Visual Impairment in Preschool Children in the United States: Demographic and Geographic Variations From 2015 to 2060 | Ophthalmology | JAMA Ophthalmology | JAMA Network
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1.
Atkinson  J, Anker  S, Nardini  M,  et al.  Infant vision screening predicts failures on motor and cognitive tests up to school age.  Strabismus. 2002;10(3):187-198.PubMedGoogle ScholarCrossref
2.
Ibironke  JO, Friedman  DS, Repka  MX,  et al.  Child development and refractive errors in preschool children.  Optom Vis Sci. 2011;88(2):181-187.PubMedGoogle ScholarCrossref
3.
Roch-Levecq  AC, Brody  BL, Thomas  RG, Brown  SI.  Ametropia, preschoolers’ cognitive abilities, and effects of spectacle correction.  Arch Ophthalmol. 2008;126(2):252-258.PubMedGoogle ScholarCrossref
4.
Menon  V, Saha  J, Tandon  R, Mehta  M, Khokhar  S.  Study of the psychosocial aspects of strabismus.  J Pediatr Ophthalmol Strabismus. 2002;39(4):203-208.PubMedGoogle Scholar
5.
Kulp  MT, Ciner  E, Maguire  M,  et al; VIP-HIP Study Group.  Uncorrected hyperopia and preschool early literacy: results of the Vision in Preschoolers-Hyperopia in Preschoolers (VIP-HIP) Study.  Ophthalmology. 2016;123(4):681-689.PubMedGoogle ScholarCrossref
6.
Healthy People 2020. Reduce blindness and visual impairment in children and adolescents aged 17 years and under. https://www.healthypeople.gov/2020/topics-objectives/topic/vision/objectives. Published 2016. Accessed June 21, 2016.
7.
Multi-Ethnic Pediatric Eye Disease Study (MEPEDS) Group.  Prevalence and causes of visual impairment in African-American and Hispanic preschool children: the multi-ethnic pediatric eye disease study.  Ophthalmology. 2009;116(10):1990-2000.e1.PubMedGoogle ScholarCrossref
8.
Tarczy-Hornoch  K, Cotter  SA, Borchert  M,  et al; Multi-Ethnic Pediatric Eye Disease Study Group.  Prevalence and causes of visual impairment in Asian and non-Hispanic white preschool children: Multi-ethnic Pediatric Eye Disease Study.  Ophthalmology. 2013;120(6):1220-1226.PubMedGoogle ScholarCrossref
9.
Friedman  DS, Repka  MX, Katz  J,  et al.  Prevalence of decreased visual acuity among preschool-aged children in an American urban population: the Baltimore Pediatric Eye Disease Study, methods, and results.  Ophthalmology. 2008;115(10):1786-1795, 1795.e1-1795.e4.PubMedGoogle ScholarCrossref
10.
Colby  SL, Ortman  JM.  Projections of the Size and Composition of the US Population: 2014 to 2060, Current Population Reports. Washington, DC: US Census Bureau; 2014.
11.
Cotter  SA, Tarczy-Hornoch  K, Wang  Y,  et al; Multi-Ethnic Pediatric Eye Disease Study Group.  Visual acuity testability in African-American and Hispanic children: the multi-ethnic pediatric eye disease study.  Am J Ophthalmol. 2007;144(5):663-667.PubMedGoogle ScholarCrossref
12.
Cotter  SA, Cyert  LA, Miller  JM, Quinn  GE; National Expert Panel to the National Center for Children’s Vision and Eye Health.  Vision screening for children 36 to <72 months: recommended practices.  Optom Vis Sci. 2015;92(1):6-16.PubMedGoogle ScholarCrossref
13.
Pan  Y, Tarczy-Hornoch  K, Cotter  SA,  et al; Multi-Ethnic Pediatric Eye Disease Study Group.  Visual acuity norms in pre-school children: the Multi-Ethnic Pediatric Eye Disease Study.  Optom Vis Sci. 2009;86(6):607-612.PubMedGoogle ScholarCrossref
14.
Fay  MP, Feuer  EJ.  Confidence intervals for directly standardized rates: a method based on the gamma distribution.  Stat Med. 1997;16(7):791-801.PubMedGoogle ScholarCrossref
15.
Kemper  AR, Bruckman  D, Freed  GL.  Receipt of specialty eye care by children.  Ambul Pediatr. 2003;3(5):270-274.PubMedGoogle ScholarCrossref
16.
Heslin  KC, Casey  R, Shaheen  MA, Cardenas  F, Baker  RS.  Racial and ethnic differences in unmet need for vision care among children with special health care needs.  Arch Ophthalmol. 2006;124(6):895-902.PubMedGoogle ScholarCrossref
17.
Kemper  AR, Helfrich  A, Talbot  J, Patel  N, Crews  JE.  Improving the rate of preschool vision screening: an interrupted time-series analysis.  Pediatrics. 2011;128(5):e1279-e1284.PubMedGoogle ScholarCrossref
18.
Hartmann  EE, Block  SS, Wallace  DK; National Expert Panel to the National Center for Children’s Vision and Eye Health.  Vision and eye health in children 36 to <72 months: proposed data system.  Optom Vis Sci. 2015;92(1):24-30.PubMedGoogle ScholarCrossref
19.
Marsh-Tootle  WL, Russ  SA, Repka  MX; National Expert Panel to the National Center for Children’s Vision Eye Health.  Vision and eye health in children 36 to <72 months: proposed data definitions.  Optom Vis Sci. 2015;92(1):17-23.PubMedGoogle ScholarCrossref
20.
National Academies of Sciences and Medicine.  Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press; 2016.
21.
Pew Research Center. Multiracial in America: proud, diverse and growing in numbers. http://www.pewsocialtrends.org/2015/06/11/multiracial-in-america/. Published 2015. Accessed June 20, 2016.
Original Investigation
June 2017

Visual Impairment in Preschool Children in the United States: Demographic and Geographic Variations From 2015 to 2060

Author Affiliations
  • 1Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles
  • 2Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles
  • 3Department of Ophthalmology, University of Washington, Seattle
  • 4Seattle Children's Hospital, Seattle, Washington
JAMA Ophthalmol. 2017;135(6):610-616. doi:10.1001/jamaophthalmol.2017.1021
Key Points

Question  What are the demographic and geographic variations in visual impairment in preschool children in the United States in 2015 and what is the projected prevalence through 2060?

Findings  In this prevalence study, the number of preschool children with visual impairment is projected to increase by 26% in 2060, with 69% of visual impairment resulting from simple uncorrected refractive error. Hispanic white children will account for the largest number and proportion of cases, followed by African American children.

Meaning  Vision screening and early intervention targeting preschool populations might prevent unnecessary VI and associated developmental delays such as poor reading skills.

Abstract

Importance  Visual impairment (VI) in early childhood can significantly impair development.

Objective  To determine demographic and geographic variations in VI in children aged 3 to 5 years in the United States in 2015 and to estimate projected prevalence through 2060.

Design, Setting, and Participants  Descriptive study reporting statistics estimated based on prevalence data from 2 major population-based studies conducted in the United States between 2003 and 2011. Using US census projections, prevalence of VI and cause-specific VI in the better eye were reported by race/ethnicity, state and region, and per capita prevalence of VI by state. The study included preschool children in the United States. Analyses for this study were conducted between February 2016 and March 2017.

Main Outcomes and Measures  Prevalence of VI among children aged 3 to 5 years in the United States.

Results  In 2015, more than 174 000 children aged 3 to 5 years in the United States were visually impaired. Almost 121 000 of these cases (69%) arose from simple uncorrected refractive error, and 43 000 (25%) from bilateral amblyopia. By 2060, the number of children aged 3 to 5 years with VI is projected to increase by 26%. In 2015, Hispanic white children accounted for the highest number of VI cases (66 000); this group will remain the most affected through 2060, with an increasingly large proportion of cases (37.7% in 2015 and 43.6% in 2060). The racial/ethnic group with the second most VI is projected to shift from non-Hispanic white children (26.3% in 2015 decreasing to 16.5% in 2060) to African American children (24.5% in 2015 and 22.0% in 2060). From 2015 to 2060, the states projected to have the most children with VI are California (26 600 in 2015 and 38 000 in 2060), Texas (21 500 in 2015 and 29 100 in 2060), and Florida (10 900 in 2015 and 13 900 in 2060).

Conclusions and Relevance  These data suggest that the number of preschool children with VI is projected to increase disproportionally, especially among minority populations. Vision screening for refractive error and related eye diseases may prevent a high proportion of preschool children from experiencing unnecessary VI and associated developmental delays.

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