A Nationwide Study of Myopia in Taiwanese School Children: Family, Activity, and School-Related Factors

Holton, Valerie; Hinterlong, James E.; Tsai, Ching Yao; Tsai, Jo Ting; Wu, Jia Shan; Liou, Yiing Mei

doi:10.1177/1059840519850619

Cited by 15 publications

(22 citation statements)

References 54 publications

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“…The characteristics of all included studies are shown in table 1 and in the appendix (pp 28-29). Ten (30%) studies 18,20,23,27,28,32,[35][36][37][38] met the criteria for inclusion in category one, ten (30%) studies 19,21,22,29,30,[39][40][41][42][43] for inclusion in category two (table 1), and 13 (39%) studies [44][45][46][47][48][49][50][51][52][53][54][55][56] for inclusion in category three (appendix pp [28][29]. Seven (70%) category one studies 18,20,23,27,28,32,35 and four (40%) category two studies 19,22,29,30 were included in the meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Seven (70%) category one studies 18,20,23,27,28,32,35 and four (40%) category two studies 19,22,29,30 were included in the meta-analysis. Risk of bias assessment with the JBI Critical Appraisal Checklists revealed the following sources of bias: the absence of valid or reliable measurement of exposure in all 33 studies; the absence of objective standard criteria for measurement of the condition in seven (21%) studies; 22,28,32,[36][37][38]42 no assessment of confounders in nine (27%) studies; 21,39,41,42,45,48,52,55,56 insufficient strategies for dealing with confounders in nine (27%) studies; 21,28,39,40,42,45,48,52,55 incomplete follow-up in three (9%) studies; 19,51,54 the absence of strategies to address incomplete follow-up in four (12%) studies; 19,35,51,54 and unclear reporting of whether participants were free from myopia at baseline in two (6%) studies. 32,…”

Section: Resultsmentioning

confidence: 99%

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Association between digital smart device use and myopia: a systematic review and meta-analysis

Foreman

Salim²,

Praveen³

et al. 2021

The Lancet Digital Health

139

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Background Excessive use of digital smart devices, including smartphones and tablet computers, could be a risk factor for myopia. We aimed to review the literature on the association between digital smart device use and myopia.Methods In this systematic review and meta-analysis we searched MEDLINE and Embase, and manually searched reference lists for primary research articles investigating smart device (ie, smartphones and tablets) exposure and myopia in children and young adults (aged 3 months to 33 years) from database inception to June 2 (MEDLINE) and June 3 (Embase), 2020. We included studies that investigated myopia-related outcomes of prevalent or incident myopia, myopia progression rate, axial length, or spherical equivalent. Studies were excluded if they were reviews or case reports, did not investigate myopia-related outcomes, or did not investigate risk factors for myopia. Bias was assessed with the Joanna Briggs Institute Critical Appraisal Checklists for analytical cross-sectional and cohort studies. We categorised studies as follows: category one studies investigated smart device use independently; category two studies investigated smart device use in combination with computer use; and category three studies investigated smart device use with other near-vision tasks that were not screen-based. We extracted unadjusted and adjusted odds ratios (ORs), β coefficients, prevalence ratios, Spearman's correlation coefficients, and p values for associations between screen time and incident or prevalent myopia. We did a meta-analysis of the association between screen time and prevalent or incident myopia for category one articles alone and for category one and two articles combined. Random-effects models were used when study heterogeneity was high (I²>50%) and fixed-effects models were used when heterogeneity was low (I²≤50%).Findings 3325 articles were identified, of which 33 were included in the systematic review and 11 were included in the meta-analysis. Four (40%) of ten category one articles, eight (80%) of ten category two articles, and all 13 category three articles used objective measures to identify myopia (refraction), whereas the remaining studies used questionnaires to identify myopia. Screen exposure was measured by use of questionnaires in all studies, with one also measuring device-recorded network data consumption. Associations between screen exposure and prevalent or incident myopia, an increased myopic spherical equivalent, and longer axial length were reported in five (50%) category one and six (60%) category two articles. Smart device screen time alone (OR 1•26 [95% CI 1•00-1•60]; I²=77%) or in combination with computer use (1•77 [1•28-2•45]; I²=87%) was significantly associated with myopia. The most common sources of risk of bias were that all 33 studies did not include reliable measures of screen time, seven (21%) did not objectively measure myopia, and nine (27%) did not identify or adjust for confounders in the analysis. The high heterogeneity between studies included in the meta-analys...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Association between digital smart device use and myopia: a systematic review and meta-analysis

Foreman

Salim²,

Praveen³

et al. 2021

The Lancet Digital Health

139

View full text Add to dashboard Cite

show abstract

“…This rapid increase in the prevalence of myopia among the young generation may lead to myopia becoming one of the main blinding causes in the future because high myopia is associated with myopic maculopathy [4] and an increase in glaucomatous optic neuropathy prevalence [5]. Although the causes of myopia remain unclear, numerous studies have suggested its development is caused by environmental and genetic factors [6,7].…”

Section: Introductionmentioning

confidence: 99%

Longitudinal association between myopia and parental myopia and outdoor time among students in Wenzhou: a 2.5-year longitudinal cohort study

Jiang

Lin

et al. 2021

BMC Ophthalmol

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Background To evaluate the impact of parental myopia and outdoor time on myopia among students in Wenzhou. Methods We examined 1388 primary students from first grade to third grade in Wenzhou from September 2012 to March 2015. We performed noncycloplegic refractometry on each student every six months and axial length (AL) measurements every year. At the commencement of our study, children were asked to complete a questionnaire regarding near work activity and outdoor activity, whereas parents were asked to complete a self-administered questionnaire regarding their background circumstances and their history of myopia. Results A total of 1294 students (93.2%) returned for follow-up examinations. Children with initial and final no myopia spent more time on outdoor activities than those with new onset myopia (1.92 vs. 1.81 h/d, p = 0.022), and elongation of AL in children with a high level (> 2.5 h/day) of outdoor time (0.22 ± 0.13 mm/Y) was less than those with a low level (≤ 1.5 h/day) of outdoor time (0.24 ± 0.14 mm/Y, p = 0.045). The proportion of rapid myopia progression (≤-0.5D/Y) was 16.7%, 20.2% and 31.5% among the children with no myopic parent, one myopic parent and two myopic parents, respectively (X2 = 28.076, p < 0.001), and the elongation of AL in children among different numbers of myopic parents was significantly different (p < 0.001). A high level of outdoor time was a protective factor for children with one myopic parent (HR 0.49, 95% CI 0.27–0.88; p = 0.018). Conclusions In this sample, parental myopia and outdoor time were associated with myopia in children. A high level of outdoor time was a protective factor for children with one myopic parent.

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“…Children aged 7-9 who read two or more books a week run a three times higher risk of myopia as compared to those children who read two or fewer books a week [21,22]. Children aged 12-13 who hold a book at a distance equal to 29 cm or less when reading run 2.5 times higher risk of myopia; uninterrupted reading that lasts for longer than 30 minutes results in 1.5 times higher risks of myopia [21]; 6-year old children who work at a short distance from objects for more than 1 hour a day run 1.26 times higher risk of myopia [23]. However, if we take into account other significant factors (such as belonging to a specific ethnic group, for example), we should specify that intensity is a leading factor and not a period of time spent working at a short distance from objects.…”

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confidence: 99%

Analysis of risk factors that cause myopia in pre-school children and primary school students

Тарутта¹,

Проскурина²,

Na³

et al. 2019

Health Risk Analysis

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The article summarizes literature data on significant risk factors that cause myopia in children; it also dwells on an algorithm that can be applied by ophthalmologists, pediatricians, family doctors, and medical optometrists to determine risk groups as per myopia, to accomplish dynamic observation, and to implement medical and prophylaxis activities aimed at its prevention. A hereditary factor in myopia development is considered to be the most significant one. There are also several other significant factors such as refraction being greater than +0.75 diopter at an age 6-10; an anterior-posterior axis of the eye being longer than 23.5 mm; pseudo-myopia; relative accommodation resources being lower than 1.0 diopter; axial length over cornea radius ratio (AL/CR) being higher than 3; accommodative convergence over accommodation ratio (AC/A) being higher than 4 pr.diopter / diopter; relative peripheral hypermetropia and off-axis refraction asymmetry when the nasal side of the eye is higher than the temporal one. We paid special attention to influences exerted by the environment and urbanization. High educational and social status of a family results in elevated risks of myopia. We also spotted out several risk factors that could be eliminated; they were hypodynamia under great visual loads and a period of time spent outdoors being shorter than 10 hours a week. Reliable preventive measures include parents' control over visual activities of a child; imposing limits on visual loads; outdoor activities for not less than 10-14 hours a week; physical exercises and doing some sports; home training to improve accommodation; correction aimed at compensating peripheral hypermetropia and /or inducing myopic defocus; local medical treatment. Early detection of risk factors and direct or indirect influence on them allow preventing myopia or postponing its development for an older age; it results in lower frequency of significant myopia and reduces a number of complicated and severe myopia cases.

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A Nationwide Study of Myopia in Taiwanese School Children: Family, Activity, and School-Related Factors

Cited by 15 publications

References 54 publications

Association between digital smart device use and myopia: a systematic review and meta-analysis

Association between digital smart device use and myopia: a systematic review and meta-analysis

Longitudinal association between myopia and parental myopia and outdoor time among students in Wenzhou: a 2.5-year longitudinal cohort study

Analysis of risk factors that cause myopia in pre-school children and primary school students

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