti Zagui RM. ‘Amblyopia: Types, Diagnosis, Treatment, and New Perspectives’. American Academy of Ophthalmology, ONE Network. [ June 2019]. Available from: https://www.aao.org/disease-review/amblyopia-types-diagnosis-treatment-new-perspectiv. Accessed: June 07, 2021.
Newman DK, East MM. Prevalence of amblyopia among defaulters of preschool vision screening. Ophthalmic Epidemiol. 2000;7(1):67-71. pmid: 10652173
Dandona R, Dandona L. Refractive error blindness. Bull World Health Organ. 2001;79(3):237-43. Epub 2003 Jul 7. pmid: 11285669
Ravindran M, Pawar N, Renagappa R, Ravilla T, Khadse R. Identifying barriers to referrals in preschool-age ocular screening in Southern India. Indian J Ophthalmol. 2020;68(10):2179-84. doi: 10.4103/ijo.IJO_1603_19 pmid: 32971635
Holmes JM, Levi DM. Treatment of amblyopia as a function of age. Vis Neurosci. 2018;35:E015. doi: 10.1017/S0952523817000220 pmid: 29905125
Webber AL, Wood J. Amblyopia: prevalence, natural history, functional effects and treatment. Clin Exp Optom. 2005;88(6):365-75. doi: 10.1111/j.1444-0938.2005.tb05102.x pmid: 16329744
Committee on P, Ambulatory Medicine Section on O, American Association of Certified O, American Association for Pediatric O, Strabismus, American Academy of O. Eye examination in infants, children, and young adults by pediatricians: organizational principles to guide and define the child health care system and/or improve the health of all children. Ophthalmology. 2003;110(4):860-5. doi: 10.1016/S0161-6420(03)00414-7 pmid: 12689914
Ohlsson J. Defining amblyopia: the need for a joint classification. Strabismus. 2005;13(1):15-20. doi: 10.1080/09273970590890949 pmid: 15824012
Ohlsson J, Villarreal G, Sjostrom A, Abrahamsson M, Sjostrand J. Screening for amblyopia and strabismus with the Lang II stereo card. Acta Ophthalmol Scand. 2002;80(2):163-6. doi: 10.1034/j.1600-0420.2002.800208.x pmid: 11952482
Tan JH, Thompson JR, Gottlob I. Differences in the management of amblyopia between European countries. Br J Ophthalmol. 2003;87(3):291-6. doi: 10.1136/bjo.87.3.291 pmid: 12598440
Matta NS, Singman EL, Silbert DI. Performance of the plusoptiX S04 photoscreener for the detection of amblyopia risk factors in children aged 3 to 5. J AAPOS. 2010;14(2):147-9. doi: 10.1016/j.jaapos.2010.01.006 pmid: 20451857
Powell C, Hatt SR, Powell C. Vision screening for amblyopia in childhood. The Cochrane Library. 2005. doi: 10.1002/14651858. CD005020.pub3 pmid: 19588363
Logan NS, Gilmartin B. School vision screening, ages 5-16 years: the evidence-base for content, provision and efficacy. Ophthalmic Physiol Opt. 2004;24(6):481-92. doi: 10.1111/j.1475-1313.2004.00247.x pmid: 15491475
Konig HH, Barry JC. Economic evaluation of different methods of screening for amblyopia in kindergarten. Pediatrics. 2002;109(4):e59. doi: 10.1542/peds.109.4.e59 pmid: 11927732
Lagreze WA. Vision screening in preschool children: do the data support universal screening? Dtsch Arztebl Int. 2010;107(28-29):495-9.
König H-H, Barry J-C. Cost-Utility Analysis of Orthoptic Screening in Kindergarten: A Markov Model Based on Data From Germany. Methods. 2000.
Groenewoud JH, Tjiam AM, Lantau VK, Hoogeveen WC, de Faber JT, Juttmann RE, et al. Rotterdam AMblyopia screening effectiveness study: detection and causes of amblyopia in a large birth cohort. Invest Ophthalmol Vis Sci. 2010;51(7):3476-84. doi: 10.1167/iovs.08-3352 pmid: 20089868
Ohlsson J, Sjöstrand J. Preschool vision screening: is it worthwhile? Pediatric Ophthalmology, Neuro-Ophthalmology. Genetics: Springer. 2006:19-36. doi: 10.1007/3-540-31220-x_2
Fotouhi A, Hashemi H, Mohammad K, Jalali KH, Tehran Eye S. The prevalence and causes of visual impairment in Tehran: the Tehran Eye Study. Br J Ophthalmol. 2004;88(6):740-5. doi: 10.1136/bjo.2003.031153 pmid: 15148203
Shahriari HA, Izadi S, Rouhani MR, Ghasemzadeh F, Maleki AR. Prevalence and causes of visual impairment and blindness in Sistan-va-Baluchestan Province, Iran: Zahedan Eye Study. Br J Ophthalmol. 2007;91(5):579-84. doi: 10.1136/bjo.2006.105734 pmid:17124245
Moradabadi AS, Ghanbarnejad A, Bani-Hashemi A, Pourshoorijeh LT, Tofighi M, Zamzam T, et al. Amblyopia screening in children in Bandar Abbas (Iran) during 2011-2012. Electron Physician. 2014;6(3):906-11. doi: 10.14661/2014.906-911 pmid: 25763166
Rajavi Z, Sabbaghi H, Baghini AS, Yaseri M, Moein H, Akbarian S, et al. Prevalence of Amblyopia and Refractive Errors Among Primary School Children. J Ophthalmic Vis Res. 2015;10(4):408-16. doi: 10.4103/2008-322X.176909 pmid: 27051485
Yekta A, Hashemi H, Ostadimoghaddam H, Haghighi B, Shafiee H, Mehravaran S, et al. Strabismus and Near Point of Convergence and Amblyopia in 4-6 Year-Old Children. Strabismus. 2016;24(3):113-9. doi: 10.1080/09273972.2016.1205103 pmid: 27485705
Yekta A, Hashemi H, Norouzirad R, Ostadimoghaddam H, Nabovati P, Dadbin N, et al. The Prevalence of Amblyopia, Strabismus, and Ptosis in Schoolchildren of Dezful. Eur J Ophthalmol. 2017;27(1):109-12. doi: 10.5301/ejo.5000795 pmid: 27228971
Ikuomenisan SJ, Musa KO, Aribaba OT, Onakoya AO. Prevalence and pattern of amblyopia among primary school pupils in Kosofe town, Lagos state, Nigeria. Niger Postgrad Med J. 2016;23(4):196-201. doi: 10.4103/1117-1936.196261 pmid: 28000640
Robaei D, Kifley A, Rose KA, Mitchell P. Impact of amblyopia on vision at age 12 years: findings from a population-based study. Eye (Lond). 2008;22(4):496-502. doi: 10.1038/sj.eye.6702668 pmid: 17384576
Faghihi M, Hashemi H, Nabovati P, Saatchi M, Yekta A, Rafati S, et al. The Prevalence of Amblyopia and Its Determinants in a Population-based Study. Strabismus. 2017;25(4):176-83. doi: 10.1080/09273972.2017.1391849 pmid: 29144181
- Abstract Viewed: 150 times
- Full Text PDF Downloaded: 46 times