title: Refractive error study in young subjects: results from a rural area in Paraguay.
abstract: OBJECTIVE
  To evaluate the distribution of refractive error in young subjects in a rural area of Paraguay in the context of an international cooperation campaign for the prevention of blindness.
  
  
  METHODS
  A sample of 1466 young subjects (ranging from 3 to 22 years old), with a mean age of 11.21±3.63 years old, were examined to assess their distance visual acuity (VA) and refractive error. The first screening examination performed by trained volunteers, included visual acuity testing, autokeratometry and non-cycloplegic autorefraction. Inclusion criteria for a second complete cycloplegic eye examination by an optometrist were VA <20/25 (0.10 logMAR or 0.8 decimal) and/or corneal astigmatism ≥1.50 D.
  
  
  RESULTS
  An uncorrected distance VA of 0 logMAR (1.0 decimal) was found in 89.2% of children. VA <20/25 and/or corneal astigmatism ≥1.50 D was found in 3.9% of children (n=57), with a prevalence of hyperopia of 5.2% (0.2% of the total) in this specific group. Furthermore, myopia (spherical equivalent ≤-0.5 D) was found in 37.7% of the refracted children (0.5% of the total). The prevalence of refractive astigmatism (cylinder ≤-1.50 D) was 15.8% (0.6% of the total). Visual impairment (VI) (0.05≤VA≤0.3) was found in 12/114 (0.4%) of the refracted eyes. Main causes for VI were refractive error (58%), retinal problems (17%, 2/12), albinism (17%, 2/12) and unknown (8%, 1/12).
  
  
  CONCLUSIONS
  A low prevalence of refractive error has been found in this rural area of Paraguay, with higher prevalence of myopia than of hyperopia.
authors.affiliation: Non-governmental Organization Vision Without Borders (Visio Sense Fronteres), Alicante 03710, Spain; School of Advanced Education, Research and Accreditation (SAERA), Castellón de la Plana 12001, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Signes-Soler
authors.affiliation: Non-governmental Organization Vision Without Borders (Visio Sense Fronteres), Alicante 03710, Spain; Faculty of Optics and Optometry, University Complutense of Madrid, Madrid 28037, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Hernández-Verdejo
authors.affiliation: Non-governmental Organization Vision Without Borders (Visio Sense Fronteres), Alicante 03710, Spain; European University of Madrid, Madrid 28108, Spain.
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Estrella Lumeras
authors.affiliation: Non-governmental Organization Vision Without Borders (Visio Sense Fronteres), Alicante 03710, Spain; School of Advanced Education, Research and Accreditation (SAERA), Castellón de la Plana 12001, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Tomás Verduras
authors.affiliation: Foundation for the Visual Quality (FUNCAVIS), Alicante 03016, Spain; Department of Optics, Pharmacology, and Anatomy, University of Alicante, Alicante 03690, Spain.
authors.forename: David P
authors.initials: DP
authors.lastname: Piñero
keywords: blindness; hyperopia; myopia; refractive error; visual impairment