Abstract
PURPOSE: To assess the associations of specific ocular conditions on parental concerns for child development and quality of life in multiethnic preschool-age children. METHODS: We conducted a cross-sectional analysis using parental interview and comprehensive eye examination data from the Multi-Ethnic Pediatric Eye Disease Study, a population-based study of children aged 6-72 months. Parental concerns were assessed using the Parents' Evaluation of Developmental Status Screening Instrument; quality of life, via the Pediatric Quality of Life Inventory. Multivariable regression analyses were performed. RESULTS: Data were available for 8,265 children. Parental concerns were reported for 16.0%. Strabismus was associated with parental concerns even after adjusting for covariates (P < 0.001). Astigmatism was associated with parental concerns among children aged 36-72 months (P(trend) = 0.018). In this group, odds ratios for parental concerns were 1.33 (95% CI, 1.02-1.72) for astigmatism of 1.50 to <3.0 D, 1.39 (0.85-2.25) for ≥3.0 D, and 1.65 (1.12-2.41) for strabismus. Hyperopia, myopia, anisometropia, or amblyopia showed no association. Astigmatism of 3.0 D or greater and strabismus were also associated with a history of physician-diagnosed developmental delay (OR [95% CI] = 3.97 [1.53-10.28] and 6.58 [3.52-12.32], resp.) and with lower physical health/emotional function scores (2.3 ± 0.8 and 3.5 ± 1.3 points lower for astigmatism ≥3.0 D vs <1.5 D, and 2.0 ± 0.6 and 2.0 ± 0.9 points lower for strabismus vs no strabismus; all Ps ≤ 0.031). CONCLUSIONS: Both astigmatism and strabismus correlated with greater parental concerns about development and worse quality of life in preschoolers.