Clinical research
Prevalence of strabismus among preschool, kindergarten, and first-grade Tohono O'odham children

https://doi.org/10.1016/j.optm.2009.10.010Get rights and content

Abstract

Background

Although the prevalence of strabismus is 2% to 5% in European-based and African-American populations, little is known about the prevalence of strabismus in Native-American populations. We report the prevalence of strabismus in children who are members of a Native-American tribe with a high prevalence of astigmatism.

Methods

Subjects were 594 children enrolled in Head Start and 315 children enrolled in kindergarten or first grade (K/1) in schools on the Tohono O'odham Reservation. Distance and near cover tests were performed on each child by an ophthalmologist or optometrist, and cycloplegic refraction was obtained.

Results

Strabismus was detected in 9 Head Start children (1.5%) and 3 K/1 children (1.0%). Ratio of esotropia to exotropia was 1:3 in Head Start and 1:2 in K/1. Anisometropia ≥1.00 diopter (D) spherical equivalent was present in 2 children with strabismus, and anisometropia ≥1.00 D cylinder was present in 4 with strabismus.

Conclusion

The prevalence of strabismus in Tohono O'odham children is at the low end of the prevalence range reported in studies of European-based and African-American populations.

Section snippets

Subjects

Subjects were 909 children, 594 of whom were enrolled in Head Start, and 315 of whom were enrolled in kindergarten or first grade in schools on the Tohono O'odham Reservation between September 2005 and November 2008. All were participants in a longitudinal study of the development and treatment of astigmatism-related amblyopia, in which participants receive an annual eye examination with cycloplegic refraction, beginning at age 3 years. Participation was offered to all children attending Head

Results

Strabismus was detected in 9 of the 594 (1.5%; 95% confidence interval [CI] 0. 0% to 2.8%; 1.7% [5/289] for girls and 1.3% [4/305] for boys) children in the younger sample, with 2 (0.3%) showing esotropia (ET), 6 (1.0%) showing exotropia (XT), and 1 (0.2%) with hypertropia. Three (1.0%; 95% CI 0.7% to 2.9%; 1.8% [3/165] for girls and 0% [0/150] for boys) of the 315 children in the K/1 grade sample had strabismus, 1 (0.3%) with ET and 2 (0.6%) with XT. For the Head Start sample, the rate of

Discussion

Prevalence of strabismus in the population-based sample of kindergarten and first-grade Native American children examined in the present study was 1.0%. A similar prevalence of 1.5% was found in the younger sample of Head Start children, even though this sample was not population based. These prevalence values are lower than the prevalences of 2% to 5% reported in studies of white and black populations1, 2, 3, 4, 5, 6, 7, 8, 9, 10 and lower than the prevalence value reported in 124 of 224, 25

Acknowledgments

Supported by grants from the National Eye Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland (EY11155 [J.M.M.] and EY13153 [E.M.H.]), and Research to Prevent Blindness, New York, New York (unrestricted grant to University of Arizona Department of Ophthalmology and Vision Science [J.M.M.], The Walter E. and Lilly Disney Award for Amblyopia Research [J.M.M.], and a Career Development Award [E.M.H.]).

The authors thank the Tohono O'odham Nation,

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