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Refractive Errors, Myopia, and Presbyopia
Published in Ching-Yu Cheng, Tien Yin Wong, Ophthalmic Epidemiology, 2022
Ka Wai Kam, Chi Pui Pang, Jason C. S. Yam
Protection of outdoor time against myopia development in schoolchildren is evident. Randomized controlled trials have been conducted to determine the optimal and practically possible outdoor time in the school curriculum. In a randomized study involving 16 schools in Taiwan, children were arranged to leave the classroom for outdoor activities after classes.111 Myopia progression and axial elongation were significantly reduced in the intervention group compared to the control group (–0.35 D vs. –0.47 D and +0.28 mm vs. +0.33 mm, respectively). A previous study by the same research team compared two neighboring schools and found a significantly lower rate of myopia onset in the intervention group (8.41% vs. 17.65%).112 Intermittent outdoor time of 80 minutes per day during recess decreased myopia onset by up to 9% in just 1 year.112 A randomized trial of 952 schoolchildren in the city of Guangzhou in mainland China showed that an intervention of 40 minutes per day outdoors decreased myopia onset by 9% after 3 years.113 Children have been advised to spend at least 2 hours per day outdoors, in addition to avoiding excessive near work. In Taiwan, policy interventions to promote increased time outdoors to 2 hours per day in schools were followed by a reversal of the long-term trend toward increased low visual acuity in schoolchildren.114 The school-based approach to increasing children’s time outdoors should be advocated in all parts of the world.
Paper 2
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
Marfan syndrome is an autosomal dominant connective tissue disorder which can lead to cardiac failure. Other cardiovascular associations include a dilated aortic root, aortic aneurysm, coarctation and dissection. Patients also have an increased risk of spontaneous pneumothorax as well as emphysema and bullae formation. The condition is associated with both pectus excavatum and carinatum and scoliosis. Ocular complications include myopia, cataracts, glaucoma and lens dislocation.
Wavy Lines, Distorted Vision and Blur
Published in Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen, Practical Emergency Ophthalmology Handbook, 2019
Pre-slit lamp examination: Visual acuity should always be measured and documented and should be clearly written whether or not glasses are used. An improvement of vision with pinhole suggests there is an element of refractive error. Macular disorders would not produce an improvement with pinhole unless patient is fixating eccentrically. Near vision should ideally be tested as well in the case of myopia, but this is not usually feasible in a busy emergency clinic.
Low Dose Atropine in Preventing the Progression of Childhood Myopia: A Randomised Controlled Trial
Published in Current Eye Research, 2023
Isha Sharma, Gopal K. Das, Jolly Rohatgi, Pramod K. Sahu, Pragti Chhabra, Rahul Bhatia
Myopia management options using various optical and surgical methods are well known. However, the rising number of cases suggest that prevention, although difficult to achieve if exact cause of myopia is not established, should be emphasized upon besides the current approach of treating myopia, else the burden of this existing global public health issue may worsen. The options available to slow the progression include adapting healthy ocular habits, like increasing time outdoors and reducing the duration of near activities,8 which requires immense amount of counselling and motivation and is difficult considering the busy parental schedules. Other options like orthokeratology,9 soft contact lens10 have shown to be effective, but the concerns of hygiene and patient compliance is an issue, more so in developing countries where such a preventive modality for reducing myopia progression may not be possible on a large scale.
The Prevalence and Progression of Myopia in Elementary School Students in Shanxi Province, China During the COVID-19 Pandemic
Published in Seminars in Ophthalmology, 2022
Fei F. Ma, Hao Luo, Guo H. Zhao, Xiu L. Luo
In this study, the prevalence of myopia increased with age in males and females. In particular, children in the fifth grade exhibited the largest increase. Age was positively correlated with the prevalence of myopia. The prevalence was related to the increased axial length observed in the senior grades, which might be due to the fact that students in the senior grades experience intensive pressure for the upcoming enrollment into more competitive middle schools. The students in the senior grades need to reduce time spent on outdoor activities to allow for increased time spent on studying.33 Previous investigations have shown that the earlier myopia starts, the faster it progresses and the higher the probability of the occurrence of pathological myopia.34,35 Thus, if students experience myopia in elementary school, they are more likely to suffer from severe myopia in the future. Patients with severe myopia are highly susceptible to ocular diseases such as glaucoma, cataracts, and retinal detachment.36 Preventing the development of myopia in students in their early school years will facilitate the control of severe ocular diseases in the future.
Pre-clinical and cellular toxicity evaluation of 7-methylxanthine: an investigational drug for the treatment of myopia
Published in Drug and Chemical Toxicology, 2021
Harjeet Singh, Nikhil Shri Sahajpal, Harmanpreet Singh, Vanita Vanita, Partha Roy, Surinder Paul, Shashank Kumar Singh, Inderjit Kaur, Subheet Kumar Jain
Myopia, also known as near-sightedness, is a state of refraction in which parallel rays of light do not focus on the retina but focus in front of a resting eye. A refractive error of greater than 0.25 or 0.50 diopter is defined as myopia (Saw et al. 1996). Myopia remains the most prevalent refractive error with its prevalence varying across different regions and races. The greater time spent on near sighted work i.e., computer, mobile phone, video game, indoor lifestyle, higher educational setup, and history of myopia in family have been reported as increased risk factors for myopia. The prevalence remains higher in urban regions and in East Asian population. The prevalence in children indicates that the Asian population, specifically, the Chinese population is more susceptible to myopia compared to the western population. Whereas, no such clear distinction in susceptibility emerges in adult population of age greater than 40 years (Pan et al.2012). Furthermore, it is much more prevalent in industrialized countries and in cities as compared to non-industrialized and rural areas (Saw et al.2006). The environmental factors have a considerable influence on the development of myopia and it cannot be explained only by a genetic model (Bar et al.2005), as its origin remains to be both genetic and environmental.