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Table 2 Hyperopia associated factors

From: Hyperopia: a meta-analysis of prevalence and a review of associated factors among school-aged children

Author (Year)

Location

Hyperopia associated factors

Ip (2008) [29]

Sydney Myopia Study (SMS)

GENDER: Age 6, girls were more hyperopic 15.5% (95%CI 12.7 – 18.4) than boys 10.9% (95%CI 8.5 – 13.2) (p = 0.005). Age 12, boys: 5.1% (95%CI 3.8–6.5), girls: 4.7% (95%CI 3.5–6.0), NS.

Australia

ETHNICITY: At age 6, more prevalent in European Caucasian 15.7% (95%CI 13.2–18.2) when compared with East Asian 6.8% (95%CI 4.0–9.5) and South Asian 2.5% (95%CI 0.0–7.5). East Asian, South Asian and Middle Eastern 8.4% (95%CI 1.6–15.2) do not present differences among their prevalence. At age 12, more prevalent in European Caucasian, 6.4% (95%CI 5.2–7.7) than East Asian 2.0% (95%CI 1.0–3.0). No difference between East Asian and Middle Eastern 7.4% (95%CI 2.7–12.0) and European Caucasian and Middle Eastern.

PARENTAL EDUCATION: Age 12, Maternal Education, (p = 0.055).

SOCIO-ECONOMIC STATUS: Age 6, Maternal Occupation, (p = 0.02). Home Ownership or Paternal Education or Employment (p > 0.1), after adjusted for demographic factors (gender, ethnicity, parental education, parental employment). Parental Employment was associated with moderate hyperopia (≥ + 2.00 D), (p = 0.02).

Ip (2008) [30]

Sydney Myopia Study (SMS)

GENDER: Age 11–15, no difference among boys 3.6% (95%CI 2.6–4.7) and girls 3.3% (95% CI 2.2–4.4). Age 12, girls showed a lower mean spherical equivalent (SE) (+0.39D) than boys (+0.58D), (p = 0.04).

Australia

ETHNICITY: European Caucasian 4.4% (95%CI 3.6–5.3) are more likely to have moderate hyperopia (≥ + 2.00 D) than East Asian 1.1% (95%CI 0.2–2.1), South Asian 0.0%(-) and other mixed ethnicity 1.7% (95%CI 0.0–3.6). Middle Eastern 6.1% (95%CI 1.5–10.7) are more likely to have moderate hyperopia than South Asian. There was no difference between European Caucasian and Middle Eastern. Age 12, Middle East showed a lower mean of SE (+0.71) than Caucasian (+0.82D) (p = 0.03). Caucasian had the highest mean SE (+0.82D) when compared to all ethnicities together (+0.04D), (p < 0.0001).

Ip (2008) [59]

Sydney, Australia

OUTDOOR ACTIVITIES: Age 12, greater time, (β coefficient = 0.03, p <0.0001), and weakly correlated with near-work activities (r =0.1, p < 0.0001).

NEAR WORK ACTIVITIES: Parental Reports of Close Reading Distance (<30 cm) (p < 0.0001), after adjustment for age, sex, ethnicity, and school type.

Rose (2008) [8]

Sydney Myopia Study (SMS)

OUTDOOR ACTIVITIES: Age 6 and 12, Greater Number of Hours, p = 0.009 and p = 0.0003 respectively, after adjustment for gender, ethnicity, parental myopia, near work, maternal and parental education, and maternal employment.

Australia

NEAR WORK ACTIVITIES: Age 12, Greater Levels of Near-work Activity, p =0.8.

Maul (2000) [37]

La Florida, Chile

AGE: 515, inverse relation (p < 0.05).

GENDER: Age 5–15, girls OR = 1.21 (95% CI 1.03-1.43).

Zhao (2000) [10]

Shunyi, China

AGE: 5–15, inverse relation OR = 0.75 (95% CI 0.71-0.79).

GENDER: Age 5–15, girls OR = 1.51 (95%CI 1.08-2.13).

Zhan (2000) [13]

Xiamen city, Xiamen Countryside and Singapore, China

RESIDENCE AREA: Age 6–7, Residence Zone, p = 0.50.

He (2004) [11]

Guangzhou, China

AGE: 5–15, inverse relation OR = 0.77 (95% CI 0.73-0.81).

GENDER: Age 5–15, NS p = 0.233.

PARENTAL EDUCATION: inverse relation OR = 0.81 (95%CI 0.66-0.98).

Pi (2010) [14]

Yong Chuan District, Western China

AGE: 6 – 15, inverse relation OR = 0.831 (95%CI 0.728-0.948), p < 0.01.

GENDER: Age 6–15, χ2 = 2.977, NS p = 0.08.

Dandona (2002) [47]

Andhra Pradesh, India

AGE: 0 – 5, were more hyperopic than those 10 – 15, OR = 3.34 (95%CI 2.69–4.14), p < 0.05. and 6 – 9 were more hyperopic than 10 – 15, OR = 1.72 (95%CI 1.41–2.10), p < 0.05

GENDER: Age 0–15 OR:1.19 (95%CI 0.76 – 1.86), NS.

SOCIO-ECONOMIC STATUS: Base Group: extreme lower income, Upper OR = 2.27% (95%CI 0.59 – 8.77), Middle OR = 2.21% (95%CI 0.89 – 5.50), Lower OR = 1.76% (95%CI 0.74 – 4.19).

RESIDENCE AREA: Two Rural Areas, OR = 2.84 (95%CI 2.16-3.75) and OR = 1.50 (95%CI 1.17-1.92) when compared with Urban.

Laatikainen (1980) [33]

Uusimaa County, Finland

AGE: 7–15 years, inverse relation, x2 = 28.617, p < 0.0005.

Grönlund (2006) [32]

Gothenburg, Sweden

AGE: 4 – 15, Correlation SE OD: r = -0.37, p < 0.0001 and SE OS: R = -0.33, p < 0.0001.

GENDER: Age 4–15, SE OD (p = 0.61) and SE OS: (p = 0.85).

OBS: The mean and standard deviation (SD) of the spherical equivalent (SE) was used in this study.

Dandona (2002) [22]

Andhra Pradesh, India

AGE: 7–15, NS.

GENDER: Age 7–15, NS.

PARENTAL EDUCATION: Education of the father (grade level achievement: none, 1–5, 6–12, 13–15, 15 or more), NS.

SOCIO-ECONOMIC STATUS: Extreme Lower, Lower, Middle, Upper, NS.

Dandona (1999) [41]

Andhra Pradesh, India

AGE: 0 – 15, NS.

GENDER: Age 0–15, NS.

SOCIO-ECONOMIC STATUS: Extreme Lower, Lower, Middle, Upper, NS.

Murthy (2002) [21]

New Delhi, India

GENDER: Age 11–13, girls OR = 1.72 (95% CI 1.05-2.81).

PARENTAL EDUCATION: Age 11–13, Child Education, inversely associated OR = 0.89 (95%CI 0.81-0.99).

Hashemi (2004) [46]

Tehran, Iran

AGE 5–15, inverse association, S p < 0.001.

GENDER: Age 5–15, Boys, 78.6% (95%CI 74.6 – 82.6), Girls, 73.2 (95%CI 68.5 – 77.9), NS.

Fotouhi (2007) [9]

Dezful, Iran

AGE 7–15, inverse relation OR = 1.73 (95%CI 0.83-0.94), p < 0.001.

GENDER: Age 7–15, boys 16.1% (95% CI 11.0–21.1), girls 16.1% (95%CI 11.0–21.1), NS.

RESIDENCE AREA: Rural, OR = 2.0 (95%CI 1.09-3.65).

Yekta (2010) [27]

Shiraz, Iran

AGE: 7–15, inverse relation OR = 0.84 (95%CI 0.73-0.97), S, p = 0.021.

GENDER: Age 7–15, boys: 5.17% (95%CI 3.19–7.15), girls, 4.90% (95%CI 2.32–7.48), NS, p = 0.863.

Ostadimoghaddam (2011) [25]

Mashhad, Iran

AGE: 5 – 15 inverse relation, S, (p < 0.001).

GENDER: Age 5–15, NS, p = 0.724.

Goh (2005) [17]

Gombak District, Malaysia

AGE: 7–15, inverse relation OR = 0.72 (95%CI 0.62-0.82).

GENDER: Age 7–15, boys, 1.7% (95%CI 1.1–2.3), girls, 1.4% (95%CI 0.8–2.1).

ETHNICITY: Age 7–15, “other” ethnicities were more hyperopic OR = 3.72 (95%CI 1.34-10.35) than Malaysian and Chinese. No differences were found among Malaysian 1.5% (95%CI 1.1–1.9), Chinese 1.1% (95%CI 0.4–1.7) or Indian 2.0% (95%CI 0.1–3.9).

PARENTAL EDUCATION: Parental with highest level of schooling, NS.

Varma (2009) [56]

Multi-Ethnic Pediatric Eye Disease Study Group (MEPEDS)

AGE: 6 – 72 months, Hispanic children, inverse relation, (6–11 months) vs (60–72 months) OR = 1.46 (95%CI 1.08–1.98) (P = 0.0017). Age 6–72 months, African-American, NS.

 

Los Angeles County, California USA

ETHNICITY: Age 6–72 months, Hispanic were more hyperopic 27.1% (95%CI 24.0 – 30.1) than African-American 21.1% (95%CI 17.9 – 24.3), after controlling for age, S, p < 0.001. Age 6–11 months and 36–47 months Hispanic are more hyperopic 35.1% (95%CI 29.7 – 40.5) and 29.9% (95%CI 26.0 – 33.8) than African-American, 18.1% (95%CI 13.5 – 22.7) and 20.7% (95%CI 17.3 – 24.1) respectively.

Pokharel (2000) [18]

Mechi Zone, Nepal

AGE: 5 – 15, as continuous variable, NS.

GENDER: Age 5–15, girls OR = 1.44 (95%CI 1.02-2.03).

Czepita (2007) [43]

Czeczecin, Poland

AGE 6–18, negative correlation, Sr = 0.907, S, p < 0.001

GENDER: Age 6–18, boys 40.3%(95% CI 38.5 – 42.1) are more hyperopic than girls, 35.3% (95%CI 33.6 – 37.0).

Naidoo (2003) [36]

Durban area, South Africa

AGE: 5 – 15 years, NS.

GENDER: Age 5–15, NS.

PARENTAL EDUCATION: parent with the highest education (grade level achievement: none, 1–5, 6–12, 13–15, 15 or more), NS.

Garner (1990) [60]

Island of Efaté, Republic of Vanatu, Melanesia

AGE: 6 – 17, age groups Melanesian, NS.

Kuala Lumpur, Malaysia

ETHNICITY: Age 6, Malaysian were more hyperopic than Melanesian.

Kleinstein (2003) [39]

Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error Study Group

ETHNICITY: Age 5 – 17, white are more hyperopic 19.3% (95%CI 16.9 – 21.7) than Asians 6.3% (95%CI 4.1 – 8.4) and African-Americans 6.4% (95%CI 4.3 – 8.5), x2 = 236.15, S, p < 0.001. Age 5–17 white didn’t differ from Hispanics 12.7% (95% CI 9.7 – 15.7), NS, p = 0.48. Age 5–17 Asians and Africa-Americans, NS, p = 0.07.

(CLEERE) Study

Eutaw, Alabama; Irvine, California and Houston, Texas USA

GENDER: Age 5–17, boys 12.6% (95%CI 10.8 – 14.4) are more hyperopic than girls 13.1% (95%CI 11.2 – 15.0).

Zadnik (2003) [40]

Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error Study Group

AGE: Age 6 to 7 and age 8 were more hyperopic than 9 to14, S, p < 0.0001.

(CLEERE) Study

Eutaw, Alabama; Irvine and Orinda, California and Houston, Texas USA

Giordano (2009) [54]

Baltimore Pediatric Eye Disease Study (BPEDS)

ETHNICITY: 6 – 72 months, white are more hyperopic (≥ + 1.00) than African-American OR = 1.62 (95%CI 1.51-1.74). White, 6 – 11: 33.0% (95%CI 22.9 – 43.1), 12 – 23: 30.3% (95%CI 23.5 – 37.1), 36 – 47: 27.5% (95%CI 21.5 – 33.5), 48 – 59: 33.3% (95%CI 26.8 – 39.9) and 60 – 72: 31.5% (95%CI 24.5 – 38.4) months are more hyperopic (≥ + 2.00D) than African American at same age ranges, 21.2% (95%CI 12.4 – 30.0, 15.7% (95%CI 10.5 – 20.9), 16.2% (95%CI 11.5 – 20.9), 17.2% (95%CI 12.6 – 21.8) and 17.4% (95%CI 12.6 – 22.1) respectively.

USA

Borchert (2011) [61]

Baltimore Pediatric Eye Disease Study (BPEDS)

AGE: 6 – 72 months. Those 12 – 23 months and 24 – 35 months are more hyperopic than 60 – 72 months OR = 0.81(95%CI 0.68 – 0.97) and OR = 0.74 (95%CI 0.62 – 0.88) respectively.

USA

ETHNICITY: Age 6–72 months, Non-Hispanic white, children are more hyperopic than African-American OR = 1.63 (95%CI 1.43 – 1.87). Age 6–72 months, Hispanic white are more hyperopic than African-American OR = 1.49 (95%CI 1.32 – 1.68).

SOCIO-ECONOMIC STATUS: Age 6–72 months with Health insurance, OR = 1.51 (95%CI 1.12 – 1.69).

O’Donoghue (2012) [34]

Northern Ireland Childhood Errors of Refraction

AGE: 6 – 7 are more hyperopic 26% (95%CI 20–33) than 12 – 13 years, 14.7% (95%CI 9.9 - 19.4), p < 0.005.

(NICER)

GENDER: Age 6–7, NS. Age 13–13, S.

Northern Ireland

Dirani (2010) [57]

The Strabismus, Amlyopia and Refractive Errors in Singaporean children

AGE: 6 – 72 months, inverse relation, Age 6 – 11.9 months 15.7% (95%CI 10.6 – 22.2), Age 24 – 35.9 months 6.8% (95%CI 4.6 – 9.6), Age 36 – 47.9 months 5.1% (95%CI 3.3 – 7.3) and age 60 – 72 months 5.7% (95% CI 3.8 – 8.0), S, p trend = 0.001.

(STARS)

Singapura

GENDER: Age 6–72 months, boys 6.6% (95%CI 5.1 – 7.7), girls: 9.4% (95%CI 7.9 – 11.1), NS, p = 0.75.

Casson (2012) [20]

Vientiane Province, Lao PDR

GENDER: 6 – 11, NS, p = 0.95.

Uzma (2009) [23]

Hyderabad, Índia

GENDER: 7 – 15, Urban, boys 1.5% (95%CI 0.7–2.3), girls, 1.4% (95%CI 0.6–2.2). Rural, boys, 2.7% (95%CI 1.3–4.1), girls, 2.1% (95%CI 0.9–3.3), NS.

RESIDENCE AREA: Age 8, 9, 12 and 13, Rural, are more hyperopic than urban, 8.1% (95%CI 5.4–10.8) v 2.0% (95%CI 0.4–3.6), 7.3% (95%CI 3.7–10.9) v 1.7% (95%CI 0.8–2.6), 3.2% (95%CI 1.6–4.8) v 0.4% (95%CI 0.0–0.8) and 2.4% (95%CI 0.9–3.9) v 0.2% (95%CI 0.0–0.4), respectively.

Rezvan (2012) [26]

Bojnourd, Iran

AGE: 6 – 17, inverse relation, S, p < 0.0001.

GENDER: Age 6–17, boys, 4.4% (95%CI 2.8–5.9), girls, 6.1% (95%CI 4.5–7.7), NS.

Saw (2006) [16]

Gombak District, Kuala Lumpur Malaysia Singapore

AGE: 7, Malaysian are more hyperopic (5%) than Singapore (2.1%), Prevalence difference, -22.9% (95%CI -24.8 to -20.9), S, p < 0.001.

GENDER: Age 7–9, Malaysian boys are more hyperopic (3.2%) than Singaporean boys (1.3%), Prevalence difference, -21.9% (95%CI -23.3 to -20.6), p < 0.001.

ETHNICITY: Age 7–9, Singaporean, are less hyperopic (1.7%) than Malaysian (2.9%), Prevalence difference, -21.1% (95%CI -22.1 to -20.2), p = 0.005.

PARENTAL EDUCATION: Age 7–9, Completed Education Level of the Father, NS.

OBS: Differences in the prevalence rates of hyperopia between Malaysia and Singapore were considered significant if the 95% confidence intervals of the differences in the prevalence rates did not cross zero and p values were <0.05.

Logan (2011) [35]

Birmingham, England (AES)

ETHNICITY: Age 6–7, White European are more hyperopic, 22.9% (95%CI 12.9% – 32.8%) than South Asian 10.3% (95%CI 6.2% - 14.4%) and Black African Caribbean 9.1% (95%CI 0.5 – 17.7). South Asian v Black African Caribbean, NS. Age 12 – 13, White European 10.4% (95%CI 4.8% – 16.1%) v South Asian 2.6% (95%CI 0.0 - 5.6%), NS.

Czepita (2008) [38]

Szeczecin, Poland

RESIDENCE AREA: Age 618, living in the city, are less hyperopic than those in the countryside, S, p < 0.001.

Gao (2012) [19]

Phnom Penhn, Cambodia

AGE: 12, 13 and 14, Prevalence Rates, 0.7% (95%CI 0.4–1.0), 0.7% (95%CI 0.4–0.9) and 0.8% (95%CI 0.3–1.3) respectively, NS.

GENDER: Age 12–14, boys: 0.6% (95%CI 0.3–0.8), girls, 0.9% (95%CI 0.6–1.1), NS.

RESIDENCE AREA: Age 12–14, urban, 1.4% (95%CI 0.1–1.7) v rural, 0.4% (95%CI 0.2–0.6), NS.

Niroula (2009) [48]

Pokhara, Nepal

GENDER: 10 – 19, boys, 1.48% (95%CI 0.3–2.6), girls, 1.02% (95%CI 0.1–1.9), NS.

  1. OR: odds ratio; CI: confidence interval; SE: spherical equivalence; NS: non-significant; S: significant.