Prevalence of amblyopia or strabismus in asian and non-Hispanic white preschool children: multi-ethnic pediatric eye disease study

Ophthalmology. 2013 Oct;120(10):2117-24. doi: 10.1016/j.ophtha.2013.03.001. Epub 2013 May 19.


Objective: To determine the age- and race-specific prevalence of amblyopia in Asian and non-Hispanic white children aged 30 to 72 months and of strabismus in children aged 6 to 72 months.

Design: Cross-sectional survey.

Participants: A population-based, multiethnic sample of children aged 6 to 72 months was identified in Los Angeles and Riverside counties in California to evaluate the prevalence of ocular conditions.

Methods: A comprehensive eye examination and in-clinic interview were conducted with 80% of eligible children. The examination included evaluation of ocular alignment, refractive error, and ocular structures in children aged 6 to 72 months, as well as a determination of optotype visual acuity (VA) in children aged 30 to 72 months.

Main outcome measures: The proportion of 6- to 72-month-old participants with strabismus and 30- to 72-month-olds with optotype VA deficits and amblyopia risk factors consistent with study definitions of amblyopia.

Results: Strabismus was found in 3.55% (95% confidence interval [CI], 2.68-4.60) of Asian children and 3.24% (95% CI, 2.40-4.26) of non-Hispanic white children, with a higher prevalence with each subsequent older age category from 6 to 72 months in both racial/ethnic groups (P=0.0003 and 0.02, respectively). Amblyopia was detected in 1.81% (95% CI, 1.06-2.89) of Asian and non-Hispanic white children; the prevalence of amblyopia was higher for each subsequent older age category among non-Hispanic white children (P=0.01) but showed no significant trend among Asian children (P=0.30).

Conclusions: The prevalence of strabismus was similar in Asian and non-Hispanic white children and was found to be higher among older children from 6 to 72 months. The prevalence of amblyopia was the same in Asian and non-Hispanic white children; prevalence seemed to be higher among older non-Hispanic white children but was relatively stable by age in Asian children. These findings may help clinicians to better understand the patterns of strabismus and amblyopia and potentially inform planning for preschool vision screening programs.

Financial disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Distribution
  • Amblyopia / epidemiology*
  • Amblyopia / ethnology
  • Asian Continental Ancestry Group
  • California / epidemiology
  • Child
  • Child, Preschool
  • European Continental Ancestry Group
  • Female
  • Humans
  • Male
  • Prevalence
  • Strabismus / epidemiology*
  • Strabismus / ethnology
  • Visual Acuity