Analysis of suspected visual impairment risks based on objective refraction in 3-year-old children

Abstract

Purpose To evaluate the relationship between uncorrected visual acuity and non-cycloplegic refractive value among 3-year-old children in a vision screening program in Japan. Study design Retrospective, cross-sectional study. Methods The participants were 1746 Japanese children screened from April 2009 to July 2018, and ranged in age from 36 to 47 months. Visual acuity and handheld refractive values were collected from the clinical records of 3-year-old children in a vision screening program. Multiple logistic regression analysis was used to evaluate the association between 0.3 logarithm of the minimum angle of resolution (logMAR) and > 0.3 logMAR. Correlation analysis was also performed for the presence of myopic shift. Results Among the 1746 children (aged [mean ± standard deviation], 37.6 ± 1.6 months; percentage of boys, 50.4%), representing 3492 eyes, 116 eyes (3.3%) had > 0.3 logMAR. Multiple logistic regression analysis revealed that the risk factors for 1.75–2.00 diopter (D) spherical power (odds ratio [OR], 2.51; 95% confidence interval [CI] 1.12–5.64; P = 0.026) and 1.25–1.50 D cylindrical power (OR, 5.66; 95% CI 1.58–20.40; P < 0.01) were increased in eyes with > 0.3 logMAR. There was no myopic shift for 10 years (Spearman’s rank correlation coefficient; P = 0.65). Conclusion It is important to set a threshold that comprises the characteristics of the autorefractor used in screening, and to ensure that, to help prevent amblyopia a thorough eye examination in ophthalmic institutions will be conducted taking into account population-based refractive values.