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Making sense of a markets is a necessary precursor to any strategizing such as shaping. Still, the nature of this sense-making is oftentimes kept in the dark. It is somehow subordinate to what follows. The lack of such explicit market portrayals entails the risk of myopia to the detriment of seeing shaping possibilities. It also means that ensuing strategic efforts risk to go in vain as they possibly mirror an oversimplified reality. Making agile sense of the surrounding market context turns these two potential shortcomings into opportunities. Such contextual agility is an aptitude of some firms. It is a knowledge ability which prepares for agency in a prompt and responsive way as some representational practices translate into shaping practices. This conceptual research introduces contextual agility which hosts representational, entrepreneurial, and agile elements. This ability of individual firms promises to inform market shaping as its points of departure are clarified. It is here illustrated via contested product qualification, consumer Covid-19 vaccine skepticism. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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Improving the system of adolescent myopia prevention and control and promoting adolescent healthy development is one of the main directions of healthy China construction in the new era. The paper reviewed national myopia policies and local practices, and proposed reflections on the high burden and complex etiology of myopia among adolescents, as well as unclear role and lack of coordination mandate during the COVID-19 epidemic. Based on the synergy theory, through the analysis of the functional positioning of multiple subjects in the prevention and control of myopia, the paper highlighted the multi-party linkage of government, schools, medical institutions, communities, families and markets, profiling the resources and advantages of each subject, as well as dynamic management of adolescent myopia, as well as a multi-subject collaborative prevention and control system with national unity, clear rights and responsibilities, and long-term cooperation.
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Given the high incidence and prevalence of myopia, the current healthcare system is struggling to handle the task of myopia management, which is worsened by home quarantine during the ongoing COVID-19 pandemic. The utilization of artificial intelligence (AI) in ophthalmology is thriving, yet not enough in myopia. AI can serve as a solution for the myopia pandemic, with application potential in early identification, risk stratification, progression prediction, and timely intervention. The datasets used for developing AI models are the foundation and determine the upper limit of performance. Data generated from clinical practice in managing myopia can be categorized into clinical data and imaging data, and different AI methods can be used for analysis. In this review, we comprehensively review the current application status of AI in myopia with an emphasis on data modalities used for developing AI models. We propose that establishing large public datasets with high quality, enhancing the model's capability of handling multimodal input, and exploring novel data modalities could be of great significance for the further application of AI for myopia.
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Background/Aims Myasthenia gravis (MG) is an antibody-mediated autoimmune disease targeting proteins at the postsynaptic membrane of the neuromuscular junction. MG is thought to occur in genetically susceptible individuals following an environmental trigger. SARS-CoV-2 infection has been associated with new-onset autoimmune disease, new-onset MG, and exacerbations of pre-existing MG, with molecular mimicry between SARS-CoV-2 epitopes and autoantigen-induced autoreactivity thought to be part of the underlying mechanism. We report a case of newonset ocular MG following first dose Pfizer-BioNTech BNT162b2 SARS-COV2 vaccination which was referred to rheumatology as suspected mononeuritis multiplex. Methods A 53-year-old man of East Asian ethnicity presented to the emergency department (ED) with sudden onset diplopia and left lateral gaze restriction 7 days after receiving his first dose of the Pfizer-BioNTech BNT162b2 SARS-COV2 vaccination. He had longstanding myopia and dry eyes but no other medical history, no regular medications or significant family history. He was a current smoker, with a 50-pack year history. He did not drink alcohol or use any recreational drugs. He was found to have an isolated left VI cranial nerve (CN) palsy with an otherwise normal ocular and physical examination. Blood tests were unremarkable apart from raised cholesterol, and he was discharged with a suspected self-limiting microvascular CN lesion. Three weeks later he presented to ED with worsening diplopia, increasingly restricted eye movements, headache, nausea, vomiting and blurred vision. Ophthalmology assessment noted new right sided CN III and VI palsy, persistent left CN VI palsy, and vertical diplopia in all fields of gaze. Neurological and physical examination were normal. Bloods including an autoimmune screen were unremarkable. SARS-CoV-2 Spike antibodies were positive consistent with SARS-CoV-2 vaccination but not infection. Intracranial and thoracic imaging were unremarkable. He was referred to and seen by both rheumatology and neurology as a case of suspected mononeuritis multiplex. Results A diagnosis of ocular MG was confirmed with positive serum acetylcholine receptor antibodies, and he was started on prednisolone, and pyridostigmine to good effect. Daily forced vital capacity (FVC) showed no respiratory muscle involvement, and nerve conduction studies and electromyography were normal, excluding secondary generalisation. Conclusion A review of the literature found 14 reported cases of new-onset MG all within 4 weeks following SARS-CoV-2 vaccine. Whilst these cases provide interesting insights into the pathogenesis of autoimmune conditions such as MG, they are not epidemiological studies to inform vaccine safety. Ultimately, current evidence suggests that the risks of SARS-COV-2 infection outweigh the risk of vaccine-related adverse events, therefore we suggest clinicians should be aware of potential new-onset autoimmune conditions, but support the safety of SARSCOV2 vaccination. Further, research into possible immunological mechanisms behind this phenomenon, including identifying potential epitopes inducing molecular mimicry, could help establish the likelihood of a causative link.
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Background: The pandemic resulted in increased screen hours in children due to virtual education. The rate of progression of myopia was noticed to be remarkable in the past 2 years. This study is an endeavor to study the effect of increased screen hours during COVID home confinement on the degree of progression of myopia in school children and to evaluate the difference in change of refractive errors with a variation in the screen size of the digital device used. Method(s): This was prospective observational study with a retrospective comparison arm, wherein 70 school children (140 eyes) aged 4-18 years were subjected to a cycloplegic refraction test. The difference in spherical equivalent refraction from the year 2018 to 19 was compared with that of the difference observed in the pandemic year 2019-2020. A statistical analysis was also made regarding the correlation of variation in refraction between the different genders, age groups, and screen sizes. Result(s): Of the 70 children, 29 (41.42%) were girls and 41 (58.58%) were boys. The gadgets being used vary from mobiles to laptops, and the range of screens and sizes varies from 100 cm2 to 500 cm 2. Similarly, the duration of device use varied from 4 to 8 h. For 2018, the mean value of the spherical equivalent was -1.69 +/- 1.42, for 2019 it was -1.92 +/- 1.50 and for 2020 the mean value was -2.61 +/- 1.47 for the right eye. The mean value of the spherical equivalent for the left eye in 2018 was -1.68 +/- 1.51, in 2019 the value was -1.87 +/- 1.58, and in 2020, the mean value was -2.73 +/- 1.78. Conclusion(s): Increased exposure to digital devices during the COVID-19 period has a role to play in the progression of myopia in school-aged children.Copyright © 2023 Authors. All rights reserved.
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PURPOSE: This study investigated the impact of different levels of COVID-19 social restrictions (social distancing in 2020, large-scale home confinement in 2021) on myopia prevalence and behaviours in a preschool population with school-based eyecare programme. METHODS: Repeated cross-sectional surveys were conducted between August and December in 2019, 2020 and 2021. Children aged 5-6 years received ocular examinations, and questionnaires were answered by caregivers before the day of the examination. The main outcome measures were the changes in after-school time spent on homework, screen-based devices and outdoors. Secondary outcome was the change in myopia prevalence (spherical equivalent [SE] ≤ -0.5 D in either eye after cycloplegia). RESULTS: A total of 9997 preschoolers were included in the analysis. Under tighter restrictions, more preschoolers spent ≥1 h/day on screen-based devices (42.8% in 2019, 45.2% in 2020, 48.9% in 2021, p < 0.001), and fewer preschoolers spent ≥30 min/day on after-school outdoor activities (49.5% in 2019, 46.0% in 2020, 41.0% in 2021, p < 0.001) on weekdays. A similar trend was found on weekends. While more preschoolers spent ≥2 h/day on screen-based devices (35.3% in 2019, 38.5% in 2020, 43.0% in 2021, p < 0.001), fewer preschoolers spent ≥2 h/day on outdoor activities (41.7% in 2019, 41.7% in 2020, 34.0% in 2021, p < 0.001). The mean SE and myopia prevalence were stable (9.1% in 2019, 10.3% in 2020, 9.4% in 2021, p = 0.707). CONCLUSION: Our study showed dose-dependent effect of social restrictions on near-work and outdoor behaviours at home. The prevalence of myopia did not increase significantly with short-term cessation of school-based eyecare programmes.
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PURPOSE: This study reports visual health during the COVID-19 pandemic in 2021 in Spain and Portugal, focusing on eye complaints and population habits. MATERIAL AND METHODS: Cross-sectional survey through an online email invitation to patients attending ophthalmology clinics in Spain and Portugal from September to November 2021. Around 3833 participants offered valid anonymous responses in a questionnaire. RESULTS: Sixty percent of respondents identified significant discomfort related to dry eye symptoms for increased screen time and lens fogging using facemasks. 81.6% of the participants used digital devices for more than 3â¯h per day and 40% for more than 8â¯h. In addition, 44% of participants referred to worsening near vision. The most frequent ametropias were myopia (40.2%) and astigmatism (36.7%). Parents considered eyesight the most important aspect of their children (87.2%). CONCLUSIONS: The results show the challenges for eye practices during the initial COVID-19 pandemic. Focusing on signs and symptoms that lead to ophthalmologic conditions is an essential concern, especially in our digital society highly dependent on vision. At the same time, the excessive use of digital devices during this pandemic has aggravated dry eye and myopia.
Subject(s)
COVID-19 , Dry Eye Syndromes , Myopia , Child , Humans , COVID-19/epidemiology , Pandemics , Portugal/epidemiology , Spain/epidemiology , Cross-Sectional Studies , Myopia/epidemiologyABSTRACT
Background: The outbreak of COVID-19 has significantly affected people's lives worldwide. Governments have used various measures to contain the spread of the pandemic, including confinement policies that have changed children's lifestyles. Children had to limit their outdoor activities and daily routine to indoor activities. Alternative learning systems, such as online and offline teaching via digital devices have replaced traditional teaching methods. Therefore, children have to spend many hours in front of digital devices. As a natural side effect of the pandemic, these changes may influence children's ocular health who may not be able to complain about these problems as early as adults.Objectives: This study reviews the literature regarding the effects of the COVID-19 pandemic on children's eye health, including myopia and digital eye strain.Methods: For this narrative review, a comprehensive literature search was performed on December 30, 2021, in Google Scholar, PubMed, and Scopus using the following keywords: "COVID-19," "lockdowns," "children," "ocular health," "eye health," "visual health," "ocular complications," "myopia," " myopia progression," "digital eye strain," "computer vision syndrome," "quarantine," and "prevention." A total of 22 eligible studies were identified for review.Results: Studies performed during the COVID-19 pandemic have shown an increase in myopia prevalence, incidence, and progression in children, especially among young children. Strategies imposed by governments to control the spread of COVID-19 during confinement have led to dramatic changes in children's lifestyles. These measures have compelled children to restrict outdoor activities and increase their near-work time (e.g., online e-learning), which contributes to the increase in digital eye strain and myopia progression.Conclusions: Children's eye health can be influenced by the COVID-19 outbreak. These can serve as a warning to policymakers, health professionals, teachers, parents, and children about the effects of pandemics, such as COVID-19, on children's visual health and the need to implement preventive and therapeutic measures.
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Purpose: This study reports visual health during the COVID-19 pandemic in 2021 in Spain and Portugal, focusing on eye complaints and population habits. Material and methods: Cross-sectional survey through an online email invitation to patients attending ophthalmology clinics in Spain and Portugal from September to November 2021. Around 3833 participants offered valid anonymous responses in a questionnaire. Results: Sixty percent of respondents identified significant discomfort related to dry eye symptoms for increased screen time and lens fogging using facemasks. 81.6% of the participants used digital devices for more than 3 h per day and 40% for more than 8 h. In addition, 44% of participants referred to worsening near vision. The most frequent ametropias were myopia (40.2%) and astigmatism (36.7%). Parents considered eyesight the most important aspect of their children (87.2%). Conclusions: The results show the challenges for eye practices during the initial COVID-19 pandemic. Focusing on signs and symptoms that lead to ophthalmologic conditions is an essential concern, especially in our digital society highly dependent on vision. At the same time, the excessive use of digital devices during this pandemic has aggravated dry eye and myopia.
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Purpose: To compare the myopic progression in children treated with 0. 01% atropine and those who discontinued atropine during the 2022-home quarantine in Shanghai. Methods: In this retrospective study, children aged 6-13 years with follow-up visits before (between January 2022 and February 2022) and after the lockdown (between July 2022 and August 2022) were included. Cycloplegic refraction and axial length (AL) were measured at both visits. The atropine group had continuous medication during the lockdown while the control group discontinued. The 0.01% atropine eyedrops were administered daily before bedtime. The types of spectacle lens were recorded: single vision (SV) spectacles or defocus incorporated multiple segments lenses (DIMS). Results: In total, 41 children (81 eyes) in the atropine group and 32 children (64 eyes) in the control group were enrolled. No significant difference was found in the demographic characteristics, spherical diopter, spherical equivalent (SE), AL, and follow-up time between the two groups before the lockdown in 2022 (all p > 0.1). After the home confinement, a greater myopia progression was observed in the control group (-0.46 ± 0.42 D) compared to atropine group (-0.26 ± 0.37 D; p = 0.0023). Axial elongation was also longer in the control group than that in children sustained with atropine (0.21 ± 0.17 vs. 0.13 ± 0.15 mm, p = 0.0035). Moreover, there was no significant change of spherical diopter and SE during lockdown in the atropine + DIMS combined subgroup (0.03 ± 0.033 D for spherical diopter, p = 0.7261 and 0.08 ± 0.27 D for SE, p = 0.2042, respectively). However, significant myopic shift was observed in the atropine + SV subgroup during the quarantine time (-0.31 ± 0.39 D for SE and 0.15 ± 0.16 mm for AL, both p < 0.001). Conclusion: Children treated with 0.01% atropine had slower myopia progression during the lockdown period in Shanghai compared with children discontinued. Moreover, the effect of atropine on myopic prevention can be strengthened with DIMS lenses.
Subject(s)
Atropine , Myopia , Humans , Child , Atropine/therapeutic use , Retrospective Studies , China/epidemiology , Myopia/drug therapy , Myopia/epidemiology , Refraction, OcularABSTRACT
Improving the system of adolescent myopia prevention and control and promoting adolescent healthy development is one of the main directions of healthy China construction in the new era. The paper reviewed national myopia policies and local practices and proposed reflections on the high burden and complex etiology of myopia among adolescents as well as unclear role and lack of coordination mandate during the COVID-19 epidemic. Based on the synergy theory through the analysis of the functional positioning of multiple subjects in the prevention and control of myopia the paper highlighted the multi-party linkage of government schools medical institutions communities families and markets profiling the resources and advantages of each subject as well as dynamic management of adolescent myopia as well as a multi-subject collaborative prevention and control system with national unity clear rights and responsibilities and long-term cooperation. © 2023 Journal of Chinese Agricultural Mechanization. All rights reserved.
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Objective: Low levels of outdoor activity are known to be an important risk factor for the development of myopia in schoolchildren. This study aimed to determine outdoor and near work patterns in Polish schoolchildren before and during school closure due to the SARS-CoV-2 pandemic. Methods: All children undergoing a routine pediatric examination in the Elblag branch of the Hygeia Clinic, together with their parents, were asked to fill an anonymous questionnaire. The subject's age, spherical equivalent (SE) refractive error, time spent outdoors, screen time and total near work in hours per day before and during the pandemic, were recorded. As substantial differences in physical activity by time of year were reported, activity patterns for June (summer) and December (winter) were recorded. Multiple logistic regression analysis was used to analyze the association between the presence of myopia and outdoor and total near work time at different timepoints. Results: A total of 61 schoolchildren aged 11.95 ± 2.74 (range 7 to 17) years were included in this study. The mean SE in the right eye was -1.78 ± 2.11 with 46% of the individuals (n=28) classified as myopic. Before the pandemic, higher time outdoors was associated with less myopic SE (OR=0.47, 95% Confidence Interval [CI] 0.24 to 0.93). During the pandemic, time outdoors among non-myopic children was similar to myopic children, both during winter and summer months (2.18 ± 1.81 vs. 1.89 ± 1.50; P=.51, and 3.47 ± 2.66 vs. 3.31 ± 1.65; P=.79 respectively). Time outdoors was not significantly associated with myopia during the pandemic (OR=1.17, 95% CI 0.64 to 2.14). Total near work was not associated with myopia at any time point. Conclusion: The long-term influence of the changing patterns of outdoor and near work on myopia prevalence and progression in our population is still to be established. Nevertheless, it is likely that the decrease of outdoor time may influence the rates of myopia in this region.
Subject(s)
COVID-19 , Myopia , Humans , Child , SARS-CoV-2 , Pandemics , Leisure Activities , COVID-19/epidemiology , Surveys and Questionnaires , Myopia/epidemiologyABSTRACT
Aim: To investigate the relationship between related factors and visual acuity of Chinese school students before and during the COVID-19 pandemic. Subject and methods: Chinese students from primary and secondary schools were included from the Chinese National Surveys on Students' Constitution and Health CNSSCH (2019). A total of 1496 participants completed follow-ups in June and December 2020, respectively. Generalized estimating equations were used to test the differences in visual environment. Logistic regression models were utilized to examine the roles of behaviors and surrounding environment changes associated with myopia before and during the pandemic. Results: The prevalence of myopia was 47.7%, 55.6%, and 57.2% in baseline and two follow-ups, respectively. Significant differences existed for gender, learning level, and region (all P < 0.05). The proportion of new myopia and myopia torsion was the highest in the primary schools. Multivariate logistic regression analysis found that screen time ≥ 4h/d (OR = 2.717), poor eye habits (OR = 1.477), insufficient lighting for studying at night (OR = 1.779), desk or roof lamps only (OR = 1.388), and poor sleep quality (OR = 4.512) were the risk factors for myopia (all P < 0.05), and eye exercises (OR = 0.417), milk intake (OR = 0.758), and eggs intake (OR = 0.735) were the protective factors for myopia (all P < 0.05). Conclusion: Prevalence of myopia increased among Chinese students before and during the COVID-19. It is necessary to pay more attention to the pupils' visual acuity, especially in primary school students, in the future. Supplementary Information: The online version contains supplementary material available at 10.1007/s10389-023-01900-w.
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Aim: The current study aimed to assess the effect of refractive errors among school children due to online classes. Material(s) and Method(s): School-going children who were attending online classes between five and fifteen years were subjected to ophthalmic evaluation. A questionnaire including sections like demographics, gadget use, on-screen time, and physical complaints was administered to collect the required data. Result(s): The participants in our study had a mean age of 9 +/- 2 years (range 5-15 years) of whom 48.4% (n = 140) were males and 51.6% (n = 149) were females. There was a predominance of myopia (86.5%) in children where 44.6% of them have newly developed refractive errors. Around 70 (67.8%) children with a previous refractive error have been shown to have progression of refractive error. Conclusion(s): Our study reports that children were exposed to prolonged screen time which led to a rise in the number of myopia cases.Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
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Myopia is a prevalent yet confusingocular disorder. Myopia,formerlyconsidered abenignrefractivecondition, is nowassociatedwithanincreasedriskofdevelopingseveraloculardisorders,evenatmodestlevels.Myopiaisaglobalproblemthatexpe rts have documented. Despite the fact that the specific cause of myopia remains a mystery, it appears to be a combinationof genetic and environmental factors, making the prevention and treatment of the condition difficult and highly personalised.Myopia can have a positive impact on both the quality of life and the health of the eyes if it is prevented. Progressive additionlenses (PAL), topical atropine, ortho-k (orthokeratology) lenses and multifocal contact lenses are some of the most commoncontrol options currently available. Myopia has gained prominence in optometry studies as a result of its high prevalence. It ismore common for children to suffer from problems, such as extreme myopia and myopic macular degeneration, if they begindevelopingmyopiaatanearlyage.Thepurposeofthisstudywillbetoconductaninquiryintotheepidemiologyandriskfactorsfor myopiainschool-agedchildren(aged 6-19years)aroundtheworld.Copyright © 2022, Anka Publishers. All rights reserved.
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Introduction: The test applied to the students of the Agroindustry career of the National University of Chimborazo presents previous visual diseases in: 33.3 % myopia, 5.1 % astigmatism, 0.5 % presbyopia, referring to the use of the computer we have: 54.9 % of 2 to 4 hours, 39 % of 4 to 8 hours and 6.2 % more than 8 hours which can cause visual fatigue. This research aims to determine the level of visual computer syndrome when applying the CVSS 17 test and technostress by applying the NTP 730 test. The reliability of the instruments is 0. 693 good and 0.959 mu and good, and the reliability of 0.916 and 0.931 which is very good respectively. The result of visual fatigue is 29.2% symptomatic and 70.8% asymptomatic. Regarding technostress, 55.4% is low, 35.9% is medium, and 8.7% is high. The conclusions are determined: the existence of visual fatigue determines the presence of ocular and visual symptoms which will cause short-term affections to the organ of sight and referring to technostress there is resistance to the use of technology. The presence of visual fatigue is associated with the tele study due to the high frequency of computer use and other environmental factors, theCovid 19 pandemic is one of the factors that has contributed to the phenomenon under study, so it is necessary to implement preventive measures.Copyright © 2023, Anka Publishers. All rights reserved.
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As per our literature search studies on convergence insufficiency are being conducted in children or among the geriatric age group and before the pandemic affected the world. Since the commence of COVID 19 pandemic, increased screen time has increased with online teaching and work affecting their near work and increased convergence, refractive errors especially myopia. Hence the rate of change of convergence insufficiency might be possible. As per our knowledge this is one of first study being conducted among students on convergence insufficiency post Pandemic with increased near work as well as display time. The purpose of this study is to determine the frequency of convergence insufficiency and also determine the correlation between gender, refractive error (Corrected and uncorrected refractive error) and the amount of screen time among the students of same age group.
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The purpose of this study was to explore the findings from the Hong Kong Children Eye Study and the Low Concentration Atropine for Myopia Progression (LAMP-1) Study. The incidence of myopia among schoolchildren in Hong Kong more than doubled during the COVID-19 pandemic, with outdoor time decreased significantly and screen time increased. The change in lifestyle during the COVID-19 pandemic aggravated myopia development. Low-concentration atropine (0.05%, 0.025% and 0.01%) is effective in reducing myopia progression with a concentration-related response. This concentration-dependent response was maintained throughout a 3-year follow-up period, and all low concentrations were well tolerated. An age-dependent effect was observed in each treatment group with 0.05%, 0.025% and 0.01% atropine. Younger age was associated with a poor treatment response to low-concentration atropine. Additionally, low-concentration atropine induced choroidal thickening along a concentration-dependent response throughout the treatment period. During the third year, continued atropine treatment achieved a better effect across all concentrations compared with the washout regimen. Stopping treatment at an older age and receiving lower concentration were associated with a smaller rebound effect. However, differences in the rebound effect were clinically small across all the three concentrations studied.
Subject(s)
COVID-19 , Myopia , Child , Humans , Atropine , Pandemics , COVID-19/epidemiology , Myopia/diagnosis , Myopia/drug therapy , Myopia/prevention & control , Life Style , Ophthalmic Solutions , Disease Progression , Refraction, Ocular , MydriaticsSubject(s)
COVID-19 , Esotropia , Myopia , Humans , Esotropia/etiology , COVID-19/complications , Pandemics , Acute Disease , Oculomotor MusclesABSTRACT
(1) Background: Myopia is one of the leading causes of visual impairment. Visual work and usage of electronic devices are known risk factors of myopia. Many education systems were forced to apply online and hybrid teaching methods, to reduce the number of new cases of COVID-19. Medical students are a population well-known for intense visual work in the form of learning; (2) Methods: Visual acuity and refractive error were measured in the population of medical students. Participants also filled out the survey that included their population characteristic and their habits related to the hygiene of vision; (3) Results: We found a correlation between the age of the first diagnosis of myopia and current values of refractive error. The majority of participants believe that the COVID-19 pandemic had an impact on the health of their vision. Among methods of studying, usage of the computer screen was less preferred by myopic students; (4) Conclusions: In the population of medical school students in Eastern Poland, visual acuity was lower than 1.0 in 232 (52.97%) in the right eye and 234 (53.42%) in the left eye. Early recognition of refractive error has influenced its current values. Among methods of studying, usage of the computer screen was less preferred by myopic students. More population-based studies should focus on the impact of the COVID-19 pandemic on the health of vision.