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What groups of American teens are most likely to have vision problems?

Racial, ethnic, and socioeconomic disparities in vision outcomes were apparent in adolescents, according to a cross-sectional study using data from the National Health and Nutrition Examination Survey.

Among nearly 3,000 participants representing a weighted survey of 57 million American adolescents, those who were Black (OR 2.85, 95% CI 2.00-4.05) or Mexican American (OR 2.83, 95% CI 1.70-4.73) were more likely to self-report poor vision compared to their white counterparts, reported Isdin Oke, MD, of Boston Children’s Hospital and Harvard Medical School, and colleagues.

Low-income people were also more likely to self-report poor vision (OR 2.44, 95% CI 1.63-3.65; all P<0.001), noted in JAMA Ophthalmology.

There was also an increased odds of worse objective visual acuity (worse than 20/40 in the better seeing eye) among African Americans (OR 2.13, 95% CI 1.41-3.24, P=0.001) and Mexican-American (OR 2.13, 95% CI 1.39-3.26, P=0.001) adolescents versus whites, and among non-US citizens (OR 1.96 compared to citizens, 95% CI 1.10-3.49, P=0.02).

“Our findings likely account for underlying social and economic inequalities in access to vision care services. Children from disadvantaged backgrounds may have fewer eye diagnoses, lower utilization of vision care, and a higher likelihood of being lost during follow-up,” Oke and his team wrote. “In adolescence, the combination of underdiagnosis and undertreatment may contribute to observed differences in subjective and objective visual function.”

“Much of the visual impairment in this study appears correctable, emphasizing the importance of access to refractive correction in adolescence, a time when poor vision can affect academic performance, future employment, and economic opportunity,” they added.

Visual impairments have been found to be more likely in Black, Hispanic, and low-income adults, often due to preventable causes. “Understanding the association of race, ethnicity, and socioeconomic status with childhood visual impairment may provide insights into the occurrence of disparities in vision health and reveal opportunities for intervention,” the authors suggested.

For this study, Oke and colleagues used data from the 2005-2008 National Health and Nutrition Examination Survey on 2,833 participants ages 12 to 18, who completed visual function questionnaires and underwent eye exams.

The median age was 15.5 years, 49% were female, 14% were black, 11% were Mexican American, and 63% were white. Five percent of the participants were not US citizens and 19% had a family income below the poverty line.

Self-reported vision was determined by asking participants how they would rate their own vision with glasses or contact lenses, if necessary. Visual acuity was measured at a distance with the participants’ usual refractive correction using the acuity chart of the Nidek Autorefractor, model ARK-760.

The prevalence of poor subjective visual function was higher among non-US citizens compared to US citizens households (8.8% vs. 6.0%), while the prevalence of visual acuity less than 20/40 in the better seeing eye was higher among non-U.S. citizens compared to U.S. citizens (21.3% vs. 9.7%) and among those from large vs. small households (13.9% vs. 9.6%).

Oke and his team acknowledged that using survey data from 2005 to 2008 was a limitation for their study, as it may no longer reflect the current US teen population.

  • Author['full_name']

    James Lopilato is a staff writer for Medpage Today. He covers a variety of topics that are being explored in current medical scientific research.

Disclosures

This study was supported by the Office of Academic Engagement at Harvard Medical School, the Agency for Healthcare Research and Quality, and the Ophthalmology Foundation at Boston Children’s Hospital.

The study authors reported no conflicts of interest.

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