Association Of Refractive Error Research Articles

Association of Refractive Errors with Axial Length and Anterior Chamber Depth in Different Age Groups

Purpose: To determine association of refractive errors with axial length and anterior chamber depth in different age groups. Study Design: Cross-sectional study. Place and Duration of Study: Ophthalmology Department of Dow University Hospital (Ojha campus),Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan from October 2020 to December 2020. Methods: Eighty-three individuals of different age groups ranging from 11-80 years were included in the study.Ocular measurements including refractive error, axial length, and anterior chamber depth were determined in all participants. The association of refractive error with anterior chamber depth and axial length was tested by using two independent sample t test, Mann-Whitney U test and ANOVA. Results: Among 83 individuals, males were 42.2% (n=35) and females were 57.8% (n=48). Most common type of refractive error was astigmatism which was found in 48.2% (n=40) participants. The overall average depth of anterior chamber (mm) and average axial length (mm) were 3.11±0.39 and 23.27±0.87 respectively. Mean differences in anterior chamber depth were statistically significant among different age groups . Statistically significant differences in mean axial length were found among different refractive errors . Conclusion: These results show a significant relation of different refractive errors with axial length and anterior chamber depth and it can be helpfulin explaining the risk factors of different ocular diseases as well asit can also be helpful in clinical and diagnostic purposes in ophthalmology.

Assessment of Refractive Status of 5-15 Years Old Children Attending Government Schools of Rural Agra

Introduction: In children uncorrected refractive errors have a profound effect on educational and psychosocial development hence it is necessary to estimate the prevalence both at the community and at the school level to aid planning and implementation of refractive error services in children. Objective: To determine the refractive status of 5 to 15 years old children attending government schools of rural areas of district Agra, Uttar Pradesh (UP), India. Method: Study conducted on 902 students of age group 5-15 years of randomly selected government schools of Bichpuri Block of district Agra. Children underwent visual acuity assessment and torch light examination, height and weight measurement. Children with VA ≤6/9 were further examined and cycloplegic retinoscopy, fundus examination, slit lamp examination and post mydriatic refraction was done. On the basis of values of cycloplegic refraction and post mydriatic refraction, refractive error was classified as myopia, hypermetropia and astigmatism. Statistical Analysis was done by applying Chi square test. Result: Out of 902 children, 125 children (13.86 %) were having refractive error of which 76 were myopic (8.43%), 39 were astigmatic (4.32%) and 10 were hypermetropic (1.11%). There was an increase in the overall prevalence of refractive error with advancing age. There was no significant association of refractive error with gender and nutritional status. Conclusion: Vision screening of school children is very useful for early detection and correction of refractive errors. Screening of the refractive errors in school should be carried out periodically and regularly.

Characteristics of Headache in Children Presenting to Ophthalmology Services in a Tertiary Care Center of South India.

Introduction: Headache is a common cause of disability worldwide and can disrupt the education and social life of children. Children regularly present to ophthalmologists with headache. So, we aimed to describe the characteristics of headache in children presenting to the ophthalmology outpatient department (OPD) in our center.Methodology: We conducted this cross-sectional, prospective study in Bangalore, India. We included all children aged 5-18 years, presenting with headache to the ophthalmology OPD, from September 2018 to September 2020, and excluded nonverbal children, those with prior head trauma, diagnosed psychiatric illnesses, or epilepsy. We provided each child with a headache questionnaire, following which they received a detailed ophthalmologic evaluation. We performed relevant descriptive and inferential analyses.Results: We included 311 children, with a mean age of 11.1 years. Sixty-eight percent were males. Fifty-one percent reported holocranial headache, and 28% reported frontal headache. Sixty-nine percent reported screen time of ≥2 hours/day. The most common refractive error (RE) was myopia, seen in 48%. The most common type of headache was headache associated with refractive errors (HARE), seen in 64%, followed by migraine, in 19%. Children with HARE were more likely to be males, have daily screen time of >2 hours/day, or have myopia. Their headache was more likely to be for >1 month, or have frontal localization. Children with headache due to other causes were more likely to be adolescents.Discussion: We found that almost two-thirds of children presenting to our ophthalmology OPD had HARE. Our findings support the association of REs with headache. Children with HARE had a longer history and predominantly frontal localization. Further, they reported longer screen time, a significant finding in today’s world. Ophthalmologists must be aware of the various etiologies of headache and ensure that each child with headache receives a full ophthalmologic evaluation.

MAGNITUDE OF REFRACTIVE ERRORS IN CHILDREN IN TERTIARY CARE HOSPITAL OF WESTERN NEPAL

Background: Refractive error is one of the most common causes of the visual impairment and second leading cause of treatable blindness. The objective of the study was to determine the mag­nitude of refractive errors in children.
 Methods: This was a hospital based cross-sectional study conducted on 254 children attending Ophthalmology OPD of Manipal Teaching Hospital, Pokhara. The children whose visual acuity was worse than 6/6 but improved with pinhole were included in this study. Vision test, retinoscopy and subjective refraction was done in all subjects and cycloplegic refraction was done when needed. Statistical analysis was carried out using Epi-info version 7.
 Results: The commonest type of refractive error was astigmatism (46.06%) followed by myopia (42.31%). Majority of children had low grade of refractive errors (46.85%). Among the children, “with the rule astigmatism” was maximum (27.56%). Majority of children were in the age between 11 to 15 years (77.95%). The refractive error was seen more in female (63.78%). Among the chil­dren of refractive errors, 29.13% had family history, 33.46% had given the history of wearing spec­tacles and 10.24% children had amblyopia. There was statistically significant association between refractive errors and age groups, history of wearing spectacles, amblyopia and grading of refractive errors. However, there was no statistically significant association of refractive error with gender, residence and family history.
 Conclusions: Astigmatism was the common type of refractive error followed by myopia. This study emphasizes the importance of detection of refractive error in children.

The Visual and Refractive Status in One Sample Population of ‘Orang Asli’(Indigenous) Children in Hulu Langat, Selangor

Background: The aim of this study is to assess the visual and refractive status among ‘Orang Asli’ (indigenous) children in Kampung Sungai Lalang, Semenyih, Selangor. Uncorrected refractive error is a major burden among children around the world. It results in a significant number of problems among this high-risk group including educational loss, low productivity and impaired quality of life. Besides that, there are lacking information regarding vision problems among aborigine children or ‘Orang Asli’ in Malaysia. This study was undertaken to determine the prevalence of refractive error, and the association of the refractive error and visual acuity with age among ‘Orang Asli’ children.
 Methods: A cross sectional study was conducted on ‘Orang Asli’ children (n=43) where 51.2% were male and 48.8% were female. Visual acuity and refraction assessment were done on every child using Refractive Error Study in School Children (RESC) protocol.
 Results: The prevalence of refractive error was simple myopia (1.2%), simple hyperopia (18.6%), compound myopic astigmatism (7.0%), and mixed astigmatism (73.3%) respectively. The visual acuity measurement shows that the majority of subjects achieved 6/6 represented by 88.4% of the right eye and 86% of the left eye. There is no association between refractive error and age (P>0.05).
 Conclusion: This study concludes that there is a high prevalence of hyperopia among ‘Orang Asli’ children and There is no association of refractive error with age and gender. Therefore, there is a need to create better awareness programs among the parents about the importance of eye examination to their children.
 Bangladesh Journal of Medical Science Vol.19(4) 2020 p.609-613

Association of refractive error with vision-related quality of life in junior high school students

Background/PurposeTo evaluate the relationship between refractive error and vision-related quality of life in 16-year-old students in Taiwan. MethodsA cross-sectional study was designed for 16-year junior-high-school students in Taiwan. Myopia was defined as a spherical refractive error (SRE) < −0.50 D, hyperopia as SRE > +1.0 D, and emmetropia as SRE −0.5–+1.0 D in the better eye. Vision-related quality of life was assessed using the Taiwan Chinese version of the 25-Item National Eye Institute Visual Functioning Questionnaire. ResultsOf the 688 participants, 466 (68%) had myopia and 22 (3%) had hyperopia. In logistic-regression models adjusted for gender, parents' education, family income, and parental refractive error, myopia was an independent risk factor of poorer vision-related quality of life for both near vision (odds ratio 1.73, 95% confidence interval 1.22–2.45) and distance vision (odds ratio 3.11, 95% confidence interval 2.23–4.35). Hyperopia was not associated with near- or distance-vision difficulty. ConclusionIn this study population, myopia was associated with difficulties in near and distance vision compared to emmetropia. Further studies are needed to confirm our findings in other populations.

Association of refractive errors with intraocular pressure and its relationship with age and gender

Background & Objectives: Glaucoma is one of the leading causes of blindness worldwide. Increased Intraocular Pressure (IOP) is a well-known and important risk factor for development of glaucoma. Refractive errors are one of the growing problems worldwide with myopia as the most common refractive error. The present study is conducted to analyze the correlation between IOP and refractive status of eye and also to study the influence of age and gender on IOP. Methodology: 120 cases of refractive error (ametropic eyes) aged between 20 to 60 years, attending Ophthalmology OPD were selected. They were categorized into four groups as High myopia (power > -6D), Moderate myopia (-3D to -6D), Low myopia (+0.25D). 120 subjects with normal vision (emmetropic eyes) of same age group were selected as control group. Visual acuity was determined by Snellen’s chart, refractive error diagnosed by retinoscopy. IOP was measured by applanation method (using Perkin’s Tonometer). Results: Student’s t-test for comparison between two groups and one way ANOVA test for multiple group comparison was used in analysis of data. In the Correlation of refractive status and IOP, it is observed that in high myopic ‛p’ value is

The Association of Refractive Error with Glaucoma in a Multiethnic Population

To evaluate the association between refractive error and the prevalence of glaucoma by race or ethnicity. Cross-sectional study. Kaiser Permanente Northern California Health Plan members with refractive error measured at 35 years of age or older between 2008 and 2014 and with no history of cataract surgery, refractive surgery, or a corneal disorder. We identified 34 040 members with glaucoma or ocular hypertension (OHTN; cases) and 403 398 members without glaucoma (controls). Glaucoma cases were classified as primary angle-closure glaucoma (PACG); 1 of the 4 forms of open-angle glaucoma: primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), pigmentary glaucoma (PIGM), and pseudoexfoliation glaucoma (PEX); or OHTN. Refractive error, expressed as spherical equivalent (SE), was coded as a continuous trait and also as categories. Logistic regression analyses were used to estimate theassociation between refractive error and the prevalence of glaucoma overall and in specific racial or ethnic groups. The association between refractive error and glaucoma subtypes evaluated as odds ratios (ORs) with 95% confidence intervals (CIs). In controls, the mean SE was-0.59 diopters (D) (standard deviation, 2.62 D). Each 1-D reduction in SE was associated with a 22% decrease in the odds of PACG (OR, 0.78; 95% CI, 0.77-0.80) and with increases in the odds of open-angle glaucoma ranging from 1.23 (95% CI, 1.20-1.26) for PIGM, to 1.07 (95% CI, 1.03-1.11) for PEX, and to 1.05 (95% CI, 1.04-1.06) for OHTN. In addition, we observed a stronger association between myopia and POAG among non-Hispanic whites (OR, 1.12; 95% CI, 1.11-1.13) and NTG among Asians (OR, 1.17; 95% CI, 1.15-1.20) and non-Hispanic whites (OR, 1.19; 95% CI, 1.15-1.22). Myopia was associated with an increased prevalence of all forms of open-angle glaucoma and OHTN, whereas hyperopia was associated with a substantially increased prevalence of PACG. Although high myopia is a strong risk factor for glaucoma subtypes, low and moderate myopia also have a significant effect on glaucoma risk. Additionally, there were moderate racial differences in the association of myopia with the risk of POAG and NTG.

Population‐based survey of refractive error among school‐aged children in rural northern China: the Heilongjiang eye study

The prevalence of refractive error in the north of China is unknown. The study aimed to estimate the prevalence and associated factors of refractive error in school-aged children in a rural area of northern China. Cross-sectional study. The cluster random sampling method was used to select the sample. A total of 1700 subjects of 5 to 18 years of age were examined. All participants underwent ophthalmic evaluation. Refraction was performed under cycloplegia. Association of refractive errors with age, sex, and education was analysed. The main outcome measure was prevalence rates of refractive error among school-aged children. Of the 1700 responders, 1675 were eligible. The prevalence of uncorrected, presenting, and best-corrected visual acuity of 20/40 or worse in the better eye was 6.3%, 3.0% and 1.2%, respectively. The prevalence of myopia was 5.0% (84/1675, 95% CI, 4.8%-5.4%) and of hyperopia was 1.6% (27/1675, 95% CI, 1.0%-2.2%). Astigmatism was evident in 2.0% of the subjects. Myopia increased with increasing age, whereas hyperopia and astigmatism were associated with younger age. Myopia, hyperopia and astigmatism were more common in females. We also found that prevalence of refractive error were associated with education. Myopia and astigmatism were more common in those with higher degrees of education. This report has provided details of the refractive status in a rural school-aged population. Although the prevalence of refractive errors is lower in the population, the unmet need for spectacle correction remains a significant challenge for refractive eye-care services.

The association of refractive error, strabismus, and amblyopia with congenital ptosis

To determine the frequency of amblyopia and its associations among children with congenital ptosis. A retrospective chart review of 92 active patients with congenital ptosis in the practices of 2 of the authors. The main outcome measures were relative eyelid ptosis severity, presence and type of strabismus, refractive error, and amblyopia. Amblyopia was identified in 22 of 92 patients (23.9%), in almost every case occurring in the context of coexisting anisometropia or strabismus and affecting the eye with the more severe ptosis (P = 0.0001). Amblyopia was more likely to occur in cases with greater relative eyelid asymmetry and did not develop in children with symmetric ptosis. In several cases, anisometropia and amblyopia were not initially apparent but progressively developed during follow-up. Children with congenital ptosis are at risk of anisometropic and strabismic amblyopia, which may progress during early development. Patients should be examined at regular intervals to evaluate and treat these potential complications.

Prevalence and associations of refractive error in indigenous Australians within central Australia: the Central Australian Ocular Health Study

To determine the prevalence and associations of refractive error within the indigenous Australian population living in central Australia. 1884 individuals aged 20 years or older, living in one of 30 remote communities within the statistical local area of 'central Australia' were recruited for this study. This equated to 36% of those aged 20 years or older and 67% of those aged 40 years or older within this district. Participants were recruited as they presented to the eye clinic at each remote community. Participants underwent subjective refraction to determine spherical equivalent and then had a slit-lamp anterior segment examination. Participants were only included if they were phakic and only the right eye was considered. The prevalence of hypermetropia worse than +1.0 dioptres (D), myopia worse than -0.5 D and astigmatism worse than 1.0 D is presented. From those recruited, 15.2% were hypermetropic; 11.1% were myopic; and 6.2% had astigmatism. Participants became progressively more hypermetropic with increasing age until the age of 70 years, after which time they become more myopic. Furthermore, there was an increasing likelihood of myopia and a decreasing likelihood of hypermetropia with increasing nuclear opalescent cataract. Our study has shown that indigenous Australians are less likely to be ametropic compared with non-indigenous groups. Variations with age and nuclear opalescent cataract seen in other previous work have also been observed in our sample.

Refractive Error among the Elderly in Rural Southern Harbin, China

Purpose: To estimate the prevalence and associated factors of refractive errors among the elderly in a rural area of Southern Harbin, China.Methods: Five thousand and fifty seven subjects (age ≥50 years) were enumerated for a population-based study. All participants underwent complete ophthalmic evaluation. Refraction was performed by ophthalmic personnel trained in the study procedures. Myopia was defined as spherical equivalent worse than -0.50 diopters (D) and hyperopia as spherical equivalent worse than +0.50 D. Astigmatism was defined as a cylindrical error worse than 0.75D. Association of refractive errors with age, sex, and education were analyzed.Results: Of the 5,057 responders (91.0%), 4,979 were eligible. The mean age was 60.5 (range 50–96) years old. The prevalence of myopia was 9.5% (95% confidence interval [CI], 8.5–10.1) and of hyperopia was 8.9% (95% CI, 7.9–9.5). Astigmatism was evident in 7.6% of the subjects. Myopia, hyperopia and astigmatism increased with increasing age (p<0.001, respectively). Myopia and astigmatism were more common in males, whereas hyperopia was more common in females. We also found that prevalence of refractive error weas associated with education. Myopia was more common in those with higher degrees of education, whereas hyperopia and astigmatism were more common in those with no formal education.Conclusions: This report has provided details of the refractive status in a rural population of Harbin. The prevalence of refractive errors in this population is lower than those reported in other regions of the world.

Prevalence of Refractive Errors in a Brazilian Population: The Botucatu Eye Study

Purpose: To determine the prevalence and demographic associations of refractive error in Botucatu, Brazil.Methods: A population-based, cross-sectional prevalence study was conducted, which involved random, household cluster sampling of an urban Brazilian population in Botucatu. There were 3000 individuals aged 1 to 91 years (mean 38.3) who were eligible to participate in the study. Refractive error measurements were obtained by objective refraction.Results: Objective refractive error examinations were performed on 2454 residents within this sample (81.8% of eligible participants). The mean age was 38 years (standard deviation (SD) 20.8 years, Range 1 to 91) and females comprised 57.5% of the study population. Myopia (spherical equivalent (SE) < − 0.5 dropters (D)) was most prevalent among those aged 30–39 years (29.7%; 95% confidence interval (CI) 24.8–35.1) and least prevalent among children under 10 years (3.8%; 95% confidence interval (CI) 1.6–7.3). Conversely hypermetropia (SE > 0.5D) was most prevalent among participants under 10 years (86.9%; 95% CI 81.6–91.1) and least prevalent in the fourth decade (32.5%; 95% CI 28.2–37.0). Participants aged 70 years or older bore the largest burden of astigmatism (cylinder at least −0.5D) and anisometropia (difference in SE of > 0.5D) with a prevalence of 71.7% (95% CI 64.8–78.0) 55.0% (95% CI 47.6–62.2) respectively. Myopia and hypermetropia were significantly associated with age in a bimodal manner (P < 0.001), whereas anisometropia and astigmatism increased in line with age (P < 0.001). Multivariate modeling confirmed age-related risk factors for refractive error and revealed several gender, occupation and ethnic-related risk factors. Conclusions: These results represent previously unreported data on refractive error within this Brazilian population. They signal a need to continue to screen for refractive error within this population and to ensure that people have adequate access to optical correction.

Prevalence of Refractive Errors in a Rural South Indian Population

To report the prevalence of refractive errors in a rural south Indian population. Four thousand eight hundred subjects (age, >39 years) from rural south India were enumerated for a population-based study. All participants underwent complete ophthalmic evaluation. Subjects who were phakic in the right eye with best corrected visual acuity of 20/40 or better were included for analysis. Association of refractive errors with age, sex, cataract, and diabetes mellitus were analyzed. Of the 3924 responders, 2508 were eligible. The unadjusted prevalence of emmetropia (spherical equivalent [SE], -0.50 to +0.50 diopter sphere [DS]), myopia (SE < -0.50 DS), high myopia (SE < -5.00 DS), and hyperopia (SE > 0.50 DS) were 50.60%, 26.99%, 3.71%, and 18.70% and age and gender adjusted for the rural Tamil Nadu population were 46.77%, 30.97%, 4.32%, and 17.94%, respectively. The prevalence of emmetropia decreased significantly with age (P < 0.0001), and the prevalence of myopia and high myopia increased significantly with age (P < 0.001) and were significantly associated with nuclear sclerosis (P < 0.001). The prevalence of hyperopia increased until 60 years of age and then decreased. Hyperopia was more common among women than men (P < 0.001) and was negatively associated with nuclear sclerosis (P < 0.001) and positively with diabetes mellitus (P = 0.008). Of the participants with astigmatism (cylindrical error greater than 0.50 DC), 9.80% had with-the-rule (WTR) and 77.44% against-the-rule (ATR) astigmatism. The prevalence of WTR and ATR astigmatism significantly decreased (P < 0.001) and increased (P = 0.006) with age, respectively. The pattern of refractive errors in this rural south Indian population is similar to those reported in other tropical regions of the world.