Abstract
PurposeTo investigate the association between concomitant esotropia or concomitant exotropia and refractive error in preschool childrenMethodsA population-based sample of 5831 children aged 3 to 6 years was selected from all kindergartens in a representative county (Yuhuatai District, Nanjing, Jiangsu Province) of Nanjing, China. Clinical examinations including ocular alignment, ocular motility, visual acuity, optometry, stereopsis screening, slit lamp examination and fundus examination were performed by trained ophthalmologists and optometrists. Odd ratios (OR) and 95% confidence intervals (95% CI) were calculated to evaluate the association of refractive error with concomitant esotropia and concomitant exotropia.ResultsIn multivariate logistic regression analysis, concomitant esotropia was associated independently with spherical equivalent anisometropia (OR, 3.15 for 0.50 to <1.00 diopter (D) of anisometropia, and 7.41 for > = 1.00 D of anisometropia) and hyperopia. There was a severity-dependent association of hyperopia with the development of concomitant esotropia, with ORs increasing from 9.3 for 2.00 to <3.00 D of hyperopia, to 180.82 for > = 5.00 D of hyperopia. Concomitant exotropia was associated with astigmatism (OR, 3.56 for 0.50 to 1.00 D of astigmatism, and 1.9 for <0.00 D of astigmatism), myopia (OR, 40.54 for -1.00 to <0.00 D of myopia, and 18.93 for <-1.00 D of myopia), and hyperopia (OR, 67.78 for 1.00 to <2.00 D of hyperopia, 23.13 for 2.00 to <3.00 D of hyperopia, 25.57 for 3.00 to <4.00 D of hyperopia, and 8.36 for 4.00 to <5.00 D of hyperopia).ConclusionsThis study highlights the close associations between refractive error and the prevalence of concomitant esotropia and concomitant exotropia, which should be considered when managing childhood refractive error.
Highlights
Strabismus is a common childhood ocular disorder with population-based prevalence estimates ranging from 1.2% to 5% in Chinese children [1, 2]
There was a severity-dependent association of hyperopia with the development of concomitant esotropia, with Odd ratios (OR) increasing from 9.3 for 2.00 to = 5.00 D of hyperopia
Concomitant exotropia was associated with astigmatism (OR, 3.56 for 0.50 to 1.00 D of astigmatism, and 1.9 for
Summary
Strabismus is a common childhood ocular disorder with population-based prevalence estimates ranging from 1.2% to 5% in Chinese children [1, 2]. The manifest misalignment of the eyes often results in deficient binocular depth perception and even amblyopia. Besides these functional effects, there are psychological distresses because of strabismus, such as depression and anxiety, impaired self-esteem and self-confidence, unsatisfied interpersonal relationships and social prejudice [3,4,5,6,7]. Population-based research is significant in exploring the effect of refractive error on the development of various types of childhood strabismus. The present study aimed to analyze associations between refractive error and different types of strabismus in preschool children aged 3 to 6 years enrolled in the population-based Nanjing Pediatric Vision Project (NPVP)
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