Capturing myopia and hypermetropia ‘phenotypes’ without formal refraction

Abstract

Purpose Understanding genetic and environmental factors that together contribute to the development of myopia is an international research priority. We have investigated the feasibility and accuracy of identifying and classifying refractive error, without formal refraction, as a means of easily identifying affected individuals in a large-scale, non-ophthalmological, and population-based survey. Methods At age 44/45 years, members of the 1958 British birth cohort underwent a biomedical, community survey. Refractive error (autorefraction) was measured and categorised by spherical equivalent (SE) measurement; myopia (SE of À1.00 or more extreme), hypermetropia ( þ 1.00 or more extreme), or emmetropia (À0.99 to þ 0.99). Lenses of prescribed distance glasses, if worn, were assessed as minifying, magnifying, or making no difference to a standard viewed image and cohort members reported on 'short' or 'long' sightedness. Results A total of 2499 cohort members, randomly selected, had formal refraction (autorefraction) and 917 (36.7%) of these individuals had their prescribed distance glasses examined. Sensitivities for myopia and hypermetropia using examination of glasses were over 80% and positive predictive values were 95 and 65% respectively whereas self-report of 'short-sightedness' or 'long-sightedness' had poor accuracy. Conclusion We suggest examination of prescribed distance glasses can be an effective method of 'screening' for refractive error in the field, especially where prevalence is high.

Validity of noncycloplegic refraction in the assessment of refractive errors: the Tehran Eye Study

“…Given that there are many studies that have used noncycloplegic techniques for studies on both children and adults, including large studies such as the Avon Longitudinal Study of Parents and Children (Williams et al. 1996) and the British Birth Cohort studies (Cumberland et al. 2007, 2008), an important question is whether noncycloplegic refractions can be adjusted to give an accurate cycloplegic refraction.…”

An investigation into the validity of self‐reported classification of refractive error

“…Previous population‐based studies have determined familial refractive error status using objective or subjective refraction, in‐person interview and questionnaire responses . While subjective refraction is considered the gold standard it is time‐consuming and expensive . Questionnaire administration can decrease both the cost and the time taken to collect data .…”

“…[5][6][7][8] While subjective refraction is considered the gold standard 1 it is time-consuming and expensive. 9 Questionnaire administration can decrease both the cost and the time taken to collect data. 1 However, use of this method without validation may result in erroneous conclusions.…”

An Ecologic Study of Trends in the Prevalence of Myopia in Chinese Adults in Singapore Born from the 1920s to 1980s

“…37 Examining prescribed distance glasses like GUSTO showed a good sensitivity (80%) and specificity (89%). 38 The Singapore Malay Eye Study (populationbased, cross-sectional study), examined 2912 adults aged 40 to 80 years, and found that people with uncorrected myopia who do not wear spectacles was 4.5%. 39 We project that the rates of self-reported myopia in our study may be underestimated by approximately 4% and thus the true myopia rates are slightly higher.…”