Prevalence of myopia and unmet needs of vision care among children and adolescents in rural and underserved areas of Taiwan

Background: The prevalence and severity of myopia among youths have posed public health challenges in Taiwan. Untreated myopia can lead to visual impairment and have long-term effect on the quality of life of the youth and place a burden on public health resources. 

Methods: The Chang Gang Memorial Hospital- Chia-Yi in partnership with County Public Schools, developed a school-based program to evaluate youth’s vision health in the underserved communities. A total of 2,426 children and adolescents aged 7-16 years were examined between 2012 and 2013. The ophthalmologic examination included visual acuity, auto-refraction status, intra-ocular pressure (IOP), stereo-acuity, ocular alignment and eye position. The fitting of myopia glasses is evaluated by the power of lenses, pupil distance, the quality and transparency of glasses, the frame size, and the structure of spectacles. Linear regression analysis was used to determine the effect of the spectacle suitability and ocular alignment on the refraction equivalence and stereo-acuity.  

Results and Conclusion: Myopia was found in 26% of the participants. About 32% of the participants wearing myopia glasses had improper spectacle fitting. Participants with poor fitting spectacles had mean refraction of -4.61D (SD ±1.86D) compared to -4.33D (SD±1.39D) for participants with good fitting spectacles. Myopia refraction was significantly correlated with spectacle prescription (p<0.01). Our results suggested that myopia was poor-controlled in the rural area with limited resources and fewer healthcare professionals. Effective strategies are needed to eliminate the cause of a significant visual problem and to address the unmet need of vision care in the rural communities.