Abstract
Purpose: To determine the prevalence of ptosis (congenital/acquired) in Iranian children aged 7 years and its relationship with amblyopia and strabismus.
Methods: Eight Iranian cities were selected for this cross-sectional study using multistage randomized cluster sampling. A number of primary schools were randomly selected in each city. All grade 1 students in each selected primary school underwent optometric examinations including the measurement of uncorrected and corrected visual acuity, cover test, and cycloplegic and non-cycloplegic refraction.
Results: Of 4614 selected students, 4106 students participated in the study (response rate = 89%). The prevalence of ptosis (congenital/acquired) was 1.41% (95% CI 1–1.83); 0.49% (95% CI 0.26–0.72) and 0.93% (95% CI 0.59–1.26) had unilateral and bilateral ptosis, respectively. The prevalence of ptosis had no significant correlation with sex (p = 0.810, OR = 1.07, 95% CI 0.59–1.97). The prevalence of amblyopia was 48.28% and 0.89% in students with and without ptosis, respectively. The prevalence of tropia was significantly higher in cases with bilateral ptosis (p < 0.001). The mean cylinder error was 1.63 ± 1.72 and 0.44 ± 0.60 in ptotic and non-ptotic eyes, respectively (p < 0.001). With-the-rule (WTR) astigmatism was significantly more prevalent in students with ptosis.
Conclusion: We report the prevalence of ptosis (congenital/acquired) in children in Iran and the Middle East region for the first time. Amblyopia was considerably more prevalent in ptotic patients. We found a significant correlation between ptosis and tropia. Astigmatism, especially WTR stigmatism, was more prevalent in children with ptosis.
Declaration of interest
No conflicting relationships exist for any of the authors.
This project is funded by the Noor Ophthalmology Research Center and Arak University of Medical Sciences.