Amplitude of Accommodation in Schoolchildren.

PURPOSE: Hofstetter's equations are based on studies of Amplitude of Accommodation (AA) with methodological limitations, particularly in the case of children younger than 10 years of age. The aim of this study is to evaluate AA by age, gender, economic status, and time of day as well as accommodative insufficiency prevalence. METHODS: A cross-sectional study was conducted with 867 schoolchildren aged 6-16 years attending two public schools in the urban area of the South Brazilian city of Pelotas. Subjective refraction was performed using a monocular fogging method to standard end point of maximum plus for best visual acuity (20/25). AA was assessed using the push-up method. RESULTS: The median AA value was 14.3D (P25 13.3-P75 16.7) among children aged 6-16 years, being 15.5D (P25 14.3D-P75 16.7) among children aged 6-10 years, 14.2D (P25 12.5D-P75 15.4) among 11-13-year-olds, 13.3D (P25 12.5D-P75 15.4) among children aged 14-15 and 12.9D (P25 11.1D-P75 14.3) among those aged 16. AA variability was 2.4D in those aged 6-8, 3.4D in children aged 9-12, and 2.9D in those aged 13-16. There was no significant difference in median AA according to gender, time of examination, or economic status; 2.8% of children showed AA of less than 2D lower than Hofstetter's minimum reference value. CONCLUSIONS: This study reports AA in a large sample of children and therefore may contribute to current knowledge on AA norms. In order to avoid the impact of outliers, it proposes the use of the median and percentiles to define AA standards by specific age. A set of studies using precise AA measurement and large sample size are needed to determine clinical standards for AA.

Moderate hyperopia prevalence and associated factors among elementary school students.

Hyperopia is the most common refractive condition in childhood. There are few studies on moderate hyperopia and associated factors. This study aims to investigate the prevalence of moderate hyperopia and associated factors among school children. A cross-sectional study comprising 1,032 students attending 1st to 8th grades at two public schools was conducted in a Southern Brazilian urban area in 2012. Cycloplegia was used to examine both eyes and refractive error was measured through auto-refraction. A socioeconomic and cultural questionnaire was administered. Multivariable analysis was performed through Poisson regression. Moderate hyperopia prevalence was 13.4% (95% CI, 11.2-15.4) and 85% of these did not wear glasses. Age was inversely associated with moderate hyperopia, while female gender RP = 1.39 (95%CI, 1.02 - 1.90) and white skin RP = 1.66 (95%CI, 1.04 - 2.66) were risk factors for this outcome. This study makes progress in estimating mild and moderate hyperopia prevalence both by age range and specific age. It emphasizes how the lack of this condition being corrected in southern Brazil is a serious problem. It highlights the importance of detailing and characterizing the amount of time spent on close-range, long-range and outdoor activities.

Moderate hyperopia prevalence and associated factors among elementary school students / Prevalência de hipermetropia e fatores associados em escolares do ensino fundamental

Hyperopia is the most common refractive condition in childhood. There are few studies on moderate hyperopia and associated factors. This study aims to investigate the prevalence of moderate hyperopia and associated factors among school children. A cross-sectional study comprising 1,032 students attending 1st to 8th grades at two public schools was conducted in a Southern Brazilian urban area in 2012. Cycloplegia was used to examine both eyes and refractive error was measured through auto-refraction. A socioeconomic and cultural questionnaire was administered. Multivariable analysis was performed through Poisson regression. Moderate hyperopia prevalence was 13.4% (95% CI, 11.2-15.4) and 85% of these did not wear glasses. Age was inversely associated with moderate hyperopia, while female gender RP = 1.39 (95%CI, 1.02 - 1.90) and white skin RP = 1.66 (95%CI, 1.04 - 2.66) were risk factors for this outcome. This study makes progress in estimating mild and moderate hyperopia prevalence both by age range and specific age. It emphasizes how the lack of this condition being corrected in southern Brazil is a serious problem. It highlights the importance of detailing and characterizing the amount of time spent on close-range, long-range and outdoor activities.

A hipermetropia é o estado refrativo mais comum na infância. Este estudo objetiva investigar a prevalência de hipermetropia moderada e fatores associados entre escolares, tendo em vista haver poucos estudos sobre o assunto. Métodos: Estudo transversal com 1.032 crianças do 1º ao 8º anos de duas escolas públicas da zona urbana de uma cidade do sul do Brasil, no período de abril a dezembro de 2012. Ambos os olhos foram cicloplegiados e o erro refrativo foi medido através de autorrefração. Foi aplicado questionário socioeconômico e cultural. A análise multivariada foi realizada utilizando a regressão de Poisson. Resultados: A prevalência de hipermetropia moderada foi de 13,4% IC95% (11,2% - 15,4%) e 85% deles não usam óculos. Idade ficou inversamente associada com hipermetropia moderada enquanto sexo feminino OR=1,39 IC95% (1,02 - 1,90) e cor de pele branca OR=1,66 IC95% (1,04 - 2,66) foram fatores de risco para o desfecho. Conclusão: Este estudo avança na estimativa de prevalência de hipermetropia leve e moderada por faixa etária e por idade específica, enfatizando o grave problema da falta de correção no sul do Brasil. O estudo destaca a importância de detalhar e caracterizar a quantidade de tempo gasto em atividades de longe e de perto e ao ar livre.

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.

Prevalência da doença de Chagas em gestantes da região sul do Rio Grande do Sul / Prevalence of Chagas disease among pregnant women in the southern region of Rio Grande do Sul

Anticorpos antiTrypanosoma cruzi no cordão umbilical de 351 parturientes da Cidade de Pelotas, RS foram pesquisados a fim de investigar a prevalência da doença de Chagas em gestantes. Um (0,3 por cento) caso foi identificado, não sendo detectada transmissão congênita. Salienta-se a importância da investigação da doença de Chagas em gestantes de zonas endêmicas ou provenientes destas.

Anti-Trypanosoma cruzi antibodies in the umbilical cord of 351 parturients in the city of Pelotas, Rio Grande do Sul were investigated to determine the prevalence of Chagas disease among pregnant women. One case was identified (0.3 percent), without detection of congenital transmission. This highlights the importance of investigating Chagas disease among pregnant women living in or originating from endemic areas.

[Shortage of ocular health care in the public system: a population-based study]. / Carência de atenção à saúde ocular no setor público: um estudo de base populacional.

This cross-sectional population-based study investigated the prevalence of eye care services utilization and the association with socioeconomic and demographic factors, need for health care, and type of service payment. The study evaluated 2,960 adults aged 20 and older. In the previous 5 years, 46% of the sample and 30% of those aged 50 and older had not visited an eye care service. Among the persons who used a service, 18% went to an optical store and only 17% used the public health system. The main reason for using eye care services was poor vision (69.5%). Lack of money (29%) and time (24.6%) were the most frequently cited reasons for non-utilization. Age, education, and economic status were directly associated with the outcome. Female gender, cataract, glaucoma, prescription eyewear, and private appointments were also associated with the outcome. It is necessary to increase the public health system's role, integrating ocular health with all levels of health care, expanding participation by other health professionals, and intensifying screening and prevention of eye problems.

Carência de atenção à saúde ocular no setor público: um estudo de base populacional / Shortage of ocular health care in the public system: a population-based study

Este estudo transversal de base populacional investigou a prevalência de utilização de serviços de saúde ocular e sua associação com fatores sócio-demográficos, necessidades em saúde e forma de financiamento da consulta. Avaliaram-se 2.960 indivíduos de 20 anos ou mais. Nos últimos cinco anos, 46 por cento dos entrevistados e 30 por cento daqueles com 50 anos ou mais não consultaram para os olhos. Dos que consultaram, 18 por cento foram em óticas, e apenas 17 por cento foram no setor público. O principal motivo foi não enxergar bem (69,5 por cento). Falta de dinheiro (29 por cento) e de tempo (24,6 por cento) foram os principais motivos para ter deixado de consultar. Idade, escolaridade e nível econômico estiveram diretamente associados com ter consultado nos últimos cinco anos. Ser mulher, ter catarata, glaucoma e usar correção, bem como consultar no setor privado também estiveram positivamente associados com o desfecho. É preciso não só aumentar a participação do setor público, integrando a saúde ocular a todos os níveis de atenção, ampliando a participação de outros profissionais de saúde, como também intensificar o rastreamento de problemas oculares e a sua prevenção.

This cross-sectional population-based study investigated the prevalence of eye care services utilization and the association with socioeconomic and demographic factors, need for health care, and type of service payment. The study evaluated 2,960 adults aged 20 and older. In the previous 5 years, 46 percent of the sample and 30 percent of those aged 50 and older had not visited an eye care service. Among the persons who used a service, 18 percent went to an optical store and only 17 percent used the public health system. The main reason for using eye care services was poor vision (69.5 percent). Lack of money (29 percent) and time (24.6 percent) were the most frequently cited reasons for non-utilization. Age, education, and economic status were directly associated with the outcome. Female gender, cataract, glaucoma, prescription eyewear, and private appointments were also associated with the outcome. It is necessary to increase the public health system's role, integrating ocular health with all levels of health care, expanding participation by other health professionals, and intensifying screening and prevention of eye problems.

[Prevalence of Chagas disease among pregnant women in the southern region of Rio Grande do Sul]. / Prevalência da doença de Chagas em gestantes da região sul do Rio Grande do Sul.

Anti-Trypanosoma cruzi antibodies in the umbilical cord of 351 parturients in the city of Pelotas, Rio Grande do Sul were investigated to determine the prevalence of Chagas disease among pregnant women. One case was identified (0.3%), without detection of congenital transmission. This highlights the importance of investigating Chagas disease among pregnant women living in or originating from endemic areas.