Abstract
BackgroundLifestyle behaviour may play a role in refractive error among children, but the association between near work habits and refractive anisometropia remains unclear.MethodsWe estimated the prevalence of refractive anisometropia and examined its association with near work activities among 23,114 children in the Myopia Investigation Study in Taipei who were grade 2 elementary school students at baseline in 2013 and 2014. Baseline data on demographics, medical history, parental history and near work habits were collected by parent-administered questionnaire survey. Refractive status was determined by cycloplegic autorefraction. Refractive anisometropia was defined as the spherical equivalent difference ≥ 1.0 diopter between eyes.ResultsThe prevalence of refractive anisometropia was 5.3% (95% confidence interval [CI], 5.0% to 5.6%). The prevalence and severity of refractive anisometropia increased with both myopic and hyperopic refractive error. Multivariate logistic regression analysis revealed that refractive anisometropia was significantly associated with myopia (odds ratio [OR], 2.98; 95% CI, 2.53–3.51), hyperopia (OR, 2.37; 95% CI, 1.98–2.83), degree of astigmatism (OR, 1.005; 95% CI, 1.005–1.006), amblyopia (OR, 2.54; 95% CI, 2.06–3.12), male gender (OR, 0.88; 95% CI, 0.78–0.99) and senior high school level of maternal education (OR, 0.69; 95% CI, 0.52–0.92). Though anisometropic children were more likely to spend more time on near work (crude OR, 1.15; 95% CI, 1.02–1.29) and to have less eye-to-object distance in doing near work (crude OR, 1.15; 95% CI, 1.01–1.30), these associations became insignificant after additional adjustment for ocular, demographic and parental factors.ConclusionsThe present study provides large-scale, population-based evidence showing no independent association between refractive anisometropia and near work habits, though myopia is associated with refractive anisometropia.
Highlights
Refractive anisometropia, a between-eye difference in ocular refraction, is of great clinical interest because it is a well-known amblyogenic factor in children
Multivariate logistic regression analysis revealed that refractive anisometropia was significantly associated with myopia, hyperopia (OR, 2.37; 95% CI, 1.98–2.83), degree of astigmatism (OR, 1.005; 95% CI, 1.005–1.006), amblyopia (OR, 2.54; 95% CI, 2.06–3.12), male gender (OR, 0.88; 95% CI, 0.78–0.99) and senior high school level of maternal education (OR, 0.69; 95% CI, 0.52–0.92)
The present study provides large-scale, population-based evidence showing no independent association between refractive anisometropia and near work habits, though myopia is associated with refractive anisometropia
Summary
Refractive anisometropia, a between-eye difference in ocular refraction, is of great clinical interest because it is a well-known amblyogenic factor in children. Refractive anisometropia represents a unique condition in that the fellow eyes of an individual with presumably similar sociodemographic, environmental, and genetic influences can have asymmetric ocular growth. Near work activities can generate transient axial elongation [5, 6]. Given that the two eyes of an individual may have different refractive status at baseline, with stimuli of unequal convergent or accommodative demand during near work tasks, these interocular differences in visual experience may potentially induce asymmetric axial length elongation and result in refractive anisometropia. Lifestyle behaviour may play a role in refractive error among children, but the association between near work habits and refractive anisometropia remains unclear.
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