Prevalence of abnormal vision in one-year-old Thai children, based on a prospective cohort study of Thai children (PCTC).

OBJECTIVES

To collect preliminary data on the prevalence of abnormal vision in one-year-old Thai children.

MATERIAL AND METHOD

A retrospective study was conducted using data collected from a prospective cohort study of Thai children (PCTC) carried out during 2000-2002, to examine the prevalence of abnormal vision in one-year-olds. Data from five districts in five provinces were examined. One-year-old children in the present study underwent vision screening and eye examination performed by non-medical research assistants.

RESULTS

There were records from 3,898 children in five districts, 49.7% females and 50.2% males. Their eye examinations showed very good vision in 77.8% (9.8 cy/cm at 38 cm), good vision in 21.5% (6.5 cy/cm at 38 cm), and fair vision in 0.7% (< or = 1.6 cy/cm at 38 cm). Normal ocular motility was found in 99.7% and 99.9% had normal anterior segment and lens. No strabismus was found in 99.4%, 99.9% had normal pupil light reflex, 99.8% had normal red reflex, 93.6% could fix and follow at 3 months of age, 85.7% could detect a falling object at 6 months, and 78.5% of mothers and 46.5% of fathers regularly played with the children. Logistic regression analysis indicated that some factors had statistical significance, such as "fix and follow" by 1 month of age, and lack of father-child interaction, but these were not clinically significant. Using Kappa analysis, the authors combined groups 1 (very good vision) and 2 (good vision) to create a "normal vision" category. If children had 2 abnormal eye examinations (eye exam for strabismus, cornea, anterior chamber, lens, pupil and red reflex), the authors recommended sending them to a specialist. The sensitivity and specificity of the visual screening and eye examination instruments were 19.23% and 99.38%, respectively. The Kappa statistic was 0.17. These instruments are not appropriate for eye screening in one-year-old children.

CONCLUSION

More than 99% of the children examined had normal results. The majority of children could fix and follow from 2-3 months of age. The early fix and follow development may be related to better visual acuity. The interaction between father and child may be associated with eye development. However, eye screening of one-year-old children by assistant researchers may be inappropriate due to lack of expertise and experience.