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AIM: To analyze the clinical characteristics of acute acquired concomitant esotropia(AACE)in patients among different age groups.METHODS: Retrospective analysis of clinical data. A total of 112 non-Swan type AACE patients who underwent surgery at Peking University People's Hospital from January 2015 to December 2022 were retrospectively analyzed. Clinical data were collected and the characteristics were compared, including gender, age, diopter, duration of disease, daily time spent on near work, angles of deviation before and after surgery, stereopsis, etc. According to age, patients were divided into three groups: <18 years old group(22 cases), 18-45 years old group(67 cases), and >45 years old group(23 cases). The clinical characteristics of patients were compared in each group.RESULTS: A total of 112 patients were included in the study, comprising 56 males and 56 females, with a median age of 29.50(19.25, 41.75)years old. Among them, 97 patients had myopia(86.6%). There were 93 patients(83.0%)who spent more than 8 h on near work. The age group <18 years old had the shortest duration before surgery, with a median time of 1.00(0.50, 1.00)a, the minimum negative diopter, with a median diopter of -0.75(-3.19, -0.56)D in the right eye and the diopter of -1.25(-2.81, -0.75)D in the left eye, and the maximum preoperative near angle of deviation, with a median angle of 30.00(18.50, 80.00)PD, and the maximum preoperative distant angle of deviation, with a median angle of 35.00(23.75, 80.00)PD. All these differences were statistically significant compared with other two groups(both P<0.05). For the age group from 18 to 45 years old, the median near angle of deviation was 20.00(14.00, 30.00)PD, and the median distant angle of deviation was 25.00(20.00, 35.00)PD, both of which were higher than those in the age group >45 years old(both P<0.05). For the age group >45 years old, the median near angle of deviation after surgery was -4.50(-7.50, 0)PD, and the median distant angle of deviation after surgery was 4.50(0, 9.50)PD, which were smaller than those in other two groups(all P<0.05). The age group >45 years old had the hiughest surgical success rate(100%). The preoperative stereopsis was better in age group >45 years old than the group <18 years old(P<0.05). The postoperative stereopsis of the age group of 18 to 45 years old and the age group >45 years old was better than age group <18 years old(both P<0.05).CONCLUSION: Surgical patients with AACE are mainly in the age group from 18 to 45 years old. The characteristic of angle of deviation is that distant angle of deviation is greater than near angle of deviation. The patients <18 years old have larger preoperative angles of deviation than adults, while their stereoacuity is worse than adults in the early postoperative period. It is recommended that augmented-dose surgery should be performed in AACE patients who are in the age group of 18 to 45 years old(5-10 PD). A conservative surgery should be designed for hyperopia young children without established binocular vision.
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ObjectiveTo compare the changes of retinal microcirculation indexes in the anterior and posterior macular areas of the eyes used at close range and to explore the possible causes of myopia affected by near work. MethodsWatching mobile phone video for 1 hour at close range was used as the method of defining near work. The OCTA technology was used to measure the superficial retinal microcirculation indexes within 6 by 6 mm macular area before and after near work， including the superficial retinal VLD from the nerve fiber layer to the inner boundary of the outer plexiform layer， the VPD， nonperfusion area of FAZ， FAZ-P and FAZ circulation，. The FAZ was divided int center， inner layer， outer layer and overall according to the region， and 11 microcirculation indexes were obtained to compare the differences between before and after near work. ResultsThe indexes of superficial retinal microcirculation in the macular area generally decreased after near work， except for FAZ-A and FAZ-P（P = 0.148， 0.975）. The largest differences among both VLD and VPD occurred between the central and inner layer（Difference = 1.00， 0.80， 0.02， 0.02，P = 0.001， 0.008， 0.001， 0.008）. No differences in microcirculation indexs were observed in the macular area after near work with different diopters and axial lengths. ConclusionNear work may affect the occurrence and development of myopia by affecting the changes of retinal microcirculation in the superficial layer of macula， leading to ischemia and hypoxia.
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Purpose: The aim of this study was to determine the association of near work and dim light with myopia among school children in a district in North India. Methods: This study included a total of 1400 children of either sex studying in classes 5?10 in various schools of a district in North India, after taking consent from their guardians. Visual acuity was measured using Snellen’s chart. Myopes were called to our institute where wet retinoscopy was done and spectacles were prescribed. Results: There was a highly statistically significant correlation between myopia and increase in reading hours (P=0.001). There was a statistically significant correlation between myopia and >6hours of using mobile phones /week, more hours spent on using mobile phones correlated with an increased prevalence of myopia (P< 0.01). There was a statistically significant correlation between myopia and increasing hours of playing video games (P<0.01). We found a highly statistically significant positive correlation between the prevalence of myopia and reading in dim light (P=0.0006). Conclusion: There was a positive association between myopia and hours of doing near work. The prevalence of myopia increased with increased hours of doing near work (reading, playing video games and using mobile phones). The study showed a correlation between reading in dim light and myopia. Prevention of myopia may be possible by avoiding these risk factors.
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Purpose: To evaluate the causes of acute acquired comitant esotropia (AACE) in young adults and children in the setting of COVID?19?induced home confinement. Methods: A retrospective, clinical study of all patients, who presented to the Pediatric Ophthalmology and Strabismus services of a tertiary eye care center in South India from August 2020 to January 2021 during the COVID?19 pandemic, with acute?onset, comitant esotropia. Results: 11 (73.3%) of the total 15 patients were students, above 10 years and with a mean age of 16.8 years. 12 patients (80%) had more than 8 hours of near activity a day with a mean duration of 8.6 hours per day. The most common near activity was online classes, followed by job?related work and mobile games, and 86.7% used smartphones for near work. The average esotropia was 22.73 prism diopter (PD) for distance and 18.73 PD for near. Majority (66.6%) had hyperopia with basic or divergence insufficiency esotropia, and the remaining 33.3% had myopia and fitted in to the Bielschowsky type AACE. There was no precipitating event other than sustained near work in all, except in one patient who also had fever prior to the onset of esotropia. Conclusion: The habit of long?time and sustained near work, especially on smartphones, may increase the risk of inducement of AACE
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Juvenile myopia has become a serious public health problem in China, presenting rapidly increasing incidence and younger onset age.Refractive eye development is controlled by both genetic and environmental factors.In recent years, near work among environmental factors has become a hotspot in myopia risk factors research.However, the association between near work and myopia still remains controversial.In this article, the epidemiological studies on the relationship between near work content, total time spent on near work, intensity of near work and myopia, and its possible mechanisms (including near-work-induced transient myopia, accommodative lag and scleral hypoxia) were summarized, so as to provide reference for myopia epidemiology and etiology.
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Background:prevalence of refractive errors among medical students pursing higher studies is very high. Very little data about the prevalence of refractive errors among medical students in western Odisha is available. So, this Present study was undertaken with an objectivewere to estimate the prevalence of refractive errorsamong medical students of VIMSAR, Burla,Western Odisha, Indiaand to study the association between various risk factors with the prevalence of refractive errors.Methods:A cross-sectional study was conducted among undergraduates i.e. (from 1styear to final year) students of VIMSAR, Burla for a period of 2 months i.e.FebruarytoMarch 2020 with sample size of 200.A pre-designed, semi-structured questionnaire was prepared and distributed to students. To assess refractive errors among study population auto refractometer was used.Results:The overall prevalence of refractive errors in our study was 65%.Most common type of refractive error was Myopia i.e. 113 (86.92%) among the medical students followed by Astigmatism (10.77%) and Hypermetropia (2.31%) respectively. It was observed in our present study that the prevalence of refractive errors was highly associated withincrease in study duration, use of electronic gadgets such as smartphones and computers and with the presence of family history this group difference was found to be significantly associated withchi-square=9.4183,78.9173,114.235 and 56.1899respectively with P<0.05.Conclusion:High prevalence of refractive errors was found among medical students of VIMSAR, Burla which emphasis on the need for routine ophthalmological evaluation and their proper assessment and management
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@#AIM: To analyze the vision distribution and its related risk factors of two teenager aviation schools in Western China. <p>METHODS: The study was a cross-sectional survey. A total of 233 participants were randomly selected from two teenager aviation schools in Western China in November and December of 2017, which were all qualified through the standard of physical examination by Air Force. Distance visual acuity of students was checked and questionnaires about influencing factors of vision were filled voluntarily. Mann-Whitney <i>U</i> rank-sum test and chi-square test were applied for single factor analysis, and Multiple factor Logistic regression analysis was used for the main influence factors of the vision difference. <p>RESULTS: The proportion of students with less than 0.8 eyesight in school B of Grade 2 and Grade 3 were 18.6% and 45.9%, which was significantly higher than that of 2.6% and 20% of school A. The well-vision distribution in school B of Grade 2 and Grade 3 were lower than that of school A(<i>P</i><0.05). Single factor analysis showed that school reading and writing time in school B of Grade 2(360min, average: 180-535min)and Grade 3(470min, average: 440-500min)were higher than that of school A(Greade 2: 200min, average: 180-315min; Grade 3: 440min, average: 400-480min; <i>P</i><0.05); and outdoor activity time of the two grades(Grade 2: 420min, average: 325-516min and Grade 3: 378min, average: 265-515min)were lower than that of school A(Grade 2: 510min, average: 439-681min and Grade 3: 440min, average: 370-601min; <i>P</i><0.05), and the proportion of students whose mother had a senior high school degree or above in school B was lower than that of school A(<i>P</i>=0.032). Multiple factor Logistic regression analysis showed that reading and writing time was a risk factor for vision loss(<i>OR</i>=1.109, <i>P</i>=0.010)and outdoor activity time was a protective factor(<i>OR</i>=0.986, <i>P</i>=0.001). Mothers' education background, father's educational background, parents' myopia, primary school enrollment age, class time and electronic product using time were not the main factors affecting the vision. <p>CONCLUSION: More reading and writing time and less outdoor activity time are the main factors for loss of vision, the key point of school myopia prevention needs to coordinate the time between reading, writing and outdoor activity.
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?AIM: To investigate the changes of nearwork induced transient myopia ( NITM ) in different refractive status after continuous near tasking.?METHODS:Prospective study. Thirty subjects ( aged 18-24, average 20. 9 ± 2. 1, 12 males and 18 females) were recruited in this study. They were divided into 3 groups according to the subjective refraction: 10 with hyperopia (H), 10 with emmetrope (E) and 10 with myopia (M). All the subjects with soft contact lens watched videos on a panel computer at near distance (33cm ~ 40cm). Five measurements of distance refraction in the right eye were performed by using an infrared optometer before, after 30min and 60min sustained viewing task, and the mean of 5 refractive values was recorded as spherical equivalent. Then distance refraction of right eyes was done every 5s followed by stopping near tasking until NITM was disappeared completely and the decay time of NITM was recorded for each subject. The value of NITM was the difference of refractive values between before and after near tasking. Paired-t test was used to compare the changes of refractive values in the same group. ANOVA was used to determine the differences of NITM and its decaying time among three groups.?RESULTS: Compared with pre - task, no significant refractive changes were found in hyperopic group ( t =1. 627,P= 0. 138 ); While subjects with emmetropia and myopia showed more myopic shifts at the two time points (tE = 2. 699, PE = 0. 024;tM = 4. 930, PM = 0. 001 ). With continuous viewing until the 30th min and 60th min, significant differences of averaged NITM were found between myopic group and other 2 groups (P0. 05). Significant differences of the decay time of NITM can be seen among the three groups after near tasking (F=787. 983,P<0. 001).? CONCLUSION: Subjects with myopia are more susceptible to produce NITM than other 2 groups during sustained nearwork for the same time and the decaying time of NITM is longer in myopia group after near tasking, thus it is suggesting that NITM might be attributed to the development and progression of myopia.
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To investigate the relationship between the watching television and myopia, 301 middle school students of different school grade and sex were given questionnaires of the average television watching period per a day and examined the degree of myopia by the manifest refraction. The results showed that no statistically significant correlation existed between the degree of myopia and the television watching period, however the degree of myopia progresses with advancing school grade. From this results, we concluded that the usual television watching is not related to the degree of myopic refractive changes.