Child Development and Refractive Errors in Preschool Children

Abstract

Purpose Many parents are concerned about their child's development. The purpose of this study is to determine if parental concerns about overall development are associated with significant refractive errors among urban preschool children. Methods A cross-sectional population-based study was conducted to evaluate the prevalence of ocular disorders in white and African American children 6 through 71 months of age in Baltimore, Maryland, United States. A comprehensive eye examination with cycloplegic refraction was performed. Parental concerns about development were measured with the Parents' Evaluation of Developmental Status screening tool. 2381 of 2546 eligible children (93.5%) completed the refraction and the parental interview. Results Parental concerns about development were present in 510 of the 2381 children evaluated (21.4%; 95% CI: 9.8% – 23.1%). The adjusted odds ratios [OR] of parental concerns with hyperopia (≥ 3.00D) was 1.26 (95% CI: 0.90 – 1.74), with myopia (≥ 1.00D) was 1.29 (95% CI: 0.83 – 2.03), with astigmatism (≥ 1.50D) was 1.44 (95% CI: 1.08 – 1.93) irrespective of the type of astigmatism, and with anisometropia ≥ 2.00D was 2.61 (95% CI: 1.07 – 6.34). The odds of parental concerns about development significantly increased in children older than 36 months with hyperopia ≥ 3.00D, astigmatism ≥ 1.50D, or anisometropia ≥ 2.00D. Conclusions Parental concerns about general developmental problems were associated with some types of refractive error, astigmatism ≥ 1.50D and anisometropia ≥ 2.00D in children ages 6 to 71 months. Parental concerns were also more likely in children older than 36 months of age with hypermetropia, astigmatism or anisometropia. Parental concerns were not associated with myopia. Due to the potential consequences of uncorrected refractive errors, children whose parents have expressed concerns regarding development should be referred for an eye examination with cycloplegic refraction to rule out significant refractive errors.

Vision and Hearing Deficits and Associations with Parent-Reported Behavioral and Developmental Problems in International Adoptees

“…33, 34, 71–74 We partially confirmed our hypotheses that hearing and visions problems would be related to behavioral and developmental problems, independent of other acknowledged risk markers prevalent in this group of children. Hearing problems were strongly associated with about a 2.5 to 5.0-fold risk for practitioner diagnosed or treated developmental, learning, cognitive and speech problems.…”

Parents’ Awareness and Perception of Children’s Eye Diseases in Chennai, India

“…5 Nirmalan et al 5 reports that according to World Health Organization criteria, 6.2 of 10,000 children were blind in India. In Baltimore (United States), Ibironke et al 15 has shown parents' prediction of developmental problems in children to be 80% sensitive and 94% specific if parents carefully elicit concerns toward the child's development. 5 Dandona and Dandona 6 report a prevalence of 0.17% of blindness (presenting distance visual acuity less than 6/60 in the better eye) among children between 3 and 9 years of age.…”

The screening of visual impairment among preschool children in an urban population in Malaysia; the Kuching pediatric eye study: a cross sectional study

“…These include visual acuity assessment, cover-uncover and alternate cover tests, ocular movements, cycloplegic refraction, slit-lamp examination and dilated fundus examination. Significant refractive error were defined as hyperopia ≥3.00 diopters (D), myopia ≥1.00 D or astigmatism ≥1.50 D in either eye, or anisometropia ≥ 2.00 D [8]. Children with underlying refractive errors were prescribed glasses and children with other ocular problems were managed accordingly.…”