A systematic review of near work and myopia: measurement, relationships, mechanisms and clinical corollaries

Gajjar, Shail; Ostrin, Lisa A

doi:10.1111/aos.15043

Cited by 42 publications

(44 citation statements)

References 117 publications

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“…This assertion is supported by the fact that in 2010, the pre-primary school enrolment rate in the most populous country in Africa (Nigeria) was 41.83% compared to 89.12% in 2012 in China (the most populous country in Asia) [ 64 ]. We acknowledge that a recent investigation [ 65 ] has shown that more precise objective measures are required to make definitive conclusions about the relationship between myopia and near work.…”

Section: Discussionmentioning

confidence: 99%

Systematic review and meta-analysis of myopia prevalence in African school children

et al. 2022

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Purpose Increased prevalence of myopia is a major public health challenge worldwide, including in Africa. While previous studies have shown an increasing prevalence in Africa, there is no collective review of evidence on the magnitude of myopia in African school children. Hence, this study reviews the evidence and provides a meta-analysis of the prevalence of myopia in African school children. Methods This review was conducted using the 2020 Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Five computerized bibliographic databases, PUBMED, Scopus, Web of Science, ProQuest, and Africa Index Medicus were searched for published studies on the prevalence of myopia in Africa from 1 January 2000 to 18 August 2021. Studies were assessed for methodological quality. Data were gathered by gender, age and refraction technique and standardized to the definition of myopia as refractive error ≥ 0.50 diopter. A meta-analysis was conducted to estimate the prevalence. Significant heterogeneity was detected among the various studies (I2 >50%), hence a random effect model was used, and sensitivity analysis was performed to examine the effects of outliers. Results We included data from 24 quality assessed studies, covering 36,395 African children. The overall crude prevalence of myopia over the last two decades is 4.7% (95% CI, 3.9–5.7) in African children. Although the prevalence of myopia was slightly higher in females (5.3%, 95%CI: 4.1, 6.5) than in males (3.7%, 95% CI, 2.6–4.7; p = 0.297) and higher in older [12–18 years 5.1% (95% CI, 3.8–6.3) than younger children (aged 5–11 years, 3.4%, 95% CI, 2.5–4.4; p = 0.091), the differences were not significant. There was a significantly lower prevalence of myopia with cycloplegic compared with non-cycloplegic refraction [4.2%, 95%CI: 3.3, 5.1 versus 6.4%, 95%CI: 4.4, 8.4; p = 0.046]. Conclusions Our results showed that myopia affects about one in twenty African schoolchildren, and it is overestimated in non-cycloplegic refraction. Clinical interventions to reduce the prevalence of myopia in the region should target females, and school children who are aged 12–18 years.

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Section: Discussionmentioning

confidence: 99%

Systematic review and meta-analysis of myopia prevalence in African school children

et al. 2022

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“… 5–7 Moreover, prolonged exposure to digital screens during intensive near-work activities and increased time spent on indoor activities are considered well-known risk factors for myopia progression. 8 , 9 …”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7] Moreover, prolonged exposure to digital screens during intensive near-work activities and increased time spent on indoor activities are considered well-known risk factors for myopia progression. 8,9 Myopia development is determined by age, the age at which myopia first appears, the duration and intensity of myopia, and ethnic origin. 10,11 Myopia can progress quickly in children and become stable as they grow older.…”

Section: Introductionmentioning

confidence: 99%

Outbreak of COVID-19-Related Myopia Progression in Adults: A Preliminary Study

Kohmarn¹,

Srisurattanamethakul²,

Watcharapalakorn³

et al. 2022

OPTO

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Purpose The COVID-19 pandemic has necessitated specific public health measures, resulting in the alteration of lifestyles, such as increased digital screen time and fewer outdoor activities. Such conditions have increased the progression of myopia in children. However, no investigation of myopia progression in early adulthood has been conducted during this period. Consequently, this study aimed to evaluate the outbreak of COVID-19-related myopia progression among adults at an optometry clinic during the COVID-19 pandemic. Materials and Methods This was a retrospective cohort study in which participants aged 18–25 years who first visited (baseline) the optometry clinic between June 2019 and March 2020 were recruited for follow-up from November 2021 to March 2022. Spherical equivalent refraction (SER), uncorrected distance visual acuity (UCDVA), and binocular cross cylinder (BCC) were recorded at baseline and a follow-up visit. Using questionnaires, a survey was conducted to assess the lifestyle changes that transpired during the COVID-19 pandemic. Results In total, 37 participants with a mean age of 22.5±1.4 years were enrolled, of which 89.2% were female. Following the outbreak of the COVID-19 pandemic, most participants self-reported increased daily use of digital devices (89.2%), online education (86.5%), and spending more time at home (94.6%), which increased by approximately 7.6±3.2 hours, 5.9±1.7 hours, and 13.2±7.5 hours, respectively. There were statistically significant differences between SER and BCC at baseline and after approximately 2 years of the COVID-19 pandemic ( p < 0.05). The mean two-year myopia progression was −0.59±0.67 D (Maximum = 0.00 D, Minimum = −3.38 D). Conclusion This study revealed that myopia could progress during adulthood among those who have lived under public health measures intended to address the COVID-19 pandemic.

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“…Many confounding environmental factors are associated with myopia including outdoor VL exposure [ 21 , 22 , 24 ], time of outdoor activity before entering elementary school [ 25 ], time spent performing near work [ 32 ], reading distance [ 4 ], time spent sleeping [ 33 , 34 ], club activity [ 35 ], average time of sunlight exposure [ 14 , 15 ], intraocular pressure [ 40 , 41 ], and dry eye [ 3 , 42 ]. We used these factors as fixed effects for the subgroup analysis of the MMRM in the subsequent subjects aged 8 to 10 years, which was the largest subgroup in the current study; the axial elongation and myopia progression were suppressed significantly in the VLf group compared with the control group.…”

Section: Discussionmentioning

confidence: 99%

“…After the examinations, the patients and guardians completed a questionnaire that included the recording of age [ 29 , 30 ], sex [ 31 ], parental myopia [ 9 ], time spent in outdoor activity before entering elementary school [ 25 ], time spent performing near work [ 32 ], reading distance [ 4 ], time spent sleeping [ 33 , 34 ], club activity (outdoors/indoors) [ 35 ], and time exposed to sunlight [ 14 , 15 ], all of which are known to be confounding environmental factors regarding myopia progression.…”

Section: Methodsmentioning

confidence: 99%

Short-Term Exposure to Violet Light Emitted from Eyeglass Frames in Myopic Children: A Randomized Pilot Clinical Trial

Torii

Mori

Okano

et al. 2022

JCM

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Violet light (VL), 360–400 nm wavelength, is contained in the sunlight and is an effective element for myopia suppression. This study is to investigate the safety and efficacy of novel eyeglasses that emit VL from the frames. This is a double-masked, randomized, pilot clinical trial conducted in a clinic in Japan. Forty-three children with myopia were enrolled. Participants were randomly assigned to two groups, wearing VL-emitting eyeglass frames (VLf) that emitted VL of 310 μW/cm2 (VLf group, n = 22) or pseudo-placebo eyeglass frames with a minimal emission of VL (<10 μW/cm2) (control group, n = 21). The exposure time was 3 h per day. The primary outcomes were visual acuity, tear film break-up time, corneal endothelial cell density, and the slit-lamp/fundus examinations. The secondary outcome was the 6-month changes in the axial lengths and cycloplegic refractions. Forty-one (95%) participants were included; twenty-one in the VLf group and twenty in the control group. No significant differences were seen in any safety evaluation. Significant changes were seen in axial elongation, choroidal thickness, and cycloplegic refractions in the subgroup analysis of 8- to 10-year-old children (p < 0.05), but otherwise no significant differences were seen. The VLf showed short-term safety and effectiveness against myopia progression.

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A systematic review of near work and myopia: measurement, relationships, mechanisms and clinical corollaries

Cited by 42 publications

References 117 publications

Systematic review and meta-analysis of myopia prevalence in African school children

Systematic review and meta-analysis of myopia prevalence in African school children

Outbreak of COVID-19-Related Myopia Progression in Adults: A Preliminary Study

Short-Term Exposure to Violet Light Emitted from Eyeglass Frames in Myopic Children: A Randomized Pilot Clinical Trial

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