title: Prevalence of refractive error in Singaporean Chinese children: the strabismus, amblyopia, and refractive error in young Singaporean Children (STARS) study.
abstract: OBJECTIVE
  To determine the prevalence of refractive error types in Singaporean Chinese children aged 6 to 72 months.
  
  
  METHODS
  The Strabismus, Amblyopia and Refractive Error in Singaporean Children (STARS) is a population-based study in southwest Singapore. Door-to-door recruitment of participants was used, with disproportionate random sampling in 6-month increments. Parental questionnaires were administered. Participant eye examinations included logMAR visual acuity, cycloplegic autorefraction, and ocular biometry. Overall and age-specific prevalences of myopia (spherical equivalence [SE] <or= -0.50 D), high myopia (SE <or= -6.00 D), hyperopia (SE >or= +3.00 D), astigmatism (cylinder >or= +1.50 D), and anisometropia (SE difference between each eye >or=2.00 D) were calculated.
  
  
  RESULTS
  A total of 3009 children were examined (participation rate, 72.3%). Right eye (OD) cycloplegia data were available for 1375 boys and 1264 girls (mean age, 41 months). Mean OD SE was +0.69 D (SD 1.15). Overall myopia prevalence was 11.0% with no variance between the sexes (P = 0.91). The prevalence of high myopia (at least -6.00 D) was 0.2%. The prevalences of hyperopia, astigmatism, and anisometropia were 1.4%, 8.6%, and 0.6%, respectively. Most astigmatism (>95%) was with-the-rule (cylinder axes between 1 degrees and 15 degrees or 165 degrees and 180 degrees ). Myopia was present in 15.8%, 14.9%, 20.2%, 8.6%, 7.6%, and 6.4% of children aged 6 to 11, 12 to 23, 24 to 35, 36 to 47, 48 to 59, and 60 to 72 months, respectively. Prevalence increased with age for astigmatism (P < 0.001), but not for hyperopia or anisometropia (P = 0.55 and P = 0.37), respectively.
  
  
  CONCLUSIONS
  The prevalences of myopia and astigmatism in young Singaporean Chinese children are high, but that of hyperopia is low. Age effects were observed for each refractive error category, but differences between the sexes were not significant. Age-related variation in myopia prevalence may be influenced by ocular development, environment, and/or testability.
authors.affiliation: Singapore Eye Research Institute, Singapore. dirani@unimelb.edu.au
authors.forename: Mohamed
authors.initials: M
authors.lastname: Dirani
authors.forename: Yiong-Huak
authors.initials: YH
authors.lastname: Chan
authors.forename: Gus
authors.initials: G
authors.lastname: Gazzard
authors.forename: Dana Marie
authors.initials: DM
authors.lastname: Hornbeak
authors.forename: Seo-Wei
authors.initials: SW
authors.lastname: Leo
authors.forename: Prabakaran
authors.initials: P
authors.lastname: Selvaraj
authors.forename: Brendan
authors.initials: B
authors.lastname: Zhou
authors.forename: Terri L
authors.initials: TL
authors.lastname: Young
authors.forename: Paul
authors.initials: P
authors.lastname: Mitchell
authors.forename: Rohit
authors.initials: R
authors.lastname: Varma
authors.forename: Tien Yin
authors.initials: TY
authors.lastname: Wong
authors.forename: Seang-Mei
authors.initials: SM
authors.lastname: Saw
mesh_terms: D000550:Amblyopia / Q000175:diagnosis / Q000208:ethnology*; D044466:Asian People / Q000208:ethnology*; D001699:Biometry; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010865:Pilot Projects; D015995:Prevalence; D012029:Refraction, Ocular / Q000502:physiology; D012030:Refractive Errors / Q000175:diagnosis / Q000208:ethnology*; D042262:Retinoscopy; D012846:Singapore / Q000453:epidemiology; D013285:Strabismus / Q000175:diagnosis / Q000208:ethnology*; D011795:Surveys and Questionnaires; D014792:Visual Acuity