Disclosures

1
Disclosures

• Grant support
• National Eye Institute, National Institutes of
  Health, EY 14483
  
• No commercial support

2
Prevalence of Decreased Visual Acuity in
Preschool-Aged Children in an American Urban
Population

• Michael X. Repka, MD
• Professor of Ophthalmology
• Professor of Pediatrics
• Johns Hopkins University School of Medicine
• Baltimore, Maryland

3
Research Group

• David S. Friedman, MD, MPH, PhD
• Michael X. Repka, MD
• Joanne Katz, ScD
• Lydia Giordano, OD
• Josephine Ibironke, OD
• Patricia Hawes, MS, COMT, CRA
• Diane Burkom, MA
• James M. Tielsch, PhD

4
BPEDSBaltimore Pediatric Eye Disease Study
5
BPEDS Purpose of the Study

• To determine the extent and types of eye disease
  in the white and African-American populations of
  Baltimore, Maryland
  
• By extrapolation determine these data for the US
  population

6
BPEDS - Methods

• Age range - 6 months to 71 months
• Examine every child in the selected census areas
• Comprehensive eye exam

7
US Population

• US Population Estimates 9/2008
• age 6 to 71 months (about 44 million)
• about 20 million white boys and girls
• about 4.1 million black boys and girls

8
BPEDS Study Data Collected

• Visual acuity
• As presenting to the exam
• Best corrected
• Refractive Error
• Presence of eye problems
• Strabismus (eye misalignment)
• Amblyopia (reduced vision in one or both eyes)
• Usually caused by refractive error or strabismus
• Other eye conditions such as cataract and glaucoma

9
Prevalence of Decreased Visual Acuity

• Affects the quality of life for many years
• Treatment for many eye conditions is best when
  identified early
  
• Assist planning care for this population
• Provision of necessary care to children
• Targeted health care expenditures / programs
• Develop specific screening programs

10
BPEDS Definition of Decreased Vision

• Visual acuity worse than 20/50 in children 30
  47 months of age
  
• Visual acuity worse than 20/40 in those 48 71
  months of age

11
Children

• 2546 children enrolled in the project
• 1607 white
• 1990 black
• 338 other
• Able to participate in this portion
• 577 white
• 725 black
• 26 (1.7) presented with spectacles

12
Visual Acuity Testability

• 30 to
• 48 to 71 months of age 97.2

13
Decreased Presenting Vision in Better Eye
14
Decreased Vision in Better Eye

• Presenting 1.2 W, 1.8 AA
• Same Day 0.5 W, 1.6 AA
• Tested with refractive error correction
• Best Measured 0.5 W, 1.1 AA
• Includes a retest on another day

p
15
Decreased Vision in One Eye

• After all testing and with appropriate eye
  glasses correction
  
• 3.7 of whites
• 5.3 of blacks

16
Causes of Reduced Vision

• 50 from uncorrected refractive error
• After correction
• Amblyopia second most common
• Albinism
• No cause found likely testability

17
Subgroups

• Age
• No association with visual impairment
• Gender
• 6 girls (1.7) versus 1 boy (0.3) (P
• 48 71 months
• no difference

18
BPEDS Visual Acuity Outcome

• In preschool children
• Decreased vision in the better eye is uncommon.
• Uncorrected refractive error is the most common
  cause of decreased vision
  
• Decreased vision is not associated with age or
  race.