An Epidemiologic Survey of Strabismus and Nystagmus in South Korea: KNHANES V

Ji Eun Lee; Chang Zoo Kim; Ki Yup Nam; Seung Uk Lee; Sang Joon Lee

doi:10.3341/jkos.2017.58.11.1260

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Lee, Kim, Nam, Lee, and Lee: An Epidemiologic Survey of Strabismus and Nystagmus in South Korea: KNHANES V

Original Article

J Korean Ophthalmol Soc 2017;58(11):1260-1268.

Published online: 25 September 2017

DOI: https://doi.org/10.3341/jkos.2017.58.11.1260

An Epidemiologic Survey of Strabismus and Nystagmus in South Korea: KNHANES V

Ji Eun Lee, MD¹, Chang Zoo Kim, MD², Ki Yup Nam, MD, PhD², Seung Uk Lee, MD, PhD², Sang Joon Lee, MD, PhD^2,^3,

¹Department of Ophthalmology, Maryknoll Medical Center, Busan, Korea

²Department of Ophthalmology, Kosin University College of Medicine, Busan, Korea

³Institute for Medicine, Kosin University College of Medicine, Busan, Korea

Address reprint requests to Sang Joon Lee, MD, PhD Department of Ophthalmology, Kosin University Gospel Hospital, #262 Gamcheon-ro, Seo-gu, Busan 49267, Korea Tel: 82-51-990-6228, Fax: 82-51-990-3026 E-mail: hhiatus@gmail.com

Received 20 July 2017 Revised 28 August 2017 Accepted 16 October 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Strabismus affects any age and represents various functional or non-functional eye problems. This population-based study was conducted to determine the prevalence of strabismus and nystagmus in South Korea according to various sociodemo-graphic factors.

Methods

We acquired data from the Korea National Health and Nutrition Examination Survey, a nation-wide cross-sectional survey and examinations of the non-institutionalized civilian population in South Korea (n = 30,538), conducted from July 2008 to December 2011. The prevalence of strabismus and nystagmus were verified, and associated sociodemographic factors was evaluated.

Results

The overall prevalence of strabismic disorder in participants over 3 years of age was 1.4 ± 0.1% (95% confidence interval [CI] 1.3–1.6%; 1.5 ± 0.1% in males, 1.3 ± 0.1% in females). The prevalence of exodeviation (15 or more prism diopters), esodeviation (10 or more prism diopters), vertical deviation, and other complicated strabismus and nystagmus was 1.0%, 0.2%, 0.2%, 0.1% and 0.1% respectively. The prevalence was highest in the 6 to 15-year age group (1.9 ± 0.3%), and lowest in the 40 to 49 years age group (0.8 ± 0.1%) (p = 0.005). There were no statistically significant differences for gender, region, residential area, household income, educational level and occupation.

Conclusions

This nation-wide epidemiologic study demonstrated that the prevalence of strabismus and nystagmus according to various sociodemographic factors in South Korea was not statistically significant except for age group. Further investigations are required based on more surveys to better recognize the etiologic or risk factors that may be related to strabismus and nystagmus.

Keywords: Korea National Health and Nutrition Examination Survey, Prevalence, Strabismus

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Figure 1.

Total prevalence of strabismus and nystagmus according to age and gender. The 6–11 year old age group showed the highest frequency (1.9%), while the 40–49 year old age group has the lowest occurrence (0.8%, p = 0.005). ^* The highest and lowest prevalence age group.

Table 1.

Prevalence of strabismic disease in Korea according to age, gender and type of deviation (n = 30,538)

Variables	Total		Male		Female		p-value
Variables	n	Prevalence (n [%, 95% CI])	n	Prevalence (n [%, 95% CI])	n	Prevalence (n [%, 95% CI])	p-value
Total	30,538	452 (1.4, 1.3–1.6)	13,754	224 (1.5 1.3–1.8)	16,784	228 (1.3, 1–1.6)	0.285
Type of disorder
Exodeviation		303 (1.0, 0.9–1.2)		156 (1.1, 0.9–1.3)		147 (1.0, 0.8–1.2)	0.505
Esodeviation		62 (0.2, 0.2–0.3)		30 (0.3, 0.2–0.4)		32 (0.2, 0.1–0.3)	0.505
Vertical deviation		80 (0.2, 0.2–0.3)		37 (0.2, 0.2–0.4)		43 (0.2, 0.2–0.4)	0.976
Other type of deviation		22 (0.1, 0–0.1)		10 (0.1 0–0.1)		12 (0.1, 0–0.1)	0.711
Nystagmus		33 (0.1, 0.1–0.2)		15 (0.1, 0.1–0.2)		18 (0.1, 0.1–0.2)	0.989
Age (years) (9 group)
3–5	1,244	14 (1.2, 0.7–2.2)	657	4 (0.7, 0.2–2.4)	587	10 (1.8, 0.9–3.6)	0.188
6–11	2,803	56 (1.9, 1.4–2.6)	1,464	27 (1.7, 1.1–2.5)	1,339	29 (2.2, 1.4–3.3)	0.394
12–18	2,842	53 (1.8, 1.3–2.3)	1,509	33 (2.4, 1.6–3.7)	1,333	20 (1.2, 0.7–1.9)	0.220
19–29	3,020	49 (1.7, 1.2–2.3)	1,293	18 (1.5, 0.9–2.5)	1,727	31 (1.9, 1.2–2.8)	0.474
30–39	4,520	63 (1.3, 1.0–1.7)	1,879	32 (1.5, 1.1–2.2)	2,641	31 (1.0, 0.7–1.5)	0.120
40–49	4,477	40 (0.8, 0.5–1.1)	1,961	20 (0.8, 0.5–1.3)	2,516	20 (0.7, 0.4–1.2)	0.812
50–59	4,249	56 (1.5, 1.1–2.1)	1,804	28 (1.7, 1.1–2.6)	2,445	28 (1.4, 0.9–2.1)	0.550
60–69	3,889	63 (1.4, 1.1–1.9)	1,732	35 (1.6, 1.1–2.4)	2,157	28 (1.2, 0.8–1.9)	0.293
≥70	3,494	58 (1.8, 1.3–2.4)	1,455	27 (1.9, 1.2–2.9)	2,039	31 (1.7, 1.2–1.6)	0.808

n = number; CI = confidence interval.

Table 2.

Prevalence of strabismic disease in Korea according to region and residential area

Variables	n	Prevalence (n [%, 95% CI])	p-value
16 Region	30,538	452 (1.4, 1.3–1.6)	0.474
Seoul	5,665	86 (1.5, 1.2–2.0)
Busan	1,845	26 (1.4, 0.8–2.6)
Daegu	1,490	24 (1.3, 0.8–2.0)
Incheon	1,870	29 (1.3, 0.7–2.2)
Gwangju	1,017	15 (1.2, 0.6–2.4)
Daejeon	1,006	21 (1.9, 1.0–3.3)
Ulsan	766	14 (1.3, 0.6–2.9)
Gyeonggi	6,637	101 (1.6, 1.2–2.1)
Gwangwon	963	15 (1.1, 0.6–1.9)
Chungbuk	1,001	18 (1.6, 0.8–3.1)
Chungnam	1,379	24 (2.3, 1.3–4.0)
Jeonbuk	1,247	21 (1.9, 1.0–3.5)
Jeonnam	1,386	17 (1.1, 0.7–1.9)
Gyeongbuk	1,956	18 (0.8, 0.5–1.4)
Gyeongnam	1,706	17 (1.0, 0.5–1.9)
Jeju	604	6 (0.5, 0.1–2.1)
Residential area	30,538	452 (1.4, 1.3–1.6)	0.282
Urban	23,894	343 (1.4, 1.2–1.6)
Rural	6,644	109 (1.6, 1.2–2.2)

n = number; CI = confidence interval.

Table 3.

Prevalence of strabismic disease in Korea according to socioepidemiologic factors

Variables	n	Prevalence (n [%, 95% CI])	p-value
Monthly household income	30,122	440 (1.4, 1.2–1.6)	0.151
Lowest level	5,525	100 (1.7, 1.3–2.2)
Middle-lowest level	7,717	121 (1.6, 1.2–2.0)
Middle-highest level	8,695	124 (1.4, 1.1–1.7)
Highest level	8,185	95 (1.1, 0.9–1.5)
Educational level	30,162	449 (1.4, 1.3–1.6)	0.078
Lowest level	11,952	210 (1.8, 1.5–2.1)
Middle-lowest level	3,653	52 (1.4, 1.0–2.1)
Middle-highest level	8,067	108 (1.3, 1.0–1.7)
Highest level	6,490	79 (1.2, 0.9–1.6)
Occupation	24,675	350 (1.4, 1.2–1.6)	0.627
Managers and professionals	2,742	33 (1.3, 0.8–1.9)
Clerical supports	1,808	23 (1.2, 0.8–1.9)
Service and sale	2,991	36 (1.1, 0.8–1.7)
Skilled agricultural, forestry and fishery	2,105	26 (1.1, 0.6–1.7)
Craft, plant and machine operators, and assemblers	2,167	27 (1.3, 0.8–2.1)
Labor works	2,052	36 (1.5, 1.1–1.2)
Etc.	10,810	169 (1.6, 1.3–1.9)

n = number; CI = confidence interval.

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