Spectacle Wear Research Articles

Slowing myopia progression with cylindrical annular refractive elements (CARE) spectacle lenses-Year 1 results from a 2-year prospective, multi-centre trial.

To evaluate the effectiveness of 12 months of spectacle lens wear incorporating cylindrical annular refractive elements (CARE) in slowing myopia progression compared to single vision (SV) spectacle wear. In an ongoing 2-year prospective, double-masked, multi-centre clinical trial, 240 Chinese children aged 6-13 years, spherical equivalent refractive error (SE) -0.75 D to -5.00 D were randomised to one of three groups of 80 participants each to wear: SV spectacle lens (N = 80), CARE spectacles (7 mm central clear zone surrounded by treatment zone incorporating CARE with mean surface power of +4.6 D) and CARE S (9 mm central clear zone surrounded by treatment zone comprising CARE with mean surface power of +3.8 D). Cycloplegic SE and axial length (AL) were measured at 6-month intervals. Compared to baseline, changes in SE and AL were significantly different between the groups at both 6 and 12 months (p < 0.001, linear mixed model). Adjusting for site, group, parental myopia and age, at 12 months, the estimated change in SE and AL with 95% CI with SV was -0.65 D (CI: -0.56 to -0.74 D)/0.32 mm (CI: 0.29-0.36 mm). In comparison, the estimated change in SE/AL at 12 months with CARE was -0.35 D (-0.26 to -0.44 D)/0.19 mm (0.15-0.22 mm) and with CARE S was -0.36 D (-0.27 to -0.46 D)/0.21 mm (0.18-0.25 mm) at 12 months. Progression was slower with CARE and CARE S compared to SV (p < 0.05) but did not differ from each other (p = 0.793 and 0.336 for SE and AL, respectively). In children with myopia, after 12 months of lens wear, both CARE and CARE S spectacle lenses significantly slowed myopia progression compared to SV lenses.

Early assessment of vision-related quality of life predicts long-term spectacle-wear compliance

Non-compliance with spectacle wear undermines global health initiatives aimed at eliminating uncorrected refractive error—a preventable cause of visual impairment—by providing free or affordable spectacles to underserved populations. Non-compliance, however, is often identified too late, delaying effective health promotion strategies. This study evaluates the association between early-assessed vision-related quality of life (QoL) following spectacle correction and long-term compliance in adults. A comprehensive eye examination was conducted on 3052 university students to identify those visually impaired (presenting acuity ≥ Snellen 6/12 in the better eye) due to uncorrected refractive error. After refractive correction, participants achieving a best-corrected visual acuity of Snellen 6/6 completed the National Eye Institute 25-item Visual Function Questionnaire (NEI-VFQ-25) at baseline and within the first week of correction. A 6-month follow-up assessed compliance with spectacle wear. The average baseline NEI-VFQ-25 score improved from 67.35 (± 13.53%) to 90.56 (± 8.45%) with spectacle correction (P < 0.001) in the first week, with individual changes ranging from 2 to 70%. After 6 months, only 54 (47%) out of the 115 eligible participants (58 females; ages 18 to 29) were compliant. Following the adjustment for covariates, the results revealed that gains in NEI-VFQ-25 score below 40 were significantly associated with reduced compliance over the 6-month period (OR: 0.39, 95% CI: 0.06–0.99, P = 0.047). This supports an association between early vision-related QoL and long-term compliance. Scheduling a short follow-up to assess vision-related QoL within the first week after dispensing spectacles may help identify potential non-compliant wearers early, allowing for timely interventions.

Orthokeratology for high myopia

Purpose. With an increasing proportion of children with myopia especially in Asia, efforts have been made to reduce chances of preventable sight loss related to high myopia in the future. Orthokeratology lens has been used as one of the modalities not just to correct myopia, but also to slow down myopic progression and axial elongation. This case report reviews a patient with clinically significantly high myopia, whose refractive errors was partially corrected with orthokeratology lens and spectacle lenses. Material and Methods. A now 14-year-old patient with a history of fast progressing myopia, was prescribed and commended orthokeratology to manage myopia, while regularly monitoring her refractive errors, axial length, binocular vision status, corneal topography, and anterior eye health was monitored regularly at the author’s practice. Results. Over a two year follow up period, a partial correction of high myopia with orthokeratology lenses and residual refractive errors with additional spectacle lenses was effective in managing this patient’s myopia, as well as slowing of axial elongation. An updated pair of orthokeratology lens with a steeper back optic zone radii were prescribed to reduce superficial corneal staining and to maintain corneal health. Conclusion. Patient commitment and adherence to close monitoring of eyes in terms refractive errors, axial length, and anterior eye health, are vital in achieving a successful orthokeratology lens wear for high myopia. A dual fitting strategy consisting of orthokeratology lens and spectacle wear can be a safe management strategy that is acceptable for patients with high myopia. It would be helpful for practitioners to be able to rely on robust evidence-based guidance when determining whether lens wear can be ceased, i.e. when further axial elongation and myopic progression are no longer likely.

Scleral lens fitting after paediatric limbal dermoid removal

Purpose. This case report describes the management of refractive error and amblyopia using a scleral lens fitted to the eye of a young child with an irregular cornea resulting from limbal dermoid removal and corneal transplant in infancy. Material and Methods. A young infant was initially fitted with spectacles and occlusion therapy following the surgical excision of a limbal dermoid and full thickness corneal transplant. The vision did not improve in spite of patching so the child was referred for contact lens fitting. Various iterations of scleral lens fitting were carried out. Results. Scleral lens fitting was attempted from the age of 2 years but transplant rejections, the COVID-19 pandemic and variable cooperation meant that adequate lens wear could not be achieved in the early stages. In addition, the corneal shape changed during the course of the fitting. During these periods, spectacle wear and occlusion therapy were maintained until a good lens fit could be achieved following several modifications. Treatment is ongoing but at the age of 5 years, the visual acuity is 0.24 logMAR letters. Conclusion. Scleral lenses can be used to habilitate the vision in an eye with an irregular cornea but when scleral lens wear is not possible, it is important to persevere with spectacle correction and patching therapy. Several iterations of scleral lenses may be needed as the eye changes and the child grows.

Compliance and Determinants of Spectacle Wear Among Moroccan Adults Residing Beni-Mellal Khénifra Region.

Ensuring a high level of adherence to wearing spectacles is essential to preserve eye health and achieve optimal vision correction. Comprehending the factors influencing adherence to wearing spectacles can inform strategies to improve eye care outcomes. This study aimed to assess the prevalence and factors influencing adherence to wearing spectacles among Moroccan adults residing the Beni-Mellal Khenifra region. A cross-sectional interview survey was conducted involving 389 adult spectacle wearers. Participants were recruited through a multilevel random sampling technique and interviewed using a structured questionnaire. This questionnaire collected data on demographics, spectacle prescription, usage patterns, and barriers to compliance. Compliance was assessed based on self-reported frequency and duration of spectacle wear according to the prescription. Possible factors influencing the wearing of spectacles were investigated using both univariate and multivariate regression models. This study revealed that 57.6% of participants adhered to the recommended use of spectacles. Factors associated with compliance were higher education level, longer duration of spectacle use, awareness about the importance of spectacle wear, absence of a family history, specific refractive error types, and increased severity of refractive errors. Participants reported various reasons for not adhering to the recommended use of spectacles, with the most common being forgetfulness, perceiving improved vision without spectacle, discomfort while wearing spectacle, difficulty adapting to spectacle, and loss of spectacle. Given the high prevalence of non-compliance to spectacle wear among adults in the Beni-Mellal Khenifra region, it is evident that additional efforts are required to improve understanding and education regarding the advantages of consistent spectacle usage. Targeted educational and awareness initiatives have the potential to substantially enhance adherence rates and consequently improve visual health outcomes in the region.

Pediatric refractive surgery: Review article.

Refractive surgery is one of the most commonly performed elective procedures in ophthalmology; it is mostly performed in patients who are older than 18 years of age. This routine procedure has been time-tested and is proven to be both safe and effective in adults. However, little is known about the safety and efficacy of refractive surgery in pediatric patients. Granted, refractive surgery should not be used in kids merely for the purpose of avoiding spectacles wear, but it can be of valuable help is preserving vision in patients with amblyopia and accommodative esotropia who otherwise couldn't comply with traditional management options. Refractive surgery in pediatric patients is a complex and challenging field due to the unique characteristics of their developing eyes. This review article aims to provide an overview of the current literature on refractive surgery in pediatric patients, focusing on the different surgical options, the advantages and disadvantages of each procedure.

Utilisation of eye health services and compliance with spectacles wear among community school adolescents: a mixed-methods study from Bagmati province of Nepal

ObjectivesThis study aims to determine the factors influencing eye care service utilisation and compliance with spectacles wear among school students.DesignMixed-methods study.Setting27 community schools from 6 districts of Bagmati province of...

Association between vision-related quality of life and mental health status in myopia children using various optical correction aids

PurposeTo evaluate the relationship between vision-related quality of life and mental health in myopia children with various optical aids. MethodsThis cross-sectional study enrolled children aged 8–13 years, exhibiting myopia ranging from −4.50 to −0.75 D, and utilizing various optical aids for correction. Full ocular examinations and completion of two questionnaires were performed. Vision-related quality of life was evaluated using the Paediatric Refractive Error Profile (PREP), and mental health status was assessed utilising the Screen for Child Anxiety Related Emotional Disorders (SCARED). Univariate and multivariate analyses were conducted to evaluate the association between vision-related quality of life and mental health status. ResultsThe study sample comprised 209 children with corrected myopia using single vision spectacles (100 [47.8 %]), soft contact lenses (66 [31.6 %]), and orthokeratology lenses (43 [20.6 %]). The mean age was 10.31 ± 1.65 y, and males accounted for 50.7 % of the sample. The distribution of demographic characteristics showed no significant difference among all correction types, except that the myopia duration was longer for orthokeratology lens wearers than those using spectacles (P=0.03). Contact lens showed clear benefits in almost all dimensions of vision-related quality of life, especially in appearance, satisfaction, activity and peer perceptions dimensions. The prevalence of anxiety disorders among spectacle wearers was 25.0 %, the highest among all groups. For myopia children with optical corrections, not being in the top 30 percent of their class rank, reporting lower PREP scores on symptoms, handling and peer perceptions dimensions were related with a higher prevalence of anxiety disorders. ConclusionsLower vision-related quality of life was associated with worse mental health status of myopia children with optical corrections. Identifying this association is crucial for protecting the mental health of myopia children and enhancing corrective measures.

Protective properties of spectacle lenses used as ultraviolet blockers

In this study, we evaluated the UV transmittance of spectacle lenses in the Turkish market, which are reported to have UV blocking properties, and tested their suitability. Samples were obtained from patients who were admitted to the ophthalmology outpatient clinic of our hospital for refractive error and who wore glasses as UV block. No limitation was made regarding the spectacle size and duration of spectacle wear. Measurements were tested by the principal investigator using an ultraviolet detector. The right and left lens were measured separately. All measurements were performed at room temperature (22-25°C) in a humidity regulated (20-40%) room without direct light. UV protection level was measured for 120 spectacles used for refractive errors. Only 28 (23.3%) of 120 glasses had protection level up to 400 nm UV. Twenty-four (20%) of the glasses had a protection level of 0 even though they were labeled as having UV blocking properties. It is clear that strict regulations need to be implemented to improve the protection levels of glasses.

Perception and awareness of the public about presbyopia and its corrective approaches in Saudi Arabia: a population-based survey

BackgroundThis study investigated patients’ awareness of presbyopia and its management approaches and their preferred methods for near vision correction.MethodsIn Saudi Arabia, 785 participants (aged between 35 and 60 years) completed a structured survey online, consisting of hard copies and direct interviews. The survey consisted of twenty-eight items divided into three parts. It was designed to record participants’ awareness of and preferences for presbyopia and its refractive corrections. Nonparametric tests and descriptive analyses were conducted to analyse participants’ responses.ResultApproximately half of the participants had difficulty with near vision activities, such as reading newspapers or using mobile phones. Among all the participants, 76% were not aware of presbyopia. The prevalence of uncorrected presbyopia was 48% of the 785. The majority (82%) felt that spectacles were acceptable for correction of presbyopia. Most reported that they did not experience social stigma when using reading spectacles (87% of participants). When asked if they were aware of management approaches other than spectacles, 72% responded with not at all. Most participants had no earlier knowledge of the use of multifocal contact lenses or eye drops for presbyopia correction (67% and 82%, respectively). In the present study, some tendencies to use corrective approaches to presbyopia other than spectacles were noted. Finally, participants’ age, sex, region, education, and income had a statistically significant impact on essential parts of their responses (p < 0.05).ConclusionPresbyopia is a highly prevalent age-related ocular disorder, and a significant percentage of cases are uncorrected due to a lack of awareness or reluctance to wear spectacles. More efficient health education about presbyopia and its corrective alternatives is urgently needed.

Impact of spectacle wear on the quality of life of learners with hearing impairment in Ghana

Background: Visual impairment significantly affects learners with hearing impairment.Aim: To assess the impact of spectacle wear on the quality of life (QoL) of learners with hearing impairment in Ghana.Setting: Six schools for the deaf in Ghana.Methods: A prospective case-control study design was used to assess the QoL among learners with uncorrected refractive error (URE) using the quality-of-life impact of refractive correction (QIRC) questionnaire before and after the provision of spectacles.Results: A total of 138 learners were enrolled in this study, with 69 learners in both the intervention and control groups, respectively. The mean QIRC score improved significantly for the intervention group: QIRC score before = 43.89 ± 8.96 vs. after = 48.82 ± 6.71 (P 0.05 and Cohen’s d = 0.62) but not the control group: QIRC score before = 50.79 ± 11.66 and 51.77 ± 10.67 (P = 0.607). Among the learners provided with spectacles, those who did not comply with spectacle wear had significant differences (P 0.05) in mean QIRC scores before and after the intervention. Only visual acuity (VA) and the magnitude of prescription with QIRC scores after intervention had a significant relationship (P 0.05).Conclusion: Uncorrected refractive error affected the QoL of learners with hearing impairment, and spectacle correction significantly improved their QoL.Contribution: The use of spectacle lenses, VA and magnitude of prescription affected the QoL scores; however, sex and age did not influence the QoL scores.

Large-scale study in Chengdu, China: The prevalence of myopia full-correction decreased with increasing myopia in adolescents

Myopia is an increasingly serious health issue among children and adolescents worldwide. This study investigated the situation related to myopia among students in Chengdu, a city in western China, and analyzed the prevalence of myopia spectacle wear and myopia full-correction and their influencing factors to understand the current status of myopia prevention. This school-based cross-sectional study investigated 1582 schools in seven districts of Chengdu City, China, enrolling a total of 417,337 students aged 6–18 years (elementary, middle, and high school) from 2020 to 2022. Examination items included uncorrected visual acuity (UCVA), slit lamp examination and non-cycloplegic autorefraction. Myopia was defined as non-cycloplegic SE ≤ −0.50 D + UCVA> 0 log MAR (age ≥6). The prevalence of myopia spectacle wear is defined as the number of people wearing glasses for myopia/the number of people with myopia (%) within the study population, and myopia full-correction is defined as normal vision after wearing glasses for myopia (≤0 log MAR for 6 years and above). With the support of the government, this programme is conducted 1–2 times a year. Statistical analyses are conducted to determine the association between myopia and various parameters.The average age of the entire survey population was 10.96 ± 3.5 years, and the overall prevalence of myopia was 48.7%, myopia spectacle wear was 65.7%, and myopia full-correction was 50.5%. With increasing age and educational levels, the prevalence of moderate to high myopia, the prevalence of myopia spectacle wear, and the prevalence of myopia full-correction all rise. The prevalence of mild myopia full-correction (46.5%) was higher than that for moderate myopia (47.1%) and even higher than that for high myopia (39.6%). The correct utilization rate of myopic spectacles was 33.17%, increasing with age and education levels, with the highest correct utilization rate of 40.7% among those with moderate myopia. The prevalence of myopia among children and adolescents in Chengdu is relatively low, and the prevalence of myopia spectacle wear and myopia full-correction need to be improved, and it was found that with the increase of myopia, the prevalence of myopia full-correction among adolescents decreased instead.

Effectiveness of optical treatment in amblyopia and validation of measuring spectacle compliance with the ODM.

The improvement in visual acuity (VA) was determined during optical treatment in children with amblyopia before their participation in a randomised clinical trial comparing the effect of dichoptic video gaming using virtual reality goggles with occlusion therapy. Children aged 4-12 years with an interocular VA difference ≥0.20 logMAR and an amblyogenic factor: strabismus <30Δ, ≥1.00 D anisometropia, astigmatism ≥1.50 D and/or hypermetropia ≥1.50 D were eligible for 16 weeks of optical treatment. Children with previous amblyopia treatment were excluded. Compliance with spectacle wear was measured electronically over 1 week using the occlusion dose monitor (ODM). The reliability of these measurements was verified. The main outcome was an increase in amblyopic eye VA from baseline to 16 weeks. Sixty-five children entered the optical treatment period. Mean age was 6.0 ± 2.2 years (range: 4-12 years; IQR 4.5-6.7 years). Amblyopia was caused by anisometropia in 53 (82%) children, strabismus in 6 (9%) and combined mechanism in 6 (9%). After optical treatment, mean VA improved by 0.20 logMAR (SD 0.28; p < 0.001) and 0.07 in the amblyopic and fellow eye, respectively (SD 0.20; p = 0.03). This resulted in 24 children (37%) with an interocular VA difference <0.20 logMAR and in 17% of children with VA at the start of 0.30 logMAR or worse. Poor VA in the amblyopic eye at baseline (p = 0.001) and high anisometropia (p = 0.001) were associated with VA improvement. On average, spectacles were worn 9.7 ± 2.4 h/day (range: 2.3-13.6 h); mean compliance was 73% ± 18% of estimated wake time. Only ambient temperature ≥ 31°C or when spectacles were worn on top of the head prevented a reliable ODM measurement. VA improved by two lines resulting in more than a third of the children being treated sufficiently with spectacles alone and no longer being classified as amblyopic. The ODM proved to be a reliable method of measuring compliance with spectacle wear.

In vivo assessment of human corneal epithelial cells in orthokeratology lens wearers: A pilot study.

Central corneal epithelial thinning associated with midperipheral epithelial thickening has been reported as the main factor contributing to the effectiveness of orthokeratology (ortho-k) in myopia control. Yet, the cellular mechanism governing the regional change in refractive power remains elusive. This study aimed to evaluate the correlation between the regional change in corneal epithelial thickness and cell density in ortho-k wearers. A new human prototype of a polarization-dependent optical coherence microscope was developed to enable noncontact and noninvasive in vivo imaging of corneal epithelial cells in ortho-k wearers with and without their ortho-k lens. The epithelial thickness and cell density were evaluated at the central and midperipheral corneal locations in four ortho-k wearers and four spectacle wearers serving as controls. Polarization-dependent optical coherence microscope achieved in vivo volumetric imaging of all epithelial cell types in ortho-k wearers with and without their lens over a field of view of 0.5 × 0.5 mm2 with an isotropic resolution of ~2.2 mm. The central epithelial thinning and midperipheral epithelial thickening were consistent across all ortho-k wearers. However, the inconsistency in their regional epithelial cell density highlighted a great variability in individual response to ortho-k treatment. There was no strong correlation between epithelial thickness and cell density, especially at the midperipheral cornea, in ortho-k participants. This study constitutes our first step toward uncovering the cellular mechanism underlying the effectiveness of ortho-k in myopia control. Future studies will focus on the longitudinal evaluation of epithelial cells before and during ortho-k treatment to identify factors governing individual response to ortho-k treatment and ultimately inform the dynamics of epithelial cells taking place during the ortho-k treatment.

How small changes to one eye’s retinal image can transform the perceived shape of a very familiar object

Vision can provide useful cues about the geometric properties of an object, like its size, distance, pose, and shape. But how the brain merges these properties into a complete sensory representation of a three-dimensional object is poorly understood. To address this gap, we investigated a visual illusion in which humans misperceive the shape of an object due to a small change in one eye's retinal image. We first show that this illusion affects percepts of a highly familiar object under completely natural viewing conditions. Specifically, people perceived their own rectangular mobile phone to have a trapezoidal shape. We then investigate the perceptual underpinnings of this illusion by asking people to report both the perceived shape and pose of controlled stimuli. Our results suggest that the shape illusion results from distorted cues to object pose. In addition to yielding insights into object perception, this work informs our understanding of how the brain combines information from multiple visual cues in natural settings. The shape illusion can occur when people wear everyday prescription spectacles; thus, these findings also provide insight into the cue combination challenges that some spectacle wearers experience on a regular basis.

Following prevalence of myopia in a large Swiss military cohort over the last decade: where is the European “myopia boom”?

PurposeMyopia prevalence is increasing globally, with the highest rates found in Asia. Data from European countries is scarce. We aimed to investigate whether the prevalence of myopia is rising in our meridians.MethodsData from male military conscripts for the recruitment period of 2008–2017 were retrospectively analyzed. Year of recruitment, conscripts’ birth year, visual acuity, refractive status (spherical equivalent), and spectacle wear (yes/no) were available.ResultsThe dataset contained data of a total of 355,657 male conscripts, who had been recruited in the years 2008 to 2017. The mean number of conscripts per year was 35,566 (MD = 35,440, SD = 1249), reaching a minimum number of 33,998 conscripts in 2017 and a maximum of 37,594 in 2011. Mean age at recruitment was 19.7 years (MD = 19.0 years, SD = 1.1 years). Overall, the number of conscripts wearing spectacles remained stable over the observation time; on average 29.6% (n = 10,540; MD = 10,472; SD = 492) of conscripts wore glasses at recruitment. Of 21.8% (n = 77,698) of conscripts, data on the refractive status was available: The mean spherical equivalent for both right and left eyes was -2.3D (MD = -2 D, SD = 2.4 D). No decrease in mean spherical equivalent per recruitment year was noted over the observation period. Estimated myopia prevalence reached an average of 27.5% (SD = 0.8%) and did not increase during the observation period.ConclusionIn summary, no change in spherical equivalent refractive errors of male Swiss army conscripts was found for the years 2008–2017. Equally, the percentage of spectacle wearers (MN = 29.6%) and estimated myopia prevalence (MN = 27.5%) did not significantly increase during the observation time.Trial registration: BASEC 2019-00060 (18/01/2019)

Parent strategies for improving compliance with eyeglass wear in young children.

Results of this study provide preliminary data on parent strategies for improving compliance with eyeglass treatment in young children, an age group for which previous data are limited. Parent responses provide important insights to support parents of young children who wear eyeglasses and provide preliminary data to guide additional research. The goal of this exploratory study was to learn more about parents' strategies to improve compliance with eyeglass treatment of young children. An online survey of parents of 1-year-old to less than 5-year-old children who wear eyeglasses was conducted. Parents indicated whether they used various strategies to encourage wear and were asked to provide advice for parents of young children recently prescribed eyeglasses. Use of various strategies by age was determined. Open-ended responses regarding advice for other parents were analyzed using qualitative content analysis. The final sample included 104 parents who were predominantly White (81%), non-Hispanic (76%), and college graduates (68%). During the 2 weeks prior to survey completion, 74% of parents reported their child wore their eyeglasses ≥8 hours/day. Use of strategies for improving eyeglass wear varied by child age. The most frequent recommendations that parents provided for other parents were to be consistent in encouraging wear, use social modeling, provide positive reinforcement when the eyeglasses are worn, and ensure that the eyeglasses fit well and were comfortable. Parents provided many useful insights into their experiences. However, results may not be broadly generalizable, because of the limited diversity and high rate of compliance in the study sample. Further research with more diverse populations and research on effectiveness of various strategies to increase compliance in this age group are recommended to support eyeglass treatment compliance in young children.

Factors Associated with the Myopia Degree in Students

Purpose: to identify the most significant factors associated with myopic refraction in medical university students, which can be used for early prediction and prevention of myopia.Materials and methods. The survey data of students of 1–6 courses of Kazan State Medical University and the data on refraction of patients’ eyes obtained from the “Medical record of a patient receiving medical care on an outpatient basis” (registration form No. 025/y) were used. The refraction of the eye in each of the participants was calculated as the average value of the spherical equivalent of the right and left eyes.Results. According to the ophthalmologist’s examination, myopia was detected in 219 (69 %) of the surveyed students. 134 (42 %) students had mild myopia, 66 (21 %) had moderate myopia, 19 (6 %) were highly myopic. Among myopes, 73 % of students wear glasses (160/219), contact lenses — 41 % of respondents (90/219). The median age of onset of spectacle wear was 13 years (Q1–Q3 = 10–26). The median refraction of the right eye (D) was -2.50 D (Q1–Q3 = -1.5…-4.0), the left eye -2.75 D (Q1–Q3 = -1.6…-4.0). The early age of onset of spectacle wear is the factor most significantly associated with myopic refraction (+0.23 D/year, p = 1.30×10-11), and an important prognostic sign of the development of high myopia. Factors associated with stronger myopic refraction are high height and low weight, as well as less physical activity.Conclusion. It is necessary to take into account the anthropometric and behavioral features of the patient when developing an individual plan for the prevention and treatment of myopia, in order to avoid the development of complications leading to vision loss.

Ocular effects of exposure to low-humidity environment with contact lens wear: A pilot study.

To compare the ocular effects of exposure to a low-humidity environment with and without contact lens (CL) wear using various non-invasive tests. Fourteen habitual soft CL wearers were exposed to controlled low humidity (5% relative humidity [RH]) in an environmental chamber for 90 min on two separate occasions. First, when wearing their habitual spectacles and then, on a separate visit, when wearing silicone hydrogel CLs that were fitted specifically for this purpose. All participants had adapted to the new CL prior to data collection. Three non-invasive objective measurements were taken at each visit: blinking rate, objective ocular scatter (measured using the objective scatter index) and ocular surface cooling rate (measured using a long-wave infrared thermal camera). At each visit, measurements were taken before the exposure in comfortable environmental conditions (RH: 45%), and after exposure to environmental stress (low humidity, RH: 5%). CL wearers showed increased blinking rate (p < 0.005) and ocular scatter (p = 0.03) but similar cooling rate of the ocular surface (p = 0.08) when compared with spectacle wear in comfortable environmental conditions. The exposure to low humidity increased the blinking rate significantly with both types of corrections (p = 0.01). Interestingly, ocular scatter (p = 0.96) and cooling rate (p = 0.73) were not significantly different before and after exposure to low humidity. There were no significant two-way interactions between correction and exposure in any of the measurements. CLs significantly increased the blinking rate, which prevented a quick degradation of the tear film integrity as it was refreshed more regularly. It is hypothesised that the increased blinking rate in CL wearers aids in maintaining ocular scatter quality and cooling rate when exposed to a low-humidity environment. These results highlight the importance of blinking in maintaining tear film stability.

Exemplifying practice-based research: the influence of age on myopia progression

ABSTRACT Clinical relevance The electronic storage of patient records and modern-day search engines present private practitioners with a unique opportunity to extract valuable data for investigative research purposes. However, practitioners seldom harness this resource and consequently a vast repository of clinical data remains largely unexplored. Background This study, based on real-world data from an optometric practice, stands as an example of how clinicians can actively contribute to research. In doing so it underscores the role played by age in determining the rate of natural myopia progression. Methods A retrospective data analysis of the refractive status, age and optical correction type of participants, was conducted over six years. Forty-four participants were recruited (25 contact lens and 19 spectacle wearers), with a presenting age varying from 5 to 20 years (median, 11 years). Non-cycloplegic, monocular foveal refractions were completed using a ShinNippon open-field autorefractor, corroborated with subjective refraction. The mean spherical equivalent refractive error was calculated for the participants’ initial visit (baseline measure) and for a six-year follow-up visit (progression measure), with myopia progression defined as the difference between these measures. Statistical analyses were computed using Decision Tree Analysis, with a significance level set at 95%. Results The participant age at first visit exerted a significant influence on natural myopia progression over the assessment period (F 1,42 = 17.11, p < 0.001). Individuals aged ≤ 10 years had approximately twice the myopic progression (mean, −2.27 D) of those aged > 10 years (mean, −1.13 D). Neither degree of myopia at the initial visit nor optical correction type had a significant effect on progression (p > 0.05). Conclusions Utilizing the advantage of small real-world data samples, the benefit of research by private practitioners was demonstrated, providing evidence that the age at which a child first presents for an eye examination is highly influential in determining their rate of myopia progression.