Abstract
Uncorrected refractive error, especially myopia, in young children can cause permanent visual impairment in later life. However, data on the normative development of refractive error in this age group is limited, especially in Malaysia. The aim of this study was to determine the distribution of refractive error in a sample of infants and young children between the ages of 6 to 36 months in a prospective, cross-sectional study. Cycloplegic retinoscopy was conducted on both eyes of 151 children of mean age 18.09 ± 7.95 months. Mean spherical equivalent refractive error for the right and left eyes was +0.85 ± 0.97D and +0.86 ± 0.98D, respectively. The highest prevalence of refractive error was astigmatism (26%), followed by hyperopia (12.7%), myopia (1.3%) and anisometropia (0.7%). There was a reduction of hyperopic refractive error with increasing age. Myopia was seen to emerge at age 24 months. In conclusion, the prevalence of astigmatism and hyperopia in infants and young children was high, but that of myopia and anisometropia was low. There was a significant reduction in hyperopic refractive error towards emmetropia with increasing age. It is recommended that vision screening be conducted early to correct significant refractive error that may cause disruption to clear vision.
Highlights
Uncorrected refractive error is one of the leading causes of visual impairment in the world.Over the years, a number of investigators have performed cross-sectional and longitudinal studies on the refractive status of neonates, infants, toddlers, preschool and school-aged children
In our present cross-sectional study, we aim to describe the distribution of refractive error in a sample of healthy, full term infants and young children aged 6 to 36 months in Kuala Lumpur and to determine the association between refractive error group with age, gender and race
Astigmatism (≥1.50 DC) was the most common type of refractive error found in this study population with a prevalence rate of 25.8%, followed by hyperopia, myopia and anisometropia, with prevalence rates of 12.6%, 1.3% and 0.7%, respectively
Summary
A number of investigators have performed cross-sectional and longitudinal studies on the refractive status of neonates, infants, toddlers, preschool and school-aged children. More population-based studies on the prevalence of refractive error have been conducted in school-aged children as compared to infants and toddlers. A recent meta-analysis by Hashemi et al [1] has estimated pooled prevalence (EPP) globally and regionally as defined by the World Health Organization. For children (defined as less than 20 years of age), the estimated pooled prevalence of astigmatism (defined as >0.50 D) was 14.9% (95% confidence interval 12.7–17.1), myopia (defined as ≤ −0.50 D). There was a notable increase in the prevalence of myopia from 10.4% in 1993 to 34.2% in 2016
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