title: Prevalence of vision disorders by racial and ethnic group among children participating in head start.
abstract: OBJECTIVE
  To compare the prevalence of amblyopia, strabismus, and significant refractive error among African-American, American Indian, Asian, Hispanic, and non-Hispanic white preschoolers in the Vision In Preschoolers study.
  
  
  METHODS
  Multicenter, cross-sectional study.
  
  
  METHODS
  Three- to 5-year old preschoolers (n=4040) in Head Start from 5 geographically disparate areas of the United States.
  
  
  METHODS
  All children who failed the mandatory Head Start screening and a sample of those who passed were enrolled. Study-certified pediatric optometrists and ophthalmologists performed comprehensive eye examinations including monocular distance visual acuity (VA), cover testing, and cycloplegic retinoscopy. Examination results were used to classify vision disorders, including amblyopia, strabismus, significant refractive errors, and unexplained reduced VA. Sampling weights were used to calculate prevalence rates, confidence intervals, and statistical tests for differences.
  
  
  METHODS
  Prevalence rates in each racial/ethnic group.
  
  
  RESULTS
  Overall, 86.5% of children invited to participate were examined, including 2072 African-American, 343 American Indian (323 from Oklahoma), 145 Asian, 796 Hispanic, and 481 non-Hispanic white children. The prevalence of any vision disorder was 21.4% and was similar across groups (P=0.40), ranging from 17.9% (American Indian) to 23.3% (Hispanic). Prevalence of amblyopia was similar among all groups (P=0.07), ranging from 3.0% (Asian) to 5.4% (non-Hispanic white). Prevalence of strabismus also was similar (P=0.12), ranging from 1.0% (Asian) to 4.6% (non-Hispanic white). Prevalence of hyperopia >3.25 diopter (D) varied (P=0.007), with the lowest rate in Asians (5.5%) and highest in non-Hispanic whites (11.9%). Prevalence of anisometropia varied (P=0.009), with the lowest rate in Asians (2.7%) and highest in Hispanics (7.1%). Myopia >2.00 D was relatively uncommon (<2.0%) in all groups with the lowest rate in American Indians (0.2%) and highest rate in Asians (1.9%). Prevalence of astigmatism >1.50 D varied (P=0.01), with the lowest rate among American Indians (4.3%) and highest among Hispanics (11.1%).
  
  
  CONCLUSIONS
  Among Head Start preschool children, the prevalence of amblyopia and strabismus was similar among 5 racial/ethnic groups. Prevalence of significant refractive errors, specifically hyperopia, astigmatism, and anisometropia, varied by group, with the highest rate of hyperopia in non-Hispanic whites, and the highest rates of astigmatism and anisometropia in Hispanics.
authors.affiliation: Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: gsying@mail.med.upenn.edu.
authors.forename: Gui-shuang
authors.initials: GS
authors.lastname: Ying
authors.affiliation: Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Maureen G
authors.initials: MG
authors.lastname: Maguire
authors.affiliation: College of Optometry, Northeastern State University, Tahlequah, Oklahoma.
authors.forename: Lynn A
authors.initials: LA
authors.lastname: Cyert
authors.affiliation: Pennsylvania College of Optometry at Salus University, Elkins Park, Pennsylvania.
authors.forename: Elise
authors.initials: E
authors.lastname: Ciner
authors.affiliation: The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: Graham E
authors.initials: GE
authors.lastname: Quinn
authors.affiliation: College of Optometry, Ohio State University, Columbus, Ohio.
authors.forename: Marjean Taylor
authors.initials: MT
authors.lastname: Kulp
authors.affiliation: School of Optometry, University of California, Berkeley, California.
authors.forename: Deborah
authors.initials: D
authors.lastname: Orel-Bixler
authors.affiliation: New England College of Optometry, Boston, Massachusetts.
authors.forename: Bruce
authors.initials: B
authors.lastname: Moore
mesh_terms: D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D018479:Early Intervention, Educational; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012030:Refractive Errors / Q000175:diagnosis / Q000208:ethnology; D042262:Retinoscopy; D013285:Strabismus / Q000175:diagnosis / Q000208:ethnology; D014481:United States / Q000453:epidemiology; D014786:Vision Disorders / Q000175:diagnosis / Q000208:ethnology*; D015351:Vision Screening; D014792:Visual Acuity / Q000502:physiology