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Abstract
To determine the age-specific prevalence of strabismus in white and African American
children aged 6 through 71 months and of amblyopia in white and African American children
aged 30 through 71 months.
Cross-sectional, population-based study.
White and African American children aged 6 through 71 months in Baltimore, MD, United
States. Among 4132 children identified, 3990 eligible children (97%) were enrolled
and 2546 children (62%) were examined.
Parents or guardians of eligible participants underwent an in-home interview and were
scheduled for a detailed eye examination, including optotype visual acuity and measurement
of ocular deviations. Strabismus was defined as a heterotropia at near or distance
fixation. Amblyopia was assessed in those children aged 30 through 71 months who were
able to perform optotype testing at 3 meters.
The proportions of children aged 6 through 71 months with strabismus and of children
aged 30 through 71 months with amblyopia.
Manifest strabismus was found in 3.3% of white and 2.1% of African American children
(relative prevalence [RP], 1.61; 95% confidence interval [CI], 0.97-2.66). Esotropia
and exotropia each accounted for close to half of all strabismus in both groups. Only
1 case of strabismus was found among 84 white children 6 through 11 months of age.
Rates were higher in children 60 through 71 months of age (5.8% for whites and 2.9%
for African Americans [RP, 2.05; 95% CI, 0.79-5.27]). Amblyopia was present in 12
(1.8%) white and 7 (0.8%) African American children (RP, 2.23; 95% CI, 0.88-5.62).
Only 1 child had bilateral amblyopia.
Manifest strabismus affected 1 in 30 white and 1 in 47 African American preschool-aged
children. The prevalence of amblyopia was <2% in both whites and African Americans.
National population projections suggest that there are approximately 677,000 cases
of manifest strabismus among children 6 through 71 months of age and 271 000 cases
of amblyopia among children 30 through 71 months of age in the United States.