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Behboudi H, Rajavi Z, Sabbaghi H, Katibeh M, Kheiri B, Yaseri M, Moradian S, Alizadeh Y, Ahmadieh H, Pakbin M, Bouyeh A, Moradi A. Prevalence of refractive errors in population aged 50 years and over: The Gilan eye study. Eur J Ophthalmol 2024; 34:449-460. [PMID: 37349990 DOI: 10.1177/11206721231184544] [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] [Indexed: 06/24/2023]
Abstract
PURPOSE To describe the prevalence of refractive error (RE) and its association with other environmental and health factors among population aged ≥50 years who lived in Gilan, Iran in 2014. METHODS In this population-based cross-sectional study, 3281 individuals aged ≥50 years living in Gilan for at least 6 months were enrolled. The prevalence of different types of REs including myopia (spherical equivalent (SE)≤-0.50D), high myopia (SE ≤ -6.00D), hyperopia (SE≥ + 0.50D), high hyperopia (SE≥ + 3.00D), astigmatism (cylinder < -0.50D) and high astigmatism (cylinder < -2.25D) were determined. Anisometropia was defined as the SE difference of ≥1.00D between the two eyes. Associated factors including age, body mass index (BMI) and education were also studied. RESULTS 2587 eligible individuals (58% female subjects) with the mean age of 62.6 ± 8.8 years participated (87.6% response rate). The prevalence of myopia, hyperopia and astigmatism was 19.2%, 48.6% and 57.4%, respectively. 3.6% high hyperopia, 0.5% high myopia and 4.5% high astigmatism were identified. The positive simultaneous effects3 of older age (Odds Ratio (OR) = 3.14), nuclear (OR = 1.71) and posterior subcapsular (OR = 1.61) cataracts as well as the negative effects of higher levels of education (OR = 0.28) were obtained on myopia. Higher BMI was found as a risk factor for hyperopia (OR = 1.67), while older patients were less likely to be hyperopic (OR = 0.31). CONCLUSION Higher incidence of myopia and astigmatism was found in patients aged over 70 years. It was also found that patients at older ages who suffered with cataracts were at a higher risk of myopia, while elderly people with greater BMI were at a higher risk of hyperopia.
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Affiliation(s)
- Hassan Behboudi
- Department of Ophthalmology, Guilan University of Medical Sciences, Rasht, Iran
| | - Zhale Rajavi
- Ophthalmic Epidemiology Research Centre, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Negah Aref Ophthalmic Research Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Ophthalmology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamideh Sabbaghi
- Ophthalmic Epidemiology Research Centre, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marzieh Katibeh
- Department of Public Health, Centre for Global Health, Aarhus University, Aarhus, Denmark
| | - Bahareh Kheiri
- Ophthalmic Research Centre, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Siamak Moradian
- Ophthalmic Research Centre, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yousef Alizadeh
- Department of Ophthalmology, Guilan University of Medical Sciences, Rasht, Iran
| | - Hamid Ahmadieh
- Ophthalmic Research Centre, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mojgan Pakbin
- Noor Ophthalmology Research Centre, Noor Eye Hospital, Tehran, Iran
- Translational Ophthalmology Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Aria Bouyeh
- Rehabilitation Research Centre, Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Moradi
- Department of Ophthalmology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Gong W, Wang J, Zhang B, Xu X, Zou H, Liu K, Xu X, He X, Huang J. Cylinder power progression associated with axial length in young children: a two-year follow-up study. Graefes Arch Clin Exp Ophthalmol 2024; 262:295-303. [PMID: 37410179 PMCID: PMC10806115 DOI: 10.1007/s00417-023-06149-3] [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: 11/24/2022] [Revised: 05/06/2023] [Accepted: 06/12/2023] [Indexed: 07/07/2023] Open
Abstract
PURPOSE To describe the association of refraction development and axial length (AL) in young children and provide new insights into the progression of cylinder power. METHODS Children (2-3 grades) were enrolled from primary schools in Shanghai and followed up for two years. Cycloplegic refraction, AL, and corneal curvature radius were measured. Refraction parameters were compared among groups with different AL, AL1 (AL < 23.5 mm), AL2 (23.5 mm ≤ AL < 24.5 mm), and AL3 (AL ≥ 24.5 mm). Multiple regression analysis was used to explore risk factors of diopter of cylinder (DC) progression. RESULTS In total, out of 6891 enrolled children, 5961 participants (7-11 yrs) were included in the final analysis. Over the two-year period, the cylinder power significantly changed, and those with longer AL had more rapid DC progression over the two years (AL1, -0.09 ± 0.35 D; AL2, -0.15 ± 0.39 D; AL3, -0.29 ± 0.44 D) (P < 0.001). The change in DC was independently associated with AL at baseline (P < 0.001). The proportion of with-the-rule astigmatism increased from 91.3% to 92.1% in AL1 group, from 89.1% to 91.8% in AL2 group and from 87.1% to 92.0% in AL3 group. CONCLUSIONS Young children with long AL experienced rapid progression of cylinder power. Both the control of myopia progression and attention to the correction of astigmatism are necessary in the health management of children with long AL. The significantly increased AL in participants might contribute to both the extent and direction of astigmatism.
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Affiliation(s)
- Wei Gong
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Jingjing Wang
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Bo Zhang
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Xian Xu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Haidong Zou
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Kun Liu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Xun Xu
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Xiangui He
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China.
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China.
| | - Jiannan Huang
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China.
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Hayashi K, Uno K, Manabe SI, Yoshimura K. Age-Related Changes in Total Corneal Astigmatism in Eyes With High Myopia. Cornea 2023:00003226-990000000-00432. [PMID: 38049154 DOI: 10.1097/ico.0000000000003447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/26/2023] [Indexed: 12/06/2023]
Abstract
PURPOSE The purpose of this study was to compare age-related changes in corneal astigmatism in eyes with and without high myopia. METHODS Eight-hundred eyes with high myopia (axial length ≥26.0 mm) and 800 eyes without high myopia (200 eyes each from patients in their 40s, 50s, 60s, and ≥70s) underwent videokeratographic examination. The amounts of vertical/horizontal (Rx) and oblique astigmatism (Ry) components, irregular astigmatism, and corneal shape were compared between eyes with and without high myopia and among age categories. RESULTS In both groups, the mean Rx significantly changed to more positive with age (P < 0.001), whereas the Ry did not change significantly. The Rx was significantly more negative in the high myopia group than in the control group in all age categories (P ≤ 0.003), whereas the Ry did not differ significantly. The mean changes in the Rx and Ry during each 2 consecutive decades did not differ significantly between groups. The asymmetry and higher-order irregularity components increased with age (P ≤ 0.001) but did not differ significantly between groups, except for the higher-order irregularity in patients in their 60s (P = 0.018). In the averaged map, the corneal shape changed from with-the-rule to against-the-rule astigmatism with age in both groups, but the changes occurred later in the high myopia group. CONCLUSIONS Age-related changes from with-the-rule to against-the-rule astigmatism occurred later in eyes with high myopia compared with eyes without high myopia in middle or older aged patients, but this change in each age decade was comparable between eyes with and without high myopia.
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Zhang L, Zeng L, Ye Y, Zhang Z, Liu F, Xian Y, Shen Y, Sun L, Xu Y, Zheng K, Zhou X, Zhao J. Refractive and corneal astigmatism in Chinese 4-15 years old children: prevalence and risk factors. BMC Ophthalmol 2023; 23:449. [PMID: 37950161 PMCID: PMC10638796 DOI: 10.1186/s12886-023-03201-y] [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: 03/13/2023] [Accepted: 11/06/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND To investigate the prevalence and risk factors of refractive astigmatism (RA) and corneal astigmatism (CA) in preschool children and school-aged children in Shanghai, China. METHODS In this school-based, cross-sectional study, 4-15 years old children across three learning stages of kindergarten, primary school, and junior high school underwent noncycloplegic autorefraction and completed comprehensive questionnaires involving time spent on daily homework and outdoor activities. Data from the right eyes were analysed. RESULTS Overall, 7084 children (mean ± standard deviation (SD) of age: 8.08 ± 3.11 years) were included, and the prevalence rates of RA/CA ( ≤ - 1.0 D) in children were 15.8%/64% in kindergartens, 16.5%/65% in primary schools, and 32.8%/76.9% in junior high schools. The magnitude and prevalence of RA and CA all increased with age or with learning stage (all P < 0.001). The presence of RA was associated with more myopic spherical power (odds ratio (OR) 0.956, P = 0.021), junior high school (OR 1.973, P < 0.001), longer homework time on weekdays (OR 1.074, P = 0.029), and shorter outdoor activity time on weekends (odds ratio 0.929, P = 0.013). CONCLUSION In the wide age range of 4 to 15 years, the magnitude and prevalence of RA and CA increased with the learning stage, and these increases mainly began at the primary school stage. Factors, including longer homework time and shorter outdoor time were correlated with the presence of RA.
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Affiliation(s)
- Luoli Zhang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 200031, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), 200031, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, 200031, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, 200031, Shanghai, China
| | - Li Zeng
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 200031, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), 200031, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, 200031, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, 200031, Shanghai, China
| | - Yuhao Ye
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 200031, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), 200031, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, 200031, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, 200031, Shanghai, China
| | - Zhe Zhang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 200031, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), 200031, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, 200031, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, 200031, Shanghai, China
| | - Fang Liu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 200031, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), 200031, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, 200031, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, 200031, Shanghai, China
| | - Yiyong Xian
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 200031, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), 200031, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, 200031, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, 200031, Shanghai, China
| | - Yang Shen
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 200031, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), 200031, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, 200031, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, 200031, Shanghai, China
| | - Ling Sun
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 200031, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), 200031, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, 200031, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, 200031, Shanghai, China
| | - Ye Xu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 200031, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), 200031, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, 200031, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, 200031, Shanghai, China
| | - Ke Zheng
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 200031, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), 200031, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, 200031, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, 200031, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 200031, Shanghai, China.
- National Health Commission Key Lab of Myopia (Fudan University), 200031, Shanghai, China.
- Shanghai Research Center of Ophthalmology and Optometry, 200031, Shanghai, China.
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, 200031, Shanghai, China.
| | - Jing Zhao
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 200031, Shanghai, China.
- National Health Commission Key Lab of Myopia (Fudan University), 200031, Shanghai, China.
- Shanghai Research Center of Ophthalmology and Optometry, 200031, Shanghai, China.
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, 200031, Shanghai, China.
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Leung TW, Li RW, Kee CS. Brief Adaptation to Astigmatism Reduces Meridional Anisotropy in Contrast Sensitivity. Invest Ophthalmol Vis Sci 2023; 64:4. [PMID: 37656478 PMCID: PMC10479241 DOI: 10.1167/iovs.64.12.4] [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: 04/06/2023] [Accepted: 08/08/2023] [Indexed: 09/02/2023] Open
Abstract
Purpose To investigate the effect of visual adaptation to orientation-dependent optical blur on meridional contrast sensitivity function in artificially imposed astigmatism. Methods The study adopted a top-up adapt-test paradigm. During the blur adaptation process, the 18 non-astigmatic young adult participants were briefly presented with natural scene images (first trial, 10 minutes; subsequent trials, 6 seconds). Contrast sensitivities for horizontal and vertical gratings at spatial frequencies ranging from 1 to 8 cycles per degree (cpd) were measured immediately before and after adaptation to +3.00 diopters cylinder (DC) with-the-rule or against-the-rule astigmatism. Meridional anisotropy was measured to quantify the contrast sensitivity difference between the two grating orientations. Results Adapting to astigmatic blur enhanced contrast sensitivity at the blurred power meridian but reduced contrast sensitivity at the least affected axis meridian. In with-the-rule conditions, contrast sensitivity for horizontal gratings was significantly increased, whereas that for vertical gratings was significantly decreased. Similarly, in against-the-rule conditions, contrast sensitivity for vertical gratings was significantly increased, whereas that for horizontal gratings was significantly decreased. These two factors together resulted in a substantial systematic reduction, averaging 34%, in meridional anisotropy of contrast sensitivity across the spatial frequency spectrum. Conclusions Astigmatism adaptation occurs in natural scene viewing. Brief exposure to astigmatic blur altered contrast sensitivity in the opposite direction at the two principal meridians, indicating that the mature visual system possesses functional plasticity to recalibrate the response characteristics of orientationally tuned cortical filters and thus promote substantial reductions of meridional anisotropy in astigmatic vision, to some extent counterbalancing the elongated oval shape of astigmatic blur.
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Affiliation(s)
- Tsz-Wing Leung
- School of Optometry, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR
- Research Centre for SHARP Vision, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong
| | - Roger W. Li
- College of Optometry, Nova Southeastern University, Fort Lauderdale, Florida, United States
| | - Chea-Su Kee
- School of Optometry, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR
- Research Centre for SHARP Vision, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong
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Zhang J, Wu Y, Sharma B, Gupta R, Jawla S, Bullimore MA. Epidemiology and Burden of Astigmatism: A Systematic Literature Review. Optom Vis Sci 2023; 100:218-231. [PMID: 36749017 PMCID: PMC10045990 DOI: 10.1097/opx.0000000000001998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 01/15/2023] [Indexed: 02/08/2023] Open
Abstract
SIGNIFICANCE This is the first literature review to report the epidemiology, patient burden, and economic burden of astigmatism in the general adult population. The unmet needs of astigmatism patients with coexisting ocular conditions (cataract, glaucoma, dry eye, presbyopia, or macular degeneration) and risks associated with untreated astigmatism are also reviewed and reported. PURPOSE This study aimed to identify, report, and summarize the published literature on epidemiology, patient burden, and economic burden of astigmatism using a systematic literature review. METHODS MEDLINE, EMBASE, and Cochrane Library databases were searched (January 1996 to May 2021). Search results were limited to the English language. Proceedings (2018 to 2021) from ophthalmology congresses were searched along with gray literature using the Google Scholar platform. RESULTS The literature search yielded 6804 citations, of which 125 met the inclusion criteria (epidemiology, 68; patient burden, 60; economic burden, 6). Astigmatism prevalence in the general population varied from 8 to 62%, with higher rates in individuals 70 years or older. The prevalence of with-the-rule astigmatism was higher in individuals 40 years or younger, whereas rates of against-the-rule and oblique astigmatism increased with age. Astigmatic patients experienced decreased vision quality, increased glare (53 to 77%), haloes (28 to 80%), night-time driving difficulties (66%), falls, and spectacle dependence (45 to 85%). Astigmatic patients performed vision-related tasks slower (1 D, 9% slower; 2 D, 29% slower) and made more errors (1 D, 38% more errors; 2 D, 370% more errors) compared with fully corrected individuals. In cataract patients with astigmatism, the annual mean per-patient productivity loss costs ranged from €55 ($71) to €84 ($108), and mean informal care costs ranged from €30 ($39) to €55 ($71) with a mean of 2.3 to 4.1 hours spent on informal care. CONCLUSIONS Uncorrected astigmatism decreases patients' vision-related quality of life, decreases productivity among working-age adults, and poses an economic burden on patients and their families.
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Affiliation(s)
| | - Yifei Wu
- Alcon Vision LLC, Fort Worth, Texas
| | - Bhavna Sharma
- Skyward Analytics Pvt. Ltd., Gurugram, Haryana, India
| | - Ritu Gupta
- Skyward Analytics Pvt. Ltd., Gurugram, Haryana, India
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Liang D, Leung TW, Kee CS. Measuring Retinal Thickness and Visual Acuity in Eyes with Different Types of Astigmatism in a Cohort of Hong Kong Chinese Adults. Invest Ophthalmol Vis Sci 2023; 64:2. [PMID: 36595274 PMCID: PMC9819738 DOI: 10.1167/iovs.64.1.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Purpose The purpose of this study was to investigate optical coherence tomography (OCT)-measured retinal thickness (RT) and best-corrected distance visual acuity (BCDVA) in eyes with different types of astigmatism. Methods This is a case-control study of 101 participants stratified into With-The-Rule (WTR; n = 41), Against-The-Rule (ATR; n = 25), and control (n = 35) groups by noncycloplegic subjective refraction. Inclusion criteria were ages between 18 and 45 years, spherical-equivalent (SE) refraction ≥-10.00 diopters (D), negative cylindrical power (CYL) ≤-0.75 D with axes of 0 to 30 degrees/150 to 180 degrees for WTR and 60 to 120 degrees for ATR, or CYL ≥-0.25 D for controls. Participants suffering from ocular diseases related to retinal defects, having a history of ocular surgery, with BCDVA >0.10 LogMAR, or poor OCT imaging quality were excluded. Fovea-centered scans were performed using spectral-domain OCT (SD-OCT), and RT automatically measured by the inbuilt software. Only right eyes were analyzed. Groups were matched for age, gender, SE, axial length, and corneal curvature. Results One-way ANOVA showed a significant difference in both BCDVA (P = 0.039) and macular RT (P = 0.028) among the three groups. Bonferroni's post hoc test revealed statistically significant between-group differences in BCDVA (WTR vs. controls, P = 0.041), as well as in RT at inner-nasal (WTR vs. ATR, P = 0.034) and outer-temporal subfields (WTR vs. controls, P = 0.042). BCDVA was positively associated with macular RT (r = 0.206, P = 0.041) after adjusting for age, gender, and axial length. Conclusions Greater RT and poorer BCDVA were found in eyes with WTR astigmatism. Our findings suggest that the effect of astigmatism on retinal thickness and BCDVA may vary depending on not only magnitude, but also axis of astigmatism.
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Affiliation(s)
- Dong Liang
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong
| | - Tsz-Wing Leung
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong,Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Hong Kong,Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong
| | - Chea-Su Kee
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong,Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Hong Kong,Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong
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de Lestrange-Anginieur E. Meridional Attentional Asymmetries in Astigmatic Eyes. Eye Brain 2023; 15:63-76. [PMID: 37200891 PMCID: PMC10188198 DOI: 10.2147/eb.s407481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 05/06/2023] [Indexed: 05/20/2023] Open
Abstract
Purpose To investigate the impact of attention orientation in young myopic adults with astigmatism. Methods The effect of attention on foveal meridional performance and anisotropy was measured in corrected myopes with various levels of astigmatism (with-the-rule astigmatism ≤ -0.75D, Axis: 180 ± 20) using orientation-based attention. Attention was manipulated by instructing subjects to attend to either the horizontal or the vertical line of a central pre-stimulus (a pulsed cross) along separate blocks of trials. For each attention condition, meridional acuity and reaction times were measured via an annulus Gabor target situated remotely from the cross and presented at random horizontally and vertically in a two-alternative forced-choice employing two interleaved staircase procedures (one-up/one-down). Attention modulations were estimated by the difference in performance between horizontal and vertical attention. Results Foveal meridional performance and anisotropy were strongly affected by the orientation of attention, which appeared critical for the enhancement of reaction times and resolution. Under congruent orienting of attention, foveal meridional anisotropy was correlated with the amount of defocus for both reaction time and resolution, demonstrating greater vertical performance than horizontal performance as myopia increased. Compatible with an attentional compensation of blur through optimal orienting of attention, vertical attention enhanced reaction times compared to horizontal attention and was accompanied by an increase in overall acuity when myopia increased. Increased astigmatism was associated with smaller attention effects and asymmetry, suggesting potential deficits in the compensation of blur in astigmatic eyes. Conclusion Collectively, attention to orientation plays a significant role in horizontal-vertical foveal meridional anisotropy and can modulate the asymmetry of foveal perception imposed by the optics of the eye in episodes of uncorrected vision. Further work is necessary to understand how attention and refractive errors interact during visual development. These results may have practical implications for methods to enhance vision with attention training in myopic astigmats.
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Affiliation(s)
- Elie de Lestrange-Anginieur
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong
- Laboratory of Experimental Optometry, Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
- Centre for Eye and Vision Research (CEVR), Kowloon, Hong Kong
- Correspondence: Elie de Lestrange-Anginieur, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, Tel +8522766 4186, Fax +852 2764 6051, Email
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Lin J, An D, Lu Y, Yan D. Correlation between ocular residual astigmatism and anterior corneal astigmatism in children with low and moderate myopia. BMC Ophthalmol 2022; 22:374. [PMID: 36123634 PMCID: PMC9487078 DOI: 10.1186/s12886-022-02560-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 07/29/2022] [Indexed: 11/10/2022] Open
Abstract
Background To assess the correlation between ocular residual astigmatism and anterior corneal astigmatism in children with low and moderate myopia. Methods Refractive astigmatism was determined by subjective manifest refraction. Anterior corneal astigmatism was determined by IOL Master. Thibos vector analysis was used to calculate ocular residual astigmatism. Correlation analysis was used to assess the relationship between the amounts of ocular residual astigmatism and anterior corneal astigmatism. The relationship between the vectors of ocular residual astigmatism and anterior corneal astigmatism was evaluated by a physical method. Results The study analysed 241 right eyes of 241 children aged 8 to 18 years old. In this study, the median magnitude of ocular residual astigmatism was 1.02 D, with an interquartile range was of 0.58 D. Against-the-rule ocular residual astigmatism was seen in 232 eyes (96.3%). There was a significant and moderate correlation between ocular residual astigmatism and anterior corneal astigmatism (r = 0.50, P < 0.001). Ocular residual astigmatism compensated for anterior corneal astigmatism in 240 eyes (99.6%). The mean compensation value was 1.00 ± 0.41 D (range 0.02 D to 2.34 D). Based on this effect, 37 eyes had a different axial classification of anterior corneal astigmatism and refractive astigmatism. In contrast, one eye (0.4%) had oblique ocular residual astigmatism and the ocular residual astigmatism superimposed with-the-rule anterior corneal astigmatism. Conclusions The magnitude of ocular residual astigmatism was relatively large in myopic children and predominantly compensated for anterior corneal astigmatism. Ocular residual astigmatism should be assessed in patients before fitting them with orthokeratology lenses. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-022-02560-2.
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Affiliation(s)
- Jian Lin
- Lianyungang Maternal and Child Health Hospital, Lianyungang, 222000, Jiangsu, China
| | - Dexiang An
- Lianyungang Maternal and Child Health Hospital, Lianyungang, 222000, Jiangsu, China
| | - Yun Lu
- Lianyungang Maternal and Child Health Hospital, Lianyungang, 222000, Jiangsu, China
| | - Dongmei Yan
- Lianyungang Maternal and Child Health Hospital, Lianyungang, 222000, Jiangsu, China.
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10
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Chan KH, Shik HT, Kwok KW, Kee CS, Leung TW. Bi-directional Refractive Compensation for With-the-Rule and Against-the-Rule Astigmatism in Young Adults. Invest Ophthalmol Vis Sci 2022; 63:15. [PMID: 36155745 PMCID: PMC9526370 DOI: 10.1167/iovs.63.10.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to investigate the short-term effect of imposing astigmatism on the refractive states of young adults. Methods Nineteen visually healthy low-astigmatic young adults (age = 20.94 ± 0.37 years; spherical-equivalent errors [M] = -1.47 ± 0.23 diopters [D]; cylindrical errors = -0.32 ± 0.05 D) were recruited. They were asked to wear a trial frame with treated and control lenses while watching a video for an hour. In three separate visits, the treated eye was exposed to one of three defocused conditions in random sequence: (1) with-the-rule (WTR) astigmatism = +3.00 DC × 180 degrees; (2) against-the-rule (ATR) astigmatism = +3.00 DC × 90 degrees; and (3) spherical defocus (SPH) = +3.00 DS. The control eye was fully corrected optically. Before and after watching the video, non-cycloplegic autorefraction was performed over the trial lenses. Refractive errors were decomposed into M, J0, and J45 astigmatism. Interocular differences in refractions (treated eye - control eye) were analyzed. Results After participants watched the video with monocular astigmatic defocus for an hour, the magnitude of the J0 astigmatism was significantly reduced by 0.25 ± 0.10 D in both WTR (from +1.53 ± 0.07 D to +1.28 ± 0.09 D) and 0.39 ± 0.15 D in ATR conditions (from -1.33 ± 0.06 D to -0.94 ± 0.18 D), suggesting an active compensation. In contrast, changes in J0 astigmatism were not significant in the SPH condition. No compensatory changes in J45 astigmatism or M were found under any conditions. Conclusions Watching a video for an hour with astigmatic defocus induced bidirectional, compensatory changes in astigmatic components, suggesting that refractive components of young adults are moldable to compensate for orientation-specific astigmatic blur over a short period.
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Affiliation(s)
- Kin-Ho Chan
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, Special Administration Region of the People's, Republic of China.,Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong, Special Administration Region of the People's, Republic of China
| | - Ho-Tin Shik
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, Special Administration Region of the People's, Republic of China
| | - Kwan William Kwok
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, Special Administration Region of the People's, Republic of China
| | - Chea-Su Kee
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, Special Administration Region of the People's, Republic of China.,Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong, Special Administration Region of the People's, Republic of China
| | - Tsz-Wing Leung
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, Special Administration Region of the People's, Republic of China.,Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong, Special Administration Region of the People's, Republic of China.,Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Hong Kong, Special Administration Region of the People's, Republic of China
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11
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Hashemi H, Asharlous A, Yekta A, Aghamirsalim M, Nabovati P, Sadoughi MM, Khabazkhoob M. Astigmatism profile in the elderly population: Tehran Geriatric Eye Study. Jpn J Ophthalmol 2022; 66:461-473. [PMID: 35947225 DOI: 10.1007/s10384-022-00936-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 06/23/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine the prevalence of astigmatism and its associated factors and examine astigmatism symmetry patterns in an elderly population. STUDY DESIGN Population based cross-sectional study. METHODS The present population-based cross-sectional study was conducted on an elderly population above 60 years of age in Tehran, Iran in 2019. The sampling was done using the stratified multistage random cluster sampling method. All study participants underwent a complete optometric examination and slit-lamp biomicroscopy. RESULTS The prevalence of astigmatism higher than -0.50, -1.00, and -2.00 D was 83% (95% CI: 81 -84), 52 % (95% CI: 50 -54), and 19% (95% CI: 17-20), respectively. These prevalence was 79%(95% CI: 77-81), 46(95% CI: 44-49) and 14(95% CI: 13-16) in subjects without a history of ocular surgery, respectively. Based on cylinder power worse than -1.00 D, 10% (95% CI: 9-12), 20% (95% CI: 18-22), and 21% (95% CI:19-23) of study participants had with the rule, against the rule, and oblique astigmatism, respectively. According to the results of the multiple regression model, male gender, older age, low education level, pure posterior subcapsular cataract, pseudophakia, and myopia were independent factors associated with astigmatism. The prevalence of anisorule astigmatism was 57 % (95% CI: 56-59), the most common anisorule astigmatism was against the rule-oblique type with a prevalence of 36% (95% CI: 34-38). CONCLUSION The prevalence of astigmatism was high in the elderly population of Tehran. More than half of the participants in this study had anisorule astigmatism, and against the rule-oblique combination was more prevalent than other types. A posterior subcapsular cataract, a history of cataract surgery, and myopia were the associated factors of astigmatism in this study.
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Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Amir Asharlous
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Abbasali Yekta
- Department of Optometry, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Payam Nabovati
- Rehabilitation Research Center, Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mehdi Sadoughi
- Department of Ophthalmology, School of Medicine, Shahid Labbafinezhad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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12
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High Prevalence of Astigmatism in Children after School Suspension during the COVID-19 Pandemic Is Associated with Axial Elongation. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9060919. [PMID: 35740857 PMCID: PMC9245603 DOI: 10.3390/children9060919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/08/2022] [Accepted: 06/16/2022] [Indexed: 11/17/2022]
Abstract
During the COVID-19 pandemic, the Hong Kong Government enforced a “school from home” policy between February and September 2020. This cross-sectional epidemiological study was conducted to investigate the prevalence of astigmatism and visual habits after the home confinement period. Vision screenings were conducted at three local government-funded primary schools in Hong Kong from October 2020 to December 2020. A total of 418 ethnically Chinese primary school children completed the eye examination and returned questionnaires concerning demographic information and visual habits. It was found that 46.5% (95% CI, 41.7−61.4%) of the children aged 8 to 11 years had astigmatism ≥ 0.75 D, which was predominately With-The-Rule astigmatism. The prevalence of astigmatism reported in these children is generally higher than that of studies conducted before COVID. Compared to their non-astigmatic peers, astigmatic children had a longer axial length (p < 0.001) and engaged in fewer outdoor activities (p = 0.04). Multiple linear regression analyses also revealed significant relationships between axial length and both cylindrical error and J0 astigmatism. Due to the high astigmatism prevalence, there is a pressing need for further studies on the long-term impact of the pandemic on children’s vision.
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13
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Liang Y, Leung TW, Lian JT, Kee CS. Significant increase in astigmatism in children after study at home during the COVID-19 lockdown. Clin Exp Optom 2022; 106:322-330. [PMID: 35021950 DOI: 10.1080/08164622.2021.2024071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
CLINICAL RELEVANCE Evaluating changes in refractive astigmatism after 'study at home' during the COVID pandemic may shed light on the aetiology of refractive errors. BACKGROUND To investigate whether there has been a change in the proportion of astigmatism among primary school children after the school closure period during the COVID-19 pandemic. METHODS This observational study compared cross-sectional (2018: n = 112; 2020: n = 173) and longitudinal data (n = 38) collected from two vision screenings, one in 2018 and the other after the school closure period in 2020, in the same primary school for children aged 8-10 years. Non-cycloplegic refraction and axial length were measured using an open-field auto-refractometer and IOL Master, respectively. A questionnaire focusing on demographic information, near-work time, and outdoor activities was administered to parents of all participants. RESULTS While there were no significant differences in age, gender, or monthly family income between the two cohorts, astigmatism proportion (Cyl ≥ 0.75 D) in 2020 was 1.5-fold higher than that in 2018 (49.1% vs. 33.9%). The median cylindrical power was significantly higher in 2020 in older children (9 or 10 years old). More importantly, the children participating in both vision screenings had cylindrical power and J0 astigmatism significantly increased by 0.35 ± 0.40 D and 0.21 ± 0.25 D, respectively. CONCLUSION A significant increase in astigmatism (both proportion and magnitude) was found after the school closure period. Further studies are needed to investigate the origin of this increased astigmatism.
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Affiliation(s)
- Yuanyuan Liang
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Tsz-Wing Leung
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR.,Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Jinxiao Tina Lian
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR.,Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Chea-Su Kee
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR.,Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong
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14
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Wajuihian SO, Mashige KP. Gender and age distribution of refractive errors in an optometric clinical population. JOURNAL OF OPTOMETRY 2021; 14:315-327. [PMID: 33487574 PMCID: PMC8569398 DOI: 10.1016/j.optom.2020.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/10/2020] [Accepted: 09/18/2020] [Indexed: 06/12/2023]
Abstract
AIM To determine the patterns of distribution of refractive errors in a clinical sample of patients examined in an optometry practice. METHOD In this retrospective study, the clinic records of 6687 patients aged 6 to 85 years comprising 2168 (32.2%) males and 4519 (67.5%) females were reviewed. Refractive error were analysed according to gender, age, as well as types and categories including axis of astigmatism using the vector power analysis method where the traditional sphero-cylinder was transformed into J0 (primary) and J45 (oblique) astigmatic components. RESULTS Only the analysis for right eye was reported as right and left spherical equivalent were similar. The mean with standard deviations for refractive errors were: Myopia: -1.95 ± 2.6, hyperopia: 1.04 ± 0.9, astigmatism: -1.22 ± 0.71 and anisometropia: -0.01 ± 2.5 DS. The distributions with significant changes included males that were significantly more myopic and astigmatic, while females were more hyperopic across the age groups. Furthermore, myopia decreased, while hyperopia, astigmatism and anisometropia increased with increasing age. Unique findings from this study include: myopia peaked earlier, second hyperopic shift commenced after age 82 years and the distribution of severity of astigmatism contrasts with previous understanding. CONCLUSION Although the patterns of distribution of refractive errors in patients aged 6 to 85 years corroborates previous findings, myopia and hyperopia peak, as well as severity of astigmatism were unique to the present study. Results from non-clinic populations will be useful to confirm trends reported in this study.
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Affiliation(s)
- Samuel Otabor Wajuihian
- Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban 4000, South Africa.
| | - Khathutshelo Percy Mashige
- Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban 4000, South Africa.
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15
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Leung TW, Li RW, Kee CS. Meridional Anisotropy of Foveal and Peripheral Resolution Acuity in Adults With Emmetropia, Myopia, and Astigmatism. Invest Ophthalmol Vis Sci 2021; 62:11. [PMID: 34379095 PMCID: PMC8363766 DOI: 10.1167/iovs.62.10.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To quantify astigmatism-related meridional anisotropy in visual resolution at central, nasal, and inferior visual fields. Methods Three groups of young adults (range, 18–30 years) with corrected-to-normal visual acuity (logMAR 0) were recruited: (1) myopic astigmats (MA): spherical-equivalent error (SE) < −0.75D, with-the-rule astigmatism ≥ 2.00D, n = 19; (2) simple myopes (SM): SE < −0.75D, astigmatism ≤ 0.50D, n = 20; and (3) emmetropes (EM): SE ± 0.50D, astigmatism ≤ 0.50D, n = 14. Resolution acuity was measured for the horizontal and vertical gratings at central and peripheral visual fields (eccentricity: 15°) using a 3-down 1-up staircase paradigm. On- and off-axis refractive errors were corrected by ophthalmic lenses. Results The MA group exhibited meridional anisotropy preferring vertical gratings. At the central field, the MA group had better resolution acuity for vertical than horizontal gratings, and their resolution acuity for horizontal gratings was significantly worse than the SM and EM groups. At peripheral visual fields, both the SM and EM groups showed better resolution acuity for the radial (i.e., nasal field: horizontal gratings; inferior field: vertical gratings) than tangential orientation. However, the MA group tended to have better resolution acuity for the tangential orientation (i.e., vertical gratings), and their resolution acuity for horizontal gratings was significantly lower than the SM and EM groups at the nasal field. No significant differences were found in the inferior field among the three groups. Conclusions This study provided evidence of astigmatism-related meridional anisotropy at the fovea and nasal visual fields, underscoring the significant impact of astigmatism on orientation-dependent visual functions.
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Affiliation(s)
- Tsz-Wing Leung
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR
| | - Roger W Li
- Vision and Eye Research Institute, School of Medicine, Anglia Ruskin University, Cambridge, United Kingdom
| | - Chea-Su Kee
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR
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16
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Heydarian S, Sardari S, Heidari Z, Yekta AA, Ostadimoghaddam H, Khabazkhoob M. Corneal and Ocular Residual Astigmatism in School-Age Children. J Curr Ophthalmol 2021; 32:355-360. [PMID: 33553837 PMCID: PMC7861098 DOI: 10.4103/joco.joco_8_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 04/08/2020] [Accepted: 04/21/2020] [Indexed: 11/04/2022] Open
Abstract
Purpose To determine the distribution of residual and corneal astigmatism (CA) in children aged 6-18 years and their relationship with age, sex, spherical equivalent, and biometric parameters. Methods In this cross-sectional study, multi-stage stratified cluster sampling was done to select students from Dezful, a city in Southwestern Iran. Examinations included the measurement of visual acuity with and without optical correction, refraction with and without cycloplegia, and biometry using the Biograph (Lenstar, Germany). The main outcomes in this report were corneal and residual astigmatism. The CA was measured by Biograph (difference between k1 and k2), and residual astigmatism was calculated using Alpine method. The power vector method was applied to analyze the data of astigmatism. Results Of 864 students that were selected, 683 (79.1%) participated in the study. The mean residual and CA were -0.84 diopter (D) and -0.85 D, respectively. According to the results of J0 and J45 vectors, residual astigmatism was -0.33 D and 0.04 D, and CA was 0.38 D and 0.01 D, respectively. With-the-rule (WTR), against-the-rule (ATR), and oblique astigmatism were seen in 3.4%, 66.8%, and 4.5% of the children with residual astigmatism and 67.94%, 1.3%, and 1.5% of the children with CA. Residual astigmatism decreased with an increase in spherical refractive error, whereas CA increased with an increase in spherical refractive error. Conclusion The results of the present study showed a high prevalence and amount of residual astigmatism with ATR pattern among the 6-18-year-old population and the compensatory effect of this type of astigmatism on CA that mostly followed a WTR pattern.
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Affiliation(s)
- Samira Heydarian
- Department of Rehabilitation Science, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
| | - Sara Sardari
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Zahra Heidari
- Department of Rehabilitation Science, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran.,Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Abbas Ali Yekta
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Ostadimoghaddam
- Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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17
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De Lestrange-Anginieur E, Kee CS. Optical performance of progressive addition lenses (PALs) with astigmatic prescription. Sci Rep 2021; 11:2984. [PMID: 33542417 PMCID: PMC7862262 DOI: 10.1038/s41598-021-82697-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 01/18/2021] [Indexed: 11/09/2022] Open
Abstract
The progressive addition lens (PAL) is a spectacle lens design with progressive refractive power changes across the lens surface to provide sharp vision at different viewing distances for patients with reduced accommodative strength. It has gained in popularity not just for presbyopic patients, but also patients with occupational (office, driving, or digital device) and therapeutic (e.g., myopia control) needs. However, despite the increasing prevalence of astigmatism in adults > 40 years old who rely on PAL correction, no metric is available to reflect the optical variation in PALs with astigmatic prescriptions. Based on recent studies, four novel optical metrics sensitive to variation of refractive power across the lens surface of PALs have been developed. These metrics were used to compare the optical performance of PALs of various prescriptions, designs, and manufacturers. For each lens, the refractive power profile was first measured with a Moire-deflectometry-based instrument.The data was then exported and analyzed using a two-dimensional error map for each of the four metrics. The results revealed significant impacts of astigmatic prescription, providing evidence for the usefulness of these metrics in quantifying the optical performance of PALs for patients with astigmatic prescriptions.
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Affiliation(s)
| | - C S Kee
- School of Optometry, Hong Kong Polytechnic University, Hong Kong, China.,Interdisciplinary Division of Biomedical Engineering, Hong Kong Polytechnic University, Hong Kong, SAR, China
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18
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Vyas SA, Kee CS. Early Astigmatism Can Alter Myopia Development in Chickens. Invest Ophthalmol Vis Sci 2021; 62:27. [PMID: 33605983 PMCID: PMC7900885 DOI: 10.1167/iovs.62.2.27] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 01/25/2021] [Indexed: 12/17/2022] Open
Abstract
Purpose To determine the effects of optically imposed astigmatism on myopia development in chickens. Methods Chicks were randomly assigned to wear either spherical (-10D, "LIM", n = 14) or sphero-cylindrical lenses (n ≥ 19 in each group) monocularly for a week from 5 days of age. All lenses imposed the same magnitude of spherical-equivalent hyperopic defocus (-10D), with the two astigmatic magnitudes (-8D or -4D) and four axes (45°, 90°, 135°, or 180°) altered to simulate four subtypes of clinical astigmatism. At the end of the treatment, refractive state was measured for all birds, whereas ocular axial dimensions and corneal curvature were measured for subsets of birds. Results Sphero-cylindrical lens wear produced significant impacts on nearly all refractive parameters (P < 0.001), resulting in myopic-astigmatic errors in the treated eyes. Compared to LIM, the presence of astigmatic blur induced lower myopic error (all except L180 group, P < 0.001) but with higher refractive astigmatism (all P < 0.001) in birds treated with sphero-cylindrical lenses. Distributions of the refractive, axial, and corneal shape parameters in the sphero-cylindrical lens-wear groups indicated that the astigmatic blur had directed the eye growth toward the least hyperopic image plane, with against-the-rule (ATR) and with-the-rule (WTR) astigmatisms typically inducing differential biometric changes. Conclusions The presence of early astigmatism predictably altered myopia development in chicks. Furthermore, the differential effects of WTR and ATR astigmatisms on anterior and posterior segment changes suggest that the eye growth mechanism is sensitive to the optical properties of astigmatism.
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Affiliation(s)
- Sonal Aswin Vyas
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Chea-su Kee
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
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19
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Leung TW, Chan CT, Lam CH, Tong YK, Kee CS. Changes in corneal astigmatism and near heterophoria after smartphone use while walking and sitting. PLoS One 2020; 15:e0243072. [PMID: 33270709 PMCID: PMC7714198 DOI: 10.1371/journal.pone.0243072] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 11/14/2020] [Indexed: 11/23/2022] Open
Abstract
Background/Aims Smartphone use has become an indispensable part of our daily life. The handy design and powerful processor allow smartphone users to perform diversified tasks even when walking. This study aimed to investigate and compare the optical aftereffect and vergence adaptation of using a smartphone while walking and sitting. Methods Twenty-nine young healthy adults (aged 19 to 24 years old) with normal binocular and accommodative functions were recruited. Participants were asked to watch a movie for 30 minutes using a smartphone while either walking on a treadmill or sitting on a chair. Corneal aberrations and near heterophoria were measured before and after smartphone use by a corneal topographer and modified Thorington heterophoria test, respectively. Results Using the smartphone while walking induced a change in corneal H/V astigmatism, becoming 0.11±0.03 μm less negative (two-way ANOVA repeated measures, Bonferroni post-hoc test, p = 0.001). This optical aftereffect was significantly higher than after smartphone use while sitting by 0.10±0.03 μm (paired t-test, p = 0.003). Although smartphone use did not result in a significant change in near heterophoria (Bonferroni post-hoc test, p > 0.15), the vergence adaptation showed relatively more eso- or less exo-deviation by 0.79±0.36Δ in the walking than the sitting condition (paired t-test, p = 0.037). Conclusions Eyecare practitioners should be cautious of the potential optical after effect and vergence adaptation after prolonged smartphone usage.
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Affiliation(s)
- Tsz Wing Leung
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
- The Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
- * E-mail:
| | - Chui-Ting Chan
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Chi-Hin Lam
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Yuk-Kwan Tong
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Chea-Su Kee
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
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20
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Wang J, Cheng QE, Fu X, Zhang R, Meng J, Gu F, Li J, Ying GS. Astigmatism in school students of eastern China: prevalence, type, severity and associated risk factors. BMC Ophthalmol 2020; 20:155. [PMID: 32306963 PMCID: PMC7168812 DOI: 10.1186/s12886-020-01425-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 04/06/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND China has been undergoing dramatic economic development, accompanied by increased education load on the young children. This study is to investigate the prevalence, type, severity, and associated risk factors of astigmatism in school students in eastern China. METHOD In this cross-sectional school-based study, students underwent refraction using NIDEK non-cycloplegic autorefractor. Astigmatism was defined as cylinder 1.5 diopter (D) or greater, and high astigmatism was defined as cylinder 3.0 D or greaterMultivariate regression models were used to determine factors associated with astigmatism. RESULTS Among 4801 children (55% male) with mean age (±standard deviation) 12.3 (±3.8) years, 680 (14.2, 95% confidence interval (95% CI): 13.2-15.2%) had astigmatism (85% were with-the-rule) and 103 (2.2, 95% CI: 1.8-2.6%) had high astigmatism. The prevalence rate of astigmatism was 7-8% in grades 4 or below, 15-16% in grades 6-8, 20% in grade 9, and 20-25% in grade 10 or above. In multivariate analyses, higher grade and male gender were associated with higher prevalence of astigmatism (all p < 0.0001) and high astigmatism (p = 0.04 for grade, p = 0.001 for gender). When multivariate models were further adjusted by spherical equivalent, only gender remained statistically associated with astigmatism (odds ratio (OR) = 1.65, p < 0.0001) and high astigmatism (OR = 2.21, p = 0.0004), myopic and hyperopic refractive error were significantly associated with higher risk of astigmatism and high astigmatism (all p < 0.0001). CONCLUSION Astigmatism is common in Chinese school-age children and increases with grade. Majority of astigmatism is with-the-rule. Male gender and myopic or hyperopic refractive error are significantly associated with higher prevalence and severity of astigmatism.
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Affiliation(s)
- Jianyong Wang
- Department of Ophthalmology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, People's Republic of China.
| | | | - Xiaojin Fu
- Department of Ophthalmology, Central Hospital of Yiwu City, Zhejiang, People's Republic of China
| | - Ronghua Zhang
- Center for Disease Prevention and Control, Hangzhou, Zhejiang, People's Republic of China
| | - Jia Meng
- Center for Disease Prevention and Control, Hangzhou, Zhejiang, People's Republic of China
| | - Fang Gu
- Center for Disease Prevention and Control, Hangzhou, Zhejiang, People's Republic of China
| | - Juanjuan Li
- Center for Disease Prevention and Control, Hangzhou, Zhejiang, People's Republic of China
| | - Gui-Shuang Ying
- Center for Preventive Ophthalmology and Biostatistics, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Asgari S, Mehravaran S, Fotouhi A, Makateb A, Hashemi H. Total corneal refractive power and shape in Down syndrome. Eur J Ophthalmol 2019; 31:69-77. [PMID: 31635486 DOI: 10.1177/1120672119883594] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To determine the total corneal refractive power in 1-8 mm corneal zones and the 8 mm Q-value in non-keratoconic patients with Down syndrome and normal subjects aged 10-30 years. METHODS Right eye data from 203 Down syndrome patients (mean ± standard deviation age: 17.0 ± 4.7 years) and 189 age- and gender-matched normal subjects (17.1 ± 4.5 years) were compared. Main extracted Pentacam indices were total corneal refractive power in steep and flat axes, and mean and difference (corneal astigmatism) total corneal refractive power in 1-8 mm zones. RESULTS Mean total corneal refractive power in 1-8 mm zones was 45.17-45.74 D and 42.91-43.52 D in Down and normal group, respectively (all p < 0.001). The coefficients of variation of total corneal refractive power from the center to the periphery were similar in the two groups (p = 0.855). None of the mean total corneal refractive powers significantly correlated with age, and all of them were significantly higher in females (p < 0.001). Mean total corneal refractive power-based corneal astigmatism in these zones changed from 1.46 to 1.66 D in Down syndrome patients and 1.64 to 1.99 D in normal group. All corneal astigmatism indices were similar between two groups (all p > 0.05). The prevalence of against the rule and oblique astigmatism in all zones were higher in the Down syndrome group (all p < 0.05). CONCLUSION Adolescent and young non-keratoconic patients with Down syndrome have a more prolate cornea and a homogeneous keratometry distribution. In this population, females have a steeper cornea.
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Affiliation(s)
- Soheila Asgari
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Shiva Mehravaran
- ASCEND Center for Biomedical Research, Morgan State University, Baltimore, MD, USA
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Makateb
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
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Yap TP, Luu CD, Suttle CM, Chia A, Boon MY. Electrophysiological and Psychophysical Studies of Meridional Anisotropies in Children With and Without Astigmatism. Invest Ophthalmol Vis Sci 2019; 60:1906-1913. [PMID: 31042798 DOI: 10.1167/iovs.18-25924] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose We investigated the pattern of meridional anisotropies, if any, for pattern onset-offset visual evoked potential (POVEPs) responses and psychophysical grating acuity (GA) in children with normal letter visual acuity (20/20 or better). Methods A total of 29 children (aged 3-9 years), nine of whom were astigmatic (AS), were recruited. Orientation-specific monocular POVEPs were recorded in response to sinewave grating stimuli oriented along the subjects' principal AS meridians. Horizontal and vertical gratings were designated Meridians 1 and 2, respectively, for nonastigmatic patients (Non-AS). Binocular POVEPs in response to the same stimuli, but oriented at 45°, 90°, 135°, and 180°, were recorded. Psychophysical GAs were assessed monocularly and binocularly along the same meridians using the same stimuli by a 2-alternative-forced-choice staircase technique. The C3 amplitudes and peak latencies of the POVEP and GAs were compared across meridians using linear mixed models (monocular) and ANOVA (binocular). Results There were significant meridional anisotropies in monocular C3 amplitudes regardless of astigmatism status (P = 0.001): Meridian 2 (mean ± SE Non-AS, 30.13 ± 2.07 μV; AS, 26.53 ± 2.98 μV) was significantly higher than Meridian 1 (Non-AS, 26.14 ± 1.87 μV; AS, 21.68 ± 2.73 μV; P = 0.019), but no meridional anisotropies were found for GA or C3 latency. Binocular C3 amplitude in response to horizontally oriented stimuli (180°, 29.71 ± 3.06 μV) was significantly lower than the oblique (45°, 36.62 ± 3 .05 μV; P = 0.03 and 135°, 35.95 ± 2.92 μV; P = 0.04) and vertical (90°, 37.82 ± 3.65 μV; P = 0.02) meridians, and binocular C3 latency was significantly shorter in response to vertical than oblique gratings (P ≤ 0.001). Conclusions Meridional anisotropy was observed in children with normal vision. The findings suggest that horizontal gratings result in a small, but significantly lower POVEP amplitude than for vertical and oblique gratings.
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Affiliation(s)
- Tiong Peng Yap
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Chi D Luu
- Centre for Eye Research Australia; Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.,Department of Surgery (Ophthalmology), The University of Melbourne, Parkville, Victoria, Australia
| | - Catherine M Suttle
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia.,Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, United Kingdom
| | - Audrey Chia
- Pediatric Ophthalmology and Adult Strabismus Department, Singapore National Eye Centre (SNEC), Singapore.,Pediatric Ophthalmology and Strabismus Department, KK Women's and Children's Hospital (KKH), Singapore
| | - Mei Ying Boon
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
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Abstract
SIGNIFICANCE Growing popularity of handheld digital devices imposes significant challenges to our visual system and clinical management. This study aimed to determine the effects of lens design on parameters that may influence the refractive management of pre-presbyopic adult computer users. PURPOSE To determine the effects of wearing conventional single-vision lenses (SVL) versus progressive addition lenses (PAL) on the working distance and refractive status. METHODS Adult computer users, recruited from two age cohorts (18 to 25 years, n = 19; 30 to 40 years, n = 45), were prescribed SVLs and PALs designed for use with handheld digital devices. For each lens type, the working distance and refractive shift (post-task − pre-task) were measured immediately after lens delivery (T0) and after 1 month of lens wear (T1). Working distances were recorded with an automatic ultrasound device while the participants were playing a video game. Refractive status through the subjects' glasses was measured before (pre-task) and after playing the game (post-task). Questionnaires assessing the frequencies of 10 digital work–related visual symptoms were conducted for both lens types at T1. RESULTS Switching from SVL to PAL increased the working distance in both cohorts (mean ± SEM = 1.88 ± 0.60 cm; P = .002) and induced a small but significant positive refractive shift (+0.08 ± 0.04 D, P = .021) in the older cohort at T1. In the younger cohort, the changes in working distance due to the switching lens design were correlated with myopic error (r = +0.66, P = .002). In the older cohort, the changes in refractive shift due to switching lens design were correlated with amplitude of accommodation at both time points (r for T0 and T1 = −0.32 and −0.30, respectively; both P < .05). Progressive addition lens was rated as causing less “increased sensitivity to light” compared with SVL. CONCLUSIONS Switching from SVL to PAL increased the working distance and induced a positive refractive shift in the majority of pre-presbyopic adults.
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Rozema JJ, Hershko S, Tassignon M, Lorenz K, von Trentini M, Sala Pomares E, Corral MJG, Bataille L, Alió JL, Jongenelen S, Ruiz‐Hidalgo I, Rauscher FG, Blüsch MT, Dawczynski J, Wiedemann P, Mosca L, Guccione L, Riso M, Toro ME, Rosati A, Duch F, Escude R, Martinez A, Morilla‐Grasa A, Peris‐Martínez C, Díez Ajenjo A, Garcia Domene C, De Febrer MB, Solans TT, Gazdik AV, Varssano D, Gold B, Toto L, Mastropasqua A, Mastropasqua L, Fasce F, Spinelli A, Knutsson K, Fogliato G. The components of adult astigmatism and their age‐related changes. Ophthalmic Physiol Opt 2019; 39:183-193. [DOI: 10.1111/opo.12616] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 03/19/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Jos J Rozema
- Department of Ophthalmology Antwerp University Hospital Edegem Belgium
- Department of Medicine and Health Sciences University of Antwerp Wilrijk Belgium
| | - Sarah Hershko
- Department of Ophthalmology Antwerp University Hospital Edegem Belgium
- Department of Medicine and Health Sciences University of Antwerp Wilrijk Belgium
| | - Marie‐José Tassignon
- Department of Ophthalmology Antwerp University Hospital Edegem Belgium
- Department of Medicine and Health Sciences University of Antwerp Wilrijk Belgium
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Navarro R, Rozema JJ, Emamian MH, Hashemi H, Fotouhi A. Average biometry of the cornea in a large population of Iranian school children. JOURNAL OF THE OPTICAL SOCIETY OF AMERICA. A, OPTICS, IMAGE SCIENCE, AND VISION 2019; 36:B85-B92. [PMID: 31044964 DOI: 10.1364/josaa.36.000b85] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
This work establishes the average Scheimpflug corneal tomography for a population of 4953 healthy Iranian primary school children. These data were transformed to determine the corneal position and orientation in three-dimensional space, followed by a model fit that combines a biconic with a Zernike expansion. Girls were found to have slightly steeper corneas than boys. Both corneal surfaces show negative conic constants and significant higher-order aspheric Zernike terms. The corneal surfaces are decentered and misaligned with respect to each other and to the line of sight. Consequently, the average corneal surfaces may be considered as decentered and misaligned higher-order aspheres.
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Hashemi H, Asharlous A, Yekta A, Ostadimoghaddam H, Mohebi M, Aghamirsalim M, Khabazkhoob M. Enantiomorphism and rule similarity in the astigmatism axes of fellow eyes: A population-based study. JOURNAL OF OPTOMETRY 2019; 12:44-54. [PMID: 29625892 PMCID: PMC6318548 DOI: 10.1016/j.optom.2017.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Revised: 12/03/2017] [Accepted: 12/06/2017] [Indexed: 06/02/2023]
Abstract
PURPOSE To evaluate the relationship patterns between astigmatism axes of fellow eyes (rule similarity and symmetry) and to determine the prevalence of each pattern in the studied population. METHODS This population-based study was conducted in 2015 in Iran. All participants had tests for visual acuity, objective refraction, subjective refraction (if cooperative), and assessment of eye health at the slit-lamp. Axis symmetry was based on two different patterns: direct (equal axes) and mirror (mirror image symmetry) or enantiomorphism. Bilateral astigmatism was classified as isorule if fellow eyes had the same orientation (e.g. both eyes were with-the-rule) and as anisorule if otherwise. RESULTS Of the total cases of bilateral astigmatism, 80% were isorule, and in the studied population, the prevalence of isorule and anisorule astigmatism was 14.89% and 3.53%, respectively. The prevalence of isorule increased with age (p<0.001). The prevalence of both isorule and anisorule increased at higher degrees of spherical ametropia (p<0.001). Median inter-ocular axis difference was 10° in mirror symmetry and 20° in direct symmetry with no significant difference between two genders (p>0.288). Both symmetry patterns reduced with age (p<0.001). Among cases of bilateral astigmatism, 15.5% and 19.8% had exact direct and mirror symmetry, respectively. CONCLUSION Bilateral astigmatism is mainly isorule in the population and anisorule astigmatism is rare. The enantiomorphism is the most common pattern in the population of bilateral astigmatism.
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Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Amir Asharlous
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Abbasali Yekta
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Ostadimoghaddam
- Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masumeh Mohebi
- Farabi Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Shi XY, Ke YF, Jin N, Zhang HM, Wei RH, Li XR. The prevalence of vision impairment and refractive error in 3654 first year students at Tianjin Medical University. Int J Ophthalmol 2018; 11:1698-1703. [PMID: 30364305 DOI: 10.18240/ijo.2018.10.19] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 06/05/2018] [Indexed: 01/16/2023] Open
Abstract
AIM To determine the prevalence of vision impairment (VI) and refractive error in first year university students at the Tianjin Medical University. METHODS This is a cross-sectional observational cohort study of VI and refractive error among first year university students at the Tianjin Medical University. The first year university students were involved in this study and were given a detailed questionnaire including age, birth date, and spectacle wearing history. A standardized ophthalmologic examination including visual acuity (VA), slit-lamp examination, non-cycloplegic auto-refraction, objective refraction, fundus photography, and examination of their spectacles were recorded. RESULTS A total of 3654 participants were included in this study. Totally 3436 (94.03%) individuals had VI in this population. Totally 150 (4.10%) individuals had VI due to ocular disease, including amblyopia, congenital cataract, retinal atrophy or degeneration, strabismus, congenital nystagmus, refractive surgery orthokeratology. Totally 3286 (89.93%) subjects had VI due to refractive error. Only 218 (5.97%) students were emmetropia. Moreover, refractive error was the main cause for the VI (95.63%). Totally 3242 (92.52%) students were myopia and the prevalence of mild, moderate, and high myopia subgroup was 27.05%, 44.35%, and 21.26% respectively. Totally 44 (1.29%) subjects were hyperopic. The rates of uncorrected visual acuity (UCVA), presenting visual acuity (PVA) and best corrected visual acuity (BCVA) which better than 20/20 in both eyes were 5.65%, 22.32% and 82.13% respectively. The rates of correction, under correction and well correction in myopia subjects were 82.73%, 84.39% and 15.61%, respectively. CONCLUSION We present a high prevalence of refractive errors and high rates of under correction refractive error among first year university students. These results may help to promote vision protection work in young adults.
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Affiliation(s)
- Xue-Ying Shi
- Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute & Tianjin Medical University School of Optometry and Ophthalmology, Tianjin 300384, China
| | - Yi-Feng Ke
- Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute & Tianjin Medical University School of Optometry and Ophthalmology, Tianjin 300384, China
| | - Nan Jin
- Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute & Tianjin Medical University School of Optometry and Ophthalmology, Tianjin 300384, China
| | - Hong-Mei Zhang
- Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute & Tianjin Medical University School of Optometry and Ophthalmology, Tianjin 300384, China
| | - Rui-Hua Wei
- Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute & Tianjin Medical University School of Optometry and Ophthalmology, Tianjin 300384, China
| | - Xiao-Rong Li
- Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute & Tianjin Medical University School of Optometry and Ophthalmology, Tianjin 300384, China
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Li H, Li SM, Liu LR, Ji YZ, Kang MT, Gan JH, Bai YW, Yan R, Zhan SY, Mitchell P, Wang N, Atchison DA. Astigmatism and its components in 12-year-old Chinese children: the Anyang Childhood Eye Study. Br J Ophthalmol 2018; 103:768-774. [DOI: 10.1136/bjophthalmol-2018-312114] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 06/10/2018] [Accepted: 06/22/2018] [Indexed: 11/04/2022]
Abstract
PurposeTo determine prevalence of refractive (RA), corneal (CA) and internal astigmatism (IA), including variation with gender and spherical equivalent refraction (SE), in a population of 12-year-old Chinese children.MethodsA total of 1783 students with a mean age of 12.7 years (range 10.0–15.6 years) completed comprehensive eye examinations in the Anyang Childhood Eye Study. Data of cycloplegic refraction and corneal curvature were analysed.ResultsPrevalences of RA, CA and IA ≥1.0 D were 17.4% (95%CI 15.6% to 19.2%), 52.8% (50.5% to 55.1%)%) and 20.9% (19.0% to 22.8%), respectively. With different limits of astigmatism axes classification, including ±15°, ±20° and ±30°, RA and CA axes were mainly ‘with-the-rule’ (WTR) (ie, correcting axis of negative cylinders at or near 180°), while those for IA axes were mainly ‘against-the-rule’ (ATR) (ie, correcting axis of negative cylinders at or near 90°). RA was not different between the genders, but girls had higher prevalence and greater means of CA and IA. RA and CA increased in students with higher ametropia (more myopia and more hyperopia) and were the highest in a high myopic group (SE≤−6 D), while IA was stable across refraction groups. Children with RA higher than 0.50 D were more likely to have lens corrections (51%, 57%, 61% and 69% for magnitudes of ≥0.50 D, ≥0.75 D, ≥1.0 D and ≥1.5 D, respectively).ConclusionsPrevalence of RA in the Chinese 12-year-old children was relatively high compared with other studies. RA and CA had mainly ‘WTR’ astigmatism, while IA was mainly ATR and partially compensated for CA. Girls had greater means and prevalences of CA and IA than did boys. Both RA and CA, but not IA, increased with refractive errors away from emmetropia.
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Ajayi IA, Omotoye OJ, Omotoso-Olagoke O. Profile of refractive error in Ekiti, south western Nigeria. AFRICAN VISION AND EYE HEALTH 2018. [DOI: 10.4102/aveh.v77i1.415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: Refractive error is one of the eye disorders with the capability of causing visual impairment. We needed to know the various types and proportion of refractive errors seen in patients attending an eye clinic at the tertiary health centre.Aim: An observational study was carried out to determine the profile of refractive error in a southwestern Nigeria hospital.Methods: All new cases with the diagnosis of refractive error between January 2015 and December 2016 had autorefraction and subjective refraction to determine the types and values of refractive error. Data were analysed with SPSS 20. Statistical significance was inferred at p < 0.05.Results: Refractive error constituted 618 (21.4%) of the total new cases. The mean age was 39.3 ± 22.96 years. The male to female ratio was 1:1.8. Children constituted 25.7% of all the cases. The most common refractive error was myopia in 64.3%. A total of 312 (50.5%) patients had other co-existing ocular disorders with allergic conjunctivitis on the top of the list. The number of visually impaired reduced to 70 (5.64%) after the correction of existing refractive error with about 94.1% having their visual acuity restored to normal.Conclusion: Refractive error was a common eye disorder among our patients with the proportion of children about a quarter of all patients. We recommend that childhood refractive errors should be given prioritised attention in eye outreach programmes.
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Sandfeld L, Weihrauch H, Tubaek G, Mortzos P. Ophthalmological data on 4.5- to 7-year-old Danish children. Acta Ophthalmol 2018; 96:379-383. [PMID: 29369530 DOI: 10.1111/aos.13650] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 10/23/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE To report normative data on visual acuity (VA) for near and distance, refraction, ocular alignment, ocular motility and stereo acuity in a cohort of children aged 4.5-7 years. METHODS A total of 950 children with normal development from the municipality of Roskilde, Denmark, were invited to participate in an ophthalmic cross-sectional population-based survey, of which 445 children in the age of 54-87 months participated with a complete ocular examination including cycloplegia. Visual acuity (VA) was tested using Kay Picture charts and notified in logMAR units. RESULTS Mean distance VA was 0.010 logMAR [standard deviation (SD): 0.048] in right eye, and near VA in right eye was 0.012 logMAR (SD: 0.054), with a nonsignificant difference between right and left eye in both parameters (paired t-test, p = 0.15 and p = 0.08, respectively). Amblyopia was found in 12 children (2.7%), mainly related to refractive errors. The mean refractive error of right eye was +1.75 D, and significant hyperopia (greater than +3.0 D) was found in 7.9%. No myopia (greater than or equal to -0.5 D) was found, astigmatism (>1 D) was seen in 4.3%. Manifest strabismus was present in 1.6%, and heterophoria in 4.0%. Reduced or absent stereo acuity was present in 35 children (7.9%) and was related to a reduced VA, refractive error and strabismus. CONCLUSION Ophthalmic data of 445 normally developed children are presented, supplementing previous reported normative data in children. We found a relatively high prevalence of amblyopia and of hyperopia, while myopia was not found, confirming previous studies that myopia is not developing at early age in Danish children.
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Affiliation(s)
| | - Hanne Weihrauch
- Eye Department, Zealand University Hospital; Roskilde Denmark
| | - Gitte Tubaek
- Eye Department, Zealand University Hospital; Roskilde Denmark
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Chen Z, Liu L, Pan C, Li X, Pan L, Lan W, Yang Z. Ocular residual and corneal astigmatism in a clinical population of high school students. PLoS One 2018; 13:e0194513. [PMID: 29630629 PMCID: PMC5890987 DOI: 10.1371/journal.pone.0194513] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 03/05/2018] [Indexed: 11/18/2022] Open
Abstract
Purpose Total refractive astigmatism is usually the first consideration that guides the selection of contact lens type (e.g., spherical or toric), while the ocular source of the astigmatism is a second, but more important consideration, for the final clinical decision. This study was conducted to provide detailed data on this topic by evaluating astigmatic components in Chinese adolescents. Methods Participants were recruited from healthy high school students undergoing an annual ocular examination at a local hospital. Total astigmatism (TA), corneal astigmatism (CA), and ocular residual astigmatism (ORA) were determined by a Hartmann-Shack wavefront analyzer system (KR-1W, Topcon) with the natural pupil. The axis relationship between CA and ORA was placed into three categories: on-axis, defined as an axis with a difference of 0 ± 10°; opposite-axis, a difference of 90 ± 10°; and the rest defined as oblique-axis. Results The study consisted of 1,466 students (57.84% girls, age: 16.49 ± 1.05 years). ORA was present in 83.97%, 66.64%, and 45.23% of participants, according to the various criteria for astigmatism (≥ 0.50 D, ≥ 0.75 D, and ≥ 1.00 D, respectively). While with-the-rule was the most common axis orientation for both TA (76.28%) and CA (89.94%), against-the-rule predominated in ORA (93.82%; χ2 = 1688.544, p < 0.001). Opposite-axis was the major type of axis difference (90.96%) of clinical significance (i.e., ≥ 1.00 D) between CA and ORA, which also prevailed in all levels of TA (range: 56.25–82.26%). Conclusions ORA is common in high school students and usually demonstrates a compensation relationship with CA, which should be taken into consideration when determining the design of contact lenses to correct refractive error.
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Affiliation(s)
- Zhao Chen
- Aier Institute of Optometry and Vision Science, Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, China
| | - Luoru Liu
- Anyang Eye Hospital, Anyang, Henan Province, China
| | - Chenglin Pan
- Aier Institute of Optometry and Vision Science, Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, China
| | - Xiaoning Li
- Aier Institute of Optometry and Vision Science, Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, China
| | - Lun Pan
- Aier Institute of Optometry and Vision Science, Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, China
| | - Weizhong Lan
- Aier Institute of Optometry and Vision Science, Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, China
- * E-mail: (WL); (ZY)
| | - Zhikuan Yang
- Aier Institute of Optometry and Vision Science, Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, China
- * E-mail: (WL); (ZY)
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Anderson DF, Dhariwal M, Bouchet C, Keith MS. Global prevalence and economic and humanistic burden of astigmatism in cataract patients: a systematic literature review. Clin Ophthalmol 2018; 12:439-452. [PMID: 29563768 PMCID: PMC5846755 DOI: 10.2147/opth.s146829] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To systematically review the published evidence on the prevalence and economic and humanistic burden of astigmatism in cataract patients. Materials and methods For this systematic literature review, the Medline, PubMed, Embase, and Cochrane databases were searched from 1996 to September 2015 for available scientific literature that met the inclusion criteria. Studies published in the English language reporting prevalence and humanistic and economic burden in patients diagnosed with cataract and astigmatism were included. Results Of 3,649 papers reviewed, 31 studies from 32 publications met the inclusion criteria of this review. Preexisting astigmatism ≥1 D was present in up to 47% of cataract eyes. The cost burden of residual uncorrected astigmatism after cataract surgery was driven by the cost of spectacles, which was estimated to range from $2,151 to $3,440 in the US and $1,786 to $4,629 in Europe over a lifetime. In cataract patients, both preexisting and postoperative residual astigmatism were associated with poor vision-related patient satisfaction and quality of life, as well as higher spectacle burden. Astigmatism correction during cataract surgery appears to improve visual outcomes and results in overall lifetime cost savings compared to astigmatism correction with postoperative vision correction. Conclusion There is a high prevalence of preexisting astigmatism in cataract patients. Although published data are limited, both preoperative astigmatism and postoperative residual astigmatism affect visual function and vision-related quality of life, resulting in increased humanistic burden. Suboptimal correction of astigmatism during cataract surgery drives the continuous need for vision correction with spectacles in the postoperative period. Patients must bear the out-of-pocket expenses, since payers often do not reimburse the cost of spectacles. Greater access to astigmatism correction during cataract surgery could improve visual outcomes and quality of life in patients. More research is required to gain a better understanding of the disease burden of astigmatism in cataract patients.
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Affiliation(s)
- David F Anderson
- University Hospital Southampton, NHS Foundation Trust, Southampton, UK
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Astigmatism in Chinese primary school children: prevalence, change, and effect on myopic shift. Jpn J Ophthalmol 2018; 62:321-326. [PMID: 29500535 DOI: 10.1007/s10384-018-0580-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 01/21/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE To study the prevalence, type, and progression of astigmatism in primary school children, and its effect on myopic shift. STUDY DESIGN A prospective study carried out in a primary school in southern Taiwan. METHODS The study was performed on a subset of children, one year after initial examination. Refractive error measured by cycloplegic autorefraction was the main study outcome. Astigmatism was recorded as negative cylinder form, and we defined clinical significant astigmatism (CSA) as cylinder refraction -1.0 D or greater. Myopia was defined as a spherical equivalent refraction (SER) of -0.50 D or greater. RESULTS Three hundred sixty-two children, mean age was 8.97 y/o (SD 1.41; range 7 to 11 y/o) participated in the study. One hundred nineteen (32.9 %) subjects had CSA at the initial screening. The mean cylinder refraction was -0.80 + 0.84 diopters (D) (-5.25 D to 0.00 D), with predominant with rule astigmatism (69.7%). In the 183 children studied longitudinally, the mean cylinder refraction was reduced from -0.74 D to -0.58 D (p< 0.05). The cylinder refraction in the initial CSA group was not associated with SER change (p=0.99) or axial length change (p=0.55). Compared to the initial non-CSA group, the initial CSA group had no significant difference in axial length elongation (p=0.20). CONCLUSION The prevalence of astigmatism was not low in the Chinese primary school children and with-the-rule astigmatism was predominant. The astigmatism decreased during the 1 year follow-up. The CSA was not associated with myopia progression (p=0.99).
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Refractive, corneal and ocular residual astigmatism: distribution in a German population and age-dependency - the Gutenberg health study. Graefes Arch Clin Exp Ophthalmol 2017; 255:2493-2501. [DOI: 10.1007/s00417-017-3775-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 07/21/2017] [Accepted: 08/02/2017] [Indexed: 10/19/2022] Open
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Srivannaboon S, Chirapapaisan C, Chonpimai P, Koodkaew S. Comparison of corneal astigmatism measurements of 2 optical biometer models for toric intraocular lens selection. J Cataract Refract Surg 2015; 41:364-71. [PMID: 25661130 DOI: 10.1016/j.jcrs.2014.06.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Revised: 05/29/2014] [Accepted: 06/01/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE To compare corneal astigmatism measurements obtained using a new optical biometer (AL-Scan) and a standard biometer based on partial coherence interferometry (IOLMaster 500) for toric intraocular lens (IOL) selection. SETTING Siriraj Hospital, Mahidol University, Bangkok, Thailand. DESIGN Prospective comparative study. METHODS Keratometry (K) readings were taken with the 2 biometers in eyes of cataract patients. The corneal astigmatism readings from the 2 devices were compared. The cylinder measurements were transformed into J0 and J45 vector components for analysis, and the devices' values were compared using the paired t test. Correlation coefficients were calculated. The Bland-Altman method was used to evaluate the agreement between the sets of measurements. RESULTS One hundred thirty-seven eyes (81 patients) were enrolled. The magnitude of astigmatism between the new biometer 2.4 mm zone and the standard biometer was similar (P = .19). There was a statistically significant difference between values from the new biometer 3.3 mm zone and the standard biometer (P < .05). There was good correlation in the overall magnitude of astigmatism between devices. There was a trend of low correlation toward the flat cornea (K <43.0 diopters [D]), low corneal cylinder (<1.0 D), and with-the-rule astigmatism. The IOL toricity calculated from both devices was similar. CONCLUSIONS Corneal astigmatism measurements with the 2 biometers were similar in magnitude, especially in 2.4 mm zone of the new biometer. There was no difference in the toric IOL selections between the devices. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Sabong Srivannaboon
- From the Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chareenun Chirapapaisan
- From the Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
| | - Pratuangsri Chonpimai
- From the Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sunisa Koodkaew
- From the Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Sanfilippo PG, Yazar S, Kearns L, Sherwin JC, Hewitt AW, Mackey DA. Distribution of astigmatism as a function of age in an Australian population. Acta Ophthalmol 2015; 93:e377-e385. [PMID: 25585855 DOI: 10.1111/aos.12644] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 11/24/2014] [Indexed: 11/28/2022]
Abstract
PURPOSE Astigmatism is a common cause of refractive error and is known to vary in prevalence with age. Although the search for genes associated with spherical refractive errors (especially myopia) has met with limited success, current efforts to identify genetic variants implicated in astigmatism development have been less rewarding. We aimed to assess the association between astigmatism and age to identify appropriate age cut-offs for maximizing power in genetic studies of astigmatism. METHODS We performed a cross-sectional analysis of right eye astigmatism data from four Australian-based eye studies comprising 3841 participants aged 5-90 years. Measurements were performed under cycloplegia using an autorefractor, and individuals with a history of cataract, refractive surgery or corneal pathology were excluded from the analysis. In addition to the magnitude and type (against-the-rule, with-the-rule, and oblique) of astigmatism, we calculated the vector components (J0 , J45 ) and evaluated the association of these outcome measures with age. RESULTS The magnitude of refractive astigmatism (RA) remained relatively stable [mean ± SD (-0.44 D ± 0.50)] until individuals reached the age of 50, thereafter increasing in average magnitude by approximately 1.00 D for those subjects aged 90. In contrast, corneal astigmatism (CA) remained relatively stable from childhood until the age of 80 (-0.76 D ± 0.61). The prevalence of clinically significant RA (≥1.00 D) increased with age and was highest in those aged >70 years [55.1% (47.2-62.7%)]. Age was significantly associated with RA in adults [odds ratio (OR) = 1.04 per 1 year, p < 0.001]. A weaker relationship was observed between CA and age (OR = 1.007 per 1 year, p = 0.02). CONCLUSIONS We have confirmed the previously documented association between RA and age. Our results indicate that most of the observed change occurs after the age of 50, providing a recommended cut-off for participants in genetic studies of this refractive condition.
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Affiliation(s)
- Paul G. Sanfilippo
- Centre for Ophthalmology and Visual Science; Lions Eye Institute; University of Western Australia; Perth Western Australia Australia
- Centre for Eye Research Australia; Royal Victorian Eye and Ear Hospital; University of Melbourne; Melbourne Victoria Australia
| | - Seyhan Yazar
- Centre for Ophthalmology and Visual Science; Lions Eye Institute; University of Western Australia; Perth Western Australia Australia
| | - Lisa Kearns
- Centre for Eye Research Australia; Royal Victorian Eye and Ear Hospital; University of Melbourne; Melbourne Victoria Australia
| | - Justin C. Sherwin
- Centre for Eye Research Australia; Royal Victorian Eye and Ear Hospital; University of Melbourne; Melbourne Victoria Australia
| | - Alex W. Hewitt
- Centre for Ophthalmology and Visual Science; Lions Eye Institute; University of Western Australia; Perth Western Australia Australia
- Centre for Eye Research Australia; Royal Victorian Eye and Ear Hospital; University of Melbourne; Melbourne Victoria Australia
- School of Medicine; Menzies Research Institute Tasmania; University of Tasmania; Hobart Tasmania Australia
| | - David A. Mackey
- Centre for Ophthalmology and Visual Science; Lions Eye Institute; University of Western Australia; Perth Western Australia Australia
- Centre for Eye Research Australia; Royal Victorian Eye and Ear Hospital; University of Melbourne; Melbourne Victoria Australia
- School of Medicine; Menzies Research Institute Tasmania; University of Tasmania; Hobart Tasmania Australia
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Abstract
PURPOSE To characterize and compare the corneal shapes and monochromatic aberrations in Chinese myopic adults with and without astigmatism. METHODS Forty-six Hong Kong Chinese aged 50 to 70 years with compound against-the-rule myopic astigmatism (n = 18) or simple myopia (n = 28) were recruited. Corneal shapes were measured by a Scheimpflug-based corneal topographer: the semimeridian corneal shape factors at the nasal, temporal, inferior, and superior corneal quadrants measured from the corneal apex to 3 mm midperiphery were analyzed. The ocular aberrations were measured by the COAS (Complete Ophthalmic Analysis System) Shack-Hartmann wavefront aberrometer; the corneal aberrations were computed using the corneal topographic map data measured by the Medmont E300 corneal topographer; and the internal aberrations were calculated from the ocular and corneal aberrations. RESULTS Compared with simple myopia, myopic astigmatism had more oblate nasal and temporal corneal shapes and showed significantly more negative Y trefoil and more positive vertical coma. The asymmetry in corneal shape along the vertical principal meridian (inferior - superior) was significantly associated with the Y trefoil and vertical coma of the cornea, suggesting that this regional asymmetry in corneal shape may contribute to the ocular aberrations. CONCLUSIONS The significant relationships found between astigmatism, corneal shapes, and monochromatic aberrations underscore the importance of taking corneal shape into account when correcting the optical defects in myopic Chinese adults with astigmatism.
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Wajuihian SO. Frequency of asthenopia and its association with refractive errors. AFRICAN VISION AND EYE HEALTH 2015. [DOI: 10.4102/aveh.v74i1.293] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background: Asthenopia is a common complaint amongst patients who attend eye care settings. Owing to associated discomfort or distress, asthenopia affects efficient reading and performance of near tasks.Purpose: To study the prevalence of asthenopia and any association with refractive errors in a clinical setting.Methods: In this cross-sectional practice-based study, the clinic records of 1109 school-aged children (mean age and standard deviation 14.39 ± 3.39 years) were analysed. The sample comprised 427 (38.5%) male and 682 (61.5%) female patients between the ages of 6 and 19 years. Refractive errors were classified into various types, and the association between these refractive types and symptoms in asthenopia were explored.Results: The most common symptom of asthenopia was headaches (40.8%), of which temporal headaches were the most frequent type (15.7%). Various symptoms were significantly associated with mainly astigmatism.Conclusion: Headaches were the most frequent complaint amongst patients who attended the author’s optometric practice. Astigmatism was the most frequent cause of asthenopia. Female patients were more likely than male patients to complain of asthenopia, whilst high school students were more likely than primary school children to complain of asthenopia. Further studies to relate asthenopia to binocular anomalies will be relevant in enhancing our understanding of the relationship between asthenopia and vision anomalies.
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Larsson E, Holmström G, Rydberg A. Ophthalmological findings in 10-year-old full-term children--a population-based study. Acta Ophthalmol 2015; 93:192-8. [PMID: 25041696 DOI: 10.1111/aos.12476] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Accepted: 05/08/2014] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine different ophthalmological parameters in 10-year-old, healthy, full-term children in Stockholm County, Sweden. METHODS Two hundred and seventeen children were included in the study. Best-corrected distance and near visual acuities (VA) were measured using logMAR charts. Cycloplegic retinoscopy was performed, and spherical equivalent and astigmatism were determined. Examination of ocular movement and cover test for distance and near were performed. Stereopsis was assessed with the TNO test, and contrast sensitivity with the Vistech test. The Royal Air Force rule was used for assessing accommodation, and near point of convergence was measured with the Lang fixation stick. Ophthalmoscopy was performed through dilated pupils. RESULTS Eighty-two per cent of the children had a distance VA of -0.1 logMAR (1.3 Snellen acuity) or better. None of the children were visually impaired [VA>0.6 logMAR (<0.3 Snellen acuity)]. Ninety-three per cent had a near VA of -0.1 logMAR (1.25 Snellen acuity) or better. Mean spherical equivalent was 0.6 D. Eight (3.6%) children had hypermetropia (≥+2 D), and 17 (7.8%) were myopic (≤-0.5 D). Nine (4.1%) children had an astigmatism≥1 D, and two (0.9%) had anisometropia of ≥1 D. Manifest strabismus was found in seven (3.2%) children, five of whom had exotropia. Heterophoria for distance and/or near was found in 80.2% of the children. In children without manifest strabismus, stereopsis>60 seconds of arc was found in five (2.4%). Three (1.4%) of 215 children had contrast sensitivity below normal limits. Binocular median near point of accommodation was 14 D, and median near point of convergence 6 cm. CONCLUSION Knowledge of various visual functions in normally developing children is crucial to be able to draw conclusions from ophthalmological examinations in children with eye diseases. This population-based study describes different ophthalmological parameters in full-term ten-year-old children. The material can be used as a control when examining children of similar ages with various ophthalmological conditions, such as groups of children with specific neurological or retinal diseases, and syndromes.
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Affiliation(s)
- Eva Larsson
- Department of Neuroscience/Ophthalmology; Uppsala University; Uppsala Sweden
| | - Gerd Holmström
- Department of Neuroscience/Ophthalmology; Uppsala University; Uppsala Sweden
| | - Agneta Rydberg
- Division of Ophthalmology and Vision; Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
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Chang SW, Su TY, Chen YL. Influence of Ocular Features and Incision Width on Surgically Induced Astigmatism After Cataract Surgery. J Refract Surg 2015; 31:82-8. [DOI: 10.3928/1081597x-20150122-02] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 12/10/2014] [Indexed: 11/20/2022]
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Hrynchak PK, Mittelstaedt A, Machan CM, Bunn C, Irving EL. Increase in myopia prevalence in clinic-based populations across a century. Optom Vis Sci 2014; 90:1331-41. [PMID: 24100476 DOI: 10.1097/opx.0000000000000069] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The study's aim was to report prevalence estimates and age-related trends in refractive error in a clinic-based series and compare them to results from studies of a similar nature conducted since 1892. METHODS Refractive error, patient age, and sex were collected from the files of all patients seen at the University of Waterloo School of Optometry and Vision Science clinic between January 2007 and January 2008. Patients were categorized as having myopia (<-0.5D mean ocular refraction [MOR]), hyperopia (>0.5D MOR), emmetropia, astigmatism (<-0.5D), and/or anisometropia (>1.0D difference between eyes). The prevalence of all refractive components was determined overall and in 1- and 5-year age groups, and then compared to data from older clinic-based studies. Refractive trends over time were noted. The prevalence of myopia and hyperopia were compared to older studies. RESULTS The lowest prevalence of myopia was 5% at 0 to 5 years of age, after which it increased to 72% at 20 to 30 years of age and then decreased to 22% in patients older than 70 years. A myopic peak occurred at 24 years of age. The prevalence of hyperopia followed opposite trends with a minimum prevalence of 6% at 25 to 30 years of age. Peaks in emmetropia prevalence were 55% at 5 to 10 years of age and 37% at 45 to 50 years of age. The prevalence of astigmatism and anisometropia increased with age. The Waterloo Eye Study showed a higher prevalence of myopia across all ages compared to the older studies with a peak prevalence of 72% compared to 21% in the oldest (Herrnheiser) study from 1892. CONCLUSIONS In the last 100 years, there appears to have been a myopic shift in clinic-based populations and myopia prevalence appears to follow a predictable pattern with age.
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Affiliation(s)
- Patricia K Hrynchak
- *OD, FAAO †OD, MSc ‡OD §OD, PhD School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
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Abstract
PURPOSE Myopia and astigmatism are highly prevalent in the Hong Kong Chinese. This study aimed to determine the effects of age and myopic astigmatism (MA) on the corneal shape factors in the Hong Kong Chinese. METHODS One hundred subjects with compound MA or emmetropia (EM) were recruited from three age groups: 10 to 15 years (n = 32), 20 to 25 years (n = 37), and 40 to 45 years (n = 31). Refractive errors were measured by noncycloplegic subjective refraction. Corneal astigmatism and corneal shape factors were measured by the Scheimpflug-based Pentacam. The effects of age and refractive errors on the whole corneal shape (mean-P) and the semimeridian corneal shapes (semi-Ps) at the nasal, temporal, superior, and inferior corneal quadrants (from corneal apex to 3 mm peripheral cornea) were analyzed. RESULTS Age had significant effects on the mean-P and semi-Ps (both p < 0.001), with both EM and MA showing less prolate corneal shapes in older age groups. Partial correlation analyses adjusted for age showed that mean-P and semi-Ps were correlated with multiple refractive-error components (Pearson r = -0.30 to -0.78, all p < 0.05), with higher correlations found along the horizontal semi-Ps in MA (Pearson r = +0.37 to -0.78, all p < 0.01). Compared with EM, MA had more prolate temporal semi-Ps in all the three age groups (p < 0.05). Strikingly, age and refractive errors also had significant impacts on the asymmetry of the corneal shape along the horizontal meridian. CONCLUSIONS Corneal shapes were influenced by age and MA in the Hong Kong Chinese. These results highlight the importance of controlling these factors when designing a study on corneal shape.
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Read SA, Vincent SJ, Collins MJ. The visual and functional impacts of astigmatism and its clinical management. Ophthalmic Physiol Opt 2014; 34:267-94. [PMID: 24635572 DOI: 10.1111/opo.12128] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 02/25/2014] [Indexed: 01/14/2023]
Abstract
PURPOSE To provide a comprehensive overview of research examining the impact of astigmatism on clinical and functional measures of vision, the short and longer term adaptations to astigmatism that occur in the visual system, and the currently available clinical options for the management of patients with astigmatism. RECENT FINDINGS The presence of astigmatism can lead to substantial reductions in visual performance in a variety of clinical vision measures and functional visual tasks. Recent evidence demonstrates that astigmatic blur results in short-term adaptations in the visual system that appear to reduce the perceived impact of astigmatism on vision. In the longer term, uncorrected astigmatism in childhood can also significantly impact on visual development, resulting in amblyopia. Astigmatism is also associated with the development of spherical refractive errors. Although the clinical correction of small magnitudes of astigmatism is relatively straightforward, the precise, reliable correction of astigmatism (particularly high astigmatism) can be challenging. A wide variety of refractive corrections are now available for the patient with astigmatism, including spectacle, contact lens and surgical options. CONCLUSION Astigmatism is one of the most common refractive errors managed in clinical ophthalmic practice. The significant visual and functional impacts of astigmatism emphasise the importance of its reliable clinical management. With continued improvements in ocular measurement techniques and developments in a range of different refractive correction technologies, the future promises the potential for more precise and comprehensive correction options for astigmatic patients.
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Affiliation(s)
- Scott A Read
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
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Abstract
PURPOSE To assess the changes of the surfaces and optical properties of the cornea as a function of age. METHODS The corneal shape of 407 normal eyes of 211 subjects with ages ranging from 4 to 79 years old was determined by means of Scheimpflug imaging. These data were analyzed by fitting their elevation topographies to a general surface model, which consists of a biconic plus a Zernike polynomial expansion. The analysis includes the computation of the position and orientation of the model in the three-dimensional space to determine the orientation of the optical axis and the apex coordinates. RESULTS Both average corneal surfaces show negative conic constant plus higher order aspheric terms Z(0)(4) and Z(0)(6) are significant). These surfaces are misaligned between them and with the line of sight. Such misalignment increases with age as the cornea seems to rotate as a solid body. The apex curvature and the magnitude of the conic constant along the most curved meridian increase as well, but the largest change with age correspond to the aspheric terms Z(0)(4) and Z(0)(6). As a result, the spherical aberration (SA) of the average cornea increases with age at a rate similar to the total SA of the eye. CONCLUSIONS The average corneal surfaces are misaligned general aspheres. Corneal SA is higher than total SA, but both SAs increase with age at a similar rate. This confirms that the lens is partially compensating SA and that such compensation is preserved with aging. Misalignment and solid body rotation seem to reduce astigmatism and coma for young and middle-aged corneas.
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Zhu X, Chen M, Dai J, Lu Y. The effect of 0.5% tropicamide/0.5% phenylephrine mixed eye drop in Chinese adults with myopia and its inter-eye difference in refractive outcomes. Curr Med Res Opin 2014; 30:481-7. [PMID: 24215472 DOI: 10.1185/03007995.2013.861348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate the effect of 0.5% tropicamide/0.5% phenylephrine mixed eye drop and make the inter-eye comparison of refractive outcomes in Chinese adults with myopia. METHODS Refractive measurements were performed without cycloplegia and repeated 30 minutes later with 0.5% tropicamide/0.5% phenylephrine mixed eye drop (Mydrin-P*) on 341 myopic adults. Vector analysis was used to analyze the data. Changes of spherical equivalent (M) and astigmatism for both J0 and J45 components between these two refractions were calculated as Error_M, Error_J0 and Error_J45. Inter-eye correlations were studied. The inter-eye difference after cycloplegics were described as Diff M, Diff J0 and Diff J45. The effect of anisometropia, age and the higher order aberrations (HOAs) on inter-eye differences toward the cycloplegic agent were analyzed. RESULTS Difference was found only for the Error_J45 component between the two eyes (p=0.0040). Pearson correlation coefficients between the two eyes for Error_M, Error_J0, and Error_J45 were 0.3140 (p<0.0001), 0.1464 (p=0.0068), and 0.0099 (p=0.8558), respectively. The inter-eye differences (Diff) in response to cycloplegic agent increased with the amount of anisometropia. The oldest group had the highest Diff M values. However, HOAs were found not to be related to the inter-eye differences. CONCLUSIONS Accommodation was still relaxed by tropicamide/phenylephrine eye drops in myopic adults. The changes of refraction due to cycloplegia were not well correlated between the two eyes in myopic patients. Anisometropia and ocular dominance might be an important factor for the inter-eye difference.
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Affiliation(s)
- Xiangjia Zhu
- EYE and ENT Hospital of Fudan University , Shanghai , China
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Practical applications to modify and control the development of ametropia. Eye (Lond) 2013; 28:134-41. [PMID: 24310242 DOI: 10.1038/eye.2013.255] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 10/10/2013] [Indexed: 11/09/2022] Open
Abstract
For many individuals, the developmental trend of lessening hyperopia from birth continues past emmetropia towards myopia during childhood. The global pattern for prevalence of refractive errors indicates that the prevalence of hyperopia is low; in contrast, the burden of myopia is on the rise because of rising prevalence and magnitude of myopia. This review highlights the need to lessen the global burden of myopia by intervening with the development and/or slowing the progression of myopia. Further, outcomes from human clinical trials of pharmaceutical, optical, and environmental approaches to control myopia will be summarised. Pharmaceutical treatments are effective in controlling eye growth but are associated with deleterious side effects. Optical strategies that induce myopic defocus at the retina such as peripheral defocus reducing lenses, simultaneous defocus lenses, bifocals, and orthokeratology as well as environmental influences such as increased outdoor activity show promise and provide a substantially risk-free environment in which to control eye growth.
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Kee CS. Astigmatism and its role in emmetropization. Exp Eye Res 2013; 114:89-95. [DOI: 10.1016/j.exer.2013.04.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2013] [Revised: 04/23/2013] [Accepted: 04/24/2013] [Indexed: 10/26/2022]
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Astigmatism prevalence and biometric analysis in normal population. Eur J Ophthalmol 2013; 23:779-83. [PMID: 23640506 DOI: 10.5301/ejo.5000294] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2013] [Indexed: 11/20/2022]
Abstract
PURPOSE To analyze the magnitude, orientation, and age-related changes of corneal astigmatism and its correlation with biometric parameters in healthy eyes.
METHODS Patients over 15 years of age were enrolled in our study. Exclusion criteria were previous ocular surgery, corneal disease, or contact lens wear. Axial length (AL), keratometric readings, and anterior chamber depth (ACD) were assessed using IOLMaster.
RESULTS In our study, 1092 eyes were examined. The mean age was 69.64 ± 15.25 years (range
15-100 years). The AL was 23.32 ± 1.49 mm and ACD was 3.17 ± 2.03 mm. Higher AL and ACD values were observed in male patients. The overall astigmatism was 0.89 ± 0.72 D. The magnitude of astigmatism was =0.5 D in 73.53% of the cases, =1.0 D in 32.78%, =1.5 D in 13.55%, and =2.0 D in 6.86%. In our population, 582 eyes (53.3%) showed with-the-rule astigmatism, 309 (28.3%) against-the-rule, and 201 (18.4%) oblique astigmatism, regardless of sex. Significant against-the-rule astigmatic shift was verified with aging. Significant correlation was found between age and ACD (r = <0.39, p<0.001), age and AL (r = <0.15, p<0.001), and AL and flat (r = <0.54, p<0.001) and steep keratometric readings
(r = <0.49, p<0.001).
CONCLUSIONS In order to obtain adequate refraction results, at the time of cataract surgery distinct attention should be drawn to ophthalmologic biometric parameters, which are continuously changing even in adulthood, and to astigmatism above 1.0 D, present in >32% of the population.
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