High Prevalence of Refractive Errors in 7 Year Old Children in Iran
Abstract
Background: The latest WHO report indicates that refractive errors are the leading cause of visual impairment throughout the world. The aim of this study was to determine the prevalence of myopia, hyperopia, and astigmatism in 7 yr old children in Iran.
Methods: In a cross-sectional study in 2013 with multistage cluster sampling, first graders were randomly selected from 8 cities in Iran. All children were tested by an optometrist for uncorrected and corrected vision, and non-cycloplegic and cycloplegic refraction. Refractive errors in this study were determined based on spherical equivalent (SE) cyloplegic refraction.
Results: From 4614 selected children, 89.0% participated in the study, and 4072 were eligible. The prevalence rates of myopia, hyperopia and astigmatism were 3.04% (95% CI: 2.30-3.78), 6.20% (95% CI: 5.27-7.14), and 17.43% (95% CI: 15.39-19.46), respectively. Prevalence of myopia (P=0.925) and astigmatism (P=0.056) were not statistically significantly different between the two genders, but the odds of hyperopia were 1.11 (95% CI: 1.01-2.05) times higher in girls (P=0.011). The prevalence of with-the-rule astigmatism was 12.59%, against-the-rule was 2.07%, and oblique 2.65%. Overall, 22.8% (95% CI: 19.7-24.9) of the schoolchildren in this study had at least one type of refractive error.
Conclusion: One out of every 5 schoolchildren had some refractive error. Conducting multicenter studies throughout the Middle East can be very helpful in understanding the current distribution patterns and etiology of refractive errors compared to the previous decade.
Pascolini D, Mariotti SP (2012). Global estimates of visual impairment: 2010. Br J Ophthalmol, 96(5):614-18.
Brown SA, Weih LM, Fu CL, Dimitrov P, Taylor HR, McCarty CA (2000). Prevalence of amblyopia and associated refractive errors in an adult population in Victoria, Australia. Ophthalmic Epidemiol, 7(4):249-58.
Yekta A, Fotouhi A, Hashemi H, Dehghani C, Ostadimoghaddam H, Heravian J, Derakhshan A, Yekta R, Rezvan F, Behnia M, Khabazkhoob M (2010). The prevalence of anisometropia, amblyopia and strabismus in schoolchildren of Shiraz, Iran. Strabismus, 18(3):104-10.
Negrel AD, Maul E, Pokharel GP, Zhao J, Ellwein LB (2000). Refractive Error Study in Children: sampling and measurement methods for a multi-country survey. Am J Ophthalmol, 129(4):421-26.
Zhao J, Pan X, Sui R, Munoz SR, Sperduto RD, Ellwein LB (2000). Refractive Error Study in Children: results from Shunyi District, China. Am J Ophthalmol, 129(4):427-35.
Pokharel GP, Negrel AD, Munoz SR, Ellwein LB (2000). Refractive Error Study in Children: results from Mechi Zone, Nepal. Am J Ophthalmol, 129(4):436-44.
Maul E, Barroso S, Munoz SR, Sperduto RD, Ellwein LB (2000). Refractive Error Study in Children: results from La Florida, Chile. Am J Ophthalmol, 129(4):445-54.
Fotouhi A, Hashemi H, Khabazkhoob M, Mohammad K (2007). The prevalence of refractive errors among schoolchildren in Dezful, Iran. Br J Ophthalmol, 91(3):287-92.
Rezvan F, Khabazkhoob M, Fotouhi A, Hashemi H, Ostadimoghaddam H, Heravian J, Azizi E, Khorasani AA, Yekta AA (2012). Prevalence of refractive errors among school children in Northeastern Iran. Ophthalmic Physiol Opt, 32(1):25-30.
Yekta A, Fotouhi A, Hashemi H, Dehghani C, Ostadimoghaddam H, Heravian J, Derakhshan A, Yekta R, Behnia M, Khabazkhoob M (2010). Prevalence of refractive errors among schoolchildren in Shiraz, Iran. Clin Experiment Ophthalmol, 38(3):242-48.
Anera RG, Soler M, de la Cruz Cardona J, Salas C, Ortiz C (2009). Prevalence of refractive errors in school-age children in Morocco. Clin Experiment Ophthalmol, 37(2):191-96.
He M, Zeng J, Liu Y, Xu J, Pokharel GP, Ellwein LB (2004). Refractive error and visual impairment in urban children in southern china. Invest Ophthalmol Vis Sci, 45(3):793-99.
Dandona R, Dandona L, Srinivas M, Sahare P, Narsaiah S, Munoz SR, Pokharel GP, Ellwein LB (2002). Refractive error in children in a rural population in India. Invest Ophthalmol Vis Sci, 43(3):615-22.
Naidoo KS, Raghunandan A, Mashige KP, Govender P, Holden BA, Pokharel GP, Ellwein LB (2003). Refractive error and visual impairment in African children in South Africa. Investigative Ophthalmol Visual Sci, 44(9):3764-70.
Goh PP, Abqariyah Y, Pokharel GP, Ellwein LB (2005). Refractive error and visual impairment in school-age children in Gombak District, Malaysia. Ophthalmology, 112(4):678-85.
Hashemi H, Rezvan F, Ostadimoghaddam H, Abdollahi M, Hashemi M, Khabazkhoob M (2013). High prevalence of refractive errors in a rural population: "Nooravaran Salamat" Mobile Eye Clinic experience. Clin Experiment Ophthalmol, 41(7):635-43.
Ostadi-Moghaddam H, Fotouhi A, Khabazkhoob M, Heravian J, Yekta AA (2008). Prevalence and risk factors of refractive errors among schoolchildren in Mashhad, 2006-2007. Iran J Ophthalmol, 20(3):3-9.
Yekta AA, Fotouhi A, Khabazkhoob M, Hashemi H, Ostadimoghaddam H, Heravian J, Mehravaran S (2009). The prevalence of refractive errors and its determinants in the elderly population of Mashhad. Ophthalmic Epidemiol, 16(3):198-203.
Ostadimoghaddam H, Fotouhi A, Hashemi H, Yekta A, Heravian J, Rezvan F, Ghadimi H, Rezvan B, Khabazkhoob M (2011). Prevalence of the refractive errors by age and gender: the Mashhad eye study of Iran. Clin Experiment Ophthalmol, 39(8):743-51.
Hashemi H, Khabazkhoob M, Jafarzadehpur E, Yekta AA, Emamian MH, Shariati M, Fotouhi A (2012). High prevalence of myopia in an adult population, Shahroud, Iran. Optom Vis Sci, 89(7):993-99.
Jamali P, Fotouhi A, Hashemi H, Younesian M, Jafari A (2009). Refractive errors and amblyopia in children entering school: Shahrood, Iran. Optom Vis Sci, 86(4):364-69.
Muszynska-Lachota I, Czepita D, uczynska V, Wysiecki P.(2005). Prevalence of refractive errors in 7 and 8 year-old children in the province of Western Pomerania. Ann Acad Med Stetin,51 Suppl 1:109-11.
Zhan MZ, Saw SM, Hong RZ, Fu ZF, Yang H, Shui YB, Yap MK, Chew SJ.(2000). Refractive errors in Singapore and Xiamen, China--a comparative study in school children aged 6 to 7 years. Optom Vis Sci,77(6):302-8.
Khandekar RB, Abdu-Helmi S (2004). Magnitude and determinants of refractive error in Omani school children. Saudi Med J, 25(10):1388-93.
Fan DSP, Lam DSC, Lam RF, Lau JTF, Chong KS, Cheung EYY, Lai RYK, Chew SJ (2004). Prevalence, incidence, and progression of myopia of school children in Hong Kong. Invest Ophthalmol Vis Sci, 45(4):1071-75.
Wong TY, Foster PJ, Hee J, Ng TP, Tielsch JM, Chew SJ, Johnson GJ, Seah SK (2000). Prevalence and risk factors for refractive errors in adult Chinese in Singapore. Invest Ophthalmol Vis Sci, 41(9):2486-94.
Saw SM, Gazzard G, Koh D, Farook M, Widjaja D, Lee J, Tan DT (2002). Prevalence rates of refractive errors in Sumatra, Indonesia. Invest Ophthalmol Vis Sci, 43(10):3174-80.
Cheng CY, Hsu WM, Liu JH, Tsai SY, Chou P (2003). Refractive errors in an elderly Chinese population in Taiwan: the Shihpai Eye Study. Invest Ophthalmol Vis Sci, 44(11):4630-38.
Shimizu N, Nomura H, Ando F, Niino N, Miyake Y, Shimokata H (2003). Refractive errors and factors associated with myopia in an adult Japanese population. Japanese J Ophthalmol, 47(1):6-12.
Quek TP, Chua CG, Chong CS, Chong JH, Hey HW, Lee J, Lim YF, Saw SM (2004). Prevalence of refractive errors in teenage high school students in Singapore. Ophthalmic Physiol Opt, 24(1):47-55.
Saw SM, Chan YH, Wong WL, Shankar A, Sandar M, Aung T, Tan DT, Mitchell P, Wong TY (2008). Prevalence and risk factors for refractive errors in the Singapore Malay Eye Survey. Ophthalmology, 115(10):1713-19.
Padhye AS, Khandekar R, Dharmadhikari S, Dole K, Gogate P, Deshpande M (2009). Prevalence of uncorrected refractive error and other eye problems among urban and rural school children. Middle East Afr J Ophthalmol, 16(2):69-74.
Ostadimoghaddam H, Fotouhi A, Hashemi H, Yekta A, Heravian J, Rezvan F, Ghadimi H, Rezvan B, Khabazkhoob M (2011). Prevalence of the refractive errors by age and gender in Mashhad, Iran: the Mashhad eye study. Clin Experiment Ophthalmol, 39(8):743-51.
Tan CSH, Chan YH, Wong TY, Gazzard G, Niti M, Ng TP, Saw SM (2011). Prevalence and risk factors for refractive errors and ocular biometry parameters in an elderly Asian population: The Singapore Longitudinal Aging Study (SLAS). Eye, 25(10):1294-301.
Das A, Dutta H, Bhaduri G, De Sarkar A, Sarkar K, Bannerjee M (2007). A study on refractive errors among school children in Kolkata. J Indian Med Assoc, 105(4):169-72.
Czepita D, Mojsa A, Ustianowska M, Czepita M, Lachowicz E (2007). Role of gender in the occurrence of refractive errors. Ann Acad Med Stetin, 53(2):5-7.
Garner LF, Yap MK, Kinnear RF, Frith MJ (1995). Ocular dimensions and refraction in Tibetan children. Optometry and vision science : Optom Vis Sci, 72(4):266-71.
Zadnik K, Manny RE, Yu JA, Mitchell GL, Cotter SA, Quiralte JC, Shipp M, Friedman NE, Kleinstein RN, Walker TW, Jones LA, Moeschberger ML, Mutti DO (2003). Ocular component data in schoolchildren as a function of age and gender. Optom Vis Sci, 80(3):226-36.
Rudnicka AR, Owen CG, Nightingale CM, Cook DG, Whincup PH (2010). Ethnic differences in the prevalence of myopia and ocular biometry in 10- and 11-year-old children: the Child Heart and Health Study in England (CHASE). Invest Ophthalmol Vis Sci, 51(12):6270-76.
Czepita D, Mojsa A, Ustianowska M, Czepita M, Lachowicz E (2007). Prevalence of refractive errors in schoolchildren ranging from 6 to 18 yr of age. Ann Acad Med Stetin, 53(1):53-6.
Fotouhi A, Hashemi H, Yekta AA, Mohammad K, Khoob MK (2011). Characteristics of astigmatism in a population of schoolchildren, Dezful, Iran. Optom Vis Sci, 88(9):1054-59.
Read SA, Collins MJ, Carney LG (2007). A review of astigmatism and its possible genesis. Clin Exp Optom, 90(1):5-19.
Hashemi H, Khabazkhoob M, Yekta A, Jafarzadehpur E, Emamian MH, Shariati M, Fotouhi A.(2012). High prevalence of astigmatism in the 40- to 64-year-old population of Shahroud, Iran. Clin Experiment Ophthalmol,40(3):247-54
Mandel Y, Stone RA, Zadok D (2010). Parameters associated with the different astigmatism axis orientations. Invest Ophthalmol Vis Sci, 51(2):723-30.
Murthy GV, Gupta SK, Ellwein LB, Munoz SR, Pokharel GP, Sanga L, Bachani D (2002). Refractive error in children in an urban population in New Delhi. Invest Ophthalmol Vis Sci, 43(3):623-31.
Pi L-H, Chen L, Liu Q, Ke N, Fang J, Zhang S, Xiao J, Ye W-J, Xiong Y, Shi H, Yin Z-Q (2010). Refractive status and prevalence of refractive errors in suburban school-age children 2010. Int J Med Sci, 7(6):342-53.
Khalaj M, Aghazadeh Amiri M, Mohammadi Zeidi I, Khosravi B, Mohammadi Nia M, Keshtkar A (2014). Refractive Errors in School-age Children in Qazvin, Iran. Biotech Health Sci, 1(2):e22087.
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Issue | Vol 45 No 2 (2016) | |
Section | Original Article(s) | |
Keywords | ||
Refractive errors Cross-sectional study Iran |
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