Delayed Diagnosis of Amblyopia in Children of Lower Socioeconomic Families: The Hong Kong Children Eye Study

ABSTRACT

Aims

To determine the prevalence of amblyopia and the factors associated with delayed diagnosis among school-aged children in Hong Kong.

Methods

Completed comprehensive ophthalmoscopic examinations were conducted among 4.273 children aged 6–8 years in the population-based Hong Kong Children Eye Study. New and previous diagnoses of amblyopia were identified. Socioeconomic status was surveyed through questionnaires.

Results

According to criteria from the Multi-Ethnic Pediatric Eye Disease Study (MEPEDS), amblyopia was present in 43 out of 4,273 children (1.01%; 95% CI, 0.71–1.31). Among them, 33 (0.77%) were newly detected cases that were more likely from families living in Public Rental Housing or subdivided flats (OR, 4.22; P = .012), with lower paternal (OR 6.68, P = .008) and maternal education levels (OR, 4.38; P = .039). Multivariate analysis revealed associations of amblyopia with hyperopia (≥+2.00D; OR, 6.23; 95% CI, 2.86–13.56, P < .001), astigmatism (≥+2.00D; OR, 24.88; 95% CI, 10.69–57.91, P < .001) and anisometropia (≥2.00D; OR, 14.49; 95% CI, 5.93–37.63, P < .001).

Conclusion

These children with delayed diagnoses of amblyopia were more likely to come from lower socioeconomic backgrounds. Public education aimed at increasing awareness and utilization of child vision screening among such families is needed.

KEYWORDS:

• Amblyopia
• delayed diagnosis
• lower socioeconomic families

Acknowledgments

We thank all the children and their families for their participation in the Hong Kong Children Eye Study. We also thank our colleagues and volunteers for all their hard work and dedication in data collection for this study. We are very grateful to Ms Mandy P.H. Ng from the Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong, for her overall coordination and logistic arrangements on the study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This study was supported in part by CUHK Jockey Club Children Eye Care Programme; the General Research Fund (GRF), Research Grants Council, Hong Kong (14111515 and 14103419 [JCY]); the Health and Medical Research Fund (HMRF), Hong Kong (5160836 [LJC] and 07180826 [XJZ]); the Direct Grants of the Chinese University of Hong Kong, (4054193 [LJC] and 4054121 & 4054199 [JCY]); the UBS Optimus Foundation Grant 8984 (JCY); and the Centaline Myopia Fund [JCY].