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PubMed1984

Clinical evaluation of the Humphrey automatic refractor.

A new automatic objective refractor was used on healthy adults. In the absence of cycloplegic drugs, spherocylindrical objective refractions performed with the instrument provided 20/20 acuity 96% as often as with standard subjective techniques. No instrument-induced accommodations effects were seen. One hundred percent of instrument spherical findings were repeatable within 0.50 diopters; all cylindrical findings were repeatable within 0.37 D. This result represents a higher level of repeatability than that reported for standard subjective refraction under clinical conditions. In the absence of cycloplegic drugs, the correlation coefficient between the instrument's findings and standard subjective spherical findings was .97 v .98 between two practitioners' subjective refractions. The average difference between cylindrical findings of the instrument and those of an experienced practitioner was 0.04 D larger than the average difference seen between two practitioners using subjective techniques.

Accommodation, Ocular↗
PubMed1987

Clinical evaluation of a commercial photorefractor.

The Visiscreen 100 is a system designed to detect ocular anomalies photographically. Photorefractions obtained in 63 consecutive 3-month-old to 8-year-old patients were compared in a masked fashion with results obtained by conventional techniques, including cycloplegic refraction. In 87% of the 57 patients with analyzable photographs, photorefractive and examination results correlated for the detection of constant tropias. The photorefractor detected all ocular media opacities. In 77% of the cases, its refraction was within 2.5 diopters or 33% of the cycloplegic spherical equivalent. In detecting abnormal ocular status, the Visiscreen had a 91% sensitivity and a 74% specificity. The overall agreement rate in distinguishing abnormal from normal status was 84%. Most errors were related to inaccuracies in fixation and positioning, rather than the optical principles utilized. This device offers a rapid technique for the detection of factors predisposing preverbal children to amblyopia.

Child↗
PubMed1993

Personality, psychophysical stress and myopia progression. A prospective study on 57 university students.

Personality profile, psychophysical stress and cycloplegic refraction were evaluated at the baseline (T0) and after 12 months (T1) in 57 university students comprising 39 myopes and 18 emmetropes/hyperopes (controls) whose age, sex distribution and academic results were comparable. At T0, a tendency toward a higher degree of anxiety, somatization and inadequacy was found in myopes in comparison with controls; however, only the anxiety state was different (Wilcoxon signed-rank test P < 0.001). Personality profiles, psychophysical stress and blood levels of cortisol, ACTH, GH, prolactin were similar in myopes and controls. The myopes were classified at T1 as either well-corrected (if their lenses corresponded to refractometer values of +/- 0.50 D and were worn full-time) or undercorrected (if their lenses were > or = 0.75 D with respect to refractometric values and/or were worn part-time). When the spherical cycloplegic values at T0 and T1 were compared, a myopic shift was revealed only in the undercorrected myopes (P < 0.001 in both eyes). These findings suggest that personality profile and psychophysical stress do not play a primary pathogenetic role in myopia. Undercorrection seems to accelerate the progression of myopia.

Adrenocorticotropic Hormone↗
PubMed2004

[Refraction and visual acuity after laser coagulation treatment for retinopathy of prematurity in stage 3+].

PURPOSE: Correlations between myopia < or =-4.0 D, birth weight, gestation age at birth, extension of laser photocoagulation and mild posterior pole changes were assessed in eyes of 1-year-old children who underwent laser treatment for stage 3+ retinopathy of prematurity (ROP). In addition the relationship between best-corrected visual acuity (VA) and mild posterior pole alterations was evaluated at 3 years of age. PATIENTS AND METHODS: Patients who underwent argon or diode laser photocoagulation between 1996 and 2000 for ROP 3+ disease were analyzed in this retrospective study. Cycloplegic refraction was determined in 72 eyes of 1-year old patients ( n=39). At 3 years of age cycloplegic refraction was measured in 36 eyes of 19 patients, and visual acuity was determined in 25 eyes of 13 children. RESULTS: Myopia of < or =-4.0 D significantly correlated only with mild posterior pole changes (i.e. clinically significant dragging of the temporal vessels of the retina or macular heterotopia, p=0.001). The correlation was significant between a VA reduction to <0.8 and mild posterior pole alterations ( p=0.014). CONCLUSIONS: The prevalence of myopia < or =-4,0 D and visual acuity <0.8 appears to be increased even with mild posterior pole changes. Birth weight does not seem to be significant factor in the prevalence of myopia < or =-4.0 D following laser coagulation of stage 3 threshold ROP.

Child, Preschool↗
PubMed2005

Accuracy of a new photo-refractometer in young and adult patients.

BACKGROUND: Photorefraction can be carried out in both eyes simultaneously from a distance and is therefore suitable for examination of children. This study evaluated the accuracy of a commercially available photo-refractometer (Power Refractor, Plusoptix, Erlangen, Germany) and investigated whether the working distance relaxes the accommodation sufficiently without cycloplegia. METHODS: Photo-refractometer readings were compared to cycloplegic retinoscopy. Because of the limited working range the group of patients consisted of low and moderate ametropic eyes within a spherical power of -7.0 to +5.0 D. One hundred and ninety-two eyes from 104 patients (2-81 years) were photo-refracted under cycloplegia. A subgroup of 83 eyes from 46 patients was additionally refracted without cycloplegia. RESULTS: Under cycloplegia, the Power Refractor measured the spherical equivalent slightly below that of cycloplegic retinoscopy (too much minus). The mean difference in spherical equivalent was -0.12+/-0.91 D (SD). The mean difference of cylindrical power was -0.17+/-0.73 D. The mean weighted axis difference was 0.61+/-0.71 D which is comparable to an axis deviation of 18 degrees at a cylinder power of 1.00 D. Without cycloplegia, the mean difference of the spherical equivalent was -0.73+/-1.25 D. The mean difference of cylindrical power was -0.20+/-0.65 D. The mean weighted axis difference was 0.44+/-0.58 D which is comparable to an axis deviation of 13 degrees at a cylinder power of 1.00 D. CONCLUSIONS: Without cycloplegia, the spherical equivalent of the Power Refractor tends to be underestimated due to uncontrolled accommodation, especially in children. Cycloplegia improves the accuracy in evaluating the spherical equivalent, but decreases the accuracy of cylinder power and axis.

Accommodation, Ocular↗
PubMed1987

The effect of refractive error on automated global analysis program G-1.

We determined the effect of induced refractive errors on the visual field indices of the Octopus global analysis program G-1. After cycloplegia, refractive errors were introduced randomly in ten nonglaucomatous eyes of ten patients. Mean defect values (+/- S.D.) were lowest (2.4 +/- 0.8 dB) with full cycloplegic correction. With increasing ametropia, the mean defect increased significantly; it was 3.6 +/- 0.8 dB (P less than .0001) with the addition of +1.00 diopter and 5.3 +/- 0.9 dB (P less than .0001) with +2.00 diopters of sphere over the full cycloplegic correction. No significant differences in corrected loss variance, skew, short-term fluctuation, or reliability factor could be determined with changes in refractive error.

Adult↗
PubMed1992

Refractive state, corneal curvature, accommodative range and ocular anatomy of the Asian elephant (Elephas maximus).

The resting refractive state of six mature, female, Asian elephants (Elephas maximus) was determined using streak retinoscopy and neutralizing video retinoscopy. The amplitude of accommodation was also measured by neutralizing video retinoscopy of two animals and the corneal curvatures of three animals was measured by photokeratoscopy. The net spherical refraction was found to be +0.23 D. No difference was observed between cyclopleged and non-cyclopleged eyes (data from three animals), nor was there any difference between right and left eyes. Nine of the twelve eyes refracted had > or = 0.5 D astigmatism. The mean corneal power, as measured by photokeratometry was 21.3 D (SD = 1.8 D). There was a tendency towards with-the-rule corneal astigmatism in our sample (mean value: 1.2 D), though it did not reach statistical significance (P = 0.06). Two elephants were examined using neutralizing video photoretinoscopy. They were able to accommodate through 3 D. Three fixed eyes from three different elephants were obtained for gross and microscopic examination. The mean axial length of the eye was 38.75 mm and the lens had an axial diameter of approx. 10 mm. The posterior sclera was thick (8.0-8.5 mm). Histologically, the cornea was comprised of five distinct layers. A thin, meridionally oriented smooth ciliary muscle was identified. Individual muscle fibers were also observed associated with the posterior trabeculae of the uveal meshwork.

Accommodation, Ocular↗
PubMed1988

The pretectum and visual discrimination learning in the hooded rat.

In previous studies on the effects of pretectal lesions on visual discrimination performance, the lesions have either been small or their effects confounded with damage to the adjacent thalamus and the results have been inconsistent. This study compares the effects of large pretectal lesions (PRT) with lesions in lateral (TLP) and medial (MPT) posterior thalamus on simultaneous black versus white (BW), horizontal versus vertical (HV) discrimination acquisition and low frequency flicker detection. An unoperated control group treated regularly with a cycloplegic to produce mydriasis was also tested in the discrimination learning phase. PRT lesions and treatment with the cycloplegic produced mydriasis as well as an impairment on BW. Neither group was impaired on HV. Animals with MPT and TLP lesions were impaired on BW and HV and those with TLP lesions were also impaired on flicker detection. It is concluded that the pretectum is important for visual intensity discrimination learning but the effects of lesions are due to disturbances of pupillary control. The significance of this finding for the interpretation of deficits produced by lesions elsewhere in the thalamus is discussed.

Animals↗
PubMed2005

Pediatric Amblyopia Risk Investigation Study (PARIS).

PURPOSE: To assess the learning curve, testability, and reliability of vision screening modalities administered by pediatric health extenders. DESIGN: Prospective masked clinical trial. METHODS: Two hundred subjects aged 3 to 6 underwent timed screening for amblyopia by physician extenders, including LEA visual acuity (LEA), stereopsis (RDE), and noncycloplegic autorefraction (NCAR). Patients returned for a comprehensive diagnostic eye examination performed by an ophthalmologist or optometrist. RESULTS: Average screening time was 5.4 +/- 1.6 minutes (LEA), 1.9 +/- 0.9 minutes (RDE), and 1.7 +/- 1.0 minutes (NCAR). Test time for NCAR and RDE fell by 40% during the study period. Overall testability was 92% (LEA), 96% (RDE), and 94% (NCAR). Testability among 3-year-olds was 73% (LEA), 96% (RDE), and 89% (NCAR). Reliability of LEA was moderate (r = .59). Reliability of NCAR was high for astigmatism (Cyl) (r = .89), moderate for spherical equivalent (SE) (r = .66), and low for anisometropia (ANISO) (r = .38). Correlation of cycloplegic autorefraction (CAR) with gold standard cycloplegic retinoscopic refraction (CRR) was very high for SE (.85), CYL (.77), and moderate for ANISO (.48). CONCLUSIONS: With NCAR, physician extenders can quickly and reliably detect astigmatism and spherical refractive error in one-third the time it takes to obtain visual acuity. LEA has a lower initial cost, but is time consuming, moderately reliable, and more difficult for 3-year-olds. Shorter examination time and higher reliability may make NCAR a more efficient screening tool for refractive amblyopia in younger children. Future study is needed to determine the sensitivity and specificity of NCAR and other screening methods in detecting amblyopia and amblyopia risk factors.

Amblyopia↗
PubMed2006

Accommodative spasm after laser-assisted in situ keratomileusis (LASIK).

PURPOSE: To report a case of accommodative spasm following laser-assisted in situ keratomileusis (LASIK). DESIGN: Observational case report. METHODS: Ophthalmic examination including manifest and cycloplegic refraction to assist in diagnosis. RESULTS: Two months following LASIK surgery, a 41-year-old healthy woman complained of intolerable headaches that had interfered with her daily activities. The patient sought medical consultation, and an MRI of the brain was normal. Best-corrected visual acuity (BCVA) was 20/20 and 20/25 with manifest refraction of -2.25 -0.50 x 170 and plano in the right and the left eye, respectively. Cycloplegic refraction was plano in the right and +0.75 sphere in the left eye, and she was corrected to 20/20 bilaterally. After being treated with cyclopentolate 1% one drop at bedtime to each eye for approximately six weeks, the headache completely resolved. CONCLUSIONS: Accommodative spasm should be considered in patients undergoing LASIK surgery complicated with fluctuating refraction of uncertain causes.

Accommodation, Ocular↗
PubMed2004

Treatment outcomes in refractive accommodative esotropia.

PURPOSE: To document and compare the clinical features and functional outcomes in patients with accommodative esotropia. To assess the efficacy of conventional management of accommodative esotropia, to determine functional outcomes of amblyopia and binocular vision, and to analyze possible risk factors involving the development of amblyopia. METHODS: We retrospectively reviewed the charts of 147 patients whose esotropia was corrected to within 10 prism diopters of orthotropia at both distance and near with use of full cycloplegic hyperopic correction. Multiple parameters were reviewed, including initial and final cycloplegic refraction, distance, and near deviation with and without glasses, stereoacuity, age of onset, and initiation of treatment, presence of anisometropia, and change in hyperopia. RESULTS: At presentation, 87 (59.2%) of the 147 patients were amblyopic, and anisometropia was found to be the only statistically significant risk factor for this (P = .001). Only 24.2% of these patients have stereo acuity between 40 and 100 sec/arc, 20.96% of patients have 200 to 800 sec/arc, and 22.58% of patients have 1980 to 3000 sec/arc; the remaining 32.26% had no stereo acuity. Fusion was achieved in 73.5% of the patients and later presentation (> 24 months) of esodeviation significantly determined their fusional ability (P = .031). Consecutive exotropia developed in 5.4 % of the patients an average of 5.5 years after institution of full optical correction. For clinical and functional outcomes we did not find any statistically significant difference between early onset (before 1 year old) and typical onset (2 to 3 years) age groups. The trend towards decreasing hyperopia was apparent, averaging -0.16 +/- 0.20 diopters annually in 80.5% of the patients with at least 5 years follow-up, although 23% of patients still had 20/40 or worse visual acuity in the amblyopic eye. CONCLUSIONS: Amblyopia is a commonly associated finding at presentation for patients with accommodative esotropia. Most of the patients developed good fusion but poor stereopsis at the end of treatment.

Accommodation, Ocular↗
PubMed2006

Long-term refractive and biometric outcomes following diode laser therapy for retinopathy of prematurity.

PURPOSE: To assess the long-term refractive and biometric outcomes of diode laser-treated eyes in threshold retinopathy of prematurity (ROP). METHODS: Cycloplegic autorefraction and biometry (Zeiss IOLMaster) were performed, at a mean follow-up of 11 years, on 16 laser-treated eyes with threshold ROP and 9 comparison eyes with subthreshold untreated ROP. RESULTS: The laser-treated eyes had a mean spherical equivalent of -2.33 D with a mean astigmatic error of 1.38 D. The comparison eyes had a mean spherical equivalent of +1.07 D with a mean astigmatic error of 0.42 D. This trend toward increased myopia in treated eyes did not achieve statistical significance (p=0.08). The myopia in the laser group appeared to be slowly progressive in nature when compared with earlier refractive data for these patients. The laser-treated eyes had reduced anterior chamber depth (ACD) compared with the subthreshold eyes (p=0.02). When physiologic accommodation was inhibited by cycloplegic drops, the anterior chamber deepened by 0.13 mm in the laser-treated eyes and by 0.06 mm in the comparison eyes. This effect of accommodation on ACD did not differ significantly between the two groups (p=0.23). The laser-treated eyes and the comparison eyes did not differ significantly in terms of axial length, corneal power, corneal diameter, or lens power. However, both groups had steeper corneas, shallower anterior chambers, and shorter axial lengths when compared with historical full-term controls. CONCLUSIONS: Myopia in premature infants requiring laser treatment for ROP is associated with a shallowing of the anterior chamber and a steepening of the cornea. Physiological accommodation is not impaired by laser therapy or by severe ROP.

Accommodation, Ocular↗
PubMed2005

Long-term outcomes of photorefractive keratectomy for anisometropic amblyopia in children.

PURPOSE: To evaluate the long-term visual acuity (VA) and refractive error responses to excimer laser photorefractive keratectomy (PRK) for treatment of anisometropic amblyopia in children. DESIGN: Prospective interventional case-control study. PARTICIPANTS: Eleven children, 2 to 11 years old, with anisometropic amblyopia who were noncompliant with conventional therapy with glasses or contact lenses and occlusion therapy were treated with PRK. A cohort derived retrospectively of 13 compliant and 10 noncompliant children with refractive errors similar to those of the PRK group who were treated with traditional anisometropic amblyopia therapy served as control groups. INTERVENTION: Photorefractive keratectomy for the eye with the higher refractive error. MAIN OUTCOME MEASURES: (1) Refractive error reduction and stability in the treated eye, (2) cycloplegic refraction, (3) VA, (4) stereoacuity, and (5) corneal haze up to 3 years after PRK. Compliant and noncompliant children with anisometropia amblyopia were analyzed as controls for refractive error and VA. RESULTS: Preoperative refractive errors were -13.70 diopters (D) (+/-3.77) for the myopic group and +4.75 D (+/-0.50) for the hyperopic group. Mean postoperative refractive errors at last follow-up (mean, 31 months) were -3.55 D (+/-2.2.5) and +1.41 D (+/-1.07) for the myopic and hyperopic groups, respectively. At last follow-up, cycloplegic refractions in 4 (50%) of 8 myopes and all hyperopes (100%) were within 3 D of that of the fellow eye. Five (63%) of 8 myopic children achieved a refraction within 2 D of the target refraction. Two (67%) of 3 hyperopic patients maintained their refractions within 2 D of the target. Refractive regressions (from 1 year after surgery to last follow-up) were 0.50+/-1.41 D (myopes) and 0.60+/-0.57 D (hyperopes). Seven children (77%) were able to perform psychophysical VA testing preoperatively and postoperatively. Five (71%) of the 7 children had uncorrected VA improvement of at least 2 lines, and 4 (57%) of 7 had best spectacle-corrected VA improvement of at least 2 lines, with 1 improving 7 lines. Five (55%) of 9 children had improvement of their stereoacuity at last follow-up. Subepithelial corneal haze remained negligible. The mean final VA of the PRK group was significantly better than that of the noncompliant control group (P = 0.003). The mean final refractive error for both myopic and hyperopic groups was also significantly better that that of the control groups (P = 0.007 and P<0.0001, respectively). CONCLUSIONS: Photorefractive keratectomy for severe anisometropic amblyopia in children resulted in long-term stable reduction in refractive error and improvement in VA and stereopsis, with negligible persistent corneal haze.

Amblyopia↗
PubMed2006

Refractive error and visual impairment in school children in rural southern China.

PURPOSE: To assess the prevalence of refractive error and visual impairment in school children in a rural area of southern China. DESIGN: Prospective cross-sectional survey. PARTICIPANTS: Two thousand four hundred children from junior high schools in Yangxi County. METHODS: Random selection of classes from the 3 junior high school grade levels was used to identify the study sample. Children from 36 classes in 13 schools were examined in April 2005. The examination included visual acuity (VA) testing; ocular motility evaluation; cycloplegic autorefraction; and examination of the external eye, anterior segment, media, and fundus. MAIN OUTCOME MEASURES: Distance VA and cycloplegic refraction. RESULTS: Among 2515 enumerated children, 2454 (97.6%) were examined. The study population consisted of the 2400 children between 13 and 17 years old. Prevalences of uncorrected, presenting, and best-corrected VA < or = 20/40 in the better eye were 27.0%, 16.6%, and 0.46%, respectively. Sixty percent of those who could achieve acuity > or =20/32 in at least one eye with best correction were without the necessary spectacles. Refractive error was the cause in 97.1% of eyes with reduced vision; amblyopia, 0.81%; other causes, 0.67%; and unexplained causes, 1.4%. Myopia (spherical equivalent, -0.50 diopters [D] or more in either eye) affected 36.8% of 13-year-olds, increasing to 53.9% of 17-year-olds. Myopia was associated with higher grade level, female gender, schooling in the county urban center, and higher parental education. Hyperopia (+2.00 D or more) affected approximately 1.0% in all age groups. Astigmatism (> or =0.75 D) was present in 25.3% of all children. CONCLUSIONS: Reduced vision because of uncorrected myopia is a public health problem among school-age children in rural China. Effective VA screening strategies are needed to eliminate this easily treated cause of visual impairment.

Adolescent↗
PubMed2006

Initial destination of the disaccommodation step response.

Peak velocity and peak acceleration of disaccommodation step responses remain invariant of response magnitude for a constant starting position and they increase linearly with proximity of starting position. This suggests that disaccommodation response is initiated towards an initial (default) destination and is switched mid-flight to attain the desired final destination. The dioptric location of initial destination was estimated from the x-intercept of regression of peak velocity on response starting position. The x-intercept correlated well with subject's cycloplegic refractive state and poorly with their dark focus of accommodation. Altering the dark focus by inducing fatigue in the accommodative system did not alter the x-intercept. These observations suggest that cycloplegic refractive state is a good behavioral correlate of initial destination of disaccommodation step responses.

Accommodation, Ocular↗
PubMed1996

Drug-induced transient myopia and angle-closure glaucoma associated with supraciliary choroidal effusion.

PURPOSE: We investigated the mechanism of drug-induced transient myopia, anterior chamber shallowing, and secondary angle-closure glaucoma in a young woman. METHODS: Ultrasound biomicroscopy was performed and the effects of cycloplegic eyedrops and unilateral laser iridotomy were evaluated. RESULTS: Cycloplegic eyedrops and unilateral laser iridotomy had no effect. Ultrasound biomicroscopy identified the presence of a supraciliary choroidal effusion that caused forward displacement of the lens-iris diaphragm, resulting in increased myopia, anterior chamber shallowing, and angle-closure glaucoma. Discontinuance of trimethoprim and sulfamethoxazole combination led to the complete resolution of the condition. CONCLUSIONS: Idiosyncratic drug reactions may produce a supraciliary choroidal effusion, resulting in myopia and secondary angle-closure glaucoma from the induced forward shift in the position of the crystalline lens and ciliary body.

Adult↗
PubMed1995

Refractive changes at extreme altitude after radial keratotomy.

PURPOSE: We studied the effects of altitude on four corneas that had undergone radial keratotomy and four normal corneas exposed to increasing elevation during a high-altitude excursion. METHODS: We measured visual acuity, cycloplegic refraction, keratometry, and intraocular pressure at sea level and after 24-hour exposure to 12,000 and 17,000 ft. RESULTS: We observed a significant increase in spherical equivalence (hyperopic shift) in radial keratotomy eyes exposed to altitude as compared to controls (P < .0001). The average change in spherical equivalent cycloplegic refraction from sea level to 12,000 ft was 1.03 +/- 0.16 diopters and from sea level to 17,000 ft was 1.94 +/- 0.26 diopters. We also observed a significant decrease in keratometry values at altitude as compared with control corneas (P < .0001). The average change in keratometry from sea level to 12,000 ft was 0.59 +/- 0.19 diopter and from sea level to 17,000 ft was 1.75 +/- 0.27 diopters. CONCLUSIONS: Although the specific origin of these changes is open to question, we hypothesize that hypoxic corneal expansion in the area of the radial keratotomy incisions may lead to central corneal flattening and a hyperopic shift in refractive error. The cornea that has undergone radial keratotomy appears to adjust constantly to changing environmental oxygen concentration, producing a new refractive error over a period of 24 hours or more. Additional study is required to identify with certainty the specific origin of the hyperopic shift at high altitude.

Adult↗
PubMed2000

Refractive Error Study in Children: results from Shunyi District, China.

PURPOSE: To assess the prevalence of refractive errors and vision impairment in school-age children in Shunyi District, northeast of Beijing, the Peoples Republic of China. METHODS: Random selection of village-based clusters was used to identify a sample of children 5 to 15 years of age. Resident registration books were used to enumerate eligible children in the selected villages and identify their current school. Ophthalmic examinations were conducted in 132 schools on children from 29 clusters during May 1988 to July 1998, including visual acuity measurements, cycloplegic retinoscopy, cycloplegic autorefraction, ocular motility evaluation, and examination of the external eye, anterior segment, media, and fundus. Independent replicate measurements of all children with reduced vision and a sample of those with normal vision were done for quality assurance monitoring in three schools. RESULTS: A total of 6,134 children from 4,338 households were enumerated, and 5,884 children (95.9%) were examined. The prevalence of uncorrected, presenting, and best visual acuity 0.5 (20/40) or worse in at least one eye was 12.8%, 10.9%, and 1.8%, respectively; 0.4% had best visual acuity 0.5 or worse in both eyes. Refractive error was the cause in 89.5% of the 1,236 eyes with reduced vision, amblyopia in 5%, other causes in 1.5%, with unexplained causes in the remaining 4%. Myopia -0.5 diopter or less in either eye was essentially absent in 5-year-old children, but increased to 36.7% in males and 55.0% in females by age 15. Over this same age range, hyperopia 2 diopters or greater decreased from 8.8% in males and 19.6% in females to less than 2% in both. Females had a significantly higher risk of both myopia and hyperopia. CONCLUSIONS: Reduced vision because of myopia is an important public health problem in school-age children in Shunyi District. More than 9% of children could benefit from prescription glasses. Further studies are needed to determine whether the upward trend in the prevalence of myopia continues far beyond age 15 and whether the development of myopia is changing for more recent birth cohorts.

Adolescent↗