Smith L K, Thompson J R, Woodruff G
Department of Ophthalmology, University of Leicester.
J Epidemiol Community Health. 1995 Dec;49(6):606-9. doi: 10.1136/jech.49.6.606.
To investigate the relationship between age at presentation of amblyopia and social deprivation before and after the introduction of changes to a vision screening service.
Two cohorts of children treated for amblyopia in 1983 and 1992.
THe orthoptic department of Leicester Royal Infirmary.
The 209 patients treated for amblyopia who first attended the orthoptic department in 1983, and 203 who first attended in 1992.
Age at presentation to the orthoptic department was the main outcome measure. Social deprivation was measured by Townsend deprivation score for the electoral ward in which the child lived, using 1981 and 1991 census data.
After the introduction of changes in the screening programme, the mean at presentation of amblyopia associated with microtropia or no strabismus was reduced from 6.6 years to 5.0 years. In 1983 there was a significant relationship between deprivation and age at presentation (p = 0.0001), with those from more deprived areas presenting later. No similar association was found in children referred in 1992 (p = 0.17). There was no change in mean age of presentation of amblyopia associated with a large angle of strabismus (3.3 years in 1983 and 1992) and no relationship between deprivation and age at presentation 1983 or 1992 (p = 0.24 and p = 0.39 respectively).
Since the introduction of changes to vision screening, the relationship between social deprivation and the age of presentation of asymptomatic amblyopia seems to have disappeared. Children are now referred earlier and those from deprived areas are not being overlooked.
调查视力筛查服务改变前后弱视就诊年龄与社会剥夺之间的关系。
1983年和1992年接受弱视治疗的两组儿童队列研究。
莱斯特皇家医院眼科。
209例于1983年首次到眼科就诊的弱视患者，以及203例于1992年首次就诊的患者。
到眼科就诊的年龄是主要的观察指标。利用1981年和1991年的人口普查数据，通过儿童居住选区的汤森德剥夺分数来衡量社会剥夺程度。
在筛查项目改变后，与微小斜视或无斜视相关的弱视就诊平均年龄从6.6岁降至5.0岁。1983年，剥夺程度与就诊年龄之间存在显著关系（p = 0.0001），来自剥夺程度较高地区的儿童就诊较晚。在1992年转诊的儿童中未发现类似关联（p = 0.17）。与大角度斜视相关的弱视就诊平均年龄没有变化（1983年和1992年均为3.3岁），1983年或1992年剥夺程度与就诊年龄之间均无关系（分别为p = 0.24和p = 0.39）。
自视力筛查改变以来，社会剥夺与无症状弱视就诊年龄之间的关系似乎已消失。现在儿童转诊更早，来自贫困地区的儿童也没有被忽视。
