Association Between Physical Indicators and Myopia in American Adolescents: National Health and Nutrition Examination Survey 1999-2008.

PURPOSE: Myopia is the most prevalent refractive error, imposing a substantial economic burden. Physical indicators constitute significant influencing factors for myopia. The National Health and Nutrition Examination Survey (NHANES) investigates the health and nutritional status of both children and adults in the United States. This study leveraged NHANES to explore the association between physical indicators and myopia among American adolescents. DESIGN: Retrospective case-control study. METHODS: The final study cohort consisted of 9008 adolescents. Demographic data, physical indicators, and vision data were extracted. The association between myopia and demographic factors, as well as physical indicators, employed weighted methods. Regression models were utilized to identify the associations between physical indicators and myopia. Cumulative odds logistic regression analysis was employed to investigate the association between physical indicators and the degree of myopia. Restricted cubic spline analysis was employed to examine the potential nonlinear relationship between physical indicators and the risk of myopia. RESULTS: The occurrence of myopia was significantly correlated with age (P < .001) and race (P = .019). Adolescents in the fourth percentile for weight (odds ratio [OR] 1.38, 95% confidence interval [CI] 1.13-1.70) and body mass index (BMI) (OR 1.26, 95% CI 1.05-1.51) exhibited an increased possibility of myopia. The highest risk of myopia was observed when the BMI approached 30. Height emerged as a risk factor for the degree of myopia (OR 1.02, 95% CI 1.01-1.03). CONCLUSIONS: A certain association existed between physical indicators and myopia. Weight and BMI were related to the occurrence of myopia, while height and race were associated with the degree of myopia.

Epidemiological investigation of the status of myopia in children and adolescents in Fujian Province in 2020.

PURPOSE: The 2020 epidemiological investigation of myopia in children and adolescents in Fujian Province' aimed to provide reference guidelines for the prevention and control of myopia. The purpose of the present study was to address shortfalls in the epidemiological survey of myopia in Fujian and provide a basis for government decision making. STUDY DESIGN: A cross-sectional and epidemiological investigation METHODS: Based on their levels of economic development and other economic factors, three cities in Fujian Province (Fuzhou, Xiamen, Longyan) were chosen through cluster random sampling and epidemiological investigation. Final analysis included 41,906 cases. Examinations including visual acuity and mydriatic optometry were performed on all subjects. RESULTS: The overall proportion of myopia was 63.35% in boys and 70.55% in girls living in Fujian in 2020. The proportions of myopia in Xiamen and Longyan were similar; both cities showed a higher proportion of myopic cases than Fuzhou. The proportion of girls with myopia was higher than boys. The proportion of primary and middle school students with myopia was higher in economically developed regions compared with underdeveloped regions. The proportion of urban students with myopia was higher than in suburban students. Analysis showed that the prevalence of myopia increased with age. Interestingly, the prevalence of myopia was higher in children born in June and August than in children born in other months. CONCLUSION: Children and adolescents in Fujian have a high rate of myopia which increases as the school grade increases. The better the economic conditions are, the higher the myopic rate. In addition, the myopic rate is higher in girls in and students born in June and August. The government, schools, hospitals, and parents should be alerted to this issue and coordinate to control the risk of myopia exacerbation and improve eyesight conditions of students in Fujian Province.

Association Between Myopia and Primary Open-Angle Glaucoma by Race and Ethnicity in Older Adults in the California Medicare Population.

Importance: Racial and ethnic differences in the association between myopia and primary open-angle glaucoma (POAG) are not well understood. Objective: To investigate the association between myopia and POAG in the 2019 California Medicare population and to investigate whether there was evidence of effect measure modification of this association by race and ethnicity. Design, Setting, and Participants: This cross-sectional study used administrative claims data from 2019 California Medicare beneficiaries 65 years or older with California residence and active coverage with Medicare parts A and B. Analysis took place between October 2021 and October 2023. Exposures: The primary exposure was myopia, which was defined by International Statistical Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis codes. Main Outcomes and Measures: The outcome of interest was POAG, which was defined by ICD-10-CM code. Results: Of 2 717 346 California Medicare beneficiaries in 2019, 1 440 769 (53.0%) were aged 65 to 74 years, 1 544 479 (56.8%) identified as female, 60 211 (2.2%) had myopia, and 171 988 (6.3%) had POAG. Overall, 346 723 individuals (12.8%) identified as Asian, 117 856 (4.3%) as Black, 430 597 (15.8%) as Hispanic, 1 705 807 (62.8%) as White, and 115 363 (4.2%) as other race and ethnicity. In adjusted logistic regression analyses, beneficiaries with myopia had higher odds of POAG compared with beneficiaries without myopia (odds ratio [OR], 2.41; 95% CI, 2.35-2.47). In multivariable models stratified by race and ethnicity, the association between myopia and POAG was stronger in Asian (OR, 2.74; 95% CI, 2.57-2.92), Black (OR, 2.60; 95% CI, 2.31-2.94), and Hispanic (OR, 3.28; 95% CI, 3.08-3.48) beneficiaries compared with non-Hispanic White beneficiaries (OR, 2.14; 95% CI, 2.08-2.21). Conclusions and Relevance: In the 2019 California Medicare population, myopia was associated with greater adjusted odds of POAG. This association was stronger among Asian, Black, and Hispanic beneficiaries compared with non-Hispanic White beneficiaries. These findings suggest possible disparities in glaucoma risk by race and ethnicity in individuals with myopia and may indicate greater need for glaucoma screening in individuals with myopia from racial and ethnic minority backgrounds.

Healthcare utilization and economic burden of myopia in urban China: A nationwide cost-of-illness study.

Background: China contributes to a significant proportion of the myopia in the world. The study aims to investigate the utilization of various correction methods and health service in urban China, and to estimate the cost of myopia treatment and prevention. In addition, we aimed to estimate the cost of productivity loss due to myopia. Methods: The study was a cross-sectional investigation carried out in urban areas in three provinces located in the east (Shanghai), middle (Anhui) and west part (Yunnan) of China, in 2016. A total of 23819 people aged between 5 to 50 years were included. Health utilization and the cost of myopia were analyzed from patients' perspective. Results: The total number of people with myopia in the urban China was estimated to be 143.6 million. The correction rate was 89.5%, 92.1%, and 92.7% for Anhui, Shanghai, and Yunnan (χ2 = 19.5, P < 0.01). Over the recent year, 20.6%, 16.8%, and 28.8% of myopic subjects visited hospital due to myopia, in Anhui, Shanghai and Yunnan. The annual cost of treatment and prevention of myopia was 10.1 billion US dollar (US$, floating from 9.2 to 11.2 billion US$), and the cost per person was 69US$. The annual cost of loss of productivity was estimated to be 6.7 billion US$ for those with mild to moderate visual impairment (floating from 6.1 to 7.4 billion US$), and 9.4 billion US$ (floating from 8.5 to 10.4 billion US$) for those with severe visual impairment to blindness. Therefore, the total economic burden of myopia was estimated as 173.6 billion CNY (26.3 billion US$). Conclusions: The present study shows that myopia leads to substantial economic burden in China. The loss of productivity caused by myopia is an important part of the disease burden compared to the cost of correction and treatment paid by individuals. Therefore, the focus of myopia prevention and control should be to decrease the myopia prevalence, and prevent the uncorrected refractive errors and the irreversible damage of visual acuity by high myopia.

Physical Activity Spaces Not Effective against Socioeconomic Inequalities in Myopia Incidence: The Generation R Study.

SIGNIFICANCE: Our findings show that non-Dutch background, lower maternal education, and lower net household income level may be new risk factors for myopia development in the Netherlands. Newly introduced physical activity spaces may not be effective enough in increasing outdoor exposure in children to reduce eye growth. PURPOSE: The aims of this study were to evaluate socioeconomic inequalities in myopia incidence, eye growth, outdoor exposure, and computer use and to investigate if newly introduced physical activity spaces can reduce eye growth in school-aged children. METHODS: Participants (N = 2643) from the Dutch population-based birth cohort Generation R were examined at ages 6 and 9 years. Socioeconomic inequalities in myopia incidence, eye growth, and lifestyle were determined using regression analyses. Information on physical activity spaces located in Rotterdam was obtained. Differences in eye growth between those who became exposed to new physical activity spaces (n = 230) and those nonexposed (n = 1866) were evaluated with individual-level fixed-effects models. RESULTS: Myopia prevalence was 2.2% at age 6 years and 12.2% at age 9 years. Outdoor exposure was 11.4 h/wk at age 6 years and 7.4 h/wk at age 9 years. Computer use was 2.1 h/wk at age 6 years and 5.2 h/wk at age 9 years. Myopia incidence was higher in children with non-Dutch background, and families with lower household income and lower maternal education (odds ratio [OR], 1.081 [95% confidence interval, 1.052 to 1.112]; OR, 1.035 [95% confidence interval, 1.008 to 1.063]; OR, 1.028 [95% confidence interval, 1.001 to 1.055], respectively). Children living <600 m of a physical activity space did not have increased outdoor exposure, except those from families with lower maternal education (ß = 1.33 h/wk; 95% confidence interval, 0.15 to 2.51 h/wk). Newly introduced physical activity spaces were not associated with reduction of eye growth. CONCLUSIONS: Children from socioeconomically disadvantaged families became more often myopic than those from socioeconomically advantaged families. We did not find evidence that physical activity spaces protect against myopia for the population at large, but subgroups may benefit.

Socioeconomic mechanisms of myopia boom in China: a nationwide cross-sectional study.

OBJECTIVES: To assess the association between socioeconomic development and the myopia boom in China. DESIGN: Nationwide cross-sectional study. SETTING: We used data from the China Family Panel Study (CFPS 2010), and the Chinese National Survey on Students' Constitution and Health (CNSSCH 2010). PARTICIPANTS: Participants included 33 600 individuals and 14 226 families from the CFPS 2010, and 86 199 students aged 7-12 years from the CNSSCH 2010. MEASURES: The main measure was students' visual impairment (defined as Snellen visual acuity ≤20/25 (0.8) in the worse eye) rate of each province (or municipality or autonomous region); other measures included the Gini coefficient of property, logarithm of average property, Gini coefficient of education, average education duration and return-to-education rate of each province (or municipality or autonomous region). The visual impairment rate was calculated using students' data, aged 7-12 years, from the CNSSCH 2010. The Gini coefficient of property and logarithm of average property were calculated using the families' data from the CFPS 2010; the Gini coefficient of education, average education duration and return-to-education rate were calculated using individuals' data aged 18-44 years from the CFPS 2010. RESULTS: The urban environment (coefficient: 0.209; p<0.001), Gini coefficient of property (coefficient: 1.979; p=0.005), logarithm of average property (coefficient: 0.114; p<0.001), average education duration (coefficient: 0.041; p<0.001) and return-to-education rate (coefficient: 0.195; p<0.001) were positively associated with the logit function of visual impairment rate. CONCLUSIONS: Economic development may promote an increased desire to pursue wealth. Regarding high return to education and a fairly competitive education system, individuals are likely to pursue wealth through education, which is associated with a heavier education burden and higher prevalence rates of myopia.

[Prevention and control of myopia needs to integrate the cultural and social-economic spatiotemporal factors among children and adolescents in China].

The high incidence of myopia in children and adolescents has become an important public health issue. There is still a debate about the priority between genetic and environmental factors of myopia, which makes researchers realize that the related research on the prediction index of myopia natural process and the effective methods of prevention and control still lags behind the social demand. Therefore it needs innovative thinking and a deep understanding of the role of the changes of the times, reduce learning and screen time under low natural light and artificial lighting, at the same time increase daytime outdoor activities, so as to provide new strategies and actions for the prevention and control of myopia among children and adolescents in China.

Visual impairment and unmet eye care needs among a Syrian pediatric refugee population in a Canadian city.

OBJECTIVE: To assess the ocular health status of Syrian pediatric refugees in Canada and report the prevalence of vision impairment within this population. DESIGN: Cross-sectional descriptive study. PARTICIPANTS: Syrian refugees 18 years old or younger. METHODS: Five clinic days were organized from July 2016 to November 2017 in Toronto, Ontario. A total of 274 patients were enrolled. Data collection involved surveys, vision screening, and ocular examinations. χ2 was used for statistical analysis. RESULTS: The prevalence of uncorrected vision was 17.2% for distance, 4.7% for near, and 0.7% for both distance and near vision, including loss of vision. Of these, 95.3% had not visited an eye specialist in the past year, and 25.2% of parents were dissatisfied with their children's vision. The presenting visual acuity in the better-seeing eye was 20/50 or worse in 5.8% (95% confidence interval [CI] 3.6%-9.3%), and this did not correct with pinhole. This rate is 32 times (p < 0.01) higher than the prevalence rate in the average Canadian pediatric population (0.17%). Uncorrected refractive error prevalence was 26.3% (95% CI 21.2%-31.9%), with the most common etiology being myopia (19.7% CI 15.2%-24.9%). Myopia was 17.9 times (p < 0.0001) more prevalent among our Syrian refugee children compared with the average Canadian pediatric population (1.1%). CONCLUSION: Syrian pediatric refugees residing in Canada have a high prevalence of vision problems. Comprehensive vision screening, improved access to eye clinics, and developing evidence-based guidelines may help address the unmet eye care needs of this vulnerable population.

The Increasing Burden of Myopia in Israel among Young Adults over a Generation: Analysis of Predisposing Factors.

PURPOSE: To determine the trends in prevalence of myopia in Israeli young adults over approximately a generation, as well as associated factors and variation in the impact of these factors on myopia prevalence in this region over time. DESIGN: Retrospective, cross-sectional study. PARTICIPANTS: One hundred four thousand six hundred eighty-nine consecutive persons 16 to 19 years of age born between 1971 and 1994 who had not yet enlisted in the Israeli Army but had completed the medical profiling process. METHODS: Using data collected at a north Israel recruitment center, the prevalence of myopia over time was estimated, and a polynomial regression analysis was performed to assess significance of nonlinear trends. Associations of demographic and socioeconomic factors with myopia were assessed, and trends over time were analyzed using a factorial logistic regression. MAIN OUTCOME MEASURES: The primary outcome measure was factors associated with the prevalence of myopia over time. The secondary outcome measure was a description of the change in prevalence of myopia over time. RESULTS: The prevalence of myopia increased 1.284-fold over 24 years from 20.4% among participants born between 1971 and 1982 to 26.2% among participants born between 1983 and 1994. A quite similar increase was observed among males (from 17.9% to 22.7%, respectively) and females (from 23.9% to 30.8%, respectively). The factors found to be associated with myopia were as follows: more recent date of birth, female gender, more years of education, being the eldest child, non-Israeli ethnic origin, and urban residence. However, there were significant trends over time in the effects of some of these factors, most notably an attenuation of the difference between participants of different religions in the recent birth-years period. Most of these associations and trends were observed in both males and females separately, with some gender-specific variations. Immigrants from Ethiopia who were raised in Israel were highly more likely to demonstrate myopia than those who arrived at an older age. CONCLUSIONS: This study demonstrated an increase in the prevalence of myopia and the possible associations of urbanization- and higher education-related factors among several subpopulations and the risk for myopia developing.

Assessment of total corneal power after myopic corneal refractive surgery in Chinese eyes.

PURPOSE: To develop a new regression formula based on the Gaussian thick lens formula and to verify the accuracy of the regression formula. METHODS: In this prospective study, 207 eyes of 207 myopic subjects and 133 eyes of 67 postoperative subjects were included. For the 133 postoperative eyes, 127 eyes underwent laser-assisted in situ keratomileusis, and 6 eyes underwent photorefractive keratectomy. Subjective refraction and Pentacam HR were performed preoperatively and postoperatively, and IOLMaster was performed in the postoperative group. SimK, keratometry based on the Gaussian optic formula (KGOF), KCHM obtained using the clinical history method, and the regression formulas KRF1 and KRF2 were calculated. RESULTS: (1) A statistically significant difference (t = 155.164, P = 0.000) between SimK and KGOF of 1.24 ± 0.12 D was observed, and there was a good correlation between SimK and KGOF (r = 0.996, P = 0.000). The first regression formula (KRF1 = 0.351 + 1.021 × KGOF) was obtained using linear regression. (2) Statistically significant differences (t = 19.114, - 25.184, 4.702, and all P = 0.000) between SimK and KCHM, KGOF and KCHM and KRF1 and KCHM of 0.75 ± 0.45 D, 0.96 ± 0.44 D and 0.18 ± 0.43 D, respectively, were obtained. Good correlations between SimK and KCHM, KGOF and KCHM and KRF1 and KCHM (all r ≧ 0.977, all Ps = 0.000) were also observed. The regression formula (KRF2 = - 1.204 + 1.027 × KRF1) was obtained using linear regression. (3) Six methods were used for the prediction of IOL power in the postoperative group. The highest results were obtained from the Shammas formula (without preoperative data) combining Km (obtained by IOLMaster) followed by the KCHM and KRF2 combining Haigis formula. The third was obtained from the KCHM and KRF2 combining Hoffer Q formula; and the smallest was the Km combining Haigis formula. CONCLUSION: The IOL power predicted by KRF2 in eyes after myopic CRS may be accurate.

The assessment of retina in pregnant women with myopia.

OBJECTIVES: Myopia is associated with increased frequency of retinal degenerative changes which are the risk factors of intra- and postpartal ophthalmological complications. Aim of this study was to analyze the degenerative lesions detected in opthalmological examination (including peripheral retinal lesions) as a potential risk factors for eyes' status in terms of delivery in myopic women. MATERIAL AND METHODS: 254 pregnant women affected with myopia underwent opthalmological examination as a screening method to examine retina. In case of any degenerative lesions, the qualification for laser photocoagulation treatment was performed. Furthermore, study group was divided into two subgroups due to presence or absence of the retinal lesions and opthalmological outcomes compared. Follow up examination was performed in every patient from the study group between 3 and 6 months after the delivery. RESULTS: Among 508 eyes, retinal lesions were revealed in 69 women (121 eyes) what constituted for 23.8%. In remaining 185 patients results of the opthalmological examination were normal. Average maternal age was higher in group affected with degenerative lesions (p<0.001). Myopia in women with retinal lesions ranged between -0.25 and -12 dioptries (D), while in 43 cases of degenerative lesions qualified for laser photocoagulation this value ranged between -0.5 and -12.0 D (p=ns). Postpartal follow-up examination did not reveal any abnormalities in this group, as well. CONCLUSION: Degenerative retinal lesions are present in one fourth of pregnant women. Both the severity and type of the lesions are not associated with severity of myopia. Among pregnant patients, retinal lesions occur in patients with more advanced maternal age. opthalmological examination remains an important prophylactic modality in retinal disorders, especially in primary retinal detachment due degenerative disorders.

[Epidemiology of myopia]. / Epidemiologie der Myopie.

BACKGROUND: Myopia is the most common cause for impaired vision in children and young adults with increasing tendency. Although myopia is hereditary, genetic findings do not explain the full extent of its recent increase. Epidemiologic studies are required to investigate the prevalence and incidence of this disease. OBJECTIVES: The prevalence, incidence and progression of myopia with its economic impact are emphasized to review the distribution and consequences of the development and progression of myopia. METHODS: A systematic literature search was conducted in MEDLINE. RESULTS: The global prevalence of myopia is currently 28.3 % and is dramatically increasing. In 2050, half of the world population will be affected. Myopia starts earlier and exhibits a peak prevalence in young Asian adults. High myopia indicates a similar development. Interventions to slow the development and progression of myopia are strongly required due to the medical and socio-economic drawbacks for the individuals and for society. CONCLUSION: Myopia is already a ubiquitous phenomenon in some parts of the world. One out of ten persons will be at a relevant risk of becoming blind as a result of myopia in the future. Preventive measures have not shown sweeping success.

Prevalence of spectacles use in Andhra Pradesh, India: rapid assessment of visual impairment project.

BACKGROUND: To assess the prevalence and patterns of spectacles use in South India state of Andhra Pradesh. DESIGN: A population-based cross sectional study. PARTICIPANTS: Seven thousand eight hundred subjects aged ≥40 years, sampled from one urban and two locations. METHODS: Two-stage cluster random sampling method was used to enumerate 7800 subjects. Distance visual acuity and near vision were assessed. A questionnaire was used to collect information on current and previous use of spectacles, spectacles providers and type of spectacles. Among those who discontinued use of spectacles, the reasons were elicited. MAIN OUTCOME MEASURES: The prevalence of spectacles use and spectacle coverage. RESULTS: In total, 7378/7800 subjects (95.0%) were examined. Among those examined, 53.6% were female, 49.5% of them aged between 40 and 49 years, and 62% of them had no education. The overall prevalence of spectacles use was 29.5% (95% confidence interval 28.5-30.4), 30.3% (95% confidence interval 29.0-31.6) in rural area compared with 27.9% (95% confidence interval 26.1-29.7) (P < 0.05) in urban location. Bifocals (72.8%) were the most common type of spectacles. Private eye clinics were the leading spectacles provider in all three regions. On applying multiple logistic regression, the odds of spectacles use increased with increasing age and were significantly higher for rural residents and those with higher levels of education. The spectacle coverage was 38.0% and 27% for refractive errors and presbyopia, respectively. CONCLUSIONS: Although prevalence of spectacles use is moderate, the spectacle coverage for both refractive errors and presbyopia is low. The strategies are required to improve the spectacle coverage in the region.

Myopia, an underrated global challenge to vision: where the current data takes us on myopia control.

Myopia is the most frequent cause of distance impairment in the world and is creating an alarming global epidemic with deleterious ramifications for the quality of life and economic health of individuals and nations as a whole. In addition to being immediately disadvantageous, myopia increases the risk of serious disorders such as myopic macular degeneration, retinal detachment, glaucoma, and cataract and is a leading cause of visual impairment and blindness across many countries. The reduction in age of onset of myopia is of great concern since the earlier the onset, the more myopic the individual will become, with all the attendant increased risks of accompanying debilitating eye conditions. The economic burden is great; both in consequences of uncorrected refractive error and also in the provision of devices for correcting visual acuity. Earlier onset of myopia increases the lifetime economic burden related to loss of productivity and independence, leading to a reduced quality of life. Recent data suggest addressing accommodation per se has little direct amelioration of myopia progression. Pharmacological interventions that effect changes in the sclera show promising efficacy, whereas optical interventions based on a myopic shift in the retinal image are proving to effect up to 55% reduction in the rate of progression of myopia. Early contact lens and spectacle interventions that reduce the rate of progression of myopia are able to significantly reduce the burden of myopia. These non-pharmacological interventions show profound promise in reducing the overall associated morbidity of myopia.

The economic cost of myopia in adults aged over 40 years in Singapore.

PURPOSE: To estimate the economic cost of myopia among adults aged 40 years and older in Singapore. METHODS: A substudy of 113 Singaporean adults aged 40 years and older with myopia (spherical equivalent refraction of at least -0.5 diopters) in the population-based ancillary study of Singapore Chinese Eye Study (SCES) was conducted. A health expenditure questionnaire was used to assess the direct cost of myopia. RESULTS: A total of 113 (90.4%) of 125 myopic subjects participated in the survey. The mean cost was approximately SGD$900 (USD$709) per person per year. The lifetime per capita cost ranged from SGD$295 (USD$232) for those with 0 year's duration to SGD$21,616 (USD$17,020) for those with 80 years' duration. Costs of spectacles, contact lenses, and optometry services were the major cost drivers, contributing to an average of 65% of total costs. Seven subjects (6.2%) had undergone LASIK surgery, resulting in a cost of SGD$4891 (USD$3851) per patient per year. Three subjects (2.7%) reported annual costs of (SGD$33 or USD$26) for complications due to LASIK surgery or contact lenses. There was an increasing cost of myopia in adults who started to wear glasses at earlier ages. By applying our cost data to age-specific myopia prevalence data in the whole population in the country, the total cost was estimated to be approximately SGD$959 (USD$755) million per year in Singapore. CONCLUSIONS: Myopia is associated with substantial out-of-pocket expenditure, imposing considerable economic burden for patients. Myopia is a disorder with immense societal costs and public health impact.

Economic inequality in presenting near vision acuity in a middle-aged population: a Blinder-Oaxaca decomposition.

PURPOSE: To investigate economic inequality and its determinants in near vision, in a middle-aged population. METHODS: In this population-based study, the presenting near vision in the better eye was investigated as the main outcome. If this vision revealed a value ≥1.6 M, the participant was considered to have presenting near vision impairment (PNVI). The effect of variables studied on PNVI was investigated using logistic regression. Economic inequality in PNVI was investigated using the Oaxaca-Blinder decomposition method. RESULTS: PNVI in the better eye was observed in 18.2% (95% CI 16.8 to 19.6) of participants. The prevalence of PNVI in the high and low economic groups was 11.7% (95% CI 10.3 to 13.0) and 28.5% (95% CI 26.0 to 31.0), respectively. Age and education were observed as the main factors in the explained portion of this gap and were in favour of the high economic group. Gender and eye care utilisation were factors affecting the unexplained portion of this gap and were in favour of the low economic group. CONCLUSIONS: Economic inequality plays a significant role in PNVI, while age and education are among the main factors affecting this gap. The effect caused by any change in these two factors was found to have a greater effect on women with low economic status.

Lack of awareness of common eye conditions in the community.

PURPOSE: Awareness of eye conditions aids health promotion activities and leads to better outcomes. We examined factors influencing the lack of awareness of common eye conditions in a population. METHODS: The Singapore Malay Eye Study examined 3280 (78.7% response) Malays aged 40-80 years. We included 2112 (64.4%) participants with at least one of five eye conditions: 1504 (71.2%) with cataract, 1013 (47.8%) with myopia, 270 (12.8%) with diabetic retinopathy, 181 (8.6%) with age-related macular degeneration and 150 (7.1%) with glaucoma. Lack of awareness was defined in the questionnaire as not answering "yes" to previously being told by a doctor of having the eye condition. RESULTS: Among 2112 participants, 83.2% were unaware of at least one of their eye conditions. After controlling for age, sex and socioeconomic factors, participants unaware of their eye condition were older (odds ratio, OR, 1.03, per 1 year, p < 0.001), had better visual acuity (OR 1.32, p = 0.04), lower education (OR 1.89, p < 0.001), poorer literacy (OR 1.44, p = 0.02), lower income (OR 1.73, p = 0.009), higher blood glucose (OR 1.08, per 1 mmol/L, p < 0.001), higher serum cholesterol (OR 1.20, per 1 mmol/L, p = 0.003), lower annual eye examination attendance (OR 2.08, p < 0.001) and were less likely to wear glasses (OR 2.90, p < 0.001) than those who were aware of their condition. CONCLUSIONS: In this community-based population, 80% of those with common eye conditions were unaware of their condition.

Assessment of daily light and ultraviolet exposure in young adults.

PURPOSE: There are some limited reports based on questionnaire data that suggest that outdoor activity decreases the risk of myopia in children and may offset the myopia risk associated with prolonged nearwork. The aim of this study was to explore the relationship between nearwork, indoor illumination, daily sunlight, and UV exposure in emmetropic and myopic university students-given that university students perform significant amounts of nearwork and, as a group, have a high prevalence of myopia. METHODS: Participants were 35 students, aged 17 to 25 years, who were classified as being emmetropic (n = 13) or having stable (n = 12) or progressing myopia (n = 10). During waking hours on three separate days, participants wore a light sensor data logger (HOBO) and a polysulfone UV dosimeter; these devices measured daily illuminance and accumulative UV exposure, respectively. Participants also completed a daily activity log. RESULTS: No significant between-group differences were observed for average daily illuminance (p = 0.732), number of hours per day spent in sunlight (p = 0.266), outdoor shade (p = 0.726), bright indoor/dim outdoor light (p = 0.574), or dim room illumination (p = 0.484). Daily UV exposure was significantly different across the groups (p = 0.003), with stable myopes experiencing the greatest UV exposure (vs emmetropes, p = 0.002; versus progressing myopes, p = 0.004). CONCLUSIONS: The current literature suggests that there is a link between myopia protection and spending time outdoors in children. Our data provide some evidence of this relationship in young adults and highlight the need for larger studies to further investigate this relationship longitudinally.