Characteristics associated with blindness or visual impairment within the adolescent demographic: a national cohort analysis.

BACKGROUND: Psychosocial metrics associated with self-reported blindness or visual impairment for adolescents in the National Survey of Drug Use and Health (NSDUH) have not been fully characterized. This retrospective cohort analysis of the latest NSDUH aimed to determine novel characteristics associated with self-reported visual loss among adolescents in the United States. METHODS: Data from the NSDUH2020, a publicly available, federally validated database, were analyzed. Self-reported severe visual impairment or blindness was defined as being truly blind or having serious difficulty seeing even when wearing corrective lenses (s-rSVI). Inclusion criteria were all cases of s-rSVI in adolescents aged 12-17 years. NSDUH weights were used to accommodate complex survey design, nonresponse rates, and population variance. Weighted percentages, asymptotic two-sided Rao-Scott χ2 analyses, and multivariable logistic regression were performed. Statistical significance was considered reached at P < 0.05. RESULTS: A total of 5,667 adolescents aged 12-17 years were surveyed, and s-rSVI occurred in 236 cases (weighted percentage, 3.48%). Within our final multivariable risk model, characteristics associated with increased odds of s-rSVI were female sex, Asian and Latino race/ethnicity (relative to non-Hispanic White), and self-reported serious difficulty hearing and concentrating (all P < 0.05). CONCLUSIONS: This national retrospective cohort analysis highlights risk factors associated with s-rSVI for adolescents within the 2020 NSDUH. Clinicians and policymakers should consider at-risk demographics for s-rSVI during development and enhancement of screening programs, population health initiatives, and healthcare policy issues.

Comparison of Objective and Subjective Techniques of Strabismus Measurement in Adults With Normal Retinal Correspondence.

PURPOSE: Accurate measurement of strabismus is vital to proper diagnosis and treatment. Objective and subjective measurement techniques can be used. The authors hypothesized that subjective measurement techniques would measure larger deviations than objective ones. METHODS: Adults with strabismus, visual acuity greater than 20/50 in each eye, and normal retinal correspondence were measured in primary gaze at distance and near using the alternate prism and cover test and the red glass test. RESULTS: Seventy-three patients were prospectively enrolled. Objective mean deviations were 9.1 (distance horizontal), 5.1 (distance vertical), 10.0 (near horizontal), and 2.6 (near vertical) prism diopters (PD). Subjective mean deviations were 10.2 (distance horizontal), 6.8 (distance vertical), 12.2 (near horizontal), and 3.2 (near vertical) PD. Subjective measurements were larger by a statistically significant margin and were more likely to show the presence of a vertical deviation not measured objectively (19 occurrences vs 2 at near, P = .008; 15 occurrences vs 0 at distance, P = .004). The measured deviations were within 5 PD horizontally and 3 PD vertically most of the time (range: 66.7% to 83.6%). CONCLUSIONS: The red glass test was more likely to measure a larger deviation at distance and near and to identify a vertical deviation not seen objectively at both distance and near. The mean difference between the tests was usually not large enough to affect surgical treatment, but could potentially result in different amounts of prescribed prism for patients treated optically. [J Pediatr Ophthalmol Strabismus. 2017;54(4):216-220.].