Abstract
The study aims to determine the prevalence of strabismus and its risk factors among school children in Hong Kong. This is a cross-sectional study involving 6–8 year old children from different districts in Hong Kong. 4273 children received comprehensive ophthalmological examination, cycloplegic auto-refraction, best corrected visual acuity (BCVA), anterior segment examination, cover/uncover test, ocular motility, and fundus examination. Demographic information, pre- and post- natal background, parental smoking status, and family history of strabismus were obtained through questionnaires. Strabismus was found among 133 children (3.11%, 95% CI 2.59–3.63%), including 117 (2.74%) exotropia and 12 (0.28%) esotropia cases (exotropia-esotropia ratio: 9.75:1). There was no significant difference in prevalence across age (6–8 years) and gender. Multivariate analysis revealed associations of strabismus with myopia (≤ − 1.00D; OR 1.61; 95% CI 1.03–2.52; P = 0.037) hyperopia (≥ + 2.00D; OR 2.49; 95% CI 1.42–4.39; P = 0.002), astigmatism (≥ + 2.00D; OR 2.32; 95% CI 1.36–3.94; P = 0.002), and anisometropia (≥ 2.00D; OR 3.21; 95% CI 1.36–7.55; P = 0.008). Other risk factors for strabismus included maternal smoking during pregnancy (OR 4.21; 95% CI 1.80–9.81; P = 0.001), family history of strabismus (OR 6.36; 95% CI 2.78–14.50, P < 0.0001) and advanced maternal age at childbirth (> 35 years; OR 1.65; CI 1.09–2.49, P = 0.018). The prevalence of strabismus among children aged 6—8 years in Hong Kong is 3.11%. Refractive errors, family history of strabismus and maternal smoking history during pregnancy are risk factors. Early correction of refractive errors and avoidance of maternal smoking during pregnancy are potentially helpful in preventing strabismus.
Highlights
Epidemiologic studies on strabismus and its risk factors among preschool and school-aged children have been conducted in different populations of different living environments
In this population-based study of ethnic Chinese school children in the highly urbanized and densely populated city of Hong Kong, we report a prevalence rate of 3.11% for strabismus, which was similar across gender and ages from 6 to 8 years old (Table 1)
In STARS conducted in Singapore, where the majority population of Chinese descent is similar to Hong Kong, has shown significantly similar ratio of 7:15
Summary
Epidemiologic studies on strabismus and its risk factors among preschool and school-aged children have been conducted in different populations of different living environments. Similar strabismus prevalence was reported among Hispanic/Latino (2.4%) and African-American children (2.5%)[1]. Similar study conducted in Asia, the Korea National Health and Nutrition Examination Survey detected a strabismic prevalence of 1.6% among children and adolescents aged from 5 to 1 86. We aim to determine the prevalence and risk factors of strabismus in Chinese children aged 6–8 years in Hong Kong
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