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PubMed1985

Disease-associated visual image degradation and spherical refractive errors in children.

Retrospective clinical data from 496 eyes of 256 children attending a low vision clinic were analyzed to determine the relation between disease states which involve visual image degradation and refractive error. Refractive data from 1023 normal vision children were used as a control. The low vision children were grouped according to their disease classification and the acknowledged age-of-onset of their visual disability. It was found that there was an overall inability to emmetropize and a trend towards myopia. It was also observed that the diseases which led to myopia were associated with a peripheral or peripheral plus central impairment of vision and that those conditions in which foveal vision was primarily impaired showed a mild hypermetropic trend. Eyes in which the visual impairment was not congenital but occurred before the age of 3 years tended to develop hypermetropia. The deviation from emmetropia decreased with increasing age-of-onset of the visual impairment, as did the variation about the mean refraction. The plastic period for emmetropization is estimated to end at 8 to 9 years of age.

Adolescent↗
PubMed1999

Refractive errors in an urban population in Southern India: the Andhra Pradesh Eye Disease Study.

PURPOSE: To assess the prevalence, distribution, and demographic associations of refractive error in an urban population in southern India. METHODS: Two thousand five hundred twenty-two subjects of all ages, representative of the Hyderabad population, were examined in the population-based Andhra Pradesh Eye Disease Study. Objective and subjective refraction was attempted on subjects >15 years of age with presenting distance and/or near visual acuity worse than 20/20 in either eye. Refraction under cycloplegia was attempted on all subjects < or =15 years of age. Spherical equivalent >0.50 D in the worse eye was considered as refractive error. Data on objective refraction under cycloplegia were analyzed for subjects < or =15 years and on subjective refraction were analyzed for subjects >15 years of age. RESULTS: Data on refractive error were available for 2,321 (92.0%) subjects. In subjects < or =15 years of age, age-gender-adjusted prevalence of myopia was 4.44% (95% confidence interval [CI], 2.14%-6.75%), which was higher in those 10 to 15 years of age (odds ratio, 2.75; 95% CI, 1.25-6.02), of hyperopia 59.37% (95% CI, 44.65%-74.09%), and of astigmatism 6.93% (95% CI, 4.90%-8.97%). In subjects >15 years of age, age-gender-adjusted prevalence of myopia was 19.39% (95% CI, 16.54%-22.24%), of hyperopia 9.83% (95% CI, 6.21%-13.45%), and of astigmatism 12.94% (95% CI, 10.80%-15.07%). With multivariate analysis, myopia was significantly higher in subjects with Lens Opacity Classification System HI nuclear cataract grade > or =3.5 (odds ratio, 9.10; 95% CI, 5.15-16.09), and in subjects with education of class 11 or higher (odds ratio, 1.80; 95% CI, 1.18-2.74); hyperopia was significantly higher in subjects > or =30 years of age compared with those 16 to 29 years of age (odds ratio, 37.26; 95% CI, 11.84-117.19), in females (odds ratio, 1.86; 95% CI, 1.33-2.61), and in subjects belonging to middle and upper socioeconomic strata (odds ratio, 2.10; 95% CI, 1.09-4.03); and astigmatism was significantly higher in subjects > or =40 years of age (odds ratio, 3.00; 95% CI, 2.23- 4.03) and in those with education of college level or higher (odds ratio, 1.73; 95% CI, 1.07-2.81). CONCLUSIONS: These population-based data on distribution and demographic associations of refractive error could enable planning of eye-care services to reduce visual impairment caused by refractive error. If these data are extrapolated to the 255 million urban population of India, among those >15 years of age an estimated 30 million people would have myopia, 15.2 million hyperopia, and 4.1 million astigmatism not concurrent with myopia or hyperopia; in addition, based on refraction under cycloplegia, 4.4 million children would have myopia and 2.5 million astigmatism not concurrent with myopia or hyperopia.

Adolescent↗
PubMed1994

Refractive errors among engineering students in Norway.

This study reveals the prevalence of refractive errors in a group of young adults (mean age 20.6 years) exposed to high educational demands, including much reading. In all, 224 (117 females, 107 males) first-year engineering students were subjectively refracted. A prevalence of myopia of 46.9% (right eye), 49.1% (left eye) and 42.9% (both eyes), and a prevalence of hyperopia of 29.5% (right eye), 28.1% (left eye) and 23.2% (both eyes) was detected. The mean refractive error in the whole group was -0.6 +/- 2.2 D (right eye), -0.7 +/- 2.4 D (left eye) and -0.7 +/- 2.3 D (both eyes). As many as 56.4% (n = 57) of the myopic students had either no corrective lenses (11.9%, n = 12) or had their first corrective lenses prescribed at the age of 16 years or later (44.6%, n = 45). There was no significant difference in the prevalence of myopia between female and male students. No significant difference regarding body height was found among men in the different groups of refractive errors, but a significant difference was detected among women. We found no statistically significant relationship between intraocular pressure and any refractive error among men or women.

Adult↗
PubMed1990

Distribution of refractive errors in patients from Dominica, West Indies.

A total of 779 consecutive private patients requiring spectacles for correction of refractive errors were categorized according to age, sex, occupation and type of refractive error. Virtually all patients (97.1%) were black. The relationship between age, sex, occupation and refractive error was determined and showed that refractive errors were approximately equally distributed between the sexes, but myopia was more common among those with nearpoint occupations. Data also showed that more of the elderly were hyperopic than myopic in contrast to the younger patients who were more often myopic.

Adolescent↗
PubMed1987

Relationship between refractive error and visual acuity in the Prospective Evaluation of Radial Keratotomy (PERK) Study.

As part of the Prospective Evaluation of Radial Keratotomy (PERK) study, we examined the relationship between post-operative refractive error and visual acuity without correction. We included 394 eyes (one eye per patient) with refractive errors ranging from -3.00 to +3.00 diopters one year after radial keratotomy. Within each 1-D range of the spherical equivalent of the refractive error, the visual acuity spanned five to ten Snellen lines. For visual acuities of 20/16 to 20/50, the refractive error spanned 3 to 5 D. Additionally, operated eyes had a better average uncorrected visual acuity than unoperated eyes with a similar refractive error. Within the narrow range of refraction between -2.00 and -2.50 D, the mean uncorrected visual acuity was 20/125 for 56 unoperated eyes and 20/63 for 29 operated eyes, a difference of three Snellen lines.

Adult↗
PubMed1977

Refractive errors associated with hemangiomas of the eyelids and orbit in infancy.

Asymmetrical refractive errors, both astigmatic and myopic, were associated with infantile hemangiomas of the eyelids and orbit in 46% of 37 patients who had large lesions and upper eyelid involvement predisposing to the ammetropia. The axis of the astigmatic error related to the location of the eyelid hemangioma and correlated closely with keratometric measurements of corneal astigmatism. The refractive errors tended to be stable despite eventual resolution of the hemangiomas. Efforts to combat strabismic and refractive amblyopia were rewarding in many patients. A history of complete eyelid occlusion during part of the first year of life was associated with dense amblyopia and eccentric fixation in some patients, but in other patients this history was compatible with the eventual development of useful vision. Absence of an asymmetrical refractive error in patients with eyelid and orbital hemangiomas rendered the prognosis for vision good in involved eyes.

Astigmatism↗
PubMed1994

Screening of infants for significant refractive error using videorefraction.

Isotropic photorefraction has been suggested as a suitable method for screening infants for refractive error. Recently published data suggested that reasonable consistency with retinoscopy results might be achieved using cycloplegic videophotorefraction (VPR) for spherical refractive error but that results might be unreliable for astigmatic errors. Non-cycloplegic VPR did not appear to produce results consistent with retinoscopy. A practical idea of how many children might be identified using this technique and how many missed was needed by personnel designing screening projects. Hence the VPR was tested by screening a population of 247 infants for significant refractive error, and comparing the results with cycloplegic retinoscopy. Sensitivity and specificity scores were calculated for a range of test levels of ametropia. Without cycloplegia, sensitivity of VPR was poor. With cycloplegia the situation was much improved, with sensitivity for hyperopia +4.00 D or over of 83.3% and specificity of 90.6%. Sensitivity for astigmatism of 1 D or greater (84.6%) was high but specificity was poor (45.6%). Acceptable sensitivity was achieved for identifying children in this age group at risk of developing squint and amblyopia due to refractive error, providing cycloplegia was used.

Amblyopia↗
PubMed1987

The distribution of refractive errors in Nigeria.

A clinical study of the refractive errors of 349 females aged between 5 and 69 years and 473 males aged between 3 and 62 years was undertaken. This report describes the prevalence of the different types of refractive errors with regard to sex and age.

Adolescent↗
PubMed2000

Refractive error in cataract surgery after previous refractive surgery.

Bilateral cataract extraction with posterior chamber intraocular lens (IOL) implantation was performed in a patient after previous photorefractive keratectomy, radial keratotomy (RK) combined with astigmatic keratotomy, and retreatment of RK. Significant hyperopic error was observed after cataract surgery, and the IOLs were eventually exchanged in both eyes. A review of this case found that the refractive error was smaller when a refraction-derived keratometric value was selected for IOL power calculation. Nevertheless, hyperopic error still occurred.

Adult↗
PubMed1986

Refractive error and preferential looking visual acuity in human infants: a pilot study.

A clinical pilot study comparing refractive error and preferential looking (PL) visual acuity in infants 2 to 12 months of age is described. The PL visual acuity of 30 normal infants without significant visual disorders was assessed using the Acuity Card Procedure. Near retinoscopy was used to determine refractive error. Infants of this sample had monocular PL visual acuities similar to those established by McDonald et al. in a laboratory setting. Statistical analysis of the data for this sample of infants showed that refractive error did not change systematically from 2 to 12 months of age. We have found that results obtained with the Acuity Card Procedure in a clinical setting agree with infant visual acuity as described in the research literature. Refractive error did not correlate with changes in PL visual acuity in infants 2 to 12 months of age.

Humans↗
PubMed1997

Refractive errors in children born before 32 weeks gestation.

PURPOSE: To document the refractive errors in a cohort of children born before 32 weeks gestation. METHODS: All children born before 32 weeks gestation between 1 January 1990 and 31 December 1991 to mothers resident in the Northern Region of the National Health Service were examined at 2 years old (n = 558). RESULTS: Stage 3 or worse retinopathy of prematurity (ROP) was associated with myopia. In those not developing stage 3 or worse ROP, the refractive errors were myopia in 1.5%, hypermetropia > 4 dioptres (D) in 5.4%, anisometropia > 1 D in 1.1% and astigmatism > 1.25 D in 5.7%. CONCLUSION: The incidence of refractive errors in those not developing stage 3 or worse ROP was similar to that in the general population.

Acute Disease↗
PubMed1993

Effect of uncorrected refractive errors upon central visual field testing.

An investigation of the effects of uncorrected refractive errors upon a central visual field examination has been made with a view to establishing what the likely effects would be of omitting a refractive correction when screening the visual field with a threshold related, supra-threshold strategy on the Henson CFA3000. The results indicate that, while a linear relationship exists between the extent of threshold elevation and the product of residual refractive error and pupil size, the scatter in the results means that accurate predictions cannot be made in individual cases. The threshold elevation was found to be independent of eccentricity (within the central 21 degrees from fixation) and did not increase the variability of results. These last two findings indicate that uncorrected refractive errors are unlikely to affect the sensitivity of the threshold related, supra-threshold strategy to localized visual field defects.

Adult↗
PubMed1986

Stereopsis angle in relation to proximity and induced refractive errors.

Dependence of stereoacuity (SA) angle on the reciprocal of the test distance with positive, negative, and zero values of induced refractive errors is demonstrated with the three-rod test and the mean errors statistical method. Two male emmetropes and one hyperope showed linearly increasing dependence of SA angle on the reciprocal of the test distance within the subject's range of clear vision extended at both ends by 1 D. Linear regression coefficients were not influenced by the value of induced refractive error within +/- 2 D. Correlation coefficients in the case of corrected refractive error were about 0.90, but their mean value in the case of induced refractive errors was 0.83.

Adult↗
PubMed1995

Studies on the role of the retinal dopamine/melatonin system in experimental refractive errors in chickens.

We have found that development of both deprivation-induced and lens-induced refractive errors in chickens implicates changes of the diurnal growth rhythms in the eye (Fig. 1). Because the major diurnal oscillator in the eye is expressed by the retinal dopamine/melatonin system, effects of drugs were studied that change retinal dopamine and/or serotonin levels. Vehicle-injected and drug-injected eyes treated with either translucent occluders or lenses were compared to focus on visual growth mechanisms. Retinal biogenic amine levels were measured at the end of each experiment by HPLC with electrochemical detection. For reserpine (which was most extensively studied) electroretinograms were recorded to test retinal function [Fig. 3 (C)] and catecholaminergic and serotonergic retinal neurons were observed by immunohistochemical labelling [Fig. 3(D)]. Deprivation myopia was readily altered by a single intravitreal injection of drugs that affected retinal dopamine or serotonin levels; reserpine which depleted both serotonin and dopamine stores blocked deprivation myopia very efficiently [Fig. 3(A)], whereas 5,7-dihydroxy-tryptamine (5,7-DHT), sulpiride, melatonin and Sch23390 could enhance deprivation myopia (Table 1, Fig. 5). In contrast to other procedures that were previously employed to block deprivation myopia (6-OHDA injections or continuous light) and which had no significant effect on lens-induced refractive errors, reserpine also affected lens-induced changes in eye growth. At lower doses, the effect was selective for negative lenses (Fig. 4). We found that the individual retinal dopamine levels were very variable among individuals but were correlated in both eyes of an animal; a similar variability was previously found with regard to deprivation myopia. To test a hypothesis raised by Li, Schaeffel, Kohler and Zrenner [(1992) Visual Neuroscience, 9, 483-492] that individual dopamine levels might determine the susceptibility to deprivation myopia, refractive errors were correlated with dopamine levels in occluded and untreated eyes of monocularly deprived chickens (Fig. 6). The hypothesis was rejected. Although it has been previously found that the static retinal tissue levels of dopamine are not altered by lens treatment, subtle changes in the ratio of DOPAC to dopamine were detected in the present study. The result indicates that retinal dopamine might be implicated also in lens-induced growth changes. Surprisingly, the changes were in the opposite direction for deprivation and negative lenses although both produce myopia. Currently, there is evidence that deprivation-induced and lens-induced refractive errors in chicks are produced by different mechanisms. However, findings (1), (3) and (5) suggest that there may also be common features. Although it has not yet been resolved how both mechanisms merge to produce the appropriate axial eye growth rates, we propose a scheme (Fig. 7).

5,7-Dihydroxytryptamine↗
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↗
PubMed1994

[Relation between postoperative refraction errors and decentration of the intraocular lens].

In a group of 51 patients the authors measured the position of the intraocular lens (the method was based on mathematical analysis of the Purkinje images position) and calculated the postoperative refractive error. The dependence of the postoperative refractive error on IOL position was analyzed and the results of the analysis were compared with the presumptions based on theoretical calculations. The results obtained from the measurement are very close to that assessed by the theoretical calculations. The IOL decentration in the eye causes the the shift of the postoperative refractive error towards myopia and it is probably the cause of the part of the postoperative refractive error.

Humans↗
PubMed1989

Corneal asphericity and refractive error.

The relationship between corneal curvature measured by classical keratometry and refractive error raises the question of a possible systematic relationship between refractive error and the degree of corneal asphericity. A recomputation and analysis of previously published data leads to the conclusion that the different refractive groups have similar values of the parameter 'p' and differ only in the apical radius of the cornea.

Cornea↗
PubMed1980

Geometrical optics and the statistical analysis of refractive error.

Relationships among statistical quantities used in the analysis of refractive error are derived from geometrical optics principles. The accuracy of these results are verified using the data of Sorsby et al. As an application of these results, it is shown that there is difficulty in accounting for leptokurtosis of refractive error in terms of correlation among the optical parameters of the eye. Also, it is shown that the distribution of the optical parameters of the eye cannot be a joint-normal distribution.

Humans↗