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    Prevalence of, and risk factors for, presenting visual impairment: findings from a vision screening programme based on UK NSC guidance in a multi-ethnic population

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    Publication date
    2018-06-13
    Author
    Bruce, A.
    Santorelli, G.
    Wright, J.
    Bradbury, J.
    Barrett, Brendan T.
    Bloj, Marina
    Sheldon, T.A.
    Keyword
    Visual acuity (VA)
    Presenting visual impairment (PVI)
    Vision screening
    Multi-ethnic population
    UK
    Children
    Rights
    © The Royal College of Ophthalmologists 2018. Reproduced in accordance with the publisher's self-archiving policy.
    Peer-Reviewed
    Yes
    
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    Abstract
    Purpose: To determine presenting visual acuity levels and explore the factors associated with failing vision screening in a multi-ethnic population of UK children aged 4–5 years. Methods: Visual acuity (VA) using the logMAR Crowded Test was measured in 16,541 children in a population-based vision screening programme. Referral for cycloplegic examination was based on national recommendations (>0.20logMAR in one or both eyes). Presenting visual impairment (PVI) was defined as VA >0.3logMAR in the better eye. Multivariable logistic regression was used to assess the association of ethnicity, maternal, and early-life factors with failing vision screening and PVI in participants of the Born in Bradford birth cohort. Results: In total, 2467/16,541 (15%) failed vision screening, 732 (4.4%) had PVI. Children of Pakistani (OR: 2.49; 95% CI: 1.74–3.60) and other ethnicities (OR: 2.00; 95% CI: 1.28–3.12) showed increased odds of PVI compared to white children. Children born to older mothers (OR: 1.63; 95% CI: 1.19–2.24) and of low birth weight (OR: 1.52; 95% CI: 1.00–2.34) also showed increased odds. Follow-up results were available for 1068 (43.3%) children, 993 (93%) were true positives; 932 (94%) of these had significant refractive error. Astigmatism (>1DC) (44%) was more common in children of Pakistani ethnicity and hypermetropia (>3.0DS) (27%) in white children (Fisher’s exact, p < 0.001). Conclusions: A high prevalence of PVI is reported. Failing vision screening and PVI were highly associated with ethnicity. The positive predictive value of the vision screening programme was good, with only 7% of children followed up confirmed as false positives.
    URI
    http://hdl.handle.net/10454/16380
    Version
    Accepted Manuscript
    Citation
    Bruce A, Santorelli G, Wright J et al (2018) Prevalence of, and risk factors for, presenting visual impairment: findings from a vision screening programme based on UK NSC guidance in a multi-ethnic population. 32: 1599-1607.
    Link to publisher’s version
    https://doi.org/10.1038/s41433-018-0146-8
    Type
    Article
    Collections
    Life Sciences Publications

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