title: Prevalence of asthenopia in children: a systematic review with meta-analysis.
abstract: OBJECTIVE
  To estimate the prevalence of asthenopia in 0-18 year-old children through a systematic review and meta-analysis of prevalence studies.
  
  
  METHODS
  Inclusion criteria were population-based studies from 1960 to May of 2014 reporting the prevalence of asthenopia in children. The search was performed independently by two reviewers in the PubMed, EMBASE, and LILACS databases, with no language restriction. This systematic review was performed in accordance with the Cochrane Collaboration guidelines and the PRISMA Statement. Downs and Black score was used for quality assessment.
  
  
  RESULTS
  Out of 1692 potentially relevant citations retrieved from electronic databases and searches of reference lists, 26 were identified as potentially eligible. Five of these studies met the inclusion criteria, comprising a total of 2465 subjects. Pooled prevalence of asthenopia was 19.7% (12.4-26.4%). The majority of children with asthenopia did not present visual acuity or refraction abnormalities. The largest study evaluated 1448 children aged 6 years and estimated a prevalence of 12.6%. Associated risk factors were not clearly established.
  
  
  CONCLUSIONS
  Although asthenopia is a frequent and relevant clinical problem in childhood, with potential consequences for learning, the scarcity of studies about the prevalence and clinical impact of asthenopia hinders the effective planning of public health measures.
authors.affiliation: Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil. Electronic address: mapvilela@gmail.com.
authors.forename: Manuel A P
authors.initials: MA
authors.lastname: Vilela
authors.affiliation: Graduation Program in Health Sciences: Cardiology, Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil; Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.
authors.forename: Lucia C
authors.initials: LC
authors.lastname: Pellanda
authors.affiliation: Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil.
authors.forename: Anaclaudia G
authors.initials: AG
authors.lastname: Fassa
authors.affiliation: Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil.
authors.forename: Victor D
authors.initials: VD
authors.lastname: Castagno
mesh_terms: D000293:Adolescent; D001248:Asthenopia / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D042241:Early Diagnosis; D006801:Humans; D007223:Infant; D064887:Observational Studies as Topic; D015995:Prevalence; D015983:Selection Bias
keywords: Astenopia; Asthenopia; Eye fatigue; Eyestrain; Fadiga; Fadiga Ocular; Fadiga Visual; Fatigue; Tensão ocular; Visual; Visual fatigue