Adolescent ; Adult ; Blindness ; epidemiology ; etiology ; prevention & control ; Female ; Global Health ; Humans ; Incidence ; Male ; Retrospective Studies ; Risk Factors ; Smoking ; adverse effects

INTRODUCTION: Amblyopia treatment in the form of glasses and/or patching in children poses a great challenge to parents. This study aimed to assess the factors that influence visual outcome in amblyopia and children's perception towards treatment. METHODS: 180 children (aged 3.0-7.0 years) with newly diagnosed amblyopia were recruited. The effects of age, gender, type of amblyopia, treatment and compliance on visual outcome at one year were assessed. Parents completed a questionnaire on children's attitudes towards amblyopia treatment. RESULTS: 150 (83%) children with a mean age of 5.2 ± 0.8 years returned for follow-up at one year. 130 (87%) had refractive amblyopia and 20 (13%) had strabismic and refractive-strabismic amblyopia. Visual acuity (VA) of 6/9 or better in the amblyopic eye was achieved in 121 (81%) children. On multivariable analysis, poor responders were more likely to have initial VA of worse than 6/15 (relative risk [RR] 4.17, 95% confidence interval [CI] 1.58-11.00, p = 0.004), prescribed combined (glasses and patching) treatment (RR 2.83, 95% CI 1.02-7.83, p = 0.045) and poor compliance (RR 6.10, 95% CI 1.90-19.57, p = 0.002) after adjustment for age, gender and type of amblyopia. While 7% of children initially reacted poorly to treatment, 5% remained uncooperative at the first follow-up visit. Children had difficulty with schoolwork (5%), mood changes (6%) and social problems (2%) associated with treatment. CONCLUSION Most children with amblyopia respond well to treatment, but more care (i.e. more parental education and closer follow-up) may be needed in children who are non-compliant and have poorer initial VA.

INTRODUCTIONThis study aimed to evaluate the proportion of young patients with type 1 diabetes mellitus (T1DM) who have myopia, as well as the risk factors associated with myopia in this group.

METHODSIn this cross-sectional study, patients aged < 21 years with T1DM for ≥ 1 year underwent a comprehensive eye examination. Presence of parental myopia, and average hours of near-work and outdoor activity were estimated using a questionnaire. Annualised glycosylated haemoglobin (HbA1c), defined as the mean of the last three HbA1c readings taken over the last year, was calculated. Multivariate analysis using genetic, environmental and diabetes-related factors was done to evaluate risk factors associated with myopia.

RESULTSOf the 146 patients (mean age 12.5 ± 3.6 years) recruited, 66.4% were Chinese and 57.5% were female. Myopia (i.e. spherical equivalent [SE] of -0.50 D or worse) was present in 96 (65.8%) patients. The proportion of patients with myopia increased from 25.0% and 53.6% in those aged < 7.0 years and 7.0-9.9 years, respectively, to 59.2% and 78.4% in those aged 10.0-11.9 years and ≥ 12.0 years, respectively. Higher levels of SE were associated with lower parental myopia (p = 0.024) and higher annualised HbA1c (p = 0.011).

CONCLUSIONCompared to the background population, the proportion of myopia in young patients with T1DM was higher in those aged < 10 years but similar in the older age group. Myopia was associated with a history of parental myopia. Environmental risk factors and poor glycaemic control were not related to higher myopia risk.

Adolescent ; Asian Continental Ancestry Group ; Child ; Child, Preschool ; Cross-Sectional Studies ; Diabetes Mellitus, Type 1 ; complications ; ethnology ; Female ; Glycated Hemoglobin A ; analysis ; Humans ; Male ; Multivariate Analysis ; Myopia ; complications ; ethnology ; therapy ; Ophthalmology ; methods ; Refractive Errors ; Risk Factors ; Young Adult