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Form deprivation myopia in mature common marmosets (Callithrix jacchus).

PURPOSE: Experimental manipulations of visual experience are known to affect the growth of the eye and the development of refractive state in a variety of species including human and nonhuman primates. For example, it is well established that visual form deprivation causes elongation of the eye and myopia. The effects of such manipulations have generally been examined in neonatal or juvenile animals. Whether adolescent common marmosets (a new world primate) are susceptible to form deprivation myopia was studied. METHODS: Five adolescent marmosets were used in this study. Monocular form deprivation was induced by lid closure for 12 to 20 weeks, starting between 299 and 315 days of age. The effects of deprivation were assessed with keratometry, A-scan ultrasonography, and cycloplegic refractions. Both eyes (treated and fellow control) were measured before lid-closure, at the end of the deprivation period, and several times over the following 8 to 12 weeks. RESULTS: Adolescent marmosets are susceptible to visual form deprivation myopia. The experimental eyes showed significant axial elongation and myopia relative to the fellow control eyes. These changes were smaller, however, than those observed in younger eyes deprived for comparable periods. Like juvenile animals, the adolescent marmosets did not show recovery from myopia over the period monitored. CONCLUSIONS: The period for susceptibility to form deprivation myopia in the marmoset monkey extends beyond the early developmental period when ocular growth is rapid and emmetropization normally takes place. Visual form deprivation in adolescent marmosets with adult-sized eyes results in increased ocular growth and myopia. These data suggest that visual factors may influence the growth and refractive development of the human eye after puberty and may be involved in late-onset myopia.

Animals↗

Evaluation of optic disc changes in severe myopia.

PURPOSE: To evaluate the changes in the optic nerve head in highly myopic subjects by means of confocal laser scanning opthalmoscope. METHODS: Using laser scanning and a three-dimensional image analysis system, we studied 114 young (21.4 +/- 1.4 years), highly myopic subjects with refractive errors greater than -8.0 D and a control group of 29 subjects (18.9 +/- 1.2 years) with myopia of -3.0 D or less. Measurements included cycloplegic refraction, corneal curvature, biometric axial length, and morphometric values of the optic disc obtained with a laser scanning disc analyzer. RESULTS: The optic disc area in highly myopic eyes was similar to that in mildly myopic eyes. However, regression analysis revealed that the optic disc area increased with axial length in subjects with severe myopia. The cup/disc ratio, the disc depth, the neuroretinal rim area, and the tilting of the disc were not significantly different between the severe and mild myopia groups. CONCLUSIONS: These findings may be useful in further investigations of myopic progression and of the mechanisms responsible for the development of myopic complications.

Adolescent↗

Open drops in ophthalmology offices: expiration and contamination.

OBJECTIVE: To determine the relationship between eye drop use and contamination rate in ophthalmology offices. DESIGN: Following permission request, open bottles were examined and the nozzle tip and one drop of content was cultured on solid media. OUTCOME MEASURES: Drug category, volume, weight compared to full, clean legible label, expiration date; 2 or more bacterial colonies along the inoculation site. RESULTS: In 18 offices, of 1,485 open bottles (mean 12.2, range 4 to 23 per lane) on average 19.8% (range 0% to 88%) were expired (16.2 of 82.5 bottles per office). The frequency of occurrence (%) and expiration (%E) were 40.3% cycloplegics (19.4%E); 16.4% glaucoma (33.7%E); 10.8% anesthetics (8.8%E); and 4% steroids (8.8%E; or 42.2%E including one outlier). Most likely expired were glaucoma (P < 0.001); small 2-3 ml (P < 0.02), nearly empty (P < 0.05), or dirty (P < 0.001) bottles. Only one (5 ml cyclopentolate, not expired) grew a Micrococcus (0.07%). CONCLUSIONS: Drops in ophthalmology offices may be expired but are not contaminated.

Drug Contamination↗

AC/A ratio, age, and refractive error in children.

PURPOSE: To examine how the response AC/A ratio (the amount of accommodative convergence per unit of accommodative response) varies as a function of refractive error and age, to determine whether it is a risk factor for the onset of myopia, and to examine the relation between ocular structural features and the AC/A ratio. METHODS: Accommodation was stimulated by a letter target presented in a Badal system at 0.00, 2.25, and 4.37 D to 828 children aged 6 through 14 years in 1996. Of these, 726 had no myopia in 1996 and were available for examination the following year. Accommodative response and cycloplegic refractive error were measured by autorefraction and convergence by monitoring the relative movement of Purkinje images I and IV. Lens radii of curvature were measured by video phakometry, corneal radius of curvature by topography, and ocular axial dimensions by A-scan ultrasonography. RESULTS: Adjusted for age, the response AC/A ratio was highest in myopes (6.39 delta/D), intermediate in emmetropes (3.94 delta/D), and lowest in hyperopes (3.40 delta/D; P < 0.0001; two-way analysis of variance [ANOVA]). The stimulus AC/A ratio did not vary with refractive error. Adjusted for refractive error, the response AC/A ratio did not change as a function of age. In non-myopic children, having a response AC/A ratio of 5.84 delta/D or more elevated the risk of development of myopia within 1 year by 22.5 times (95% CI = 7.12-71.1). In a subsample of children without myopia who had refractive errors less than +0.75 D, having a response AC/A ratio of 5.84 delta/D or more elevated the risk of development of myopia within 1 year by 3.21 times (95% CI = 1.14-9.07). The AC/A ratio was associated with all measured ocular features except lens spherical volume. Only the negative correlations with refractive error and the shape of the crystalline lens (Gullstrand lens power) were significant in a multiple regression model (adjusted R2 = 0.16). CONCLUSIONS: An elevated response AC/A ratio was associated with myopia and was an important risk factor for its rapid onset. The association between higher AC/A ratios and flatter crystalline lens shapes, as well as other reported features of accommodation in myopia, may be explained by "pseudocycloplegia," which the authors define as tension on the crystalline lens that increases the level of effort needed to accommodate. Accommodative deficits in myopia may be the functional consequences of the underlying anatomy of the enlarged eye.

Accommodation, Ocular↗

Age-related changes of defocus-specific contrast sensitivity in healthy subjects.

To investigate the effect of defocus on contrast sensitivity as a function of age in healthy subjects, the through focus contrast sensitivity was measured in 100 healthy subjects aged 20-69. Defocus-specific changes in contrast sensitivity reflect age-related changes in the optics of the eye. Tests were performed in cycloplegic eyes varying artificial pupil size (2, 4 and 6 mm), defocus (-1 to +2 D), and spatial frequency (1-16 cpd). Integrated contrast sensitivity was taken as a measure for the total amount of visual information transferred by the optical media. At optimal focus, integrated contrast sensitivity and log contrast sensitivity at 8 cpd showed a significant age-related decline. The log contrast sensitivity at 1 cpd appeared to be independent of age. The depth of focus for a 4-mm pupil increased significantly with age, even though contrast sensitivity at +2 D defocus decreases with age too, but not as much as the contrast sensitivity at optimal focus. Our study indicates that the effect of defocus on contrast sensitivity decreases with age; this was attributed to age-related changes in the optical media.

Adult↗

[Excimer photorefractive keratectomy (PRK) versus intrastromal corneal ring segments (ICRS) for correction of low myopia].

PURPOSE: Theoretical differences between ablative and additive surgeries are obvious, but what about final outcome? We decide to compare surface excimer photorefractive ablation (PRK) with Intracorneal segments (Intacs or ICRS) for correction of low myopia. MATERIAL: and METHOD: Two homogeneous groups of 25 low pure myopic patients were considered: group A including patients operated with Excimer and group B corresponding to Intacs implanted eyes. Retrospective analysis was performed and compared data achieved at two years follow-up, in term of refractive results and qualitative vision. RESULTS: Considering non corrected visual acuity, percentages of eyes who achieved 20/40 or better are comparable in the two series (respectively 97% in group A and 99% in group B). In the adverse, proportion of patients achieving 20/20 or more is superior in Intacs group (77%) versus 62% in PRK group. In all cases, quality of vision is altered in early postoperative period, then returns to normal between 1 and 3 months. Functional complaints appear more frequent and persisting in intrastromal segments group. Based on videotopography and cycloplegic refraction, it seems that risk of induced astigmatism occurrence is significantly increased in case of Intacs. No severe complication is mentioned in both groups. DISCUSSION CONCLUSION: Final outcome are in favor of the efficacy, safety and predictability of the two methods for correction of low myopia. Concept of Intacs presents the interest of potential adjustability and respect of central corneal area; however it appears to be limited by the occurrence of an induced astigmatism.

Adult↗

[Ocular findings associated with hypertelorism].

PURPOSE: To show that in hypertelorism (a horizontal orbital dystopia in which interorbital distance is increased) there are various ophthalmologic abnormalities associated: strabismus, nystagmus, amblyopia, refractive errors, palpebral malpositions, lacrimal system imperforation, fundoscopic and anterior segment lesions. We want to show that the frequence and severity of ophthalmic findings are associated to the severity of hypertelorism. But the evolution and treatment of ocular findings is independent from the treatment of this orbital dystopia. METHODS: We have studied 12 cases of hypertelorism. We made a previous ophthalmologic examination which included: visual acuity, ocular motility, cycloplegic refraction, palpebral statics, lacrimal system, slit lamp and fundoscopic examination. All four walls of each orbit are osteotomized to free them from the frontal, zygomatic, maxillary, nasal and sphenoid bones in surgical correction of hypertelorism. RESULTS: Amblyopia and strabismus appeared in 58.3% of patients each of them, being exotropias the most common. The most frequent refractive error was hypermetropia (40%). Other ocular findings were: ptosis, lacrimal system impermeability, heterochromic iris, optic disk hypoplasia and enophthalmos. None of the deffects was modified after surgical correction of hypertelorism. CONCLUSIONS: Ophthalmologic findings associated with hypertelorism are not caused by the deformity. They are more frequent as higher the severity of the hypertelorism is. The ocular findings do not modify after surgical treatment of hypertelorism, except if we treat them specifically.

Adolescent↗

[A preliminary report of epikeratophakia for the treatment of Terrien's degeneration].

PURPOSE: To evaluate the efficacy of epikeratophakia for the treatment of severe Terrien's degeneration. METHODS: Four eyes with severe Terrien's corneal degeneration are studied. The lesions were located at the peripheral cornea and the corneal thickness was less then 1/3 of normal. Plano keratoplasty was performed. A lamellar lenticule with a 2 mm scleral rim was grafted on the cornea of which the epithelium had been removed. Keratometry and cycloplegic refraction were performed pre- and post-operatively. RESULTS: Follow-up was between 3 and 13 months (mean, 10 months). All grafts remain clear. The properative mean cylinder was 11.5 diopters and the postoperative mean cylinder was 3.9 diopters. Best corrected visual acuity was improved in 3 eyes. Interface opacification is the main complication, like other forms of epikeratoplasty. Epithelial ingrowth occurred in one eye and the lenticule was replaced. CONCLUSIONS: Epikeratophakia is a simple and effective way for the treatment of severe Terrien's degeneration. This procedure not only increases the corneal thickness, but also hepls the cornea to preserve its transparency, since the Bowman's layer remains intact.

Adult↗

Unusual presentations of accommodative esotropia.

PURPOSE: Most patients with accommodative esotropia are first examined between the ages of 6 months and 2 years. This paper discusses unusual presentations of accommodative esotropia that occur outside of this age-group and/or have a precipitating event that triggered the esotropia. In a series of patients who were from 5 to 11 years of age, trauma was the precipitating event. In some of the patients under 6 months of age, high myopia, as well as a moderate to large amount of hyperopia, was the cause. In 1 teenager, diabetic ketoacidosis precipitated accommodative esotropia. METHODS: We reviewed all of our records for the past 25 years involving patients with a diagnosis of esotropia, and we found 17 patients who had unusual presentations of accommodative esotropia. Of 8 who were under the age of 6 months, 2 had high myopia and 6 had moderate to large amounts of hyperopia. Nine patients were older than age 5. Eight of the 9 had suffered trauma associated with the presentation of accommodative esotropia, and 1 patient's accommodative esotropia was associated with diabetes. The patients with myopia received their full myopic correction. The children under 6 months of age with hyperopia received their full cycloplegic refraction, and the children over age 5 received the most plus that they were able to accept in a noncycloplegic state consistent with good visual acuity (at least 20/30 in each eye). RESULTS: In 17 patients, accommodative esotropia was initially controlled with glasses. In a few of the trauma cases, bifocals were required for control of near deviation. Only 2 of the patients, in whom onset was under 6 months of age, came to surgery. One had hyperopia controlled for 2 years with glasses, and the other had myopia controlled for 3 years with glasses. CONCLUSIONS: Accommodative esotropia can occur prior to 6 months of age. It can also occur in older children (5 to 14 years of age) and can be precipitated by trauma or diabetic ketoacidosis.

Accommodation, Ocular↗

Contact dermatitis.

BACKGROUND: Anatomically, the eyelid can be divided microscopically into (1) skin, which is made up of epidermis and dermis; (2) submucosa (3) muscular layer; (4) submuscular layer (dense connective tissue); (5) fibrous layer; and (6) palpebral conjunctiva. The thin nature of the eyelid makes it susceptible to inflammation resulting from allergy. Minimum levels of irritants contacting the adnexal area can penetrate the skin to initiate the allergic cascade. Allergic reactions that involve the eye may begin via contact to the skin, but often involve the conjunctiva. Eczema is the general term that describes the superficial inflammatory process involving the epidermis. Contact eczema is characterized by varying elements of epidermal erythema, papules, and vesicles. Allergic dermatoconjunctivitis connotes involvement of both the skin and conjunctiva. CASE REPORT: A 24-year-old man came to the clinic with a red, swollen left eye. Based on the history, the constellation of signs and symptoms (lack of diffuse or focal pain, presence of periorbital and conjunctival edema, absence of fever), and failed resolution after treatment with injectable antibiotics, the diagnosis of type IV delayed hypersensitivity reaction secondary to toxic/chemical exposure was made. Speedy resolution was accomplished using a sequenced therapy, which included oral antihistamines, topical cycloplegics, topical antibiotics, topical steroids, and palliative therapies. CONCLUSION: Optometrists should be familiar with the signs and symptoms of contact eczema and allergic dermatoconjunctivitis. Treatment includes management of the skin and adnexae, as well as the ocular manifestations.

Adult↗

[Treatment of intermediate hypermetropia using laser in situ keratomileusis--retrospective study (1995-1999)].

In this study, the authors present their findings concerning the usage of the LASIK method in 225 cases of hyperopia. This method has been used in our ELAS refractive centre from 1995 in the treatment of hyperopia up to +7.0 D. The average preoperative spherical equivalent in this group was +4.91 D, and in cycloplegic refraction 20 D (+/- 1.94 D). The postoperative average spherical equivalent was 0.53 D (+/- 0.58 D). Uncorrected visual acuity is used as the main criterion in assessing the effectiveness of the refractive procedure. The average uncorrected visual acuity was improved from a preoperative value of 0.4 (+/- 0.27) to a postoperative one of 0.8 (+/- 0.24). The average value of the best correct visual acuity worsened from 0.98 (+/- 0.31) preoperatively to 0.88 (+/- 0.23) postoperatively. This was perhaps caused by the side-effects of laser ablation (glare), which occurred in using LASIK with cases of hyperopia of over 0 D. For this reason, the choice of the LASIK method for correction of middle hyperopia should be made with caution.

Astigmatism↗

Refractive errors and strabismus in premature Asian infants with and without retinopathy of prematurity.

AIM: In Caucasian populations, premature infants with retinopathy of prematurity (ROP) have been reported to have higher risks of developing refractive errors and strabimus. The purpose of this study is to evaluate the rate of these complications in Asian premature infants with and without ROP. METHODS: A retrospective case review of all premature infants referred to the Singapore National Eye Centre for ophthalmology screening. These included all neonates born earlier than 34 weeks gestational age and less than 1500 grams in birth weight. Standardized ophthalmology examinations including cycloplegic refraction and fundus examination at regular intervals were performed to determine the presence of ROP, refractive errors, squints and other ocular abnormalities until the patients were 3 years old. RESULTS: During 1991 to 1993, a total of 113 neonates were reviewed. Of these, 16 (14.2%) developed ROP. The risk of ROP was higher with lower birth weights and earlier gestational ages. At 1-year follow-up, the rate of myopia was 33.3% in babies with ROP compared to 3.7% in babies with no ROP (p < 0.001). The higher rates of myopia in babies with ROP remained with longer follow-up (33.3% and 25% in ROP group versus 3.4% and 3.8% in no ROP group, at 2 and 3 years respectively). There was no difference in rates of astigmatism or hyperopia throughout the 3 years. At 1 year follow-up, the rate of strabismus was 20% in the ROP group compared to 4.9% in the no ROP group (p = 0.07). However, this difference in rates of strabismus was not significant at 2 and 3 years of follow-up. CONCLUSION: Premature babies with ROP had higher rates of myopia and strabismus than those without ROP. Long-term follow-up of these babies is important for early detection and treatment of these ocular problems.

Asian People↗

Clinical evaluation of the Shin-Nippon SRW-5000 autorefractor in adults.

A clinical evaluation of the Shin-Nippon SRW-5000 (Japan), a newly released commercial autorefractor, was undertaken to assess its repeatability and validity compared to subjective refraction. Measurements of refractive error were performed on 200 eyes of 100 subjects (aged 24.4 +/- 8.0 years) subjectively (non-cycloplegic) by one optometrist and objectively with the SRW-5000 autorefractor by a second. Repeatability was assessed by examining the differences between the seven autorefractor readings taken from each eye and by re-measuring the objective prescription of 50 eyes at a subsequent session. Although the SRW-5000 read slightly more plus than subjective refraction (mean spherical equivalent +0.16 +/- 0.44 D), it was found to be highly valid (accurate) compared to subjective refraction and repeatable over the prescription range of +6.50 to -15.00 D examined. The Shin-Nippon SRW-5000 autorefractor is therefore a valuable complement to subjective refraction and as it offers the advantage of a binocular open field-of-view, has a great potential benefit for accommodation research studies.

Adolescent↗

Comparison of preschool vision screening methods in a population with a high prevalence of astigmatism.

PURPOSE: To compare the effectiveness of four methods of screening 3- to 5-year-old children for astigmatism high enough to require spectacle correction. METHODS: Lea Symbols Visual Acuity Screening (LSVAS), MTI Photoscreening (MTIPS), Nidek KM-500 Keratometry Screening (KERS), and Retinomax K-Plus Noncycloplegic Autorefraction Screening (NCARS) were attempted on 379 preschool children who are members of a Native American tribe having a high prevalence of astigmatism that is primarily corneal in origin. The need for spectacle correction was determined by cycloplegic refraction. Receiver Operating Characteristic (ROC) curves were fit, confidence intervals were determined, and area under the curves was compared. RESULTS: Astigmatism > or = 1.00 D was present in the right eye of 47.5% and in the left eye of 48.0% of children. Spectacles were prescribed for children < 48 months of age who had cylinder > or = 2.00 D and children > or = 48 months who had cylinder > or = 1.50 D, with the result that 33% of subjects required spectacles. Area under the ROC curve was 0.98 for NCARS, 0.92 for KERS, 0.78 for MTIPS, and 0.70 for LSVAS, and each of these values differed significantly from the other three (all P < 0.007). Testability was significantly higher for NCARS (99.5%) and KERS (99.7%) than for MTIPS (93.5%) and LSVAS (92.0%). CONCLUSIONS: In a population that included many children with astigmatism, objective, fully automated screening methods (NCARS and KERS) were superior to both visual acuity screening and photoscreening with subjective interpretation in identifying children who had astigmatism requiring spectacle correction.

Amblyopia↗

[Treatment of post-traumatic cyclodialysis using by direct cyclopexy].

INTRODUCTION: We report 2 cases of posttraumatic cyclodialysis treated by direct cyclopexy. We decided to operate because of the presence of a macular and disc oedema after an ocular chronic hypotony. PATIENTS: The case was a blunt ocular trauma and the other case a perforating injury. For the latter, a cycloplegic treatment was ineffective. The ocular hypotony persisted 2 months in the first case and 2 and a half years in the second. In both cases, the hypotony was major (0mmHg) and the cyclodialysis cleft was extended to 90 degrees (in the superior temporal quadrant and the inferior nasal quadrant). A direct cyclopexy was performed with cilioscleral sutures with 10-0 monofilament. RESULTS: One patient presented a moderate and temporary postoperative hypertony. The maximal follow-up was 9 months: ocular tonus was normalized (10 and 11mmHg), the fundus aspect was improved, and visual acuity was either the same (hand movement perception) or increased from 0.1, 14 to 1.0, 2 on the Parinaud scale. DISCUSSION: The direct cyclopexy was effective in both cases. It precisely defined the cyclodialysis limits, it allowed the suprachoroïdal fluid to drain and restored the anatomic features. Moreover, it allowed treating larger cyclodialysis for which a simple laser treatment would be incomplete. On the other hand, it was invasive intraocular surgery which presented risks of hemorrhage, infection and retinal detachment. CONCLUSION: The direct cyclopexy is an advisable method in the treatment of cyclodialysis. It normalized an ocular tonus and improved of hypotonus retinopathy. However, vision remained sometimes limited because of the posttraumatic sequels are or ocular hypotony that was too lengthy.

Adult↗

Continuous ambient lighting and eye growth in primates.

PURPOSE: To determine the effect of continuous light exposure on ocular growth and emmetropization in infant monkeys. METHODS: Nine infant rhesus monkeys were reared with the normal vivarium lights on continuously. The 24-hour light cycle was initiated between 1 and 4 weeks of age and maintained for 6 months. The ocular effects of continuous light were assessed by cycloplegic retinoscopy, keratometry, and A-scan ultrasonography. Longitudinal control data were obtained from 23 normal infants that were reared with an illumination cycle that included defined light and dark phases (either 12-hour light:12-hour dark or 8.5-hour light:15.5 hour dark). RESULTS: In contrast to previous studies involving light-reared chickens, no monkeys exhibited exaggerated ocular growth. There were no significant differences between treated and control monkeys in corneal radius, overall eye size, or the axial dimensions of individual ocular components. At the end of the treatment period, eight of the nine experimental monkeys also exhibited the moderate hyperopic errors (range, +1.5 to +3.4 D) that are typically found in normal animals. Aspects of emmetropization were, however, unusual for three monkeys. One monkey manifested a -0.50 D myopic error that was associated with an abnormally steep cornea but had normal axial lengths. Two additional monkeys developed persistent axial anisometropias. CONCLUSIONS: In infant primates constant light exposure does not promote the constellation of ocular changes (in particular corneal flattening, a decrease in anterior chamber depth, and an increase in vitreous chamber depth) that has been observed in light-reared chickens. The slight variations from the expected developmental sequence observed in three infants may reflect individual differences. However, it is also possible that aspects of the emmetropization process may not operate as effectively under constant light as they do under an ordinary light/dark cycle.

Aging↗

[Excimer surface photoablation versus Lasik for correction of mild myopia].

INTRODUCTION: Above -6 diopters, Lasik procedure has shown its superiority in term of predictibility, efficacy and stability. In the adverse, in the field of low myopia, Lasik and surface excimer photoablation (PRK) are very controversial. We compare quantitative and qualitative outcome achieved in series of 25 PRK operated patients and 25 Lasik. MATERIAL AND METHOD: 2 homogeneous groups were constituted: group A for Excimer patients and group B for Lasik. Initial ametropia had to be ranged between -2 and -6 diopters (D), eventually associated to a myopic astigmatism that needed to be under -1,75 D. Excimer laser model was a Visx (Visx 20/20 or Star S2). In case of Lasik, flap was performed with an Automated corneal shaper microkératom (Baush & Lomb) or with a Flap Maker (Ioltech). Evaluation of refraction and visual results was associated to measurements of contrast and glare sensitivities and collection of functional complaints. RESULTS: A retrospective analysis is performed with a 2 years follow-up. At that term, rate of eyes, that achieved 20/20 or better is comparable in the two groups (62% in group A and 64% in group B). However, profile of visual recovery goes faster after Lasik. Best corrected visual acuity is favorably preserved in two groups, but is altered with glare in Lasik group. Cycloplegic refraction shows a tendency to regression more important in case of surface ablation (10% versus 4%), especially above -4 D (28%). No significant difference is noted concerning contrast sensitivity, correctly unchanged in the two groups. No case of severe complication is mentioned after both surgical methods. DISCUSSION-CONCLUSION: In the field of low myopia, PRK and Lasik appear to guarantee same predictibility and safety, in conditions of preliminary learning curve. Stability and visual recovery are earlier achieved after Lasik, in addition to postoperative indolence. However, application of this technique to all degrees of myopia requires its perfect control and an adjustment of ablation nomograms.

Adult↗

Myopia in Singapore kindergarten children.

PURPOSE: The purpose of this study was to examine whether close-up work was related to myopia in Singapore kindergarten children. METHODS: One hundred twenty-eight children, ages 3 to 7 years, from a kindergarten in Singapore were examined by cycloplegic autorefraction. The parents also completed a questionnaire on the different types of close-up work activities each child was engaged in, socioeconomic status, and parental history of myopia. RESULTS: Myopic children spent 3.0 hours per day (median) on close-up work activity, while nonmyopic children spent 2.0 hours per day (median) on close-up work activity. The prevalence of myopia in the sample was 8.6%. CONCLUSION: Close-up work activity was not related to myopia in pre-school children.

Child↗