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Refractive Error and Ethnicity in Children
Robert N. Kleinstein, OD, MPH, PhD;
Lisa A. Jones, PhD;
Sandral Hullett, MD, MPH;
Soonsi Kwon, OD;
Robert J. Lee, OD;
Nina E. Friedman, OD, MS;
Ruth E. Manny, OD, PhD;
Donald O. Mutti, OD, PhD;
Julie A. Yu, OD;
Karla Zadnik, OD, PhD; for the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error Study Group
Arch Ophthalmol. 2003;121:1141-1147.
Objective To report the baseline prevalence of refractive error in the study population.
Design A multicenter, longitudinal, observational study of refractive error and ocular development in children from 4 ethnic groups.
Patients and Methods The study population included 2523 children (534 African American, 491 Asian, 463 Hispanic, and 1035 white) in grades 1 to 8 (age, 5-17 years). Myopia was defined as -0.75 diopters (D) or more and hyperopia as +1.25 D or more in each principal meridian, and astigmatism was defined as at least a 1.00-D difference between the 2 principal meridians (cycloplegic autorefraction).
Results Overall, 9.2% of the children were myopic, 12.8% were hyperopic, and 28.4% were astigmatic. There were significant differences in the refractive error prevalences as a function of ethnicity ( 2, P<.001), even after controlling for age and sex (polychotomous logistic regression, P<.001). For myopia, Asians had the highest prevalence (18.5%), followed by Hispanics (13.2%). Whites had the lowest prevalence of myopia (4.4%), which was not significantly different from African Americans (6.6%). For hyperopia, whites had the highest prevalence (19.3%), followed by Hispanics (12.7%). Asians had the lowest prevalence of hyperopia (6.3%) and were not significantly different from African Americans (6.4%). For astigmatism, Asians and Hispanics had the highest prevalences (33.6% and 36.9%, respectively) and did not differ from each other (P = .17). African Americans had the lowest prevalence of astigmatism (20.0%), followed by whites (26.4%).
Conclusion There were significant differences in the prevalence of refractive errors among ethnic groups, even after controlling for age and sex (P<.001).
From the University of Alabama at Birmingham, School of Optometry, Birmingham (Dr Kleinstein); Ohio State University, College of Optometry, Columbus (Drs Jones, Mutti, and Zadnik); West Alabama Health Services, Eutaw (Dr Hullett); Southern California College of Optometry, Fullerton (Drs Kwon, Lee, and Yu); University of California, School of Optometry, Berkeley (Dr Friedman); and the University of Houston, College of Optometry, Houston, Tex (Dr Manny). The authors have no relevant financial interest in this article.
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