Myopia in Singapore kindergarten children.

PURPOSE: The purpose of this study was to examine whether close-up work was related to myopia in Singapore kindergarten children. METHODS: One hundred twenty-eight children, ages 3 to 7 years, from a kindergarten in Singapore were examined by cycloplegic autorefraction. The parents also completed a questionnaire on the different types of close-up work activities each child was engaged in, socioeconomic status, and parental history of myopia. RESULTS: Myopic children spent 3.0 hours per day (median) on close-up work activity, while nonmyopic children spent 2.0 hours per day (median) on close-up work activity. The prevalence of myopia in the sample was 8.6%. CONCLUSION: Close-up work activity was not related to myopia in pre-school children.     

厦门地区城市与农村儿童近距离用眼与近视的关系

目的 :调查中国厦门城市与农村 8～ 9岁儿童近视的患病情况 ,并以此评估环境因素对近视患病率的影响。方法 :对中国厦门城市 (n =119)和农村 (n =91)的小学二年级学生进行散瞳电脑验光和眼生物参数测量 ,并采用同一标准的调查表进行面对面地问卷调查 ,内容包括社会经济地位、近距离用眼活动情况、读写习惯、近视眼家族史等。结果 :近视的发病率在城市为 19.3% [95 %可信区间confidenceinterval(CI) :12 .3,2 9],在农村是 6 .6 % (95 %CI:2 .4 ,14 .3)。城市在校学生每天课外读写平均时间是 2 .2h ,农村学生的收稿日期 :2 0 0 2 -0 3 -14 ;修回日期 :2 0 0 2 -0 5 -0 8基金项目 :新加坡政府及厦门开元区科委资助项目。作者简介 :张铭志 (195 7-) ,女 ,山东费县人 ,医学硕士 ,副主任医师。研究方向 :白内障、青光眼、近视。通信作者 :张铭志 (E -mail:fu- zhifu @hotmail.com)。时间是 1.6h(P <0 .0 0 1) ,所得结果经近视眼家族史因素校正后 ,总体读写时间比值比为 2 .2 (95 %CL :1.1,4 )。结论 :近视眼发病率 ,城市高于农村。城市儿童的课外读书时间比农村儿童长 ,城市和农村的近视儿童在读书上花费的时间明显高于非近视儿童。近距离用眼的增多可能导致了近视眼的发生 ,这为近距离用眼学说提供了更多依据     

Relation between work and myopia in Singapore women.

BACKGROUND: Work and related activities may be connected to myopia development and progression. We investigated the relationship between working activities and the onset as well as worsening of myopia. METHODS: Information on the working status of the mothers of 374 children, the number of hours of close-up work activity, and whether the mother was short-sighted, was obtained by a face-to-face interview. In addition, a subsample of 84 mothers was interviewed over the telephone and asked whether the myopia occurred in adulthood and, if so, the age of cessation of myopia. RESULTS: The adjusted odds ratio for myopia in working women was 1.9 [95% confidence interval (CI) 1.2 to 3.2] and the adjusted odds ratio for high myopia (> -6.0 D) was 1.6 (95% CI 0.8 to 3.0). Women who were working also had higher rates of adult-onset myopia, odds ratio 4.4 (95% CI 0.9 to 21.2), and a later age of cessation of myopia than nonworking women. CONCLUSIONS: In our study, work was related to myopia in Singapore women. Work may be a surrogate for another risk factor, close-up work activities such as reading, writing, and computer use.     

Nearwork in early-onset myopia

PURPOSE: To determine the relationship of nearwork and myopia in young elementary school-age children in Singapore. METHODS: A cross-sectional study of 1005 school children aged 7 to 9 years was conducted in two schools in Singapore. Cycloplegic autorefraction, keratometry, and biometry measurements were performed. In addition, the parents completed a detailed questionnaire on nearwork activity (books read per week, reading in hours per day and diopter hours [addition of three times reading, two times computer use, and two times video games use in hours per day]). Other risk factors, such as parental myopia, socioeconomic status, and light exposure history, were assessed. RESULTS: In addition to socioeconomic factors, several nearwork indices were associated with myopia in these young children. The multivariate adjusted odds ratio of higher myopia (at least -3.0 D) for children who read more than two books per week was 3.05 (95% confidence interval [CI], 1.80-5.18). However, the odds ratios of higher myopia for children who read more than 2 hours per day or with more than 8 diopter hours (1.50; 95% CI, 0.87-2.55 and 1.04; 95% CI, 0.61-1.78, respectively) were not significant, after controlling for several factors. CONCLUSIONS: Children aged 7 to 9 years with a greater current reading exposure were more likely to be myopic. This association of reading and myopia in a young age cohort was greater than the strength of the reading association generally found in older myopic subjects. Whether these results identify an association of early-onset myopia with nearwork activity or other potentially confounding factors is discussed.     

Exposición al aire libre en niños de la Provincia de Buenos Aires,Argentina

ObjectivesTo evaluate myopia risk factors, mainly outdoor exposure and reading habits, in a country with low prevalence of myopia (Buenos Aires Province, Argentina).MethodsConsecutive children interviewed in a clinical private practice setting were autorefracted under cycloplegia with cyclopentolate 1%. Their parents consented to fill a questionnaire about schooling, tutorial classes, outdoor exposure, reading habits, and cellphone use, both on weekdays and weekends. The Spanish questionnaire was based on past English questionnaires of myopia clinical trials. The spherical equivalent of the right eye was used for the refractive distribution. The average daily hours spent for each activity were calculated.ResultsThis study involved 115 children aged 10.48±3.65 years (range 5 to 18 years), with 56.5% being girls. Children had 8 h of schooling per day in 62.6% of cases, and only 14.8% had tutorial classes after school. There were 38.3% myopes (< ?0.50 D), 24.3% hyperopes (> +2.00 D) and the rest were emmetropes. The mean time that these children spent outdoors per day was 3.94±1.45 hs. (27.60±10.16 hs. per week). The total mean time spent reading and writing per day was 1.50±0.98 h, and that spent using cellphones and tablets was 2.43±1.66 h.ConclusionIn an environment with low myopia prevalence, children spend almoast 4 hours per day outdoors, much more than the usual recommendation of 2 hours a day for myopia prevention.     

Parental myopia,near work,school achievement,and children's refractive error

PURPOSE: To quantify the degree of association between juvenile myopia and parental myopia, near work, and school achievement. METHODS: Refractive error, parental refractive status, current level of near activities (assumed working distance-weighted hours per week spent studying, reading for pleasure, watching television, playing video games or working on the computer), hours per week spent playing sports, and level of school achievement (scores on the Iowa Tests of Basic Skills [ITBS]) were assessed in 366 eighth grade children who participated in the Orinda Longitudinal Study of Myopia in 1991 to 1996. RESULTS: Children with myopia were more likely to have parents with myopia; to spend significantly more time studying, more time reading, and less time playing sports; and to score higher on the ITBS Reading and Total Language subtests than emmetropic children (chi(2) and Wilcoxon rank-sum tests; P < 0.024). Multivariate logistic regression models showed no substantial confounding effects between parental myopia, near work, sports activity, and school achievement, suggesting that each factor has an independent association with myopia. The multivariate odds ratio (95% confidence interval) for two compared with no parents with myopia was 6.40 (2.17-18.87) and was 1.020 (1.008-1.032) for each diopter-hour per week of near work. Interactions between parental myopia and near work were not significant (P = 0.67), indicating no increase in the risk associated with near work with an increasing number of parents with myopia. CONCLUSIONS: Heredity was the most important factor associated with juvenile myopia, with smaller independent contributions from more near work, higher school achievement, and less time in sports activity. There was no evidence that children inherit a myopigenic environment or a susceptibility to the effects of near work from their parents.     

Risk Factors for Developing Myopia among Schoolchildren in Yerevan and Gegharkunik Province,Armenia

Purpose: Myopia is a complex condition leading to visual impairment and blindness. This study assessed the prevalence of and risk factors for myopia among schoolchildren in urban and rural areas of Armenia.

Methods: A cross-sectional interviewer-administered survey together with eye screenings was conducted among schoolchildren in the capital Yerevan and in Gegharkunik Province. The study used multi-stage random sampling to obtain the sample of 1260 schoolchildren. Study questionnaires were developed based on the Sydney Myopia Study questionnaire. Continuous reading was defined as the average number of hours spent reading or on near work without a break. Children underwent measurements of visual acuity using a Golovin-Sivtsev eye chart, cycloplegic retinoscopy, and dilated fundus examination.

Results: The mean age of the children was 13 years, and myopia was present in 18.1%. The prevalence of myopia was higher among Yerevan children (23.3%) than those living in Gegharkunik Province (12.5%). In the adjusted model, myopia was significantly associated with age (odds ratio, OR, 1.11, 95% confidence interval, CI, 1.04–1.18), region (OR 2.40, 95% CI 1.62–3.57), school achievement (OR 1.62, 95% CI 1.05–2.51), parental myopia (OR 2.89, 95% CI 1.79–4.69), and continuous reading (OR 1.99, 95% CI 1.31–3.02), but not near work (OR 0.97, 95% CI 0.89–1.05).

Conclusion: The study found that a positive family history of myopia and environmental factors had independent associations with myopia. The number of near work hours did not play a major role in the development of myopia, but length of time of focused continuous reading did.     

A randomized trial of rigid gas permeable contact lenses to reduce progression of children's myopia

PURPOSE: To test whether rigid gas permeable (RGP) contact lens wear can reduced the rate of myopia progression in school age children. DESIGN: Randomized clinical trial. METHODS: SETTING: Single clinical center. STUDY POPULATION: Both eyes of 428 Singaporean children. INCLUSION CRITERIA: 6 through 12 years of age with myopia between -1 and -4 diopters, astigmatism 相似文献   

Comparison of measurements of time outdoors and light levels as risk factors for myopia in young Singapore children

Aims

To compare methods to measure time outdoor and light levels, two possible predictors of myopia, in Singapore children.

Methods

Outdoor time from a diary and portable light meter over a 1-week period was compared in 117 Singapore children aged 6–12 years with and without myopia. All children wore a (HOBO Pendant temp/light Part # UA-002-64) light meter for 1 week and the parents filled the 7-day outdoor diary to track the outdoor activity.

Results

Mean outdoor time from diary and time with light levels was 5.44 hours per week and 7.91 hours per week, respectively, during school term and school holidays. Time spent with light levels of >1000 Lux from the light meter were 7.08 h per week and 9.81 h per week, respectively, during school term and school holidays. The intraclass correlation coefficients were 0.21 and 0.28 for outdoor time from the diary and light meter (1000 Lux cut-off) during the school term and holidays, respectively. The correlation coefficient was 0.34 (95% CI 0.05, 0.58) for a weekday during school holidays, 0.17 (−0.14, 0.45) for a weekday during school term, 0.07 (−0.16, 0.29) for a weekday during school term, and 0.25 (0.02, 0.46) for a weekend during school term.

Conclusions

The agreement between the light meter and 1-week diary was poor to fair. Both instruments measure different parameters, time outdoors and light intensity, and could therefore capture different aspects of risk in future myopia studies.     

学龄前儿童屈光状态影响因素分析

目的探讨视近活动、户外活动和饮食习惯对学龄前儿童屈光状态的影响。方法对象为在我院健康体检的儿童共690名,年龄3~6岁。双眼屈光度检查用Suresight自动屈光筛查仪在自然状态下完成,将球镜屈光度≤+0.75D列为近视眼可能者。受检儿童家长填写调查问卷,问卷内容包括儿童每日在家参与的主要的视近活动时间(读写画画、看电视、电脑游戏)、每日户外活动时间和儿童饮食习惯(甜食、肉类和奶类、蔬菜和水果)。计算总视近强度(屈光度小时)。采用SPSS 11.5软件进行统计学分析,用Logistic回归模型分析近视眼可能者的危险因素。结果共收回有效问卷501份,其中男271名,女230名。左右眼近视眼可能的百分比分别为14.4%和16.0%,两眼间无统计学差异。女童中近视眼可能者的百分比为20%,而男童为12.5%,单因素Logistic回归模型显示女童为近视眼可能的危险是男童的1.74倍(P=0.024,OR:1.743,95%CI:1.075~2.826);户外活动可以降低发展为近视眼可能者的危险(P=0.035,OR:0.683,95%CI:0.479~0.973);各种视近活动均与屈光状态无关,总视近强度与屈光状态也无关(P=0.378,OR:0.949,95%CI:0.845~1.066);饮食习惯与屈光状态无关。多因素Logistic回归模型显示去除性别、总视近强度和户外活动的交互作用后,女童为近视眼可能者的危险仍高于男童,而户外活动与屈光状态无关。结论在学龄前儿童中,女童为近视眼可能者的危险较男童高,环境因素对此年龄段儿童的屈光状态影响小。     

Levels of agreement between parents' and children's reports of near work

purpose To assess whether parents and children report the same information regarding children's near vision activities when given similar questionnaires. methods Data from questionnaires administered to 406 children and their parents were analyzed to evaluate the agreement between parent and child reports. The questionnaires were completed during the 1994 testing of the Orinda Longitudinal Study of Myopia. Each child and parent was asked to categorize how often the child reads for pleasure. In addition, each subject was asked to estimate how many hours per week were spent in each of five visual activities. The weighted kappa statistic, paired t-tests, and polytomous logistic regression were used for analyses. results A weighted kappa = 0.42 (moderate agreement) was found in the comparison of child-reported vs. parent-reported classification of reading. Agreement between parent- and child-reported number of hours spent doing homework (0.21), reading for pleasure (0.31), watching television (0.31), playing video games (0.31), and engaging in sports/outdoor activities (0.26) was fair for each activity. conclusions Although the results indicate fair to moderate levels of agreement, better methods of reporting near-work activities are needed for future myopia research.     

广东省汕尾市城乡及渔村小学生近视调查

目的调查广东省汕尾市城市、农村与渔村小学生近视的发生、发展状况及影响近视的相关因素。方法对1783名小学生进行视力及屈光状态的调查；调查项目包括学生近视的检出率及近视程度；学生父母的屈光状态、学生的学习情况及近距离用眼活动情况等。结果小学生近视的平均检出率为20．53％；其中城市、农村及渔村小学生分别为33．33％、11．48％和9．47％，城市小学生学习及平均课外近距离用眼时间为2．6h，农村小学生为2．1h，渔村小学生为2．0h；近视的发生随学龄的上升而增加，近视的屈光度随年龄的增长而增加。结论学习行为和长时间近距离用眼是近视发生的重要因素。     

Distance, lighting, and parental beliefs: understanding near work in epidemiologic studies of myopia.

PURPOSE: To develop measures and indices of factors (distance of eye from object, posture, and lighting) that may modify a possible effect of near work activity on myopia. METHODS: The duration of near work, the distance of an object from eye, lighting conditions, and other sociodemographic characteristics were asked in an interview. Both distance and lighting information from the questionnaire were compared with more precise measurements. RESULTS: Diopter hours were quantified as the duration of near work multiplied by the reciprocal of the distance which the activity was performed. The intraclass correlation coefficient of the reliability of distance information for each type of near work activity ranged from 0.43 to 0.91. Home light meter readings were significantly higher for children who were reading under both room and reading light, and the distances from the questionnaire were comparable to the measured distances. CONCLUSIONS: Measures of posture, distance, and lighting factors have been developed to study the possible effect modifiers of the effects of near work on myopia.     

Influence of indoor and outdoor activities on progression of myopia during puberty

The purpose of this study was to investigate whether time spent on indoor and outdoor activities or the other possible risk factors including age, gender, parental history, and initial refraction was associated with progression of myopia, during puberty. Fifty eyes of 50 myopic children aged 9–14 years were enrolled in the study. The parents were interviewed to determine the amounts of time in hours per day spent on reading and writing, using computer, watching TV, and outdoor activities (i.e., sports, games, or being outdoor with no activities) on an average day. The annual myopia progression rate (diopters per year) was calculated for each subject and was used in the statistical analyses. The mean initial age of the subjects was 10.9 ± 1.5 (ranging from 9 to 14) years. The mean follow-up period was 33.3 ± 10.3 (ranging from 17 to 55) months. There was a significant increase in the mean myopia value of the subjects after follow-up period (p < 0.001). The mean daily time spent on reading and writing and initial refraction value were independently associated with annual myopic progression rate. On the other hand, age, gender, parental myopia, and the mean daily times spent on computer use, watching TV, and outdoor activities had no correlations with annual myopia progression rate. The present study showed that myopia progression was associated with time spent on reading and writing and initial refraction value, during puberty. However, myopia progression was not associated with parental myopia, age, gender, and daily times spent on using computer, watching TV, and outdoor activities.     

Environmental factors and refractive error in Chinese schoolchildren

We surveyed and assessed 2,323 schoolchildren aged seven to 17 years from four schools in China, two in the city of Tianjin and the other two in a neighbouring rural village, Ban Chau, to investigate the prevalence of refractive error and its relationship with environmental factors. Every child from each of the participating classes was recruited in this study to avoid self-selection. A questionnaire was issued which queried some aspects of the child's visual habits and home. Refraction was canied out using the Canon R-22 autorefractor. The degree and frequency of myopia in these children increased almost linearly from age seven to 17 years. There was little difference between the urban and rural groups. Of the factors explored, the number of hours spent on near work showed the best correlation with the degree of myopia, albeit only weakly.     

Refractive errors of medical students in Turkey: one year follow-up of refraction and biometry.

PURPOSE: This study was conducted to determine the prevalence of refractive errors in Turkish medical students as well as to determine the change in refractive status of medical students within 1 year. Besides general refractive characteristics of the students, the possible relationship between the occurrence of myopia and several factors was also determined. METHODS: Two hundred and seven medical students (114 female/93 male) were checked for their refractive status as determined by cycloplegic autorefraction. In addition to keratometric and biometric measurements students also answered a detailed questionnaire. One year later, medical students who participated to the study were re-examined. RESULTS: Myopia occurred in 32.9% of medical students with low myopia (spherical equivalent between -0.75 diopters [D] and -2.99 D) being the most common type (81%). The frequency of myopia was not significantly different between female and male medical students (37.7 and 26.8%, respectively; p=0.13). Adult onset myopia (onset at age 18 years or older) comprised 14.7% of all myopia cases. Myopic students were significantly more likely to report parental myopia. The percentage of myopes and nonmyopes reporting having one or two myopic parents was 51.5 and 28.8%, respectively (p=0.002). Parental myopia was also an independent risk factor associated with the occurrence of myopia on multivariate analysis (odds ratio [OR]=3.69, 95% confidence interval [CI]=1.98-6.87). Nonmyopes also reported a significantly higher prevalence of outdoor activity before and at age seven (68.4%) than did myopes (48.6%), (p=0.009). Outdoor activity during early childhood was found to be protective for myopia on multivariate analysis (OR=0.44, %95 CI=0.23-0.82). There was no significant difference between myopes and nonmyopes with respect to amount of close-up activity. No significant shift of refraction occurred within 1 year. CONCLUSIONS: About one-third of Turkish medical students had myopia. Parental myopia was more common among myopic students and was a risk factor for the occurrence of myopia suggesting a familial predisposition. Outdoor activity in early childhood has had a protective role against the development of myopia in this study sample.     

A cohort study of incident myopia in Singaporean children

PURPOSE: To determine the risk factors of incident myopia in a school-based cohort study in Singaporean children. METHODS: A 3-year prospective cohort study was conducted in Singaporean school children aged 7 to 9 years in three schools at entry. Chinese children without myopia at baseline (n = 994) were included in the analysis. The main outcome was incident myopia, defined as spherical equivalent (SE) at least -0.75 D based on cycloplegic autorefraction. Other definitions of incident myopia, at least -0.5 D and at least -1.0 D, were also assessed. RESULTS: After controlling for school, age, gender, income, reading in books per week and intelligence quotient (IQ) test scores, we found the relative risk (RR) of incident myopia defined as -0.75 D to be 1.55 (95% confidence interval [CI] 1.18-2.04) for two versus no myopic parents. The multivariate RR of myopia for IQ in the third versus first tertile was 1.50 (95% CI, 1.19-1.89). However, the RR of incident myopia was 1.01 (95% CI, 0.97-1.05) for every unit increase in books read per week. Similar results were obtained with definitions of -0.5 and -1.0 D for incident myopia. CONCLUSIONS: These data provide new prospective evidence of essential links between parental myopia, IQ scores and subsequent myopia development. However, reading in books per week was not associated with incident myopia.