Data from the

NATIONAL HEALTH SURVEY

Eye Examination Findings

Among Youths

Aged 12=17 Years

United States

Eye examination findings and medical history of eye conditions, wearing and need for glasses among youths in relation to

vision “test results and by race, geographic region, and family

income.

DHEW Publication No. (HRA) 76-1637

U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

Public Health Service

Series 11

Number 155

Health Resources Administration

National Center for Health Statistics

Rockville, Md. November 1975
..-,... .

●

Library of Congress Cataloging in Publication Data

Roberts, Jean.

. Eye examination findings among youths age 12-17 years, United States.

Vital and health statistics: Series 11, Data from the National Health Survey; no. 155

(DHEW publication no. (HRA) 76-1637)

Includes bibliographical references.

Supt. of Dec. no.: HE 20.6209:11/155

1. Eye–Diseases and defects–United States–Statistics. 2. Vision disorders–United

States–Statistics I. Title. II. Series: United States. National Center for Health Statistics.

Vital and health statistics: Series 11, Data from the National Health Survey, Data from the

health examination survey; no. 155. III. Series: United States. Dept. of Health, Education,

and Welfare. DHEW publication; no. (HRA) 76-1637.

RA407.3.A347 no. 155 [RE48.2.Y6] 312’.0973s

ISBN 0-8406-O047-X [312’.3’047700973] 75-619231

For sale by the Superintendent of Documents, U.S. Government Printing Opice, W’ashmcton, 1).C. 20402. l>ricc $1.45
NATIONAL CENTER FOR HEALTH STATISTICS

HAROLD MARGULIES, M.D., Acting Director

ROBERTA. ISRAEL,ActirzgDeputy Director

GAIL F. FISHER, Associate Director for the Cooperative Health Statistics System

ELIJAH L. WHITE, Associate Director for Data Systems

EDWARD E, MINTY, Associate Director for Management

PETER L. HURLEY, Acting Associate Director for Operations

JAMES M. ROBEY, Ph.D., Associate Director for Program Development

ALICE HAYWOOD, Information Officer

DIVISION OF HEALTH EXAMINATION STATISTICS

ARTHUR J. McDOWELL, Director

JEAN-PIERRX HABICHT, M.D., Ph.D., Special Assistant to Director

PETER V, V. HAMILL, M.D., Medical Adviser

JEAN ROBERTS,c~ief Medicals~atis~icsBra~~

ROBERT S. MURPHY, ChieJ Survey Planning and Devei!opment Branch

COOPERATION OF THE BUREAU OF THE CENSUS

In accordance with specifications established by the National Center for Health Statistics, the

Bureau of the Census, under a contractual agreement, participated in the design and selection of

the sample, and carried out the first stage of the field interviewing and certain parts of the

statistical processing.

Vital and Health Statistics–Series 1l-No. 155

DHEW Publication No. (H RA) 76-1637

Library of Congress Catalog Card Number 75-619231
CONTENTS

. ----------- . ” ------------- ---------------------------- ..--..

Data Sources ---------------------------------------------------------

Eye Examination ---------------------- --------------------- ------------

Vision Tests --------------------- ---------------------- ------- ------

Medical Histories --------------------------------------------------

Findings -------------------- “--------- -------------------- -----------

Eye Conditions ------- -------------- ------- ------- ------- ------- .--”-

Eye Conditions -Vision Tests -------- ------- --------------------- ----

Eye Conditions -Race, Region, Income --------------------------------

Medical Histories - ------------------ ----------------- --*------ -----

MedicalHistories -Race, Region,Income ------- ------- ------- ------- --

Children-Youth Comparison --------------------------- --------------

Summary -------------------------------------------------------------

References --------------------------- --.-.------------.--” ----- ------

List of Detailed Tables -------------------------- . ------------ ”--------

Appendix I. Statistical Notes ---------------------------- ----------------

The Survey Design -- ”------------------------ -----------------------

Reliability ------- ------- --------------------- ------- ---------------

Sampling and Measurement Error -------------------------------------

Small Numbers --------------------------- --------------------------

AppendixII. Demographic and Socioeconomic Terms ----------------------

Appendix III. Recording Forms -- . . ---- . - . . -- . -------- .”... --------- -----

Physical Examination - Youth------------------- --------- -------------

Physical Examination - Children -------------- --------------------- ---

Medical History of Youth --------------------------------------------

Health Habits and History-Youth --------- ------------------- -----------

Child’s Medical History -------------------- -------------------- -----

Supplemental Information from School ------------------ ---------------

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Quantity morethan Obutless than0.05----- 0.0

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iv
EYE EXAMINATION FINDINGS

YOUTHS 12-17 YEARS

Jean Roberts, Division of Health Examination Statistics

INTRODUCTION

This report contains eye examination findings

with their relation to vision test results and medical histories of eye conditions among youths

12-17 years of age in the noninstitutionalized population of the United States, as estimated from the

Health Examination Survey findings of 1966-70.

Differentials in these findings with respect to age,

sex, race, geographic region, and annual family

income are shown.

The Health Examination Survey is one of the

major programs of the National Center for Health

Statistics, authorized under the National Health

Survey Act of 1956 by the 84th Congress as a

continuing Public Health Service function to determine the health status of the population.

To carry out the intent of the National Health

Survey three different types of survey programs

are used.l The Health Interview Survey, which

collects health information from samples of people

by household interview, is focused primarily on

the impact of illness and disability within various

population groups. The Health Resources programs obtain health data as well as health resource and utilization information through surveys

of hospitals, nursing homes and other resident

institutions, and the entire range of personnel in

the health occupations. The Health Examination

Survey collects health data by direct physical

examination, tests, and measurements performed

on samples of the population. This latter program

provides the most efficient and economical way

of obtaining actual diagnostic data on the prevalence of medically defined illnesses. It is the

only effective survey

AMONG

method for securing information on unrecognized and undiagnosed conditions and on a variety of physical, physiological,

and psychological measures within the population.

In addition it collects demographic and socioeconomic data on the sample population under study

to which the examination findings for these persons

can be related.

The Health Examination Survey is organized

as a series of separate programs, or cycles, each

of which is limited to some specific segment of

the U.S. population and to specific aspects of

health. From the first program in 1960-62, the

prevalence of certain chronic diseases and the

distribution of various physical and physiological

measures were determined on a cross-section

of the defined adult population as previously

described.2’3

The target population for the second cycle

in 1963-65 was the Nation’s noninstitutionalized

children 6-11 years of age. For this program the

examination focused primarily on health factors

related to growth and development as described

in an earlier report.4

For the third cycle, on which findings in this

report are primarily based, a probability sample

of the noninstitutionalized youths 12-17 years

in the United States were selected and examined.

As in the preceding program among children,

the study of youths was designed to obtain basic

measures of growth and development as well as

data on other health characteristics for this

segment of the population. The questionnaires

and examination content and procedures were

basically similar to those in the children’s pro1
gram, so as to obtain comparable information

for the entire continuum of childhood through

adolescence to young adulthood. Additional data

were also obtained through the examination and

histories specifically related to adolescent health.

Included were a physical examination given by a

pediatrician assisted by a nurse, an examination

by a dentist, tests administered by a psychologist,

and a variety of tests and measurements by

laboratory X-ray technicians. The survey plan,

sample design, examination content, and operation

of the survey program have been described in

a previous report.5

Field data collection operations for the

youth’s cycle started in March 1966 and were

completed in March 1970. Of the 7,514 youths

selected in the sample for this program, 6,768

(90 percent) were examined. This national sample.

is representative, and the examined group closely

so, of the 22.7 million noninstitutionalized youths

age 12-17 years in the United States with respect

to age, sex, race, geographic region, population

qize of place of residence, and rate of change in

size of place of residence from 1950 to 1960.

As in the preceding program among children,

examinations in the youth’s program were carried

out consecutively in 40 different locations throughout the United States. Each youth was given a

standardized examination by the examining team

in the mobile units specially designed for use in

the survey., Prior to the examination, demographic

and socioeconomic data on household members

as well as medical history, behavioral, and related data on the youth to be examined were obtained from his parents. In addition, a Health

Habits and History form was completed by the

youth before he arrived for the examination, and

a Health Behavior form was completed by him

while in the examination center. Ancillary data,

requested from the school attended by the youth,

included his grade placement, teacher’s ratings

of his behavior and adjustment, and health problems known to his teacher. For each youth, a

birth certificate was obtained to verify his $ge

and provide information related to his. condition

at birth.

Statistical notes on the sample design, reliability of the data, and sampling and measurement error are included in appendix I. Demographic and socioeconomic term definitions

are in appendix II.

DATA SOURCES

Eye Examination

The eye examination and the vision test

battery for the youths were developed with the

advice of Dr. J. Theodore Schwartz, ophthalmologist,now with the National Eye Institute, and

Dr. Herbert A. Urweider, ophthalmologist, George

Washington University School of Medicine.

Each youth ‘was given an eye examination by

the survey staff pediatrician. This included a

careful, general inspection for evidence of abnormal. conditions of the lids, conjunctival,

sclerae, pupils, and irides; a cover test to detect

the presence of tropia (manifest strabismus),

lateral phoria, and other abnormal conditions of

the extraocular muscles; an inspection of the

conjugate gaze; and a determination of the focusing

or dominant eye (appendix III).

Vision ,Tests

The vision tests included those to detect and

classify color vision deficiencies, both monocular

and binocular, tests to determine the level of distance and near central visual acuity, tests of

lateral phoria at distance and near, trial lens

tests giving a crude determination of the presence

and severity of myopia at distance for those

scoring less than 20/20 (Snellen) at distance, and

lensometer measurements of the correction in the

refractive lenses worn by the examinee. All tests

except color vision were done without correction.

For those who had their glasses or contact lenses

with them, tests at distance were also done with

their usual correction.

These tests were performed by the survey

examining dentists who had been specially trained

in their, administration by Dr. Urweider.

Testing of phoria and visual acuity was done

with the same targets and type of instrument, the

Master Ortho-Rater, as in the children’s study

to maintain comparability across the entire 6-17

year age range. The design of the instruments,

the limitations of the instruments in visual acuity

testing, and the specially constructed targets used

are described in the reportVisualAcuity of Youths

12-17 Years.6 The standard targets used for

phoria testing, the trial lens test for myopia, and

the lensometer measurements are described in

2
the report Refraction Status of Youths 12-17

Years.7s

Medical Histories

Pavent questionnaire. —At the time of the ini.

tial visit to the sample household, the census

interviewer left a Medical History of Youth form

with the parent or guardian to be completed for

each eligible youth.

A few days later the Health Examination

Survey representative (HER) visited the household

and reviewed the self-administered medical history for completeness and consistency. If the form

was not completed or only partially so, the HER

attempted, with the parent’s help, to complete it

at that time.

The history form included three questions

concerning whether the youth wore or needed

glasses and whether or not he or she had ever

had any other eye trouble or an eye operation

(appendix III).

Youth questionnaire, —At the time of the

HER’s visit to the household, she left a Health

Habits and History form with instructions that

it be completed by the eligible youth and re.

turned to the survey in the envelope provided

before the youth arrived for the scheduled examination.

This history form contained questions relating to the necessity for glasses, the occasions

when they were worn, and any other eye problem

that the youth may have (appendix III).

The staff pediatrician reviewed both medical histories in advance of the examination and

administered some further special examinations

in those instances where either the medical

history or his initial examination made him’

suspect the presence of an eye defect.

School questionnaire. — At the time sample

youths were picked up or returned to the schools,

the escorts left a Supplemental Information From

School form, for each sample youth in the school,

with the school principal, who had been asked

to have each form completed by the youth’s

teacher or whoever he believed would be the

best informed respondent. In locations visited

during the summer months when school was not

in session, the questionnaires were mailed to

the school in the early fall with a request that

they be completed and returned.

The school questionnaire included a question

regarding the youth’s need for and use of special

facilities for the visually handicapped (appendix

III).

FINDINGS

In this report, the prevalence of the “examination findings are shown in rates per 1,000

youths to preserve some meaningful measure

for the rarer conditions identified; while findings

from the medical history items and related material on vision where the proportions affected

are substantially greater are given in rates per

100, similar to the report on Eye Examination

Findings Among Children.g

Eye Conditions

Nearly one-twelfth (79.2 per 1,000 youths)

or an estimated 1.8 million of the 22.7 million

youths age 12-17 years in the civilian noninstitutionalized population of the United States have

one or more significant eye abnormalities— tropia

or other extraocular muscle abnormalities; acute

or chronic conditions of the lids, conjunctival,

sclerae, pupils, or irides; or other types of eye

abnormalities (table 1). These national estimates

are based on the eye examination findings of the

pediatricians in the Health Examination Survey

among a national probability sample representative of noninstitutionalized youths in 1966-70.

The prevalence rate for these eye conditions

decreases slightly with age from 81.8 per 1,000

at 12 years to 64.8 per 1,000 at 15 years then

rises to 90.0 by age 17 years (figure 1). Boys are

substantially more likely than girls of this age to

have such conditions. The difference in rates for

the 12-17 year age range—89.3 per 1,000 among

boys compared with 68.8 per 1,000 among girls—

exceeds the 95-percent confidence limit for such

estimates (i.e., is statistically significant at the

5-percent probability level). Across the entire

12-17 year age range the rates for boys consistently exceed-those for girls and the decrease with

age to 15 years is consistent only among the girls

(figure 2).

Eye abnormalities are substantially less

prevalent among U.S. youths from the present

study than among U.S. children 6-11 years of age

based on findings from the 1963-65 Health Exam3
0 II I I I I I I I I I I I

6789 10 11 12 13 14 15 16 17

AGE IN YEARs

Figure 1. Prevalence rates for abnormal findings from eye examinations of children and youths 6-17 years by age: United

States, 1963-70.

ination Survey in which a similar type of eye

examination was given—79.2 per 1,000 youths

compared with 91.8 per 1,000 children .8 Except at

ages 6 and 7 years, the prevalence rates for eye

conditions were consistently higher among children than youths at each year of age (figure 1).

Across the age range 11-17 years boys were consistently more likely than girls to have such conditions, while among younger children 6-10 years

the reverse was consistently found (figure 2).

Information was obtained and pubIished on

eye conditions among U.S. adults in the 1960-62

Health Examination Survey. 9 Howev”er, the purpose and type of eye examination differed from

that given children and youths in the more recent

surveys to the extent that the findings will not be

125 ~

50

0

AGE IN YEARs

Figure 2. Prevalence rates for abnormal findings from eye examinations of boys and girls 6-17 years by age: United States,

1963-70.

comparable. The adults were given only a funduscopic examination with an ophthalmoscope to

identify abnormalities of the retina commonIy

associated with elevated blood pressure and

certain other eye conditions that tend to increase with age such as venous engorgement,

lens opacities including cataracts, other disc

abnormalities, and iritis. It included no tests

to detect eye muscle abnormalities. Among the

youngest group of adults age’ 18-24 years from

this first Health Examination Survey the prevalence of eye conditions was nearly 60 per

1,000 or substantially less than the rates of

92 per 1,000 children and 79 per 1,000 youths.

However, if the eye muscle problems are removed from the findings among the two younger

age groups to be more nearly consistent with

those from the earliest national study among

adults, the prevalence rates among children and

youths would both be reduced to slightly less than

40 per 1,000 or just slightly (but not significantly) less than the rate of 60 per 1,000 young

adults.

The number of specific eye conditions identified per youth from the present study averaged 1.2 or just slightly more than the 1.1

found among children.

Tropia or manifest strabismus was the

most prevalent eye condition among youths, as

among children. Nearly half (44 percent) of all

youths with some type of eye abnormality had

this problem. About one-fourth of those with any

eye abnormality had one or more acute or

chronic conditions of their lids, conjunctival,

or sclerae. Other types of extraocular muscle

conditions (other than tropia) were identified

among nearly one in five youths with eye abnormalities. These proportions were similar

among boys and girls though the rates were lower

among girls since relatively fewer of them had

abnormal eye conditions.

Tropkz.-The prevalence rate for tropia (or

manifest strabismus) among U.S. youths was

estimated at nearly 4 percent (34.5 per 1,000

youths) as determined in the present study (tables

1 and 4). Hence approximately 800,000 youths of

this age in the country have such conditions. The

rate is slightly but not significantly (statistically)

greater among boys than girls of that age_38.8

per 1,000 boys compared with 30.1 per 1,000 girls.

4
I I I I I I I I I 1 I I

878010111213 14151617

AGE IN YEARS

Fiwre 3. Prevalence rates for tropia (manifest strabismus) from

eye examination findings among children and youths 6-17

years by age: United States, 1963-70.

No consistent age-related trend is evident, though

for boys the prevalence is slightly higher among

those 16 and 17 years old than younger boys but

not girls.

The prevalence of tropia is slightly greater

among youths age 12-17 years from the present

study than among children 6-11 years from the

1963-65 national survey—34.5 per 1,000 youths

compared with 23.8 per 1,000 children—though

the difference is not large enough to be considered

statistically significant (at the 5-percent probability level). Over the 6-17 year age range there

is some indication of a gradual increase in. prevalence with age that is slightly more consistent

among boys than girls (figures 3 and 4).

Among youths, tropia was identified in the left

eye nearly as frequently as in the right—20.3

per 1,000 compared with 21.0 per 1,000 (table 6).

For those youths who have this condition only one

eye was affected more frequently than both—80

percent only one eye, 20 percent both. ‘The

deviation in gaze tended to be outward (60 percent)

o~678 9 10 11 12 13 16 IS 16 17

AGE IN YEARS

Figure 4, Prevalence rates for tropia (manifest strabismus) from

eye examination findings among boys and girls 6-17 years by

age: United States, 1963-70.

[:

. %

0

878910111213 141 S1617

AGE IN YEARS

Figure 5. Prevalence rates for other extraocular muscle conditions from eye examination findings among children and

youths 6-17 years by age: United States, 1963-70.

more frequently than inward (35 percent) among

youths with tropia, in contrast to the findings

among children with this manifest condition in the

earlier national study where 47 percent had

convergent and 25 percent divergent gazes

Othev extvaocula~ muscle condition. —Among

youths age 12-17 years the prevalence rate for

extraocular muscle conditions, other than tropia,

is 18.3 per 1,000. Boys are slightly more likely

than girls to have such problems— 18.9 per 1,000

boys compared with 17.5 per 1,000 girls. (Tables

1 and 4.)

The prevalence rates for such conditions are

at about the same level for boys and girls (18.9 and

17.5 per 1,000, respectively) and show no consistent age-related trend. These rates are minimal at age 12 years and maximal at age 16 years

for both boys and girls, but only at 16 years for

girls do the rates differ significantly from those

at other ages in this range. (Figures 5 and 6.)

&JJ-w-u

9 10 11 :2 13 14 15 16 17

AGE IN YEARS

Figure 6. Prevalence rates for other extraocular muscle conditions from eye examination findings among boys and girls

6-17 years by age: United States, 1963-70.

5
In contrast to the findings for tropia, the prevalence of other extraocular muscle conditions

among youths 12-17 years from the present study

is significantly less than among children 6-11

years of age from the 1963-65 national survey ---

18.3 per 1,000 youths compared with 43.4 per

1,000 children. The difference in these rates

between the two age groups, in the absence of

any age-related trend for either, probably reflects

the improved examination methods used among

youths and the fact that the latter may have been

more cooperative than the children in this part of

the examination, rather than any actual difference

in prevalence.

In the earlier examination among children all

such conditions were recorded as “latent strabismus” while in the examination among youths

the medical examiner specifically differentiated

among conditions of latent strabismus; paralyzed,

weakened, or palsied muscles; and nystagmus.

As shown in table 4 and figure 7 one-third of the

youths with other extraocular muscle conditions

were considered to have paralyzed eye muscles

(rate of 6.1 per 1,000 of all youths), slightly less

than one-third had nystagmus (rate of 5.1 per

1,000 of all youths), and slightly less than onethird had latent strabismus (rate of 4.7 per

1,000 of all youths). The remainder had weakened or palsied eye muscles.

Among youths with these other extraocular

muscle problems, the right eye was nearly as

frequently affected as the left (12.3 for the right

LID%

Co.i.r,.tlvttts

B1.pharitrs

News

Pt.sis

PUPILS:

Anis.xo rim

EYE MUSCLES,

Paralyzed eye

muscle

Nwwms

Latent st,abl,rm,

Weakened m“ecles

,,

8

R.ms PER I,cca yOUTHS

I

Figure 7. Prevalence rates for salected eye examination findings

among youths 12-17 years: United States, 1966-70.

eye compared with 14.0 for the left eye per

1,000 y&ths) and both of the eyes were nearly

as frequently affected as just one (47 percent

compared with 53 percent of youths with such

problems) (table 7).

Lids.— Acute or chronic conditions of the

eyelids and adjacent skin or tissue were present

in 21.4 per 1,000 youths age 12-17 years (tables

1 and 2). The prevalence rate among boys was

nearly twice that among girls (26.8 per 1,000

boys compared with 15.8 per 1,000 girls). There

was no consistent trend with age, the rates being

just slightly higher among the youngest and oldest

youths, but at each year of age boys were more

likely than girls to have such conditions.

The most prevalent of these lid conditions

were conjunctivitis (6.2 per 1,000 youths), blepharitis (3.4 per 1,000 youths), nevus (2.0 per

1,000 youths), and ptosis (1.9 per 1,000 youths).

The prevalence rates for conditions of styes,

seborrhea, hemorrhage, scars, and (open) lacerations were each less than 1.5 per 1,000

youths.

Of the th:ee infectious or allergic conditions

identified in this region among children age

6-11 years from the 1963-65 national survey,

conjunctivitis was the only one more prevalent

among youths age 12-17 years—the rates being

6.2 per 1,000 youths compared with 4.3 per 1,000

children. The prevalence of blepharitis decreased

slightly from 4.4 per 1,000 children to 3.4 per

1,000 youths, while that for styes dropped from

2.9 per 1,000 children to 1.3 per 1,000” youths.

The prevalence for each of these three conditions

was greater among boys than girls 12-17 years of

age in contrast to the findings among children

where this occurred only with conjunctivitis.

Conditions of skin malformation (nevus) in

this region, drooping of the upper lid from paralysis of the third nerve or other cause (ptosis),

and excessive secretion of the sebaceous glands

in the skin of the lids (seborrhea) were not identified among children in the previous examination

survey.

Pupils .—Abnormalities of the pupils or irides

were present in 9.6 per 1,000 youths, with the rate

being slightly larger among boys than girls (11.2

per 1,000 boys, 8.0 per 1,000 girls). No trend with

age is evident in these abnormalities among youths

(tables 1 and 3).
The condition of the pupils or irides most

frequently identified on examination of the youths

was anisocoria or unequal sized pupils (rate of

2.3 per 1,000 youths). Less than 1.5 per 1,000

youths have conditions such as limbic rings (1.3

per 1,000), photosensitivity (0.9 per 1,000), depigmented iris (0.9 per 1,000), cataracts (0.8

per 1,000), with lower rates for scars, lens

opacities, aphakia, slow or unreactive pupils,

and other conditions.

Eye Conditions - Vision Tests

Comparison is made here between the medical

examiner’s findings of tropia or other extraocular

muscle abnormality and results from the standard

phoria and visual acuity tests given these youths.

These comparisons are shown as an aid in

screening programs where either a commercial

instrument or simple eye inspection may be used

to identify persons in need of further examination

or treatment.

In the phoria tests, as described previously, 7

a measure was obtained of the degree of misalignment between the visual axes of the two

eyes in the lateral (horizontal) plane under conditions in which the stimulus to fusion (seeing

one single image or binocular viewing) is low.

No differentiation is made in this test between

conditions of tropia (manifest strabismus) in

which the youth’s eyes are unable to fuse (see

a single image) normally in binocular viewing

and those in which the extraocular muscles are

able to make such compensation.

The examining pediatrician, through trained,

skilled observation, using cover and other physical tests, differentiated between conditions of

tropia and other extraocular muscle abnormalities.

Phoria - examination. —An indication of the

type and extent of agreement between moderate

or severe heterophoria of 5 prism diopters (5A)

or more deviation from normal on the standard

test and the examination findings of tropia or

other extraocular muscle abnormalities may be

seen in tables 8 and 9. Among youths with tropia,

less than half (43.5 percent) showed moderate

or severe heterophoria on the standard test. The

proportion was slightly higher am~ng girls than

boys (46.6 percent compared with 40~7 percent)

and was slightly lower among youths over 14

years of age than those who were younger (2%38

percent among those age 15-17 years compared

with 47-57 percent among youths age 12-14 years).

Those youths with other extraocular muscle

abnormalities, only some of which would be expected to affect binocular fusion, show somewhat

lower proportions with moderate or severe heterophoria on test— 38 percent with deviations

of 5A or more among this group compared with

nearly 44 percent among youths with tropia.

The relationship between this p?rt of the eye

examination findings and the standard heterophoria test results obtained with corrective

lenses (the youth’s own glasses or contacts) as

shown in tables 10 and 11 is similar to that found

with their tests without corrective lenses.

The extent of agreement between the eye

examination findings and moderate to severe

heterophoria on test for youths age 12-17

years in the present national study is similar

to the comparable findings among children age

6-11 years from the preceding Health Examination

Survey in 1963-65. Among children age 6-11 years

with tropia, 47 percent tested as having heterophoria of 5A or more compared with the nearly

44 percent among youths age 12-17 years. For

those with other extraocular muscle abnormalities, the proportion with at least moderate

heterophoria (5A or more) was slightly less

among children (27 percent) than youths (38

percent) as shown in figure 8.

Phorzb - acuity.—The extent to which visual

acuity is associated with heterophoria test results

among youths ages 12-17 years is shown for unFigure 8. Proportion of children 6-11 years and youths 12-17

years with significant heterophoria on distance vision test

and with tropia or other extraocular muscle conditions:

United States, 1963-70.

7
corrected distance acuity in table 13 and for uncorrected near acuity in table 14.

Youths with visual acuity at distance of

20/20 or better include a significantly (statistically) greater proportion with moderate or

severe heterophoria (5A or more) at distance than

do youths with defective visual acuity at distance

or 20/40 or less. The proportions are 19 percent

among those with acuity 20/20 or better compared

with 10 percent among youths with defective

visual acuity of 20/40 or less. Both girls and

boys show this pattern, however, the proportion

with this degree of heterophoria among both the

visually (acuity) normal and those with defective

acuity is slightly greater among girls than boys

The association of heterophoria test results

with near visual acuity among youths is substantially stronger than with distance acuity.

Only 12 percent of those with near acuity (uncorrected) of 14/14 or better have moderate

to severe heterophoria at near (6A or more

esophoria or 10A or more exophoria) compared

with 69 percent among youths with near acuity

no better than 14/35. As for tests at distance,

the findings at near are similar for boys and

girls, but, in contrast to the findings at distance,

slightly more of the boys than the girls in both

the visually normal and visually defective acuity

groups have moderate to severe near heterophoria.

Comparison of these test results among

youths in the present national study with those

for children age 6-11 years in the previous national Health Examination Survey show that on

tests at distance the proportion with at least

moderate heterophoria (5A or more) among

those with acuity of 20/20 or better is slightly

greater among youths than children (19.3 percent

compared with 12.8 percent); while relatively

fewer youths than children with defective acuity

of 20/40 or less had that degree of heterophoria

(24.1 percent of children compared with 10.3 percent of youths), as shown in figure 9.

At near, the proportion of youths with at least

moderate heterophoria among those with near

acuity of 14/14 or better is substantially lower

than this proportion among children (12. 1 per

100 youths compared with 24.2. per 100 children);

while among those with defective near acuity of

14/35 or less the findings among both age groups

— DISTANCE — —NEAR—

Fiaure 9. Proportion of children 6-11 vears and vouths 12-17

~ears with “significant heterophoria on vision t&.ts and with

essentially normal or defective visual acuity at distance:

United States, 1963-70.

are similar—69.O percent of youths and 63.0

percent of children with defective near acuity

have moderate or severe near heterophoria

(6A or more esophoria or 10A or more exophoria)

(figure 9).

Examination - acuity.—The prevalence of

tropia among youths age 12-17 years with distance

visual acuity of 20/20 or better is nearly twice

that rate among youths with defective distance

acuity of 20/40 or less—rates of 2 per 100 youths

with at least “normal” acuity compared with 1

per 100 youths with defective acuity at distance

(table 12). Similarly the prevalence of other

extraocular muscle abnormalities among youths

with distance acuity 20/20 or better is also about

twice the rate for such conditions among youths

with defective distance acuity of 20/20 or less—

1.2 per 100 youths with at least “normal”

acuity compared with 0.5 per 100 youths with

defective acuity. These findings are consistent

with those for heterophoria at distance among

youths (tables 13 and 14).

Eye Conditions - Race, Region, Income

Race.—The prevalence rates for any eye

abnormality, as found on examination, is slightly

but not significantly greater among Negro than

white youths age 12-17 years, the rates being

75.8 per 1,000 white youths compared with 103.9

per 1,000 Negro youths. This racial pattern is

consistent among both boys and girls and across

8
ANY EYE ABNORMALITY

140

TROPIA

r

WllIll Nlblo Wm. New

Figure 10. Prevalence rates for any abnormal findings and for

tropia from eye examinations of children 6-11 years and

youths 12-17 years by race: United States, 1963-70.

the 12-17 year age range, except at 14 years

(table 15).

The reverse, but also nonsignificant, racial

pattern was found among children age 6-11 years

from the previous national Health Examination

Survey in 1963-65, from which the corresponding

rates were 129.0 per 1,000 white children compared with 90.2 per 1,000 Negro children. The

racial pattern among children was consistent

for boys and girls as well as across the entire

6-11 year age range.

Among the white population, the prevalence

of eye abnormalities is slightly but not significantly greater for children than youths, while

the reverse was found among the Negro population (figure 10).

Tropia was slightly, but not significantly,

more prevalent among white than Negro children

and youths, though this differential for the most

prevalent type of eye condition among youths

was not found consistently among boys and girls

nor across the 6-17 year age range. In each

racial group relatively more youths than children

had conditions of tropia.

Region. -No consistent pattern of geographic

regional differences were found in the prevalence

rates for eye abnormalities among youths in the

United States. Since for the purposes of this survey

the country was divided into four broad heterogeneous regions, it is not possible hereto detect

any State or smaller area differences that may

exist.

The rates for any eye abnormality were

slightly higher among youths—both boys and

girls—in the Midwest where the rate is 86.6 per

1,000 youths and slightly lower among those in the

Northeast, 69.5 per 1,000 youths, than in either the

South or West (table 16), but these regional

differences were not consistent across age and

were small enough to be due to sampling variability

alone (with the size and design of the sample used

in the present study).

In contrast among children age 6-11 years

from the preceding Health Examination Survey

in 1963-65 the prevalence rates for eye abnormalities were consistently highest in the

West (172.5 per 1,000 children) and lowest in the

South (83.6 per 1,000 children) than elsewhere

among both boys and girls and across the 6-11

year age range.

Eye abnormalities were slightly less prevalent among youths age 12-17 years than children

age 6-11 years in each of the four regions (figure

11). This age differential existed in each of the

regions for girls and in all but the South for boys.

Across the 6-17 age range from the two national

surveys, however, only in the Northeast and West

were the age-specific rates among the children

consistently higher than those among youths.

For the most prevalent of the eye conditions

identified among youths, tropia, rates were highest

in the Midwest (50.6 per 1,000 youths), for all

eye conditions, but at about the same level in

the other three regions (26.4 -28.8 per 1,000

youths). In contrast to the findings for all eye

conditions, tropia was less prevalent among

children 6-11 years from the previous survey than

among youths 12-17 years in the present national

study in three of the four regions, the only exception being the Northeast (figure 11).

The pattern of regional differences in the

prevalence of any eye abnormality among white

youths 12-17 years is consistent with that for all

youths—the highest rates in the Midwest and the

lowest in the Northeast (table 18). However, among

Negro youths the prevalence of such conditions

was slightly but not significantly lower in the South

and higher in the West than elsewhere (table 19).

Income.-Eye abnormality rates show a consistent association with the income level of the

family among youths age 12-17 years. The prevalence is highest among those in families with

9
1s0 ANY EYE ABNORMALITY TROPIA

r

Northeast Midwest South west

m C.M..6-TI yea.

= Youths 12-17 years

40

20

0 I

Northeast hlidn’est South west

Figure 11. Prevalence rates for any abnormal findings and for tropia from eye examinations of children 6-11 years and youths 12-17

years by geographic region: United States, 1963-70.

less than

youths in

69.4 and

levels of

$5,000 annual income-105 .7perl,000

the below $5,000 group compared with

70.0 per 1,000 youths in the income

$5,000-$9,999 and $10,000 or more--

though the difference in rates is not large enough

to be statistically significant. These higher rates

among youths in the lowest income level families

are present among both boys and girls and are

consistent across the 12-17 year age range

(table 17).

Among children 6-11 years from the 1963-65

national survey, the association of these eye

conditions with income is somewhat less consistent than among youths. For the entire 6-11

year age group, eye abnormality rates were

highest among those in the lowest income level

famiIies—L33.4 per 1,000 children where family

income was below $5,000 compared with 117.5

and 115.2 per 1,000 children in the two higher

income leveI groups. The income leveI pattern

in these rates was consistent for boys and girls

but in only three of me age groups-6, 7, and 1(I

years—in the 6-11 year span.

Across all three family income levels, the

prevalence of eye abnormalities was greater

among children age 6-11 years from the previous

national survey than youths age 12-17 years in the

present national survey (figure 12). This age

differential exists across income among both

boys and girls and with one minor exception, at

age 6 years, the age specific rates for children

are higher than those for youths.

The prevalence rates for any eye abnormality are also maximal among both children and

youths of the white races from the lowest income

level families (table 20). In contrast, Negro

children and youths in the highest income level

families show the highest rates for these conditions but the number of Negroes in the population is too small to provide reliable estimates

in

in

this detaiI with the size of the samples used

this national survey (table 21).

10
ANY EYEABNORMALITY

140 ~

Lessthan $5,000 $5,000$9,999 $10,O2Oor more

40

20

0

Lm than $5,S00 $5,0Lm.$9,999 $10,CQOor more

Figure 12. Prevalence rates for any abnormal findings and for tropia from eye examinations of children 6-11 years and youths 12-17

years by annual family income: United States, 1963-70.

In contrast to the findings for any eye abnormality, the most prevalent of these conditions

among youths—tropia —occurs relatively more

frequently among both children and youths in the

highest income level families. Among youths, the

prevalence rate for tropia is 49.3 per 1,000 youths

in families with $10,000 ~r more annual income

compa ed with 33.2 apd 30.8 per 1,000 youths

in fam 7lies with less thap $S,000 and $5,000-$9,999

annual income (table 17). However, this pattern

is present among girls but not boys and is not

consistent across the 12-17 year age range. For

children in the highest income level group the

rate was 32.3 per 1,000 compared with rates

of 22.4 and 19,9 in the lowest and middle income

bracket. This pattern existed among both boys

and girls age 6-11 years.

Similar to the findings by region and race,

the prevalence of this condition-tropia-was

lower among children than youths across all

three family income levels for both boys and

girls.

As for aN racial groups combined, the prevalence of tropia was greatest among white children and youths from the highest income level

families ($1O,OOOand over). For the Negro population the findings here are inconsistent because

the sample was too small to provide reliable

estimates in this detail.

Medical Histories

Weaying glasses. —More than one-third (35.3

percent) or 8 million youths age 12-17 years in

the noninstitutionalized population of the United

States wear glasses or contact lenses, as estimated from the Health Examination Survey of

1966-70. About 4 percent of this group wear

contact lenses, with the remaining 96 percent

wearing only glasses. These estimates are based

on the answer given by the youth examinee in

the self -administered Health Habits and History

questionnaire. Responses from the Medical Histovy - Youth as given by the parent for him or her

show a negligibly lower proportion of youths

wearing glasses or contact lenses— 34.2 percent

compared with 35.3 percent from the youth’s own

response (table 22).

Relatively more girls than boys age 12-17

years wear glasses or contact lenses (29.4 percent for boys compared with 41.2 percent for

girls as reported by the youths; 28.5 percent for

boys compared with 40.0 percent for girls as

reported for them by their parents).

11
Ea

0

/&:

8 9 10 11 12 13 14 1S 18 17 1s24

AGE IN YEARS 153c.f

-1 %3.66 mm” — -1 S66.70WYW+ WIW)

Figure 13. Proportion of children, youths, and young adults

6-24 years wearing glasses or contact lenses and proportion

with defective distance acuity of 20/40 or lessby age: United

States, 1963-65, 1966-70, and 1960-62.

In this age group the proportion of youths

indicating they wear corrective lenses increases

with age from 29.7 at 12 years to 42.8 percent

at 17 years. The proportion of this group who

wear contact lenses shows an even more rapid

rise with age from 1 percent of those wearing

corrective lenses at age 12 years to 8 percent

at age 17 years.

Comparable data on the wearing of corrective lenses are available from the two previous

national Health Examination Surveys among noninstitutionalized children 6-11 years in 1963-65

and adults in 1960-62. The proportion wearing

corrective lenses increased consistently from

2.3 percent at age 6 years to 43.0 percent at age

17 years then drops to 31 percent for the 18-24

year-old (figure 13). As a rough indicator of the

need for corrective lenses the figure also shows

the proportion of children, youths, and young

adults whose uncorrected binocular visual acuity

was no better than 20/40. The proportion with

this degree of binocular visual deficiency generally increased with age from 7.4 percent at 6

years to 24.2 percent at 17 years then dropped

to 14.8 percent at 18-24 years. In the surveys

among children and youths, the methods for testing visual acuity were similar. Test results were

somewhat less reliable at ages 6 and 7 years

because of the number at those ages who were

unable to read letters. 10 Testing methods in the

national survey among adults were also not completely comparable to those used for children

and youths and the test targets for adults provided a somewhat less precise estimate of visual”

acuity as previously described. 6$11The proportion wearing glasses or contact lenses consistently exceeds the proportion whose uncorrected

acuity is no better than 20/40 at distance except

for the youngest children ages 6 and 7 years.

Among the latter group less than half of the children (6 or 7 years) with that degree of defective

acuity were reported to be wearing glasses. This

may reflect in part the less accurate visual

acuity test results for them, as well as some

unmet need for vision care, The fact that the

proportion wearing corrective lenses increases

more rapidly with age “than the proportion with

that degree of defective binocular acuity reflects,

of course, the need for corrective lenses for near

vision as well as other types of visual problems

than just defective distance acuity.

The proportion wearing corrective lenses

increases with age more rapidly and consistently among girls than boys from about 3 percent

for both \at age 6 years to 51 percent for girls

and 35 percent for boys at age 17 years (figure

14) as expected since the prevalence of defective

acuity increases more rapidly with age among

girls than boys over this age range. 6’10Comparable data for 1960-62 on wearing of corrective

lenses among young adult men and women (figure

14) shows a proportion using them among both

groups substantially below that at age 17 years

in the present study for 1966-70,

Youths in the present survey were asked

about the extent and type of use made of these

corrective lenses—glasses or contact lenses.

For the entire 12-17 year age range, youthswere

slightly more likely to wear corrective lenses

all day (18.3 per 100 youths) than just for special

occasions (17.1 per 100 youths). Boys were

I ‘r

2 Girls ‘

9.40

‘m0 ;.&: 6789,0111213 141?. 18171S24

AGE IN YEARS

Figure 14. Proportion of males and females wearing glassesor

contact lensesamong children, youths, and young adults 6-24

years by age: United States, 1963-65, 1966-70, and 1960-62.

12
slightly more likely to wear them full time than

not (16.6 percent full time, 13.0 percent part

time) while girls were slightly more likely to

wear them part time than full time (21.4 percent

compared with 20.1 percent). Across the 12-17

year age range for boys and girls, only at ages

1.5and 17 years for girls did the rates for special

or part time use exceed those for full time

(table 23).

Youths were more likely to wear corrective

lenses for reading (7. 1 percent of all youths)

than for distance vision (4.9 percent of all youths)

when they did wear them only part of the time.

The proportion of all youths wearing them just

for distance vision increased with age from 2.7

percent at age 12 years to 7.9 percent at 17 years,

while the proportion wearing glasses (or contact

lenses) just for reading showed no consistent

trend with age.

Need for glasses. —An estimated 11.6 percent

or 2.6 million youths age 12-17 years reported

they do not wear but need glasses. The proportion is nearly twice as great among girls as boys—

15.0 percent compared with 8.8 percent (table

22). Older girls 15-17 years were slightly more

likely than younger girls age 12-14 years to need

glasses—the rates are 16-19 percent among older

girls compared with 12-14 percent among the

younger group under age 15 years—but the proportions for girls consistently exceed those for

boys across the age range.

The estimate of need for glasses as reported

by the youths is nearly twice as great as that

known to the youth’s parents. From the medical

history given for these youths by the parents,

only 6,4 percent stated that the youths needed

glasses while an additional 15 percent indicated

they did not know. Thus, for about half of this

latter group the parent was not aware that the

youth thought he or she needed glasses.

Youths who wore glasses or contact lenses

were asked whether with them they thought they

saw as well as most. Among the 35.3 percent of

youths who do wear such corrective lenses 93.3

percent indicated that they thought they did see

as well as most. The proportion was just slightly

higher among girls (93.9 percent) than boys

(92.5 percent) and showed no consistent trend

with age.

When youths who wore glasses or contact

lenses were asked if they needed a change about

one in five or 21.0 percent (of those who wore

them) indicated they did need a change. The proportion ranged from 20.2 percent at age 12 years

to 22.4 percent at age 16 years but showed

no consistent age-related trend. The rate was

slightly greater among girls (21.4 percent) than

boys (20.5 percent). Among this group stating

they needed a change about two-thirds or 14.3

percent had also said they thought they saw as

well as most with their present glasses or contacts. The proportion of this latter group—needing a change but seeing as well as most—was

over twice as large among girls as boys (19.8

percent of girls compared with 8.9 percent of

boys among those wearing corrective lenses).

Other eye conditions .-More than 6 percent

of youths age 12-17 years, or an estimated 1.5

million, had ever had eye trouble other than

what is corrected by glasses or contact lenses.

The proportion based on the parent’s report for

the youths on the Medical History - Youth (6.8

percent) is just slightly greater than that based

on the youthts answer for himself in the Health

Habits and History (6.4 percent). The agreement

for girls in answers from the two histories (7.0

percent as reported by the parent, 7.1 percent

as reported by the girls) is slightly closer than

that for boys (6.7 percent from the parents, 5.6

percent from the boys themselves).

Eye operations. —The proportion of youths

who had had an eye operation for strabismus,

because of an injury, or for some other reason

was 1.4 percent, based on the Medical History -

Youth as given by the parent. Except for the

youngest and oldest—ages 12 and 17 years—where

the rates among both sexes were nearly identical,

the proportion among boys was nearly three times

as large as that among girls (at ages 13-16 years).

Facilities for the visually handicapped. —

Some further indication of the functional severity

of visual defects was obtained in the reports from

the school, where the teacher with the most immediate knowledge of the youth (for those still

in school) indicated whether the youth needed

special educational facilities because of a severe

visual handicap. The proportion ranged from a

minimum of 0.1 percent at ages 13 and 16 years

to a maximum of 0.4 percent at age 15 years and

was generally similar among boys and girls

13
(0.2 percent). Most of the youths needing these

additional facilities appeared to be receiving

them though the proportions with this degree of

handicap are so low that reliable estimates for

them could not be obtained with the sample size

used in this survey.

Relation of histories. —While estimates of

the proportion of youths wearing glasses or contact lenses based on the medical history given

for the youth by his or her parent and that given

directly by the youth are in close agreement, the

estimates of the need for glasses from these two

sources differ substantially, as previously indicated, and will be considered further here.

The extent and type of disagreement with

respect to the need for glasses between these

two sources are shown in table 24. Among the

youths who do not wear glasses or contact lenses

both on the statement by the parent and the youth,

there is nearly 80 percent agreement between the

two answers with respect to this need. The agreement is just slightly better in the responses for

boys than girls (81 percent compared with 77

percent). Where the parent and youth disagree

regarding the need for glasses the youth is more

likely to feel the need for glasses when the parent

does not than the reverse (4.2 percent with parent

saying no but youth yes, compared with 1.6 percent with parent saying yes and youth no).

In addition 7 percent of the parents indicated

the youth had glasses but the youth stated he did

not. These may be youths who have lost or misplaced their glasses but that fact was not known

to the parent. An additional 18 percent of the

youths stated they had glasses but the parent

either had forgotten or appeared to be unaware

of that fact.

Relation to visual acui@.--Comparisons have

been made in the preceding sections between

the proportion of youths with defective distance

acuity and the proportion wearing and/or needing

glasses (the 35.3 percent as reported by the

youths, 34.2 on parent reports for them). The

actual relationship between the acuity test results and responses from parent and youth regarding the wearing of or need for glasses gives

some indication of the reliability or meaning of

the responses from the two history sources. This

consideration will be limited to those youths with

at least “normal” binocular acuity (20/20 or

better at distance, 14/14 or better at near) and

those with moderate or more severely defective

binocular acuity (20/40 or less at distance, 14/28

or less at near), recognizing that glasses or contact lenses are needed for visual defects other

than those apparent from binocular acuity tests

as given in this examination.

Among youths whose uncorrected binocular

didtance acuity is 20/20 or better, 15.7 percent

stated they owned glasses or contact lenses compared with 14,6 percent based on parent histories

for ihese youths (table 25). For those with at

least normal uncorrected binocular rlear acuity

(14/14 or better), the rates are 27.2 percent based

on the youths’ response and 26.4 percent from the

parent statement for them. The proportion of these

youths with at least “normal” vision uncorrected

who are wearing corrective lenses increases with

age, more consistently on the basis of the parent’s

answer, but on either history basis is significantly greater among youths 15-17 years than

those under 15 years. The proportions are nearly

twice as great among girls as boys, and there is

a similar small underreporting by the parent for

both groups. It should be kept in mind that youths

who test at least normal on distance acuity may

need glasses for near work (hyperopic) and that

those who have at least normal near acuity may

need glasses for distance vision (myopic) in

addition to those with relatively normal binocular

vision but problems of astigmatism or motility.

Nearly 90 percent of youths with moderate

to severely defective binocular acuity at distance

and near are wearing glasses or contact lenses,

on the basis of the history given by the youth or

by his parent. The agreement is slightly better

between parent and youth answers among this

group than for those with essentially normal

acuity. The proportion who have corrective lenses

are similar among boys and girls (88-90 percent)

on the basis of either history and increase with

age from about 80 percent at 12 years (85 percent

on youth responses for defective near acuity)

to 96 percent or more at age 17 years.

Prevalence estimates of the need for glasses

among youths age 12-17 years are consistently,

nearly twice as great on the basis of the reports

by the youths as by their parents for them, both

among youths with at least “normal” and those,

with defective binocular acuity at distance and

14
I

I

I

near (table 26). This degree of differential in

reported need is present among both boys and

girls with “normal” and “defective” acuity. Across

age the rates from the youth responses are con1 s istently higher, with the insignificant exception

I at age 16 years. The proportion needing glasses I

is 6 (distance) and 7 (near) times as great among

those with moderately to severely defective binocular distance and near acuity than those with

at least “normal” acuity from the youth responses

and about 7 (distance) to 9 (near) times as great

based on the parent history data.

Medical Histories - Race, Region, Income

Racial, geographic regional, and family income differentials with respect to the wearing

of and need for corrective lenses and the medical

history of other eye conditions as reported independently by the youth and by his parent are

analyzed here. Comparison is made, where possible, to the findings among U.S. children from

the previous Health Examination Survey of 1963-

65.

Race .—The proportion of youths wearing

glasses or contact lenses is half again as large

among white as Negro youths. From the youth’s

history the rates are 36.7 per 100 white youths

compared with 24.9 per 100 Negro youths. From

the parentfs reports for these youths the proportions are similar but just slightly lower among

both races—35.7 per 100 white youths and 23.5

per 100 Negro youths (table 27). Among youths

who wear glasses, white youths are also more

likely than Negro youths to wear them all day

rather than for special uses.

Racial differentials in the wearing of glasses

could be expected since the previous report on

visual acuity of youths shows the prevalence of

defective acuity to be substantially greater among

white than Negro youths. 6 For example, the proportion with distance acuity of 20/40 or less

(only one of the visual defects for which refraction may be needed) is 65 percent greater among

white than Negro youths age 12-17 years (23.6

per 100 white youths, 14.3 per 100 Negro youths).

(Figure 15.)

The proportion wearing glasses is substantially greater among both white boys and girls

age 12-17 years than their Negro counterparts,

and for each racial group is significantly greater

among girls than boys, again reflecting the

greater need for refraction among girls than

boys of either race and among white than Negro

youths. Youth reports show 30.8 per 100 white

boys wearing corr~tive lenses compared with

ACUITY 20/40 OR LESS, UNCORRECTED I

WEARS GLASSES IYOUTHS NEED GLASSES

white Negro White Negro White New White Negro white Negro White Negro

CHILDREN YOUTHS CHILDREN YOUTHS PARENT ANSWERS YOUTH ANSWERS

PARENT ANSWERS

Figure 15. Proportion of white and Negro children 6-11 years and youths 12-17 years with defective distance acutiy, wearing glasses

or contact lenses, and needing glasses:United States, 1963-70.

15
19.3 per 100 Negro boys; and 42.8 per 100 tvhite

girls compared with 30.4 per 100 Negro girls.

The corresponding rates from parent histories

for these youths are just slightly lower than

those from the youths themselves in each of the

four groups.

There is a consistent increase with age in

the proportion wearing glasses among white

youths from 30.1 per 100 white 12-year-olds to

43.7 per 100 white 17-year-olds, based on the

youth’s own history (and from 28.4 at age 12 to

42.0 at age 17 years based on the parent’s report).

Among Negro youths, the proportion wearing

glasses at each year of age remains consistently

less than among white youths and does reach a

maximum for them at age 17 years but shows no

consistent increase with age, probably reflecting in part the lesser precision possible for the

estimates among this smaller group in the population from the size sample used in the survey.

The pattern of racial differences in the wearing of glasses among U.S. youths is similar to

but more pronounced than that among U.S. children

from the previous Health Examination Survey

in 1963-65. At ages 6-11 years, parent reports

showed 10.8 per 100 white children compared

with 7.4 per 100 Negro children wearing glasses

or contact lenses. At that age also the proportions with defective acuity were only slightly

higher among the white than Negro children.

Among youths, while proportionately more

white than Negro youths are wearing corrective

lenses and have defective acuity, the proportion

of Negro youths not wearing but needing glasses

is significantly greater than among their white

counterparts. The rates based on history given

by the youths are 19.3 per 100 Negro youths compared with 10.1 per 100 white youths, On the basis

of the parent history for them, the rate among the

Negro youths is over twice that among the white

group–12.7 per 100 compared with 5.2 per 100.

This relatively greater need among the Negro

than white groups exists among both boys and

girls and across the 12-17 year age range.

In response to seeing as well as most with

their present glasses, the rates are slightly

greater among white than Negro youths (93.7

percent of white youths, 90.2 percent of Negro

youths). However, when asked about a need for

change in their present glasses the rates are

substantially greater among Negro youths—40, 1

per 100 Negro youths wearing glasses compared

with 19.2 per 100 white youths wearing glasses.

Other eye trouble, than that which could be

corrected with glasses, was reported more frequently among Negro than white youths. However,

answers regarding this in the parent and youth

histories for white youths were in fairly close

agreement (6 per 100 from either source) while

those for Negro youths show a lower prevalence

rate in their own report (8.5 percent) than in the

report from their own parents (11.8 percent).

Relatively more white than Negro youths

were reported to have ever had an eye operation— 1.5 per 100 white youths compared with

1.0 per 100 Negro youths, and among both racial

groups the proportion is greater among boys than

girls. However, the differences in these rates

are not large enough to be considered statistically significant with the size and design of the

sample used in this survey.

Geographic re~”on. —Youths in the South,

where the prevalence of defective acuity among

this age group 12-17 years is the lowest, 6 are

less likely to wear glasses or contact lenses

than those in the other regions of the country

(table 28). The proportion wearing corrective

lenses ranges from 25.2 per 100 youths in the

South to 41.1 per 100 youths in the Midwest on

the basis of the youth’s statements (24.5 per 100

youths in the South compared with 40.7 per 100

youths in the Midwest from the parent’s medical

history for them). This regional pattern is found

among both boys and girls.

If only the white youth population in each of

the regions is considered, the proportion of white

youths wearing corrective lenses is lowest in the

South and highest in the Midwest for both boys

and girls. Among Negro youths? while the proportion wearing glasses is also lowest in the

South among both boys and girls, the rates are

slightly higher among those in the Northeast

than elsewhere (table 29 and 30).

Recognized need for glasses is slightly

greater in the South among both boys and girls

than elsewhere in the country. On the basis of

the youths reports, 15.6 percent in the South

need glasses compared with 11.3 percent in the

Midwest, 10.5 percent in the West and 7.9 percent

in the Northeast. The rates based on parents’

16
responses are again slightly lower— 9.5 percent

of youths in the South, and 5.0-5.4 in the other

three regions.

White youths show a similar regional pattern

in their need for glasses—the rates are highest

in the South (12.9 percent based on the youth’s

report and 7.3 percent based on the history given

by the parents). From the youthst response the

rates are slightly lower in the Northeast than

elsewhere, while from the parent history they

are slightly lower in the Midwest and Northeast

than in the West. The proportion of Negro youths

needing glasses is slightly greater in the South

than elsewhere among boys but not girls, while

on the basis of the parent report the rates are

highest in the South for both Negro boys and

girls.

The proportion of those with glasses needing

a change is slightly greater among those in the

South and West than elsewhere—a pattern found

among both white and Negro youths. In each of

the four regions, the proportion of youths needing

a change in their present glasses is substantially greater among the Negro than white youths.

The prevalence of other eye trouble, not

correctable with glasses among youths, is generally similar in the four regions— ranging from

5.4 percent in the Northeast to 7.2 percent in the

South when reported by the youths and from 5.7

percent in the Midwest to 7.7 percent in the South

when reported for them by their parents.

History of eye operations was reported

slightly less frequently among youths in the Midwest (1.0 percent) and more frequently among

those in the West (1.7 percent) than elsewhere.

The need for special educational facilities

in the school for the visually’ handicapped was

slightly more frequently reported by the teacher

among youths in the Northeast (O.5 percent) than

elsewhere, though the proportions needing this

type of facility were too small to give reliable

estimates of regional need.

Comparison with findings among U.S. children

from the previous Health Examination Survey h“

1963-65 show a somewhat similar regional pattern

to that for U.S. youths in the present study, with

the lowest proportion of defective acuity and of

wearing glasses and the highest proportion not

wearing but in need of glasses among children

in the South than elsewhe;e (figure 16).-

40

30 [

NORTHEAST

Wears gkes

Parent

answers

SOUTH

40

30 [

20

10

0

Youth needsglasses Ac.itv 20140 or less

Parent Youth

uncorrected

answers answers

MIDWEST

Parent

answers

WEST

- children 6-11 wars

m Youths 12-17 years

Youth needsglasses

Parent Youth

answers answers

AcuIty 20/40 or less Wearsglasses Youth needsglasses Acuity 20/40 or less

uncorrected

Wearsglasses Youth needsglasses

Parent Parent Youth

uncorrected

Parent Parent Youth

answers answers anwers amwers answers answers

Figure 16. Proportion of children 6-11 years and youths 12-17 vears with defective distance acuitv. wearing alassesor contact lenses.

and needing glassesby geographic region: United States, 1963-70. --

17
Income. —Youths age 12-17 years from higher

income level families are substantially more

likely than those from poorer families to wear

glasses or contact lenses, either all day or part

of the time. Some, but not this extent of association with income, would be expected since the

proportion with defective acuity among these U.S.

youths has been shown to increase with income.b

From the youth’s report, the proportion wearing

corrective lenses increased from 28.7 percent

among those in famiIies with annual income under

$5,000 to 40.3 percent among those in families

with $10,000 or more annual income (table 31).

The corresponding rates based on parent histories for these youths a,re just slightly lower

but shfow a similar trend, increasing from 27.5

percent to 39.7 percent. This economic relationship exists both with respect to the wearing of

glasses and contact lenses.

The increase with income in the proportion

wearing corrective lenses is found among both

white and Negro youths, but is more rapid for

the latter. Among Negro youths 22.2 per 100

with family income less than $5,(XI0 report they

are wearing glasses or contact lenses compared

with the rate of 36.6 per 100 among those with

family incomes of $10,000 or more; while among

white youths the increase is from 31.4 per 100

to 40.2 per 100 (tables 32 and 33).

The proportion of youths who wear glasses

or contact lenses within each income level is

greater among white than Negro youths, however,

the racial difference in the rates decreases with

income from about 9 percent among those in

families with amual income under $10,000 to

less than 4 percent among those in the level of

$10,000 or more.

The increase with family income in the proportion of youths wearing corrective lenses is

more rapid than that found among U.S. children

age 6-11 years from the preceding Health Examination Survey in 1963-65 (figure 17). On the basis

of parent histories for both age groups, the rate

among youths increased from 27.5 per 100 in the

lowest income level (under $5,000) to 39.7 per

100 in families with income of $10,000 or more.

The increase among children was from 7.7 per

100 with annual family income below $5,000 to

12.4 per 100 in the highest level ($10,000 or

more). A corresponding increase with income

in the proportion with defective acuity is present

among both children and youths as indicated in

figure 17 with respect to defective distance vision.

Among youths both the need for glasses and

the need for a change, if they are now worn, is

substantially greater among those in the lowest

income level families, with under $5,000, than

among youths from middle or higher income

ACUITY 20/40 OR LESS, UNCORRECTED

40 r

L

- Children 6-11 years

30 H Youth 12-17 Y,,=

Lessthan $5,000.$9,9S9 $10,IMO or more

$5,000

WEARS GLASSES

Las than $5,CO0.$9,999 $10,GUO or mare

$5,033

YOUTHS NEEO GLASSES

Lessthan $5,COO $5,CW$9,S99 $10,000 or more

Parent Youth Parent Youth Parent Youth

answers ans+ws a.- answers a-. answers

Figure 17. Proportion of children 6-11 years and youths 12-17 years with defective distance acuity, wearing glasses or contact lenses,

and naeding glassesby annual family income: United States, 1963-70.

18
level families. Based on the youths’ tesponses,

the proportion needing glasses decreases from

16.8 percent for those with under $5,000 family

income to 8.5 percent at the $10,000 or more

level; while the proportion needing a change in

their present glasses decreases from 30.2 percent to 15,6 percent. The underreporting of the

youths’ need for glasses by the youths’ parents

is found across income and is greater at the

highest income level than for those with less than

$10,000 incomes. The association between family

income and the need for glasses or for a change

among white youths is similar. This decreased

need for glasses or new glasses with increase in

family income is evident among white youths but

only for need as reported by the parent for Negro

youths.

History of eye trouble (as reported by the

parents), other than that correctable with glasses,

is slightly more prevalent among those youths

in the lowest income level families than others.

This trend is present among both white and Negro

youths.

No significant or consistent association with

income was found with respect to having had an

eye operation.

Children - Youth Comparison

The sample design and methods used in the

1966-70 Health Examination Survey among youths

age 12-.17 years make it possible to obtain some

limited longitudinal health data on eye conditions

and related medical history for nearly one-third

of these youths in addition to the findings from this

present cross-sectional study described and analyzed in the preceding sections. In this 1966-70

Health Examination Survey among a national

probability sample representative of noninstitutionalized youths age 12-17 years, the same

sampling areas and housing units were utilized

as in the preceding 1963-65 Health Examination

Survey among a national probability sample representative of noninstitutionalized children age 6-11

years. As a result, about 31 percent of the youths

in the present study had also been examined in

the childrents survey. The time lapse between

the two examinations ranged from 28 months

to 5 years, with a median time lapse of 4 years.

Since the group reexamined is limited to those

living in the same location at both points in time

and who were willing to be examined a“gain, this

subgroup cannot be considered typical of the

total group of youths.

Parts of the eye examination were similar

in both surveys. In addition, medical history

questions pertaining to the wearing of glasses

or contact lenses, other eye problems not correctable with glasses, and previous eye operations were asked of the parent and the need for

special facilities for visually handicapped were

obtained from the school in both the children’s

and youth’s surveys. These data, where comparable, permit the analysis of change in eye

conditions for these youths from the time of the

first examination to the time of the second or

over the 2-5 year period.

As may be seen in table 34, about half of the

youths ages 12-14 years had been in the previous

children’s survey, by age 15 years only one-fourth

had had both examinations, and at age 16 years

the proportion was less than 2 percent.

From the eye examination, the prevalence

estimates of tropia or manifest strabismus were

slightly higher among this subsample at the time

of the second examination than they were in the

first examination (3.7 per 100 at the time they

were age 12-16 years compared with 2.8 per

100 at the time they were age 6-11 years). Nearly

one-third of the youths with this condition had

also had this problem at the time of the first

examination (1. 1 per 100), for the remaining twothirds this condition had not been present or

detected at the time of the first examination

(2.6 per 100); while slightly more than half of

the children with this finding in the first examination did not have it at the time of the second

(1.7 per 100).

The prevalence of other extraocular muscle

conditions among youths in this subgroup is less

than half that as determined at the time of their

first examination, similar to the findings for all

youths and all children from each of the two surveys. Since as previously noted rigorous criteria

were used by the examiners for this group of conditions in this part of the examination among

youths than had been used in the children~s study

and possibly the cooperation of the youth examinees with the examiner may have been better

than it had been among children, the decrease in

19
prevalence rates is probably an artifact of

method rather than any real decrease in prevalence.

Prevalence rates for the three infectious or

allergic conditions of the lids and adjacent tisue—blepharitis, conjunctivitis, and styes—among

the youths who had also been examined as children were similar to those for all youths and,

at the earlier point in time for them, similar

to the rates among all children. The-prevalence

of blepharitis and styes was slightly greater for

them when they were in the age range 6-11 years

and that for conjunctivitis slightly less than at

the time of their second examination. (Blepharitis

3.7 per 1,000 youths, 5.3 per 1,000 as children;

conjunctivitis 7.3 per 1,000 youths, 4.4 per 1,000

as children; and styes 2.2 per 1,000 youths, 3.0

per 1,000 as children, for those examined in

both survey s.)

Three questions in the medical history obtained from the parent in both surveys are probably comparable— the wearing of glasses or

contact lenses, previous eye operations, and

previous eye trouble not correctable with glasses

(table 35). Among this subgroup, the proportion

of youths reported by their parent to have glasses

or contact lenses at the time of the second examination was slightly lower than for all youths

(31.6 per 100 compared with 34.2 per 100 for all

youths). The proportion based on their own answer

to this question was also lower than that for all

youths (32.5 per 100 compared with 35.3 per 100

for all youths). However, the proportion in this

subgroup who had worn them as children (15.9

per 100) was substantially greater than it had

been for all children (10.3 per 100) at the time

of the first examination. More than one-third of

the youths with corrective lenses in this subgroup

had also had them as children(13.7 per 100), while

only about one in eight who wore them as children

no longer wore corrective lenses (2.2 per 100).

The proportion with previous eye operations

reported in the history by the parent for this

subgroup were similar to these data for all youths

and all children and were slightly greater by the

time of the second examination (1.4 per 100 as

youths compared with 1.2 per 100 as children

for this subgroup). The majority of the eye operations had been performed before the age of 12

years and there was negligible evidence of underreporting at the time of the second examination

(0.2 per 100 whose parents had reported such an

event for them at the time of the first but not

the second study).

Other eye trouble not correctable with glasses

was less prevalent among youths as it had been

among children both for the subgroup at two

points in time and for the total groups of youths

and children, The parent answers to this history

question probably reflect some differences in the

content of the histories in the two examinations

as well as a memory problem with these conditions that were probably less serious than those

requiring surgery.

SUMMARY

This report contains national estimates of

the prevalence of eye conditions and related

problems of noninstitutionalized youths age 12-17

years in the United States based on eye examination, vision test, and medical history findings

of youths examined in the Health Examination

Survey of 1966-70. Findings are shown for the

total youth population as well as by race, geographic region, and family income. Also included

are data on the extent of change in eye problems

and related history over a 2-5 year period for

the nearly one-third of the youths who had also

been examined in the Health Examination Survey

of 1963-65 among U.S. children age 6-11 years.

For this survey, a probability sample of

7,514 youths was selected to represent the 22.7

million noninstitutionalized youths age 12-17

years in this country at midsurvey point. Of

these, 6,768 (90 percent) were examined. The

examined group closely represented the target

population from which the sample was drawn with

respect to age, sex, race, geographic region,

population size of place of residence, and rate

of change in size of place of residence from

1950-1960.

The principal findings include:

Nearly one-twelfth or an estimated 1.8 million

youths in the United States have one or more

significant eye abnormalities as determined

by direct examination, the most prevalent of

which is tropia or manifest strabismus.

20
Boys

girls

were substantially more likely than The prevalence of eye abnormalities was

at age 12-17 years to have significant greater among youths in families with less

eye conditions but no marked trend with age

was evident.

These types of eye conditions were substantially less prevalent among U.S. youths age

12-17 years from the present study (79.2 per

1,000 youths) than among U.S. children age

6-11 years from the previous Health Examination Survey (91.8 per 1,000 children).

The rate for tropia or manifest strabismus

which was the most prevalent of these eye

conditions among youths was 34.5 per 1,000

youths and was slightly greater than the rate

of 23.8 per 1,000 children from the previous

survey findings.

than $5,000 per year annual income than those

with $5,000 or more but showed no significant

differential by race or geographic region.

Nearly one-eighth or 2.6 million youths age

12-17 years in this country indicate they do

not wear but need glasses. The proportion is

nearly twice as great among girls as boys and

is greater among older than younger youths,

consistent with the increase in defective

visual acuity during this age range. Parents

were aware of the need for only about half bf

those youths.

In addition nearly one-fifth of those youths

who owned glasses or contact lenses indicated they needed a change in them.

000

21
REFERENCES

1National Center for Health Statistics: Origin, program and operation of the U.S. National Health Survey.

Vital and Health Statistics. PHS Pub. No. 1000 -Series

l-No. 1. Public Health Service. Washington. U.S. Government Printing Office, Aug. 1963.

2National Center for Health Statistics: Plan and

initial program of the Health Examination Survey. Vital

and Health Statistics. PHS Pub. No. 1000-Series l-No. 4.

Public Health Service. Washington. U.S. Government

Printing Office, July 1965.

3National Center for Health Statistics: Cycle I of

the Health Examination Survey, sample and response,

United States, 1960-62. Vital and Health Statistics. PHS

Pub. No. 1000-Series 1l-No. 1. Public Health Service.

Washington. U.S. Government Printing Office, Apr.

1964.

4National Center for Health Statistics: Plan, operation and response results of a program of children’s examinations. Vital and Health Statistics. Series 1, No. 5.

DHEW Pub. No. (HSM) 73-1251. Health Services and

Mental Health Administration. Washington. U.S. GovernmentPrinting Office, Oct. 1967.

5National Center for Health Statistics: Plan and

operation of a Health Examination Survey of U.S.

youths 12-17 years of age. Vital and Health Statistics.

PHS Pub. No. 1000-Series l-No. 8. Public Health Service. Washington. U.S. Government Printing Office, Sept.

1969.

6National Center for Health Statistics: Visual acuity of youths 12-17 years, United States. Vital and

Health Statistics. Series 11, No. 127. DHEW Pub. No.

(HSM) 73-1609. Health Services and Mental Health Administration. Washington. U.S. Government Printing

Office, May 1973.

7National Center for Health Statistics: Refraction

status of youths 12-17 years, United States. Vital and

Health Statistics. Series 11, No. ‘148. DHEW Pub. No.

‘(HRA) 75-16$0.

Washington. U.S.

1974.

Health Resources Administration.

Government Printing Office, Dec.

8National Center for Health Statistics: Eye &xamination findings among children, United States. Vital and

Ifeah$h Statistics. PHS Pub. No. 1000-Series 11-No. 115.

Public Health Service. Washington. U.S. Government

Printing Office, June 1972.

9National Center for Health Statistics: History and

examination findings related to visual acuity among

adults, United States, 1960-62. Vital and Health Statistics. PHS Pub. No. ”1000 -Series 1l-No. 28. Public Health

Service. Washington. U.S. Government Printing Office,

Mar. 1968.

I%ational Center for Health Statistics: Visual acuity of children, United States. Vital and Health Statistics.

PHS Pub. No. 1000-Series 1l-No. 101. Public Health

Service. Washington. U.S. Government Printing Office,

Feb. 1970.

11Nation~ Center for Health Statistics: Binocu]m

visual acuity of adults, United States, 1960-62. Vital and

Health Statistics. PHS Pub. No. 1000-Senes 11-No. 3.

Public Health Service. Washington. U.S. Government

Printing Office, June 1964.

12National Center for Health Statistics: Sample design and estimation procedures for a National Health

Examination Survey of children. Vital and Health Statistics. Series 2, No. 43. DHEW Pub. No. (HSM) 72-1005.

Health Services and Mental Health Administration.

Washington. U.S. Government Printing Office, Aug.

1971.

13 National Cenier for Health Statistics: Quality control in a National Health Examination Survey. Vital and

Health Statistics. Series 2, No. 44. DHE W Pub. No.

(H RA) 74-1023. Health Resources Administration.

Washington. U.S. Government Printing Office, Aug.

1973.

22
LIST OF DETAILED TABLES

Table 1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

Prevalence rates of eye abnormalities observed on direct

12-17 yeara, by area of eye affected

examination of youths

, age, and sex: United States, 1966-70------

Prevalence rates for selected conditions of the eye lids observed on direct examination of youths age 12-17 years, by type of condition, age, and sex: United

States, l966-7O--"---------------------------------------------------------------

Prevalence rates for selected conditions of the pupils and

direct examination of youths

irides observed on

age 12-17 years, by type of condition, age, and

sex: United States, 1966-70-----------------------------------------------------

Prevalence rates for selected conditions of the extraocular muscles observed on

direct examination of youths age 12-17 years,by type of condition, age, and sex:

United States, 1966-70 ----------------------------------------------------------

Prevalence rates for other eye conditions observed on direct examination of

youths age 12-17 years, by type of condition, age, and sex: United States,

1966-70-------------------------------------------------------------------------

Prevalence rates for tropia (manifest strabismus) among youths age 12-17 years,

by eye affected, direction of deviation, age, and sex: United States, T966-70---

Prevalence rates for all other (than tropia) extraocular muscle conditions among

youths age 12-17 years, by eye affected, age, and sex: United States, 1966-70---

Percent distribution of youths age 12-17 years with tropia (manifest strabismus)

by degree and direction of uncorrected lateral phoria at distance and near, by

age and sex: United States, 1966-70---------------------------------------------

Percent distribution of youths age 12-17 years with other (than tropia) extraocular muscle conditions by degree and direction of uncorrected lateral phoria

distance and near, by age and sex: United States, 1966-70-----------------------

Percent distribution of youths age 12-17 years with tropia (manifest strabismus)

by degree and direction of lateral phoria at distance and near with own glasses,

by age and sex: United States, 1966-70------------------------------------------

Percent distribution of youths age 12-17 years with other (than tropia) extraocular muscle conditions by degree and direction of lateral phoria at distance

and near with own glasses, by age aridsex: United States, 1966-70---------------

Prevalence rates for tropia and for other extraocular muscle problems among

youths age 12-17 years with at least “normal” and with defective uncorrected

acuity at distance and near, by age and sex: United States, 1966-70-------------

Percent distribution of degree and type of lateral phoria among youths age 12-17

years with essentially normal or defective uncorrected binocular visual acuity

at distance, by age and sex: United States, 1966-70-----------------------------

Percent distribution of degree and type of lateral phoria among youths age 12-17

years with essentially normal or defective uncorrected binocular near visual

acuity, by age and sex: United States, 1966-70----------------------------------

Prevalence rates for principal infectious and functional eye abnormalities observed on direct examination of white and Negro youths age 12-17 years, by general type of condition, age, and sex: United States,1966-70; with selected rates

white and Negro children age 6-11 years: United States, 1963-65-----------------

Prevalence rates for principal infectious and functional eye abnormalities observed on direct examination of youths age 12-17 years, by general type of condition, age, sex, and geographic region: United States, 1966-70; with selected

rates for children age 6-11 years by geographic region: United States, 1963-65--

Yage

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

41

23
Table 17.

18.

19.

20.

21.

22.

23.

24.

25.

26.

27.

28.

29.

30.

31.

32.

List of Detailed Tables-Con.

Prevalence rates for principal infectious and functional eye abnormalities observed on direct examination of youths age 12-17 years, by general type of condition, age, sex, and annual family income: United.States, 1966-70; with selected

rates for children age 6-11 yearsby annual family income:united States 1963-65--

Prevalence rates for principal infections and functional eye abnormalities observed on direct examination of white youths age 12-17 years, by general type of

condition, age, sex, and geographic region: United States, 1966-70--------------

Prevalence rates for principal infectious and functional eye abnormalities observed on direct examination of Negro youths age 12-17 years, by general type of

condition, age, sex, and geographic region: United States, 1966-70--------------

prevalence rates for principal infectious and functional eye abnormalities observed on direct examination of white youths age 12-17 years by general type of

condition, age, sex, and annual family income: United States, 1966-70; with selected rates for white children age 6-11 years by annual family income: United

States, l963-65-----------------------------------------------------------------

Prevalence rates for principal infectious and functional eye abnormalities observed on direct examination of Negro youths age 12-17 years by general type of

condition, age, sex, and annual family income: United States, 1966-70; with selected rates for Negro children age 6-11 years by annual family income: United

States, l963-65-----------------------------------------------------------------

Prevalence rates for past and present eye problems reported on medical history

(from parent, youth, school) among youths age 12-17 years,by age and sex: United

States, 1966-70-----------------------------------------------------------------

Percent of youths age 12-17 years wearing glasses all day or only for special

use, by age and sex: United States, 1966-70-------------------------------------

Percent of youths age 12-17 years by parent’s and youth’s statement on medical

history regarding need for glasses: United States, 1966-70----------------------

Percent of youths age 12-17 years wearing glasses or contact lenses according to

parent’s and youth’s medical history response among those with at least “normal”

and those with defective uncorrected acuity by age and sex: United States,

1966-70-------------------------------------------------------------------------

Percent of youths age 12-17 years needing glasses according to parent’s and

youth’s medical history response among those with at least “normal” and those

with defective uncorrected acuity by age and sex: United States, 1966-70--------

Prevalence rates for past and present eye problems reported on medical history

(from parent, youth, school) among white and Negro youths age 12-17 years by age

and sex: United States 1966-70; with selected rates for white and Negro children

age 6-11 years: United States, l963-65------------------------------------------

Prevalence rates for past and present eye problems reported on medical history

(from parent,u~~~, ~s~o~) by geographic region for youths age 12-17 years by

age and sex: 1966-70; with selected rates for children age 6-11

years by geographic region: ’United States, 1963-65------------------------------

Prevalence rates for past and present eye problems

(from parent,

reported on medical history

youth, school) by geographic region for white youths 12-17 years

by age and sex: United States, 1966-70------------------------------------------

Prevalence rates for past and present eye problems reported on medical history

(from parent, youth, school) by geographic region for Negro youths age 12-17

years by age and sex: United States, 1966-70------------------------------------

Prevalence rates for past and present eye problems reported on medical history

(from parent, youth, school) by annual family income for youths age 12-17 years

by age and sex: United States, 1966-70; with selected rates for children age

6-11 years by annual family income: United States, 1963-65----------------------

Prevalence rates for past and present eye problems reported on medical history

(from parent, youth, school) by annual family income for white youths age 12-17

years by age and sex: United States,1966-70; with selected rates for white children age 6-11 years by annual family income: United States, 1963-65-------------

Page

43

44

45

46

47

48

49

50

51

52

53

54

56

57

58

60

24
List of Detailed Tables-Con.

Page

Table 33. Prevalence rates for past and present eye problems reported on medical history

(from parent, youth, school) by annual family income for Negro youths age 12-17

years by age and sex: United States,1966-70; with selected rates for Negro children age 6-11 years by annual family income: United States, 1963-65------------- 61

34. Prevalence rates of tropia and other eye muscle problems at age 12-17 years and

6-11 years among youths included in both surveys with population estimates for

youths represented: United States, 1966-70-------------------------------------- 62

35. Prevalence rates for wearing of glasses, history of eye operations, or history

of other eye trouble at ages 12-17 years and 6-11 years among youths included in

both surveys: United States, 1966-70-------------------------------------------- 63

25 “
Table 1. Prevalence rates of eye abnormalities observed on direct examination of youths 12-17 years, by area

of eye affected, age, and sex: United States, 1966-70

Age and sex

Both sexes

12-17 years -------------------

12 years ----------------------------

13 years ----------------------------

14 years ----------------------------

15 years ----------------------------

16 years ----------------------------

17 years ----------------------------

Boys

12-17 years -------------------

12 years ----------------------------

13 years ----------------------------

14 years ----------------------------

15 years ----------------------------

16 years ----------------------------

17 years .........--------- ----------

Girls

12-17 years -------------------

12 years --- .----- 7--------.........-.

13 years ------------------ ----------

14 years ----------------------------

15 years ----------------------------

16 years ----------------------------

17 years ----------------------------

Both sexes

12-17 years -------------------

12 years --------------------------- -

13 years ----------------------------

14 years ----------------------------

15 years ----------------------------

16 years ----------------------------

17 years ----------------------------

Boys, 12-17 years -------------------

Girls, 12-17 years ------------------

Both sexes

12-17 years -------------------

12 years ----------------------------

13 years ----------------------------

14 years ......--------------------- -

15 years ----------------------------

16 years -------------------------- --

17 years ----------------------------

Boye, 12-17 years -------------------

Girls, 12-17 years ------------------

Abnormal findings-one or both eyes

Other extraocular muscle

Any eye

Lids, con- PU$U:;:,

conditions Other

abnormalityy

junctivae, . . Tropia eye

sclerae conditions

Any Latent

type strabismus

Sate per 1,000 youths

79.2I 21.4

I

81.8 25.7

77.2 20.3

75.5 20.9

64.8 14.0

86.8 24.0

90.0 23.4

89.3 26.8

I

86.6 27.8

81.6 20.4

90.2 30.3

81.0 22.9

95.4 28.9

102.9 31.2

68.8 /. 15.8

I

76.9 23.5

72.6 20.2

60.5 11.3

48.2

77.9 1::;

76.9 15.5

9.6

10.4

;.:

7:9

1;:;

11.2

13.3

13.3

11.1

8.7

J:;

8.0

::;

8.0

7.2

6.9

14.5

T

5.4 2.6

9.6 4.9

4.9

;:: 3.6

8.3

:::

J:; 5.9

$;

::2 .

1,798

328

305

291

243

315

316

1,027

771

31.4 15.4

34.9 18.3

35.6 16.5

28.1 16.5

32.9 27.5

44.7 16.0

+-=

28.8 16.5

37.0 16.7

38.0 20.5

31.6 17.5

;;.: :;.;

. .

34.0 12.1

32.8 17.1

33.2 12.4

24.5 15.4

21.7 32.7

33.6 14.1

Standard errors of rates

2.3

4.9

3.4

u

2.7

5.1

3.3

1.9

T

4.5 2.2

8.0 2.9

6.2 4.4

5.5 2.8

5.9 4.4

6.7

8.0 ::;

3.0

;:! 2.4

4.7

4.1

4.7

4.2

2.5

6.7

5.8

6.0

4.3

u

HI

8.3

3.2

3.9

1.4

3.;

H

Number of youths in thousands

486

103

80

81

i%

82

309

177

4.8

6.3

3.2

4.2

3.9

3.8

4.;

2.3

1.6 0.8

,

219

g

37

30

::

129

90

1.9

1.6 ::2

II782 417 107

126 62 17

138 19

137 E 16

105

119 1% ii

156 56 21

445 220 70

336 197 37

109

26

16

%

12

26
Table 2. Prevalence rates for selected conditions of the eve lids observed on direct examination of

youths ag

Age and sex

Both sexes

12-17 years----

12 years-----------

13 years-----------

14 years-----------

M years-----------

16 years-----------

17 years-----------

Boys

12-17 years----

12 years-----------

13 years-----------

14 years-----------

15 years-----------

16 years-----------

17 years-----------

Girls

12-17 years----

12 years-----------

13 years-----------

14 years-----------

15 years-----------

16 years-----------

17 years-----------

12-17 years, b

I

Total

with

ab- Blephnormal aritis

1ids

===4=

25.7 4.4

20.3 3.2

20.9

14.0 2::

24.0 4.0

23.4 3.3

--P

27.8

20.4

30.3

22.9

28.9

31.2

t

15.8 2.1

23.5

20.2 M

11.3 -

1::: 1.;

15.5 1.9

type of condition, age,-and sex: United States, 1966-70

Conjunc- Stye Sebor- Lacera- Hemorrhea tion rhage Scar Nevus Ptosis Other

tivitis

6.2

5.9

5.4

::i

6.7

7.2

9.2

8.0

1::;

1::;

12.5

3.1

N

3.2

2.0

R

5.4

1.;

2.5

1.0

1.;

1.5

2.;

Rate per 1,000 youths

2.0

3.i

1.;

1.4

3.7

2.3

2.;

0.3

1.;

0,6

0.4

2.;

0.2

l.i

l.l

1.4

1.3

0.8

1.;

1.2

1.2

;:;

1.6

2.;

1.0

1.8

1.7

2.4

+====

2.3

0.7 0.9

0.6 2.0

0.8 0.6

3.5

1.5 3.1

-t0.5 2.0

i

l.i

::;

1.?

2.7

3.7

0.6 2.1

1.s

1.2

1.6

2.C

2.9

1.0

3.C

2.4

2.4

::?

1.9

3.2

1.4

3.i

2.5

2.;

6.3

3.0

1.6

1.6

3.2

1.9

27
Table 3. Prevalence rates for selected conditions of the mmils and irides obsemed cm direct examination of vcmth. . . . 7?.77

years, by type of conditj n; age, and sex: United S ates, 1966-70

.. ,.—-----0- -- -.

I 1 I

Age and sex

Total

with

abnormal Aniso- Li.mbit

pupils coria ring Cataract

or

irides

Photo- ~lind Scar Medica- ~epigsensi- from tion

eye for mented Other

tive injury ~nj~ry iris

slow

~~ayicyAphakia &-

active

1 I

Both sexes Rate per 1,000 youths

12-17 years--- 0.1

1.;

0.3

2.;

9.6

10.4

9,0

9.6

;::

13.7

11.2

2.3

5.3

2.3

::$

2.;

2.9

8.8

1.4

3.5

3.5

1.7

0.2

0.;

0.s

0.5

::?

0.6

0.;

0.5

::;

0.4

1.;

1.;

0.8

1.3

3.1

0.7

1.5

::i

1,2

1.2

0.9 0.4 0.7 0.9 1.3

12 years------------

13 years------------

14 years------------

15 years------------

16 years------------

17 years------------

0.8

$:

1.;

1.0

1.2

0.1

;.;

1:0

1.0

2.9

1.7

0.;

1.;

3.;

0.5

l,i

1.;

1.4

0.;

0.6

1.:

0.7

1.:

1.2

2.;

::?

2.5

0.9

Boys —

12-17 years---

12 years------------

13 years------------

14 years------------

15 years------------

16 years------------

17 years------------

13.3

13.3

1:.+

1;::

8.0

4.4

1.4

1.;

1.5

0.1

2,;

1.7

5.;

0.6

0.2

o.i

0,1

1.8

0.2

1.;

1.3

1.;

0.9

2.;

1.5

1.7

0.5

3.;

4.; ~

1.2 I

7

2.;

0.6

1.7

2.1

Girls

12-17 years---

12 years------------

13 years------------

14 years------------

15 years------------

16 years------------

17 years------------

::2

8.0

::;

14.5

1.7

3.;

1.;

2.4

2.2

1.3

2.1 1.;

3.;

1.;

7.;

Standard errors

Total---------------

Boys----------------

Girls---------------

2.3 0.6 1.3 0.1

3.3 0.8

0.3 0.5 -

;:; $; 0.3

H

M

--L

0.4

1.9 0.7 :::

M 0.6 :::

::; - - 0.5 0.4 0.2

28
Table 4. Prevalence rates for selected conditions of the extraocular muscles observed on direct

examination of youths age 12-17 years, by type of

1966-70

condition, age, and sex: United States,

Tropia

:manifest

strabismus)

All other extraocular muscle conditions

Age and sex

Totall Latent Paralyzed Weakened Palsied

strabismus muscles muscles muscles Nys tagmus

Both sexes

12-17 years -------

years----------------

years----------------

years-..-....-..-..=-

years ----------------

years----------------

years----------------

-

12-17 years -------

years-------.-=------

years----------------

years ----------------

years-..-....--------

years----------------

years----------------

-

12-17 years -------

years----------------

years----------------

years----------------

years----------------

years ----------------

years----------------

Rate per 1,000 youths

34.5 18.3 4.7 6.1 2.4 0.7 5.1

31.4

34.9

35.6

28.1

32.9

44.7

38.8

15.4

18.3

16.5

16.5

27.5

16.0

18.9

4.1 2.8

2:?

6.4

10.5

6.0

2;

2.2

0.9

2.3

2.1

2.9

1.4

1.:

1.1

.

0.6

4.7

4.2

2.5

6.7

5.8

6.0 5.5

28.8

37.0

38.0

31.6

43.9

55.6

30.1

34.0

32.8

33.2

24.5

21.7

33.6

16.5

16.7

20.5

17.5

22.6

17.9

17.5

1.:

2.2

-

0.7

5.9

8.2

3.2 6.7

12.1

17.1

12.4

15.4

32.7

14.1

3.9

1.4

3.;

H

2.9

0.;

.

.

7.5

2::

15.3

3.7

10.6 youths per 1,000 have more than one type of these conditions.

29
Table 5. Prevalence rates for other eye conditions observed on direct examination of youths age 12-17 years, by type of condition,

age, and sex: United States, 1966-70

Iotalwith Extensive Double Light Underother “i~ion perception Blind ~blyopia ~:::~t;~ developed Ptot!is pr~in-

%bnonnality scarring only eye orb ent eye other Age and sex

12

13

14

}2

17

12

13

14

15

16

17

12

13

14

H

17

—

Both sexes

12-17 years-----

years--------------

years--------------

years--------------

years--------------

years--------------

years--------------

Boys

12-17 years-----

years--------------

years--------------

years--------------

years--------------

years--------------

years--------------

Girls

12-17 years-----

years--------------

years--------------

years--------------

years--------------

vears--------------

$ears--------------

4.8

6.3

3.2

$;

3:8

4.;

2.3

0.6

2.2

1.4

1.0

3.;

2.7

0.2

1.;

0.1

0.6

0.2

1.1

0.4

0.7

0.;

0.9

0.5

1.;

1.;

0.2

1.;

Rate per 1,000 youths

0.4

1,1

1,;

0.4

2.;

0.4

2.3

0.2

1.;

0.4

2.;

0.4

M

0.6

0.2

1.;

0.6

2.0

1.;

0.1

0.;

.

.

-

0.3

0.1

0,;

-

0.2

2.1

3.0

0.8

1.5

1.7

:::

3.2

1.1

2.6

.

2.;

2.3
Table 6. Prevalence rates for tropia (manifest strabismus) among youths age 12-17 years,by

eye affected, direction of deviation, age, and sex: United States, 1966-70

.

Age and sex

I I Right eye I Left eye

Left Bo

eye

Right

eye

>th

eyes

In uyf~:- ~n out . . out

Unspecified

Both sexes

12-17 years--------------

years-----------------------

years-----------------------

~ears-----------------------

years-----------------------

years-----------------------

years-----------------------

Boys

12-17 years--------------

years-----------------------

years-----------------------

years-----------------------

years-----------------------

years-----------------------

years-----------------------

Girls

12-17 years--------------

years-----------------------

years-----------------------

years-----------------------

years-----------------------

years-----------------------

years-----------------------

Rate per 1,000 youths

21.0 20.3 6.9 7.3 12.8 0.9 7.3 11.9 1.1

18.0

23.8

23.3

13.5

18.2

29.8

26.5

16.6

20.3

21.7

16.9

21.5

25.2

21.0

3.9

9.2

9.3

2.3

6.8

10.3

9.0

1%2

7.7

:::

11.0

9.5

10.3

13.2

14.9

7.3

13.4

17.9

16.3

1.3

0.;

2.7

0.;

0.7

8.8

6.2

6.7

1;:!

- 6.2

8.7

J:;

13.5

10.9

10.6

19.0

11.9

;::

1.5

1.0

0.4

18.6

24.0

27.7

17.3

28.8

45.0

15.4

17.4

23.6

18.7

9.6

1;::

14.1

20.2

17.9

19.0

27.0

29.3

19.5

19.3

20.4

25.5

14.8

15.8

21.1

6.7

15.1

::;

1!:!

5.1

6.0

N

2.4

:;;

10.9

1::;

2:::

31.8

9.1

1;:;

11.4

5.2

5.8

3.8

1.0

3.2

1.2

11.0

1;::

6.5

10.3

2.8

5.9

6.5

$::

1;::

9.7

;::

1;::

16.7

26.5

11.9

1::;

20.4

z:;

11.4

2.i

1.7

2.7

11.2

11.0

::$

1.7

M

1.;

3.7

i::

2.0

Standard error

J- u

2.4

;:; 3.2

2.9 3.3

Total-------------------------

Boys--------------------------

Girls-------------------------

31
Table 7. Prevalence rates for all other (than tropia) extraocular muscle conditions

among youths age 12-17 years, by eye affected, age,and sex: United States, 1966-70

Age and sex

Both sexes

12-17 years -----------------------

years-------- ---------------- --------

years -------- -------- -------- --------

years ---------------- -------- --------

years-------- -------- -------- -------- .

years-------- ------------------------

years--------------------------------

Boys

12-17 years-----------------------

years ------- ------- ------- ------- ----

years-------- ------------------------

years-------- -------- -------- --------

years-------. -------- ------.- --------

years -------- -------- ----------------

years--------------------------------

Girls

12-17 years-----------------------

years --------------------------------

years-------. -------- -------- ------years -------- -------- ----------------

years.------- -------- -------- --------

years -------- ---------------- -------.

years-------- ---------------- --------

Total ---------------- -------- -------- ---

Boys ------------------------------------

Girls -----------------------------------

Right eye Left eye Both eyes

Rate per 1,000 youths

12.3

11.8

14.1

13.8

1;::

9.8

13.0

12.3

16.6

18,8

11.2

10.6

8.0

11.5

11.3

11.5

14.0

10.6

11.4

11.1

14.7

25.1

12.1

14.8

11.9

12.8

12,2

15.8

20.5

16.1

13.3

1:::

1%:

29.7

8.1

8.4

8.7

;:;

10.6

9.5

8,.6

6.1

8.0

Standard error

2.1 2.4 1.6

3.1

;:: 2.6 ?:;

32
Table 8. Percent distribution of youths age 12-17 years with tropia (manifest strabismus)by degree and direction of uncorrected lateral phoria at distance and near, by

age and sex: United States, 1966-70

H

14

15

16

17

12

13

14

15

16

17

12

13

14

15

16

17

Age and sex

Both sexes

12-17 years --------

years-----------------

years-----------------

years--..------.-y----

years-----------------

years-----------------

years-----------------

12-17 years--------

years -----------------

years -----------------

years-----------------

years-----------------

years-----------------

years-----------------

Girls

12-17 years--------

years-----------------

years-----------------

years------.-=--------

years-----------------

years-----------------

years--.-.--=---------

Lateral phoria-distance I

Lateral phoria-near

I

I I

Esophoria Normal Exophoria Esophoria

(5A+) (O-4A) (5A+) (6A+)

Normal

(5jLt.-

9 Rt.)

38.9

50.5

43.4

53.4

24.5

26;9

31.1

35.9

43.7

46.9

67.2

24.6

26.9

15.9

42.3

58.1

39.7

41.4

24.3

27.0

55.2

56.5

46.9

53.4

42.8

71.5

62.1

64.2

59.3

56.3

53.1

24.6

67.2

66.9

76.5

53.4

36.3

53.6

58.6

75.7

51.9

44.8

Percent distribution

4.6

2.6

3.2

2::

11.0

4.7

4.8

8.2

8.2

6.2

7.6

4.3

30.5

58.8

34.0

28.7

18.6

26.9

14.7

27.0

50.8

34.6

28.5

13.3

32.0

7.6

34.7

67.1

33.4

28.9

24.3

14.8

26.0

49,9

36.6

38.6

35.7

65.7

51.0

71.3

54.1

45.1

45.6

31.9

56.3

54.3

79.7

44.9

27.7

30.3

38.9

75.7

43.3

57.9

Exophoria

(1OA+)

19.6

2;::

35.6

15.7

22.1

14.0

18.9

1;::

39.6

30.4

13.7

12.7

20.4

32::

32.2

41.;

16.1

33
Table 9. Percent distribution of youths age 12-17 years with other (than tropia) extraocular muscle conditions by degree and direction of uncorrected lateral phoria at

distance and near, by age and sex: United States, 1966-70

Lateral phoria-distance

I

Lateral phoria-near

Age and sex

Esophoria

(5A+)

Normal

(O-4A)

Exophoria

(5A+)

Esophoria

(6A+)

Normal

(5ALt .-

!#Rt .)

Exophoria

(1OA+)

Both sexes

12-17 years --------

years -----------------

years -----------------

years -----------------

years -----------------

years -----------------

years -----------------

Boys

12-17 years --------

years -----------------

years .................

years----.-=----------

years -----------------

years---==. -----------

years-..-------.=-----

Girls

12-17 years --------

years-.-----..----=---

years -----------------

years -----------------

years -----------------

years -----------------

years -----------------

Percent distribution

0.9

4.;

1.7

21.8

43.7

39.9

:::

14.8

21.0

24.4

36.8

61.7

42.1

15.2

35.6

43.3

13.9

38.2

62.3

38.3

57.9

84.8

59.6

56.7

86.1

60.1

10.6

16.1

19.8

4.8

1;::

10.0

67.6

56.3

44.0

71.9

90.8

76.7

63.9

65.6

55.4

54.5

16.9

28.5

62.3

12.7

35.4

44.6

45.5

83.1

62.2

37.7

87.3

64.6

49.3

58.5

7.0

15.;

12.7

19.4

50.7

33.2

77.9

90.7

69.1

74.6

69.5

9.5

8.;

15.1

1;::

12.7

11.1

67.5

25.2

12.2

43.4

31.7

15.8

32.5

74.8

87.8

56.6

68.3

84.2

62.2

56.2

61.8

90.9

80.0

53.4

37.8

19.0

10.5

1::;

29.1

24.8

27.7

1;:;

34
Table 10. Percent distribution of youths age 12-17 years with tropia (manifest strabismus) by degree and direction of lateral phoria at distance and near with own

~lasses...- by age and sex: United States. 1966-70

Age and sex

12

13

::

16

17

12

13

14

15

16

17

Both sexes

12-17 years--------

years-----------------

years-----------------

years-----------------

years-----------------

years-----------------

years-----------------

Boys

12-17 years--------

years-----------------

years-----------------

years-----------------

years-----------------

years-----------------

years-----------------

Girls

12-17 years--------

years-----------------

years-----------------

years-----------------

years-----------------

years-----------------

years-----------------

Lateral phoria-distance

Esophoria Normal Exophoria

(5A+) (O-4A) (5A+)

36.7

65.9

40.7

21.3

34.6

43.8

18.3

33.0

44.5

47.6

32.6

18.8

50.2

7.9

41.9

88.8

32.2

10::;

35.9

34.5

55.0

34.1

51.4

70.0

55.5

50.1

65.0

59.5

55.5

38.3

67.4

68.9

49.8

76.9

48.5

11.2

67.8

73.1

50.;

46.3

Lateral phoria-near

I [

Esophoria Normal Exophoria

(6A+) (5;Lt .- (1OA+)

9 Rt.)

Percent distribution

8.:

7.;

8.7

:::

16.7

7.5

14.;

12.;

15.;

9.6

18.;

13.;

19.2

38.t

66.6

38.6

24.2

32.1

53.5

24.3

42.8

84.5

47.6

38.5

40.7

50.2

7.9

33.5

47.5

2;.$

.

56.;

49.9

48.9

28.0

43.1

60.7

60.5

40.9

59.0

48.9

15.5

38.3

53.9

49.9

49.8

76.9

48.9

41.3

49.0

69.0

100.0

31.5

30.9

12.3

12:;

15.1

7.4

5.6

16.7

8.3

14.:

7.6

9.4

15.;

17.6

11.2

23.6

24.3

11.;

19.2

35
Table 11. Percent

traocular muscle

distribution of youths age 12-17 years with other (than tropia) exconditions by degree and direction of lateral phoria at distance

and near with own glasses, by age,and sex: United States, 1966-70

I

Lateral phoria-distance ILateral phoria-near

Exophoria

(lo~+)

Age and sex Esophoria

(5A+)

Esophoria

(6A+)

Normal

(5ALt.-

9%W .)

Both sexes Percent distribution

12-17 years--------

years-----------------

years-----------------

years -----------------

years -----------------

years-----------------

years-----------------

Boys

12-17 years--------

years-----------------

years-----------------

years-----------------

years-----------------

years-----------------

years-----------------

Girls

12-17 years--------

years-----------------

years-----------------

years-----------------

years-----------------

years-----------------

years-----------------

37*C 60.2 2.8 57.1 33.4 9.4

19,0

66.3

15.1

76.3

48.;

28.1

49.8

41.6

17.7

27.0

46.6

34.8

50.2

58.4

82.3

49.3

53.4

100.0

60.4

68.s

33.7

66.1

100.6

51.8

61.0

12.1

23.;

4.8

18.8

23.7

10.9

31.0

31.4

36.~

67.9

40.1

69.0

68.6

100.0

31.4

32.1

59.9

63.3

53.1

77.5

100.6

51.6

16.3

46.9

22,5

68.0

41.3

20.4

32,0

7,1

77.2

59.4

43.1

22.8

40.6

56.9

100.0

100.0

100.0

77.2

43.i

100.6

51.8

22.8

100.0

100.i

48.;

56.9

36
Table 12. Prevalence rates for tropia and for other extraocular muscle problems among youths age 12-17

years with at least “normal” and with defective uncorrected acuity at distance and near, by age and

sex: United States, 1966-70

Age and sex

Tropia I

Other eye I

Tropia

I

Other eye

muscle conditions muscle conditions

I J

Distance acuity without glasses Near acuity with own glasses

20/20 20/40 20/20 20/40 14/14 14/35 14/14 14/35

)r better or less or better or less or better or less or better or less

Both sexes

12-17 years-----

Prevalence rates per 100 youths

1.2 0.

0.

0.

0.

0.

0.

0.

0.

2.0 1.0 0.5 2.2 1.3 0.2

0.2

0.1

0.2

~::

.

0.3

::;

2.3

2.2

1.6

3.1

2.5

2.3

2.4

2.4

2.2

2.6

3.4

1.9

1.0

1.3

1.2

1.4

1.9

1.0

12

13

14

15

16

17

12

13

;;

16

17

12

13

;:

16

17

2.4

1.8

1.5

:::

2.4

2.3

0.5

1.1

1.7

0.5

1.3

1.1

1.1

0.9

1.2

R

1.6

1.0

1.3

0.3

0.6

0.5

0.3

0.8

0.3

0.5

years--------------

years--------------

years--------------

years--------------

years--------------

years--------------

Boys

12-17 years----- 1.4

0.3

0.1

0.3

::;

0.1

2.6

;::

2.1

2.8

2.9

1.7

0.3

0.9

1.8

0.8

::;

0.9

1.1

1.2

1.2

1.4

1.1

1.3

1.1

0.5

0.4

0.6

0.3

0.7

0.4

0.4

0.

::

0,

0.

1.

0.

1.2

1.4

1.6

1.4

1.3

1.1

years--------------

years--------------

years--------------

years--------------

years--------------

years--------------

Girls

12-17 years----- 1.2

2.1

1.5

2.2

2.3

0.7

2.7

0.7

;::

1.4

2.6

0.9

0.1

0.;

0.1

0.2

0.2

:::

1.6

2.3

0.8

1.8

0.7

1.3

::;

1.3

0.4

0.7

1.0

0.7

1.2

::;

0.1

0.7

0.4

0.3

0.8

0.2

years--------------

years--------------

years--------------

years--------------

years--------------

years--------------

0,

1,

0.

0.

37
Table 13. Percent distribution of degree and type of lateral phoria among youths age

12-17 years with essentially normal or defective uncorrected binocular visual acuity

at distance, by age and sex: United States, 1966-70

Age and sex

Both sexes

12-17 years--------

12

13

::

16

17

12

13

14

15

16

17

H

M

15

16

17

years-----------------

years-----------------

years-----------------

years-----------------

years-----------------

years-----------------

Boys

12-17 years--------

years-----------------

years-----------------

years-----------------

years-----------------

years-----------------

years-----------------

Girls

12-17 years--------

years-----------------

years-----------------

years-----------------

years-----------------

years-----------------

years-----------------

Total--------------------

Boys---------------------

Girls--------------------

Binocular acuity of 20/20 Binocular acuity of 20/40

or better-distance or less-distance

Esophoria Normal Exophoria Esophoria Normal Exo horia

(5A+) (O-4A) (5~+) (5*+) (o-4*) (A+)

Percent distributionwithin acuity group

17.5

21.8

17.8

20.3

15.5

14.0

17.2

16.3

22.0

19.3

19.4

14.1

12.3

13.1

18.3

21.7

16.8

20.8

16.5

15.2

19.7

80.7

75.6

81.5

77.6

83.1

84.6

80.2

82.2

-

76.8

80.7

74.8

82.6

87.7

86.9

79.7

74.5

82.1

79.2

83.5

82.3

76.1

1.8

2.6

0.7

2.1

1.4

1.4

2.6

1.5

1.2

5.8

3.3

2.0

;:!!

9.5

10.5

10.1

1::;

::;

8.6

8.8

8.5

1::2

7.8

6.9

10.6

12.4

12.1

8.7

1;:;

9.9

89.7

88.6

89.4

90.4

89.7

89.4

90.7

90.7

90.9

91.1

90.3

89.4

90.6

91.7

88.5

86.2

87.2

90.6

90.0

87.8

89.5

0.8

0.9

0.5

0.8

0.1

::;

0,7

u

0.8

1.;

1.4

0.9

Standard error

1.71 1.53 0.43 0.50 0.51 0.13

2.14 2.11 0.59 0.58 0.61 0.13

2.12 2.18 0.56 0.79 0.87 0.29

38
Table 14. Percent distribution of degree and type of lateral phoria among youths age

12-17 years with essentially normal or defective uncorrected binocular near visual

acuity, by age and sex: United States, 1966-70

Age and sex

Binocular acuity of

14/14 or better-near

Binocular acuity of

less than 14/35-near

1-” “’-’l”-””-”’”

Esophoria Normal Exophoria

(6%) (5ALtc9ARt.)

(1OA+)

Esophoria N rmal Exophoria

(6s+) ($Lt.-

9 W.)

(l@+)

Both sexes

12-17 years--------

Percent distributionwithin acuity groups

4.4 87.9 7.7 7.1 31.0 61.9

“40.6

38.4

24.9

38.4

3::;

28.2

48.1

57.1

66.7

47.1

87.5

61.8

66.3

4.7

:::

M

4.1

4.8

“89.3

86.8

87.7

89.3

86.8

86.9

87.7

12

13

H

16

17

years-----------------

years-----------------

years-----------------

years-----------------

years-----------------

years-----------------

-11.3

4.5

1::;

5.2

5.5

Boys

12-17 years--------

4.0

7.2

5.3

3.3

H

4.0

89.8

86.2

87.8

87.3

88.4

86.7

88.0

::;

6.9

9.4

7.9

8.1

8.0

20.6

7.2

6.2

8.1

26.8

52.5

23.7

38.2

2?3:;

32.8

52.6

47.5

76.3

54.2

89.4

71.3

59.1

years-----------------

years-----------------

years-----------------

years-----------------

years-----------------

17 years-----------------

Girls

12-17 years--------

88.7

87.6

87.6

91.4

85.1

87.1

5.9

8.6

8.2

1;::

10.0

;:?

11.8

18.4

4.2

50.0

30.3

25.2

38.6

10.3

47.6

:;.:

63:0

43.0

85.5

52.4

years-----------------

years-----------------

years-----------------

years-----------------

years-----------------

years-----------------

16

17

Standard error

0.28 0.54 0.59 1.56 4.34

0.27

3.74

0.53 0.47 3.10 7.52 6.66

0.47 0.93 0.92 2.26 3.98 4.82

Total--------------------

Boys---------------------

Girls--------------------

39
Table 15. Prevalence rates for principal infectious and functional eye abnormalities observed on direct examination of white and Negro youths age 12-17 years, by general type of condition, age, and sex: United States,

1966-70; with selected rates for white and Negro children age 6-11 years: United States, 1963-65

Both sexes

12-17 12 13 14 15 16 17

years years years years years years years I

30ys Girls

12-17 12-17

rears years

12-17 years

Abnormality and race

E!13k2-

Rate per 1,000 youths Standard errors

Any eye abnormality:

White----------------------

Negro----------------------

87.8

108.1

21.7

35.7

4::;

48.0

24.5

16.0

16.6

6.0

5.3

77.0

80.5

15.9

48.6

10.4

38.8

11.3

17.7

16.8

4.6

6.0

77.4

65.3

22.8

9.3

1;:?

35.9

34.9

15,3

21.1

4.c

5.9

56.6

125.9

10.9

36.5

1::$

25.3

49.0

13.0

41.3

1;:8

83.8

109.2

23.3

29.0

8.3

31.0

46.5

24.6

41.5

1::$

84.9

122.8

25.6

36.0

10.9

13.3

37.2

50.7

17,1

32.9

12::

Boys

6-11

years

66.5

85.4

12.7

35.9

1;:?

32.7

14.7

15.8

23.5

2.e

6,1

Girls

6-11

years

1::?

;:;

2.0

7,3

5.5

4.7

1::;

1.5

3.6

75.8

103.9

19.3

36.0

1?::

35.0

32.5

16.5

28.2

;:?

73.5

136.4

21.2

54.6

10.5

10.5

31.6

31.2

12.7

32.9

1;::

Lids, sclerae, conjunctival:

White ----------------------

Negro----------------------

Pupils, irides:

White ----------------------

Negro----------------------

TrOPia (manifest strabismus):

White ----------------------

Negro---------------- ------

All other extraocular muscle

conditions:

White ----------------------

Negro----------------------

Latent strabismus:

White----------------------

Negro----------------------

Both sexes 6-11 years

Abnormality and race

6 7 8 9 10 11

years years years years years years

6-11

years

129.0

90.2

24.3

21.3

$;.;

.

Rate per 1,000 children Standard errors

Any eye abnormality:

27.4 32.9

12.4 13.7

2.9

7.5 ;:;

9.3 10.8

8.9 7.0

1;; .:

26.2

32.4

49.4

24.1

115.5

95.9

23.6

27.5

37.2

29.C

143.c

84.4

25.1

15.(

54.:

28.(

29,9

8.4

2.8

3.7

H

White ----------------------

Negro----------------------

Tropia (manifest strabismus):

White ----------------------

Negro ----------------------

Latent strabismus(confirmed):

White----------------------

Negro----------------------

1

40
Table 16. Prevalence rates for principal infectious and functional eye abnormalities observed on direct examination

of ouths age 12-17 years, by general type of condition, age, se~and geographic region: United States, 1966-70;

witK selected rates for children age 6-11 vears bv Zeograr.hicre$zion:United States. 1963-65

Abnormality and

geographic region

Any eye abnormality:

Northeast------------------

Midwest--------------------

South----------------------

West-----------------------

Lids, sclerae, conjunctival:

Northeast ------------------

;;ihst --------------------

.----------------------

west-:---------------------

Pupils, irides:

Northeast ------------------

Midwest--------------------

South----------------------

West-----------------------

Tropia (manifest strabismus):

Northeast ------------------

M?slt--------------------

----------------------

West-----------------------

All other extraocular muscle

conditions:

Northeast------------------

W&eat --------------------

----------------------

West -----------------------

Latent strabismus:

Northeast------------------

:;~~t --------------------

----------------------

West-----------------------

12-17

years

69.5

86.6

81.2

77.4

29.1

13.6

28.0

17.2

6.8

::$

16.7

26.4

50.6

28.8

28.6

1::2

25.0

21.5

1.1

1::?

4.2

56.4

95,2

88.5

84.4

32.6

14.7

37.1

22.1

2.4

;::

24.4

12.0

57.4

22.5

27.4

1:::

21.2

21.7

1;::

2.2

64,9

100.1

74.7

63.4

25.3

17.0

26.9

13.5

;:!?

21.3

29.3

53.9

31.7

20.2

2:::

12.1

27.0

2.;

6.4

10.0

Rate per 1,000 youths

80.4

79.3

84.7

58.1

27.7

14.3

25.6

17.5

15.6

3.8

12::

40.0

44.2

37.4

20.5

19.2

16.8

25.4

3.1

;::

;;.;

53:3

72.5

28.8

1;::

8.8

4.1

1!::

5.6

16.8

47.0

3;::

4.1

2;:;

25.9

10.;

71.6

80.3

99.0

94.9

23.1

12.4

32.4

29.4

$:

16.8

34.5

35.8

36.3

25.7

13.9

30.4

29.7

30.1

3.0

1;:;

3.6

89.6

88.8

89.6

92.0

37.6

15.2

33.7

11.4

20.1

1:::

14.8

26,9

65.0

36.4

44.3

4.6

3;:;

21.3

4.6’

9.;

9.9

82.1

93.5

92.4

88.2

41.0

16.6

33.9

19.4

7.7

7.3

2;:;

26.5

55.6

36.3

33.0

1::?

28.8

25.1

1:::

7.5

56.6

79.7

69.6

66.4

17.0

10.7

21.8

15.0

Z:;

11.2

10.4

26.3

45.7

21.0

24.0

11.8

16.2

21.1

17,9

2.3

1.0

9.6

0.8

12-17 years

Both

sexes Boys Girls

Standard errors

1?::

14.5

19.6

llo~

1.7

3.7

2.9

3.2

1.5

i:;

6.8

13.1

6.9

7.2

2.6

1::;

11.2

;::

5.5

2.4

17.E

13.C

18.$

16.6

17.e

3.5

6.7

5.1

4.8

;::

11.5

8.9

14.0

11.0

10.8

3.5

Ld:i

10.9

;:;

4.4

10.3

12.3

;:::

5.7

2.4

1.7

8.3

4.0

3.2

2::

9.1

13.6

6.8

6.9

3.4

1:::

13.4

2.1

H

1.0

41
Table 16. Prevalence rates for principal infectious and functional eye abnormalities observed on direct examination

of youths age 12-17 years, by general type of condition, age, sex,and geographic region: United States, 1966-70;

with selected rates for children age 6-11 years by geographic region: ‘United States, 1963-65—Con.

I I

Abnormality and

geographic region

Any eye abnormality:

Northeast ------------------

Midwest --------------------

South----------------------

West-----------------------

Tropia (manifest strabismus):

Northeast ------------------

Midwest --------------------

South----------------------

West -----------------------

Latent strabismus (confirmed):

Northeast ------------------

Midwest --------------------

South----------------------

West -----------------------

Both sexes

Boys :iz--s

6-11

6-11 -

6 7 8 9 10 11 years years

years years years years years years years

Rate per 1,000 children

123.6

114.5

83.6

172.5

30.1

22.9

22.3

20.5

56.1

43.4

21.7

52.8

93.8

85.2

60.9

Y62.7

24.5

18.2

17.4

15.5

37.8

26.6

6?:$

103.8 166.6

99.0 120.8

77.3 80.1

155.2 179.7

31.0 38.2

21.6 19.0

21.9 31.9

20.9 36.9

32.9 89.3

g.; 47.5

25.7

44:0 51.9

116.5

121.6

77.2

199.4

24.8

26.5

19.2

17.0

46.6

44.0

15.7

76.5

125.1

137.2

100.2

166.3

18.3

33.7

12.9

13.1

69.1

50.6

32.0

34.5

137.6

121.4

107.6

173.8

:;.;

31:6

18.6

63.8

46.1

33.5

42.2

118.7

102.1

66.5

160.7

27.4

22.9

20.4

25.7

51.2

32.2

15.5

45.9

128.5

127.3

100.7

185.5

32.8

23.0

24.2

14.7

61.1

55.0

27.9

60.4

6-11 years

Both

sexes ‘“ys ‘iris

1 1

Standard errors

18.8

10.4

9.8

117.7

5.1

::!/

5.9

14.8

4.9

3$; 1

19.3 22.2

12.0 13.5

.0::: 1%?

6.9 6.8

2.9 4.0

3.3 :.;

6.9 .

1;.$ 17.6

. 5.7

3;:: 4::;
Table 17,. Prevalence rates for principal infectious and functional eye abnormalities observed on direct examination of youths age 12-17 years, by general type of condition, age,

sex, and annual family income: United States, 1966-70; with selected rates for children

age 6-11 years by annual family income: United States, 1963-65

Abnormality and

family income

Any eye abnormality:

Less than $5,000-----------

$

5,000-$9,999--------------

10,000 or more------------

Lids, sclerae, conjunctival:

Less than $5,000-----------

I

5,000-$9,999--------------

10,000 or more------------

Pupils, irides:

Less than $5,000-----------

t

5,000-$9,999--------------

10,000 or more------------

Tropic (manifest strabismus):

Less than $5,000-----------

i

5,000-$9,999--------------

10,000 or more------------

All other extraocular muscle

conditions:

Less than $5,000-----------

$

5,000-$9,999--------------

10,000 or more------------

Latent strabismus:

Less than $5,000-----------

!

5,000-$9,999--------------

10,000 or more------------

Abnormality and

family income

&y eye abnormality:

Less than $5,000-----------

$

5,000-$9,999--------------

10,000 or more------------

Tropic (man’ifeststrabismus):

Less than $5,000-----------

!

5,000-$9,999--------------

10,000 or more------------

Latent strabismus (confirmed):

Less than $5,000-----------

$

5,000-$9,999--------------

10,000 or more------------

Both sexes

12-17 12 13 14 15 16 17

years years years years years years years

Rate per 1,000 youths

105.7

69.4

70.0

27.5

20.4

18.4

17.6

6.9

6.1

33.2

30.8

49.3

37.0

12.8

7.8

::?

0.4

122.4

66.0

75.9

27.8

;;.;

.

22.7

1$:;

40.9

26.4

31.2

39.8

10.7

1.8

10.7

2.1

I I

101.4

62.4

79.7

34.9

19.2

10.0

14.0

6.1

7.6

30.4

25.0

51.6

28.5

13.0

12.6

8.3

6.5

81.9

70.3

71.8

20.3

22.0

18.3

12.9

8.5

5.8

32.2

29.4

41.2

21.8

18.2

9.9

9.;

Both sexes

98.3

63.0

48.4

21.4

12.5

12.3

15.1

8.8

2.4

40.2

29.0

30.8

47.0

9.4

9.8

115.5

78.6

74.9

22.6

28.8

20.6

11.8

4.9

5.7

39.1

32.0

34.9

44.8

20.3

13.4

13.6

7.5

I

118.3

78.6

69.4

38.4

21.3

15.4

29.8

:::

26.5

::.;

.

41.9

5.0

9.7

13.6

2.6

2.2

6-11 6 7 8 9 10 11

years years years years years years years

Rate per 1,000 children

133.4

117.5

115.2

22.4

19.9

32.3

43.0

44.1

39.5

126.3 132.1

88.5 92.6

61.6 111.5

20.5 22.6

14.6 19.6

19.1 41.1

-!--- 42.1 45.9

37.7 31.9

7.6 20.8

127.4

146.9

120.9

25.8

31.0

31.1

44.9

52.2

63.7

129.3

139.5

93.4

27.4

16.9

21,4

35.9

52.6

40.1

149.3

115.5

141.6

14.1

15.9

33.1

52.0

41.6

47.9

137.4

123.8

160.7

24.6

21.0

48.9

36.8

50.0

54.2

-

Boys Girls

12-17 12-17

years years

116.5

83.6

72.7

31.1

26.6

23.9

22.7

5.8

8.3

39.1

37.5

37.7

36.7

15.8

6.1

::;

Boys

6-11

years

122.9

104.7

102.1

24.4

19.8

29.0

37.1

33.5

35.3

95.3

54.1

67.3

24.1

13.8

12.9

12.7

8.0

3.8

27.6

23.6

40.8

37.3

9.6

9.6

8.8

H

Girls

6-11

years

143.8

130.7

130.1

20.5

20.0

36.1

48.8

55.2

44.3

43
Table 18. Prevalence rates for principal infectious and functional eye abnormalities observed on direct examination of white youths age 12-17 years, by general

States, 1966-70

type of condition, age, sex, and geographic region: United

Abnormality and

geographic region

Any eye abnormality:

Northeast ------------------

~~hst --------------------

-------- --------------

West -----------------------

Lids, sclerae, conjunctival:

Northeast ------------------

Midwest --------------------

South----------------------

West -----------------------

Pupils, irides:

Northeast ------------------

g~st --------------------

--------- -------------

West -----------------------

Tropia (manifest strabismus):

Northeast ------------------

Midwest --------------------

South----------------------

West -----------------------

All other extraocular muscle

conditions:

Northeast ------------------

Midwest --------------------

South----------------------

Weat -----------------------

Latent strabismus:

Northeast ------------------

Midwest --------------------

South----------------------

West -----------------------

12-17 12

years years

59.2 36.0

84.3 91.2

75.9 59.6

71.7 81.7

25.2 23.1

14.0 16.1

25.5 27.2

15.6 21.3

2.8

5.6 ;:!

13.6

1?:: 24.3

28.8 14.0

53.1 62.8

27.8 12.4

25.1 24.5

1

10.0 4.0

11.1

23.7 1:::

22.5 23.9

1.3 -

1;:: 12.;

4.1 2.4

I 1 1 1

Rete per 1,000 white youths

57.3

94.2

72.3

67.7

21.6

15.7

11.2

14.4

J::

22.7

34.3

52.6

45.9

21.6

J::

12.7

28.8

1::;

76.5

78.?

95.C

60.C

28.2

15.6

31.8

19.1

::;

1::;

41.7

48.1

33.4

19.1

21.9

10.3

30.4

3.4

u

52.2

72.2

34.0

45.3

28.3

5.8

6.6

6.0

;::

6.1

19.1

48.5

2::!

:.;

19:5

25.3

4.;

66.2

78.2

97.2

93.4

17.0

13.7

44.3

23.2

k;

18.1

33.2

35.6

27.0

27.6

15.8

23.0

25.2

32.4

3.5

17.;

3.9

69.6

89.6

100.1

82.3

33.7

16.5

33.2

9.0

4.0

d:;

16.5

31.1

70.4

47.8

35.8

?2

38.7

20.8

5.3

12.;

8.0

71.5

93.2 85.3

81.?

37.0

17.2

34.2

18.9

3.3

7.0

2;:;

26.7

58.6

31.7

26.5

7.7

2::;

26.5

2.;

9.8

8.2

45.:

75.:

66.(

62.C

12.5

10.7

16.4

12.3

2.3

1;:;

11.3

31.0

47.6

23.6

23.7

12.4

12.9

20.4

18.5

2.7

11.1

12-17 years

Both

sexes Boys Girls

I I

Standard errors

12.5

13.3

11.8

19.8

1:;

3.5

2.8

1.5

;:;

8.9

1;::

4.4

7.1

X

10.2

12.1

1.2

H

2.4

19.7

14.4

14.6

16.4

13.4

3.8

6.1

5.2

k;

1$!

1;:;

9:2

3.9

7.6

1!::

2.;

5.2

5.0

11.3

13.5

13.0

24.0

2.7

2.2

2.5

6.2

;:;

3.7

5.7

10.1

15.6

7.3

7.4

4.9

1::;

14.6

2.5

5.;

-

44
Table 19. Prevalence rates for principal infectious and functional eye abnormalities observed on direct examinatfOtI Of Ne ro youths age 12-17 years, by general type of condition, age, sex, and geographic region: united

States, 196~-70

Both sexes 12-17 years

Abnormality and Boys Girls

geographic region 12-17 12-17

12-17 12 13 14 15 16 17 years years Both

years years years years years years years sexes ‘“YS ‘=rl’

Any eye abnormality:

Northeast------------------

ki:ihst--------------------

----------------------

West-----------------------

Lids, sclerae, conjunctival:

Northeast ------------------

Midwest --------------------

South----------------------

West -----------------------

Pupils, iridis:

Northeast ------------------

;;~hst --------------------

........--------------

West -----------------------

----------------------Tropic (manifest strabismus):

Northeast ------------------

Midwest--------------------

South----------------------

west -----------------------

All other extraocular muscle

conditions:

Northeast ------------------

Midwest --------------------

South----------------------

west-----------------------

Latent strabismus:

Northeast ------------------

l.l:.lhst--------------------

.........-------------

klest-----------------------

100. (

104.1

95.C

138.(

55.~

10.?

34.7

41.2

33,7

12.2

6.0

5.8

10.8

25.6

31.6

79.1

10.0

68.5

28.5

12.3

2;.;

6:0

116.(

103.I

163.(

125.[

92.(

62.:

34.1

36.;

28.1

48.;

63.6

50.2

66.2

36.4

36.;

13.7

Rate per 1,000 Negro youths

47.0

202.6

So.o

j;.:

62:0

-

82.i

81.;

10.8

43.6

81.3

89.5

57.1

40.9

23.9

9.;

57.4

28.7

48.;

40.9

;;.~

12.;

69.(

99.7

111.6

311,2

33.3

31.C

35.6

53.9

35.7

24.;

37.;

30.8

213.8

31.;

61.1

43.4

27.;

115.:

103.:

103.;

131.(

70.:

131.;

.

-

45.0

39.4

61.6

103.;

42.1

78.;

186.5 132.3

37.2 101.5

56.4 112.2

215.6 173.9

62.7 73.9

10.2

35.; 33.4

39.7 29.2

123.8 44.2

37.2 10.8

15.3

1::!

25.1

25.8

144.$ 1%:

37.2 79.;

10.8 34.1

31.6 12.0

38.;

12.8

31.; -

I Standarclerrors

76.6 46.;

107.1 26.:

78.9 23.5

99.1 63.6

42.3 40.8

11.3

36.0 ;::

54.5 23.9

25.9 25.5

13.8 13.7

9.1 4.6

5.6

‘7.8

25.;

14.0 1;::

31.7 52.2

17.5 6.0

56.4 23.1

22.9 19.4

12.7 12.0

13.8 15.;

6.8

1;:? 5.8

64.f

28.?

38.:

88.;

64.C

10.2

11.8

29.8

44.9

10.7

3.4

10.8

19.5

18.6

32.8

B7.1

12.;

22.1

11.9

13.4

8.7

41.8

62.7

21.8

74.9

25.5

12.1

5!:+

24.4

18.0

7.4

8.i

Ii::

10.5

47.3

19.5

12.3

18.;

1;:;

45
Table 20. Prevalence rates for principal infectiousand functional eye abnormalitiesobserved on direct examination of white youths age 12-17 years by general type of

family income: United States,

condition, age, sex, and annual

1966-70; with selected rates for white children age 6-11 years by annual family income: United States, 1963-65

Both sexes

Boys Girls

12-17 12-17

13 14 15 16 17 years years

years years years years years

Abnormality and family

income

Rate per 1,000 white youths

Any eye abnormality:

Less than $5,000------------

$5,000-$9,999---------------

$10,000 or more-------------

104.2

65.0

65.4

23.4

19.7

16.9

20.4

6.4

5.7

35.7

28.6

40.8

39.2

12.6

6.9

10.0

3.8

96.9

63.3

68.1

13.8

17.9

31.3

29.7

;.;

.

43.6

25.3

32.5

37.1

9.6

1.9

10.9

103.0

60.8

76.5

19.3

19.1

10.2

21.0

6.8

7.8

40.8

25.8

52.8

34.5

12.2

12.9

12.5

4.9

89.9

73.2

66.8

22.3

24.4

18.9

18.9

4.7

6.0

28.6

30.2

42.5

28.0

20.1

5.4

lo.i

90.0

49.8

40.4

16.5

10.4

9.9

13.2

7.2

2.4

28.0

22.2

32.1

46.0

8.2

4.8

122.5

73.7

70.3

32.5

27.2

14.3

17.0

5.5

5.8

38.6

26.5

36.1

38.3

19.6

13.9

13.3

5.3

128.4

70.3

70.7

::.:

16:3

22.3

H

34.3

43.4

49.2

53.1

5.4

7.9

20.1

2.8

118.3

76.3

69.6

91.0

52.8

61.2

Lids, sclerae, conjunctival:

Less than $5,000------------

$5,000-$9,999---------------

$10,000 or more-------------

28.2

26.0

23.7

19.1

12.9

10.1

Pupils, irides:

Less than $5,000------------

$5,000-$9,999---------------

$10,000 or more-------------

29.5

4.1

8.5

11.9

8.9

2.9

Tropia (manifest strabismus):

Less than $5,000------------

$5,000-$9,999---------------

$10,000 or more-------------

38.0

33.0

38.9

33.5

23.8

42.7

All other extraocularmuscle

conditions:

Less than $5,000------------

$5,000-$9,000---------------

$10,000 Or more-------------

39.3

15.2

4.7

Latent strabismus:

Less than $5,000------------

$5,000-$9,999---------------

$10,000 or more-------------

11.0

0.8

Both sexes

Boys

6-11

years

Girls

6-11

years

Abnormality and family

income 6-11

years

146.5

121.6

113.8

21.9

20.6

31.7

48.2

45.4

39.0

6

I

7

I

8

I

9 10 11

years years years years years years

Rate per 1,000 white children

Any eye abncm-mality:

Less than $5,000------------

$5,000-$9,999---------------

$10,000 or more-------------

149.8

95.0

62.1

139.7

98.6

107.8

126.0

156.0

123.2

24.2

33.5

31.7

31.5

55.0

65.0

170.7

121.6

132.2

16.1

14.4

27.6

63.8

44.7

43.0

139.9

130.9

94.6

26.9

16.3

21.7

41.2

48.0

40.7

153.3

130.1

161.6

18.0

21.9

49.2

43.3

53.2

54.5

130.2

108.4

99.5

162.4

135.3

130.2

Tropia (manifest strabismus):

Less than $5,000------------

$5,000-$9,999---------------

$10,000 or more-------------

20.5

15.7

19.2

25.1

21.3

41.8

23.4

19.6

27.4

20.4

21.7

36.6

Latent strabismus (confirmed):

Less than $5,000------------

$5,000-$9,999---------------

$10,000 or more-------------

58.9

40.5

7.7

48.9

32.8

21.1

37.8

35.8

33.9

58.3

55.4

44.9
Table 21. Prevalence rates for principal infectious and functional eye abnormalities observed on di.

rect examination of Negro youths age 12-17 years by general type of condition, age, sex, and annual

family income: United States, 1966-70; with selected rates for Negro children age 6-11 yearsbyamual

family income: United States, 1963-65

Girls

12-17

years

Both sexes

Boys

12-17

12-17

12 13 14 15 16 17 years

years years years years years years years

Abnormality and family

income

Rate per 1,000 Negro youths

Any eye abnormality:

Less than $5,000------------

$5,000-$9,999---------------

$10,000 or more-------------

64.5

45.3

156.7

16.1

45.;

40.0

22.8

8.5

161.;

108.2

169.1

93.C

34.3

33.3

96.4

20.1

23.3

36.9

93.7

51.0

20.5

22.5

97.1

51.1

142.7

105.7

99.4

123.5

36.8

28.1

69.4

11.5

11.3

16.6

28.4

53.8

32.8

16.0

38.4

1;::

12.1

161.4

89.9

178.7

59.1

32.7

89.2

7.5

90.:

36.1

36.3

46.7

21.1

10.7

21.1

98.8

60.9

67.0

21.2

1::;

16.9

21.6

21.;

99.!

128.4

226.C

98.:

108.2

52.:

34.E

38.6

45.9

.

10.4

82.2

19.1

53.5

53.5

114.:

145. s

97.t

37.t

33.t

37.C

8.5

22.1

42.2

83.7

31.9

23.3

62.0

11.2

16.6

Lids, sclerae,

conjunctival:

Less than $5,000------------

$

5,000-$9,999---------------

10,000 or more-------------

35.7

22.4

93.1

45.;

236.9

Pupils, irides:

Less than $5,000------------

~

5,000-$9,999---------------

10,000 or more-------------

14.5

29.;

Tropia (manifest

strabismus):

Less than $5,000------------

$

5,000-$9,999---------------

10,000 or more-------------

40.0

8>.4

14.7

22.9

All other extraocular

muscle conditions:

Less than $5,000------------

!

5,000-$9,999---------------

10,000 or more-------------

59.6

27.7

33.6

2%;

Latent strabismus:

Less than $5,000------------

$

5,000-$9,999---------------

10,000 or more -------------

14.1

27.7

3.9

2;:;

Both sexes

Abnormality and family

income

Boys

6-11

ears

iris

6-11

ears

,

6-11

years

6

years

7 8 9 10 11

years years years years years

I I 1 I

Rate per 1,000 Negro children

Any eye abnormality:

Less than $5,000------------

t

5,000-$9,999---------------

10,000 or more -------------

99.6

60.2

364.7

24.1

12.5

133.5

29.6

22.6

127.9

67.5

20.6

94.6

55.8

236.9

114.0

22.4

347.4

16.1

38.7

22.4

130.9

38.0

29.9

79.6

18.7

99.9

215.7

28.7

27.5

20.8

67.9

94.4

36.1

100.0

3;::

510.7

21.1

489.;

94.7

29.5

43.3

12.2

19.3

17.3

104.7

64.5

463.4

Tropia (manifest

strabismus):

Less than $5,000------------

$

5,000-$9,999---------------

10,000 or more -------------

27.4

24.3

236.6

20.8

Latent strabismus

(confirmed):

Less than $5,000------------

$

5,000-$9,999---------------

10,000 Or more ------------- 2!I---Y

47
Table 22. Prevalence rates for past and present eye problems reported cm medical history (from parent, youth, school) among youths

age 12-17 years, by age and sex: United States, 1966-70

Age and

sex

Both sexes

12-17

years-----

12 years-----

13 years-----

14 years-----

15 years-----

16 years-----

17 years-----

Boys

12-17

years-----

12 years-----

13 years-----

14 years-----

15 years-----

16 years-----

17 years-----

Girls

12-17

years-----

12 years-----

13 years-----

14 years-----

15 years-----

16 years-----

17 years-----

Both sexes

12-17

years-----

12 years-----

13 years-----

14 years-----

15 years-----

16 years-----

17 years-----

Boys

12-17

years-----

12 years-----

13 years-----

14 years-----

15 years-----

16 years-----

17 years-----

Girls

12-17

years-----

12 years-----

13 years-----

14 years-----

15 years-----

16 years-----

17 years-----

Defective acuit

T

Defective acuity (youth answers) Other eye Facility for

(parent answers trouble ever visually

Wears With cwn lenses

Ever had hamI~cIOg~d

Youth wears

operation

Does not on eyes answers)

Youth wear but ~arent

needs Youth (parent

s~ll= Needs needs answers’

G1a~~e~ ~ntact~ glasses Glasses Contacts answers answers

as most

change ‘glasses Needed Used

Percent of

those

with glasses

Rate per 100 youths Rate per 100 youths

33.0

27.4

30.0

31.7

35.3

35.8

38.7

28.0

25.4

22.8

26.1

31.1

30.2

33.2

38.1

29.4

37.4

37.4

39.5

41.5

44.2

1.02

1.37

1.62

1.78

1.93

1.76

1.79

0.82

1.81

2.05

2.24

1.91

2.05

1.84

1.54

1.2

0.2

0.4

0.8

0.8

2.7

2.5

0.5

0.;

0.1

0.4

1.8

0.4

1.9

0.5

0.4

1.5

1.3

::2

0.14

0.06

0.12

0.29

0.31

0.38

0.67

0.10

0.2;

0.12

0.24

0.48

0.24

0.27

6.4 33,9 1.4 93.3

4.5 29.4 91.9

5.9 31.2 ::2 94.6

31.7 0.6 92.2

::? 36.6 1.3 92.0

7.0 36.1 2.8 93.4

7.1 39.4 3.4 95.5

4.9 28.7 0.7 92.5

4.5 27.3 0.1 89.8

5.0 23.9 0.1 93,5

5.1 25,2 90.6

5.5 32.7 1.6 91.8

3.8 30.2 2.0 93.5

5.4 33.5 1.4 95.5

8.2 39.2 2.0 93.9

4.6 31.5 0.5 93.7

7.0 38.6 0.2 95.3

3S.2 1.2 93.3

1::: 40.6 1.6 92.2

11.1 42.2 93.4

9.3 45.3 H 95.4

T

21.0 11.6

20.2

20.9 1?:?

20.6 12.4

21.5 12.9

22.4 11.0

20.6 12.6,

1

20.5 8.8

1s.1

19.5 Ii:+

20.8 10.9

19.0 7,7

19.7

25.6 ;:2

21.4 15.0

22.0 11.7

21.7 ;:.:

20.4

23.6 19:1

24.4 15.7

17.0 18.0

Standard error

0.451 1.00I 0.131 0.59

0.45

0.88

0.92

1.02

1.12

1.01

I

T

0.32

0.78

0.88

0.95

1.06

1.23

1.23

1.59 0.09 1.98

1.74 0.10 1.39

1.71 0.26 1.83

1.91 0.43 1.10

:.:: 0.40 1.08

. 0.66 1.15

0.80 0.14 0.91

1.70 0.14 3.18

2.11 0.12 2.09

2.12 2.13

2.05 0.5; 2.14

1.80 0.52 1.44

2.07 0.46 1.59

0.731 1.49 I 0.27 I 0.57

E-M.-EM

T

1.14 0.70

2.91 0.90

2.18 1.34

2.35 1.33

1.88 0.90

2.20 1.72

2.04 1.30

T

1.04

2.87

2.97

3.01

2.66

2.69

3.68

0.70

0.73

1.36

1.69

1.29

1.51

1.41

4-.--!=

4.18 1.77

3.08 2.32

2.93 1.65

;.:; 1.86

2.58

2:05 2.49

6.8

6.6

8.1

6.2

6.2

;::

6.7

;.:

1:3

H

8.3

7.0

7.8

M

6.4

6.0

7.7

0.51

0.87

1.08

0.s0

0.72

1.03

0.79

0.52

0.73

1.13

1.26

1.06

1.21

0.91

0.60

1.45

1.22

1.11

1.05

1.31

1.18

6.4

5.3

7.8

M

6.0

6.1

5.6

4.5

::+

5.3

4.9

6.o

7.1

6.0

8.5

6.6

8.3

7.2

6.2

0.44

0.61

1.11

0.82

0.60

1.00

0.87

0.62

0.73

1.28

1.11

0.81

1.10

1.31

0.45

1.02

1.37

1.43

1.01

1.42

1.22

7

1.4 0,2 0.1

1.9 0.2 0.2

1.5 0.1

1,3 ::; 0.2

1.2 0.4 0.2

1.2 0.1

1.2 0,2 o.i

T

1.8 0.2 0.2

1.9

2,1 0.; 0,;

1.9 0.2

M 0.4

i:?

1.3 0,; 0.;

1.0 0$2 0.1

1.8 0.5 0.5

0.8

0.7 0,5 o,i

0.7

0.6 0.; :

1.2 0.2 -

T

0.13 0.05 0,04

0.47 0,17 0.17

0,41 0.09 0.09

0.32 0.17 0.11

0.37 0.08 0.14

0.29 0.09

0.35 0,12 0.0;

0.201 0.041 0.05

! I

0.65 -

0.74 0.18 0.1;

0.58 0.17 0.17

0.51 0.17 0.29

0.52

0.65 0.1; 0.1;

II0.18 0.09 0.06

0.68 0.34 0.34

0.36

0.34 0.26 0.1;

0.41

0,33 O,lii :

0.51 0.19 -

48
Table 23. Percent of youths age 12-17 years wearing glasses all day or only for special use, by

age and sex: United States, 1966-70

Wear

glasses

all day

Wear

glasses Wear glasses for special use only All

youths

who

wear

glasses

Age and sex

Distance Reading TV

Both sexes

12-17 years---

years------------

years------------

years---=--------

years------------

years------------

years------------

Boys

12-17 years---

years------------

years------------

years------------

years------------

years------------

years------------

Girls

12-17 years---

years------------

years------------

years------------

years------------

years------------

years------------

Rate per 100 youths Standard errors

2.4 3.4 0.3

0.1

0.2

0.1

0.4

0.4

0.3

0.3

35.4 20.1 1.6

27.3 1.0

22.1 1.5

16.4 1.0

18.9 2.1

18.4 2.3

18.4 1.3

21.7 2.3

30.0 2.1

24.4 -

21.9 1.4

20.2 4.3

12.9 2.9

20.6 2.0

19.0 1.2

18.3 17.11 13.9

#

29.8

31.5

32.9

37.9

38.9

43.0

29.6

15.3

17.6

18.0

18.0

20.4

21.1

16.6

14.5 9.2

13.9

14.9 1;::

19.9 16.4

18.5 15.0

21,9 18.4

4.0

M

3.8

:::

2.8

1.3

1.3

1.8

M

400

2.3

13.3 14.1

1::; 1::$

15.3 22.4

12.4 17.9

16.4 23.3

14.2

14.6

14.3

18.4

19.7

18.9

20.1

4.0

2.4

2.5

3.1

M

4.1

0.3

0.;

0.7

0,4

0.3

0.3

0.;

0.1

0.2

U

27.5

24.3

25.6

33.7

32.1

35.3

41.5

-

32.3

39.1

40.3

42.3

45.8

51.0

16.4

20.8

21.8

17.7

21.0

23.4

15.9 4.9

18.3 9.4

18.5

24.6 1;::

24.8 13.5

27.6 15.6 4

25.0 -

20.9 2.3

12.9 0.8

18.1 0.7

21.2 2.0

17.1 0.9

49
Table 24. Percent of youths age 12-17 years by parent’s and youth’s statement on medical history regarding

need for glasses: United States, 1966-70

Parent-youth

disagreement

Parentyouth

agreement]

Parent statement

on youth’s need

for glassesl

Other parent-youth disagreement

Parent-youth

has glasses

Youth says he

has glasses

I

Parent Parent

says says he

he does not

needs need

Don’ t

know

Youth’s statement

of need for

glasses, age,

and sexl IITotal Yes No

Parent.

nO—

youthyes

Parenty%hno

Youth

says he

needs

Youth

says he

does

not

need

Percent of all youths without glasses Percent of all youths

Both sexes,

12-17 years- 1.6

---

---

---

1.8

---

---

---

1.6

100.0

11.2

8;.;

.

100.0

9::$

0.5

100.0

5.5 —

—

3.8

::!

4.2

2.4

1.8

7.1

79.8

7;:;

0.4

82.4

7:::

0.3

76.6

14.7

1;::

0.2

13.4

1;::

0.2

16.3

79.2

---

---

---

80.9

---

---

---

76.9

4.:

---

--.

---

3.[

---

---

---

4.;

---

---

---

5.3

---

---

---

4.5

---

---

---

6.0

---

---

---

1.7

---

---

---

2.0

---

---

---

1.4

---

---

---

Yes------- ---------

No----------------

Don’t know ---------

+

--- ----

--- ---

15.1 1.6

--- ---

--- .--

BOYS, 12-17

years -------

Yes----------------

No ------------------

Don’t knOw ---------

+

--- ---

16.4 2.4

--- ---

Girls, 12-17

years -------

yes--------.----..-

No -----------------

Don’t knOw ---------

14.4

84.7

0,9

1?:;

0.2

---

---

---

---

---

---

--- I

---

--- ..-

llkcludes those youths who say or whose parents say the youths have glasses.

50
Table 25. Percent of youths age 12-17 years wearing glasses or contact lenses according to

parent’s and youth’s medical history response among those w%h at least _.“normal’l_and . those with

defective uncorrected acuity by age and sex: United States, 1966-70

Age and sex

Both sexes, 12-I.7years-------

12 years..................---------.

13 years.........---------.........-

1.4years----------------------------

15 years---------...................

16 years ----------------------------

17 years - . . . . . . . . -------------------

Boys, 12-17 years---------------

Gi,rLs,12-17 years--------------

Both sexes --------------------------

Boys--------------------------------

Girls-------------------------------

Parent-youth wears I

Youth-wears glasses

glasses or contact lenses or contact lenses

Uncorrected acuity I

Uncorrected acuity

20/20 20/40

be~er 1::s

14/28

1::s

20/20

be;;er

20/40 14/ 14 14/28

1::s be~er 1%

Rate per 100 youths in acuity group

14.61 88.9

I

11.8 79.6

11.6 81.3

11.6 90.0

17.1 92.2

17.4 93.5

18.8 96.3’

10.8 88.0

18.8 89.6

26.4

20.9

23.2

24.1

29.3

29.3

32.6

21.4

31.7

88.9

79.9

85.2

90.8

80.7

95.5

97.2

89.2

88.6

15.7

14.0

12.5

11.8

18.8

17.7

20.5

11.9

20.2

89.6

81.1

82.7

89.8

93.0

94.0

96.7

89.0

90.1

==4===

22.2 90.5

32.7 90.3

Standard errors

0.57 1.00 1.08 1.25 0.60 0.97 1.04 1.54

0.77 1.49 0.93 1.78 0.69 1.51 0.89 ;.;;

0.95 1.30 1.58 1.42 1.06 1.20 1.57 ,.

51
Table 26. percent of youths age 12-17 years needing !+lassesaccording to parent’s and youth’s

medical history response among those with at least ‘normal” and those with defective uncorrected acuity by age and sex: United States, 1966-70

Age and sex

Parent-youth

needs glasses

Youth-needs

glasses

Uncorrectedacuity Uncorrectedacuity

20/20 20/40 14/14 14/28

be;;er 1::s be;;er 1::s

Rate per 100 youths in acuity group

Both sexes, 12-17 years------- 4.71 32.4 5.3 47.3 8.7 52.9 10.0 68.6

7

2.7 27.8

3.9 27.2

24.6

::? 42.0

5.7 35.7

5.4 79.8

12

13

:;

16

17

years----------------------------

years----------------------------

years----------------------------

years----------------------------

years -------- -------- -------- ----

years ----------------------------

3.2

5.3

5.4

6.4

6.3

5.8

4.2

6.7

42.3

27.2

56.0

58.0

59.6

49.3

44.5

49.1

6.3

‘R

10.1

1;:;

6.4

11.7

44.7

58.1

59.3

55.8

29.7

84.7

44.8

59.7

1;:2

10.5

11.1

10.0

11.2

7.9

12.7

54.8

72.2

85.9

60.1

56.4

100.0

53.8

78.9

Boys, 12-17 years---------------

Girls, 12-17 years--------------

3.8 29.5

6.0[ 34.9

Standard errors

0.41

I

4.94

0.31 6.16

0.74 5.93

0.38 5.68

0.29 9.42

0.71 9.43

0.64

0.64

1.08

2.36

4.93

3.26

Both sexes--------------------------

Girls ------------------------------- m

52
Table 27. Prevalencerates for pas

and Negro youths age 12-17 years

6.11 years:UnitedStates,1963-6

and presenteye problemsreportedon medicalhistory (fromparent,youth, school)amongwhite

>Yage and sex: United States, 1966-70;with selected rates for white and Negro childrenage

Both sexes 12-17 years

BOYS Girls

12-17 12-17

12-17 12 13 14 15 16 17 years years

years years years years years years years

Medicalhistoryand race

Both

sexes

Boys Girls

Defectiveacuity (parent)-youth Rate per 100 youths

Wears glasses:

White----------------------------

Negro----------------------------

We~L3;0ntacts:

----------------------------

Negro----------------------------

Ne#itglasses:

Negro~~~~l~~~~~IllIIIl~~~~~~~~~l

Standarderrors

34,1

23.2

1.:

0.:

&

35.2 ~4.5

1.:

93.7

90!2

19.2

40.1

10.1

19.:

1::2

6.c

8.5

1.5

1.0

0.2

0.5

%;

36.8

25.7

19.2

11.6

17.6

14.1

31.8

18.8

0.3

0.7

1::;

33.0

19.8

0.2

;$:

19.3

39.0

10.2

19.0

11::

11::

;::

0.2

0.2

33.3

20.9

19.1

9,0

14.2

11.9

33.3

22.1

0.9

0.5

1::!

33.6

19.7

0.7

92.5

89.7

18.7

41.4

11.3

18.7

1?::

6.1

7.5

1.2

1.8

0.1

1.1

0.1

0.6

34.7

22.5

19.2

11.2

15.5

11.3

37.2

21.8

0.9

1:::

38.1

25.4

1.4

92.8

86.9

19.0

45.7

10.7

22,9

1:::

6.6

8.7

1.3

0.7

0.4

0.2

39.7

25.2

18.8

11.1

20.9

14.1

37.5

24.0

::;

1:::

37.7

25.9

3.1

93.1

96.2

21.9

30.2

Z?:i

5.8

7.2

8::

::2

0.1

&;

21.4

13.4

19.3

12,3

39.:

32..$

2.7

J:

40.C

34.1

3.7

96.1

89.2

18.1

45.2

10.6

23,3

1::;

;:;

H

0.2

0.1

44.0

34.1

21.8

14.0

22.2

20.1

39.6

28.!

::2

1:::

40.t

30.4

2.:

94.4

90.C

19.:

41.1

13.C

25.(

1:::

6.E

9.7

1.1

0.4

0.1

0.8

:::

43.0

31.7

20.9

14.1

22.1

17.6

1.73

2.01

0.31

0.27

0.74

1.59

1.67

2.62

0.31

0.54

2.42

1.53

4.58

1.07

1.99

0.60

1.49

0.48

1.81

0.21

0.41

0.06

0.56

0.02

0.44

1.88

2.24

1.02

1.35

1.03

1.15

28.;

20.(

o.:

1;::

29.[

25.:

0.:

92.[

84.[

18.(

38.7

1::!

1:::

4.E

8.4

2.2

1.;

1.;

30.0

26.6

15.6

11.1

14.4

15.5

29.4

17.6

0.5

0.2

3.5

9.$

30.C

19.:

0.8

92.7

89.5

19.C

38.5

ii::

1::?

5.3

7.2

+::

0.2

0.2

0.2

0.2

30.9

19.6

17.6

9.0

13,3

10,6

1,17

1.38

0.18

0.24

0.48

1.20

1.15

1.85

0.16

0.58

1.57

1.06

4.56

0.69

1.75

0.51

1.50

0.44

1.49

0.17

0.57

0.05

0.35

0.04

0.28

1.25

1.53

0.67

0.97

0.67

0.89

0.92

1.70

0.12

0.25

0.37

1.30

0.88

1.87

0.15

0.97

2.74

0.93

5.36

0.65

2.21

0.51

2.03

0.61

1.65

0.22

1.07

0.05

0.19

0.07

0,19

0.97

1.89

0.63

1.36

0.61

1.41

Defectiveacuity (youth)

Wegit:lasaee:

----------------------------

Negro----------------------------

Wears contacts:

White----------------------------

Negro----------------------------

With own lenses-seesas well as

most:

white----------------------------

Negro----------------------------

Nmcledtghange:

----------------------------

Negro----------------------------

Do~i~t year but needs glasses:

Negro-- -------------------------

----------------------------

Other eye troubleever

Parent:

White----------------------------

Negro----------------------------

Youth:

White----------------------------

Negro----------------------------

Ev~i&d operationon eyes:

............................

Negro----------------------------

Facilityfor visuallyhandicapped

Needed:

White----------------------------

Negro----------------------------

Used:

white----------------------------

Negro----------------------------

We~it&wsee all or part of day:

................------------

Negro----------------------------

We~it~lasses all dayz

............................

Negro----------------------------

We~it~laeees part of dayt

..............-------------

Negro----------------------------

Both sexes 6-11 years

BOYS

6-11

rears

10.0

7.6

1.5

1.7

1.4

1.8

Girls

6-11

years

11.5

7.2

;:;

1.3

2.0

Medicalhistoryand race

*

8

years

ti

Both

sexes I

BOYS IGirls

1 1

Rate per 100 children Standarderrors

We$r:t:lassae:

...........................-

Negro----------------------------

Ever had eye operation:

White Negro----.--.---------------,---

............................

Specialfacilityfor visually

h#ar&apped needed:

Nagr~~~z~;~~~~~IIIIIII~~~~~~~~~~~ L

0.62 0.77

1.67 2.03

0.19 0.23

0.28 0.45

0.13 0.18

0.64 0.73

10.8

7.4

1.3

1.1

1.4

1.9

2.6

0.6

1.0

1.1

4.8

4.2 1:::

11.3

8.8

::;

0.9

1.2

16.3

10.1

0.9

2.9

2.2

2.7

21.5

10.4

1.4

1.4

1.3

3.9

:.;;

0.23

0.40

0.22

0.76

2.0

1.4

1.5

0.3

53
Table 28. Prevalence rates for past and present eye problems reported on medical history (from parent, youth, school) by gea.

graphic region for youths age 12-17 years by age and sex: United States,1966-70;with selected rates for children age 6-11 years

by geographic region: United States, 1963-65

Medical history and geographic region

Defective acuity (Parent)-youth

Wears glasses:

Northeast----------------------------------

Midwest------------------------------------

South--------------------------------------

west---------------------------------------

Wears contacts:

Northeast----------------------------------

Midwest------------------------------------

South--------------------------------------

West---------------------------------------

Needs glasses:

Northeast----------------------------------

Midwest------------------------------------

South--------------------------------------

west---------------------------------------

Defective acuity (youth)

Wears glasses:

Northeast----------------------------------

Midwest------------------------------------

South--------------------------------------

West---------------------------------------

W3ars contacts:

Northeast----------------------------------

::~:t ------------------------------------

------------------------------------.

West---------------------------------------

With own lenses-sees as well as most:

Northeast----------------------------------

Midwest------------------------------------

South--------------------------------------

West---------------------------------------

Needs change:

Northeast----------------------------------

Midwest------------------------------------

South--------------------------------------

West---------------------------------------

Does not wear but needs glasses:

Northeast----------------------------------

Midwest------------------------------------

South--------------------------------------

West---------------------------------------

Other eye trouble ever

Parent:

Northeast----------------------------------

Midwest------------------------------------

South--------------------------------------

West---------------------------------------

Youth:

Northeast----------------------------------

Midwest------------------------------------

south--------------------------------------

West---------------------------------------

Ever had operation On eyes:

Northeast----------------------------------

Midwest------------------------------------

South--------------------------------------

west---------------------------------------

Facility for visually handicapped

Needed:

Northeast----------------------------------

~:yt ------------------------------------

--------------------------------------

West---------------------------------------

Used:

Northeast----------------------------------

;:$~t ------------------------------------

--------------------------------------

West---------------------------------------

Both sexes

36.5

39.4

23.0

32.0

0.6

1.3

1.5

1.3

5.3

5.0

;:;

3S.2

39.6

24.0

32.8

0.8

1.5

1.2

1.9

94.8

93.4

91.8

92.9

;:.;

23:2

23.0

11:?

15.6

10.5

7.2

5.7

7.7

7.0

5.4

7.L

7.2

.5.7

;::

::!

0.5

0.2

0.2

0.4

0.1

0.1

25.6

35.C

19.1

27.5

0.;

0.:

5.1

2.7

;:?

28.t

36.2

22.6

28.1

0.;

0.;

94.4

88.9

93.7

92.7

20.3

19.5

18.1

22.4

3.2

J::

7.3

8.3

5.0

6.9

6.6

5.0

5.3

5.8

5.1

2.4

2.2

1.8

1.2

1.0

1.0

30.(

38.1

18.;

30.;

0.;

0.7

:::

10.:

7-.5

32.[

37.(

20.(

32.2

0.;

95.C

96.5

93.2

92.5

20.6

19.2

25.6

20.7

1?::

17.9

11.4

9.3

J::

6.2

6.o

7.3

8.3

9.5

::;

1.6

3.0

0.;

0.;

Rate per 100 youths

38.3

36.0

19.6

32.9

0.9

0,2

0.4

1.8

:::

8.8

8.2

39.5

35.0

21.0

31.0

0.7

1.;

93.2

93.6

85.6

93.8

16.4

20.5

25.7

22.0

1::;

16.6

10.6

H

6.4

8.4

5.1

6.4

8.7

5.0

:::

1.6

1.7

1.0

0.;

0.7

0.;

40.5

39.6

25.0

36.2

1.;

1.0

0.9

7.9

7.4

;:;

43.1

41.2

25.9

36.4

1.;

;:;

92.S

92.9

89.8

91.8

19.5

20.1

19.2

26.7

12::

15.0

13.5

5.4

;::

5.7

6.o

:.$

3:8

1.4

::;

1.0

0.4

1.0

0.4

0.5

44.7

43.0

24.8

30.8

1.3

3.1

3.2

2.8

;:;

7;1

43.9

41.8

26.1

33.0

2.0

3.9

1.7

3.2

95.8

94.6

92.6

90.1

21.6

22.0

21.5

24.5

13.3

1;:;

12.3

5.8

6.0

5.1

6.6

5.8

7.4

4.8

5.7

1.5

!::

1.8

O.i

43.f

45.:

37..1

34.:

1.>

2.[

?::

6.2

4.L

12.2

5.1

44.(

46.!

28.i

36.!

2.1

3.:

4.L

3.2

97.t

93.7

94.~

96.4

18.6

17.4

28.t

20.$

13.C

13.6

15.6

8.1

8.2

1:::

8.7

4.1

7.8

;:;

1.1

1.0

i:;

0.4

0.3

0.4

31.0

34.4

18.5

27.o

0.4

H

0.4

3.4

HI

4.9

32.2

35.0

19.0

27.6

0.6

0.s

0.4

1.1

94.6

92.6

87.3

93.7

16.8

20.8

22.6

22.5

6.1

1::!

7.9

;:;

7:0

H

::;

1.4

1.1

2.0

2.8

0.3

::;

0.3

0.1

0.2

Girls

12-17

years

42.2

44.4

27.6

37.1

0.8

2.0

2.5

2.2

7.6

1::2

6.0

44.4

44.4

29.2

3S.2

1.0

2.3

2.0

2.6

94.9

94.0

94.7

92.3

21.4

18.9

23.6

23.3

10.2

15.3

19.5

13.6

:::

7.9

7.0

:::

8.0

6.5

1.6

0.9

0.8

0.6

0.6

0.1

0.1

0.5

12-17 years

I 1

*

Standard errors

2,40

1.92

1.79

3.76

0.21

0.29

0.43

0.20

0.48

0.53

1.33

1.05

2,19

2.19

1.76

3.74

0.25

0.36

0.33

0.15

1.48

0.97

1.54

0.83

1.84

1.24

4.27

2.99

1.49

7..38

1.28

1.70

y.:;

0:S6

1.44

0.75

0.78

0.70

1.20

0.39

0.18

:.;;

0.20

0.09

0.10

0.17

0.07

0.06

2.14

1.41

2.2C

2.71

0.24

O.lt

0.0[

0.27

0.6C

0.82

0.87

0.5:

2.22

1.47

1.72

3.02

0.17

0.24

O.le

0.51

1.92

1.21

1.95

2.45

1.37

1.75

3.23

1.76

1.33

1.70

1.30

1.65

0.57

1.12

1.05

1,66

0.97

1.01

1.13

1.82

0.28

0.30

0.22

0.s0

0.10

0.0s

0.11

0.10

0.15

0.11

3.05

3.36

1.97

5.31

0.35

0.58

0.80

0.34

0.90

0.89

1,92

2,02

~.;:

2:06

4.79

0.46

0.78

0.56

0.42

1.63

1.03

1.42

0,69

2,56

1.89

5.38

4.28

2.32

1.70

1.36

2.62

1.13

1.95

0.81

1,54

0.81

0.82

0.70

1.25

0.56

0.18

0,36

0,16

0.36

0.12

0.10

0.29

-

54
Table 28. Prevalence rates for past and present eye problems reported on medical history (from parent, youth, school) by geographic region for youths age 12-17 years by age and sex: United States,1966-70; with selected rates for children age 6-11 years

by geographic region: United States, 1963-65—Con.

Medical history and geographic region

Facility for visually handicapped-con.

Wears glasses all or part of day:

Northeast----------------------------------

P&i&St------------------------------------

-------------------------------------.

west---------------------------------------

Wears glasses all day:

Northeast----------------------------------

gi~hst ------------------------------------

-------------------------------------.

West---------------------------------------

Wears glasses part of day:

Northeast----------------------------------

Midwest------------------------------------

South--------------------------------------

West---------------------------------------

Medical history and geographic region

Wears glasses:

Northeast----------------------------------

Midwest------------------------------------

?@uth --------------------------------------

West---------------------------------------

Ever had eye operation:

Northeast----------------------------------

kl:lpt --------------------------------------

-------------------------------------

West---------------------------------------

S~pe&; facility for visually handicapped

North~ast----------------------------------

hl:fiyt ------------------------------------

.-------------------------------------

Weet---------------------------------------

T

12-17 12

years years

Both sexes

13 14 15 16 17

years years years years years

J

39.2 29.4 33.3

41.3 37.0 37.4

25.4 22.6 20.0

35.0 2S.4 33.6

17.0 11.s 16.6

23.6 22.7 19.4

12.5 9.7

19.0 1::? 23.6

22.2 17.6 16.7

17.7 14.3 18.0

12.9 13.7 10.3

16.0 12.7 10.0

Rate per 100 youths

40.6

36.3

21.4

33.3

18.9

21.2

10.7

20.9

21.7

15.1

10.7

12.4 1

43.0

42.7

27.6

38.6

17.1

23.6

12.7

17.9

25.9

19.1

14.9

20.7

45.8

45.7

27.9

36.1

18.5

27.2

18.9

15.9

27.3

18.5

2:::

I

RrJys Girls

12-17 12-17

years years

46.9 32.8

50.3 35.8

33.2 19.6

40.9 29.2

20.3 16.0

28.3 21.7

14.3 11.0

20.1 16.6

26.6 16.8

22.0 14.1

18.9

20.8 1:::

I

Both sexes

Boys

6-11

6-11 6 7 8 9 10 11 years

years years years years years years years

Rate per 100 children

12.6

13.3

5.2

9.8

1.6

1.4

0.9

1.3

1.7

1.1

2.2

1.0

3.2 7.6

5.7

H

1.2 i::

0.8 2.6

0.4 1.9

0.7 1.6

1.5 1.5

0.6

::: 1.1

1.4

i:: 0.8

10.2

13.3

3.4

9.1

2.0

0.9

0.8

1.5

2.5

2.0

2.5

0.2

14.8 16.1 26.1

12.6 20.4 24.1

10.9 ‘

1;:: 1::? 18.9

J--_L 1.0 2.3 0.6

1.6 ;.;

::: 0.3

0.5 0.5 2:6

1.4 2.4 2.5

0.8 1.6 0.6

0.4 3.9 3.1

1.0 1.5 0.8

12.1

12.5

4.4

9.3

1.6

1.6

1.2

1.6

1.5

1.2

2.4

1.1

45.8

47.0

31.4

41.0

18.0

25.5

14.1

21.4

27.S

21.5

17.3

19.6

;irls

,-11

rears

13.1

14.1

1:::

1.4

:::

1.1

1.9

1.1

1.9

0.8

12-17 years

Standard errors

2.58

2.07.

1.98

4.11

2.63

0.87

0.55

1.86

1.91

0.89

0.62

1.78

2.26

1.47

2.33

2.93

1.37

1.34

(?.69

1.57

1.45

1.34

0.74

1.43

3.31

3.56

2.24

5.87

2.59

1.01

0.63

2.87

2.57

1.10

0.69

2.82

6-11 years

HStandard errors

1.12 1.76 0.96

1.39 2.19 1.05

1.23 1.33 1.22

1.98 2.00 2.55

0.35 0.36 0.48

0.27 0.25 0.38

0.26 0.40 0.39

0.36 0.55 0.34

0.24 0.33 0.46

0.40 0.49 0.34

0.30 0.30 0.46

0.18 0.32 0.35

55
Table 29. Prevalence rates for past and present eye problems reported on medical history (from parent, youth, school)

by geographic region for white youths 12-17 years by age and sex: United States, 1966-70

Medical history and geographic

region

Defective acuity (parent)-youth

Wears glasses:

Northeast----------------------

Midwest------------------------

south--------------------------

West---------------------------

Wears contacts:

Northeast----------------------

Midwest------------------------

South--------------------------

West---------------------------

Needs glasses:

Northeast----------------------

Midwest------------------------

South--------------------------

West---------------------------

Defective acuitv (vouth)

Wears glasses:

Northeast----------------------

Midwest------------------------

South--------------------------

West---------------------------

Wears contacts:

Northeast----------------------

Midwest------------------------

South--------------------------

West---------------------------

With own lenses-sees as well

as most:

Northeast----------------------

Midwest------------------------

South--------------------------

West---------------------------

Needs change:

Northeast----------------------

Midwest------------------------

South--------------------------

West---------------------------

Does not wear but needs

glasses:

Northeast----------------------

Midwest------------------------

South--------------------------

west---------------------------

Other eye trouble ever

Parent:

Northeast----------------------

Midwest------------------------

South--------------------------

West---------------------------

Youth:

Northeast----------------------

Midwest------------------------

South--------------------------

West---------------------------

Ever had operation on eyes:

Northeast----------------------

Midwest------------------------

South--------------------------

West---------------------------

Both sexes

Boys

12-17

12-17 12 13 14 15 16 17 years

years years years years years years years

Rate per 100 white youths

36.7

40.4

25.8

32.>

0.7.

;:;

1.4

4.?

4.1

7.2

5.2

38.1

40.4

27.4

32.E

0.5

1.5

1.6

1.9

94.8

93.5

92.9

93.3

16.8

19.1

19.7

21.2

1::?

1;. ?

6.0

5.5

6.6

6.3

5.0

6.7

7.4

5.1

1.6

1.1

;:2

24.9

35.5

21.8

27.3

0.;

0.3

M

7.5

2.0

27.6

35.5

25.7

28.0

0.;

0.;

94.7

89.7

98.6

91.9

13.4

18.0

15.3

23.4

2.7

1?:?

7.6

~:{

6:4

4.7

4.5

:::

2,7

2.4

?::

30.6

38.4

22.4

31.1

0.;

0.8

2:;

7.3

2.6

33.5

37.9

24. C

32.8

0.;

94.3

96.2

94.4

92.2

20.1

18.2

19.1

20.3

1::;

16.1

10.2

;::

M

5.2

H

7.8

1.0

0.5

2.4

2.9

38.6

37.0

21.5

33.9

1.0

0.:

2.0

2.0

3.7

7.0

7.1

40.1

36.5

24.4

31.8

0.8

2.;

94.2

93.2

84.9

94.0

14.7

19.7

24.0

18.6

1:::

14.5

10.0

4.2

4.2

H

4.3

;.:

4;8

1.7

0.2

1.4

1.8

40.8

41.1

28.0

37.2

:::

1.0

7.5

H

8.7

42.0

42.8

29.2

37.0

1.:

1.7

2.4

91.7

93.2

90.6

94.5

15.9

20.1

13.2

23.9

1?:$

12:?

4.8

H

4.4

6.3

8.5

8.5

3.1

1.6

1.8

::;

44.6

44.3

29.2

31.1

1.5

u

3.0

::;

5.8

7.3

43.4

43.0

30.6

32.8

2.3

3.9

2.4

3.4

95.2

94.2

93.8

89.3

18.9

22.3

20.3

25.0

12.0

::;

11.0

5.1

$:

5.8

7.5

5.6

5.8

1.7

0.7

0.9

1.9

43.7

47.0

32.1

32.7

1.9

;:;

1.5

3.7

3.6

::;

44.3

47.8

30.4

35.0

2.8

3.6

5.8

2.8

98.6

94.0

95.2

97.7

17.3

16.5

26.1

15.5

10.6

12.5

13.0

7.1

5.5

5.2

6.3

7.3

;:;

ii

0.7

1.0

:::

31.6

35.0

21.3

27.2

0.5

0.5

0.5

0.5

3.0

2.8

5.0

5.0

32.4

35.2

22.4

27.6

0.6

0.7

0.6

1.1

94.8

92.4

88.7

93.6

15.4

19.8

19.9

20.8

;:$

10.3

7,5

7.1

n

5.8

4.7

;::

4.0

::;

::2

Girl!

12-1:

year:

42.1

45. t

30. (

37.:

1.(

l.f

3.:

2.:

6.(

5.;

10.:

5.!

44.1

45. (

32.7

38.1

1.2

2.:

2.7

2.7

94.t

94.:

95.[

93.1

17.5

18.6

19.6

21.5

1::?

16.2

12.2

4.8

5.8

6.9

6.7

;::

7.6

6.4

1.8

1.0

M

12-17 years

*

Standard errors

2.54

2.OC

2.17

3.92

0.24

0.31

0.66

0.24

0.80

0.76

1.28

1.12

2.09

2.31

2.30

3.81

0.29

0.40

0.45

0.18

1.49

1.01

1.32

0.94

1.34

1.20

4.12

3.16

1.65

1.56

0.96

1.74

0.58

1.26

0.96

1.28

0.62

0.57

0.83

0.97

0.45

0.18

0.33

0.35

2.47

1.57

2.40

2.88

0.27

0.16

0.22

0.31

0.69

0.88

1.00

0.59

2.36

1.51

2.25

3.06

0.19

0.23

0.20

0.51

2.12

1.19

2.07

2.82

1.20

1.69

3.03

2.42

1.33

1.64

0.91

1.58

0.49

1.22

1.29

0.98

0.99

0.77

1.23

1.39

0.29

0.31

0.38

0.71

3.09

3.43

2.44

5.56

0.42

:.;:

0:34

1.24

1.22

1.84

2.07

2,43

3.91

2.52

5.02

0.53

0.81

0.76

0,35

1.57

1.09

1.22

0.87

2.03

1.95

5.57

4.18

2.94

1.86

1.35

2.70

0.79

1.55

0.86

1.77

0.61

0.75

0.83

1.14

0.67

0.20

0.49

0.17

56
.

Table 30. Prevalence rates for past and present eye problems reported on medical histor!

by geographic region for Negro youths age 12-17 years by age and sex: Unite<

Medical history and geographic

region

Defective acuity (parent)-youth

Wears glasses:

Northeast----------------------

Midwest------------------------

south--------------------------

west---------------------------

Wears contacts:

Northeast----------------------

Midwest------------------------

South--------------------------

Weet---------------------------

Needs glasses:

Northeast----------------------

Fi:lhst------------------------

--------------------------

West---------------------------

Defective acuity (youth)

Weara glasaea:

Northeast ----------------------

l.i.i~;st------------------------

--------------------------

West---------------------------

Wears contacts:

Northeast----------------------

:;$~t ------------------------

.-------------------------

Weat---------------------------

W~;hmgn,lenses- sees as well

Northek+t ----------------------

::l;st ------------------------

..........................

West---------------------------

Needs change:

Northeast----------------------

Imw;et------------------------

--------------------------

West---------------------------

Does not wear but needs

glassea:

Northeast----------------------

;;igst------------------------

--------------------------

West---------------------------

Other eye trouble ever

Parent:

Northeast----------------------

lmw~t------------------------

--------------------------

west---------------------------

Youth:

Northeast----------------------

Midwest------------------------

South--------------------------

West---------------------------

Ever had operation on eyes:

Northeast----------------------

I&Mw:sti------------------------

--------------------------

West---------------------------

I

EEiETT@ .yaars years years years years years years

Rate per 100 Negro youths

36.2

28.?

15.2

24.6

0.;

0.5

12.0

10.8

14.6

8.2

39.8

31.5

14.7

29.0

94.7

91.0

85.7

87.7

38.0

31.6

$;.;

15.0

14.8

21.7

20.2

14.6

J:;

16.8

1::2

6.9

12.4

1.1

0.:

5.6

29.7

29.(

12.:

Zz.1

16.$

12.2

10.:

3.C

36.t

42.2

14.:

22.4

-

93.C

78.8

71.4

100.0

53.2

37.8

30.6

20.5

7.6

10.4

16.9

4.6

14.3

11.6

8.5

9.0

6.8

14.2

6.0

11.2

26.2

35.5

10.3

22.5

1,;

2?::

16.7

7.6

28.7

34.7

11.2

22.5

100.0

100.0

87.6

100.0

23.9

38.6

57.0

40.9

10.0

13.8

21.3

30.4

11.4

1;::

11.1

11.4

18.0

10.1

37.3

5.;

37.1

24.s

14.(

23.f

3.;

1?:1

13.C

23.2

36.1

18.5

11.7

25.2

S5.4

100.0

89.4

90.0

30.2

37.9

35.3

80.4

12.6

15.3

21.4

19.5

13.6

6.2

2::;

11.3

6.2

U

2.9

1;::

40.:

23.;

15.!

14.(

11.!

6.!

13./

53./

25.[

15.!

20.(

100.(

85.4

85.1

47.(

43.(

24.s

54.C

71.7

15.C

11.2

28.7

22.7

10.6

4.1

2%:

;:2

1::$

5.2

47.(

31.7

12..$

21.2

l.i

14.2

1::;

5.5

49.1

31.7

13.8

31.5

100.0

100.0

85.4

100.0

41.3

20.2

29.3

23.0

26.1

16.0

19.9

31.9

12.0

2.8

6.8

8.7

5.8

R

4.4

0.;

43.:

25.(

28.;

39.:

22.!

11.:

21.[

11.(

42.(

36.:

Z3.L

49.:

88.:

89.4

93.6

84.!

31.C

31.1

41.2

72.5

26.8

23.C

22.6

21.3

26.4

2!:;

18.3

1:::

6.8

3.0

3.9

10.;

26.8

27.2

10.E

17.4

0.:

6.5

10.C

12.C

5.C

31.1

31.2

2;::

93.0

93.7

77.8

92.8

29.2

35.1

40.7

59.0

11.7

1?:

13.6

12.5

1;::

20.9

7.2

:::

14.3

1.1

1::;

mom

tate

Girl

12-1“

year:

43.(

29.(

19.(

32.:

1.;

0./

16.S

11.[

17.)

12.:

46.!

31.t

20.2

36.7

95.6

88.C

89.4

84.5

42.7

27.7

41.6

51.9

18.3

24.3

26.6

29.2

16.2

12.6

10.6

12.5

1:::

1::;

1.0

0.;

tren::7pth, school)

12-17 years

Standard errors

4.5:

2.34

1.95

4.0:

0.5;

0.5C

3.29

1.56

2.17

2.99

3.63

2.33

1.43

6.59

3.78

3.17

3.57

4.51

8.31

2.49

9.65

22.42

3.75

2.20

2.58

9.06

3.31

4.38

1.81

3.62

3.55

3.19

1.96

3.30

0.62

0.4;

3.03

3.4!

4.9:

2.9[

2.7;

0.5;

3.9[

3.02

2.0:

2.7C

1.64

6.41

1.62

7.04

3.80

5.91

6.28

6.14

10.28

7.86

10.89

30.02

4.25

6.40

3.13

9.04

5.27

2.34

2.10

12.98

2.62

4.83

2.22

5.07

1.11

0.7;

5.59

5.90

3.70

:.;;

1.3;

0.46

5.48

0.93

2.54

6.55

5.69

3.97

2.54

8.06

6.24

3.57 .

4.16

8.66

8.42

3.79

10.58

22.08

+.;;

2:06

8.75

3.61

7.25

2.12

6.97

4.70

2.00

2.67

4.36

1.48

0.3;

57
Table 31. Prevalencerates for past and present eye problems reported on medical history (from

parent, youth, school)byannual family income for youths age 12-17 years by age and sex: United

States,1966-70;with selected rates for children age 6-11 years by annual family income: United

States, 1963-65

1 I

Medical history and family

income

Defective acuity (parent)-youth

Wears glasses:

Less than $5,000---------------

$5,000-$9,999------------------

$10,000 or more----------------

Wears contacts:

Less than $5,000---------------

$5,000-$9,999------------------

$10,000 or more----------------

Needs glasses:

Less than $5,000---------------

$5,000-$9,999------------------

$10,000 or more----------------

Defective acuity (youth)

Wears glasses:

Less than $5,000---------------

$5,000-$9,999------------------

$10,000 or more----------------

Wears contacts:

Less than $5,000---------------

. $:60::i$:;999------------------

s more----------------

With own lenses-seesas well as

most:

Less than $5,000---------------

$

5,000-$9,999------------------

10,000 or more----------------

Needs change:

Less than $5,000---------------

$5,000-$9,999------------------

$10,000 or more----------------

Does not wear but needs glasses:

Less than $5,000---------------

$

5,000-$9,999------------------

10,000 or more----------------

Other eye trouble ever

Parent:

Less than $5,000---------------

$5,000-$9,999------------------

$10,000 or more----------------

Youth:

Less than $5,000---------------

$5,000-$9,999------------------

$10,000 or more----------------

Ever had operation on eyes:

Less than $5,000---------------

$5,000-$9,999------------------

$10,000 or more----------------

Both sexes

Boys Girls

12-17 12

12-17 12-17

13 14 15 16 17 years years

years years years years years years years

Rate per 100 youths

27.2

34.0

36.9

0.3

0.6

2.8

12.3

4.5

2.5

28.4

35.1

37.2

0.3

0.8

3.1

89.9

93.3

95.2

30.2

20.2

15.6

16.8

9.7

8.5

U

5.9

:::

6.0

1.3

::;

24.3

26.6

31.8

O.i

10.5

2.9

1.1

26.0

28.8

33.7

0.;

0.8

89.9

90.9

94.5

18.7

22.9

18.2

16.3

6.4

7.0

9.8

H

;:;

4.2

0.6

2,2

2.8

25.3

32.7

33.3

0.3

0.;

U

2.6

25.2

33.8

34.9

O.z

98.2

91.9

95.9

25.7

21.2

16.8

14.7

12.2

8.9

9.4

6.5

9.1

9.4

7.4

7.4

::;

1.8

22.7

34.5

34.5

0.8

0.5

1.2

13.7

3.8

2.2

23.8

34*9

33.7

0.3

0.4

1.2

80.7

95.7

93.9

35.4

17.0

15.7

18.8

10.4

9.4

6.2

6.2

6.2

U

6.0

;:;

1.1

30.0

36.0

40.2

0.;

2.0

12.6

5.6

5.3

31.2

37.9

40.0

0.4

0.6

3.2

83,6

94.5

95.6

37.2

16.9

14.2

18.3

10.0

10.6

8.4

2::

7.7

6.2

6.9

1.1

1.5

1.2

26.7

38.4

39.3

0.4

U

12.0

7.0

2.5

26.8

38.1

40.4

0.7

;:2

95.7

91.2

95.4

36.6

23.3

14.7

14.9

7.6

8.6

:::

5.1

6.0

4.8

6.7

;::

1.5

35.3

37.6

43.0

::$

16.6

3.6

1.7

38.5

38.4

41.2

0.4

%;

92.7

96.6

96.5

28.0

20.2

14.8

18.6

11.9

6.7

12.0

::;

5.0

::;

1.0

;:!

22.0

28.6

33.4

0.1

002

1.0

8.7

3.8

1.8

22.6

30.2

32.9

0.3

;.:

.

89.0

92.0

95.7

28.8

20.5

14.1

12.6

;:5

8.6

5.8

5.9

u

5.6

1.9

1.6

2.0

32.1

39.9

40.4

16.3

5.5

3.4

33.8

40.4

41.5

0.3

;:2

90.5

94.4

94.8

31.0

20.0

16.7

21.6

13.0

10.1

8.5

6.5

6.4

0.8

0.9

1.5

58
Table 31. Prevalenceratea for past and present eye problems reported on medical history (from

parent, youth, school)by annual family income for youths age 12-17 years by age and sex: United

States,1966-70;with selected rates for children age 6-11 years by annual family income: United

States, 1963-65—Con.

Medical hi.sto;:eandfamily

Facilitv for visually

andicapped

Needed:

Less than $5,000---------------

i

5,000-$9,999------------------

10,000 or more----------------

Used:

Less than $5,000---------------

5 000-$9,999------------------

$61 ,000 or more----------------

Wears glaases all or part of day:

Leas than $5,000---------------

$6

5 000-$9,999------------------

1 ,000 or more----------------

Wears glasses all day:

Less than $5,000---------------

!6

5 000-$9,999------------------

1 ,000 or more----------------

Wears glasses part of day:

Less than $5,000---------------

ib

5 000-$9,999------------------

1 ,000 or more----------------

Medical hi:~~:eand family

Wears glasses:

Less than $5,000---------------

t

5,000-$9,999------------------

10,000 or more----------------

Special facility for visually

handica ped neede,d:

Less t1!an $5,000---------------

t

5,000-$9,999------------------

10,000 or more----------------

Both sexes

Boys Girls

12-17 12-17

12-17 12 13 14 15 16 17 years years

years years years years years years years

0.2

::;

0.2

M

28.6

36.1

40.5

14.5

19.1

21.3

14.1

17.0

19.2

0.6

0.2

0.6

0.2

26.6

29.0

34.5

15.2

15.5

15.8

11.4

13.5

18.7

0.3

0.;

0.3

0.;

25.8

34.0

35.5

14.7

20.1

18.4

11.1

13.9

17.1

Rate I

0.;

0.:

24.7

35.5

35.7

12.4

18.9

21.6

12.31

16.6

14.1

w 100 youths

0,;

0.5

0.2

31.6

38.8

43.2

13.7

19.6

21.5

17.9

19.2

21.7

Both sexes

I I I I

6-11 6 7 8 9

years years years years years

0.4

27.3

40.5

45.8

14.7

19.2

25.0

12.6

21.3

20.8

10

years

0.;

0.3

0.;

39.1

40.7

48.7

16.6

22.0

25.7

22.5

18.7

23.0

11

years

1;:;

12.4

;::

1.6

1.9

1.2

1.0

1.7

2.4

3.4

1.2

0.8

0.6

0.8

1.3

0.5

3.2

6.0

6.7

1.0

u

1.5

0.9

0.6

, ,

Rate per 100 children

1::;

7.7

0.4

1.7

1.5

2.1

1.6

1.4

1:::

10.6

1.4

0.9

1.6

0.6

M

12.0

17.3

17.7

1.2

1.4

0.8

:::

2.0

14.8

21.2

27.3

M

1.3

2.5

0.5

0.8

0.1

0.3

0.2

0.1

M

23.1

30.6

34.5

11.7

17.6

19.6

11.4

13.0

14.9

Boys

6-11

years

12;

10.6

H

1.8

2.0

;:$

:::

0.1

0.2

0.2

34.5

42.0

46.3

17.2

20.7

22.9

17.3

21.3

23.4

Girls

6-11

years

1;::

14.4

0.8

H

1.7

1.0

1.0

59
Table 32. Prevalence rates for past and present eye pr{

family income for white youths age 12-17 years by age ~

6-11 years by annual family income: United States, 196:

. . .. . . . . .. .. . .. .

ems reporcea on mealca~ rmscory {zrom parenr, youcn, scnOOl~ .y m-nl”lIJ.

sex: United States, 1966-70;with selected rates for white c ildren age

.c

Both sexes

Girls

12-17 12

1!% 12-17

13 14 15 16 17 years

years years

years

years years years years years

Medical history and family income

Defective acuity (parent)-youth Rate per 100 white youths

Wears glasses:

Less than $5,000---------------------------------------

$5,ooo-$9,999------------------------------------------

$10,000 or more ----------------------------------------

29.S

35.0

36.9

0.1

0.7

2.7

10.4

4.0

2.4

31.0

35.9

37.2

0.4

0.9

3.0

90.0

93.3

95.5

27.5

1s.4

14.9

15.0

9.0

8.0

;::

5.9

6.B

5.7

5.8

1.7

1.2

1.8

26.4

26.6

32.1

0.:

10.1

2.0

0.8

26.7

28.7

33.6

-

::;

92.6

91.0

94.9

13.8

21.3

17.6

19.6

5.6

6.6

%:

5.3

8.1

3.9

3.8

0.9

2.4

2.9

30.5

33.6

33.?

1.;

8.8

2.5

2.1

30.7

34.5

34.5

0.;

98.2

92.C

95.6

22.8

19.1

16.5

12,2

11.2

8.6

8.2

5.7

9.3

:::

7,5

2.4

1.1

1.8

25.6

35.6

34.4

0.8

0.6

1.3

10.6

3.7

2.3

28.1

36.2

33.6

0.5

0.5

1.3

7B.B

96.2

93.6

33.2

15.1

15.5

17.3

10.1

8.8

4,0

5.3

6.2

8.4

6.0

5.7

::i

1.2

36.3

3s.1

42.4

34.8

41.0

40.5

0.3

k;

14.9

:,;

36.2

41.4

41.6

0,5

:::

90,6

94.6

95.4

;;oj

16:1

19,9

11,3

9.6

2::

5.9

8.1

6.2

6,3

0,9

1.0

1.5

33.1

37.8

40.5

0.;

1.8

11.3

5.4

5.5

32.7

39.s

40.3

::!

3.0

83.1

94.2

97.0

34.9

14.9

12.4

13.6

1:::

6.5

::;

6.9

::?

1.6

1.7

1.0

2s.0

40.0

39.4

1.7

6.1

9.9

7.5

2.6

28.9

39.0

40.6

;::

5.3

95.8

90.5

95.2

35.5

23.2

14.7

11.1

;::

:::

5.0

6.1

5.2

6.6

2,3

:.$

24.6

29.4

33.3

0.;

0.9

6.3

3,7

1.5

Wears contacts:

Less than $5,000---------------------------------------

j%~;$%’%.

-----------------------------------------.

---------------------------------------. M

12.1

3.6

1.7

40.3

38.8

40.7

0.7

H

93.6

96.9

96.7

24.6

17.2

13.8

15.6

1:.;

5.4

6.1

5.0

3.8

::;

!::

2.1

Needs glasses:

Less than $5,000---------------------------------------

??:6%:$:;’%,.

-----------------------------------------.

----------------------------------------

Defective acuity (youth)

Wears glasses:

~i:i%Ec ---------------------------------------

-----------------------------------------.

---------------------------------------.

25.5

30,9

32.8

Wears contacts:

~7$%,j;4000 ---------------------------------------

----------------------------------------- .

, 00 or more ---------------------------------------- M1.5

With mm lenses-sees as well as most:

Less than $5,000---------------------------------------

g6%5$:;9%re

-----------------------------------------.

---------------------------------------.

89,2

91.9

95.7

Needs change:

g;g~y,j;6000 ---------------------------------------

----------------------------------------.

or more ----------------------------------------

26,2

19.2

13.4

Uoes not wear but need glasses:

~;:$%k:---------------------------------------

----------------------------------------.

---------------------------------------.

10,4

::;

Other eye trouble ever

Parent:

Less than $5,000---------------------------------------

$560:03;$9,999 ---------------------- . -------------------

or more ----------------------------------------

5.4

5,2

5,4

M2.0

Both sexes

Boys

6-11

years

Girls

6-11

years

Medical history and family income

6-11 6

I

7 s

I

9 10 I11

years years years years years years years

Rate per 100 white children

Wears glasses:

Less than $5,000--------------------------------------.

g6y;i$:;,::;i ----------------------------------------

----------------------------------------

l::i

7.8

0.4

1.9

1.5

2.0

1.7

1.5

13.7

17.3

17.4

0.9

i::

3.9

1.2

2.0

16.6

22.4

26,9

1.6

0.9

1,3

1.8

0,3

0.8

;::

3.4

1.6

0.9

0.6

1.2

:::

ii::

10.8

$:

.

1.5

1.5

1,s

;:;

0.9

1%:

14.4

1.0

1.0

1.5

:::

1,0

Ever have eye operation:

~%,j;6000------------------------------ .

-----------------------------------------.

or more----------------------------------------

Special facilit for visually handicapped needed:

Less than $5,500---------------------------------------

t;b!~~G$~~9~~re----------------------------------------

..........................................

60
Table 33. Prevalence rates for past and present eye problams reported on medical history

family income for Negro youths age 12-17 years by age and sex: United

(from parent, youth, school) by annual

age 6-11 years by annual family income: United States, lg63-65

States, 1966-70; with selected rates for Negro children

Medical history and family income

Defective acuity (parent)-youth

Wears glasses:

---------------------.-----------.----.

~~:J!J@gO -----------------------------------------.

-----.--.------------------------------,

Weara contacts:

Less than $5,000---------------------------------------

~;i:;::$:;999------------------------------------------

more----------------------------------------

Needs glasses:

Less than $5,000---------------------------------------

8?h~;~;$~l'~~re----.-------.----.--...--.--......-.--,

----------------------------------------- .

Defective acuity (youth)

Wears glasses:

Less than $5,000---------------------------------------

!ZA~Z;i$;;g;Zre............ ...........................

.....................--------------------.

Wears contacts:

Less than $5,000--...-.--..............................

$5,ooo-$9,999------------------------------------------

$10,000 or more----------------------------------------

With own lenses-seesas well as most:

Less than $5,000-..-...-.---..-...-----................

$;60:o-$%999-.........................----------------

, 00 or more----------------------------------------

Needs change:

- -------------------------------------

ffi;!y,:;j::o ---------------------------------------- -

, 00 or more----------------------------------------

Does not wear but needs glasses:

-------.------..-----------------------

~;::il;~~:” ......................-------------------.

.........------------------------------.

Other eye trouble ever

Parent:

.........------------------------------

gJ_#Q~g: -.-.---....................---------------

........--------------------------------

Yauth:

Less than $5,000-...-----------------------------------

~fd:;:i$:;9............................................

mOre----------------------------------------

Ever had operation on eyes:

~Jiy,fi,ooo ......................................

..........................................

or more----------------------------------------

Medical history and family income

Ever had eye operation:

Less than $5,000---------------------------------------

$:60:0-$9,999------------------------------------------

, 00 or more----------------------------------------

Special facility for visually handicapped needed:

---------------------------------------

;/gl)qJ;g” -----------------------------------------

----------------------------------------

Both sexes

12-17 12 13 14 15 16 17

years years years years years years years

21,0

24.3

33.9

0.5

16.1

7.5

5.0

22.2

27.1

36.6

89.6

92.9

86.7

39.6

45.0

39.8

20.3

13.6

25.3

13.3

9.s

5.9

8.3

8.4

11.7

0.5

1.8

1.6

19.0

25.8

15.6

11.4

10.9

10.1

23.7

29.5

30.6

82.1

89.3

S4.9

32.0

37.3

52.6

1;::

19.2

11.7

11.0

1::;

16.6

15.4

23.8

33.3

L.c

11.6

16.6

34.8

14.5

27.6

33.3

1:3.:

100:0

38.9

47.8

43.4

19.0

17.0

34.8

11.7

14.1

14.3

16.5

2.;

Rate per 100 Negro youths

16.5

25.5

42.3

0.8

19.4

4.7

14.4

23.5

42.3

92.7

95.6

100.0

44.8

46.3

23.2

21.6

14.5

35.0

10.9

14.4

S.3

7.4

1!::

i:;

Both sexes

22.0

20.7

21.0

15.8

2.8

27.3

22.2

21.0

84.8

100.0

57.8

46.6

52.4

50.0

27.1

12.7

25.5

13.5

2::;

9.9

J::

9.:

23.8

22.1

3s.2

1.2

16.4

4.1

22.0

29.2

38.2

97.0

100.0

100.0

40.1

28.2

19.3

22.7

5:::

8.7

3.2

7.9

5.7

1.9

7.6

0.8

32.2

30.0

51.8

26.6

4.3

33.7

32.1

51.8

91.0

90.4

80.6

38.0

64.5

56.9

:$.;

24.5

15.2

:;;

8.6

:::

6-11 6 7

years years years

, 1

8 9 10 11

years years years years

1 1 I

Rate per 100 Negro children

0.8 4.2 10.9 6.5 7.4

1::: - 5,4 11.0 17.3 15.9

13.4 - - - - 51.1

0.9 - 0.4 1.1

2.0 - 5.; - - ::;

1.8 - 0.7 2.4 0.9 2.6

1.5 - 3.1 - 2.4 3.8

I

BOYS Girls

12-17 12-17

years years

16.0

18.3

31.8

0.4

1:.g

11:3

16.0

22.7

35.1

8S.5

93.5

94.4

40.1

41.1

37.6

16.7

2$::

10.9

12.6

6.9

;::

13.0

0.4

3.6

3.7

Boys

6-11

7ears

26.o

30.5

35.4

0.6

19.3

12.2

28.3

31.9

37.7

90.5

94.0

S5.1

39.4

47.9

41.7

24.4

25.4

22.6

15.7

6.9

5.1

9.3

1::$

0.7

;irls

6-11

rears

10.2 6.9

8.9 1::;

2%?

ii

2.1 1.6 0.1

2.1 2.0

4.7 1.5 2.2

2.2 0.8
Table 34. Prevalence rates of tropia and other eye muscle problems at ages 12-17 years and 6-11

years among youths included in both surveys with population estimates for youths represented:

United States, 1966-70

Target population and

se+ected findings from

both examinations

U.S. noninstitut+onalized

population in 1968

Total (1,000’s)-----------------

Tqrget population for those in

both surveys (l,OOO’s)---------

Percent in both:

Total -------------------------

Boys-.....-.----------------.-

Girls-------------------------

------------------------Tropic findings

Total as youths 12-17 years-----

Total as children 6-11 years----

As both child and youth---------

As youth but pot child----------

As child but not youth----------

Other eye muscle problems

Total as youths 12-17 years-----

Total as children 6-11 years----

As both child and youth---------

As youth but not child----------

As child but not youth----------

Age at time of second examination

12-17

years

22,692

6,975

30.7

30.3

31.2

3.7

2.8

1.1

2.6

1.7

~:;

.

H

12

years

4,003

1,975

49.3

48.7

50.0

3.7

2.8

H

1.3

0.9

5.2

0.3

‘!::

Both sexes

13

years

3,952

2,034

51.5

51.3

51.6

14

years

3,851

1,949

50.6

48.9

52.4

15

years

3,750

972

25.9

25.5

26.4

16

years

3,625

45

1.2

H

17

years

3,511

Rate per 100 in both examinations

3.6

n

2.7

2.7

2.3

2.0

2.5

2.0

Boys

12-17

years

1,490

3,482

30.3

.

4.0

n

2.7

1.5

M

0.1

H

Girls

12-17

years

11,202

3,493

31.2

3.5

2.8

R

1.9

1.9

5.4

0.4

1.5

5.0

62
Table 35. Prevalence rates for wearing of glasses, history of eye operations,or history of other

eye trouble at ages 12-17 years and 6-11 years among youths included in

States, 1966-70

both surveys: United

Medical history item

reported by parent

as

Wore glasses or

contact lenses

Total as youths -----------------

Total as children ---------------

As both child and youth---------

As youth only-------------------

As child only-------------------

Ever have eye operation

ToEal as youths-----------------

Total as children ---------------

As both child and yotrth---------

As youth only-------------------

As child only-------------------

Ever have eye trouble

other than need for ~1asses

Total as youths-----------------

Total as children---------------

As both child and youth---------

As youth only-------------------

As child only-------------------

Age at time of second examination

Both sexes

Boys Girls

12-17 12-17

12-17 12 13 14 15 16 17 years years

years years years years years years years

Rate per 100 in both examinations

31.6

15.9

13.7

17.9

2.2

6.7

16.7

;:;

13.7

27.5

10.5

1::;

2.1

H

M

0.2

12:i

1.8

1;:2

32.4

16.1

14.5

17.9

1.6

1.2

:::

0.3

0.1

1%;

N

13.9

35.8

21.0

19.2

16.6

1.8

1.4

:::

8:2

1%2

2.1

3.3

14.9

30.3

16.3

11.5

18.8

4.8

:::

1.0

0.;

2!:;

::?

17.2

9.9

;:;

5.4

5.;

5.;

5.3

27.9

14.3

12.6

15.3

1.7

H

1.1

0.7

0.4

6.0

14.4

2.7

1::;

35.2

17.4

14.7

20.5

2.7

;:!)

0.9

0.1

1::$

2:;

15.6

63
APPENDIX I

STATISTICAL NOTES

The Survey Design

The sample design for the first three programs or

Cycles I-III of the Health Examination Survey has been

essentially similar in that each has been a multistage,

stratified probability sample of clusters of households

in land-based segments. The successive elements for

this sample design are primary sampling units, census

enumeration district, segment (a cluster of households),

eligible persons, and finally the sample person.

The same 40 sample areas and the same segments

were utilized in the design of both Cycles II and 111.

Previous reports describe in detail the sample design

used for CycIe II and in addition discuss the problems

and considerations given to other types of sampling

frames, cluster versus random sampling, and whether

or not to control the selection of sibIings.4 J

Requirements and limitations placed on the design

for both Cycles H and 111were that:

1. The target population be defined as the civilian

noninstitutional population of the United States,

including Alaska and Hawaii, between the ages of

6 and 11 years for Cycle H and between 12 and 17

years for Cycle III, with the special exclusion of

children residing on reservation lands of the

American Indians. The latter exclusion was due to

operational problems encountered on these lands in

Cycle I.

2. The time period of data collection be limited to

about 3 years for each cycle and the length of the

individual examination within the specially constructed mobile examination center be between 2

and 3 hours.

3. Ancillary data be collected on specially designed

household, medical history, and school questionnaires and from birth certificate copies.

4. Examination objectives be primarily related to

factors of physical and intellectual growth and

development.

5. The sample be sufficiently large to yield

reliable findings within broad geographic regions

and population density groups as well as age, sex,

and limited socioeconomic groups for the total

sample.

64

The sample was drawn jointly with the Bureau of

the Census starting with the 1960 decennial census list

of addresses and the nearly 1,900 primary sampling

units (PSLYS) into which the entire United States was

divided. Each PSU is either a standard metropolitan

statistical area (SMSA), a county, or a group of two

or three contiguous counties. These PSU’S were grouped

into 40 strata, so that each stratum having an average

size of about 4.5 million persons, in such a manner as

to maximize the degree of homogeneity within strata

with regard to the population size of the PSU’S, degree

of urbanization, geographic proximity, and degree of

industrialization. The 40 strata were than classified

into four broad geographic regions of 10 strata each

and then within each region, cross-classified by four

population density classes and classes of rate of population change from 1950 to 1960. Using a modified

Goodman-Kish controlled-selection technique, one PSU

was drawn from each of the 40 strata.

Further stages of sampling within PSU’S required

first the selection of census enumeration districts

(ED’s). The ED’s are small well-defined areas of about

250 housing units into which the entire Nation was

divided for the 1960 population census. Each ED was

assigned a “measure of size” equal to the rounded

whole number resulting from a “division by nine” of

the number of children, aged 5-9, in the ED at the time

of the 1960 census. A sample of 20 ED’s in the sample

PSU were selected by systematic sampling with each

ED having a probability of selection proportional to the

population of children 5-9 years at the time of the 1960

census date. A further random selection by size of

segments (smaller clusters of housing units) within

each ED was then made.

Because of the 3-year time interval between Cycle

II and Cycle III, the Cycle III frame had to be supplemented for new construction and to compensate for

segments where housing was partially or totally demolished to make room for highway construction or

urban redevelopment.

Advanced planning for the examinations at the

various locations or stands provided for about 17 days

of examinations which limited the number of examinees

per location to approximately 200. When the number of

eligible persons (children or youth) in the sample drawn
for a particular location exceeded this number, subsampling was done by deleting from the master list of

eligible persons (ordered by segment, household order

within segment, and age within household) every nth

name on the list starting with the ythname, ybeinga

number between 1 and n selected randomly and n being

the extent of oversampling in the original draw.

In both Cycle II and III twins who were deleted in

the sample selection, were also scheduled for examination, time permitting, as were youth deleted from

the Cycle III sample who had been examined in Cycle H.

The sample was selected in both Cycles 11and III

so as to contain the correct proportion of children from

families having only one eligible child, two eligible

children, and so on to be representative of the total

target population. However, since households were one

of the elements in the sample frame, the number of

related children or youth, in the resultant sample is

greater than would come from a design which sampled

children 6-11 or 12-17 years without regard to household. The resultant estimated meaw measurements or

rates should be unbiased but their sampling variability

will be somewhat greater than those from more costly,

time-consuming systematic sample design in which,

every kth child would be selected.

The total probability sample for Cycle II contained

7,417 children representative of the approximately 24

million United States children 6-11 years of age in the

target population at the time of the Survey while that

for Cycle HI included 7,514 youths similarly representative of the approximately 22.7 million noninstitutionalized U.S. youths of 12-17 years. Each of these

two samples contained children (or youth) from 25

different States and approximately 1,000 in each single

year of age.

The response rates in Cycles H and III were 96

and 90 percent, respectively, with 7,119 children and

6,768 youth examined out of the total sample. Both groups

of examinees were closely representative of their respective samples as well as the population from which

the samples were drawn with respect to age, sex, race,

region, population density, and population growth in

area of residence. Hence it appears unlikely that nonresponse could bias the findings appreciably.

Measures used to control the quality of thel $a~a

from these surveys have been cited previously ‘ ;

those additional measures specifically related to the

particular examinations, tests, or measurements are

outlined in the analytic reports describing and presenting the respective initial findings.

Reliability

While measurement processes in the surveys were

carefully standardized and closely controlled; the correspondence between the real world and Survey results

cannot be expected to be exact. Survey data are imperfect for three major reasons: (1) results are subject to sampling error, (2) the actual conduct of a survey never agrees perfectly with the design, and (3) the

measurement processes themselves are inexact even

though standardized and controlled.

The first reports on Cycles 114and III 5 describe

in detail the faithfulness with which the sampling design

was carried out.

Data recorded for each sample child and youth are

inflated in the estimation process to characterize the

larger universe of which the sample child or youth is

representative. The weights used in this inflation

process are a product of the reciprocal of the probability

of selecting the child or youth, an adjustment for nonresponse cases, and a poststratified ratio adjustment

which increases precision by bringing survey results

into closer alignment with known U.S. population

figures by color and sex within single years of age 6

through 11 for the children’s survey and age 12 through

17 for the youth’s survey.

In the second and third cycles of the Health Examination Survey the samples were the result of three

principal stages of selection—the single PSU from each

stratum, the 20 segments from each sample PSU, and

the sample children and youth from the eligible persons.

The probability of selecting an individual child or youth

is the product of the probability of selection at each

stage.

Since the strata are roughly equal in population

size and a nearly equal number of sample children or

youth were examined in each of the sample PSU’S, the

sample design is essentially self-weightirg with respect

to the target population; that is, each child 6-11 years

old and youth 12 through 17 yeara had about the same

probability of being drawn into the respective samples.

The adjustment upward for nonresponse is intended

to minimize the impact of nonresponse on final estimates by imputing to nonrespondents the characteristics

of “similar” respondents. Here “similar” respondents

were judged to be examined children or youth in a

sample PSU having the same age (in years) and sex as

children or youth not examined in that sample PSU.

The poststratified ratio adjustment used in the

second and third cycles achieved most of the gains in

precision which would have been attained if the sample

had been drawn from a population stratified by age,

color, and sex and made the final sample estimates of

population agree exactly with independent controls prepared by the Bureau of the Census for the noninstitutional

population of the United States as of August 1, 1964

(approximate midsurvey point for Cycle H) by color and

sex for each single year of age 6-11; and similarly as

of March 9, 1968 (approximate midsurvey point for

Cycle III) for each single year of age 12-17. The weight

of every responding sample child and for each sample

youth in each of the 24 age, color, and sex classes is

adjusted upward or downward so that the weighted total

within the class equals the independent population control for each survey.

65
In addition to children or youth not examined at all,

there were some whose examination was incomplete in

one procedure or another.

Sampling and Measurement Error

In the present report, reference has been made to

efforts to minimize bias and variability of measurement

techniques.

The probability design of the survey makes possible

tie calculation of sampling errors. The sampling error

is used here to determine how imprecise the survey

test results may be because they come from a sample

rather than from the measurements of all elements in

the universe.

The estimation of sampling errors for a study of

the type of the Health Examination Survey is difficult

for at least three reasons: (1) measurement error

and “pure” sampling error are confounded in the data—

it is not easy to find a procedure which will either

completely include both or &eat one or the other

separately, (2) the survey design and estimation procedure are complex and accordingly require computationally involved techniques for the calculation

of variances, and (3) from the survey are coming

thousands of statistics, many for subclasses of the

population for which there are a small number of

cases. Estimates of sampling error are obtained from

the sample data and are themselves subject to sampling

error which may be large when the number of cases in

a cell is small or even occasionally when the number

of cases is substantial.

Estimates of approximate sampling variability for

selected statistics used in this report are included in

the detailed tables. These estimates have been pre.

pared by a replication technique which yields overall

variability through observation of variability among

random subsamples of the total sample. The method

reflects both “pure” sampling variance and a part of

the measurement variance.

In accordance with usual practice, the interval

estimate for any statistic may be considered the range

within one standard error of the tabulated statistic with

68-percent confidence; or the range within two standard

errors of the tabulated statistic with 95-percent confidence. The latter is used as the level of significance

in this report.

An approximation of the standard error of a difference d=x.y of two statistics x and y iS given by the

L J

formula S~= S z + S 2 ~ where SXand S, are the sampling errors, respectively of x and Y. Of course,

where the two groups or measures are positively or

negatively correlated, this will give an overestimate

or underestimate, respectively, of the actual standard

error.

Small Numbers

In some tables magnitudes are shown for cells for

which the sample size is so small that the sampling

error may be several times as great as the statistic

itself. Obviously in such instances the statistic has no

meaning in itself except to indicate that the true quantity

is small. Such numbers, if shown, have been included

in the belief that they may help to convey an impression

of the overall story of the table.

000

66
APPENDIX II

DEMOGRAPHIC AND SOCIOECONOMIC TERMS

Age.—The age recorded for each youth was the age

last birthday on the date of examination. The age

criterion for inclusion in the sample used in this survey was defined in terms of age at time of interview.

Since the examination usually took place 2 to 4 weeks

after the interview, some of those who were 17 years

old at the time of interview became 18 years old by the

time of examination. There were 23 such cases. In the

adjustment and weighting procedures used to produce

national estimates, these 23 were included in the 17

year group.

Race.— Race was recorded as “white,” “Negro,”

or “Other races.” The last category included American

Indians, Chinese, Japanese, and all races other than

white or Negro. Mexican persons were included with

“white” unless definitely known to be American Indian

or of another race. Negroes and persons of mixed

Negro and other parentage were recorded as “Negro.”

Geog?’aphic veg”on.— For purposes of stratification

the United States was divided into four geographic

regions of approximately equal population. These

regions, which correspond closely to those used by

the U.S. Bureau

Re@”on

Northeast -------

of the Census, were as follows:

States Included

Maine, Vermont, New Hampshire,

Massachusetts, Connecticut,

o (

Re@”on

Northeast-Con---

Midwest --------

South -----------

States Included

Rhode Island, New York, New Jersey,

and Pennsylvania.

Ohio, Illinois, Indiana, Michigan,

Wisconsin, Minnesota, Iowa, and

Missouri.

Delaware, Maryland, District of

Columbia, West Virginia, Virginia,

Kentucky, Tennessee, North

Carolina, South Carolina, Georgia,

Florida, Alabama, Mississippi,

Louisiana, and Arkansas.

West ------------ Washington, Oregon,

California, Nevada, New Mexico,

Arizona, Texas, Oklahoma, Kansas,

Nebraska, North Dakota, South

Dakota, Idaho, Utah, Colorado,

Montana, Wyoming, Alaska, and

Hawaii.

Family Income.— The income recorded was the

total income received during the past 12 months by the

head of the household and all other household members

related to the head by blood, marriage, or adoption.

This income was the gross cash income (excluding pay

in kind) except for families with their own farms or

businesses, in which cases net income was recorded.

67
APPENDIX Ill

RECORDING FORMS

Physical Examination–’Youth

HEALTH EXAMINATION SURVEY-III

PHYSICA1 EXAMINATION - youT~I

EYES: A, LIDS, CONJUNCTIVAL AND SCLERAE

R L

la 1 ❑ NO FINDINGS

2D 2 ❑ FINDINGS ~

Describe:

C. TROPIA (indicate direction)

NORMAL IN OUT UP

D. EXTRAOCULAR

DOWN R L

5D lU 1 ❑ NORMAL

B. PUPILS AND IRIDES

R L

lo 1❑ NO FINDINGS

2D 2 ❑ FINDING$ (D.’~ri~)

I

MUSCLES AND CONJUGATE GAZE

I

I

~ Describe:

1 lo 2U an 4U So 2D

i

2 ❑ ABNORMAL ~ ~

E. OTHER EYE ABNORMALITIES lnNo 2 ❑ W5 (Describe)
Physical Examination–Child

HEALTH EXAMINATION SURVEY—II

PHYSICAL EXAM INATION : ~HILDREN CARD 04-1

EYES

(11) ❑ 1 No findings ❑ 2 Findings

FINDINGS

(12) ❑ 1 Stye (13) ❑ 1 Conjunctivitis (14) ❑ 1 Blepharitis

(15) ❑ 1 Strabismus (indicate type—location and tests positive)

(16) Manifest–R: D 1 IN ❑ 20uT D3uP IJ4DoWN

(17) L,DIIN n20uT D3uP ❑ 4DoWN

(18) Latent– R: ❑ 1 IN ❑ 20uT ❑ 3UP D4 DOWN

(19) L:DIIN l_J20uT ❑ 3uP ❑ 4DoWN

FINDINGS ON: (20) ❑ 1 Observation (21) ❑ 1 Moving light

(22) ❑ 1 H irschberg test (23) ❑ 1 Screen test

(24) ❑ 1 Other (Specify) --------------------------------------------------------------------------------------------------------- PHYS.

EXAM.

+ B.P.

1“

69
Medical History of Youth

PHS 4733-4 (Page 1) FORM APPROVED

REV. 3/66 BUDGET BUREAU NO, 68-R1700

CONFIDENTIAL - All information which would permit identification of tbeindividual will beheld strictly

confidential, will be used only by persons engagedin and for the purposes of the survey and wilI not

be disclosed or released to others for any other purposes (22FR 1687).

DEPARTMENT OF

HEALTH, EDUCATION, AND WELFARE

PUBLIC HEALTH SERVICE

NATIONALHEALTH SURVEY

MEDICAL HISTORY OF YOUTH

Parent’s Questionnaire Y

NAME OF CHILD (Last, First, MiddZe) “1 SEGMENT SERIAL COL. NO.

1 I I

NOTE: Please answer the questions by checking the correct boxes or by filling in the blanks,

as ;equired. If a question is unclear leave the answer blank and draw a line around the question. A representative of the Public Health Service will collect your filled in questionnaire

in a few days and she will help you answer the unclear questions. Thank you for your

cooperation.

22. Does he or she wear glasses or contact lenses?

23.

24.

, ❑ yes, glasses

z ❑ No, don’t wear either

IF NO: Do you think he or

3 I_.1Yes, contact lenses

she needs glasses?

‘3❑ Don;t know

Has he or she ever had eye trouble (except what is corrected by gtasses or contact tenses)?

1

7

Yes ZDNO

IF YES: What was it?

Has he or she ever had an eye operation?

1

T

Yes ,DNo

IF YES: What was it for?

70
Health Habits and History-Youth

lW#-:733-6 (PAGE 1) FORM APPROVED

. BUDGET BUREAU NO.6S-R62W4

CONFIDENTIAL - All information wbicb would permit identification of tbe individual wilt be beid

strictly confidential, will be used only by persons engaged in and for tbe purposes of tbe survey and

will not be disclosed or released to others for any other purposes (22 FR 1687).

DEPARTMENT OF HES

HEALTH, EDUCATION, AND WELFARE

PUBLIC HEALTH SERVICE

NATtONAL HEALTH SURVEY Sample No.

HEALTH HABITS AND HISTORY - Youth

Name (Last, First, Middle) SEGMENT SERIAL COL.NO.

INSTRUCTIONS: On the following pages you will find a set of questions dealing with

your health. Since every person is different, there are no “standard” answers to the

questions; just answer them as fully and honestly as you can. Your answers will be

kept confidential. Do your best to pick the most likely answer from among the choices

given. Only if you really don’t know the answer check “Don’t know. ”

HERE ARE A FEW QUESTIONS ABOUT YOUR EYES AND EARS.

12. DO you ever wear glasses or contact lenses?

1 •l Yes, glasses

30No

2 •l Yes, contact lenses

IF YES: IF NO:

a. With your glasses aa. Do you think you

(or contact lenses) need glasses?

can you see as well

as most people? 1 ❑ Yes 20No

1 •l Yes 20No

b. Do you think you need new glasses?

1 •l Yes 20No

c. When do you wear them?

1 ❑ Not all day 2 ❑ AH day

71
d. IF NOT ALL DAY: When?

1 ❑ For seeing at a distance

(Check gZJ that apply)

2 ❑ For reading

3 ❑ For TV

4 H Other (Specify)

13. Is there anything

contact lenses)?

1 U Yes

wrong with your eyes (except what is

20No

corrected tIy your gi!asses or

a. IF YES: What?

72
Child’sMedicalHistory

CONFIDENTIAL - The National ffeultb Survey is authorized by Public Law 6.52 of “ FORhi APPROVEC.

the 84th Congress (70 Stat. 489; 42 U.S. C. 242c). All information which WOU~~

BUDGET BUREAU NO. 68-R620-S4.6

permit identification oft be individua! will be held strictly confidential, will be used only by persons enguged in

and for the pu+oses of the survey and will not be disclosed or released to others {or any other purposes (22 FR 1687).

DEPARTMENT OF HES-25 6

HEALTH. EDUCATION. AND WELFARE

PUBLIC HEALTH-SERVICE

NATIONAL HEALTH SURVEY

(1-s)

CHILD’S MEDICAL HISTORY - Parent

NAME OF cHILD (Lust, First, Miaiile) SEGMENT SERIAL COL. NO.

(6-1 1)

NOTE: Please complete this form by checking the correct boxes and/or filling in the blanks where applicable.

When you have completed it, keep it until the representative of the Health Examination Survey calls on you

within a few days. If there are some questions you do not understand, please complete the others and the person who

comes for the form wi H help you with the ones that were unclear.

41. HERE ARE SOME QUESTIONS ABOUT YOUR ClilLD”S EYES.

A.

(t 0)

B.

(so)

Has he(she) ever ‘had crossed eyes?

t m Yes 20N0 s o Don’t know

Has he(she) ever had an operation on his(her) eyes?

i n Yes 2cIN0 g o Don’t know

IF YES, what was it for?

C. Has he(she) ever had other trouble with his(her) eyes?

t n Yes 213N0 .Su Don’t kno~

IF YES, what kind of trouble? .

D. Does he(she) wear either glasses or contact lenses?

I D Yes 20N0 3 n Don’t know

42. IF tiE(sHE) DOES NOT WEAR GLASSES:

A.

[2s)

B.

c.

D.

Does he(she) ever have trouble reading or doing fine work?

1 n Yes 20N0 3 H Don’t know

Do his(her) eyes or eyelids ever swell up or get red?

t O Yes 2mNo 3 u Don’t know

Does he(she) ever have styes, infections, or ‘matter’ in his(her) eyes?

1 n Yes 20N0 3 0 Don’t know

Do his(her) eyes often water?

1 n Yes 20N0 3 u Don’t know

73
E. Are his(her) eyes often bloodshot?

1 n Yes 2uN0 s o Don’t know

F. Does he(she) ever say that his(her) eyes burn or itch?

l. OYes 20N0 a u Don’t.know

G. Does bright light bother his(her) eyes?

(29) f ~ Yes 2uN0 a u Don’t know

H. Does he(she) ever see double or see things blurred?

(90) i m Yes 2uN0 s n Don’t know

I. Have you seen him(her) often rub his(her) eyes or blink when he(she) is reading?

t a Yes 20N0 s u Don’t know

J. Does he(she) sometimes close or cover one eye or hold his head on one side when Iid(she)

reads or watches T. V.?

1 n Yes 213N0 a a Doh’t kllOW

74
Supplemental Information from School

The student whose name appears below is o,ne of the sample of students being studied in the Health Examination Survey.

This student’s parent or guardian has given us written authorization to obtain information from the school. Please complete this form on the basis of school records and/or information the student’s teacher or other school officrd may have.

A pre-addressed enveIope, requiring no postage, is fiumished for your convenience in returning this form.

RESOURCE NEEDED I REASON FOR NON-USE

SPECIAL

RESOURCE

g, Special facilities for

the visually handicapped

BEING

USED

(Check one) I

(Check primary reason)

NOT AVAILABLE

BUT OVERAVAILABLE

STUDENT PARENTS

CROWDED OBJECTS OBJECT OTHER (Specify)

NOT USED

* U. S, GOVEMMENT PRINTRJG OFFICE :1975 ZI&9SI/Z3

75
-1

series1.

Series 2.

Series 3.

Series 4.

VITAL AND HEALTH STATISTICS PUBLICATIONS SERIES

Formerly fiblic Health Service Publication No. 1000

Programs and Collection Bocedures. –Reports which describe the general programs of the National

Center for Health Statistics and its offices and divisions, data collection methods used, definitions, and

other material necessary for understanding the data. ●

Data Evaluation and Methods Research. –Studies of new statistical methodology including experimental

tests of new survey methods, studies of vital statistics collection methods, new analytical techniques,

objective evaluations of reliability of collected data, contributions to statistical theory.

Analytical Studies. –Reports presenting analytical or interpretive studies based on vital and health

statistics, carrying the analysis further than the expository types of reports in the other series.

Documents and Committee ReOorts. –Final reDorts of maior committees concerned with vital and

health statistics, and documen~s such as recommended mo~el vital registration laws and revised birth

and death certitleates.

Series 10. Data from the Health Interview Survey. –Statistics on illness; accidental injuries; disability; use of

hospital, medical, dental, and other services; and other health-related topics, based on data collected in

a continuing national household interview survey.

Series 11. Data from the Health Examination Survey. –Data from diiect examination, testing, and measurement

of national samples of the civilian, non institutionalized population provide the basis for two types of

reports: (1) estimates of the medically defined prevrdence of specific diseases in the United States and

the diatsibutions of the population with respect to physical, physiological, and psychological characteristics; and (2) analysis of relationships among the various measurements without reference to an

explicit finite universe of persons.

.%n”es 12. Data from the Institutionalized Population Survey s.–Discontinued effective 1975. Future reports from

these surveys will be in Series 13.

Series 13. Data on Health Resources Utilization. –Statistics on the utilization of health manpower and facilities

providing long-term care, ambulatory care, hospital care, and family planning services.

Series 14. Data on Health Resources: Manpower and Faciliti.es. -Statistics on the numbers, geographic distrib~

ution, and characteristics of health resources including physicians, dentists, nurses, other health occupations, hospitals, nursing homes, and outpatient facilities.

Series 20. Data on Mortality .-Various statistics on mortality other than as included in regular annual or monthly

reports. Special analyses by cause of death, age, and other demographic variables; geographic and time

series analyses; and statistics on characteristics of deaths not available from the vital records, based on

sample surveys of those records.

Series 21. Data on Natality, Mum-age, and Divorce. –Various statistics on natality, marriage, and divorce other

than as included in regular annual or monthly reports. Special analyses by demographic variables;

geographic and time series analyses; studies of fertility; and statistics on characteristics of births not

available from the vital records, based on sample surveys of those records.

Series 22. Data from the National Mortality and Natality Surveys. –Discontinued effective 1975. Future reports

from these sample surveys based on vital records will be included in Series 20 and 21, respectively.

Series 23. Datu from the National Survey of Family Gro wth. –Statistics on fertility, family formation and dissolution, family planning, and related maternal and infant health topics derived from a biennial survey of

a nationwide probability sample of ever-married women 1544 years of age.

,~or a list of titles of reports published in these series, write to: Scientific and Technical Information Branch

National Center for Health Statistics

Public Health Service,

Rockville, Md. 20852

HRA

/’”

‘.‘,