Association between Socioeconomic Status and Vision Screening Outcomes among Preschool Children in Klang Valley, Malaysia: A Cross-Sectional Study

Abstract

Background: Vision screening programmes’ outcomes are routinely used to report the prevalence of vision anomalies in children. However, the association between vision screening outcomes and the children’s socioeconomic status remains underexplored. This cross-sectional study determined the association between socioeconomic and birth status with vision screening outcomes in a sample of children in Klang Valley. Methods: Total 411 children (mean age: 5.49 ± 0.47 years old) attending preschools were selected via stratified cluster sampling. Habitual distance visual acuity, near visual acuity, and stereoacuity were measured. The fail criteria were distance visual acuity ≥ 0.3 logarithm of the Minimum Angle of Resolution (logMAR), near visual acuity ≥ 0.4 logMAR or stereoacuity ≥ 300 arcsec. Socioeconomic and birth history data were obtained using parent-report questionnaires. The association between socioeconomic factors and screening outcomes were determined with binary logistic regression. Results: Sixty-two children (15.1%) failed the screening, with a significantly higher failure rate for Bumiputera children (16.34%) compared to non-Bumiputera children (4.08%) (χ2 (1, 410) = 5.21; P = 0.024). After adjusting for confounders, Bumiputera children were four times more likely to fail vision screening (OR: 4.54; 95% confidence intervals [CI]: 1.07, 17.76; P = 0.044). Other socioeconomic factors were not significant predictors for failing vision screening. Conclusion: Preschool children’s ethnicity is associated with vision screening outcomes. Bumiputera children are more likely to fail vision screening than their non-Bumiputera peers.

Association between Visual Perception and Socioeconomic Status in Malaysian Preschool Children: Results from the Test of Visual Perceptual Skills-4

“…In TVPS-4, visual form constancy is measured by asking the participants to match two similar images, one of which could be bigger, smaller, or rotated. An earlier study on Malaysian preschoolers reported that Malay children were more likely to fail vision screening, and non-Malay children (including those of Chinese ethnicity) were likelier to have better visual acuity and stereopsis [ 16 ]. Both tasks involved object recognition and visual matching, which could be related to Malay children’s relatively lower visual form constancy performance.…”

“…For example, children from higher socioeconomic backgrounds typically outperform those from middle and low socioeconomic backgrounds [ 14 ]. A recent study reported that preschoolers from low-income families had lower than average visual–motor integration performance [ 15 ] and were likelier to fail visual screening tests [ 16 ] than those from higher-income families. Thus, young children’s visual perceptual abilities must be correctly measured, as they are crucial to their functional task performance [ 17 ] and, consequently, their school readiness.…”

The Impact of School Closures during COVID-19 Lockdown on Visual–Motor Integration and Block Design Performance: A Comparison of Two Cohorts of Preschool Children

“…Particularly for children from low-income families, these include the exacerbation of consumption of unhealthy diets [ 54 ] that is associated with lower academic performance [ 55 , 56 ]. Children from low-income families are also more likely to fail vision screening, indicating the presence of associated uncorrected refractive error and blurred vision [ 57 ]. Previous studies have shown that blurred vision, especially at near range, negatively impacts VMI performance in young children [ 58 ], reading and visual information processing during sustained near work [ 59 ], and academic performance [ 60 ].…”