Prevalence of decreased visual acuity among preschool-aged children in an American urban population: the Baltimore Pediatric Eye Disease Study, methods, and results.
OBJECTIVE
To determine the age- and ethnicity-specific prevalence of decreased visual acuity (VA) in white and black preschool-aged children.


METHODS
Cross-sectional study.


METHODS
The Baltimore Pediatric Eye Disease Study is a population-based evaluation of the prevalence of ocular disorders in children 6 through 71 months of age in Baltimore, Maryland, United States. Among 4132 children identified, 3990 eligible children (97%) were enrolled and 2546 children (62%) were examined. This report focuses on 1714 of 2546 examined children (67%) who were 30 through 71 months of age.


METHODS
Field staff identified 63 737 occupied dwelling units in 54 census tracts. Parents or guardians of eligible participants underwent an in-home interview, and eligible children underwent a comprehensive eye examination including optotype visual acuity (VA) testing in children 30 months of age and older, with protocol-specified retesting of children with VA worse than an age-appropriate standard.


METHODS
The proportion of children 30 through 71 months of age testable for VA and the proportion with decreased VA as defined by preset criteria.


RESULTS
Visual acuity was testable in 1504 of 1714 children (87.7%) 30 through 71 months of age. It was decreased at the initial test (wearing glasses if brought to the clinic) in both eyes of 7 of 577 white children (1.21%; 95% confidence interval [CI], 0.49-2.50) and 13 of 725 black children (1.79%; 95% CI, 0.95-3.08), a difference that is not statistically significant. Decreased VA in both eyes after retesting was found in 3 of 598 white children (0.50%; 95% CI, 0.10-1.48) and in 8 of 757 black children (1.06%, 95% CI = 0.45, 2.10), also not statistically significantly different. Uncorrected ametropia explained the decreased VA on initial testing in 10 of the 20 children.


CONCLUSIONS
Decreased VA in both eyes of children 30 through 71 months of age at presentation in urban Baltimore was 1.2% among white children and 1.8% among black children. After retesting within 60 days of the initial examination and with children wearing best refractive correction, the rate of decreased VA in both eyes was 0.5% among white children and 1.1% among black children.
Friedman
David S
DS
Dana Center for Prevention Ophthalmology, Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland 21210, USA. david.friedman@jhu.edu
Repka
Michael X
MX
Katz
Joanne
J
Giordano
Lydia
L
Ibironke
Josephine
J
Hawes
Patricia
P
Burkom
Diane
D
Tielsch
James M
JM
D017677:Age Distribution; D015142:Baltimore / Q000453:epidemiology; D044383:Black People; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D014505:Urban Population / Q000706:statistics & numerical data*; D014786:Vision Disorders / Q000453:epidemiology*; D014787:Vision Tests; D014792:Visual Acuity; D044465:White People; D001741:Black or African American