The Incidence of Amblyopia and Strabismus in Underserved Populations

C. Robert Bernardino, MD


August 14, 2008


Amblyopia is one of the most important treatable causes of vision loss in children and adults.[1,2] Strabismus contributes to amblyopia and has its own psychosocial ramifications. The disorders are treated most effectively when detected early through screening programs. Studies suggest that certain populations, based on race/ethnicity and socioeconomic status, often lack access to preventive screening.[3] The current report examined the incidence of these 2 disorders in African-American and Hispanic children.

Prevalence of Amblyopia and Strabismus in African American and Hispanic Children Ages 6 to 72 Months: The Multi-ethnic Pediatric Eye Disease Study

Multi-ethnic Pediatric Eye Disease Study Group
Ophthalmology. 2008;115:1229-1236.e1

Amblyopia was defined as a 2-line decrease of best-corrected visual acuity in one eye with an associated risk factor, including strabismus or history of strabismus surgery, anisometropia, or visual axis obstruction. The study looked at 3007 African-American children and 3007 Hispanic children, ages 30 to 72 months (for amblyopia) and 6 to 72 months (for strabismus).

The prevalence of amblyopia was high in Hispanic children compared with African-American children (2.6% vs 1.5%). The majority of cases of amblyopia (78%) were caused by anisometropia. The incidence of strabismus was similar in both groups (2.4% for Hispanic children vs 2.5% for African-American children). Strabismus prevalence increased in both groups with age. Fewer than 0.9% of children wore glasses. Previous treatment for strabismus was found in only 1.7% of those screened.

This study is the first to demonstrate the rates of amblyopia and strabismus in these minority populations. Given that the majority of cases of amblyopia were related to refractive error, screening could be highly effective at treating and preventing long-term sequelae of this disease. The low rate of glasses wearing or previous strabismus therapy suggests that current screening and healthcare methods have been ineffective in these populations.



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