Accuracy and Utility of Self-report of Refractive Error

Cumberland, Phillippa; Chianca, Antonietta; Rahi, Jugnoo S

doi:10.1001/jamaophthalmol.2016.1275

Cited by 29 publications

(16 citation statements)

References 20 publications

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“…Finally, a limitation in this study worth mentioning is relying on subjects’ self-reports rather than specialist eye examinations. While professional ophthalmic evaluations would be ideal to obtain detailed information on refractive error, prior studies have suggested that subjects’ self-assessment of vision status does not differ systemically from professional ophthalmic evaluations [ 29 ]. Additionally, another reason for adopting self-reported measures is to allow for rapid and large-scale survey rollout [ 30 ], which would not have been feasible given the logistical and social-distancing requirements due to the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

Student Health Implications of School Closures during the COVID-19 Pandemic: New Evidence on the Association of e-Learning, Outdoor Exercise, and Myopia

Liu

Chen

et al. 2021

Healthcare

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The coronavirus disease 2019 (COVID-19) pandemic forced many education systems to consider alternative remote e-learning modalities, which have consequential behavioral and health implications for youth. In particular, increased e-learning engagement with digital screens and reduction in outdoor activities are two likely channels posing adverse risks for myopia development. This study investigated the association between e-learning screen use, outdoor activity, lighting condition, and myopia development among school-age children in China, during the first wave of the COVID-19 pandemic. Data were collected from 3405 school-age children attending primary, lower-secondary, and upper-secondary schools in China. Univariate parametric and nonparametric tests, and multivariate logistic regression analysis were used. Findings show that each diopter hour increase in daily e-learning screen use is significantly associated with progression of myopia symptoms (OR: 1.074, 95% CI: 1.058–1.089; p < 0.001), whereas engaging in outdoor exercise four to six times per week (OR: 0.745, 95% CI: 0.568–0.977; p = 0.034) and one to three times per week (OR: 0.829, 95% CI: 0.686–0.991; p = 0.048) is associated with a lower likelihood of myopia progression than none at all. In addition, we found that indoor lighting that is either “too dim” (OR: 1.686, 95% CI: 1.226–2.319; p = 0.001) or “too bright” (OR: 1.529, 95% CI: 1.007–2.366; p = 0.036) is significantly associated higher likelihood of myopic symptoms. Findings in this study uncover the less observable vision consequences of the COVID-19 pandemic on youths through digital online learning and highlight the importance of considering appropriate mitigation strategies to deal with this emerging public health challenge.

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Section: Discussionmentioning

confidence: 99%

Student Health Implications of School Closures during the COVID-19 Pandemic: New Evidence on the Association of e-Learning, Outdoor Exercise, and Myopia

Liu

Chen

et al. 2021

Healthcare

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“…The refractive error of an individual was calculated as the spherical equivalent (sphere power + 0.5 × cylinder power) averaged between the two eyes. 23 Sanfilippo et al 24 reported that lack of cycloplegia has minimal impact on population estimates of refractive error in individuals older than 20 years of age.…”

Section: Methodsmentioning

confidence: 99%

Effect of Education on Myopia: Evidence from the United Kingdom ROSLA 1972 Reform

Plotnikov

Williams²,

Atan³

et al. 2020

Invest. Ophthalmol. Vis. Sci.

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Purpose Cross-sectional and longitudinal studies have consistently reported an association between education and myopia. However, conventional observational studies are at risk of bias due to confounding by factors such as socioeconomic position and parental educational attainment. The current study aimed to estimate the causal effect of education on refractive error using regression discontinuity analysis. Methods Regression discontinuity analysis was applied to assess the influence on refractive error of the raising of the school leaving age (ROSLA) from 15 to 16 years introduced in England and Wales in 1972. For comparison, a conventional ordinary least squares (OLS) analysis was performed. The analysis sample comprised 21,548 UK Biobank participants born in a nine-year interval centered on September 1957, the date of birth of those first affected by ROSLA. Results In OLS analysis, the ROSLA 1972 reform was associated with a −0.29 D (95% confidence interval [CI]: −0.36 to −0.21, P < 0.001) more negative refractive error. In other words, the refractive error of the study sample became more negative by −0.29 D during the transition from a minimum school leaving age of 15 to 16 years of age. Regression discontinuity analysis estimated the causal effect of the ROSLA 1972 reform on refractive error as −0.77 D (95% CI: −1.53 to −0.02, P = 0.04). Conclusions Additional compulsory schooling due to the ROSLA 1972 reform was associated with a more negative refractive error, providing additional support for a causal relationship between education and myopia.

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“…Self-classification of myopia has been found to be reasonably reliable and provides lower-bound to any potential underestimation. 49 The possibility that some children may have had uncorrected refractive error may have led to an underestimation of the number of myopes. As a validation, the proportion of myopes in this study attending primary (< 13-years) and secondary school (13-18-years) was 15 and 26 per cent, respectively; comparable to the prevalence of myopia in schoolchildren reported in the recent Ireland Eye Study (12-13-years, 19.9 per cent) and to the UK NICER study (12-13-years, 16.4 per cent, 18-20-years, 18.6 per cent), so any underestimation is likely minimal.…”

Section: Limitations Of the Studymentioning

confidence: 99%

Smartphone use as a possible risk factor for myopia

McCrann

Loughman

Butler

et al. 2021

Clinical and Experimental Optometry

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Clinical relevance: This study demonstrates an association between myopia and smartphone data usage. Youths now spend more time participating in near tasks as a result of smartphone usage. This poses an additional risk factor for myopia development/progression and is an important research question in relation to potential myopia management strategies. Background: Children are now exposed to another possible environmental risk factor for myopiasmartphones. This study investigates the amount of time students spend on their smartphones and their patterns of smartphone usage from a myopia perspective. Methods: Primary, secondary and tertiary level students completed a questionnaire exploring patterns of smartphone usage and assessing their attitudes toward potential myopia risk factors. Device-recorded data usage over an extended period was quantified as the primary and objective indicator of phone use. Average daily time spent using a smartphone was also quantified by selfreported estimates. Refractive status was verified by an optometrist. Results: Smartphone ownership among the 418 students invited to participate was over 99-per cent. Average daily smartphone data and time usage was 800.37 ± 1,299.88-MB and 265.16 ± 168.02-minutes respectively. Myopic students used almost double the amount of smartphone data at 1,130.71 ± 1,748.14-MB per day compared to non-myopes at 613.63 ± 902.15-MB (p = 0.001). Smartphone time usage was not significantly different (p = 0.09, 12-per cent higher among myopes). Multinomial logistic regression revealed that myopic refractive error was statistically significantly associated with increasing daily smartphone data usage (odds ratio 1.08, 95% CI 1.03-1.14) as well as increasing age (odds ratio 1.09, 95% CI 1.02-1.17) and number of myopic parents (odds ratio 1.55, 95% CI 1.06-2.3). Seventy-three per cent of students believed that digital technology may adversely affect their eyes. Conclusion:This study demonstrates an association between myopia and smartphone data usage. Given the serious nature of the ocular health risks associated with myopia, our findings indicate that this relationship merits more detailed investigation.

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Accuracy and Utility of Self-report of Refractive Error

Cited by 29 publications

References 20 publications

Student Health Implications of School Closures during the COVID-19 Pandemic: New Evidence on the Association of e-Learning, Outdoor Exercise, and Myopia

Student Health Implications of School Closures during the COVID-19 Pandemic: New Evidence on the Association of e-Learning, Outdoor Exercise, and Myopia

Effect of Education on Myopia: Evidence from the United Kingdom ROSLA 1972 Reform

Smartphone use as a possible risk factor for myopia

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