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Purpose : To assess associations between multiple factors comprising a conceptual model of visual impairment (VI) in a population of Chinese Americans (CAs), and identify independent VI risk factors. Methods : A population-based study of 4582 CAs aged 50 years and older residing in Monterey Park, California. A comprehensive eye examination was performed. VI was defined as best-corrected visual acuity <20/40 (US definition) in the better-seeing eye. Results : Of five independent risk factors identified, age and self-reported history of ocular disease were most strongly associated with VI. Participants 70 years and older were 10.0 times as likely to have VI compared to those in their 50s (95% confidence interval (CI) 4.0-25.0), while those with a history of ocular disease were 4.2 times as likely to have VI (95% CI 2.2-7.8). Additional risk factors included low education (OR 2.8, 95% CI 1.7-4.8), low acculturation (OR 5.9, 95% CI 2.0-17.3) and self-reported history of diabetes (OR 2.0, 95% CI 1.2-3.2). A comparison to data previously described from the Los Angeles Latino Eye Study indicated that four of the factors that predict VI risk in CAs also represent clinically relevant risk factors for VI in Latinos. Conclusions : Screening programs for individuals with advanced age and a history of ocular disease have the potential to reduce the burden of VI in CAs, as do educational programs for those with fewer years in school, a history of diabetes, and low acculturation.

Purpose: To investigate the perceptions, behaviors, and recommendations that parents, school nurses, and teachers have regarding children's use of eyeglasses., Approach: Focus groups with parents, school nurses, and teachers were conducted., Setting: The study took place in one Southern California school district., Participants: There were 39 participants, including 24 parents, seven school nurses, and eight teachers., Method: An experienced moderator guided the focus group discussions. Transcripts were analyzed using grounded theory techniques., Results: Participants perceive visual impairment as a serious problem in the development of children. The lack of eyeglasses may lead to problems such as tiredness, headaches, inability to focus on school work, and decreased reading speed. Participants experienced disappointment, unhappiness, worry, and concern when they realized they needed eyeglasses at a young age. Negative societal perceptions toward eyeglasses, lack of eye doctors in minority communities, parental perceptions that children do not need eyeglasses, and peer bullying of children wearing eyeglasses are key obstacles to children's use of eyeglasses. Participants suggest school and national campaigns featuring respected public figures who wear eyeglasses to promote positive attitudes toward eyeglasses., Conclusion: Parents and teachers who closely follow the academic development of children have observed that visual impairment has negative consequences for the scholastic achievement of children. They recommend interventions to promote the attractiveness of eyeglasses in society. The participants discuss the need for a national preventative message for eye care similar to the message for dental care. The public health message should emphasize the importance of embracing and respecting differences among individuals.

Objective: To investigate risk factors associated with unilateral or bilateral decreased visual acuity (VA) in preschool children., Design: Population-based, cross-sectional prevalence study., Participants: Population-based samples of 6504 children ages 30 to 72 months from California and Maryland., Methods: Participants were preschool African-American, Hispanic, and non-Hispanic white children from Los Angeles, California, and Baltimore, Maryland. Data were obtained by a parental interview and a detailed ocular examination. Logistic regression models were used to evaluate the independent associations between demographic, behavioral, and clinical risk factors with unilateral and bilateral decreased VA., Main Outcome Measures: Odds ratios (ORs) for various risk factors associated with interocular difference (IOD) in VA of ≥2 lines with ≤20/32 in the worse eye, or bilateral decreased VA <20/40 or <20/50 if <48 months of age., Results: In multivariate logistic regression analysis, 2-line IOD with a VA of ≤20/32 was independently associated with Hispanic ethnicity (OR, 2.05), esotropia (OR, 8.98), spherical equivalent (SE) anisometropia (ORs ranging between 1.5 and 39.7 for SE anisometropia ranging between 0.50 to <1.00 diopters [D] and ≥2.00 D), and aniso-astigmatism in J0 or J45 (ORs ranging between 1.4 and ≥5.3 for J0 or J45 differences ranging between 0.25 to <0.50 D and ≥1.00 D). Bilateral decreased VA was independently associated with lack of health insurance (OR, 2.9), lower primary caregiver education (OR, 1.7), astigmatism (OR, 2.3 and 17.6 for astigmatism 1.00 to <2.00 D and ≥2.00 D), and SE hyperopia ≥4.00 D (OR, 10.8)., Conclusions: Anisometropia and esotropia are risk factors for IOD in VA. Astigmatism and high hyperopia are risk factors for bilateral decreased VA. Guidelines for the screening and management of decreased VA in preschool children should be considered in light of these risk associations., Financial Disclosure(s): The authors have no proprietary or commercial interest in any of the materials discussed in this article., (Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Background: The prevalence rates and specific risk factors for development of eye conditions among Asian-Pacific Islander schoolchildren are unknown. This information is necessary to understand their eye care needs and to improve access to eye care for this rapidly growing population., Methods: Data obtained from a computer database of vision screening examinations conducted by the UCLA Mobile Eye Clinic from October 1987 through December 1996 were analyzed for 2,687 Asian-Pacific Islander schoolchildren between 5 and 7 years of age., Results: Myopia (8.9%) and astigmatism (15.8%) represented the majority of visual disorders. Mean myopic refractive error was -1.21 +/- 0.83 D among bilateral myopes. Color-vision deficiency was prevalent among 2.8% of male children, extraocular muscle imbalance among 3.0% of children, and amblyopia among 1.0% of children. All other conditions were present in less than 4% of children screened., Conclusions: Asian-Pacific Islander schoolchildren may be at higher risk for development of juvenile myopia than white, Hispanic, and African-American children. Prevalence rates of other disorders are comparable to those obtained for other ethnic groups. This information can be used in planning to meet the eye care needs of Asian-Pacific Islander schoolchildren.

South East (SE) Asians accounted for a disproportionate percentage of the functional visual loss (FVL) seen in our area between 1983 and 1987. Moreover, 94% of the SE Asian FVL patients were Cambodian, although Cambodians only represented 20-30% of the local SE Asian patient population. Cambodian refugees are, at present, generally from lower socio-economic classes than the Vietnamese, and a much larger percentage of them have a history of camp incarceration and previous trauma. The Cambodians presenting with FVL may have conversion hysteria influenced by their wartime experience and cultural background. This study demonstrates that the SE Asian refugees in California are not a homogenous group with respect to visual problems, and that an awareness of cultural or historical factors can be important to the management of ophthalmic symptoms in our multi-cultural societies.