Abstract
BackgroundTo estimate the prevalence of strabismus and associated risk factors among grade one school children in Lhasa, Tibet, China.MethodsThe Lhasa Childhood Eye Study (LCES) was a cross-sectional, school-based childhood study conducted in Grade one students from primary schools in Lhasa, Tibet, China. Comprehensive ophthalmic examinations and basic systemic examinations were evaluated. A questionnaire survey containing information about children, as well as parents’ information, was sent to the corresponding parents of eligible children. The prevalence of strabismus and its 95% confidence interval was estimated. Univariate and multivariate logistic regression analyses were conducted to determine the associated risk factors.ResultsA total of 1942 eligible grade one students were enrolled, of which 1856 participants completed all examinations. The average age was 6.83 ± 0.46 years, 53% of participants were boys and 1762 were the Tibetan Minority. Over all, the prevalence of strabismus was 68/1856 (3.7%) (95%CI: 2.81,4.52), with no difference between the ages, genders, ethnicities and body mass index, while tilting one’s head when writing may be a risk factor for strabismus (P = 0.004). Strabismus students had mean best corrected visual acuity of 0.16 ± 0.28(LogMAR), over 50% patients with esotropia were hyperopic, and participants who had stereopsis impairments showed a significant difference between esotropia and exotropia (P = 0.026).ConclusionsThe prevalence of strabismus in LCES was 3.7%, which is higher than previous reports from Chinese childhood epidemiology studies. Strabismus is a common contributing factor to amblyopia. Tilting one’s head when writing may be a risk factor. Esotropia is more likely to affect stereopsis and be associated with the refractive state of hyperopia.Trial registrationThe study has finished the clinical registration on Chinese Clinical Trial Registry. (http://www.chictr.org.cn, ChiCTR1900026693).
Highlights
To estimate the prevalence of strabismus and associated risk factors among grade one school children in Lhasa, Tibet, China
The mean best-corrected distant visual acuity (VA) (BCVA) measured by LogMAR was 0.05 ± 0.11 and 0.05 ± 0.10 for right and left eye, respectively
We found the prevalence of strabismus was 3.66% with an exotropia: esotropia ratio was 5.38:1, and participants with esotropia were more likely to affect stereopsis, with most being hyperopic
Summary
To estimate the prevalence of strabismus and associated risk factors among grade one school children in Lhasa, Tibet, China. Strabismus, called squint, is a condition of misalignment of the visual axes of the eyes, and was first known as eye misalignment since the Hippocratic era [1]. It can adversely affect binocular single vision, like simultaneous perception, fusion and stereopsis, and cosmetic impairment, which can cause significant psychosocial consequences [2, 3] Strabismus is a common contributing factor to amblyopia in children, which will persist into adulthood if not treated in time [4]. Screening in childhood has become an important part of the children’s eye health program and should be done early [8, 9]
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