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PubMed1981

Testing for hypermetropia in the school vision screening programme.

The need and accuracy of a hypermetropia test, recommended as a screening test in Swedish schools, was evaluated in a series of 118 8-year-old children not wearing glasses. The distant visual acuity was determined without correction and with plus spheres of two different strengths, +1.5 D and +2.0 D respectively. When compared to the objective refraction and with an arbitrary limit of hypermetropia of +2.5 diopters, it could be shown that neither of the hypermetropia tests fulfilled the criteria of an adequate screening test. Except for two children all hypermetropics beyond +3.0 were previously known. The reading skills of the children were estimated by their teachers. No correlation was found between the degree of hypermetropia and reading difficulties. The results indicate that the hypermetropia test could be omitted from the regular vision tests of schoolchildren, at least in areas covered with an efficient pre-school vision screening.

Child↗
PubMed1983

The use of isotropic photorefraction for vision screening in infants.

Isotropic photorefraction is a technique which makes possible the rapid, economic, large scale screening of infants and young children for refractive errors. The relative size of blur circles reflected from the fundus in 3 flash photographs with different camera settings allows the size and direction of refractive errors to be estimated. The method has been validated against retinoscopic measures on a large group of infants. Findings of a high incidence of astigmatism in the first year are confirmed. Detection of hypermetropia in early infancy by this screening procedure may allow preventive treatment for accommodative strabismus.

Astigmatism↗
PubMed1984

The effect of phenylephrine on the accommodative process in man.

Accommodation was measured in a double-blind study on 10 healthy volunteers (22-29 years) before and after the instillation of 0.1%, 1.0% and 10% phenylephrine eye drops. Accommodation decreased exponentially with increasing concentration, reaching an average of 3 dioptres after one drop of 10% phenylephrine. The effect of adding phenylephrine to an atropinized eye was studied in 20 children (3-6 years). The children were randomized to placebo or phenylephrine treatment. The cycloplegic effect of atropine was unchanged in 8 out of 9 placebo-treated children, whereas 5 out of 11 phenylephrine-treated children showed a slight, but not significant, increase in hypermetropia.

Accommodation, Ocular↗
PubMed1985

The effect of ametropia on the accommodative response.

The accommodative response of 15 myopic, 10 hypermetropic and 15 emmetropic (less than +/- 0.50 D) subjects was assessed by the laser optometer. The Snellen E target was viewed binocularly whilst the monocular response to various levels of stimuli (0 D to 5 D) was measured. The mean response/stimulus curves and resting points for each group are compared. No significant difference is present between the 3 groups. There is no correlation between a) the resting point and spectacle prescription (r = 0.20) and b) the slope of the response/stimulus curve and the spectacle prescription (r = -0.32). The effect of ametropia on the accommodative response is insignificant.

Accommodation, Ocular↗
PubMed1985

The ophthalmological findings in autosomal recessive severe juvenile arteriosclerosis.

Severe juvenile arteriosclerosis (JAS) is a rare, fatal disease with probably autosomal recessive inheritance. Precocious arterial murmurs and calcification of aorta and major arteries are associated with anaemia, growth retardation, prolonged systolic hypertension, gradual renal failure, gastrointestinal perforations, and early death. The ophthalmological findings in 5 boys and 1 girl between 7 and 17 years of age were retinal vascular tortuosity of main vessels, pre-capillary arterioles and post-capillary venules, sausage-like bulging of central main arterioles and microaneurysms of arterioles of the central fundus. Narrowing and local constriction was a typical feature of peripheral arterioles. The combination of findings documented by fluorescein angiography in 4 children was typical for severe juvenile arteriosclerosis.

Adolescent↗
PubMed1988

Refraction and accommodation in diabetic school children.

Refraction and accommodation of 61 diabetic children (aged 9 to 16 years) and 92 non-diabetic children (aged 10 to 16 years) were studied. Myopia was found in 36.1% of the diabetic children and in 29.3% of the non-diabetic children. The difference was not statistically significant. In the diabetic children, the age of the onset of myopia and the progression of myopia were the same as in the usual myopia at school age. The refraction curve of the diabetic children was less peaked than that of the non-diabetic children; a greater number of low myopic refractions were observed, and the low hyperopic refractions were more evenly distributed in the curve of the diabetic children. The mean accommodation of the diabetic children was 9.9 D +/- 2.2, and in the non-diabetic children it was 11.8 D +/- 2.6. The difference was statistically significant. The accommodation of both the diabetic and non-diabetic girls was lower than that of the boys. The accommodation in the myopic diabetic children was statistically significantly lower than the accommodation in the hyperopic diabetic children.

Accommodation, Ocular↗
PubMed1990

A longitudinal study of a population based sample of astigmatic children. I. Refraction and amblyopia.

The refraction changes in 310 children with astigmatism greater than or equal to 1.0 D in at least one eye at one year of age were followed during a period of 3 years. At the age 4 years amblyopia was found in 23 children (7%). The refraction data of these children were compared to the rest of the sample. We found that an increasing astigmatism during the test period was associated with an increased risk to develop amblyopia. The majority of children (n = 280) showed a decrease of their astigmatism, whereas all cases with a marked amblyopia (V.A. less than 0.5) or binocular amblyopia, except one, had an increasing or unchanged astigmatism during the age period 1 to 4 years. Strabismus and oblique astigmatism at any time during the test period was also strongly related to amblyopia. The incidence of strabismus (1%) was unexpectedly low. The study also showed that independent of age there was no simple relationship between amblyopia and refraction errors measured at a single test session. The main conclusion of this study is that failure of emmetropization may play an important role in visual development.

Amblyopia↗
PubMed1992

Normal variations of the posterior corneal surface.

Measurements of the sphero-cylindrical components of the rear corneal surface were taken from 80 healthy right eyes in order to determine normal variations. Dimensions of this surface were strongly influenced by the front corneal surface with the exception that the rear surface exhibited more toricity. Both surfaces tended to be flatter in males compared to females and in myopes compared to hyperopes. The corneal surfaces were also found to be flatter in younger eyes compared to older eyes, but this finding was most likely due to the preponderance of myopes in the young and hyperopes in the older group. The influence of the ratio of anterior: posterior corneal surface radius upon the estimation of total corneal power as required for intraocular lens implant calculations was also considered.

Adult↗
PubMed1993

Dark focus of accommodation in children with accommodative esotropia and hyperopic anisometropia.

We evaluated the dark focus of accommodation, referred to as tonic accommodation, in 60 young hyperopic subjects, 20 with and 20 without accommodative esotropia, and 20 with hyperopic anisometropia. We measured the distance, dark, and cycloplegic refractive errors by the Nidek Autorefractometer AR1600. The difference between dark and cycloplegic refractive errors was defined as the dark focus. The dark focus was significantly larger in esotropic eyes than in non-esotropic eyes, despite similar cycloplegic refractive errors in both types of eyes, suggesting that tonic accommodation may be associated with ocular position. The dark focus was similar in eyes of the same subjects with hyperopic anisometropia and also in normal and amblyopic eyes, suggesting that tonic accommodation is similar in both eyes in subjects with anisometropia and amblyopia.

Accommodation, Ocular↗
PubMed2006

Refractive change in thyroid eye disease (a neglected clinical sign).

BACKGROUND/AIMS: The literature on refractive change in thyroid eye disease (TED) is limited. This study documents the refractive change in patients with TED undergoing orbital decompression. The authors propose possible mechanisms for their acquired refractive error. METHODS: This is a retrospective observational case study of five patients with progressive TED. Their detailed eye examinations including refractive state preoperatively and postoperatively are presented. RESULTS: An acquired hypermetropic shift with active TED before orbital decompression of up to 3.75 D spherical equivalent refraction (SER) is reported in one patient. Post-orbital decompression, an induced myopic shift of between 1.00-2.50 D SER for all patients is observed, noted to range from 1 day following surgery to up to 9 months, dependent on the availability of data. Axial length increased in two cases corresponding to postoperative myopic shift. Magnetic resonance imaging findings of one patient demonstrate flattening of the posterior pole as a cause of the acquired preoperative hypermetropia. CONCLUSIONS: TED has a significant effect on the refractive state of patients. The proposed mechanism of acquired hypermetropia relates to increased volume of orbital contents with flattening of the posterior globe. This is reversed with successful orbital decompression. Documentation of refractive error in all cases of progressive TED is recommended. Progressive acquired hypermetropia may be suggestive of TED activity.

Adult↗
PubMed2006

Prevalence and associations of anisometropia and aniso-astigmatism in a population based sample of 6 year old children.

AIM: To study the distribution of anisometropia and aniso-astigmatism in young Australian children, together with clinical and ocular biometry relations. METHOD: The Sydney Myopia Study examined 1765 predominantly 6 year old children from 34 randomly selected Sydney schools during 2003-4. Keratometry, cycloplegic autorefraction, and questionnaire data were collected. RESULTS: Spherical equivalent (SE) anisometropia (> or =1 dioptre) prevalence was 1.6% (95% confidence interval (CI) 1.1% to 2.4%). Aniso-astigmatism (>or =1D) prevalence was 1.0% (CI: 0.6% to 1.6%). Both conditions were significantly more prevalent among moderately hyperopic (SE > or =2.0D) than mildly hyperopic (SE 0.5-1.9D) children. Myopic children (SE < or =-0.5D) had higher anisometropia prevalence. Neither condition varied by age, sex, or ethnicity. In multivariate analyses, anisometropia was significantly associated with amblyopia, odds ratio (OR) 29, (CI: 8.7 to 99), exotropia (OR 7.7, CI: 1.2 to 50), and neonatal intensive care unit (NICU) admission (OR 3.6, CI: 1.1 to 12.6). Aniso-astigmatism was significantly associated with amblyopia (OR 8.2, CI: 1.4 to 47), maternal age >35 years (OR 4.0, CI: 1.3 to 11.9), and NICU admission (OR 4.6, CI: 1.2 to 17.2). Anisometropia resulted from relatively large interocular differences in axial length (p<0.0001) and anterior chamber depth (p = 0.0009). Aniso-astigmatism resulted from differences in corneal astigmatism (p<0.0001). CONCLUSION: In this predominantly 6 year old population, anisometropia and aniso-astigmatism were uncommon, had important birth and biometry associations, and were strongly related to amblyopia and strabismus.

Amblyopia↗
PubMed2006

Associated factors for age related maculopathy in the adult population in China: the Beijing eye study.

BACKGROUND: To evaluate factors associated with the prevalence of age related maculopathy (ARM) in the adult Chinese population. METHODS: The Beijing Eye Study, a population based prevalence study, included 4439 out of 5324 subjects from a rural area and an urban region of greater Beijing, aged 40+ years and invited to participate (response rate 83.4%). Fundus photographs were graded using the Wisconsin Age-Related Maculopathy Grading system. The following parameters were graded: drusen size, drusen type, and the area covered by drusen; pigmentary abnormalities; geographic atrophy; and exudative ARM. RESULTS: Fundus photographs were available for 8655 eyes of 4376 (98.6%) subjects. Early age related macular degeneration (ARD), late ARD, and exudative ARD, respectively, were present in 1.4%, 0.20%, and 0.10% of the subjects. In a binary logistic regression analysis, early ARM was statistically associated with age (p<0.001; 95% CI: 1.04 to 1.08), hyperopic refractive error (p = 0.008; 95% CI: 1.04 to 1.28), rural region (p<0.001; 95% CI: 0.17 to 0.49), and lower level of education (p = 0.01; 95% CI: 1.07 to 1.65). Early ARM was not significantly associated with the optic disc size (p = 0.42), and size of beta zone of peripapillary atrophy (p = 0.28), the self reported diagnosis of diabetes mellitus (p = 0.39; OR: 1.37; 95% CI: 0.66 to 2.85), amount of cortical cataract (p = 0.72), subcapsular cataract (p = 0.98), nuclear cataract (p = 0.26), sex (p = 0.23), cataract surgery (p = 1.0; OR: 0.96; 95% CI: 0.13 to 6.95), glaucomatous optic nerve damage (p = 0.77; OR: 0.62; 95% CI: 0.15 to 2.52), and history of smoking (p = 0.66; OR: 1.14; 95% CI: 0.65 to 2.00). CONCLUSIONS: Hyperopic refractive error besides age was the single most important risk factor for ARM in adult Chinese. Other associated factors were rural region and lower level of education.

Adult↗