1
|
Luo R, Wang Z, Li Z, Xie R, Zhang Y, Ye G, Chen J, Xiao Y, Zhan J, Zhu Y, Zhuo Y. Quantitative assessment of colour fundus photography in hyperopia children based on artificial intelligence. BMJ Open Ophthalmol 2024; 9:e001520. [PMID: 38969362 PMCID: PMC11227822 DOI: 10.1136/bmjophth-2023-001520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 05/14/2024] [Indexed: 07/07/2024] Open
Abstract
OBJECTIVES This study aimed to quantitatively evaluate optic nerve head and retinal vascular parameters in children with hyperopia in relation to age and spherical equivalent refraction (SER) using artificial intelligence (AI)-based analysis of colour fundus photographs (CFP). METHODS AND ANALYSIS This cross-sectional study included 324 children with hyperopia aged 3-12 years. Participants were divided into low hyperopia (SER+0.5 D to+2.0 D) and moderate-to-high hyperopia (SER≥+2.0 D) groups. Fundus parameters, such as optic disc area and mean vessel diameter, were automatically and quantitatively detected using AI. Significant variables (p<0.05) in the univariate analysis were included in a stepwise multiple linear regression. RESULTS Overall, 324 children were included, 172 with low and 152 with moderate-to-high hyperopia. The median optic disc area and vessel diameter were 1.42 mm2 and 65.09 µm, respectively. Children with high hyperopia had larger superior neuroretinal rim (NRR) width and larger vessel diameter than those with low and moderate hyperopia. In the univariate analysis, axial length was significantly associated with smaller superior NRR width (β=-3.030, p<0.001), smaller temporal NRR width (β=-1.469, p=0.020) and smaller vessel diameter (β=-0.076, p<0.001). A mild inverse correlation was observed between the optic disc area and vertical disc diameter with age. CONCLUSION AI-based CFP analysis showed that children with high hyperopia had larger mean vessel diameter but smaller vertical cup-to-disc ratio than those with low hyperopia. This suggests that AI can provide quantitative data on fundus parameters in children with hyperopia.
Collapse
Affiliation(s)
- Ruiyu Luo
- Ophthalmic Center State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan, Guangzhou, Guangdong, China
| | - Zhirong Wang
- Ophthalmic Center State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan, Guangzhou, Guangdong, China
- Foshan Women and Children's Hospital, Foshan, Guangdong, China
| | - Zhidong Li
- Ophthalmic Center State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan, Guangzhou, Guangdong, China
| | - Rui Xie
- Ophthalmic Center State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan, Guangzhou, Guangdong, China
| | - Yuan Zhang
- Ophthalmic Center State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan, Guangzhou, Guangdong, China
| | - Guitong Ye
- Ophthalmic Center State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan, Guangzhou, Guangdong, China
| | - Jianqi Chen
- Ophthalmic Center State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan, Guangzhou, Guangdong, China
| | - Yue Xiao
- Ophthalmic Center State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan, Guangzhou, Guangdong, China
| | - Jinan Zhan
- Ophthalmic Center State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan, Guangzhou, Guangdong, China
| | - Yingting Zhu
- Ophthalmic Center State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan, Guangzhou, Guangdong, China
| | - Yehong Zhuo
- Ophthalmic Center State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan, Guangzhou, Guangdong, China
| |
Collapse
|
2
|
Sun L, Qi X, Song L, Ning Y, Zeng X, Ding G, Li X, Li J, Wei N, Hua N, Qian X. Longitudinal Changes in Refractive Development in Highly Hyperopic Children: A 2.6-11.2 Year Follow-up of Preschoolers Diagnosed with High Hyperopia. Curr Eye Res 2024; 49:768-775. [PMID: 38616539 DOI: 10.1080/02713683.2024.2336162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/20/2024] [Indexed: 04/16/2024]
Abstract
PURPOSE This study aims to elucidate the longitudinal refractive and ocular biometric alterations in preschool children with high hyperopia who underwent early interventions. METHODS We conducted a retrospective analysis of preschool children diagnosed with high hyperopia at Tianjin Medical University Eye Hospital between 2011 and 2023. Inclusion criteria required an initial examination with cycloplegic refraction, bilateral spherical equivalent power (SE) ≥ +5.00D with a difference <1.00D, a minimum two-year follow-up, and at least three ocular biometric measurements. The annual axial growth rate evaluated emmetropization in highly hyperopic children. We applied Restricted Cubic Spline (RCS) models to explore potential nonlinear relationships between age and spherical equivalent, axial length, corneal curvature, and axial length-to-corneal curvature ratio. Additionally, Mixed-effects models were employed to investigate factors associated with changes in refractive error and axial length. RESULTS The study enrolled 60 eligible subjects, with a median initial diagnosis age of 3.5 years (IQR, 2.8-4.9 years) and a median last visit age of 9.3 years (IQR, 8.1-10.8 years). The average follow-up duration was 5.7 years. RCS analysis revealed notable nonlinear changes in spherical equivalent power, axial length, and axial length-to-corneal curvature ratio, although corneal curvature displayed no statistically significant nonlinear trend. Factors affecting SE changes included the presence of strabismus, the use of cycloplegia, baseline SE, and age. Conversely, changes in axial length solely correlated with baseline axial length and age. CONCLUSION Highly hyperopic preschool children undergoing early intervention display a marked emmetropization tendency, though most still remain moderately to highly hyperopic, with the progression of refractive changes showing non-uniform patterns with respect to age.
Collapse
Affiliation(s)
- Ling Sun
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xiaoli Qi
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Linlin Song
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yuxian Ning
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xiaoyu Zeng
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Gang Ding
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xue Li
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Jing Li
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Nan Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Ning Hua
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xuehan Qian
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| |
Collapse
|
3
|
Hairol MI, Ahmad M, Muhammad Zihni MA, Saidon NFS, Nordin N, Kadar M. The Impact of School Closures during COVID-19 Lockdown on Visual-Motor Integration and Block Design Performance: A Comparison of Two Cohorts of Preschool Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:930. [PMID: 37371162 DOI: 10.3390/children10060930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 05/10/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023]
Abstract
The COVID-19 outbreak has led to the closure of educational institutions, which may prevent children from attaining skills essential for learning, such as visual-motor integration (VMI) and visuospatial constructional ability (often reflected with the Block Design Test, BDT). This study compares VMI and BDT performance between a pre-pandemic cohort (children who attended preschool in late 2019) and a post-pandemic cohort (those physically attending preschool for the first time at the end of 2021). Participants were children attending government preschools with similar syllabi catered for low-income families. The pre-pandemic cohort was part of an earlier study (n = 202 for VMI and n = 220 for BDT) before lockdowns commenced in March 2020. The post-pandemic cohort comprised 197 children who completed the Beery-VMI and 93 children who completed the BDT. Compared to the pre-pandemic cohort, the post-pandemic cohort had significantly lower mean Beery-VMI scores (t(397) = 3.054, p = 0.002) and was 3.162-times more likely to have a below average Beery-VMI score (OR = 3.162 (95% CI 1.349, 7.411)). The post-pandemic cohort also had significantly lower BDT scores than the pre-pandemic cohort (t(311) = -5.866, p < 0.001). In conclusion, children with disrupted conventional preschool education due to the COVID-19 lockdowns were more likely to have below-average VMI and lower BDT scores.
Collapse
Affiliation(s)
- Mohd Izzuddin Hairol
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
- Optometry & Vision Science Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Mahadir Ahmad
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
- Clinical Psychology & Health Behaviour Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Muhammad Aminuddin Muhammad Zihni
- Optometry & Vision Science Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Nur Fatin Syazana Saidon
- Optometry & Vision Science Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Naufal Nordin
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Masne Kadar
- Centre for Rehabilitation & Special Needs Studies (iCaRehab), Faculty of Health Sciences, Universiti Kebangsaan Malaysia Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
- Occupational Therapy Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| |
Collapse
|
4
|
Mavi S, Chan VF, Virgili G, Biagini I, Congdon N, Piyasena P, Yong AC, Ciner EB, Kulp MT, Candy TR, Collins M, Bastawrous A, Morjaria P, Watts E, Masiwa LE, Kumora C, Moore B, Little JA. The Impact of Hyperopia on Academic Performance Among Children: A Systematic Review. Asia Pac J Ophthalmol (Phila) 2022; 11:36-51. [PMID: 35066525 DOI: 10.1097/apo.0000000000000492] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To assess the impact of uncorrected hyperopia and hyperopic spectacle correction on children's academic performance. DESIGN Systematic review and meta-analysis. METHODS We searched 9 electronic databases from inception to July 26, 2021, for studies assessing associations between hyperopia and academic performance. There were no restrictions on language, publication date, or geographic location. A quality checklist was applied. Random-effects models estimated pooled effect size as a standardized mean difference (SMD) in 4 outcome domains: cognitive skills, educational performance, reading skills, and reading speed. (PROSPERO registration: CRD-42021268972). RESULTS Twenty-five studies (21 observational and 4 interventional) out of 3415 met the inclusion criteria. No full-scale randomized trials were identified. Meta-analyses of the 5 studies revealed a small but significant adverse effect on educational performance in uncorrected hyperopic compared to emmetropic children {SMD -0.18 [95% confidence interval (CI), -0.27 to -0.09]; P < 0.001, 4 studies} and a moderate negative effect on reading skills in uncorrected hyperopic compared to emmetropic children [SMD -0.46 (95% CI, -0.90 to -0.03); P = 0.036, 3 studies]. Reading skills were significantly worse in hyperopic than myopic children [SMD -0.29 (95% CI, -0.43 to -0.15); P < 0.001, 1 study]. Qualitative analysis on 10 (52.6%) of 19 studies excluded from meta-analysis found a significant (P < 0.05) association between uncorrected hyperopia and impaired academic performance. Two interventional studies found hyperopic spectacle correction significantly improved reading speed (P < 0.05). CONCLUSIONS Evidence indicates that uncorrected hyperopia is associated with poor academic performance. Given the limitations of current methodologies, further research is needed to evaluate the impact on academic performance of providing hyperopic correction.
Collapse
Affiliation(s)
- Sonia Mavi
- Centre for Public Health, School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Ving Fai Chan
- Centre for Public Health, School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Gianni Virgili
- Centre for Public Health, School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
- Department NEUROFARBA, University of Florence, Florence, Italy
| | - Ilaria Biagini
- Department NEUROFARBA, University of Florence, Florence, Italy
| | - Nathan Congdon
- Centre for Public Health, School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
- Orbis International, New York, NY, US
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Prabhath Piyasena
- Centre for Public Health, School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Ai Chee Yong
- Centre for Public Health, School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Elise B Ciner
- Pennsylvania College of Optometry, Salus University, Elkins Park, PA, US
| | | | - T Rowan Candy
- School of Optometry, Indiana University, Bloomington, IN, US
| | - Megan Collins
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, US
| | - Andrew Bastawrous
- International Centre for Eye Health, Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
- Peek Vision, London, UK
| | - Priya Morjaria
- International Centre for Eye Health, Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
- Peek Vision, London, UK
| | - Elanor Watts
- Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, UK
| | - Lynett Erita Masiwa
- Optometry Unit, Department of Primary Health Care, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | | | - Bruce Moore
- New England College of Optometry, Boston, MA, US
| | - Julie-Anne Little
- Centre for Optometry and Vision Science, School of Biomedical Sciences, Biomedical Sciences Research Institute, Ulster University, Coleraine, UK
| |
Collapse
|
5
|
MacKenzie GE, Morgan IG, Baraas RC, Little JA, Congdon N, Chan VF, Moore B, Bundy D. Recognizing Eye Health as an Integral Part of Children's School Health Throughout the World. Asia Pac J Ophthalmol (Phila) 2022; 11:3-5. [PMID: 35044338 DOI: 10.1097/apo.0000000000000455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Graeme E MacKenzie
- Riemann Limited, London, United Kingdom
- Clearly Initiatives, London, United Kingdom
| | - Ian G Morgan
- Research School of Biology, Australian National University, Canberra, ACT, Australia
| | - Rigmor C Baraas
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Norway
| | - Julie-Anne Little
- Centre for Optometry and Vision Science, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Nathan Congdon
- Ulverscroft Chair for Global Eye Health, Department School of Medicine, Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
- Orbis International, Lenexa, Kansas, US
| | - Ving Fai Chan
- School of Medicine, Dentistry and Biomedical Sciences, Institute of Clinical Science, Centre for Public Health, Royal Victoria Hospital, United Kingdom
- School of Optometry, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Bruce Moore
- New England College of Optometry, Boston, Massachusetts, US
| | - Donald Bundy
- Global Research Consortium for School Health and Nutrition, Faculty of Infectious and Tropical Diseases London School of Hygiene and Tropical Medicine
| |
Collapse
|
6
|
Labiris G, Panagiotopoulou EK, Duzha E, Tzinava M, Perente A, Konstantinidis A, Delibasis K. Development and Validation of a Web-Based Reading Test for Normal and Low Vision Patients. Clin Ophthalmol 2021; 15:3915-3929. [PMID: 34588763 PMCID: PMC8473574 DOI: 10.2147/opth.s314943] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 06/21/2021] [Indexed: 11/26/2022] Open
Abstract
Purpose To develop and validate a web-based reading test for normal and low vision patients. Methods This is a prospective, comparative trial. The web-based Democritus Digital Acuity Reading Test (wDDART) was developed. wDDART introduces a series of advanced characteristics (advanced text calibration, computer-vision-based estimation of patient’s distance, and automatic calculation of patient’s reading times) that facilitate the overall examination procedure. wDDART’s reading parameters [reading acuity (RA), maximum reading speed (MRS), critical print size (CPS) and reading accessibility index (ACC)] were compared to the corresponding ones of its conventional Windows-based reading test (DDART) in a sample of normal and low vision participants. wDDART’s test–retest reliability for all reading parameters was evaluated in a 15-day time-window. Results One hundred patients (normal vision group-NVG: 70; low vision group-LVG: 30 patients) responded to DDART and wDDART. Non-significant differences between the two reading tests were found for all parameters in NVG and LVG. Intraclass correlation coefficients (ICCs) between the two tests demonstrated good or excellent correlation for RA, MRS, ACC and moderate correlation for CPS. Test–retest reliability was excellent for RA and ACC, while ICCs were 0.715–0.895 for MRS and CPS. Conclusion The wDDART demonstrated sufficient validity and repeatability making it suitable for clinical and research settings. Clinicaltrials.gov Identifier NCT04618224.
Collapse
Affiliation(s)
- Georgios Labiris
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, 68131, Alexandroupolis, Greece
| | | | - Erald Duzha
- Department of Computer Science and Biomedical Informatics, University of Thessaly, Lamia, 35131, Greece
| | - Maria Tzinava
- Department of Computer Science and Biomedical Informatics, University of Thessaly, Lamia, 35131, Greece
| | - Asli Perente
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, 68131, Alexandroupolis, Greece
| | - Aristeidis Konstantinidis
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, 68131, Alexandroupolis, Greece
| | - Konstantinos Delibasis
- Department of Computer Science and Biomedical Informatics, University of Thessaly, Lamia, 35131, Greece
| |
Collapse
|
7
|
Hopkins S, Narayanasamy S, Vincent SJ, Sampson GP, Wood JM. Do reduced visual acuity and refractive error affect classroom performance? Clin Exp Optom 2021; 103:278-289. [DOI: 10.1111/cxo.12953] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 07/03/2019] [Accepted: 07/08/2019] [Indexed: 12/18/2022] Open
Affiliation(s)
- Shelley Hopkins
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia,
| | - Sumithira Narayanasamy
- Programme of Optometry & Vision Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia,
| | - Stephen J Vincent
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia,
| | - Geoff P Sampson
- School of Medicine (Optometry), Faculty of Health, Deakin University, Geelong, Australia,
| | - Joanne M Wood
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia,
| |
Collapse
|
8
|
Cox RA, Read SA, Hopkins S, Wood JM. High Rates of Uncorrected Vision Conditions among Schoolchildren in Rural Queensland, Australia. Optom Vis Sci 2021; 98:51-57. [PMID: 33394931 DOI: 10.1097/opx.0000000000001628] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE This study is the first to report high rates of uncorrected vision conditions among Australian secondary schoolchildren living in a rural area and to comment on the rate of eye examinations undertaken on Australian Indigenous children. Uncorrected vision problems that continue throughout the school years have significant implications for children's quality of life and education. PURPOSE This study aimed to investigate the prevalence of uncorrected vision conditions among Australian schoolchildren. METHODS Participants included 280 students from rural primary and secondary schools (aged 4 to 18 years), of whom 40% identified as being of Aboriginal and/or Torres Strait Islander descent (Indigenous). All participants underwent an eye examination including measurements of monocular distance and near visual acuity, assessment of accommodative and vergence function, stereoacuity, color vision, and cycloplegic autorefraction. A parental questionnaire was used to determine whether the child had previously had his/her eyes examined. RESULTS The overall prevalence of uncorrected vision conditions in this population was 35%. The odds of previously having had an eye examination were 2.3× higher for non-Indigenous compared with Indigenous children despite both groups exhibiting high rates of uncorrected vision conditions (Indigenous, 31 [29%]; non-Indigenous, 66 [40%]; χ21 = 3.24, P = .07). Of the children who had significant refractive error (Indigenous, 23 [21%]; non-Indigenous, 49 [30%]; χ21 = 2.70, P = .10), 82% were uncorrected, and only 39% of Indigenous children and 54% of non-Indigenous children had previously had an eye examination. CONCLUSIONS These findings suggest that high rates of uncorrected vision conditions are present among Australian primary and secondary schoolchildren from a rural area and highlight that Indigenous children are much less likely to have had an eye examination. Understanding factors that affect the rate of eye examinations and compliance with spectacle correction must be addressed given the potential impact of these vision conditions.
Collapse
Affiliation(s)
- Rebecca A Cox
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | | | - Shelley Hopkins
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Joanne M Wood
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| |
Collapse
|
9
|
Abstract
PURPOSE To examine the zone of clear single binocular vision (ZCSBV) in myopic children and young adults after 12 months of orthokeratology (OK) wear, in comparison with single-vision soft contact lens (SCL) wear. METHODS Twelve children (8-16 years) and 8 adults (18-29 years) were assessed with a series of near-point binocular vision tests when myopia was corrected using single-vision SCLs and again after 1 and 12 months of OK wear, and axial length was measured. The ZCSBV was constructed for baseline SCL wear and after 12 months of OK wear. RESULTS After 1 month of OK wear, increased accommodative responses were noted in children (C) and adults (A) as increased binocular amplitude (C:P=0.03, A:P=0.04) and reduced accommodative lag (C:P=0.01, A:P=0.01). Divergence reserves improved after 1 month in both groups (P<0.04), and a near exophoric shift was evident at 12 months (C:P=0.01, A:P=0.04). All changes at 1 month maintained stability at 12 months. An increase in accommodation and vergence responses without reduction in range resulted in an expansion of the ZCSBV in both age groups. Axial length did not significantly change in either children (P=0.25) or adults (P=0.72). CONCLUSION In both pediatric and young adult myopes, the ZCSBV expands toward a more divergent, increased accommodation response in OK compared with SCL wear. This occurs without a corresponding loss of convergence or accommodation deactivation, indicating improved depth of focus. These findings are relevant to visual acceptance and possible mechanisms of OK's efficacy for myopia control.
Collapse
|
10
|
The effect of induced blur on the Beery-Buktenica developmental test of visual-motor integration and its supplemental tests. PLoS One 2020; 15:e0237807. [PMID: 32817713 PMCID: PMC7446883 DOI: 10.1371/journal.pone.0237807] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 08/03/2020] [Indexed: 11/24/2022] Open
Abstract
Background The Beery-Buktenica Test of Visual-Motor Integration (Beery VMI) is a commonly used standardized test of visual-motor integration. Performance on the test is related to academic achievement, but the effect of reduced visual acuity on test results is unknown. This study determined the visual acuity demand and the spacing of the test forms for the Beery VMI and its supplemental tests and investigated the effect of induced optical blur on test results in both adults and children. Methods The overall size and critical detail size of each form and the distance between the center of each form and its adjacent crowding source were measured. The visual acuity demand and angular separation of forms were calculated. Two groups of participants (adults aged ≥18 years [n = 19] and children aged 7–12 years [n = 20]) completed four sessions in which they performed the Beery VMI and the supplemental tests under different blur conditions (habitual near correction, monocular spherical blur, binocular spherical blur and binocular astigmatic blur) in a randomized order. Results Stroke width, overall form size and box size remained constant throughout the Beery VMI, whereas these reduced with increasing difficulty for the supplemental tests. Reduced near visual acuity from simulated blur resulted in reduced mean scores for the Beery VMI and its supplemental tests, compared with habitual near vision in both adults and children. Binocular spherical blur had the most detrimental effect (p<0.001), followed by binocular astigmatic blur (p<0.001) then monocular spherical blur (p = 0.022). Conclusions In individuals with uncorrected spherical or astigmatic ametropia, reduced scores on the Beery VMI and its supplemental tests may be due to impaired near visual acuity and not reflect reduced visual-motor abilities. This highlights the importance of excluding reduced near visual acuity as a cause of reduced performance before diagnosing impairment and initiating treatment strategies for visual-motor integration.
Collapse
|
11
|
Impact of eyeglasses on academic performance in primary school children. Can J Ophthalmol 2020; 55:52-57. [DOI: 10.1016/j.jcjo.2019.07.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 07/05/2019] [Indexed: 11/21/2022]
|
12
|
Adequacy of the Fogging Test in the Detection of Clinically Significant Hyperopia in School-Aged Children. J Ophthalmol 2019; 2019:3267151. [PMID: 31467692 PMCID: PMC6701401 DOI: 10.1155/2019/3267151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 05/16/2019] [Accepted: 06/18/2019] [Indexed: 11/17/2022] Open
Abstract
Purpose To evaluate the efficacy of the "fogging test," performed with a +2 diopters (D) lens, in the exclusion of clinically significant hyperopia in school-aged children. Methods We studied 54 children between 5 and 11 years of age, with 10/10 best-corrected bilateral visual acuity (VA) without significant degree of correction. VA was assessed in each eye with a "bilateral" +2 D sphere over-refraction followed by cycloplegic retinoscopy. The capacity of the test to detect hyperopia of ≥+2 D and ≥+1.5 D was evaluated by examining the respective receiver operating characteristic (ROC) curves and sensitivity and specificity values for different cutoff values of VA. Results For the detection of hyperopia ≥+2 D, the area under the ROC curve (AUC) was 0.955 (p ≤ 0.001). The VA cutoff with best discriminative capacity was ≥5/10, with a sensitivity of 100%, specificity of 79%, positive predictive value (PPV) of 57%, and negative predictive value (NPV) of 100%. In respect of ≥+1.5 D hyperopia, the test capacity was lower (AUC = 0.832; p ≤ 0.001). The best VA cutoff was also of ≥5/10, with a PPV of 81% and a NPV of 85%. Conclusion The accuracy of the test was high for the evaluation of ≥+2 D hyperopia but lower for ≥+1.5 D hyperopia. For the detection of ≥+2 D hyperopia, the VA cutoff of <5/10 may permit the exclusion of clinically significant hyperopia in selected children, without the need for cycloplegia. For the same cutoff, the PPV was low, meaning that in children with ≥5/10 VA cycloplegic refraction remains obligatory.
Collapse
|
13
|
Hu Y, Ding X, Zeng J, Cui D, Li C, He M, Yang X. Longitudinal Changes in Spherical Equivalent of Moderate to High Hyperopia: 2- to 8-Year Follow-Up of Children at an Initial Age of 5.5 to 8.4 Years. Invest Ophthalmol Vis Sci 2019; 60:3127-3134. [PMID: 31323683 DOI: 10.1167/iovs.18-26435] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Moderate to high hyperopia is associated with visual deficits. Currently, to our knowledge no study has reported its longitudinal refraction change in a large sample of schoolchildren. We investigated the longitudinal changes in spherical equivalent (SE) refractive error among schoolchildren with moderate to high hyperopia. Methods Medical records of patients seeking refractions at Zhongshan Ophthalmic Center between 2009 and 2017 were reviewed retrospectively. Eligible criteria included hyperopia ≥+2.00 diopters (D) at an initial age of 6 to 8 years, at least three visits, and at least a 2-year follow-up. Individual pattern of refraction development was evaluated based on the mean rate of change in SE. Mixed-effect regression analysis was used to explore factors associated with the rate of change. Results A total of 1769 cases were identified. Median initial age was 6.4 (interquartile range [IQR], 5.9 to 7.1) years and median age at the final visit was 10.1 (IQR, 8.9 to 11.5) years. Median initial SE was +3.13 (IQR, +2.38 to +5.25) D. On average, participants experienced a myopic shift of -0.35 ± 0.27 D/year. A considerable number of eyes (721, 40.8%) demonstrated a longitudinal change of less than ±0.25 D/year and approximately 1 of 3 (611/1769) eyes demonstrated a change of >-0.50 and ≤-0.25 D/year. Children with greater initial hyperopia (β = -0.02, P < 0.001) experienced significantly faster reduction in hyperopic refraction. Age and sex had statistically significant but clinically insignificant impacts on the rate of hyperopia reduction. Conclusions Variation exists in the refraction development of schoolchildren with moderate to high hyperopia. A considerable percentage of eyes demonstrates longitudinally stable refraction.
Collapse
Affiliation(s)
- Yin Hu
- State Key Laboratory of Ophthalmology, Zhongshan Opthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Xiaohu Ding
- State Key Laboratory of Ophthalmology, Zhongshan Opthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Junwen Zeng
- State Key Laboratory of Ophthalmology, Zhongshan Opthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Dongmei Cui
- State Key Laboratory of Ophthalmology, Zhongshan Opthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Cong Li
- State Key Laboratory of Ophthalmology, Zhongshan Opthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Opthalmic Center, Sun Yat-Sen University, Guangzhou, China.,Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
| | - Xiao Yang
- State Key Laboratory of Ophthalmology, Zhongshan Opthalmic Center, Sun Yat-Sen University, Guangzhou, China
| |
Collapse
|
14
|
Barugel R, Touhami S, Samama S, Landre C, Busquet G, Vera L, Bui Quoc E. Evaluation of the Spot Vision Screener for children with limited access to ocular health care. J AAPOS 2019; 23:153.e1-153.e5. [PMID: 31028870 DOI: 10.1016/j.jaapos.2018.09.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Revised: 06/30/2018] [Accepted: 09/17/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE To compare the sensitivity, specificity, and referral rate of the Spot Vision Screener (Welch Allyn Inc, Skaneateles Falls, NY) with the gold standard cycloplegic measurements acquired using the Retinomax in a population of underprivileged children and teenagers with limited access to medical care. METHODS Children were recruited for the study by social workers in the vicinity of Robert Debre Hospital, Paris, France. Refractive errors (hyperopia of ≥ +2.00 D spherical equivalent [SE]; myopia of ≤ -0.50 D SE; astigmatism of ≥1.00 D between the two main meridians; anisometropia of ≥1.00 D SE difference between eyes) were assessed using the Spot Vision Screener and the Retinomax. Sensitivity (true positive rate), specificity (true negative rate), and referral rate of this Spot Vision screening program were evaluated. RESULTS A total of 82 eyes of 41 subjects (19 males) were included; mean age was 126 months of age (range, 48-246). The sensitivity of the Spot Vision Screener for the detection of refractive errors was 82.35%; specificity was 91.67%. The sensitivity of the Spot Vision Screener to detect hyperopia, myopia, astigmatism, and anisometropia was 27.27%, 84.61%, 78.57%, and 66.67%, respectively. Its specificity to detect hyperopia, myopia, astigmatism, and anisometropia was 100%, 98.55%, 89.71% and 94.29%, respectively. CONCLUSIONS The specificity of the Spot Vision Screener to detect refractive errors was found to be relatively high (>90%). However, its low sensitivity for hyperopia seems to remain a major limitation of the device, because hyperopia is particularly important to detect in children given its high prevalence and possible adverse consequences. Global programs using cycloplegic measurements should be considered an alternative.
Collapse
Affiliation(s)
- Raphaël Barugel
- Ophthalmology Department, Robert Debré University Hospital (Assistance Publique Hôpitaux de Paris), Paris, France.
| | - Sara Touhami
- Ophthalmology Department, Robert Debré University Hospital (Assistance Publique Hôpitaux de Paris), Paris, France
| | - Sacha Samama
- Ophthalmology Department, Robert Debré University Hospital (Assistance Publique Hôpitaux de Paris), Paris, France
| | - Céline Landre
- Ophthalmology Department, Robert Debré University Hospital (Assistance Publique Hôpitaux de Paris), Paris, France
| | - Gauthier Busquet
- Ophthalmology Department, Robert Debré University Hospital (Assistance Publique Hôpitaux de Paris), Paris, France
| | - Liza Vera
- Ophthalmology Department, Robert Debré University Hospital (Assistance Publique Hôpitaux de Paris), Paris, France
| | - Emmanuel Bui Quoc
- Ophthalmology Department, Robert Debré University Hospital (Assistance Publique Hôpitaux de Paris), Paris, France
| |
Collapse
|
15
|
Oliver W, Renzi-Hammond LM, Thorne SA, Clementz B, Miller LS, Hammond BR. Neural Activation During Visual Attention Differs in Individuals with High versus Low Macular Pigment Density. Mol Nutr Food Res 2019; 63:e1801052. [PMID: 30919588 DOI: 10.1002/mnfr.201801052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 03/25/2019] [Indexed: 11/08/2022]
Abstract
SCOPE The neural efficiency hypothesis for lutein (L) and zeaxanthin (Z) suggests that higher levels of L+Z in the central nervous system (CNS) are predictive of stronger stimulus-specific brain responses. Past research suggests that supplementing L+Z can improve neural processing speed and cognitive function across multiple domains, which supports this hypothesis. The purpose of this study is to determine the extent to which CNS L+Z levels predict brain responses using an attentionally taxing task. METHODS AND RESULTS Macular pigment optical density (MPOD) is measured at baseline in 85 participants ranging in age from 18-92 years. Brain activation is measured using dense array electroencephalography. Stimuli evoking the signal include a grating array of vertical bars, oscillating at four driving frequencies. Significant stimulus-specific interactions are detected between attend condition, location, and age (p < .002) for unattended image locations, and between age and location (p < .008) for attended locations. Although no differences are found across age by MPOD, this measure is found to be predictive of neural power at parafoveal bar locations (R2 .080). CONCLUSION CNS L+Z status is related to differences in brain activation in conditions designed to stress visual attention. These differences are strongest for older subjects.
Collapse
Affiliation(s)
- William Oliver
- Clinical and Cognitive Neuroscience Laboratory, Behavioral and Brain Sciences Program, Department of Psychology, The University of Georgia, Athens, GA, 30602, USA
| | - Lisa M Renzi-Hammond
- Vision Sciences Laboratory, Behavioral and Brain Sciences Program, Department of Psychology, The University of Georgia, Athens, GA, 30602, USA.,Human Biofactors Laboratory, Institute of Gerontology, Department of Health Promotion and Behavior, The University of Georgia, Athens, GA, 30602, USA
| | - S Anna Thorne
- Vision Sciences Laboratory, Behavioral and Brain Sciences Program, Department of Psychology, The University of Georgia, Athens, GA, 30602, USA.,Athens Community Council on Aging, Athens, GA, 30602, USA
| | - Brett Clementz
- Clinical and Cognitive Neuroscience Laboratory, Behavioral and Brain Sciences Program, Department of Psychology, The University of Georgia, Athens, GA, 30602, USA
| | - L Stephen Miller
- Neuropsychology and Memory Assessment Laboratory, Clinical Psychology Program, Department of Psychology, The University of Georgia, Athens, GA, 30602, USA
| | - Billy R Hammond
- Vision Sciences Laboratory, Behavioral and Brain Sciences Program, Department of Psychology, The University of Georgia, Athens, GA, 30602, USA.,Human Biofactors Laboratory, Institute of Gerontology, Department of Health Promotion and Behavior, The University of Georgia, Athens, GA, 30602, USA
| |
Collapse
|
16
|
Daniel F, Kapoula Z. Induced vergence-accommodation conflict reduces cognitive performance in the Stroop test. Sci Rep 2019; 9:1247. [PMID: 30718625 PMCID: PMC6361994 DOI: 10.1038/s41598-018-37778-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 12/10/2018] [Indexed: 01/08/2023] Open
Abstract
Interaction mechanisms between cognition and binocular motor control in reading saccades remain unclear. In this study we examine objectively saccades and fixations parameters during the Stroop test, involving three different levels of cognitive demand (reading, color denomination and interference). In addition, we experimentally induce accommodation and vergence conflicts during the different tasks. Twenty-one visually normal subjects (age 20.9 ± 1.45) performed the Stroop test in three different randomized conditions: a control normal viewing condition, a 16Δ base-out prism condition, and a -2.50D spherical lenses condition. Prisms and spherical lenses induced Vergence-Accommodation conflict. Eye movements were recorded with the Eyeseecam video-oculography device. The results show (1) longer fixation duration in the interference task than in the denomination task, and shorter fixation duration in the reading task; (2) a higher interference effect in the conflict induced conditions compared to the control condition; (3) a lower tolerance to prism induced conflict, with a higher destabilization of the binocular motor control of saccades and fixations. This suggests an interplay between vergence accommodation conflict and cognitive load: tolerance to the conflict seems to be lower in the more cognitively demanding interference Stroop task. The results consolidate the link between cognition and high quality of single binocular vision.
Collapse
Affiliation(s)
- François Daniel
- IRIS Group, Physiopathologie de la Vision et Motricité Binoculaire CNRS FR3636, Université Paris Descartes, Paris, France.
| | - Zoï Kapoula
- IRIS Group, Physiopathologie de la Vision et Motricité Binoculaire CNRS FR3636, Université Paris Descartes, Paris, France.
| |
Collapse
|
17
|
Wood JM, Black AA, Hopkins S, White SLJ. Vision and academic performance in primary school children. Ophthalmic Physiol Opt 2018; 38:516-524. [DOI: 10.1111/opo.12582] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 08/09/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Joanne M Wood
- School of Optometry and Vision Science and Institute of Health and Biomedical Innovation; Queensland University of Technology; Brisbane Australia
| | - Alex A Black
- School of Optometry and Vision Science and Institute of Health and Biomedical Innovation; Queensland University of Technology; Brisbane Australia
| | - Shelley Hopkins
- School of Optometry and Vision Science and Institute of Health and Biomedical Innovation; Queensland University of Technology; Brisbane Australia
| | - Sonia L J White
- School of Early Childhood and Inclusive Education; Queensland University of Technology; Brisbane Australia
| |
Collapse
|
18
|
|
19
|
Negiloni K, Ramani KK, Sudhir RR. Do school classrooms meet the visual requirements of children and recommended vision standards? PLoS One 2017; 12:e0174983. [PMID: 28369118 PMCID: PMC5378392 DOI: 10.1371/journal.pone.0174983] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Accepted: 03/18/2017] [Indexed: 11/18/2022] Open
Abstract
Background Visual demands of school children tend to vary with diverse classroom environments. The study aimed to evaluate the distance and near Visual Acuity (VA) demand in Indian school classrooms and their comparison with the recommended vision standards. Materials and methods The distance and near VA demands were assessed in 33 classrooms (grades 4 to 12) of eight schools. The VA threshold demand relied on the smallest size of distance and near visual task material and viewing distance. The logMAR equivalents of minimum VA demand at specific seating positions (desk) and among different grades were evaluated. The near threshold was converted into actual near VA demand by including the acuity reserve. The existing dimensions of chalkboard and classroom, gross area in a classroom per student and class size in all the measured classrooms were compared to the government recommended standards. Results In 33 classrooms assessed (35±10 students per room), the average distance and near logMAR VA threshold demand was 0.31±0.17 and 0.44±0.14 respectively. The mean distance VA demand (minimum) in front desk position was 0.56±0.18 logMAR. Increased distance threshold demand (logMAR range -0.06, 0.19) was noted in 7 classrooms (21%). The mean VA demand in grades 4 to 8 and grades 9 to 12 was 0.35±0.16 and 0.24±0.16 logMAR respectively and the difference was not statistically significant (p = 0.055). The distance from board to front desk was greater than the recommended standard of 2.2m in 27 classrooms (82%). The other measured parameters were noted to be different from the proposed standards in majority of the classrooms. Conclusion The study suggests the inclusion of task demand assessment in school vision screening protocol to provide relevant guidance to school authorities. These findings can serve as evidence to accommodate children with mild to moderate visual impairment in the regular classrooms.
Collapse
Affiliation(s)
- Kalpa Negiloni
- Medical Research Foundation, Sankara Nethralaya, Chennai, India
- Shanmugha Arts, Science, Technology & Research Academy (SASTRA) University, Thanjavur, India
- Elite School of Optometry, Chennai, India
| | | | | |
Collapse
|
20
|
|
21
|
Gifford K, Gifford P, Hendicott PL, Schmid KL. Near binocular visual function in young adult orthokeratology versus soft contact lens wearers. Cont Lens Anterior Eye 2017; 40:184-189. [PMID: 28215499 DOI: 10.1016/j.clae.2017.01.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 12/05/2016] [Accepted: 01/10/2017] [Indexed: 12/01/2022]
Abstract
PURPOSE To compare near point binocular vision function of young adult myopes wearing orthokeratology (OK) lenses to matched single vision soft disposable contact lens (SCL) wearers. METHODS A retrospective clinical record analysis of all OK wearers (18-30 years) presenting over an 18 month period was undertaken. Data was extracted for 17 OK wearers, with 17 SCL wearers matched for age, refractive error and duration of contact lens wear. Binocular vision data included horizontal phoria (phoria), horizontal base-in (BIFR) and base-out fusional reserves (BOFR) and accommodation accuracy (AA). RESULTS The OK group was 25.8±3.2years, with a duration of wear of 45.7±25months and refractive error of R -2.09±1.23D, L -2.00±1.35D. Compared to matched SCL wearers the OK group were significantly more exophoric (OK -2.05±2.38Δ; SCL 0.00±1.46Δ, p=0.005) and had better accommodation accuracy (OK 0.97±0.33D; SCL 1.28±0.32D, p=0.009). BIFR and BOFR were not different in the two groups. Frequency histograms showed that more SCL wearers had high lags of accommodation (AA≥1.50D: 8 SCL,2 OK) and esophoria (≥1Δ: 5 SCL,1 OK) than OK wearers. A positive correlation was found between refraction and phoria in the SCL group (r=0.521, p=0.032). CONCLUSION Young adult myopes wearing OK lenses display more exophoria and lower accommodative lags at near compared to matched single vision SCL wearers. Young adult myopes with specific binocular vision disorders may benefit from OK wear in comparison to single vision SCL wear. This has relevance to both the visual acceptance of OK lenses and in managing risk factors for myopia progression.
Collapse
Affiliation(s)
- Kate Gifford
- School of Optometry and Vision Science, Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology,60 Musk Avenue, Kelvin Grove, QLD 4059 Australia.
| | - Paul Gifford
- School of Optometry and Vision Science, Faculty of Science, Rupert Myers Building, Barker Street, Kensington, NSW 2033 Australia
| | - Peter L Hendicott
- School of Optometry and Vision Science, Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology,60 Musk Avenue, Kelvin Grove, QLD 4059 Australia
| | - Katrina L Schmid
- School of Optometry and Vision Science, Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology,60 Musk Avenue, Kelvin Grove, QLD 4059 Australia
| |
Collapse
|
22
|
Kulp MT, Ciner E, Maguire M, Moore B, Pentimonti J, Pistilli M, Cyert L, Candy TR, Quinn G, Ying GS. Uncorrected Hyperopia and Preschool Early Literacy: Results of the Vision in Preschoolers-Hyperopia in Preschoolers (VIP-HIP) Study. Ophthalmology 2016; 123:681-9. [PMID: 26826748 DOI: 10.1016/j.ophtha.2015.11.023] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Revised: 11/12/2015] [Accepted: 11/20/2015] [Indexed: 10/22/2022] Open
Abstract
PURPOSE To compare early literacy of 4- and 5-year-old uncorrected hyperopic children with that of emmetropic children. DESIGN Cross-sectional. PARTICIPANTS Children attending preschool or kindergarten who had not previously worn refractive correction. METHODS Cycloplegic refraction was used to identify hyperopia (≥3.0 to ≤6.0 diopters [D] in most hyperopic meridian of at least 1 eye, astigmatism ≤1.5 D, anisometropia ≤1.0 D) or emmetropia (hyperopia ≤1.0 D; astigmatism, anisometropia, and myopia <1.0 D). Threshold visual acuity (VA) and cover testing ruled out amblyopia or strabismus. Accommodative response, binocular near VA, and near stereoacuity were measured. MAIN OUTCOME MEASURES Trained examiners administered the Test of Preschool Early Literacy (TOPEL), composed of Print Knowledge, Definitional Vocabulary, and Phonological Awareness subtests. RESULTS A total of 492 children (244 hyperopes and 248 emmetropes) participated (mean age, 58 months; mean ± standard deviation of the most hyperopic meridian, +3.78±0.81 D in hyperopes and +0.51±0.48 D in emmetropes). After adjustment for age, race/ethnicity, and parent/caregiver's education, the mean difference between hyperopes and emmetropes was -4.3 (P = 0.01) for TOPEL overall, -2.4 (P = 0.007) for Print Knowledge, -1.6 (P = 0.07) for Definitional Vocabulary, and -0.3 (P = 0.39) for Phonological Awareness. Greater deficits in TOPEL scores were observed in hyperopic children with ≥4.0 D than in emmetropes (-6.8, P = 0.01 for total score; -4.0, P = 0.003 for Print Knowledge). The largest deficits in TOPEL scores were observed in hyperopic children with binocular near VA of 20/40 or worse (-8.5, P = 0.002 for total score; -4.5, P = 0.001 for Print Knowledge; -3.1, P = 0.04 for Definitional Vocabulary) or near stereoacuity of 240 seconds of arc or worse (-8.6, P < 0.001 for total score; -5.3, P < 0.001 for Print Knowledge) compared with emmetropic children. CONCLUSIONS Uncorrected hyperopia ≥4.0 D or hyperopia ≥3.0 to ≤6.0 D associated with reduced binocular near VA (20/40 or worse) or reduced near stereoacuity (240 seconds of arc or worse) in 4- and 5-year-old children enrolled in preschool or kindergarten is associated with significantly worse performance on a test of early literacy.
Collapse
Affiliation(s)
| | | | - Elise Ciner
- Pennsylvania College of Optometry at Salus University, Elkins Park, Pennsylvania
| | - Maureen Maguire
- Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Bruce Moore
- New England College of Optometry, Boston, Massachusetts
| | | | - Maxwell Pistilli
- Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Lynn Cyert
- Northeastern State University College of Optometry, Tahlequah, Oklahoma
| | - T Rowan Candy
- Indiana University School of Optometry, Bloomington, Indiana
| | - Graham Quinn
- Division of Ophthalmology, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Gui-Shuang Ying
- Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania
| |
Collapse
|