Ocular manifestations in a cohort of 43 patients with KBG syndrome.

Ophthalmological conditions are underreported in patients with KBG syndrome, which is classically described as presenting with dental, developmental, intellectual, skeletal, and craniofacial abnormalities. This study analyzed the prevalence of four ophthalmological conditions (strabismus, astigmatism, myopia, hyperopia) in 43 patients with KBG syndrome carrying variants in ANKRD11 or deletions in 16q24.3 and compared it to the literature. Forty-three patients were recruited via self-referral or a private Facebook group hosted by the KBG Foundation, with 40 of them having pathogenic or likely pathogenic variants. Virtual interviews were conducted to collect a comprehensive medical history verified by medical records. From these records, data analysis was performed to calculate the prevalence of ophthalmological conditions. Out of the 40 participants with pathogenic or likely pathogenic variants, strabismus was reported in 9 (22.5%) participants, while astigmatism, myopia, and hyperopia were reported in 11 (27.5%), 6 (15.0%), and 8 (20.0%) participants, respectively. Other reported conditions include anisometropia, amblyopia, and nystagmus. When compared to the literature, the prevalence of strabismus and refractive errors is higher than other studies. However, more research is needed to determine if variants in ANKRD11 play a role in abnormal development of the visual system. In patients with established KBG syndrome, screening for misalignment or refractive errors should be done, as interventions in patients with these conditions can improve functioning and quality of life.

Analysis of 2-year spherical equivalent progression in emmetropic children with non-cycloplegic refraction: a retrospective chart review.

BACKGROUND: We aimed to investigate children with an emmetropic non-cycloplegic refraction (NCR) to compare the difference in progression of NC spherical equivalent (SE) over 2 years between the children with emmetropic and hyperopic cycloplegic refraction (CR) values. METHODS: Through a retrospective medical record review, 59 children aged under 10 years were evaluated. Refractive error was calculated as the average of the SE values of both eyes. According to the CR results, children with emmetropia (-0.50 to 1.00 diopter [D]) were assigned to group 1 (n = 29), and those with hyperopia (≥ 1.00 D) were assigned to group 2 (n = 30). The prevalence of myopia and SE progression were compared over 2 years. Correlations between final SE progression and baseline age and refractive error were analyzed and multiple regression analysis was conducted. Receiver operating characteristic curves that achieved the best cutoff points to distinguish between the groups were calculated. RESULTS: Group 1 showed significantly myopic SE changes compared to baseline at the 1-year follow-up, and group 1 was significantly myopic compared with group 2 at the 2-year follow-up. Myopia prevalence was 51.7% in group 1 and 6.7% in group 2 after 1 year, and 61.1% and 16.7% after 2 years, respectively. In the correlation analysis, baseline age, baseline CR, and difference between CR and NCR showed significant correlations with the 2-year SE progression (r = -0.359, p = 0.005; r = 0.450, p < 0.001; r = -0.562, p < 0.001, respectively). However, NCR refractive error showed no significant correlation (r = -0.097, p = 0.468). In multiple regression analysis, baseline age (ß= -0.082), and CR-NCR difference (ß= -0.214) showed a significant effect on SE progression for 2 years. When an NCR value of 0.20 D was set as the cut-off value to distinguish between the groups, a sensitivity of 70% and specificity of 92% were obtained. CONCLUSION: Even if NCR showed emmetropia, children with baseline CR values of emmetropia showed greater SE progression compared with those with hyperopia. Cycloplegia is essential to confirm the correct refractive status in children. It may be useful for predicting prognosis of SE progression.

High prevalence of refractive errors in an elderly population; a public health issue.

PURPOSE: To determine the prevalence of myopia and hyperopia and their associated demographic and ocular factors in people 60 years of age and above. METHODS: The sampling was performed using a multi-stage stratified random cluster sampling method. The complete demographic and case history information were collected through an interview. Then, all participants underwent optometric examinations including measurement of uncorrected and best-corrected visual acuity, objective, and subjective refraction. Myopia and hyperopia were defined as a spherical equivalent (SE) refraction worse than -0.50 diopters (D) and + 0.50 D, respectively. RESULTS: Three thousand three hundred ten of 3791 invitees participated, and the data of 3263 individuals were analyzed for this report. The mean age of participants was 68.25 ± 6.53 (60 to 97) years, and 1895 (58.1%) of them were female (number of male/female participants = 1368/1895). The prevalence of myopia and hyperopia was 31.65% (95% CI: 29.68 -33.61) and 45.36% (95% CI: 43.36 -47.37), respectively. The prevalence of severe myopia and hyperopia was 1.14% (95% CI: 0.73 -1.55) and 2.27% (95% CI: 1.57 -2.97), respectively. Based on the results of multiple logistic regression, the prevalence of myopia had a statistically significant direct relationship with age (OR: 1.04; p < 0.001), history of glaucoma surgery (OR:2.75; p < 0.001), pseudophakia (OR: 2.27; p < 0.001), axial length (OR:3.05; p < 0.001), and mean keratometry (OR:1.61; p < 0.001). The education level was significantly inversely related to the myopia prevalence. Moreover, a history of glaucoma surgery (OR:0.44; p < 0.001), pseudophakia (OR = 0.15; p < 0.001), axial length (OR:35; p < 0.001) and mean keratometry (OR:0.62; p < 0.001) were significantly inversely related to the prevalence of hyperopia. 19% and 40.02% of myopic and hyperopic patients had complete visual acuity after correction of refractive error, respectively. CONCLUSION: The prevalence of refractive errors was high in the Iranian elderly population. A large percentage of the elderly still did not have complete visual acuity after the correction of refractive errors indicating the necessity for attention to other ocular diseases in this age group. The history of cataract and glaucoma surgery could be associated with a myopic shift of refractive error.

Systemic and Ophthalmic Manifestations in Different Types of Refractive Errors in Patients with Down Syndrome.

Background and Objective: This study aims to investigate the prevalence of systemic and ophthalmic manifestations in different refractive groups in children and young adults with Down syndrome (DS). Materials and Methods: The study was a population-based, cross-sectional study that included 141 Caucasian children and young adults with DS. They were classified into the following three groups: myopia DS group (37 subjects, mean age 15.8 years), emmetropia DS group (41 subjects, mean age 11.7 years) and hyperopia DS group (63 subjects, mean age 10.9 years). The participants underwent inspection, slit-lamp examination, cycloplegic refraction, ocular alignment and ocular motility examination. Ten systemic manifestations were analyzed. Results: There was no difference in the prevalence of any systemic manifestations between the groups. Considering the ophthalmic manifestations, there was statistical difference in the distribution of proportions among the three groups for nystagmus (p = 0.011), iris-stromal atrophy (p = 0.048) and strabismus (p = 0.031). The prevalence of strabismus in our DS myopia group was 35.1%, and in DS hyperopia group 38.1%. Conclusions: The results of our study suggest that DS children and young adults with any refractive error do not have a higher chance of additional systemic manifestations. Myopia in DS was associated with a higher prevalence of nystagmus and iris stromal atrophy, whereas astigmatism was found to be more frequent in hyperopia.

[Cohort study on the association between hyperopia reserve and myopia incidence in primary school students: the Anyang Childhood Eye Study].

Objective: To analyze the longitudinal association between hyperopia reserve and the cumulative incidence of myopia in grade 1 primary school students. Methods: Cohort study. This study included 2 628 grade 1 primary school students (2 628 eyes) who without myopic at baseline from the Anyang Childhood Eye Study. There were 1 515 male and 1 113 female, aged(7.16±0.40) years. Every year, cycloplegic autorefraction was performed with 1% cyclopentolate eye drops to obtain data of hyperopia reserve. Students with different ranges of hyperopia reserve at baseline were analyzed. Axial length, anterior chamber depth, corneal curvature, lens thickness, and other parameters were obtained by ocular biometrics and compared by the independent sample t test. Qualitative data were described by frequency and percentage, and comparison between groups was performed by the Chi-square test or exact probability method. Linear regression was used to analyze the association between baseline hyperopia reserve and spherical equivalent at 5 years. Results: The average hyperopia reserve was (+1.09±0.78) diopters (D) in grade 1 non-myopic children. Axial length, anterior chamber depth, corneal radius of curvature, and lens thickness were (22.66±0.72), (2.88±0.24), (7.80±0.25) and (3.62±0.19) mm, respectively. The cumulative incidence of myopia among non-myopic grade 1 primary school students was 8.5%, 21.5%, 35.6%, 47.6% and 64.1% at 1, 2, 3, 4 and 5 years, respectively. The incidence of myopia in girls was significantly higher than that in boys at 3, 4 and 5 years. The 5-year cumulative incidence of myopia was 4.6%, 26.3%, 52.3%, 78.6%, 92.6% and 94.3%, respectively, corresponding to students with baseline hyperopia reserve of >+2.00 D,+1.50 D to +2.00 D,+1.00 D to +1.50 D,+0.50 D to +1.00 D, 0.00 D to +0.50 D and -0.50 D to 0.00 D, and the difference was statistically significant (χ²=490.59, P<0.001). The regression equation between baseline hyperopia reserve and 5-year spherical equivalent was as follows: 5-year spherical equivalent=-3.135+1.692·baseline hyperopia reserve (R2=0.454, P<0.001). Conclusions: The lower the hyperopia reserve, the higher the incidence of myopia. Monitoring children's hyperopia reserve and early protection to reduce its consumption and timely detection of children at high risk of myopia are of great significance to prevent the occurrence and development of myopia.(This article was published ahead of print on the Online-First Publishing Platform for Excellent Scientific Researches of Chinese Medical Association Publishing House on March 15, 2022).

Longitudinal analysis of axial length growth in a German cohort of healthy children and adolescents.

PURPOSE: To generate continuous growth curves for axial length (AL) in German children. We hypothesise that percentile curves of AL can be used as a predictive measure of myopia. METHODS: In this longitudinal and cross-sectional LIFE Child Study, children's non-cycloplegic refraction data was collected using the Zeiss i.Profiler plus while AL was measured using the Haag-Streit Lenstar. Reference growth curves were estimated as a continuous non-parametric function of age. RESULTS: Data from 4511 visits of 1965 participants (1021 boys and 944 girls) between 3 and 18 years of age were analysed. For all ages and percentiles, the estimated AL was higher in boys than girls. AL differences between boys and girls were most pronounced in the 98th percentile at 3 years of age, being 0.93 mm longer eyes in boys. This difference decreased to 0.21 mm at 18 years of age. While the lower percentiles of AL reach their final value around age 13, the 50th percentile was still increasing by 0.05 mm per year until the end of the observation period. While, in general, children with longer eyes are more likely to develop myopia, this relationship is weaker between the ages of 5 and 8. CONCLUSION: The LIFE Child Study data provides European AL data. In both Germany and China, AL has comparable growth rates when the baseline ALs are compared as percentiles. Thus, percentile curves of AL can be used as a predictive measure for the likelihood of developing as well as the progression of myopia.

Prevalence and risk factor for refractive error in rural Chinese adults in Kailu, Inner Mongolia.

PURPOSE: To investigate the prevalence of refractive error in adults 40 years of age and older in Kailu, Inner Mongolia. METHODS: A population-based, cross-sectional study was conducted in Chinese adults. Spherical equivalent (S.E.) refractive error was determined from the right eye. Myopia and hyperopia were defined as a spherical equivalent (S.E.) < -0.5 dioptres (D) and >0.5 D, respectively. Since the prevalence of high myopia will vary with the precise criterion chosen, the prevalence of this condition was calculated for thresholds of both <-5.0 D and <6.0 D. Astigmatism was defined as cylinder power >0.5 D. Anisometropia was defined as a difference in S.E. between the two eyes >1.0 D. RESULTS: The prevalence of myopia, high myopia (<-5.0 D/<-6.0 D) and hyperopia in Kailu adults was 60.3% (95%CI: 58.95-61.71), 5.5% (95%CI: 4.82-6.10) /4.0% (95%CI: 3.47-4.57) and 12.2% (95%CI: 11.26-13.11), respectively. The age- and gender-standardised prevalence of myopia, high myopia (-5.0 D/-6.0 D) and hyperopia were 62.5% (95%CI: 61.05-63.99), 5.0% (95%CI: 4.34-5.61) /3.5% (95%CI: 2.99-4.04) and 10.6% (95%CI: 9.71-11.49), respectively. 52.9% had refractive astigmatism >0.5 D and 18.8% of subjects had clinically significant anisometropia. Age was significantly associated with hyperopia, high myopia, astigmatism and anisometropia. Myopia was more prevalent in females. Individuals with a higher educational level had a greater and lesser likelihood of myopia and astigmatism, respectively. CONCLUSIONS: Myopia affects around two-thirds of the rural Chinese population over 40 years of age in Kailu. This high prevalence highlights that rural populations should be included in epidemiological studies of refractive error. Further investigations are needed to clarify the role of environmental factors in myopia development.

Prevalence, Characteristics, and Risk Factors of Moderate or High Hyperopia among Multiethnic Children 6 to 72 Months of Age: A Pooled Analysis of Individual Participant Data.

PURPOSE: To describe the prevalence, ocular characteristics, and associated risk factors of moderate to high hyperopia in early childhood. DESIGN: Pooled analysis of individual participant data from population-based studies. PARTICIPANTS: Six- to 72-month-old multiethnic children who participated in 4 population-based studies of pediatric eye diseases. METHODS: The pooled studies conducted comparable parental interviews and ocular examinations including cycloplegic autorefraction. Presence of hyperopia was defined based on cycloplegic refractive error in the worse eye. Multivariate analyses were performed to evaluate the association of potential risk factors with hyperopia risk. MAIN OUTCOME MEASURES: Prevalence and odds ratios of moderate to high hyperopia (≥4.0 diopters [D]). RESULTS: Cycloplegic refraction was completed in 15 051 children 6 to 72 months of age. Among these children, the overall prevalence of moderate to high hyperopia (≥4.0 D) in the worse eye was 3.2% (95% confidence interval, 2.9%-3.5%), accounting for 15.6% of all hyperopia (≥2.0 D). Among children with moderate to high hyperopia, both eyes were affected in 64.4%, 28.9% showed spherical anisometropia of 1.0 D or more, and 19.5% showed astigmatism of 1.5 D or more. Among 36- to 72-month-old children with moderate to high hyperopia, 17.6% wore glasses. Prevalence of moderate to high hyperopia was slightly less in 12- to 23-month-old children and was relatively stable in children 24 months of age and older. Non-Hispanic and Hispanic white race and ethnicity, family history of strabismus, maternal smoking during pregnancy, and being a participant in the United States studies were associated with a higher risk of moderate to high hyperopia (P < 0.05). CONCLUSIONS: By assembling similarly designed studies, our consortium provided robust estimates of the prevalence of moderate to high hyperopia in the general population and showed that in 6- to 72-month-old children, moderate to high hyperopia is not uncommon and its prevalence does not decrease with age. Risk factors for moderate to high hyperopia differ from those for low to moderate hyperopia (2.0-<4.0 D) in preschool children, with family history of strabismus and maternal smoking during pregnancy more strongly associated with moderate to high hyperopia than low to moderate hyperopia.

Prevalence of refractive errors; an evidence from the public high schools of Lahore, Pakistan.

OBJECTIVE: To assess the magnitude of refractive errors among high school children. METHODS: The cross-sectional, descriptive study was conducted from April to August 2017 in four public-sector high schools in Lahore, Pakistan. Using multistage simple random sampling, all public sector high schools of the city were initially included. Screening of refractive errors was managed on the school premises. Data was collected on a pre-tested, structured questionnaire. SPSS 23 was used for data analysis. RESULTS: There were 1000 subjects with an overall mean age of 13.78±1.72 years (range: 10-18 years). Refractive errors were present in 244(24.4%) and myopia 127(52%) was the major type of refractive error followed by astigmatism 93(38.1%) and hypermetropia 24(9.8%). Differece in the prevalence of refractive errors in urban and rural settings was significant (p=0.00002). CONCLUSIONS: Uncorrected refractive errors were present in a considerable segment of public-sector high school students of Lahore.

Refractive Error in a Sample of Black High School Children in South Africa.

SIGNIFICANCE: This study focused on a cohort that has not been studied and who currently have limited access to eye care services. The findings, while improving the understanding of the distribution of refractive errors, also enabled identification of children requiring intervention and provided a guide for future resource allocation. PURPOSE: The aim of conducting the study was to determine the prevalence and distribution of refractive error and its association with gender, age, and school grade level. METHODS: Using a multistage random cluster sampling, 1586 children, 632 males (40%) and 954 females (60%), were selected. Their ages ranged between 13 and 18 years with a mean of 15.81 ± 1.56 years. The visual functions evaluated included visual acuity using the logarithm of minimum angle of resolution chart and refractive error measured using the autorefractor and then refined subjectively. Axis astigmatism was presented in the vector method where positive values of J0 indicated with-the-rule astigmatism, negative values indicated against-the-rule astigmatism, whereas J45 represented oblique astigmatism. RESULTS: Overall, patients were myopic with a mean spherical power for right eye of -0.02 ± 0.47; mean astigmatic cylinder power was -0.09 ± 0.27 with mainly with-the-rule astigmatism (J0 = 0.01 ± 0.11). The prevalence estimates were as follows: myopia (at least -0.50) 7% (95% confidence interval [CI], 6 to 9%), hyperopia (at least 0.5) 5% (95% CI, 4 to 6%), astigmatism (at least -0.75 cylinder) 3% (95% CI, 2 to 4%), and anisometropia 3% (95% CI, 2 to 4%). There was no significant association between refractive error and any of the categories (gender, age, and grade levels). CONCLUSIONS: The prevalence of refractive error in the sample of high school children was relatively low. Myopia was the most prevalent, and findings on its association with age suggest that the prevalence of myopia may be stabilizing at late teenage years.

Prevalence of Refractive Errors in the INK Area, Durban, South Africa.

PURPOSE: To determine the prevalence and types of refractive errors in persons aged 35 years and older in the Inanda, Ntuzuma, and KwaMashu (INK) area of Durban, KwaZulu-Natal Province, South Africa. METHODS: Refractive error data were obtained by autorefraction (Retinomax K-Plus; Nikon, Tokyo, Japan), retinoscopy, and subjective refraction. Refractive error was defined using spherical equivalents as myopia (<-0.5D) and hyperopia (>+0.5D). Astigmatism was defined as cylinder equal to or greater than -0.5D in either eye. RESULTS: Participants' ages ranged from 35 to 90 years, with a mean of 53.05 ± 11.4 years. Women comprised 75% of the subjects. The prevalence of refractive error was 57.3%, with myopia 11.4%, hyperopia 37.7%, and astigmatism 25.7%. Myopia and astigmatism were significantly more prevalent in men (p < 0.01), whereas hyperopia was more prevalent in women (p < 0.01). Hyperopia was significantly associated with education (p < 0.01), whereas myopia and astigmatism were not (p = 0.09 and p = 0.15, respectively). CONCLUSIONS: Approximately 57.3% of the population 35 years and older in the INK area of Durban were affected by refractive errors, with myopia, hyperopia, and astigmatism being significantly associated with sex. This study suggests that there is a need for interventions to alleviate refractive error in the INK area as well as in other communities affected by the lack of access to affordable services.

Correlation Between Near-Vision Acuity and the Incidence of Peritoneal Dialysis-Related Infections.

Peritoneal dialysis (PD)-related infections (PDIs) such as peritonitis, exit-site infection, and tunnel infection are serious complications affecting patients on PD. Because patients with diabetes (DM) and of older age have increased in number in Japan, the number of patients with visual impairment is estimated also to have increased. Near vision is necessary for performing proper PD daily care. However, no studies have reported whether visual impairment is likely to increase the risk of PDIs.Our study included 31 PD patients (16 men, 15 women; mean age: 61.5 ± 11.8 years; mean PD duration: 27.3 ± 20.3 months; 38.7% with DM; 54.8% wearing glasses) who performed their own PD care. At our facility and related facilities, we used a standard near-vision test chart, which classifies vision into 12 grades, from 0.1 (poor) to 1.5 (clear), to assess near-vision binocular visual acuity in those patients between March 2015 and September 2015. In addition, we retrospectively examined the medical records of the patients to determine their history of PDIs. We then evaluated the correlation between near-vision acuity and the incidence of PDIs.Mean measured near-vision acuity was 0.61 ± 0.29, and we observed no significant difference in the visual acuity of patients with and without DM (0.55 ± 0.31 vs. 0.63 ± 0.26 respectively, p = 0.477). In addition, we observed no significant difference in the incidence of PDIs between patients with and without DM (1.298 ± 1.609 per year vs. 1.164 ± 0.908 per year respectively, p = 0.804). We did not find a correlation between near-vision acuity and the incidence of PDIs (r = -0.071, p = 0.795).

Eyeglasses for Children - a Survey of Daily Practice.

BACKGROUND: Glasses for children are recommended and prescribed by different groups of professionals. We set out to compare the prescription practices of ophthalmologists, orthoptists and optometrists/opticians in Switzerland. METHODS: Online questionnaire on the prescription and recommendation of glasses in fictitious cases of children of different ages, refractive values and symptoms. The questionnaire was sent out to members of the Swiss Ophthalmological Society, Swiss Orthoptics and Schweizerischer Berufsverband für Augenoptik und Optometrie. RESULTS: 307 questionnaires were analysed. Optometrists/opticians recommended glasses with a significantly smaller cycloplegic refraction value (p < 0.005) than did orthoptists and ophthalmologists. In the example of a 14-year-old asymptomatic child, ophthalmologists recommended glasses at + 2.64 [Dpt], orthoptists at + 2.44 [Dpt] and optometrists/opticians at + 1.32 [Dpt]. Optometrists/opticians tended to recommend slightly higher correction values in glasses than did ophthalmologists and orthoptists. CONCLUSION: In Switzerland, optometrists/opticians recommend glasses with significantly smaller cycloplegic refraction values than do orthoptists and ophthalmologists, regardless of age or symptoms described in these fictitious cases.

[Clinical Findings in Patients with Non-Arteritic Anterior Ischemic Optic Neuropathy (NA-AION) Under 50 Years of Age]. / Klinische Befunde bei Patienten mit nicht arteriitischer anteriorer ischämischer Optikusneuropathie (NAION) unter 50 Jahren.

BACKGROUND: The aim of our study was to determine the prevalence of NA-AION patients younger than 50 years among all our NA-AION patients and to compare clinical findings between young and elderly NA-AION patients. METHODS: This was a retrospective review of complete ophthalmic examinations, including fluorescein angiography and visual field testing, performed on all patients with the first attack of acute NA-AION admitted to our department during the period of ten years (2004 to 2013). Of 120 NA-AION patients, 10 (8.3 %) were under 50 years of age. RESULTS: The majority of these were men: 8 of 10 (80 %). The average best corrected visual acuity on admission was 0.34 (fingers counted up to 1.0) and on discharge 0.53 (fingers counted up to 1.0). Of 10 eyes, 6 were emmetropic and 4 hyperopic, from + 0.50 D to + 2.0 D. Aside from the clinical picture of AION, other ophthalmological findings were normal. In fluorescein angiography, typical changes for ischaemic optic neuropathy were observed in all patients. In a majority of patients, an inferior altitudinal visual field defect was found. As regards systemic risk factors, hyperlipidaemia was observed in 7, arterial hypertension in 3, diabetes mellitus without diabetic retinopathy in 3, and ischaemic heart disease in 1 of 10 patients. One patient was treated for rheumatoid arthritis without signs of vasculitis. In 3 patients, more than one systemic risk factor was observed. Two of our patients had no systemic risk factors except moderate hyperopia. Bilateral manifestation was observed only in one patient 8 months after the first attack. None of the patients experienced recurrent attacks. CONCLUSION: The prevalence of younger patients in our study was lower than in previous studies. The reason could be the better medical prevention in our region. Our study confirmed that even in young NA-AION patients, moderate hyperopia could be a predisposing factor. Our study did not confirm the differences between young and elderly NA-AION patients as observed in previous studies. During a period of 10 years, we did not observe recurrences, high risk of other eye involvement or severe vision loss in our young patients compared to the elderly.

[Analysis of the influence factors of school-age children's refractive status].

Objective: To analyze the influence of the eye biological parameters, height, and weight on the school-age children's refractive status. Methods: Cross-sectional study. A total of 1 656 children (1 656 eyes), aged from 7 to 14 years, were selected from 8 schools in Wenzhou during June 2012 and June 2013. The height and weight of each child were measured, and the body mass index (BMI) was calculated. The eye biological parameters, including axial length (AL), corneal power (C=1/CR), anterior chamber depth (ACD), and white to white (WTW), were measured by IOLMaster (version 5.0, Carl Zeiss, Germany), and the AL/CR was calculated. Refraction was measured by fast cycloplegic retinoscopy, and the spherical equivalent (SE) was calculated. Only right eyes were included in the analysis. SPSS16.0 was used to analyze the data. The correlations of the equivalent spherical power, the eye biological parameters, height, weight, and BMI were evaluated. Linear regression analysis was used for the SE, AL, and AL/CR. Results: The prevalence of myopia in 7- to 14-year-old school-age children was 50.2% on the average, 48.4% in boys, and 51.7% in girls. The average SE was (-1.07±1.74) D. With adjustment of the age, gender, urban and rural areas, there was an association between the SE and AL, AL/CR, ACD, height and weight. The correlation coefficient was -0.663, -0.730, -0.416, -0.365, and -0.281, respectively (P<0.05). There was no significant correlation between the SE and WTW, corneal power and BMI. Regarding the different refractive statuses, there was a stronger correlation between the SE and AL, AL/CR in children with hyperopia, moderate myopia or high myopia than those with emmetropia or mild myopia (P< 0.01). In the older children, the correlation between the SE and AL, AL/CR was stronger. Linear regression analysis showed SE= 26.55-9.11·AL/CR and 23.0-1.02·AL. Conclusions: There was an association between the SE and AL, AL/CR, ACD, height and weight in school-age children. In children with hyperopia, moderate myopia, high myopia or at an older age, the correlation was more significant between the SE and AL, AL/CR. (Chin J Ophthalmol, 2016, 52:831-835).

The incidence and clinical characteristics of adult-onset convergence insufficiency.

OBJECTIVE: The purpose of this study was to describe the clinical characteristics and natural history of convergence insufficiency (CI) in a population-based cohort of adults. DESIGN: Retrospectively reviewed population-based cohort. PARTICIPANTS: Adult (age ≥19 years) residents of Olmsted County, Minnesota. METHODS: The medical records of all adults diagnosed with CI over a 20-year period were reviewed retrospectively. MAIN OUTCOME MEASURES: Clinical characteristics and outcomes for adult-onset CI. RESULTS: A total of 118 adults (annual incidence, 8.44 per 100 000 patients older than 19 years) were diagnosed with CI during the 20-year period, constituting 15.7% of all forms of adult-onset strabismus observed in this population. The median age at diagnosis was 68.5 years (range, 21.7-97.1 years), and 68 (57.6%) were female. The mean initial exodeviation at near was 14.1 prism diopters (PD; range, 1-30 PD) and 1.7 PD (range, 0-10 PD) at distance. The Kaplan-Meier rate of exotropia increasing over time by 7 PD or more at near was 4.2% at 5 years, 13.5% at 10 years, and 24.4% at 20 years. Approximately 88% were managed with prisms, whereas less than 5% underwent surgical correction. CONCLUSIONS: Adult-onset CI included approximately 1 in 6 adults who were newly diagnosed with strabismus in this 20-year cohort. There was a significant increase in incidence with increasing age. Nearly one-fourth had an increase of their near exodeviation of at least 7 PD by 20 years after their diagnosis, and most patients were managed conservatively.

Hyperopia: a meta-analysis of prevalence and a review of associated factors among school-aged children.

BACKGROUND: Studies show great variability in the prevalence of hyperopia among children. This study aimed to synthesize the existing knowledge about hyperopia prevalence and its associated factors in school children and to explore the reasons for this variability. METHODS: This systematic review followed PRISMA guidelines. Searching several international databases, the review included population- or school-based studies assessing hyperopia through cycloplegic autorefraction or cycloplegic retinoscopy. Meta-analysis of hyperopia prevalence was performed following MOOSE guidelines and using the random effects model. RESULTS: The review included 40 cross-sectional studies. The prevalence of hyperopia ranged from 8.4% at age six, 2-3% from 9 to 14 years and approximately 1% at 15 years. With regard to associated factors, age has an inverse association with hyperopia. The frequency of hyperopia is higher among White children and those who live in rural areas. There is no consensus about the association between hyperopia and gender, family income and parental schooling. CONCLUSION: Future studies should use standardized methods to classify hyperopia and sufficient sample size when evaluating age-specific prevalence. Furthermore, it is necessary to deepen the understanding about the interactions among hyperopic refractive error and accommodative and binocular functions as a way of identifying groups of hyperopic children at risk of developing visual, academic and even cognitive function sequelae.

A retinoscopic survey of 333 horses and ponies in the UK.

INTRODUCTION: Ophthalmic examination in the horse is generally limited to crude assessment of vision and screening for ocular lesions. The refractive state of equine eyes and the potential impact on vision and performance requires further investigation. OBJECTIVE: To assess the refractive state of a large, mixed-breed sample of horses and ponies in the United Kingdom (UK). PROCEDURE: The refractive state of both eyes of 333 horses and ponies was determined by streak retinoscopy, and the effect of age, height, gender, breed and management regime on the refractive state assessed. RESULTS: Emmetropia was found in 557 of 666 (83.63%) of eyes; 228/333 (68.5%) of the horses/ponies were emmetropic in both eyes. Refractive errors of greater than 1.50 D (in either direction) were found in 2.7% of the eyes tested. Ametropic eyes included hyperopia (54%) and myopia (46%). Anisometropia was found in 30.3% of horses and ponies. Breed of horse/pony was the only factor that affected refractive state (in the left eye only, P < 0.05) with Thoroughbred crosses having a tendency toward myopia and Warmbloods/Shires toward hyperopia. DISCUSSION AND CONCLUSION: The retinoscopic survey found emmetropia to be the predominant refractive state of the equine eye with no evidence of an overall trend toward myopia or hyperopia. However, individual and breed-related differences were found. Such factors should be considered in the selection of horses for sport and leisure, and when evaluating their performance potential. More comprehensive visual testing would be valuable in identifying underlying causes of behavioral problems.

[Distribution of refraction and ocular biometric parameters in a population of junior middle school children in Anyang of Henan province].

OBJECTIVE: To investigate the distribution of spherical equivalent and ocular biometric parameters in a population of grade 7 children in central China. METHODS: 2 363 grade 7 students of junior high schools were randomly sampled. The students have been examined at baseline and followed up annually. Detailed questionnaires and most of the ocular examinations were performed. Spherical equivalent (Seq) was calculated as sphere +1/2 cylinder from cycloplegic autorefraction. Myopia was defined as spherical equivalent ≤ -0.5D, hyperopia as spherical equivalent ≥ +0.5D and emmetropia between -0.5D and +0.5D. The Lensar LS900 was used to measure corneal curvatures, axial length and anterior chamber depth. Right eyes results were analyzed. RESULTS: Among 2 267 children who have the baseline examination, 1 839 children participated the follow up examination(response rate, 81.1%), with an mean age of 14.7 years (range, 12.9-17.6) and male ratio of 48.4%. The mean spherical equivalent refraction was (-2.62 ± 2.19)D. The prevalence rates of myopia, high myopia, emmetropia and hyperopia were 82.7%, 7.1%, 9.8% and 7.5%. The cumulative incidence rates of myopia and high myopia were 47.1% and 4.5% respectively. Axial length, anterior chamber depth, and corneal curvature were normally distributed. The mean axial length, anterior chamber depth, and corneal curvature were (24.8 ± 1.1)mm, (3.18 ± 0.25)mm, (42.8 ± 1.4)D and (43.9 ± 1.6)D respectively. Axial length was longer, anterior chamber depth was deeper, and corneal were flatter in the male(P = 0.000). Axial length and anterior chamber depth correlated negatively with refraction. CONCLUSIONS: A moderate myopic distribution of refraction was present in the grade 9 students in central China. The prevalence rates of myopia and high myopia were relatively high in this 14-year-old population compared to other countries. It is necessary to strengthen the prevention of juvenile myopia.

[Epidemiologic study of hyperopia in schoolchildren in Tunisia]. / Profit épidémiologique de l'hypermétropie en milieu scolaire primaire en Tunise: à propos de 6192 enfants.

AIM: To study the epidemiological profile and the degree of severity of hyperopia in Tunisia primary school and to assess its effect on school performance. METHODS: A cross-sectional, descriptive survey was conducted among 6-14 aged Tunisian children attending primary urban and rural schools. A total of 6192 children were selected using stratified random cluster sampling. Cycloplegic refractive error was measured among all children with uncorrected visual acuity less than 9/10 or signs of astheniopia. Hyperopia was defined as spherical equivalent (SE) 2.0 diopters (D). We have also searched a possible relation between degree of severity of hyperopia and school performance. RESULTS: The prevalence of hyperopia was 2.61%. The spherical equivalent mean was + 3.73 ± 0.94 D. The mean age was 9.67 ± 0.44 years. This prevalence was 2.77% in boys and 2.47% in girls. 3.13% of students were living in urban areas and 1.42% in rural areas. The hyperopia rate decreased significantly with age (p = 0.021), but it was not significantly related to gender (p=0.54). The difference in the prevalence of hyperopia between urban and rural areas was not statistically significant (p = 0.067). There was no significant association between the degree of severity of hyperopia and school performance (p=0.41). CONCLUSION: In our study, the prevalence of hyperopia among schoolage children in Tunisia was 2.61%.The identification of this refractive error and its correction as soon as possible would ensure these children better visual comfort and a better education.