Shorter Axial Length and Increased Astigmatic Refractive Error are Associated With Socio-Economic Deprivation in an Adult UK Cohort

Goverdhan, Srini; Fogarty, Andrew; Osmond, Clive; Lockwood, Alastair; Anderson, Luke; Kirwan, James

doi:10.3109/09286586.2010.528853

Cited by 6 publications

(4 citation statements)

References 10 publications

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“…Socioeconomic status is defined by several factors such as parental education, employment, income, accessibility of services, school fees (private vs government), and housing type [ 187 , 263 – 265 ]. A large-scale study in China found a positive correlation between myopia and higher socioeconomic status indicators such as urban living, owning property, and duration of education [ 266 ].…”

Section: Environmental Factors Influencing Myopiamentioning

confidence: 99%

The influence of the environment and lifestyle on myopia

Biswas,

El Kareh,

Qureshi

et al. 2024

J Physiol Anthropol

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Background Myopia, commonly known as near-sightedness, has emerged as a global epidemic, impacting almost one in three individuals across the world. The increasing prevalence of myopia during early childhood has heightened the risk of developing high myopia and related sight-threatening eye conditions in adulthood. This surge in myopia rates, occurring within a relatively stable genetic framework, underscores the profound influence of environmental and lifestyle factors on this condition. In this comprehensive narrative review, we shed light on both established and potential environmental and lifestyle contributors that affect the development and progression of myopia. Main body Epidemiological and interventional research has consistently revealed a compelling connection between increased outdoor time and a decreased risk of myopia in children. This protective effect may primarily be attributed to exposure to the characteristics of natural light (i.e., sunlight) and the release of retinal dopamine. Conversely, irrespective of outdoor time, excessive engagement in near work can further worsen the onset of myopia. While the exact mechanisms behind this exacerbation are not fully comprehended, it appears to involve shifts in relative peripheral refraction, the overstimulation of accommodation, or a complex interplay of these factors, leading to issues like retinal image defocus, blur, and chromatic aberration. Other potential factors like the spatial frequency of the visual environment, circadian rhythm, sleep, nutrition, smoking, socio-economic status, and education have debatable independent influences on myopia development. Conclusion The environment exerts a significant influence on the development and progression of myopia. Improving the modifiable key environmental predictors like time spent outdoors and engagement in near work can prevent or slow the progression of myopia. The intricate connections between lifestyle and environmental factors often obscure research findings, making it challenging to disentangle their individual effects. This complexity underscores the necessity for prospective studies that employ objective assessments, such as quantifying light exposure and near work, among others. These studies are crucial for gaining a more comprehensive understanding of how various environmental factors can be modified to prevent or slow the progression of myopia.

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Section: Environmental Factors Influencing Myopiamentioning

confidence: 99%

The influence of the environment and lifestyle on myopia

Biswas,

El Kareh,

Qureshi

et al. 2024

J Physiol Anthropol

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“…Previous studies have found many factors associated with astigmatism including high risk genes, eyelid pressure, extraocular muscle tension, gestational age, birth weight, nutrition [1], ethnicity, spherical equivalent refractive error, maternal smoking during pregnancy [2], accommodative convergence/accommodation ratio (AC/A) [3], age, education, ametropia [4], the axial length-corneal radius ratio (AL/CR) [5], delivery mode [6], socio-economically deprivation [7] and iris color [8]. In a recent paper on 48-60-month-old Chinese children [9], we reported the prevalence of the components of astigmatism, described the difference between corneal astigmatism (CA) and anterior corneal astigmatism (ACA), and demonstrated the compensatory role of internal astigmatism (IA) in reducing ACA.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for astigmatic components and internal compensation: the Nanjing Eye Study

Wang

Tong

Hao

et al. 2020

Eye

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Purpose To determine the risk factors for total astigmatism (TA), anterior corneal astigmatism (ACA), and internal compensation in Chinese preschool children. Methods In the population-based Nanjing Eye Study, children were measured for noncycloplegic refractive error and for biometric parameters. Data from questionnaires and measures from right eyes were analyzed for determining risk factors for TA, ACA, and internal compensation from multivariate logistic regression models. Results Of 1327 children (66.8 ± 3.4 months, 53.2% male), older age of the child (OR = 0.95 for per month increase; P = 0.03), older paternal age at child birth (OR = 1.04 for per year increase; P = 0.03), paternal astigmatism (OR = 1.89; P = 0.003), maternal astigmatism (OR = 1.73, P = 0.008), and secondhand smoke exposure during pregnancy (OR = 1.64; P = 0.03) were associated with higher risk of TA, while partial breastfeeding (OR = 0.49, P = 0.006) or formula feeding (OR = 0.46, P = 0.003) were associated with lower risk of TA. Larger ratio of axial length to corneal radius (OR = 16.16 for per unit increase; P = 0.001), maternal working during pregnancy (OR = 1.27; P = 0.04), and cesarean delivery (OR = 1.68, P = 0.04) were associated with higher risk of ACA, while formula feeding was associated with lower risk of ACA (OR = 0.57, P = 0.01). Paternal astigmatism (OR = 0.50, P = 0.01) and assisted reproduction (OR = 0.56, P = 0.03) were associated with lower risk of horizontal or vertical internal compensation. More outdoor activity time (OR = 1.15 for per hour increase, P = 0.01) was associated with higher risk of oblique internal compensation while more nighttime sleep on weekends (OR = 0.83 for per hour increase, P = 0.01) was associated with lower risk of oblique internal compensation. Conclusions Our study confirmed some previously reported risk factors and identified some novel risk factors for astigmatism including formula feeding for lower risk of both ACA and TA, and older paternal age at child birth for higher risk of TA.

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“…It is worth noting that the studies comparing visual acuity and socioeconomic situation described above do not adjust for coexisting eye disease (apart from previous cataract surgery and uncorrected refractive error by Yip et al (2013)), so there may be some overlap with associations described in the following sections of this article. Goverdhan et al (2011) found that socioeconomic disadvantage was associated with shorter axial length (0.24mm difference between the highest and lowest IMD quintiles) and greater astigmatism (0.12 dioptres (D) difference between the highest and lowest quintiles), but not with spherical refraction. The absence of an association with spherical refraction and the level of difference in astigmatism would suggest that there is no clinically significant association here.…”

Section: Reduced Visual Acuity (Va)mentioning

confidence: 96%

Do Socioeconomic Inequalities Exist Within Ophthalmology and Orthoptics in the UK?: A Scoping Review

England,

O’Connor

2024

British and Irish Orthoptic Journal

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Introduction:It is well documented that socioeconomic disadvantage adversely affects general health and ocular health worldwide. Within orthoptics, while clinicians recognise a relationship between socioeconomic situation and treatment outcome, no previous literature review was found to address this issue. Neither was a UK-specific literature review found to address the same issue for ophthalmology as a whole.Aim: This literature review evaluates evidence for an association between socioeconomic situation and ophthalmic/orthoptic conditions and their treatment outcomes, specifically within the UK.Methods: Keyword searches were conducted on Google Scholar and the University of Liverpool library catalogue. Results for the main analyses were limited to full papers, specific to the UK, written in English. Literature was only included from pre-2000 if more recent evidence was insufficient.Results: There is evidence of socioeconomic disadvantage being associated with the following: reduced visual acuity; reduced attendance at diabetic retinopathy screening appointments; and delayed presentation of glaucoma, cataracts, and diabetic retinopathy. However, evidence linking socioeconomic disadvantage to AMD is mixed. There is limited evidence of the increased prevalence of amblyopia and subsequent barriers to its treatment for socioeconomically underserved children. There is also evidence of a reduction in quality of life for socioeconomically underserved adults with strabismus.Conclusions: Health inequalities within ophthalmology and orthoptics are reported, but with confounding results for some conditions. Further research should explore the reasons behind the inequalities that are found and identify methods of reducing them.

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Shorter Axial Length and Increased Astigmatic Refractive Error are Associated With Socio-Economic Deprivation in an Adult UK Cohort

Abstract: Axial length and astigmatic refraction were inversely associated with socio-economic deprivation in this population. Identification of the environmental exposures involved may identify reversible risk factors for impaired vision.

Cited by 6 publications

References 10 publications

The influence of the environment and lifestyle on myopia

The influence of the environment and lifestyle on myopia

Risk factors for astigmatic components and internal compensation: the Nanjing Eye Study

Do Socioeconomic Inequalities Exist Within Ophthalmology and Orthoptics in the UK?: A Scoping Review

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