Abstract
PurposeTo evaluate the prevalence and risk factors associated with horizontal strabismus in children and adolescents in South Korea.MethodsA total of 5,935 children and adolescents 5–18 years of age who participated in the fourth and fifth Korean National Health and Nutrition Examination Survey (KNHANES IV-V) from July 2008 to December 2011 were evaluated and the prevalence of horizontal strabismus was estimated. Univariate and multivariate logistic regression analyses were conducted to determine the association between demographic, socioeconomic and clinical risk factors and clinically significant exodeviation (≥15 prism diopters [PD]) and esodeviation (≥10 PD).ResultsAmong 5,935 eligible subjects, 84 subjects had clinically significant exodeviation and 13 had clinically significant esodeviation. The overall prevalence of clinically significant horizontal strabismus was 1.6% (95% confidence interval [CI], 1.2–2.1): 1.3% (95% CI, 1.0–1.7) for clinically significant exodeviation and 0.3% (95% CI, 0.1–0.6) for clinically significant esodeviation. Clinically significant exodeviation was associated with amblyopia (adjusted odds ratio [aOR], 6.45; 95% CI, 2.14–19.44), family history of strabismus (aOR, 4.91; 95% CI, 1.71–14.08) and astigmatism ≥1.0 D (aOR, 1.84; 95% CI, 1.13–2.98). Clinically significant esodeviation was associated with hyperopia (aOR, 12.16; 95% CI, 1.31–113.04) and amblyopia (aOR, 4.70; 95% CI, 1.12–19.81). Other demographic, socioeconomic, and clinical variables were not associated with strabismus.ConclusionThis study provides data on the prevalence and independent risk factors for clinically significant exodeviation and esodeviation in a representative population of children and adolescents in South Korea.
Highlights
Strabismus is a common ocular disorder in children; the prevalence of strabismus ranges from 0.8% to 5.65% [1,2,3,4,5,6,7,8,9]
The overall prevalence of clinically significant horizontal strabismus was 1.6% (95% confidence interval [CI], 1.2–2.1): 1.3% for clinically significant exodeviation and 0.3% for clinically significant esodeviation
Significant exodeviation was associated with amblyopia, family history of strabismus and astigmatism !1.0 D
Summary
Strabismus is a common ocular disorder in children; the prevalence of strabismus ranges from 0.8% to 5.65% [1,2,3,4,5,6,7,8,9]. Hyperopia gradually decreases during school-age years [20, 21]; most population-based studies evaluating associations between potential risk factors and strabismus have been conducted only in children aged 7 years or less (Table 1) [1,2,3, 15, 16]. The prevalence of myopia in children and adolescents in South Korea ranges from 50% in aged 5–11 years to 78.8% in aged 12–18 years [22], which is higher than that in China (16.2% in aged 5–15 years) [23] and that in Japan (43.5% at 12-yearold and 66.0% at 17-year-old) [20]. Ethnicity may influence the prevalence of strabismus and exodeviation:esodeviation ratio, the relationship between possible risk factors and strabismus in South Korean has not been evaluated. We evaluated strabismus prevalence and identified associations between demographic, socioeconomic, and clinical risk factors for strabismus in South Korean children and adolescents
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