Abstract
Objective To investigate the association between myopia progression and school entrance age among Chinese schoolchildren and to suggest a more appropriate school age. Methods 1,463 children aged six to nine years from Wenzhou, China, were examined and followed up for two and a half consecutive years. Their noncycloplegic refraction was measured twice each year by using an automatic refractometer; axial length (AL) and corneal radius of curvature (CRC) were tested annually by using the IOLMaster for 2.5 years. The questionnaires were completed by the children to collect detailed information regarding risk factors. Here, myopia is defined as a spherical equivalent less than −1.0D. Results The changes in spherical equivalent (SE) of 7-year-old children in grade 1 and grade 2 were −0.45D and -0.56D, while changes in AL were 0.59 mm and 0.62 mm, respectively. The SE changes of 8-year-old children in grade 2 and grade 3 were −0.54D and −0.75D; meanwhile, the AL changes were 0.57 mm and 0.61 mm, respectively. Significant statistical differences were observed in ocular biological structure parameters, except for corneal radius of curvature (CRC) or anterior chamber depth (ACD), among children with the same age in different grades during this study. The prevalence of myopia was also significantly higher in higher grades for children with same age. Conclusions Myopia is related to children's school entrance age. Children who start school in an earlier age are more likely to suffer from myopia, and the progression of myopia can be considerably faster. Therefore, it is recommended to enter school after the age of 7.
Highlights
In recent years, myopia has shown a high growth trend
Participants were followed up for 2.5 years, with the first visit in September 2012 to and the sixth visit in March 2015. e order by which each of the three schools was examined was the same from the first to the sixth visits to ensure a same gap between visits for each school. e detailed schedule of visits and examination items is shown in Supplemental Table 1. e cluster random sampling technique was adopted for recruiting participants
In children aged 7–9 years, myopia is defined as Spherical equivalent refraction (SER) ≤ −1.00 D. e reason of adopting the definition of myopia as a myopia refractive error of more than −1.00 D was that refractometry was carried out without cycloplegia; due to involuntary accommodation, the refractive measurements might have been artificially low in some children
Summary
To investigate the association between myopia progression and school entrance age among Chinese schoolchildren and to suggest a more appropriate school age. Myopia is defined as a spherical equivalent less than −1.0D. E changes in spherical equivalent (SE) of 7-year-old children in grade 1 and grade 2 were −0.45D and -0.56D, while changes in AL were 0.59 mm and 0.62 mm, respectively. E SE changes of 8-year-old children in grade 2 and grade 3 were −0.54D and −0.75D; the AL changes were 0.57 mm and 0.61 mm, respectively. Significant statistical differences were observed in ocular biological structure parameters, except for corneal radius of curvature (CRC) or anterior chamber depth (ACD), among children with the same age in different grades during this study. Myopia is related to children’s school entrance age. Children who start school in an earlier age are more likely to suffer from myopia, and the progression of myopia can be considerably faster. Children who start school in an earlier age are more likely to suffer from myopia, and the progression of myopia can be considerably faster. erefore, it is recommended to enter school after the age of 7
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