Prevalence of intermittent exotropia associated with health behaviors among urban and rural school children in Shantou District, Southern China

Abstract

Objective To investigate the prevalence of intermittent exotropia （IXT） and associat- ed with health behaviors among urban and rural school students in Shantou district. Methods A cross-sectional study, self-administered questionnaire survey. Stratified sampling was used in selecting 7537 students aged 6 to 19 years old from 9 schools in Shantou district. Comprehensive ophthalmo- logic examinations and orthoptic assessments were performed. Ocular alignment was assessed by us- ing the Hirschberg light reflex and cover test. Statistical analyses were performed using SPSS statisti- cal software to investigate the association of age, grades, schools and prevalence of IXT. Logistic re- gression analysis method was used to evaluate the difference between health behaviors between IXT students and orthophoria students. Results Population prevalence of IXT was 7.98%, accounting for 73.04% of all types of strabismus. The IXT prevalence in middle school students was lower than the elementary and high school students. Logistic regression analysis showed that primary school students with IXT were more common to male, high grade and living in rural area, for the secondary school students, were more common to male, higher grades and living in urban area. Analysis of health behavior questionnaire showed that the IXT students had some statistical differences in eye care habits and psychological and behavioral performance compared with orthophoria students. Con- elusions The IXT prevalence is higher in this students-based study. The IXT prevalence and distribution are difference between schools and living areas, may be related to the difference of medical conditions and prevalence of refractive errors. The IXT students are more likely to have bad eye care habits and poor psychological and behavioral performance. Key words: Intermittent exotropia; Epidemiological investigation; Prevalence; Students; Health behavior