Prevalence and associated risk factors for childhood strabismus in Lhasa, Tibet, China: a cross-sectional, school-based study
Abstract Background To estimate the prevalence of strabismus and associated risk factors among grade one school children in Lhasa, Tibet, China. Methods The Lhasa Childhood Eye Study (LCES) was a cross-sectional, school-based childhood study conducted in Grade one students from primary schools in Lhasa, Tibet, China. Comprehensive ophthalmic examinations and basic systematic examinations were evaluated. A questionnaire survey contained information about children, as well as parents’ information was sent to the corresponding parents of eligible children. The prevalence of strabismus and its 95% confidence interval was estimated. Univariate and multivariate logistic regression analyses were conducted to determine the associated risk factors. Results A total of 1942 eligible grade one students were enrolled, of which 1856 participants completed all procedures. The average age was 6.83 ± 0.46 years, 53% of participants were boys and 1762 were the Tibetan Minority. Overall, the prevalence of strabismus was 68/1856(3.7%) (95%CI: 2.81,4.52), with no difference between the ages, genders, ethnics and BMI, while tilt one's head when writing was a risk factor for strabismus (P=0.004). Strabismus students had the mean best corrected visual acuity 0.16 ± 0.28(LogMAR), over 50% patients with esotropia are hyperopia, participants who has stereopsis impairments showed a significant difference between esotropia and exotropia (P = 0.026). Conclusions The prevalence of strabismus in LCES was 3.7%, higher than previous reports from Chinese childhood epidemiology studies. Strabismus is a common contributing factor to amblyopia. Tilt one's head when writing was a risk factor. Patients with esotropia are more likely to affect stereopsis and be the refractive state of hyperopia. Trial registration: The study has finished the clinical registration on Chinese Clinical Trial Registry. (http://www.chictr.org.cn, ChiCTR1900026693).