{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T08:00:45Z","timestamp":1761897645058,"version":"3.41.2"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,4,4]],"date-time":"2022-04-04T00:00:00Z","timestamp":1649030400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>The goal of this study is to assess the prevalence and distribution of visual impairment in preschool children in southern China.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Preschool children aged 36\u201383 months were enrolled in a vision screening program in Shantou City. Visual acuity test and non-cycloplegic refraction were conducted. According to the American Academy of Ophthalmology (AAO) guidelines, visual impairment was defined as uncorrected visual acuity (UCVA) in either eye &amp;lt;20\/50, 20\/40, and 20\/32 in children aged 36\u201347, 48\u201359, and 60\u201383 months, respectively, as well as an interocular difference (IOD) of \u2265 two lines of UCVA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The UCVA test was successfully performed on 7,880 children (94.6% of the enrolled population). A total of 938 (11.9%; 95% CI 11.2\u201312.6) children were found to have reduced UCVA in the worse eye, and 393 (5%; 95% CI 4.5\u20135.5) of the children had an IOD of two or more lines. Combining the reduced UCVA with the IOD criteria identified 1,032 (13.1%; 95% CI 12.4\u201313.8) children with visual impairment. UCVA in preschool children improves with age naturally and boys have slightly better age-adjusted UCVA than girls. Causes of reduced visual acuity included uncorrected refractive error, amblyopia, congenital cataract, and others. The cylindrical diopter in the right eye of children with reduced vison was higher than that of children with normal vision (1.19 \u00b1 1.05 vs. 0.52 \u00b1 0.49, <jats:italic>P<\/jats:italic> &amp;lt; 0.001). A total of 146 (1.9%, 95% CI 1.6\u20132.2) of the preschool children wore spectacles. The proportion of wearing spectacles increased with age (\u03c7<jats:sup>2<\/jats:sup> = 35.714, <jats:italic>P<\/jats:italic> &amp;lt; 0.001), but with IOD increasing by.1 logMAR, the odds of wearing spectacles decreased by 44.8%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study provided data on the prevalence of visual impairment in preschool children in China by large-scale school-based vision screening. Further studies should be conducted to verify the benefit from vision screening.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2022.755407","type":"journal-article","created":{"date-parts":[[2022,4,4]],"date-time":"2022-04-04T05:32:50Z","timestamp":1649050370000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Prevalence of Visual Impairment in Preschool Children in Southern China"],"prefix":"10.3389","volume":"10","author":[{"given":"Hongxi","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunliang","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shengjie","family":"Yin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yali","family":"Du","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Binyao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiao","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dandan","family":"Deng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingzhi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,4,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1136\/archdischild-2016-310532","article-title":"Epidemiology of blindness in children","volume":"102","author":"Solebo","year":"2017","journal-title":"Arch Dis Child."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/S0002-9394(99)80239-6","article-title":"A global initiative for the elimination of avoidable blindness","volume":"11","author":"Thylefors","year":"1998","journal-title":"Community Eye Health."},{"key":"B3","doi-asserted-by":"publisher","first-page":"25","DOI":"10.2147\/EB.S130893","article-title":"The development of human visual cortex and clinical implications","volume":"10","author":"Siu","year":"2018","journal-title":"Eye Brain."},{"key":"B4","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1097\/WCO.0000000000000413","article-title":"Neuroplasticity and amblyopia: vision at the balance point","volume":"30","author":"Tailor","year":"2017","journal-title":"Curr Opin Neurol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/S0039-6257(97)81990-X","article-title":"Preschool vision screening: rationale, methodology and outcome","volume":"41","author":"Simons","year":"1996","journal-title":"Surv Ophthalmol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"2179","DOI":"10.4103\/ijo.IJO_1603_19","article-title":"Identifying barriers to referrals in preschool-age ocular screening in Southern India","volume":"68","author":"Ravindran","year":"2020","journal-title":"Indian J Ophthalmol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"e442","DOI":"10.1542\/peds.2010-0462","article-title":"Screening for visual impairment in children ages 1-5 years: update for the USPSTF","volume":"127","author":"Chou","year":"2011","journal-title":"Pediatrics."},{"key":"B8","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1016\/j.ophtha.2012.08.009","article-title":"Uncorrected visual acuity and noncycloplegic autorefraction predict significant refractive errors in Taiwanese preschool children","volume":"120","author":"Lai","year":"2013","journal-title":"Ophthalmology."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1985","DOI":"10.1167\/iovs.14-15422","article-title":"Normative distribution of visual acuity in 3- to 6-year-old Chinese preschoolers: the Shenzhen kindergarten eye study","volume":"56","author":"Guo","year":"2015","journal-title":"Invest Ophthalmol Vis Sci."},{"key":"B10","doi-asserted-by":"publisher","first-page":"146","DOI":"10.3928\/01913913-20210128-01","article-title":"Spot refractive screening with or without maximum atropine cycloplegia in preschool Chinese children","volume":"58","author":"Liu","year":"2021","journal-title":"J Pediatr Ophthalmol Strabismus."},{"key":"B11","doi-asserted-by":"publisher","first-page":"P184","DOI":"10.1016\/j.ophtha.2017.09.032","article-title":"Pediatric Eye Evaluations Preferred Practice Pattern\u00ae: I. 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