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Khalaf AM, Alhazimi AY, Almaymuni KK, Alsubaie NA. Prevalence of Myopia Among Schoolchildren and the Impact of Increased Screen Time: A Systematic Review. Cureus 2024; 16:e66815. [PMID: 39280371 PMCID: PMC11393148 DOI: 10.7759/cureus.66815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2024] [Indexed: 09/18/2024] Open
Abstract
Myopia is the most frequent kind of refractive error and affects hundreds of millions of people. Growing evidence suggests that extended exposure to digital screens may exacerbate nearsightedness in children and young people. The purpose of this review is to compile data on the link between too much time in front of a screen and nearsightedness in young people so far. The principles of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guided the methods used and the format of the resulting report. Articles published between January 1, 2000, and June 30, 2023, were found by searching Medline, PubMed, ScienceDirect, Google Scholar, CINAHL, the Cochrane Library, and Scopus. Studies reporting an association between myopia and time spent in front of screens in children and young adults were considered eligible. The initial search yielded a total of 1,251 studies. After eliminating duplicates and reviewing the titles and abstracts, 64 full-text articles were evaluated for eligibility. Ultimately, 15 of these studies were included in the final analysis. The 15 studies involved a total of 59,775 participants and were conducted in various countries, including China, Singapore, and the United States. Overall, the evidence did not support a significant association between screen time and myopia in school children and young adults. There is conflicting evidence on the link between screen time and myopia in children and adolescents. More research is needed to determine whether or not digital screen use is a risk factor for myopia. The complex association between screen time and myopia is not fully understood at this time because of the variability of the included studies. These results have significant public health implications since they may be used to guide recommendations for screen time use in children and the young population.
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Affiliation(s)
- Ahmed M Khalaf
- General Practice, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, SAU
| | - Amro Y Alhazimi
- Ophthalmology, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, SAU
| | | | - Noura A Alsubaie
- General Practice, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
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Güemes-Villahoz N, Gómez de Liano R, Porras Ángel P, Talavero González P, Bella Gala R, Martín García B, Burgos Blasco B, Hernández García E, Chamorro Herrera M, Hernández-Verdejo JL, Ruiz-Pomeda A. Lifestyle Factors in Myopic Spanish Children. CHILDREN (BASEL, SWITZERLAND) 2024; 11:139. [PMID: 38397251 PMCID: PMC10887306 DOI: 10.3390/children11020139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Childhood myopia represents a global concern with increasing prevalence in recent decades. Lifestyle factors significantly impact myopia. AIM To evaluate lifestyle factors in myopic children from a metropolitan area in Europe. METHODS This was a descriptive study including myopic subjects aged 4-18 years. Patient demographic and clinical data were collected, including cycloplegic refraction in spherical equivalent refraction (SER) and axial length (AL). In addition, a questionnaire on lifestyle factors was conducted between September 2022 and April 2023. RESULTS A total of 321 myopic children were included, aged 10.72 ± 3.05 years, of whom 51.4% were boys, with SER -2.25 ± 1.9 D and AL 24.54 ± 0.98 mm. The mean age of myopia onset was 7.69 ± 3.05 years. A total of 59.8% had family history of myopia. Those children who had <2 h/day of screen time (on weekdays) presented SER -2 ± 1.91 D, compared to those who had >2 h/day, SER: -2.50 ±1.88 D (p = 0.009). Children who spent <2 h/day doing near work after school were less myopic compared to those who spent >2 h/day (SER: -1.75 ± 1.83 vs. SER: -2.75 ± 1.82, respectively, p = 0.03). However, no significant association was observed between SER and AL and time spent outdoors nor between SER and AL and academic performance (p > 0.05). CONCLUSIONS Screen time and near-work time appear to be lifestyle factors related to myopia.
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Affiliation(s)
- Noemí Güemes-Villahoz
- Department of Ophthalmology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdiSCC), C/Profesor Martin Lagos S/N, 28040 Madrid, Spain; (N.G.-V.); (R.G.d.L.); (P.P.Á.); (P.T.G.); (E.H.G.); (M.C.H.)
| | - Rosario Gómez de Liano
- Department of Ophthalmology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdiSCC), C/Profesor Martin Lagos S/N, 28040 Madrid, Spain; (N.G.-V.); (R.G.d.L.); (P.P.Á.); (P.T.G.); (E.H.G.); (M.C.H.)
| | - Paloma Porras Ángel
- Department of Ophthalmology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdiSCC), C/Profesor Martin Lagos S/N, 28040 Madrid, Spain; (N.G.-V.); (R.G.d.L.); (P.P.Á.); (P.T.G.); (E.H.G.); (M.C.H.)
- Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain; (R.B.G.); (B.M.G.); (J.L.H.-V.)
| | - Paula Talavero González
- Department of Ophthalmology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdiSCC), C/Profesor Martin Lagos S/N, 28040 Madrid, Spain; (N.G.-V.); (R.G.d.L.); (P.P.Á.); (P.T.G.); (E.H.G.); (M.C.H.)
| | - Rafael Bella Gala
- Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain; (R.B.G.); (B.M.G.); (J.L.H.-V.)
| | - Beatriz Martín García
- Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain; (R.B.G.); (B.M.G.); (J.L.H.-V.)
| | - Bárbara Burgos Blasco
- Department of Ophthalmology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdiSCC), C/Profesor Martin Lagos S/N, 28040 Madrid, Spain; (N.G.-V.); (R.G.d.L.); (P.P.Á.); (P.T.G.); (E.H.G.); (M.C.H.)
| | - Elena Hernández García
- Department of Ophthalmology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdiSCC), C/Profesor Martin Lagos S/N, 28040 Madrid, Spain; (N.G.-V.); (R.G.d.L.); (P.P.Á.); (P.T.G.); (E.H.G.); (M.C.H.)
| | - Marta Chamorro Herrera
- Department of Ophthalmology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdiSCC), C/Profesor Martin Lagos S/N, 28040 Madrid, Spain; (N.G.-V.); (R.G.d.L.); (P.P.Á.); (P.T.G.); (E.H.G.); (M.C.H.)
| | - José Luis Hernández-Verdejo
- Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain; (R.B.G.); (B.M.G.); (J.L.H.-V.)
| | - Alicia Ruiz-Pomeda
- Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain; (R.B.G.); (B.M.G.); (J.L.H.-V.)
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Martínez-Albert N, Bueno-Gimeno I, Gené-Sampedro A. Risk Factors for Myopia: A Review. J Clin Med 2023; 12:6062. [PMID: 37763002 PMCID: PMC10532298 DOI: 10.3390/jcm12186062] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/15/2023] [Accepted: 09/17/2023] [Indexed: 09/29/2023] Open
Abstract
Due to the myopia prevalence increase worldwide, this study aims to establish the most relevant risk factors associated with its development and progression. A review search was carried out using PubMed, Web of Science, and Scopus databases to identify the main myopia risk factors. The inclusion criteria for the articles were those related to the topic, carried out in subjects from 5 to 30 years, published between January 2000 and May 2023, in English, and with the full text available. Myopia etiology has proven to be associated with both genetic and environmental factors as well as with gene-environment interaction. The risk of developing myopia increases in children with myopic parents (one parent ×2 times, two parents ×5 times). Regarding environmental factors, education is the main risk factor correlated with myopia prevalence increase. Further, several studies found that shorter distance (<30 cm) and longer time spent (>30 min) for near work increase the risk of myopia. Meanwhile, increased outdoor activity (>40 min/day) has been shown to be a key factor in reducing myopia incidence. In conclusion, the interventional strategy suggested so far to reduce myopia incidence is an increase in time outdoors and a reduction in the time spent performing near-work tasks.
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Affiliation(s)
| | - Inmaculada Bueno-Gimeno
- Department of Optics and Optometry and Vision Sciences, University of Valencia, 46100 Burjassot, Spain;
| | - Andrés Gené-Sampedro
- Department of Optics and Optometry and Vision Sciences, University of Valencia, 46100 Burjassot, Spain;
- Research Institute on Traffic and Road Safety (INTRAS), University of Valencia, 46022 Valencia, Spain
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Manoharan MK, Thakur S, Dhakal R, Gupta SK, Priscilla JJ, Bhandary SK, Srivastava A, Marmamula S, Poigal N, Verkicharla PK. Myopia progression risk assessment score (MPRAS): a promising new tool for risk stratification. Sci Rep 2023; 13:8858. [PMID: 37258536 DOI: 10.1038/s41598-023-35696-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 05/22/2023] [Indexed: 06/02/2023] Open
Abstract
Timely identification of individuals "at-risk" for myopia progression is the leading requisite for myopia practice as it aids in the decision of appropriate management. This study aimed to develop 'myopia progression risk assessment score' (MPRAS) based on multiple risk factors (10) to determine whether a myope is "at-risk" or "low-risk" for myopia progression. Two risk-score models (model-1: non-weightage, model-2: weightage) were developed. Ability of MPRAS to diagnose individual "at-risk" for myopia progression was compared against decision of five clinicians in 149 myopes, aged 6-29 years. Using model-1 (no-weightage), further 7 sub-models were created with varying number of risk factors in decreasing step-wise manner (1a: 10 factors to 1g: 4 factors). In random eye analysis for model-1, the highest Youden's J-index (0.63-0.65) led to the MPRAS cut-off score of 41.50-43.50 for 5 clinicians with a sensitivity ranging from 78 to 85% and specificity ranging from 79 to 87%. For this cut-off score, the mean area under the curve (AUC) between clinicians and the MPRAS model ranged from 0.89 to 0.90. Model-2 (weighted for few risk-factors) provided similar sensitivity, specificity, and AUC. Sub-model analysis revealed greater AUC with high sensitivity (89%) and specificity (94%) in model-1g that has 4 risk factors compared to other sub-models (1a-1f). All the MPRAS models showed good agreement with the clinician's decision in identifying individuals "at-risk" for myopia progression.
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Affiliation(s)
- Manoj K Manoharan
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
- Infor Myopia Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Swapnil Thakur
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
| | - Rohit Dhakal
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
- Infor Myopia Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Satish K Gupta
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
| | - Jacinth J Priscilla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
| | - Shashank K Bhandary
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
| | - Alok Srivastava
- L V Prasad Eye Institute, Hyderabad, Telangana, India
- Sri Innovation and Research Foundation, Ghaziabad, Uttar Pradesh, India
| | - Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Nitish Poigal
- L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Pavan K Verkicharla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India.
- Infor Myopia Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India.
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Kamińska A, Pinkas J, Tyszko P, Wrześniewska-Wal I, Jankowski M. Eye Care Behaviors among Adults in Poland: A Nationwide Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3590. [PMID: 36834285 PMCID: PMC9962256 DOI: 10.3390/ijerph20043590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/11/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
Implementation of eye care behaviors may reduce the risk of eye symptoms and diseases. This study aimed to assess eye care behaviors and identify factors associated with eye care practices among adults in Poland. This cross-sectional survey was carried out between 9 and 12 December 2022 on a nationwide random quota sample of adults in Poland. The study questionnaire included a set of questions on 10 different eye care behaviors. The study population included 1076 participants with a mean age of 45.7 ± 16.2 years, and 54.2% of participants were females. The most common (30.2%) eye care behavior was the use of good lighting indoors, and 27.3% used sunglasses with a UV filter. More than one-fifth of participants declared taking regular screen breaks and limiting screen time. Less than one-tenth of participants used dietary supplements with lutein, beta-carotene, or zinc. Out of 12 factors assessed in this study, self-reported knowledge of eye diseases was the most important factor associated (p < 0.05) with eye care behaviors. There were no economic or educational gaps (p > 0.05) in the implementation of most of the eye care behaviors among adults in Poland. This study revealed a low level of implementation of eye care behaviors among adults in Poland.
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Affiliation(s)
- Agnieszka Kamińska
- Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University, 01-938 Warsaw, Poland
| | - Jarosław Pinkas
- School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland
| | - Piotr Tyszko
- Department of Social Medicine and Public Health, Medical University of Warsaw, 02-007 Warsaw, Poland
- Institute of Rural Health in Lublin, 20-090 Lublin, Poland
| | - Iwona Wrześniewska-Wal
- School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland
| | - Mateusz Jankowski
- School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland
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Shneor E, Ostrin LA, Doron R, Benoit JS, Levine J, Davidson K, Gordon-Shaag A. Baseline characteristics in the Israel refraction, environment, and devices (iREAD) study. Sci Rep 2023; 13:2855. [PMID: 36806309 PMCID: PMC9938253 DOI: 10.1038/s41598-023-29563-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 02/07/2023] [Indexed: 02/19/2023] Open
Abstract
The purpose of this study is to present baseline data from a longitudinal study assessing behavioral factors in three groups of boys in Israel with varying myopia prevalence. Ultra-Orthodox (N = 57), religious (N = 67), and secular (N = 44) Jewish boys (age 8.6 ± 1.4 years) underwent cycloplegic autorefraction and axial-length measurement. Time-outdoors and physical-activity were assessed objectively using an Actiwatch. Ocular history, educational factors, and near-work were assessed with a questionnaire. Group effects were tested and mixed effects logistic and linear regression were used to evaluate behaviors and their relationship to myopia. The prevalence of myopia (≤ - 0.50D) varied by group (ultra-Orthodox: 46%, religious: 25%, secular: 20%, P < 0.021). Refraction was more myopic in the ultra-Orthodox group (P = 0.001). Ultra-Orthodox boys learned to read at a younger age (P < 0.001), spent more hours in school (P < 0.001), spent less time using electronic devices (P < 0.001), and on weekdays, spent less time outdoors (P = 0.02). Increased hours in school (OR 1.70) and near-work (OR 1.22), increased the odds of myopia. Being ultra-Orthodox (P < 0.05) and increased near-work (P = 0.007) were associated with a more negative refraction. Several factors were associated with the prevalence and degree of myopia in young boys in Israel, including being ultra-Orthodox, learning to read at a younger age, and spending more hours in school.
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Affiliation(s)
- Einat Shneor
- Department of Optometry, Hadassah Academic College, Haniviim St. 37, 9101001, Jerusalem, Israel.
| | - Lisa A. Ostrin
- grid.266436.30000 0004 1569 9707College of Optometry, University of Houston, Houston, TX 77004 USA
| | - Ravid Doron
- grid.443085.e0000 0004 0366 7759Department of Optometry, Hadassah Academic College, Haniviim St. 37, 9101001 Jerusalem, Israel
| | - Julia S. Benoit
- grid.266436.30000 0004 1569 9707Texas Institute for Measurement, Evaluation, and Statistics, Houston, TX 77004 USA
| | - Jonathan Levine
- grid.443085.e0000 0004 0366 7759Department of Optometry, Hadassah Academic College, Haniviim St. 37, 9101001 Jerusalem, Israel
| | - Kevin Davidson
- grid.266436.30000 0004 1569 9707Texas Institute for Measurement, Evaluation, and Statistics, Houston, TX 77004 USA
| | - Ariela Gordon-Shaag
- grid.443085.e0000 0004 0366 7759Department of Optometry, Hadassah Academic College, Haniviim St. 37, 9101001 Jerusalem, Israel
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Zheng X, Shi L, Ou W, Xue Y, Xu Y, Xue B, Zhang J, Liang P, Huang W, Qin Z, Zhang C. Effects of physical activity and use of digital devices on visual acuity in children and adolescents during the COVID-19 pandemic: A cross-sectional study. Front Public Health 2022; 10:1017479. [PMID: 36568779 PMCID: PMC9772536 DOI: 10.3389/fpubh.2022.1017479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 11/18/2022] [Indexed: 12/13/2022] Open
Abstract
Purpose To determine the association between poor visual acuity, the use of digital devices and physical activity (PA) during the COVID-19 pandemic. Methods A total of 327,646 Chinese children and adolescents were included in the analysis using a cluster random sampling method; this is a case-control study, of those 144,708 children and adolescents with poor visual acuity were included in the case group, while 182,938 who did not have poor visual acuity were included in the control group. A logistic regression model was used to assess the contribution of PA and the use of digital devices to poor visual acuity. Results A total of 144,708 children and adolescents experienced poor visual acuity during the COVID-19 pandemic; 54.8% were male, and 55.2% live in rural areas. Compared to controls, children and adolescents with poor visual acuity exhibited more time for the use of digital devices (4.51 ± 2.44 vs. 3.79 ± 2.34 for cases and controls, respectively; P < 0.001) and PA (3.07 ± 0.92 vs. 2.85 ± 1.00 for cases and controls, respectively; P < 0.001). During the COVID-19 pandemic, risk factors related to poor visual acuity among children and adolescents included the use of digital devices (OR 1.135; 95% CI 1.132-1.139), and PA (OR 1.269; 95%CI 1.259-1.278). The results of interaction analysis show that for children and adolescents aged 12 to 17, the positive association between the use of digital devices and poor visual acuity decreased. The interaction effect between PA and digital devices is 0.987. Conclusions Children and adolescents were at risk of poor visual acuity during the COVID-19 pandemic. Extended use of the digital devices increased the risk of poor visual acuity, especially for children aged 6-11 years. But the risk of poor visual acuity among children and adolescents decreases as the time spent on PA increases.
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Affiliation(s)
- Xiao Zheng
- Department of Health Management, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, China,School of Health Management, Southern Medical University, Guangzhou, China
| | - Lei Shi
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Weiyan Ou
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Yaqing Xue
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Ying Xu
- Division of Physical Education, Hygiene and Arts Education Department of Education of Guangdong Province, Guangzhou, China
| | - Benli Xue
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Jiachi Zhang
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Pengyan Liang
- Health Publicity and Education Center of Guangdong Province, Guangzhou, China
| | - Wei Huang
- Health Publicity and Education Center of Guangdong Province, Guangzhou, China
| | - Zuguo Qin
- Health Publicity and Education Center of Guangdong Province, Guangzhou, China,Zuguo Qin
| | - Chichen Zhang
- Department of Health Management, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, China,School of Health Management, Southern Medical University, Guangzhou, China,*Correspondence: Chichen Zhang
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Xie J, Lu C, Zhu J. Screen time and myopia: A serial multiple mediator SEM analysis. Front Public Health 2022; 10:860098. [PMID: 36299744 PMCID: PMC9589147 DOI: 10.3389/fpubh.2022.860098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 07/29/2022] [Indexed: 01/21/2023] Open
Abstract
Background COVID-19 has influenced education systems worldwide, and significantly increased screen time for college students, posing a potential risk of myopia. In China, ninety percent of college students suffer from myopia. Excessive screen time changes college students' lifestyles, imposes potential health risks, and affects opportunities for employment. It is important to identify the potential correlation between screen time use and myopia among college students. Methods This paper conducted a nationwide experiment using Chinese college students and set a multiple-mediator SEM model to analyze the potential correlation between screen time and myopia. The two mediators were sedentary behavior and physical activity, respectively. Results We obtained three valuable conclusions as follows: First, there was no significant direct relationship between screen time and myopia among Chinese college students during the COVID-19 pandemic. Second, sedentary behavior and physical activity significantly predicted the increase/decrease of myopia among Chinese college students, respectively. Third, a serial multiple mediator that encompassed sedentary behavior and physical activity sequentially fully mediated the relationship between screen time and myopia. Conclusions Although there was no directly significant relationship between screen time and myopia, screen time can indirectly influence the risk of suffering myopia by influencing sedentary behavior and physical activity. Our study demonstrates the need to prevent the potential influence of overuse of electronic devices on myopia in college students, especially during the COVID-19 pandemic.
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Affiliation(s)
- Jinchen Xie
- Department of Sociology, Xi'an Jiaotong University, Xi'an, China
| | - Chuntian Lu
- Department of Sociology, Xi'an Jiaotong University, Xi'an, China
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Li M, Wang W, Zhu B, Tan X. A Latent Class Analysis of Student Eye Care Behavior: Evidence From a Sample of 6–17 Years Old in China. Front Public Health 2022; 10:914592. [PMID: 35784217 PMCID: PMC9240341 DOI: 10.3389/fpubh.2022.914592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/16/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose To understand the latent classes and distribution of an adolescent eye care behavior, and to provide a basis for the formulation of appropriate adolescent vision health management interventions. Methods Information on eye behavior and eye health of primary and secondary school students in Wuhan was collected by multistage stratified cluster sampling. The latent class analysis (LCA) method was used to analyze the students' eye care behavior, and the latent class model (LCM) was built. Results A total of 6,130 students were enrolled in this study, of which 53.56% were males, aged from 6 to 17 years old, with an average age of 10.33 ± 2.60. The latent class results classified the adolescents' eye care behaviors into bad behaviors, moderate behaviors, and healthy behaviors. The model fitting results were as follows: Akaike Information Criterion (AIC) was 36,698.216, Bayesian Information Criterion (BIC) was 36,906.565, Adjusted Bayesian Information Criterion (aBIC) was 36,808.056, and entropy was 0.838.Compared with the healthy behaviors class, the bad behaviors class was more prevalent in high schools (p = 0.003), non-demonstration schools (p = 0.001), and most of this group had astigmatism (p = 0.002). The moderate behaviors class predominately consisted of females (p = 0.001), 15–17 years old (p = 0.005, 6~8 years old as the reference), from non-demonstration schools (p < 0.001), and most had myopia (p = 0.009). Conclusion There were differences in basic demographic characteristics, visual acuity development level, and family visual environment among different classes. In the management and intervention of an adolescent vision health, we should continue to promote the visual health management of adolescents based on visual monitoring and realize the early intervention and guidance of individuals in bad behaviors class.
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Lanca C, Yam JC, Jiang W, Tham Y, Hassan Emamian M, Tan C, Guo Y, Liu H, Zhong H, Zhu D, Hu Y, Saxena R, Hashemi H, Chen L, Wong T, Cheng C, Pang C, Zhu H, Pan C, Liang YB, Fotouhi A, Bi H, Jonas JB, Saw S. Near work, screen time, outdoor time and myopia in schoolchildren in the Sunflower Myopia AEEC Consortium. Acta Ophthalmol 2022; 100:302-311. [PMID: 34142457 DOI: 10.1111/aos.14942] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 05/10/2021] [Accepted: 05/20/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE To examine the association between near work, screen time including TV and outdoor time with myopia in children from the Sunflower Myopia Asian Eye Epidemiology Consortium (AEEC). METHODS We analysed AEEC cross-sectional data (12 241 children) on risk factors (near work, screen time including TV and outdoor time) and myopia of six population-based studies (China, Hong Kong and Singapore). Cycloplegic refraction and axial length (AL) measurements were included. Risk factors were determined using questionnaires. Data were pooled from each study, and multivariable regression analysis was performed to evaluate the associations between risks factors and myopia, spherical equivalent (SE) and AL. RESULTS Among the included children, 52.1% were boys, 98.1% were Chinese and 69.7% lived in urban areas. Mean±standard deviation (SD) for age was 8.8 ± 2.9 years, for SE was -0.14 ± 1.8 D and for AL was 23.3 ± 1.1 mm. Myopia prevalence was 30.6%. In multivariate analysis, more reading and writing (OR = 1.17; 95% CI, 1.11-1.24), more total near work (OR = 1.05; 95% CI, 1.02-1.09) and less outdoor time (OR = 0.82, 95% CI, 0.75-0.88) were associated with myopia (p's < 0.05). These factors were similarly associated with SE and AL (p's < 0.05), except for total near work and AL (p = 0.15). Screen time including TV was not significantly associated with myopia (p = 0.49), SE (p = 0.49) or AL (p = 0.83). CONCLUSION In this study, increased reading and writing and decreased outdoor time were associated with myopia. Screen time may be a surrogate factor of near work or outdoor time, but further research is needed to assess its role as an independent risk factor for myopia.
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Affiliation(s)
- Carla Lanca
- Singapore Eye Research Institute Singapore Singapore
- Comprehensive Health Research Centre Universidade NOVA de Lisboa Lisbon Portugal
| | - Jason C. Yam
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR Hong Kong
| | - Wen‐Jun Jiang
- Eye Institute of Shandong University of Traditional Chinese Medicine Jinan China
| | - Yih‐Chung Tham
- Singapore Eye Research Institute Singapore Singapore
- Ophthalmology and Visual Science Academic Clinical Program Duke‐NUS Medical School Singapore Singapore
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center Shahroud University of Medical Sciences Shahroud Iran
| | - Chuen‐Seng Tan
- Saw Swee Hock School of Public Health National University of Singapore and National University Health System Singapore Singapore
| | - Yin Guo
- Tongren Eye Care Center Beijing Tongren Hospital Capital Medical University Beijing China
| | - Hu Liu
- Department of Ophthalmology The First Affiliated Hospital with Nanjing Medical University Nanjing China
| | - Hua Zhong
- Department of Ophthalmology the First Affiliated Hospital of Kunming Medical University Kunming China
| | - Dan Zhu
- The Affiliated Hospital of Inner Mongolia Medical University Huhhot China
| | - Yuan‐Yuan Hu
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine Jinan China
| | - Rohit Saxena
- Pediatric Ophthalmology, Strabismus and Neuro‐Ophthalmology Section Dr. R P Centre for Ophthalmic Sciences All India Institute of Medical Sciences New Delhi India
| | - Hassan Hashemi
- Noor Ophthalmology Research Center Noor Eye Hospital Tehran Iran
| | - Li‐Jia Chen
- Comprehensive Health Research Centre Universidade NOVA de Lisboa Lisbon Portugal
| | - Tien‐Yin Wong
- Singapore Eye Research Institute Singapore Singapore
- Ophthalmology and Visual Science Academic Clinical Program Duke‐NUS Medical School Singapore Singapore
- Department of Ophthalmology Yong Loo Lin School of Medicine National University of Singapore Singapore Singapore
- Singapore National Eye Centre Singapore Singapore
| | - Ching‐Yu Cheng
- Singapore Eye Research Institute Singapore Singapore
- Ophthalmology and Visual Science Academic Clinical Program Duke‐NUS Medical School Singapore Singapore
- Department of Ophthalmology Yong Loo Lin School of Medicine National University of Singapore Singapore Singapore
| | - Chi‐Pui Pang
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR Hong Kong
| | - Hui Zhu
- Department of Ophthalmology The First Affiliated Hospital with Nanjing Medical University Nanjing China
| | - Chen‐Wei Pan
- School of Public Health Medical College of Soochow University Suzhou China
| | - Yuan Bo Liang
- Eye Hospital School of Ophthalmology and Optometry Wenzhou Medical University Wenzhou China
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics School of Public Health Tehran University of Medical Sciences Tehran Iran
| | - Hong‐sheng Bi
- Eye Institute of Shandong University of Traditional Chinese Medicine Jinan China
| | - Jost B. Jonas
- Department of Ophthalmology Medical Faculty Mannheim University of Heidelberg Mannheim Germany
| | - Seang‐Mei Saw
- Singapore Eye Research Institute Singapore Singapore
- Ophthalmology and Visual Science Academic Clinical Program Duke‐NUS Medical School Singapore Singapore
- Saw Swee Hock School of Public Health National University of Singapore and National University Health System Singapore Singapore
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11
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Picotti C, Sanchez V, Fernandez Irigaray L, Iurescia A, Iribarren R. Rapid progression of myopia at onset during home confinement. J AAPOS 2022; 26:65.e1-65.e4. [PMID: 35314313 DOI: 10.1016/j.jaapos.2021.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/07/2021] [Accepted: 11/09/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine whether the myopic shift at myopia onset was faster than usual during home confinement associated with the COVID-19 pandemic. METHODS Data on refractive error in consecutive children who presented for their first myopic spectacle prescription from September 2020 to May 2021 (new-onset myopia during the pandemic) were collected. Inclusion criteria were age 5-18 years and cycloplegic spherical equivalent in both eyes in the emmetropic range in the pre-pandemic years as recorded 1 year and 2 years before the actual visit. Annualized mean myopic shifts over the two previous periods were calculated. RESULTS A total of 39 subjects (59% girls) were enrolled. Mean age at the visit after confinement was 10.79 ± 2.83 years. The mean refractive error for the right eyes in 2018 was +0.29 ± 0.56 D. The year after (2019), these children had a mean spherical equivalent of -0.12 ± 0.70 D. At the enrollment visit after myopia onset in the pandemic period, they had myopia of -1.33 ± 0.73 D. The mean annualized myopic shift for the right eyes was -0.37 ± 0.43 D before the pandemic and -1.12 ± 0.70 D during the pandemic period that included home confinement (P < 0·001 [Wilcoxon text]). CONCLUSIONS Previous pre-pandemic prospective studies have reported myopic shift at onset of approximately -0.80 D. The period of strict pandemic home confinement saw higher rates of myopic shift.
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Affiliation(s)
- Carolina Picotti
- Centro Médico Lisandro de la Torre, Villa Maria, Córdoba, Argentina; Hospital Regional Pasteur, Villa Maria, Córdoba, Argentina
| | - Victoria Sanchez
- Clínica de Ojos Reyes Giobellina, Córdoba, Argentina; Instituto Oulton, Córdoba, Argentina
| | | | - Alejandra Iurescia
- Hospital General Interzonal Presidente Peron, Buenos Aires Province, Argentina
| | - Rafael Iribarren
- Consultorios Oftalmológicos Drs. Iribarren, Buenos Aires City, Argentina.
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12
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Morgan IG, Jan CL. China Turns to School Reform to Control the Myopia Epidemic: A Narrative Review. Asia Pac J Ophthalmol (Phila) 2022; 11:27-35. [PMID: 35044336 DOI: 10.1097/apo.0000000000000489] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Myopia is now a major public health issue in parts of East and Southeast Asia, including mainland China. In this region, around 80% of students completing 12 years of school education are now myopic, and from 10% to 20% have high myopia in excess of -6D. Interventions to prevent the onset of myopia based on increasing time outdoors have now been implemented at a system-wide scale in Chinese Taipei (Taiwan) and Singapore with some success, but the prevalence of myopia still remains high by international standards. In mainland China, until recently, myopia prevention was largely based on eye exercises, but these have not been sufficient to prevent an epidemic. Control of myopia progression with atropine eye drops has been widely practiced in Singapore and Taiwan, with recent practice concentrating on low-dose concentrations. Orthokeratology has also been widely used across the region. Recent research has produced both contact and spectacle lenses that slow myopia progression by imposing myopic defocus. The new approaches to myopia control are ready for systematic use, which may be facilitated by system-wide screening and referral. In recent years, renewed emphasis has been placed on the prevention of myopia in mainland China by China's President Xi Jinping. In addition to making use of all the measures outlined above, China now seems to be aiming for major reforms to schooling, reducing educational pressures, particularly in the early school years, freeing more time for outdoor play and learning. These new initiatives may be crucial to myopia prevention and control.
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Affiliation(s)
- Ian G Morgan
- Research School of Biology, Australian National University, Canberra, ACT, Australia
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Catherine L Jan
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- Lost Child's Vision Project, Sydney, Australia, Department of Ophthalmology and Surgery, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Melbourne, Australia
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13
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Foreman J, Salim AT, Praveen A, Fonseka D, Ting DSW, Guang He M, Bourne RRA, Crowston J, Wong TY, Dirani M. Association between digital smart device use and myopia: a systematic review and meta-analysis. LANCET DIGITAL HEALTH 2021; 3:e806-e818. [PMID: 34625399 DOI: 10.1016/s2589-7500(21)00135-7] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 05/25/2021] [Accepted: 06/22/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Excessive use of digital smart devices, including smartphones and tablet computers, could be a risk factor for myopia. We aimed to review the literature on the association between digital smart device use and myopia. METHODS In this systematic review and meta-analysis we searched MEDLINE and Embase, and manually searched reference lists for primary research articles investigating smart device (ie, smartphones and tablets) exposure and myopia in children and young adults (aged 3 months to 33 years) from database inception to June 2 (MEDLINE) and June 3 (Embase), 2020. We included studies that investigated myopia-related outcomes of prevalent or incident myopia, myopia progression rate, axial length, or spherical equivalent. Studies were excluded if they were reviews or case reports, did not investigate myopia-related outcomes, or did not investigate risk factors for myopia. Bias was assessed with the Joanna Briggs Institute Critical Appraisal Checklists for analytical cross-sectional and cohort studies. We categorised studies as follows: category one studies investigated smart device use independently; category two studies investigated smart device use in combination with computer use; and category three studies investigated smart device use with other near-vision tasks that were not screen-based. We extracted unadjusted and adjusted odds ratios (ORs), β coefficients, prevalence ratios, Spearman's correlation coefficients, and p values for associations between screen time and incident or prevalent myopia. We did a meta-analysis of the association between screen time and prevalent or incident myopia for category one articles alone and for category one and two articles combined. Random-effects models were used when study heterogeneity was high (I2>50%) and fixed-effects models were used when heterogeneity was low (I2≤50%). FINDINGS 3325 articles were identified, of which 33 were included in the systematic review and 11 were included in the meta-analysis. Four (40%) of ten category one articles, eight (80%) of ten category two articles, and all 13 category three articles used objective measures to identify myopia (refraction), whereas the remaining studies used questionnaires to identify myopia. Screen exposure was measured by use of questionnaires in all studies, with one also measuring device-recorded network data consumption. Associations between screen exposure and prevalent or incident myopia, an increased myopic spherical equivalent, and longer axial length were reported in five (50%) category one and six (60%) category two articles. Smart device screen time alone (OR 1·26 [95% CI 1·00-1·60]; I2=77%) or in combination with computer use (1·77 [1·28-2·45]; I2=87%) was significantly associated with myopia. The most common sources of risk of bias were that all 33 studies did not include reliable measures of screen time, seven (21%) did not objectively measure myopia, and nine (27%) did not identify or adjust for confounders in the analysis. The high heterogeneity between studies included in the meta-analysis resulted from variability in sample size (range 155-19 934 participants), the mean age of participants (3-16 years), the standard error of the estimated odds of prevalent or incident myopia (0·02-2·21), and the use of continuous (six [55%] of 11) versus categorical (five [46%]) screen time variables INTERPRETATION: Smart device exposure might be associated with an increased risk of myopia. Research with objective measures of screen time and myopia-related outcomes that investigates smart device exposure as an independent risk factor is required. FUNDING None.
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Affiliation(s)
- Joshua Foreman
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia; Plano, Singapore.
| | | | | | | | | | - Ming Guang He
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia; State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Rupert R A Bourne
- Vision and Eye Research Institute, School of Medicine, Anglia Ruskin University, Cambridge, United Kingdom
| | - Jonathan Crowston
- Plano, Singapore; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore
| | - Tien Y Wong
- Plano, Singapore; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore
| | - Mohamed Dirani
- Plano, Singapore; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore
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14
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Choi KY, Chan SSH, Chan HHL. The effect of spatially-related environmental risk factors in visual scenes on myopia. Clin Exp Optom 2021; 105:353-361. [PMID: 34612803 DOI: 10.1080/08164622.2021.1983400] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Myopia, the most common refractive error, is estimated to affect over two billion people worldwide, especially children from East Asian regions. Children with early onset myopia have an increased risk of developing sight threatening complications in later life. In addition to the contribution of genetic factors, of which expression is controversially suggested to be subject to environmental regulation, various environmental factors, such as near-work, outdoor, and living environment, have also been determined to play significant roles in the development of refractive error, especially juvenile myopia. Cues from daily visual scenes, including lighting, spatial frequency, and optical defocus over the field of visual stimuli, are suggested to influence emmetropisation, thereby affecting myopia development and progression. These risk factors in visual scenes of the everyday life may explain the relationship between urbanicity and myopia prevalence. This review first summarises the previously reported associations between myopia development and everyday-life environments, including schooling, urban settings, and outdoors. Then, there is a discussion of the mechanisms hypothesised in the literature about the cues from different visual scenes of urbanicity in relation to myopia development.
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Affiliation(s)
- Kai Yip Choi
- The Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Sonia Seen-Hang Chan
- The Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Henry Ho-Lung Chan
- The Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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15
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Mccrann S, Loughman J, Butler JS, Paudel N, Flitcroft DI. Smartphone use as a possible risk factor for myopia. Clin Exp Optom 2021; 104:35-41. [PMID: 32452059 DOI: 10.1111/cxo.13092] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
CLINICAL RELEVANCE This study demonstrates an association between myopia and smartphone data usage. Youths now spend more time participating in near tasks as a result of smartphone usage. This poses an additional risk factor for myopia development/progression and is an important research question in relation to potential myopia management strategies. BACKGROUND Children are now exposed to another possible environmental risk factor for myopia - smartphones. This study investigates the amount of time students spend on their smartphones and their patterns of smartphone usage from a myopia perspective. METHODS Primary, secondary and tertiary level students completed a questionnaire exploring patterns of smartphone usage and assessing their attitudes toward potential myopia risk factors. Device-recorded data usage over an extended period was quantified as the primary and objective indicator of phone use. Average daily time spent using a smartphone was also quantified by self-reported estimates. Refractive status was verified by an optometrist. RESULTS Smartphone ownership among the 418 students invited to participate was over 99-per cent. Average daily smartphone data and time usage was 800.37 ± 1,299.88-MB and 265.16 ± 168.02-minutes respectively. Myopic students used almost double the amount of smartphone data at 1,130.71 ± 1,748.14-MB per day compared to non-myopes at 613.63 ± 902.15-MB (p = 0.001). Smartphone time usage was not significantly different (p = 0.09, 12-per cent higher among myopes). Multinomial logistic regression revealed that myopic refractive error was statistically significantly associated with increasing daily smartphone data usage (odds ratio 1.08, 95% CI 1.03-1.14) as well as increasing age (odds ratio 1.09, 95% CI 1.02-1.17) and number of myopic parents (odds ratio 1.55, 95% CI 1.06-2.3). Seventy-three per cent of students believed that digital technology may adversely affect their eyes. CONCLUSION This study demonstrates an association between myopia and smartphone data usage. Given the serious nature of the ocular health risks associated with myopia, our findings indicate that this relationship merits more detailed investigation.
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Affiliation(s)
- Saoirse Mccrann
- Centre for Eye Research Ireland, School of Physics, Clinical and Optometric Sciences, Technological University Dublin , Dublin, Ireland
| | - James Loughman
- Centre for Eye Research Ireland, School of Physics, Clinical and Optometric Sciences, Technological University Dublin , Dublin, Ireland.,Department of Optometry, African Vision Research Institute, University of KwaZulu Natal , Durban, South Africa
| | - John S Butler
- School of Mathematical Sciences, Technological University Dublin , Dublin, Ireland
| | - Nabin Paudel
- Centre for Eye Research Ireland, School of Physics, Clinical and Optometric Sciences, Technological University Dublin , Dublin, Ireland
| | - Daniel Ian Flitcroft
- Centre for Eye Research Ireland, School of Physics, Clinical and Optometric Sciences, Technological University Dublin , Dublin, Ireland.,Department of Ophthalmology, Children's University Hospital , Dublin, Ireland
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16
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Dal Pizzol M, Freitas EC, Locatelli C, Guareze F, Reginatto P, Machado G, Fuentefria A, Marinho D. Antifungal Efficacy and Safety of Cycloheximide as a Supplement in Optisol-GS. Drug Des Devel Ther 2021; 15:2091-2098. [PMID: 34040347 PMCID: PMC8140884 DOI: 10.2147/dddt.s298059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/05/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The incidence of fungal infection after corneal transplant has increased significantly in recent years, especially Candida spp. This study aimed to evaluate the efficacy and safety of the addition of cycloheximide in Optisol-GS media in decreasing the growth of Candida spp. strains. METHODS This in vitro laboratory efficacy study measured fungal colony growth in 24 vials of Optisol-GS that were divided into 6 groups of 4 vials each, as follows: (1) MIC/2 cycloheximide, (2) MIC cycloheximide, (3) MICx5 cycloheximide, (4) MICx10 cycloheximide, from MIC values obtained for each strain, (5) unsupplemented optisol-GS as a positive control (added inoculum), and (6) unsupplemented optisol-GS as a negative control (no inoculum). In each group was added Candida albicans, C. glabrata and C. parapsilosis, except in the negative control. The evaluated variables were fungal colony growth from the Optisol-GS vials, corneal endothelial cell density and endothelial cell viability at different concentrations of cycloheximide. RESULTS In the efficacy study, all strains showed a reduction in fungal cell growth from the second day at all evaluated concentrations of optisol-GS supplemented with cycloheximide, even at subinhibitory concentrations (MIC/2). For C. glabrata, the colony count was reduced to 99%. No evidence of corneal endothelial toxicity was found at any concentration, in the safety study, compared with the paired control. CONCLUSION The addition of cycloheximide to optisol-GS decreased the fungal growth, demonstrating fungicide action against C. glabrata and fungistatic action against C. albicans and C. parapsilosis. This drug did not demonstrate toxicity to the corneal endothelium at different concentrations.
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Affiliation(s)
- Melissa Dal Pizzol
- Programa de Pós-Graduação em Medicina: Ciências Cirúrgicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Ophthalmology Department, Hospital De Clínicas De Porto Alegre, Porto Alegre, Brazil
| | | | - Claudete Locatelli
- Ophthalmology Department, Hospital De Clínicas De Porto Alegre, Porto Alegre, Brazil
| | - Felipe Guareze
- Ophthalmology Department, Hospital De Clínicas De Porto Alegre, Porto Alegre, Brazil
| | - Paula Reginatto
- Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gabriella Machado
- Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Alexandre Fuentefria
- Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Diane Marinho
- Programa de Pós-Graduação em Medicina: Ciências Cirúrgicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Ophthalmology Department, Hospital De Clínicas De Porto Alegre, Porto Alegre, Brazil
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17
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Morgan IG, Wu PC, Ostrin LA, Tideman JWL, Yam JC, Lan W, Baraas RC, He X, Sankaridurg P, Saw SM, French AN, Rose KA, Guggenheim JA. IMI Risk Factors for Myopia. Invest Ophthalmol Vis Sci 2021; 62:3. [PMID: 33909035 PMCID: PMC8083079 DOI: 10.1167/iovs.62.5.3] [Citation(s) in RCA: 153] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Risk factor analysis provides an important basis for developing interventions for any condition. In the case of myopia, evidence for a large number of risk factors has been presented, but they have not been systematically tested for confounding. To be useful for designing preventive interventions, risk factor analysis ideally needs to be carried through to demonstration of a causal connection, with a defined mechanism. Statistical analysis is often complicated by covariation of variables, and demonstration of a causal relationship between a factor and myopia using Mendelian randomization or in a randomized clinical trial should be aimed for. When strict analysis of this kind is applied, associations between various measures of educational pressure and myopia are consistently observed. However, associations between more nearwork and more myopia are generally weak and inconsistent, but have been supported by meta-analysis. Associations between time outdoors and less myopia are stronger and more consistently observed, including by meta-analysis. Measurement of nearwork and time outdoors has traditionally been performed with questionnaires, but is increasingly being pursued with wearable objective devices. A causal link between increased years of education and more myopia has been confirmed by Mendelian randomization, whereas the protective effect of increased time outdoors from the development of myopia has been confirmed in randomized clinical trials. Other proposed risk factors need to be tested to see if they modulate these variables. The evidence linking increased screen time to myopia is weak and inconsistent, although limitations on screen time are increasingly under consideration as interventions to control the epidemic of myopia.
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Affiliation(s)
- Ian G Morgan
- Research School of Biology, Australian National University, Canberra, ACT, Australia.,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Pei-Chang Wu
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Lisa A Ostrin
- College of Optometry, University of Houston, Houston, Texas, United States
| | - J Willem L Tideman
- Department of Ophthalmology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Jason C Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Hong Kong Eye Hospital, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China
| | - Weizhong Lan
- Aier School of Ophthalmology, Central South University, Changsha, China.,Aier School of Optometry, Hubei University of Science and Technology, Xianning, China.,Aier Institute of Optometry and Vision Science, Aier Eye Hospital Group, Changsha, China.,Guangzhou Aier Eye Hospital, Jinan University, Guangzhou, China
| | - Rigmor C Baraas
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Xiangui He
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Ocular Fundus Diseases, National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Padmaja Sankaridurg
- Brien Holden Vision Institute Limited, Sydney, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Seang-Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore (NUS), Singapore.,Singapore Eye Research Institute, Singapore.,Duke-NUS Medical School, Singapore
| | - Amanda N French
- Discipline of Orthoptics, Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Kathryn A Rose
- Discipline of Orthoptics, Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Jeremy A Guggenheim
- School of Optometry & Vision Sciences, Cardiff University, Cardiff, United Kingdom
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18
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Effect of reading with a mobile phone and text on accommodation in young adults. Graefes Arch Clin Exp Ophthalmol 2021; 259:1281-1288. [PMID: 33464380 PMCID: PMC8102294 DOI: 10.1007/s00417-020-05054-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/29/2020] [Accepted: 12/15/2020] [Indexed: 02/08/2023] Open
Abstract
Purpose To investigate the effects of reading with mobile phone versus text on accommodation accuracy and near work-induced transient myopia (NITM) and its subsequent decay during near reading in young adults with mild to moderate myopia. Methods The refractions of 31 young adults were measured with an open-field autorefractor (WAM-5500, Grand Seiko) for two reading tasks with a mobile phone and text at 33 cm. The mean age of the young adults was 24.35 ± 1.80 years. The baseline refractive aspects were determined clinically with full distance refractive correction in place. The initial NITM and its decay time and accommodative lag were assessed objectively immediately after binocularly viewing a mobile phone or text for 40 min. Results The mean ± standard deviation (SD) initial NITM magnitude was greater for reading with text (0.23 ± 0.26 D) than for reading with mobile phone (0.12 ± 0.17 D), but there was no significant difference between the two reading tasks (p = 0.082). The decay time (median, first quartile, and third quartile) was 60 s (16, 154) and 70 s (32, 180) in the phone task and text task groups, respectively. There was also no significant difference in the decay time between the two reading types in general (p = 0.294). The accommodative lags of text tasks and mobile phones tasks were equivalent (1.27 ± 0.52 D vs 1.31 ± 0.64 D, p = 0.792). Conclusion There were no significant differences in accommodative lags and the initial NITM and its decay time between reading with a mobile phone and text in young adults.
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Wang J, Li M, Zhu D, Cao Y. Smartphone Overuse and Visual Impairment in Children and Young Adults: Systematic Review and Meta-Analysis. J Med Internet Res 2020; 22:e21923. [PMID: 33289673 PMCID: PMC7755532 DOI: 10.2196/21923] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 10/29/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Smartphone overuse has been cited as a potentially modifiable risk factor that can result in visual impairment. However, reported associations between smartphone overuse and visual impairment have been inconsistent. OBJECTIVE The aim of this systematic review was to determine the association between smartphone overuse and visual impairment, including myopia, blurred vision, and poor vision, in children and young adults. METHODS We conducted a systematic search in the Cochrane Library, PubMed, EMBASE, Web of Science Core Collection, and ScienceDirect databases since the beginning of the databases up to June 2020. Fourteen eligible studies (10 cross-sectional studies and 4 controlled trials) were identified, which included a total of 27,110 subjects with a mean age ranging from 9.5 to 26.0 years. We used a random-effects model for meta-analysis of the 10 cross-sectional studies (26,962 subjects) and a fixed-effects model for meta-analysis of the 4 controlled trials (148 subjects) to combine odds ratios (ORs) and effect sizes (ES). The I2 statistic was used to assess heterogeneity. RESULTS A pooled OR of 1.05 (95% CI 0.98-1.13, P=.16) was obtained from the cross-sectional studies, suggesting that smartphone overuse is not significantly associated with myopia, poor vision, or blurred vision; however, these visual impairments together were more apparent in children (OR 1.06, 95% CI 0.99-1.14, P=.09) than in young adults (OR 0.91, 95% CI 0.57-1.46,P=.71). For the 4 controlled trials, the smartphone overuse groups showed worse visual function scores compared with the reduced-use groups. The pooled ES was 0.76 (95% CI 0.53-0.99), which was statistically significant (P<.001). CONCLUSIONS Longer smartphone use may increase the likelihood of ocular symptoms, including myopia, asthenopia, and ocular surface disease, especially in children. Thus, regulating use time and restricting the prolonged use of smartphones may prevent ocular and visual symptoms. Further research on the patterns of use, with longer follow up on the longitudinal associations, will help to inform detailed guidelines and recommendations for smartphone use in children and young adults.
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Affiliation(s)
- Jian Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Mei Li
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Daqiao Zhu
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Yang Cao
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
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20
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Alvarez-Peregrina C, Sánchez-Tena MÁ, Martinez-Perez C, Villa-Collar C. The Relationship Between Screen and Outdoor Time With Rates of Myopia in Spanish Children. Front Public Health 2020; 8:560378. [PMID: 33178659 PMCID: PMC7592393 DOI: 10.3389/fpubh.2020.560378] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 09/02/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Nowadays, digital devices have become usual in children's lives around the world. Five percent of the children between 5 and 7 years old have their own smartphone and forty-two percent of them have their own tablet. This fact has produced a change in their lifestyle that can imply some risks, threats and/or opportunities. The light emitted by digital devices' screens could involve, among others, possible risks to children's vision. Methods: This study shows a detailed analysis of the vision of 7,497 children between 5 and 7 years old carried out in the "Annual school campaign for children's visual health" in Spain during the years 2016, 2017, and 2019. The study connects the results in the visual screening with children's lifestyle, taking into account both, the number of hours per day that they use all digital devices and the daily time of outdoor exposure. Results: The study shows that children with myopia have more screen time use and shorter outdoor activity time when compared to those without myopia (p < 0.01). Conclusions: Myopia in children is a public health problem and requires healthy lifestyle interventions at individual as well as at community level.
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21
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Berton B, Chennell P, Yessaad M, Bouattour Y, Jouannet M, Wasiak M, Sautou V. Stability of Ophthalmic Atropine Solutions for Child Myopia Control. Pharmaceutics 2020; 12:pharmaceutics12080781. [PMID: 32824572 PMCID: PMC7465901 DOI: 10.3390/pharmaceutics12080781] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/23/2020] [Accepted: 08/07/2020] [Indexed: 12/17/2022] Open
Abstract
Myopia is an ophthalmic condition affecting more than 1/5th of the world population, especially children. Low-dose atropine eyedrops have been shown to limit myopia evolution during treatment. However, there are currently no commercial industrial forms available and there is little data published concerning the stability of medications prepared by compounding pharmacies. The objective of this study was to evaluate the stability of two 0.1 mg/mL atropine formulations (with and without antimicrobiobial preservatives) for 6 months in two different low-density polyethylene (LDPE) multidose eyedroppers. Analyses used were the following: visual inspection, turbidity, chromaticity measurements, osmolality and pH measurements, atropine quantification by a stability-indicating liquid chromatography method, breakdown product research, and sterility assay. In an in-use study, atropine quantification was also performed on the drops emitted from the multidose eyedroppers. All tested parameters remained stable during the 6 months period, with atropine concentrations above 94.7% of initial concentration. A breakdown product (tropic acid) did increase slowly over time but remained well below usually admitted concentrations. Atropine concentrations remained stable during the in-use study. Both formulations of 0.1 mg/mL of atropine (with and without antimicrobial preservative) were proved to be physicochemically stable for 6 months at 25 °C when stored in LDPE bottles, with an identical microbial shelf-life.
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Affiliation(s)
- Baptiste Berton
- CHU Clermont-Ferrand, Pôle Pharmacie, F-63003 Clermont-Ferrand, France; (B.B.); (M.Y.); (M.J.); (M.W.)
| | - Philip Chennell
- Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA, ICCF, 63000 Clermont-Ferrand, France; (Y.B.); (V.S.)
- Correspondence:
| | - Mouloud Yessaad
- CHU Clermont-Ferrand, Pôle Pharmacie, F-63003 Clermont-Ferrand, France; (B.B.); (M.Y.); (M.J.); (M.W.)
| | - Yassine Bouattour
- Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA, ICCF, 63000 Clermont-Ferrand, France; (Y.B.); (V.S.)
| | - Mireille Jouannet
- CHU Clermont-Ferrand, Pôle Pharmacie, F-63003 Clermont-Ferrand, France; (B.B.); (M.Y.); (M.J.); (M.W.)
| | - Mathieu Wasiak
- CHU Clermont-Ferrand, Pôle Pharmacie, F-63003 Clermont-Ferrand, France; (B.B.); (M.Y.); (M.J.); (M.W.)
| | - Valérie Sautou
- Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA, ICCF, 63000 Clermont-Ferrand, France; (Y.B.); (V.S.)
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22
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Yam JC, Tang SM, Kam KW, Chen LJ, Yu M, Law AK, Yip BH, Wang YM, Cheung CYL, Ng DSC, Young AL, Tham CC, Pang CP. High prevalence of myopia in children and their parents in Hong Kong Chinese Population: the Hong Kong Children Eye Study. Acta Ophthalmol 2020; 98:e639-e648. [PMID: 31981300 DOI: 10.1111/aos.14350] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 12/20/2019] [Indexed: 01/14/2023]
Abstract
PURPOSE To determine the myopia prevalence in Hong Kong Chinese children and their parents. METHODS It was a population-based cross-sectional study. A total of 4257 children aged 6-8 years, and 5880 parents were recruited in the Hong Kong Children Eye Study. Cycloplegic autorefraction was measured for children; and non-cycloplegic autorefraction for parents. Parental educational level, children's outdoor time, and near work were collected by validated questionnaires. RESULTS In children aged 6-8 years, 25.0% were myopic, and among them, 12.7% for the 6-year-olds, 24.4% for the 7-year-olds and 36.1% for the 8-year-old. About 0.7% of children aged 8 years were high myopia. In all age groups, boys (their myopia rate: 13.9% at 6 years, 26.7% at 7 years, and 38.3% at 8 years) were more myopic than girls (11.3% at 6 years, 22.0% at 7 years, 33.4% at 8 years). Among parents, 72.2% were myopic (mother, 73.2%; father, 70.7%) and 13.5% high myopia (mother, 12.8%; father, 14.5%). It was observed that prevalence decreased with ages and increased with education level. CONCLUSION There is a strikingly high prevalence of myopia in Hong Kong children aged 6-8, much higher than that of other regions of China. Of note, the prevalence of children was similar to that in 15 years ago. Furthermore, the myopia prevalence of parents is high, and it had already increased in this cohort. Prevention of childhood myopia is important, likewise for visual complications from high myopia in adults.
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Affiliation(s)
- Jason C Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong.,Hong Kong Eye Hospital, Hong Kong, Hong Kong
| | - Shu Min Tang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong.,Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fujian, China
| | - Ka Wai Kam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong.,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Kowloon, Hong Kong
| | - Li Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong.,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Kowloon, Hong Kong
| | - Marco Yu
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong.,Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Antony K Law
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
| | - Benjamin H Yip
- The Jockey Club School of Public Health and Primary Care Faculty of Medicine, The Chinese University of Hong Kong, Kowloon, Hong Kong
| | - Yu Meng Wang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
| | - Carol Y L Cheung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
| | - Danny S C Ng
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
| | - Alvin L Young
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong.,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Kowloon, Hong Kong
| | - Clement C Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
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Tsai TH, Liu YL, Ma IH, Su CC, Lin CW, Lin LLK, Hsiao CK, Wang IJ. Evolution of the Prevalence of Myopia among Taiwanese Schoolchildren: A Review of Survey Data from 1983 through 2017. Ophthalmology 2020; 128:290-301. [PMID: 32679159 DOI: 10.1016/j.ophtha.2020.07.017] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 06/18/2020] [Accepted: 07/07/2020] [Indexed: 12/13/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate the changes in the prevalence of myopia in Taiwanese schoolchildren over the past few decades and to analyze the risk factors for myopia. DESIGN Analysis of 8 consecutive population-based myopia surveys conducted from 1983 through 2017. PARTICIPANTS An average of 8917 (5019-11 656) schoolchildren 3 to 18 years of age were selected using stratified systematic cluster sampling or by probability proportional to size sampling. METHODS All participants underwent complete ophthalmic evaluations. Three drops of 0.5% tropicamide were used to obtain the cycloplegic refractive status of each participant. Questionnaires were used to acquire participant data from the 1995, 2005, 2010, and 2016 surveys. MAIN OUTCOME MEASURES Prevalence of myopia (spherical equivalence of ≤-0.25 diopter [D]) and high myopia (≤-6.0 D) was assessed. Multivariate analyses of risk factors were conducted. RESULTS The prevalence of myopia among all age groups increased steadily. From 1983 through 2017, the weighted prevalence increased from 5.37% (95% confidence interval [CI], 3.50%-7.23%) to 25.41% (95% CI, 21.27%-29.55%) for 7-year-olds (P = 0.001 for trend) and from 30.66% (95% CI, 26.89%-34.43%) to 76.67% (95% CI, 72.94%-80.40%) for 12-year-olds (P = 0.001 for trend). The prevalence of high myopia also increased from 1.39% (95% CI, 0.43%-2.35%) to 4.26% (95% CI, 3.35%-5.17%) for 12-year-olds (P = 0.008 for trend) and from 4.37% (95% CI, 2.91%-5.82%) to 15.36% (95% CI, 13.78%-16.94%) for 15-year-olds (P = 0.039 for trend). In both the 2005 and 2016 survey samples, children who spent less than 180 minutes daily on near-work activities showed significantly lower risks for myopia developing (<60 minutes: odds ratio [OR], 0.48 and 0.56; 60-180 minutes: OR, 0.69 and 0.67). In the 2016 survey, spending more than 60 minutes daily on electronic devices was associated significantly with both myopia and high myopia (OR, 2.43 and 2.31). CONCLUSIONS The prevalence of myopia among schoolchildren increased rapidly from 1983 through 2017 in Taiwan. The major risk factors are older age and time spent on near-work activities. Use of electronic devices increased the amount of time spent on near-work and may increase the risk of developing myopia.
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Affiliation(s)
- Tzu-Hsun Tsai
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yao-Lin Liu
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - I-Hsin Ma
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chien-Chia Su
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chao-Wen Lin
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Luke Long-Kuang Lin
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chuhsing Kate Hsiao
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - I-Jong Wang
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
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24
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Cheng CY, Soh ZD, Majithia S, Thakur S, Rim TH, Tham YC, Wong TY. Big Data in Ophthalmology. Asia Pac J Ophthalmol (Phila) 2020; 9:291-298. [PMID: 32739936 DOI: 10.1097/apo.0000000000000304] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Big data is the fuel of mankind's fourth industrial revolution. Coupled with new technology such as artificial intelligence and deep learning, the potential of big data is poised to be harnessed to its maximal in years to come. In ophthalmology, given the data-intensive nature of this specialty, big data will similarly play an important role. Electronic medical records, administrative and health insurance databases, mega national biobanks, crowd source data from mobile applications and social media, and international epidemiology consortia are emerging forms of "big data" in ophthalmology. In this review, we discuss the characteristics of big data, its potential applications in ophthalmology, and the challenges in leveraging and using these data. Importantly, in the next phase of work, it will be pertinent to further translate "big data" findings into real-world applications, to improve quality of eye care, and cost-effectiveness and efficiency of health services in ophthalmology.
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Affiliation(s)
- Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
| | - Zhi Da Soh
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Shivani Majithia
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Sahil Thakur
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Tyler Hyungtaek Rim
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
| | - Yih Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
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25
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Lanca C, Saw S. The association between digital screen time and myopia: A systematic review. Ophthalmic Physiol Opt 2020; 40:216-229. [DOI: 10.1111/opo.12657] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 10/30/2019] [Accepted: 11/09/2019] [Indexed: 01/05/2023]
Affiliation(s)
- Carla Lanca
- Singapore Eye Research Institute Singapore CitySingapore
| | - Seang‐Mei Saw
- Singapore Eye Research Institute Singapore CitySingapore
- Saw Swee Hock School of Public Health National University of Singapore Singapore City Singapore
- Duke‐NUS Medical School Singapore City Singapore
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26
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Long J, Richter H. The pitfalls of the traditional office ergonomics model in the current mobile work environment: Is visual ergonomics health literacy the remedy? Work 2019; 63:447-456. [PMID: 31256101 DOI: 10.3233/wor-192937] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Mobile technology has revolutionised how we work. It is now relatively easy to work anywhere and anytime, but this has placed the onus is on mobile (or flexible) workers to set up their own work environment for comfort and ease of use. Vision is an important driver of posture, and hence visual ergonomics principles are integral for setting up digital devices. If mobile workers do not have visual ergonomics knowledge, or are unable to apply visual ergonomics knowledge to appropriately set up their work environment, then they are at risk of developing visual-related occupational health issues due to exposure to adverse physical work environments. To address this potential health care issue, we propose the introduction of Visual Ergonomics Health Literacy. This would provide mobile workers (including school children) with the knowledge and skills to set up their work environment for comfort and ease of use, wherever they work. It is important to address this issue now before we have a widespread epidemic of discomfort and injury from not applying sound visual ergonomics principles to work environments.
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Affiliation(s)
- Jennifer Long
- Jennifer Long Visual Ergonomics, Katoomba, NSW, Australia.,School of Optometry and Vision Science, UNSW Sydney, NSW, Australia
| | - Hans Richter
- Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
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27
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Altered ocular parameters from circadian clock gene disruptions. PLoS One 2019; 14:e0217111. [PMID: 31211778 PMCID: PMC6581257 DOI: 10.1371/journal.pone.0217111] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 05/06/2019] [Indexed: 12/11/2022] Open
Abstract
The pathophysiology of refractive errors is poorly understood. Myopia (nearsightedness) in particular both blurs vision and predisposes the eye to many blinding diseases during adulthood. Based on past findings of diurnal variations in the dimensions of the eyes of humans and other vertebrates, altered diurnal rhythms of these ocular dimensions with experimentally induced myopia, and evolving evidence that ambient light exposures influence refractive development, we assessed whether disturbances in circadian signals might alter the refractive development of the eye. In mice, retinal-specific knockout of the clock gene Bmal1 induces myopia and elongates the vitreous chamber, the optical compartment separating the lens and the retina. These alterations simulate common ocular findings in clinical myopia. In Drosophila melanogaster, knockouts of the clock genes cycle or period lengthen the pseudocone, the optical component of the ommatidium that separates the facet lens from the photoreceptors. Disrupting circadian signaling thus alters optical development of the eye in widely separated species. We propose that mechanisms of myopia include circadian dysregulation, a frequent occurrence in modern societies where myopia also is both highly prevalent and increasing at alarming rates. Addressing circadian dysregulation may improve understanding of the pathogenesis of refractive errors and introduce novel therapeutic approaches to ameliorate myopia development in children.
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