兰州市中学生屈光状况及其影响因素的调查分析

目的:调查兰州市中学生屈光不正的发病率并探讨近视发病的危险因素。方法:采用前瞻性调查设计,对抽样的学生进行有关家庭因素及用眼状态的问卷调查,并进行视力测量以及包括裂隙灯、视网膜镜、矫正视力等的全面眼部检查。采集各项指标,输入应用程序,采用SPSS11.0软件进行统计分析。结果:在2256名年龄介于15～19岁的学生中,2037名(90.3%)学生患有屈光不正。近视是引起屈光不正的首要原因(1951/2256,86.5%),散光为第二位原因(921/2256,40.8%),弱视(10/2256,0.4%)、斜视(5/2256,0.2%)、远视(4/2256,0.2%)和其它眼病的发病率相对较低。在患有屈光不正的学生中约有95.3%在接受调查前已经佩戴眼镜。年龄、性别、用眼状态及家族史是近视发病的危险因素。结论:兰州市中学生屈光不正发病率及其发病的危险因素与国内其它地区类似,采取一定的干预措施保护中学生的视力是有必要的。     

Prevalence of refractive errors in middle school students in Lanzhou city

AIM: To assess the prevalence of refractive errors in middle school students in Lanzhou city and explore the risk factors for myopia. · METHODS: A cross-sectional survey was conducted. A questionnaire assessed the students' socioeconomic background and visual tasks followed by visual acuity assessment and a full eye examination including slit-lamp examination, fundus evaluation, retinoscopy, and subjective refraction. · RESULTS: Among 2 256 enumerated students aged 15-19 years,2 037(90.3%) students had significant refractive errors. Myopia was the leading refractive error (1 951/2 256, 86.5%), astigmatism was the second most common refractive error (921/2 256, 40.8%), but amblyopia (10/2 256, 0.4%), strabismus (5/2 256, 0.2%), hyperopia (4/2 256, 0.2%) and other treatable eye disorders were uncommon. Almost 95.3% of students with significant refractive errors wore spectacles before the survey. Age, sex, visual tasks, and a parental history of myopia were risk factors for myopia. · CONCLUSION: The prevalence of refractive errors and the risk factors for myopia in schoolchildren in Lanzhou city are similar to those reported in other regions of China. Interventions of myopia progression should be performed to protect the visual acuity of school-aged students.     

江苏省南京市区中小学生屈光状态调查

目的:了解中小学生视力不良情况和屈光状态及其与近视发生发展的关系.方法:调查江苏省南京市区12 000名中小学生的远视力,其中7 578名视力不良学生进行散瞳验光,判断屈光状态,将所得结果比较分析.结果:视力不良发生率为63.15%,各组别近视眼发病率差异有显著意义,女生发生率高于男生,视力下降的程度也随学年的升高差异明显加重.屈光不正中小学组以远视最多,初高中组以近视为主.远视性屈光不正的患病率随学年升高而下降,近视性屈光不正患病率则随学年升高逐渐增加.结论:引起中小学生视力下降的主要原因是近视,做好近视防治工作,对控制中小学生视力不良有重要意义.     

2010年上海市宝山区小学生屈光不正和视力损伤的患病率调查

背景 流行病学调查表明,青少年视力损伤是一个全球性的公共卫生问题,其首要原因是未矫正的屈光不正,因此一定规模的流行病学调查对儿童屈光不正的矫正具有重要意义.目前尚缺乏上海市大规模儿童视力损伤和屈光不正的流行病学调查资料. 目的 调查上海市6 ～12岁小学生视力损伤与屈光不正的患病情况.方法 采用横断面调查研究设计,于2010年5月至2011年4月分层随机整群抽取上海市宝山区6所学校的4 686名小学生进行研究,眼部检查包括视力、外眼、眼前节、屈光间质、眼底和眼压检查,并记录睫状肌麻痹后电脑验光的结果和眼位.结果 实际受检学生4 594人,应答率为98.0％,接受睫状肌麻痹后验光者3 975人,占84.8％.双眼裸眼视力≤0.5者占14.4％（662/4 594）,其中343人配戴眼镜,占51.8％.所有受检者中,任一眼裸眼视力≤0.5者1 031人,占22.4％.受检的视力损伤者中屈光不正占96.9％（999/1 031）,弱视占3.6％（37/1 031）.接受睫状肌麻痹后验光的小学生中,近视、远视和散光的患病率分别为31.1％、4.3％和33.0％.公办学校的小学生近视患病率高于外来务工随迁子女学校的学生,差异有统计学意义（x2=5.46,P=0.02）.Logistic回归分析显示,年龄和女生与近视的发生及发展明显有关（年龄：OR=1.60,95％ CI：1.53 ～ 1.68,P＜0.01;女生：OR=1.33,95％CI：1.16～1.54,P＜0.01）. 结论 中国上海市小学生视力损害的主要原因是近视,应注意筛查并提高小学生屈光不正的矫正覆盖率.     

广东省阳江市区小学生视力及屈光状态调查分析

目的:了解小学生视力不良情况和屈光状态及其与近视发生发展的关系。方法:调查阳江市区12021名小学生的远视力,随机抽取304名视力不良学生进行散瞳视网膜检影,判断屈光状态,将所得结果比较分析。结果:视力不良发生率为24.89%,各年级差异有显著意义,女生发生率高于男生,各年级男女生的差异随学年的升高差异越显著;视力下降的程度也随学年的升高差异明显加重。屈光不正中以近视最多,占47.55%,远视性屈光不正的患病率随学年升高而下降,近视性屈光不正患病率则随学年升高逐渐增加。结论:引起小学生视力下降的主要原因是近视,做好近视防治工作,对控制小学生视力不良有重要意义。     

Visual acuity outcome in isometropic hyperopia

Refractive amblyopia may occur as a unilateral or bilateral condition. Although bilateral refractive amblyopia may account for 1 to 2% of all refractive amblyopia, there is little consistent information in the literature regarding isoametropic amblyopia resulting from bilateral hyperopia. Hence, this retrospective study investigated the prevalence of reduced aided acuity in patients aged 10 years and younger (mean age 3.97 years) with 5 D or more of isometropic hyperopia and considered the following factors that may influence visual acuity: (1) age at first correction; (2) magnitude of hyperopia; and (3) duration of refractive correction of the hyperopia. The results indicate that the majority of patients (87%) have aided acuity poorer than 6/6 at initial correction of refractive error. However, if the full hyperopic correction was worn for 1 year or longer, only 43% of these patients demonstrated acuity poorer than 6/6 and none showed acuity poorer than 6/12. The magnitude of the hyperopia appeared to have the greatest influence on the visual acuity outcome both at initial correction of refractive error and 1 year or longer after correction. Duration of correction also influenced the visual acuity outcome, but to a lesser extent than the magnitude of refractive error. In contrast, the age of first correction showed little correlation with visual acuity either at the time of first refractive correction or after a minimum of 1 year of correction.     

Prevalence and predictors of refractive error and spectacle coverage in Nakuru, Kenya: a cross-sectional, population-based study

A cross-sectional study was undertaken in Nakuru, Kenya to assess the prevalence of refractive error and the spectacle coverage in a population aged ≥50 years. Of the 5,010 subjects who were eligible, 4,414 underwent examination (response rate 88.1 %). LogMAR visual acuity was assessed in all participants and refractive error was measured in both eyes using a Topcon auto refractor RM8800. Detailed interviews were undertaken and ownership of spectacles was assessed. Refractive error was responsible for 51.7 % of overall visual impairment (VI), 85.3 % (n = 191) of subjects with mild VI, 42.7 % (n = 152) of subjects with moderate VI, 16.7 % (n = 3) of subjects with severe VI and no cases of blindness. Myopia was more common than hyperopia affecting 59.5 % of those with refractive error compared to 27.4 % for hyperopia. High myopia (<?5.0 DS) was also more common than extreme hyperopia (>+5.0 DS). Of those who needed distance spectacles (spectacle coverage), 25.5 % owned spectacles. In conclusion, the oldest, most poor and least educated are most likely to have no spectacles and they should be specifically targeted when refractive services are put in place.     

兰州市中学生干眼症患病率及危险因素分析

目的　探讨甘肃省兰州市中学生干眼症的患病率和危险因素。方法　2018年7月对甘肃省兰州市5所中学的学生进行了横断面调查。通过随机整群抽样获得所选36个班级的1503名学生。使用Schaumberg干眼调查问卷进行调查访谈。由两位经验丰富的眼科医师于访谈后进行眼科检查（一位医师进行视敏度检查，另一位医师进行裂隙灯检查）。计算干眼症的患病率，并评估干眼症与性别、近视、配戴隐形眼镜、屈光矫正不足、经常使用滴眼液、睡眠质量和压力状态之间的相关性。采用χ²检验和Logistic回归分析评估与干眼症相关的危险因素。结果　兰州市中学生干眼症的患病率为24.5％（363/1482）。363例干眼症患者最常报告的眼部刺激症状是视疲劳（303例，83.5％），其次是疼痛（166例，45.7％），视力模糊（134例，36.9％），眼部瘙痒（129例，35.5％），以及砂砾感（96例，26.4％）。多因素Logistic回归分析结果显示，屈光矫正不足、经常使用滴眼液、睡眠质量差是干眼症的独立危险因素。结论　中学生干眼症患病率高且易被忽视，针对中学生干眼症危险因素的预防措施可能有助于降低干眼症患病率并对学生的眼健康产生积极影响。     

眼科门诊50岁以上部分人群屈光矫正前后视力分析

目的: 了解本院眼科门诊50岁以上部分人群屈光状态及视力矫正前后状况,探讨视力损害的相关影响因素。方法: 选取该组人群149例298眼,使用电脑验光联合视网膜检影进行屈光矫正,并以问卷方式了解患者年龄、文化水平、经济状况及居住地。结果: 该组人群149例298眼中,屈光不正281眼(98.6%)。其中近视性屈光不正有119眼(42.3%),远视性屈光不正有94眼(33.5%),混合性散光有68眼(24.2%)。验光矫正前后平均视力分别为0.42±0.21和0.63±0.32,可矫正的视力损害为186眼(65.3%)。低教育程度、低收入、居住在农村是视力损害的危险因素。结论: 未矫正的屈光不正是视力损害的重要因素,通过矫正可使大部分人脱离视力损害的范围。应加强老年人群特别是贫困地区、低教育程度及低收入人群的视力保健和相关知识的普及。     

Myopia in secondary school students in Mwanza City,Tanzania: the need for a national screening programme

BACKGROUND/AIMS: The prevalence of significant refractive errors and other eye diseases was measured in 2511 secondary school students aged 11-27 years in Mwanza City, Tanzania. Risk factors for myopia were explored. METHODS: A questionnaire assessed the students' socioeconomic background and exposure to near work followed by visual acuity assessment and a full eye examination. Non-cycloplegic objective and subjective refraction was done on all participants with visual acuity of worse than 6/12 in either eye without an obvious cause. RESULTS: 154 (6.1%) students had significant refractive errors. Myopia was the leading refractive error (5.6%). Amblyopia (0.4%), strabismus (0.2%), and other treatable eye disorders were uncommon. Only 30.3% of students with significant refractive errors wore spectacles before the survey. Age, sex, ethnicity, father's educational status, and a family history of siblings with spectacles were significant independent risk factors for myopia. CONCLUSION: The prevalence of uncorrected significant refractive errors is high enough to justify a regular school eye screening programme in secondary schools in Tanzania. Risk factors for myopia are similar to those reported in European, North-American, and Asian populations.     

Correctable and non-correctable visual impairment among young males: a 12-year prevalence study of the Military Service in Poland

Purpose:  To evaluate the prevalence of correctable and non-correctable visual impairment in a representative sample of young males commissioned for Military Service in Poland.
Material and methods:  Data concerning vision status was retrospectively reviewed in 969 subjects of European Caucasian origin, most of whom live and have lived in Poland. They were selected from the original database comprising 105017 subjects examined in the period 1993–2004. Based on the age of subjects they were divided into two groups; group I aged 18–24 and group II aged 25–34 years. Visual impairment was defined as distance visual acuity of <20/40 in one or both eyes. Non-correctable impairment was defined as that which was not eliminated by refractive correction.
Results:  A total of 1938 eyes of 969 white males were examined. There was statistically significant association between rates of visual impairment and increasing age ( p  < 0.001). Visual impairment was found in 128 (13.2%) subjects in at least one eye. Non-correctable visual impairment was found in 12 (1.2%) subjects. Amblyopia was the main cause, accounting for eight cases (66.67%). Correctable visual impairment was found in the remaining 116 (12.0%) patients. Among them myopia was the most common refractive error and accounted for 75.8%. Differences between age-specific rates of refractive errors were statistically significant ( p  = 0.003).
Conclusions:  Appropriate refractive correction improves visual acuity in most subjects presenting with visual impairment. There was a relatively low prevalence of non-correctable visual impairment in a population of young adults in Poland, and this was mainly due to amblyopia.     

The prevalence of refractive errors among schoolchildren in Dezful, Iran

AIM: To determine the prevalence of refractive errors among schoolchildren in urban and rural areas of Dezful County, Iran. METHODS: In a cross-sectional study, using random cluster sampling, 5721 Dezful schoolchildren were selected from 39 clusters. The participants in the study totalled 5544; 3673 elementary and middle school students and 1871 high school students. For the former group, cycloplegic refraction and for the latter, non-cycloplegic refraction was tested. In all participants, uncorrected visual acuity and best corrected visual acuity were determined, and those with a visual acuity of 20/40 or worse, underwent a complete ophthalmic examination to determine the cause of visual impairment. A spherical equivalent of -0.5 diopter (D) or worse was defined as myopia, +2.0 D or more was defined as hyperopia, and a cylinder refraction greater than 0.75 D was considered astigmatism. RESULTS: The uncorrected visual acuity was 20/40 or worse in the better eye of 224 schoolchildren (3.8% of participants). This figure (percentage) was 14 (0.03%) based on their best corrected visual acuity and 96 (1.7%) with their presenting vision. According to results of cycloplegic refraction, 3.4% (95% confidence interval (CI), 2.5 to 4.4) of the primary and middle school students were myopic and 16.6% (95% CI, 13.6 to 19.7) were hyperopic. For high school students, these rates were 2.1% (95% CI, 0.7 to 3.5) and 33.0% (95% CI, 24.9 to 41.1), respectively, with non-cycloplegic refraction. In the multivariate logistic regression for primary and middle school students, myopia was correlated with age (p = 0.030), and hyperopia was correlated with age (p<0.001) and area of residence (p = 0.007). In high school students, hyperopia again showed a correlation with their area of residence (p = 0.029). CONCLUSION: The present study reveals the considerable prevalence rates of refractive errors among schoolchildren in Dezful County and the high rate of an unmet need for their correction. Although myopia is not very prevalent, the high rate of hyperopia in the studied population emphasises its need for attention.     

Change in vision disorders among Hong Kong preschoolers in 10 years

Background: To determine the change in refractive error and the prevalence of amblyopia and strabismus among preschool children in Hong Kong over a period of 10 years. Design: Two cross‐sectional population‐based studies conducted in 1996 to 1997 (part A) and 2006 to 2007 (part B) Participants: Children attending randomly selected kindergarten participated in the study. Methods: Ocular alignment, visual acuity, cover and uncover tests, cycloplegic refraction, slit‐lamp and fundi examination were performed under a standardized testing environment. Main Outcome Measures: The prevalence of amblyopia (best‐corrected visual acuity ≤6/12 in one or both eyes, or a bilateral difference of ≥2 best‐corrected visual acuity lines), strabismus and significant refractive error (hyperopia ≥+2.50 D; myopia ≥?1.00 D; astigmatism ≥2.00 D) among preschool children. Results: Of the 601 children in part A of the study, reduced visual acuity was presented in 3.8%; whereas strabismus was found in 1.8%. The commonest type of refractive error was astigmatism in 6.3% of children, followed by hyperopia (5.8%) and myopia (2.3%). Among 823 children in part B, reduced visual acuity was presented in 2.7% of children, and strabismus was found in 1.7%. The commonest type of refractive error was myopia (6.3%), followed by astigmatism (5.7%) and hyperopia (5.1%). The percentage of children having myopia has significantly increased (P = 0.001). Conclusion: A significant increase in myopia has been noted in Hong Kong preschoolers. Visual screening programmes may need to be tailored to correspond to the local population and be adjusted accordingly from time to time.     

Refractive errors in an elderly Chinese population in Taiwan: the Shihpai Eye Study

PURPOSE: Few epidemiologic data are available on refractive status in elderly Asians. The purpose of the study was to determine prevalence and risk factors associated with refractive errors in a metropolitan elderly Chinese population in Taiwan. METHODS: A population-based survey was conducted in the Shihpai district of Taipei, Taiwan. A total of 2045 residents aged 65 years or more were randomly selected and invited to complete a comprehensive questionnaire and undertake a detailed ocular examination, including best corrected visual acuity and measurements of refractive error, using autorefraction. Of the subjects, 1361 (66.6%) participated in the ocular examination. Spherical equivalent (SE) was calculated in diopters (D), and data from right eyes were reported. RESULTS: The age- and sex-adjusted prevalence rates were determined for myopia (SE<-0.5 D, 19.4%; SE<-1.0 D, 14.5%), high myopia (SE<-6.0 D, 2.4%), hyperopia (SE>+0.5 D, 59.0%; SE>+1.0 D, 44.2%), astigmatism (cylinder<-0.5 D, 74.0%; cylinder<-1.0 D, 45.3%), and anisometropia (SE difference between right and left eyes>0.5 D, 45.2%; SE difference>1.0 D, 21.8%). The prevalence of myopia, astigmatism, and anisometropia significantly increased with age (all P<0.01). The prevalence of hyperopia tended to decrease with age. There was no gender difference in prevalence rates in any type of refractive error, except that women had a higher rate of hyperopia (SE>+1.0 D) than men (P=0.004). Multivariate regression analysis showed that myopia was weakly associated with higher educational level. The severity of lens nuclear opacity was positively associated with the rates of myopia and negatively associated with the rates of hyperopia. CONCLUSIONS: The prevalence of myopia in this elderly Chinese population is not much higher than in similarly aged elderly white populations, compared with a much greater difference in prevalence among younger Chinese versus white people. This suggests that changing environmental factors may account for the increased prevalence of myopia in younger cohorts of Chinese.     

Distance refractive error among Aboriginal people attending eye clinics in remote South Australia

PURPOSE: To determine the prevalence of distance refractive error among Aboriginal people attending eye clinics in remote South Australia. METHODS: A clinic-based cross-sectional study was conducted that involved opportunistic sampling of Aboriginal people attending eye clinics in remote South Australia. There were 189 individuals who were invited to participate in the study all of whom underwent ophthalmic examination. This examination included measurement of pinhole-corrected visual acuity and non-cycloplegic autorefraction. RESULTS: Automated refractive error examinations were performed on 148 people within this sample. The mean age was 44.8 +/- 14.5 years and women comprised 57.7% of the sample. The overall mean refractive error was -0.01 +/- 1.8 D (SD). The prevalence of myopia (spherical equivalent (SE) < -0.5 D), high myopia (SE less than or equal to -6.0 D), hypermetropia (SE > 0.5 D), astigmatism (cylinder at least -0.5 D) and anisometropia (difference in SE of >0.5 D) was 31.1%, 0.7%, 33.1%, 55.8% and 45.9%, respectively. Further analyses revealed significant age-related trends with both myopia and hypermetropia. There were no gender associations with any form of refractive error. Of those people with clinically significant refractive error, 51/148 (34%), only four people owned distance spectacles. CONCLUSIONS: There continues to be a level of uncorrected distance refractive error within these patients. This represents a need to screen for refractive error among Aboriginal people in remote locations and to provide them with appropriate spectacle correction.     

Blur adaptation in myopes.

It has been suggested that when subjects with myopia remove their refractive correction, blur adaptation develops to produce an improvement in their visual resolution. The present study measured visual acuity (VA) using high contrast letters and gratings with contrast levels between 2.5% and 40% at 30-minute intervals over the course of a 3-h period during which the subjects remained uncorrected. Twenty-two young subjects with moderate degrees of myopia (mean refractive error, -185 D) participated in the study. Immediately after a 1-h period of full correction, subjects spent 3 h without any refractive correction, during which time they watched television and videos at a viewing distance of 5 m. A significant change in letter and grating VA was observed during the course of the 3-h period of sustained blur, with the mean uncorrected letter VA improving from 0.76 (SD, +/-0.26) to 0.53 (SD, +/-0.23) logarithm of the minimum angle of resolution (logMAR). The Snellen equivalent to this change is from 6/35 to 6/20. A significant improvement in grating acuity was also observed. However, no significant change in refractive error, measured using noncycloplegic autorefraction, was found. These results demonstrate significant blur adaptation in subjects with uncorrected myopia, which does not result from a change in refractive state. We hypothesize that the improvement in visual resolution results from perceptual adaptation to the blurred image, which may occur at central sites within the visual cortex.     

沈阳市铁西区一小学学生屈光状态调查

目的 了解普通学校小学生视力不良情况和屈光状态及其与近视发生发展的关系.方法 调查沈阳市铁西区一小学636名小学生的远视力,其中230名(459只眼)视力不良学生进行散瞳验光,判断屈光状态,将所得结果比较分析.结果 视力不良发生率为36.08%,各年级近视眼发病率差异有统计学意义,女生发生率高于男生,视力下降的程度也随学年的升高差异明显加重.屈光不正中低年级以远视为主,高年级以近视为主.远视性屈光不正的患病率随学年升高而下降,近视性屈光不正患病率则随学年升高逐渐增加.结论 引起小学生视力下降的主要原因是近视,做好近视防治工作,对控制小学生视力不良有重要意义.     

沈阳市铁西区一小学学生屈光状态调查

目的 了解普通学校小学生视力不良情况和屈光状态及其与近视发生发展的关系.方法 调查沈阳市铁西区一小学636名小学生的远视力,其中230名(459只眼)视力不良学生进行散瞳验光,判断屈光状态,将所得结果比较分析.结果 视力不良发生率为36.08%,各年级近视眼发病率差异有统计学意义,女生发生率高于男生,视力下降的程度也随学年的升高差异明显加重.屈光不正中低年级以远视为主,高年级以近视为主.远视性屈光不正的患病率随学年升高而下降,近视性屈光不正患病率则随学年升高逐渐增加.结论 引起小学生视力下降的主要原因是近视,做好近视防治工作,对控制小学生视力不良有重要意义.     

沈阳市铁西区一小学学生屈光状态调查

目的 了解普通学校小学生视力不良情况和屈光状态及其与近视发生发展的关系.方法 调查沈阳市铁西区一小学636名小学生的远视力,其中230名(459只眼)视力不良学生进行散瞳验光,判断屈光状态,将所得结果比较分析.结果 视力不良发生率为36.08%,各年级近视眼发病率差异有统计学意义,女生发生率高于男生,视力下降的程度也随学年的升高差异明显加重.屈光不正中低年级以远视为主,高年级以近视为主.远视性屈光不正的患病率随学年升高而下降,近视性屈光不正患病率则随学年升高逐渐增加.结论 引起小学生视力下降的主要原因是近视,做好近视防治工作,对控制小学生视力不良有重要意义.