Refractive Error Study Research Articles

Uncorrected Refractive Error and Distance Visual Acuity in Children Aged 6 to 14 Years.

This study presents the relationship between distance visual acuity and a range of uncorrected refractive errors, a complex association that is fundamental to clinical eye care and the identification of children needing refractive correction. This study aimed to analyze data from the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error Study to describe the relationship between distance uncorrected refractive error and visual acuity in children. Subjects were 2212 children (51.2% female) 6 to 14 years of age (mean ± standard deviation, 10.2 ± 2.1 years) participating in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error Study between 2000 and 2010. Uncorrected distance visual acuity was measured using a high-contrast projected logMAR chart. Cycloplegic refractive error was measured using the Grand Seiko WR-5100K autorefractor. The ability of logMAR acuity to detect various categories of refractive error was examined using receiver operating characteristic curves. Isoacuity curves show that increasing myopic spherical refractive errors, increasing astigmatic refractive errors, or a combination of both reduces distance visual acuity. Visual acuity was reduced by approximately 0.5 minutes of MAR per 0.30 to 0.40 D of spherical refractive error and by approximately 0.5 minutes of MAR per 0.60 to 0.90 D of astigmatism. Higher uncorrected hyperopic refractive error had little effect on distance visual acuity. Receiver operating characteristic curve analysis suggests that a logMAR distance acuity of 0.20 to 0.32 provides the best balance between sensitivity and specificity for detecting refractive errors other than hyperopia. Distance acuity alone was ineffective for detecting hyperopic refractive errors. Higher myopic and/or astigmatic refractive errors were associated with predictable reductions in uncorrected distance visual acuity. The reduction in acuity per diopter of cylindrical error was about half that for spherical myopic error. Although distance acuity may be a useful adjunct to the detection of myopic spherocylindrical refractive errors, accommodation presumably prevents acuity from assisting in the detection of hyperopia. Alternate procedures need to be used to detect hyperopia.

Responsibility for Funding Refractive Correction in Publicly Funded Health Care Systems: An Ethical Analysis

Allocating on the basis of need is a distinguishing principle in publicly funded health care systems. Resources ought to be directed to patients, or the health program, where the need is considered greatest. In Sweden support of this principle can be found in health care legislation. Today however some domains of what appear to be health care needs are excluded from the responsibilities of the publicly funded health care system. Corrections of eye disorders known as refractive errors is one such domain. In this article the moral legitimacy of this exception is explored. Individuals with refractive errors need spectacles, contact lenses or refractive surgery to do all kinds of thing, including participating in everyday activities, managing certain jobs, and accomplishing various goals in life. The relief of correctable visual impairments fits well into the category of what we typically consider a health care need. The study of refractive errors does belong to the field of medical science, interventions to correct such errors can be performed by medical means, and the skills of registered health care professionals are required when it comes to correcting refractive error. As visual impairments caused by other conditions than refractive errors are treated and funded within the public health care system in Sweden this is an inconsistency that needs to be addressed.

Study of refractive errors in medical students

Introduction: Refractive errors are apparently more prevalent among the high educational group and have become a huge economic and social burden.1 Materials and Methods: The study was conducted at Era’s Lucknow Medical College and Hospital and included 420 medical students of consecutive 4ys (2013-2016). Refractive error was assessed under cycloplegia using Snellen’s visual acquity drum and streak retinoscope. The students were categorized according to their refractive error and the prevalence was calculated. Results: Of 420 students 54% had refractive error. Of these 77.7% had myopia, 8.4% had hypermetropia and 1.7% had astigmatism. Myopes were further divided into mild moderate & severe. It was found that 62.8% had mild, 35.4% had moderate and 13.7% had severe myopia. Conclusion: The commonest refractive error among medical students is myopia of varying grades. Keywords: Medical students, Myopia, Refractive error.

Refractive Error Prevalence among School Children in Dadeldhura District of Nepal

Background Uncorrected refractive error is the major cause of visual impairment worldwide. There is no data on refractive error prevalence among school children in hilly region of Far West Nepal. Objective The prevalence of refractive error has been found to vary among children of different caste/ethnic groups and geographical regions. The purpose of this study is to determine the prevalence of refractive error among school children from different caste/ethnic groups in Dadeldhura district of Far West Nepal. Method This is a cross sectional study of refractive error among secondary school children from 2 schools in Dadeldhura district. All children underwent a vision screening consisting of visual acuity, ocular examination and refraction. Myopia was diagnosed for an eye with spherical equivalent refraction (SER) ≤ -0.5 D whereas an eye with SER ≥ +2.0 D was diagnosed as hyperopic. Ethnicity was reported through self administered questionnaire. Result Among children aged 12 to 16 years (14.07 ± 1.4) prevalence of myopia was 3.5%, hyperopia 0.33% and astigmatism 1%. All except three children had spherical equivalent refraction (SER) within ±2 D. Caste/ethnicity was not associated significantly with myopia in either eye (χ2 = 0.27, df= 2, p= 0.87). Conclusion The prevalence of refractive error among secondary school children in Dadeldhura district of Far West Nepal is very low in comparison to myopia prevalence reported in studies from other parts of the world, but slightly lower than myopia prevalence found in other, eastern parts of Nepal.

Prevalence of refractive error and visual impairment among school-age children of Hargesia, Somaliland, Somalia.

Childhood visual impairment is a global public health problem, especially in low and middle-income countries. Its most common causes are avoidable by early diagnosis and treatment. To assess prevalence of refractive error and visual impairment among school-aged children in Hargeisa, Somaliland, Somalia. This was a cross-sectional study of 1204 students (aged 6-15 years) in 8 randomly selected primary schools in Hargeisa from November 2017 to January 2018. We used the modified Refractive Error Study in Children to determine prevalence of refractive error and visual impairment, including the following investigations: distance visual acuity, assessed by Snellen Tumbling E-chart; refraction, assessed by retinoscope binocular vision assessment; and examination of anterior and posterior segments. Prevalence of uncorrected, presenting and best-corrected visual impairment of 6/12 or worse was 13.6%, 7.6% and 0.75%, respectively. Only 16 of 91 (17.6%) children were using spectacles and the rest were unaware of the problem. Refractive error was the cause of visual impairment in 76.8% of participants, amblyopia in 22.0%, trachoma in 2.4%, and corneal opacity and cataract in 0.6%. Anterior segment abnormalities were found in 8.3%, mainly vernal keratoconjunctivitis, while posterior abnormalities were observed in 0.7%. Prevalence of myopia was 9.1%, hypermetropia 2.7% and astigmatism 3.9%. Prevalence of visual impairment because of Refractive Error was associated with increasing age, but there was no significant association with school grade or sex. Prevalence of visual impairment among school-aged children in Hargeisa was high, and the leading cause was uncorrected Refractive Error. There are barriers to care and it is critical that they are overcome.

Prevalence and risk factor for refractive error in rural Chinese adults in Kailu, Inner Mongolia

To investigate the prevalence of refractive error in adults 40years of age and older in Kailu, Inner Mongolia. A population-based, cross-sectional study was conducted in Chinese adults. Spherical equivalent (S.E.) refractive error was determined from the right eye. Myopia and hyperopia were defined as a spherical equivalent (S.E.)<-0.5 dioptres (D) and >0.5D, respectively. Since the prevalence of high myopia will vary with the precise criterion chosen, the prevalence of this condition was calculated for thresholds of both <-5.0D and <6.0D. Astigmatism was defined as cylinder power >0.5D. Anisometropia was defined as a difference in S.E. between the two eyes >1.0D. The prevalence of myopia, high myopia (<-5.0D/<-6.0D) and hyperopia in Kailu adults was 60.3% (95%CI: 58.95-61.71), 5.5% (95%CI: 4.82-6.10) /4.0% (95%CI: 3.47-4.57) and 12.2% (95%CI: 11.26-13.11), respectively. The age- and gender-standardised prevalence of myopia, high myopia (-5.0D/-6.0D) and hyperopia were 62.5% (95%CI: 61.05-63.99), 5.0% (95%CI: 4.34-5.61) /3.5% (95%CI: 2.99-4.04) and 10.6% (95%CI: 9.71-11.49), respectively. 52.9% had refractive astigmatism >0.5D and 18.8% of subjects had clinically significant anisometropia. Age was significantly associated with hyperopia, high myopia, astigmatism and anisometropia. Myopia was more prevalent in females. Individuals with a higher educational level had a greater and lesser likelihood of myopia and astigmatism, respectively. Myopia affects around two-thirds of the rural Chinese population over 40years of age in Kailu. This high prevalence highlights that rural populations should be included in epidemiological studies of refractive error. Further investigations are needed to clarify the role of environmental factors in myopia development.

Spectacle utilisation rate and reasons for non-compliance with wearing of spectacles amongst primary school children in Onitsha, Anambra state, Nigeria

Background: Uncorrected refractive errors (REs) are becoming very common in children in developing countries, yet the use of spectacles and compliance to wear are not well documented in African children. Aim: To determine spectacle utilisation rate and reasons for non-compliance with spectacle wear amongst primary school children. Setting: Primary schools in Onitsha, Anambra state, Nigeria. Methods: A stratified random cluster sampling procedure was used to select children aged 5–15 years in 17 primary schools. A total of 1020 were enumerated – 998 (97.8%) were examined, and 97 (9.7%) had RE (uncorrected visual acuity of 20/40 or worse in both eyes). A questionnaire interview using items derived from the revised Refractive Error Study in Children protocol was used to get information regarding reasons for spectacle wear non-compliance. Results: Of the 97 children with RE, 20 wore their spectacles during the time of study, yielding a spectacle utilisation rate of 20.6%. Eleven (55%) of those wearing spectacles were females, 13 (65%) were myopic and the highest number (50%) of spectacle wearers was in the 8–10 years age category. Age, gender and type of RE were significantly associated with spectacle wear ( p < 0.05 was considered statistically significant). The major reasons for non-compliance with spectacles wear were parental disapproval for using spectacles and misconceptions about wearing spectacles. Conclusion: Spectacle utilisation amongst primary school children in Onitsha was low. These findings suggest the need for public awareness about the importance and benefits of wearing spectacles.

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.&#x0D; 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.&#x0D; 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&gt;0.05).&#x0D; 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.&#x0D; Bangladesh Journal of Medical Science Vol.19(4) 2020 p.609-613

A comparative study of noncycloplegic refractive error values with cycloplegic refractive error values using autorefractometer

Refractive error is a global health concern affecting a huge number of people and is associated with various ocular morbidities, overall prevalence of refractive errors was found to be 29%. A refractive error study in children (RESC) in India showed, hyperopia present in 7.7% of children &myopia in 7.4%. Correction of significant refractive errors in childhood helps in preventing amblyopia & strabismus. All the patients who attended the ophthalmic OPD at tertiary health care centre with visual defects were included in the study. The study is proposed to be conducted from November 2018 to May 2019. There was no significant shift in number of patients pre and post dilation in both eyes of patients of myopic astigmatism, with (p-value = 0.6478) and (p-value = 0.3862) for right and left eyes respectively, which are not significant. All patients accepted post cycloplegic autorefractometer values without any complications with good visual acuity and relief in asthenopia symptoms.

Myopia genetics in genome-wide association and post-genome-wide association study era.

Genome-wide association studies (GWAS) of myopia and refractive error have generated exciting results and identified novel risk-associated loci. However, the interpretation of the findings of GWAS of complex diseases is not straightforward and has remained challenging. This review provides a brief summary of the main focus on the advantages and limitations of GWAS of myopia, with potential strategies that may contribute to further insight into the genetics of myopia in the post-GWAS or omics era.

Effect of cycloplegia on the measurement of refractive error in Chinese children

BackgroundTo compare the results of cycloplegic and non‐cycloplegic refractive error measurement in Chinese children, and to assess the relationship between age and the difference in refractive error measured with and without cycloplegia.MethodsThis was a prospective study that recruited 224 healthy Chinese children at an ophthalmology clinic from November 2016 to February 2017. Refraction before and after cycloplegia were measured using an auto‐refractor. Then spherical equivalent M, J0, and J45 were calculated. The enrolled children were allocated into three groups according to M: myopia, emmetropia, and hyperopia. The distribution of the refraction was further analysed by stratifying by age: four to six-years, seven to 11-years, and 12 to 16-years.ResultsMean non‐cycloplegic M, J0, and J45 were −1.68 ± 2.00 D, 0.05 ± 0.40 D, and 0.01 ± 0.35 D, while mean cycloplegic M, J0, and J45 were −1.16 ± 2.17 D, 0.02 ± 0.40 D, and −0.01 ± 0.35 D. Significant differences were found between cycloplegic and non‐cycloplegic M (p = 0.009), whereas there were no significant differences between cycloplegic and non‐cycloplegic J0 and J45 (p = 0.486 and p = 0.594, respectively). The differences between cycloplegic and non‐cycloplegic M were statistically significant in the four to six-years group (p = 0.002) and seven to 11-years group (p = 0.023), whereas there was no significant difference between cycloplegic and non‐cycloplegic M in the 12 to 16-years group (p = 0.151). The proportion of myopia decreased from 78.1-per cent before cycloplegia to 71.4-per cent after cycloplegia, while the proportion of hyperopia increased from 12.1-per cent before cycloplegia to 21.4-per cent after cycloplegia.ConclusionNon‐cycloplegic auto‐refraction is found to be inaccurate and not suitable for studies of refractive error in Chinese children.

Study of Refractive Errors on School going Children in North West Zone of Bangladesh

Refractive error is one of the most common cases of visual impairment around and it is quite common among the children but neglected. Children of age 5-15 years constitute a large portion of the country population. If the refractive errors may not corrected lead to reduced vision (amblyopia) and strabismus. Main ophthalmic problem in children is refractive errors and maximum children live in rural area of Bangladesh but a few studies on such ground had been carried out previously. Therefore it is matter of investigation in this ground. As such study of refractive error of age 5-15 years of low health facilitated area like Chapainawabgonj district situated in the North West Zone of Bangladesh have been considered in this study. On basis of the collected 500 samples the prevalence of refractive error has been computed and it was found to be 9.2% which is similar with the existing study.TAJ 2016; 29(1): 1-6

Molecular genetic aspects of complicated myopia pathogenesis

Complicated myopia (CM) is not only a refractive error but a complex, multifactorial disorder characterized by a mismatch between the optical power of the eye and the axial length that causes the image to be focused off the retina. Genetic factors in progressive myopia play a key role in determining the impact of ecologic factors on refraction development. The majority of genetic variants underlying CM are characterized by modest effect and/or low frequency, which makes them difficult to identify using classic genetic approaches. The genes identified to date account for less than 10% of all myopia cases, suggesting the existence of a large number of yet unidentified low-frequency and/or small-effect variants, which underlie the majority of myopia cases. Genome analysis revealed dozens of loci associated with non-syndromic myopia, and showed that refractive errors are associated with mutations in genes that are involved in the growth and development of the eye by regulating ion transport, neurotransmission, remodeling of extracellular matrix of the retina and other ocular structures. Genetic study of refractive error provides a unique opportunity to detect key molecules that may play important roles in the development of refractive error. Identifying the molecular basis of refractive error helps to understand mechanisms, and subsequently to design rational therapeutic intervention for this condition.

A Study of Refractive Errors in Pseudophakia

A Study of Refractive Errors in Pseudophakia

The prevalence of vision impairment and refractive error in 3654 first year students at Tianjin Medical University.

To determine the prevalence of vision impairment (VI) and refractive error in first year university students at the Tianjin Medical University. This is a cross-sectional observational cohort study of VI and refractive error among first year university students at the Tianjin Medical University. The first year university students were involved in this study and were given a detailed questionnaire including age, birth date, and spectacle wearing history. A standardized ophthalmologic examination including visual acuity (VA), slit-lamp examination, non-cycloplegic auto-refraction, objective refraction, fundus photography, and examination of their spectacles were recorded. A total of 3654 participants were included in this study. Totally 3436 (94.03%) individuals had VI in this population. Totally 150 (4.10%) individuals had VI due to ocular disease, including amblyopia, congenital cataract, retinal atrophy or degeneration, strabismus, congenital nystagmus, refractive surgery orthokeratology. Totally 3286 (89.93%) subjects had VI due to refractive error. Only 218 (5.97%) students were emmetropia. Moreover, refractive error was the main cause for the VI (95.63%). Totally 3242 (92.52%) students were myopia and the prevalence of mild, moderate, and high myopia subgroup was 27.05%, 44.35%, and 21.26% respectively. Totally 44 (1.29%) subjects were hyperopic. The rates of uncorrected visual acuity (UCVA), presenting visual acuity (PVA) and best corrected visual acuity (BCVA) which better than 20/20 in both eyes were 5.65%, 22.32% and 82.13% respectively. The rates of correction, under correction and well correction in myopia subjects were 82.73%, 84.39% and 15.61%, respectively. We present a high prevalence of refractive errors and high rates of under correction refractive error among first year university students. These results may help to promote vision protection work in young adults.

Prevalence of refractive error and spectacle coverage in schoolchildren in two urban areas of Chile.

ABSTRACTObjective.To assess the impact of efforts to reduce visual impairment by detecting and treating refractive errors (REs) among schoolchildren in two urban areas of Chile.Methods.In 2013, in the communities of Concepción and La Florida, we conducted a multicenter, multistage-sampling, cross-sectional study employing methods used by the Refractive Error Study in Children (RESC) survey. Best-corrected visual acuity was assessed using pinhole, with and without glasses. The coverage for correcting visual impairment due to refractive error was estimated.Results.We examined 5 412 schoolchildren, in the communities of Concepción (n = 3 049) and La Florida (n = 2 363). Uncorrected visual acuity (VA) of > 0.63 in at least one eye was found in 4 721 children (87.23%; 95% confidence interval (CI): 86.58%–88.30%). Of the remaining children, 1 017 of them (18.79%; 95% CI: 17.78%–19.80%) had a VA of < 0.5 in at least one eye. Of the 691 children with uncorrected visual impairment with both eyes open (12.77%; 95% CI: 11.9%–13.64%), 476 of them (8.76%; 95% CI: 8.03%–9.49%) achieved normal vision using best possible correction, and with 271 of the 476 (56.93%) having a normal presenting VA in the better eye.Conclusions.We found an increased coverage of services for RE-associated visual impairment and an increased percentage of children wearing glasses as compared to values reported for La Florida in an article published in 2000. The National Board of School Aid and Scholarships (JUNAEB) in Chile is achieving better results in its schoolchildren eye care program.

Prevalence of refractive error, presbyopia, and unmet need of spectacle coverage in a northern district of Bangladesh: Rapid Assessment of Refractive Error study

ABSTRACTPurpose: To determine the prevalence of refractive error (RE), presbyopia, spectacle coverage, and barriers to uptake optical services in Bangladesh.Method: Rapid assessment of refractive error (RARE) study following the RARE protocol was conducted in a northern district (i.e., Sirajganj) of Bangladesh (January 2010–December 2012). People aged 15–49 years were selected, and eligible participants had habitual distance and near visual acuity (VA) measured and ocular examinations were performed in those with VA<6/18. Those with phakic eyes with VA <6/18, but improving to ≥6/18 with pinhole or optical correction, were considered as RE and people aged ≥35 years with binocular unaided near vision of <N8 were considered presbyopic.Result: A total of 3,043 people were examined, of which 143 had RE (4.7%, 95% CI: 3.9–5.5). Among people aged ≥35 years (n = 1402), 869 had presbyopia (62.0, 95% CI: 59.4–64.5). Spectacle coverage for RE and presbyopia were 13.3% (95% CI 7.7–18.9) and 3.2% (95% CI 2.2–4.6), respectively. “Unaware of the problem” was the main reason for not utilizing any optical services among the people with RE (92.8%) and presbyopia (89.5%). Extrapolating the survey findings to the 2011 national census data, the magnitude of RE among people aged 15–49 years in Bangladesh is estimated to be 3,493,980 people (95% CI 2,899,260–4,088,700), of whom 3,029,280 people do not use any spectacles.Conclusion: The burden of RE and presbyopia is substantial in Bangladesh. Improving awareness and availability of refraction services is required to correct REs and presbyopia in Bangladesh.

The effect of topical administration of cyclopentolate on ocular biometry: An analysis for mouse and human models

Mydriasis with muscarinic antagonists have been used routinely prior to retinal examination and sometimes prior to refractive measurements of the mouse eye. However, biometric changes during topical administration of muscarinic antagonists have not been fully investigated in mice and humans. We found that the mouse eyes treated with cyclopentolate developed a hyperopia with a reduction in both the vitreous chamber depth and axial length. In humans, prior to the cyclopentolate treatment, a 6D accommodative stimulus produced a myopic shift with a reduced anterior chamber depth, choroidal thickness and anterior lens radius of curvature and an increase in lens thickness. After the cyclopentolate treatment, human eyes developed a hyperopic shift with an increased anterior chamber depth and anterior lens radius of curvature and a reduced lens thickness. Therefore, the biometric changes associated with this hyperopic shift were mainly located in the posterior segment of the eye in mice. However, it is the anterior segment of the eye that plays a main role in the hyperopic shift in human subjects. These results further indicate that mouse eyes do not have accommodation which needs to be taken into account when they are used for the study of human refractive errors.

Immediate Sequential vs. Delayed Sequential Bilateral Cataract Surgery: Retrospective Comparison of Postoperative Visual Outcomes

We conducted a retrospective comparative-effectiveness study of best-corrected visual acuity (BCVA) and refractive error (RE) after immediate sequential (ISBCS) and delayed sequential (DSBCS) bilateral cataract surgery. We tested 2 hypotheses: (1) among DSBCS patients, second-eye outcomes were no different than first-eye outcomes; (2) averaged between each patient's 2 eyes, outcomes did not differ between ISBCS and DSBCS patients. Retrospective comparative-effectiveness study. Kaiser Permanente Northern California members who underwent noncomplex bilateral cataract surgery from January 1, 2013, through June 30, 2015. We performed an intention-to-treat analysis comparing ISBCS to DSBCS using conditional logistic regression analysis, accounting for surgeon and patient-level factors. BCVA, RE. The analysis of visual outcomes included both eyes of 13 711 DSBCS and 3561 ISBCS patients. Because of the large sample size, some statistical differences lacked clinical significance. Ocular comorbidities were slightly more prevalent in DSBCS patients. Postoperative BCVA was 20/20 or better in 48% of DSBCS first eyes, 49% of DSBCS second eyes, 53% of ISBCS right eyes, and 51% of ISBCS left eyes. The within-person difference in postoperative BCVA averaged zero (0.00) between the first and second DSBCS eyes, and between the ISBCS right and left eyes. After adjustment, average postoperative BCVA was better in ISBCS patients, although the difference was not statistically significant (compared with 20/20 or better: odds ratio for worse than 20/20 was 0.91, 95% confidence interval 0.83-1.01). Emmetropia (spherical equivalent-0.5 to 0 diopter) was achieved in 61% of first DSBCS eyes, 61% of second DSBCS eyes, 63% of ISBCS right eyes, and 63% of ISBCS left eyes. After adjustment, average postoperative RE was no different in ISBCS compared with DSBCS patients (compared with emmetropia: odds ratio for ametropia was 1.02, confidence interval 0.92-1.12). We confirmed 1 case of postoperative endophthalmitis in 10 494 ISBCS eyes (1.0 per 10 000 eyes) and 2 cases in 38 736 DSBCS eyes (0.5 per 10 000 eyes) (P= 0.6), and no patient had bilateral endophthalmitis. Compared with DSBCS, we found no evidence that ISBCS was associated with worse postoperative BCVA or RE, or with an increased complication risk.

Study of Refractive Errors, Amblyopia and Compliance of Spectacles in School Children

Study of Refractive Errors, Amblyopia and Compliance of Spectacles in School Children