Objective: Based on a cohort and intervention study of the Eastern Chinese Student Surveillance, Cohort and Intervention Study (ES-SCI), this research aims to explore the correlation between monitor of the school environment and longitudinal data on myopia and provide evidence for the government myopia intervention strategy. Methods: This survey adopts the stratified cluster sampling method with the school as the unit. Students from grade 1 to grade 3 were selected according to the whole class to monitor the school environment in the classroom. Students will use the full-automatic computer optometer (TOPCON RM800) to conduct optometry from 2019 to 2021 under the condition of mydriasis to perform refractive eye examinations. Meantime eye axis length monitoring was also conducted. Cox proportional risk regression model was used to explore the relationship between school environmental monitoring and the occurrence and development of students' myopia. Results: From 2019 to 2021, 2 670 students from 77 classrooms participated in the observation study. The students' diopter after right/left eye mydriasis decreased in varying degrees (P<0.001), and the axial length of the right/left eye increased in various degrees (P<0.001). The weighted qualified rate of per capita area of primary school classrooms increased from 18.0% in 2019 to 26.0% in 2021, the weighted average illuminance pass rate of blackboard surface increased from 23.8% in 2019 to 26.4% in 2021, and the weighted average illuminance pass rate of classroom table decreased from 86.7% in 2019 to 77.5% in 2021. The trend chi-square test was significant (P<0.05). Cox proportional risk regression showed that after correcting for the grade, gender, parental myopia, diet, sleep, near work (sitting posture, working time, electronic mobile equipment, eye exercises), and outdoor activities, the per capita area of 1.36- m² was the protective factor of eye axis length (HR=0.778, 95%CI: 0.659-0.918, P=0.003); The average reflection ratio of blackboard 0.15-0.19 was the protective factor of eye axis length (HR=0.685, 95%CI: 0.592-0.793, P<0.001); The average illumination of the blackboard 150-, 300-, 500- lx was the protective factor of the eye axis length (HR=0.456, 95%CI: 0.534-0.761, P<0.001; HR=0.794, 95%CI: 0.705-0.895, P<0.001; HR=0.690, 95%CI: 0.619-0.768, P<0.001). The blackboard evenness 0.40-0.59 was the risk factor of eye axis length (HR=1.528, 95%CI: 1.018-2.293, P=0.041), and the blackboard evenness 0.80- was the protection factor of eye axis length (HR=0.542, 95%CI: 0.404-0.726, P<0.001). The evenness of the desktop 0.40-0.59 was the protective factor of eye axis length (HR=0.820, 95%CI: 0.698-0.965, P=0.017). The average illuminance of 150-, 300-, 500- lx was the protective factor of a diopter (HR=0.638, 95%CI: 0.534-0.761, P<0.001; HR=0.911, 95%CI: 0.848-0.978, P=0.011; HR=0.750, 95%CI: 0.702-0.801, P<0.001). The average illumination of desktop 500- lx was a protective factor of a diopter (HR=0.855, 95%CI: 0.763-0.958, P=0.007). Conclusion: School environmental monitoring indicators, such as meeting per capita area standards, passing blackboard, and desk top-related indicators, all play protective effects on myopia development in students.
Humans ; Mydriasis ; Myopia/prevention & control* ; Refraction, Ocular ; Students ; Surveys and Questionnaires ; Schools

BACKGROUNDIn recent years, computers have been intensively used at home. In contrast to paper-based books and documents, computer screen is self-illuminated with larger screen-background luminance difference, which greatly induces visual discomfort. To compensate for that, one effective solution is to offer an additional background luminance. In this study, we investigated whether and to what extent additional background lighting is needed in looking at a computer display comfortably.

METHODSIn this study, 60 healthy children aged from 9 to 12 years and 58 adults aged from 21 to 39 years participated in the experiments. They were asked to choose their most preferred background luminance intensities at three screen luminance levels. The data were analyzed by Matlab (R2012b) and SPSS 20.0.

RESULTSBoth children and adult participants selected a non-dark background as their comfortable lighting condition when watching a computer display (children: t (59) = 22.0, P < 0.01, adults: t (57) = 15.5, P < 0.01). Comparatively, children preferred brighter background in general ( F (1,116) = 7.0, P < 0.01). More importantly, participants' preferred background luminance levels were linearly correlated with screen luminance intensities (children: slope = 0.97, R(2) = 0.98; adults: slope = 0.38, R(2) = 1.00).

CONCLUSIONThese results indicate that varying background luminance to maintain screen-background luminance ratio is beneficial to human visual comfort.

Adult ; Child ; Computers ; Contrast Sensitivity ; physiology ; Female ; Humans ; Lighting ; Male ; Myopia ; prevention & control ; Young Adult

INTRODUCTIONMyopia is a significant public health problem in Singapore with estimates that more than 50% of the population is affected by it by the time of adulthood. Childhood obesity is also increasing and has been linked to long-term health problems. Recent studies have found that Singaporean children in Primary 1 spend less than 3 hours a day outdoors which is less than children in other countries. Physical activity has been shown to be protective against obesity and recently, there has been some evidence to suggest that time spent outdoors may reduce the prevalence and severity of myopia. This study aims to explore the barriers and enablers to children in Singapore participating in outdoor activities.

MATERIALS AND METHODSQualitative data, gathered from focus group discussions was thematically analysed against the PRECEDE component of the PRECEDE-PROCEED model which provided a conceptual framework for examining factors relevant to children participating in an outdoor activity intervention. A total of 31 people participated in 4 focus groups held over a 6-month period.

RESULTSThis feasibility study was exploratory in nature but provided valuable information concerning barriers and enablers to participation. Data informed the development of a larger study.

CONCLUSIONResults indicated that families preferred structured activities such as orienteering and a choice of weekend attendance days and times.

Attitude to Health ; Child ; Child, Preschool ; Community Participation ; Counseling ; Feasibility Studies ; Focus Groups ; Health Behavior ; Health Education ; Health Knowledge, Attitudes, Practice ; Humans ; Jogging ; physiology ; Medical Records ; Motivation ; Motor Activity ; Myopia ; prevention & control ; Parents ; psychology ; Program Development ; Reinforcement (Psychology) ; Running ; physiology ; Singapore ; Walking ; physiology

PURPOSE: To determine methods tried in clinical trials to reduce the progression of myopia in children, and spectacle prescribing patterns of hospital ophthalmologists. METHODS: A multi-sectioned survey composed of Likert items relating to the methods of reducing myopia progression (orthokeratology lenses [O-K lenses], undercorrected glasses, and topical atropine) and the patterns of prescribing spectacles for children (including two cases involving a 5-year-old girl and an 8-year-old boy) were distributed to members of the Korean Ophthalmological Society, and the collected data was statistically analyzed. RESULTS: A total of 78 out of 130 ophthalmologists returned the survey. On a scale of 1 to 5, the mean rates of whether the ophthalmologists think O-K lenses arrest myopia progression, and whether they recommend their patients to wear O-K lenses if indicative, were 3.06 and 2.75, respectively. Moreover, the mean rates of whether they consider that wearing glasses which are undercorrected would slow down the progression of the myopia, or if they think topical atropine helps in arresting myopia progression in children, were 2.34 and 1.27, respectively. In response to the case studies, the majority of practitioners preferred to prescribe the full amount found in cycloplegic refraction to pediatric patients with myopia. CONCLUSIONS: Ophthalmologists in clinical practice encouraged children to wear O-K lenses more than undercorrected glasses as a way to retard myopia progression. However, the application of atropine is rarely tried in clinical trials. In managing pediatric patients with myopia (case specific), the majority of the practitioners chose to prescribe glasses with full cycloplegic correction.
Atropine/administration & dosage ; Child ; Child, Preschool ; Data Collection ; Disease Progression ; Eyeglasses/classification/*utilization ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Myopia/physiopathology/*prevention & control ; Physician's Practice Patterns ; Prescriptions/*statistics & numerical data ; Republic of Korea

OBJECTIVE: To observe the inhibitive effect of pirenzepine on form deprivation myopia in guinea pigs and to explore the mechanism of Smad3 signaling pathway and connective tissue growth factor (CTGF) in the inhibition of myopia by pirenzepine. METHODS: Forty 1-week-old guinea pigs of either sex were randomly divided into 4 groups: a control group (Group I), a form deprivation group (Group II), a pirenzepine ophthalmic solution group (Group III), and a sodium chloride ophthalmic solution group (Group IV). Translucent blinders were used in the right eyes of Group II, III and IV. The left eyes were not given any treatment as the normal control group. Covered eyes of Group III and IV were given 3% pirenzepine ophthalmic solution and 0.1% azone ophthalmic solution respectively twice every day. Six weeks later, refraction and axial length were measured at the end of the experiment, and immunohistochemistry and Western blot were used to analyze the expression levels of Smad3 and CTGF in the sclera of all 4 groups. RESULTS: There was no significant difference between Group III and I in relative refraction and changes of axial length (P>0.05). The difference of Group II and IV compared with Group I was statistically significant (P<0.05). The number of Smad3 and CTGF positive cells in the sclera between Group III and I was not significantly different (P>0.05), while the difference in Group II, IV and I was significant (P<0.05). Western blot showed that the expression levels of Smad3 and CTGF in Group II and IV were much lower than those in Group I (P<0.05), but not evident in Group III and I (P>0.05). CONCLUSION Pirenzepine ophthalmic solution can inhibit the development of form deprivation myopia. Pirenzepine may affect Smad3 signaling pathway in the sclera by inhibiting the development of form deprivation myopia.
Animals ; Connective Tissue Growth Factor ; metabolism ; Guinea Pigs ; Humans ; Muscarinic Antagonists ; administration & dosage ; Myopia ; prevention & control ; Pirenzepine ; administration & dosage ; Random Allocation ; Sensory Deprivation ; Signal Transduction ; drug effects ; Smad3 Protein ; metabolism

BACKGROUNDNonselective muscarinic receptor antagonist, atropine, was believed to inhibit myopic progression. The purpose of this study was to determine the efficacy, through topical administration, of the M1-selective muscarinic antagonist pirenzepine in preventing experimentally induced form-deprivation myopia in guinea pigs.

METHODSFifty-three guinea pigs, which underwent monocular deprivation with their eyelids sutured, were divided into 6 groups. Three groups were treated with 1%, 2% or 4% pirenzepine ophthalmic solutions; the fourth group with atropine; the fifth with saline and the last group left untreated. Ocular refraction, in vivo biometric measurements and wet eye weight were collected before and after the experiment. All the eyes were finally enucleated for histopathological examination to evaluate the possible toxic effects on ocular structures.

RESULTSAnimals untreated or treated with saline produced (-2.31+/-1.47) D and (-2.25+/-0.88) D of axial myopia respectively. Those treated with 1% pirenzepine ophthalmic solution produced relative myopia of (-1.63+/-0.48) D, and those under the treatment of 2% and 4% pirenzepine ophthalmic solution only developed a relative myopia of (-0.89+/-0.42) D and (-0.70+/-0.41) D (F=9.56, P<0.05). The significant reduction in myopia in 2% and 4% pirenzepine treated animals was caused by significantly less vitreous chamber elongation and axial elongation of the deprived eyes [2% group: (0.009+/-0.052) mm, 4% group: (0.006+/-0.078) mm] when compared with untreated, saline treated or 1% pirenzepine treated guinea pigs (0.057+/-0.056) mm, (0.064+/-0.053) mm and (0.033+/-0.035) mm, respectively]. Histological examinations revealed no obviously toxic effects on the eyes treated with pirenzepine.

CONCLUSIONTopical administration of the M1-selective muscarinic antagonist, pirenzepine, can prevent induced form-deprivation myopia in guinea pigs by inhibiting axial elongation without obvious damage to ocular tissues.

Animals ; Eye ; drug effects ; pathology ; Guinea Pigs ; Muscarinic Antagonists ; therapeutic use ; Myopia ; prevention & control ; Ophthalmic Solutions ; Organ Size ; drug effects ; Pirenzepine ; therapeutic use ; Refraction, Ocular ; drug effects

This study evaluated the visual quality after wavefront-guided laser in situ keratomileusis (LASIK) for treating myopia. Thirty-two eyes with moderate myopia (-5.78~-2.17D) and 25 eyes with high myopia (-7.78~-6.17D) were prospectively reviewed. The contrast sensitivity (CS), glare and the total higher order aberrations (HOA) were measured before and 1 week, 1 month and 2 months after LASIK. The pupil diameter was measured at day- and night-time illumination. The CS and glare at all spatial frequencies were not reduced after wavefront-guided LASIK (p<0.05) and the difference between the moderate and high myopia group was not significant. No significant correlation was found between the amounts of myopia and the postoperative CS (p>0.05). The area under the log contrast sensitivity function (AULCSF) showed no correlation with the total HOA (r2=-0.071, p=0.612, between the daytime AULCSF and the total HOA with a 4 mm entrance pupil, r2=-0.176, p=0.260, between the nighttime AULCSF and the total HOA with a 6 mm entrance pupil). There was no decrease in CS and glare after wavefront-guided LASIK for myopia. In conclusion, wavefront-guided LASIK based on the individual ablation patterns is a good option for refractive surgery to improve the visual quality in both moderate and high myopia cases.
Adult ; Comorbidity ; Female ; Humans ; Keratomileusis, Laser In Situ/*statistics and numerical data ; Korea/epidemiology ; Male ; Myopia/*diagnosis/epidemiology/*surgery ; Prognosis ; Recovery of Function ; Research Support, Non-U.S. Gov't ; Treatment Outcome ; Vision Disorders/*diagnosis/epidemiology/*prevention and control ; *Vision Tests ; *Visual Acuity

To evaluate the inhibiting effect of Homoharringtonine (HHT) on the corneal haze after excimer laser photorefractive keratectomy (PRK) in rabbits. 18 healthy rabbits which underwent PRK were randomly divided into three groups (A, B and C). The refractive degree of ablation was - 10.0DS in each group. Group A was locally treated with a piece of filter paper soaked with 1 mg/mL HHT for 5 min, and then the entire cornea was repeatedly irrigated with balance solution; Group B was dropped with 0.1 mg/mL HHT after PRK for 3 months; Group C was the control group. Corneal haze, histopathology, response, ect. were investigated. The corneal haze was significantly less in group A, while the difference between group B and group C was insignificant. Keratocytes and fibrocytes in corneal stroma were more active up to 3 months in group B and group C. Intraoperative use of topical HHT can reduce corneal haze after PRK in rabbits.
Corneal Opacity/etiology ; Corneal Opacity/*prevention & control ; Endothelium, Corneal/pathology ; Harringtonines/*administration & dosage ; Myopia/*surgery ; Photorefractive Keratectomy/*adverse effects ; Random Allocation