© 2015 Wichtg Publishing EJO ISSN 1120-6721 Eur J Ophthalmol 2016; 26 (4): 379-384 Original article (9), Southern China (10, 12), Malaysia (11), Brazil (13), and Iran (14). Other studies carried out in Australia, Brazil, Chile, China, Ghana, India, Lao PDR, Mexico, Sweden, United Kingdom, and United States followed a diferent protocol (15-36), indicatng that in these countries, even if with a diferent prevalence, the correcton of refractve defect is a health problem. It has been stated that there are no recent data on VI in the high-income European countries (2), and that children from a European Caucasian background remain distnctly underrep- resented in existng surveys (19). In fact, only one study has been performed recently in the United Kingdom (25). Due to this absence of recent data on the prevalence of VI in Italian children, we studied refractve errors in children 5 to 16 years of age. Methods It was deemed important to analyze ophthalmic data recently collected by Associazione per l’Assistenza Sanitaria Integratva ai Lavoratori delle Aziende del Gruppo Telecom Italia (the Associaton for Supplementary Health Insurance to the Employees of Telecom Companies) (ASSILT). A campaign of preventve medicine in ophthalmology was implemented by ASSILT between November 2011 and January 2012, in rela- tves of members aged 5 to 16 years old, residing in all the DOI: 10.5301/ejo.5000733 Prevalence and risk factors of vision impairment among children of employees of telecom, italy carlo nucci 1 , Vincenza Cofni 2 , Rafaele Mancino 1 , Federico ricci 1 , alessio Martucci 1 , Maria rosita cecilia 2 , Vincenzo ciciarelli 3 , Francesca Zazzara 2 , claudio cedrone 1 , Ferdinando di Orio 2 1 Ophthalmology Unit, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome - Italy 2 Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila - Italy 3 Ophthalmology Clinic, Department of Medicine and Aging Sciences, University G d’Annunzio Chiet-Pescara, Chiet - Italy Introducton Vision impairment (VI) was initally defned based on best-corrected visual acuity (BCVA); later, according to the Internatonal Classifcaton of Diseases (ICD) Update and Re- vision 2006 (1), low vision and blindness have been defned by presentng visual acuity (VA). The WHO recently est- mated a prevalence of 17.5 million children aged 0-14 years with presentng low vision and 1.4 million with blindness worldwide (2). The Refractve Error Study in Children (RESC) (3) also mea- sured the prevalence of VI in children aged 5-15 years (4-6). The RESC protocol was adopted later in India (7, 8), South Africa abstract Purpose: To defne the prevalence, causes, and risk factors of vision impairment (VI) in children. Methods: In this study, relatves of Associaton for Supplemental Health Insurance to the Employees of Telecom members aged 5-16 years were examined in all Italian regions. A standardized record card was used to collect data on medical history; keratometry; objectve refracton; uncorrected, presentng, and best-corrected visual acuity (VA); examinaton of the pupils, adnexa, and anterior segment; direct ophthalmoscopy; posterior segment and fundus examinaton; and assessment for ocular pathology. Binocular and monocular VI were defned by a VA <5/10 (or <20/40). results: The campaign included 17,508 children, 12,798 of whom (73.1%) were examined (and 12,740 on whom all VA data were gathered). The prevalence of uncorrected, presentng, and best-corrected VI in the beter eye was 9.0%, 2.51%, and 0.10%, respectvely. The following variables were associated with presentng VI: age 10-16 years, family history of myopia, female sex, family history of keratoconus, and hypertension. Myopia is the main cause of VI (82.6%). A total of 96% of children with presentng VI had correctable VI. conclusions: Correctable VI because of myopia is an important public health problem in school-age children in Italy. Keywords: Children, Prevalence, Severe impairment, Vision impairment accepted: November 30, 2015 Published online: December 29, 2015 corresponding author: Carlo Nucci, MD, PhD Ophthalmology Unit Department of Experimental Medicine and Surgery University of Rome Tor Vergata Via Montpellier 1 00133 Rome, Italy nucci@med.uniroma2.it