Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)最新文献

{"title":"COVID-19 and myopia.","authors":"Mark Rosenfield","doi":"10.1111/opo.12944","DOIUrl":"https://doi.org/10.1111/opo.12944","url":null,"abstract":"At the time of writing, it seems as if there is no end in sight to the ongoing COVID19 pandemic. The Omicron variant is the latest form of the virus, and seems unlikely to be the last one. Once again, public health discussions are being held around the world regarding the need for lockdowns, mask mandates, booster vaccinations, social distancing and remote working and/or education. One thing that has become apparent since the first recognition of the SARSCoV2 virus in late 2019 is a dramatic increase in the prevalence of myopia, particularly in studies emerging from China. 3 For example, Wang et al. observed a significant increase in myopia progression in children between 6 and 9 years of age in the year 2020, although it should be noted that their data comprised noncycloplegic refractions without concurrent axial length measurements. However, other investigations have also reported significant increases in myopia under cycloplegia, generally accompanied by increased viewing of electronic screens and reduced time spent outdoors. Indeed, an editorial by Klaver et al. referred to 2020 as the year of “Quarantine Myopia”. Sadly, it seems likely that this increase in refractive development will continue through 2021 and beyond. The key question is what is the underlying cause of this marked jump in myopia progression. The dramatic increase in screen time associated with home schooling and remote working is an obvious suspect. For instance, Ma et al. reported a huge increase in the amount of time spent looking at displays, with an average of 0.67 and 5.24 h of screen time per day in October 2019 (prelockdown) and May 2020 (postlockdown), respectively. The use of digital devices and especially smartphones, which are typically held at close viewing distances, is frequently linked with refractive error development. However, the myopia epidemic taking place around the world, but most especially in East Asia has been ongoing since the 1950s. Having a personal computer outside the workplace was rare before the mid1980s, and the first smartphone did not become available to the public until 2007; more than half a century after the “myopia boom” first began. Therefore, while it is easy to link viewing digital screens with myopia development, the data supporting such an association are limited. Another possibility is that the observed change is an accommodative aftereffect, resulting from a failure to relax the accommodative response completely following sustained periods of nearwork. This maintained response could result from the prolonged viewing of screens or other near targets, restricted conditions that do not allow distance fixation or both. For instance, a study performed in Turkey found less myopia progression in children who lived in “detached houses” versus “apartment blocks”. While these terms were not specifically defined, an inability to view targets at optical infinity will inhibit the complete relaxation of accommodation. This could occur for resi","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":"255-257"},"PeriodicalIF":2.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39809635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of myopia among urban and suburban school children in Tamil Nadu, South India: findings from the Sankara Nethralaya Tamil Nadu Essilor Myopia (STEM) Study.","authors":"Aparna Gopalakrishnan,&nbsp;Jameel Rizwana Hussaindeen,&nbsp;Viswanathan Sivaraman,&nbsp;Meenakshi Swaminathan,&nbsp;Yee Ling Wong,&nbsp;James A Armitage,&nbsp;Alex Gentle,&nbsp;Simon Backhouse","doi":"10.1111/opo.12943","DOIUrl":"https://doi.org/10.1111/opo.12943","url":null,"abstract":"<p><strong>Purpose: </strong>To report the baseline prevalence of myopia among school children in Tamil Nadu, South India from a prospective cohort study.</p><p><strong>Methods: </strong>Children between the ages of 5 and 16 years from 11 schools in two districts of Tamil Nadu underwent vision screening. All children underwent visual acuity assessment using a Pocket Vision Screener followed by non-cycloplegic open-field autorefraction (Grand Seiko WAM-5500). Myopia was defined as a spherical equivalent (SE) refraction of ≤-0.75 D and high myopia was defined as SE ≤ -6.00 D. Distribution of refraction, biometry and factors associated with prevalence of myopia were the outcome measures.</p><p><strong>Results: </strong>A total of 14,699 children completed vision screening, with 2% (357) of them having ocular abnormalities other than refractive errors or poor vision despite spectacle correction. The remaining 14,342 children (7557 boys; 52.69%) had a mean age of 10.2 (Standard Deviation [SD] 2.8) years. A total of 2502 had myopia in at least one eye, a prevalence of 17.5% (95% CI: 14.7-20.5%), and 74 (0.5%; 95% CI: 0.3-0.9%) had high myopia. Myopia prevalence increased with age (p < 0.001), but sex was not associated with myopia prevalence (p = 0.24). Mean axial length (AL; 23.08 (SD = 0.91) mm) and mean anterior chamber depth (ACD; 3.45 (SD = 0.27) mm) positively correlated with age (p < 0.001). The mean flat (K1; 43.37 (SD = 1.49) D) and steep (K2; 44.50 (SD = 1.58) D) corneal curvatures showed negative correlation with age (p = 0.02 and p < 0.001, respectively). In the multivariable logistic regression, older age and urban school location had higher odds for prevalence of myopia.</p><p><strong>Conclusion: </strong>The baseline prevalence of myopia among 5- to 16-year-old children in South India is larger than that found in previous studies, indicating that myopia is becoming a major public health problem in this country.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":"345-357"},"PeriodicalIF":2.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0f/12/OPO-42-345.PMC9304285.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39813323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life in lockdown: impact of COVID-19 lockdown measures on the lives of visually impaired school-age children and their families in India.","authors":"Vijaya K Gothwal,&nbsp;KrishnaPriya Kodavati,&nbsp;Ahalya Subramanian","doi":"10.1111/opo.12928","DOIUrl":"https://doi.org/10.1111/opo.12928","url":null,"abstract":"<p><strong>Purpose: </strong>The COVID-19 outbreak has adversely impacted all societal domains including education. Home confinement, school closures and distance learning impacted children's, teachers' and parents' lives worldwide. In this study, we aimed to examine the impact of the COVID-19 lockdown on the lives, including education, of school-age children with vision impairment (VI) and their parents in India.</p><p><strong>Methods: </strong>Primary and secondary school children with VI were recruited from the Institute for Vision Rehabilitation, L V Prasad Eye Institute, Hyderabad, India. A qualitative research methodology, utilising a self-constructed questionnaire with open and closed questions and stem and leaf design, was employed to explore the experiences of school closure and its impact on education and attending online classes during the COVID-19 lockdown. Textual data from responses to the questions were analysed using content analysis to identify themes pertinent to the cohort studied.</p><p><strong>Results: </strong>Forty eight child-parent dyads were included. The median age of children was 10 years (range, 7-19 years) and 60% were male. Inherited retinal disorders were the major cause of VI (40%). Best spectacle corrected visual acuity (better eye) ranged from 0.30 to 2.09 logMAR (6/12 to 6/750). Six major themes were identified: (1) accessibility of technology (online learning and technology); (2) parental beliefs/concerns (harmful effects of technology, prioritisation of normally sighted children, online classes considered a distraction); (3) support (peers, parents, teachers, private tuition); (4) socialisation and physical activity; (5) socioeconomic status and (6) near vision.</p><p><strong>Conclusions: </strong>This study provides an understanding of the adverse impact of lockdown on the lives of children with VI and their parents, especially related to education in India. The study identified critical factors that affect online learning and the participation of children with VI in these sessions. Policymakers and educators should implement effective measures for supporting online classes.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":"301-310"},"PeriodicalIF":2.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39698533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of autorefractors using the image-size principle in determining on-axis and off-axis refraction. Part 1: Analysis of optical principles of autorefractors.","authors":"Charles E Campbell,&nbsp;Marwan Suheimat,&nbsp;Stanislovas Zacharovas,&nbsp;David A Atchison","doi":"10.1111/opo.12933","DOIUrl":"https://doi.org/10.1111/opo.12933","url":null,"abstract":"<p><strong>Purpose: </strong>To study the optical principles and properties of autorefractors that use the image-size principle in which the size of the reimaged retinal image determines refraction.</p><p><strong>Methods: </strong>The retinal illumination and reimaging of the retinal image were described, as were variations in the basic system. Imaging was determined for systems in which the light source is either diverging or converging as it passes into the eye. Equations were determined to describe the dependence of refraction on the heights and angles of incoming and outgoing beams, and refraction error was determined when eye position was not correct.</p><p><strong>Results: </strong>The fundamental refraction equation is <math><mrow><msub><mi>D</mi><mi>E</mi></msub><mo>=</mo><mo>±</mo><mrow><mo>(</mo><mi>α</mi><mo>+</mo><mi>θ</mi><mo>)</mo></mrow><mo>/</mo><msub><mi>h</mi><mn>1</mn></msub></mrow></math> where D_E is refraction, h₁ is the beam height entering the eye, and θ and α are the angles of the incoming and outgoing beams, respectively. The negative sign outside the brackets applies if the beam focuses before entering the eye, while the positive sign applies if the beam focuses after entering the eye. When light is diverging as it reaches the anterior eye, hyperopia produces greater retinal image sizes than myopia. The opposite is the case when light is converging as it reaches the anterior eye. The effect of incorrect ocular longitudinal position on the measured refraction was determined; this produced errors identical to those for vertex errors with ophthalmic lenses.</p><p><strong>Conclusion: </strong>For image-size principle autorefractors, simple equations describe the dependence of measured refraction on the height and angle of the instrument beam as it enters the eye and the angle of the light, reflected back from the retina, after it exits the eye. Further work will investigate the validity of such instruments for determining peripheral refraction.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":"283-292"},"PeriodicalIF":2.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39740916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of autorefractors using the image-size principle in determining on-axis and off-axis refraction. Part 2: Theoretical study of peripheral refraction with the Grand Seiko AutoRef/Keratometer WAM-5500.","authors":"David A Atchison,&nbsp;Marwan Suheimat,&nbsp;Stanislovas Zacharovas,&nbsp;Charles E Campbell","doi":"10.1111/opo.12936","DOIUrl":"https://doi.org/10.1111/opo.12936","url":null,"abstract":"<p><strong>Purpose: </strong>To determine, through simulations, the likely validity of Grand-Seiko autorefractors with annular targets in peripheral refraction.</p><p><strong>Methods: </strong>Using a physical model eye, the distance inside the eye to which the Grand Seiko AutoRef/Keratometer WAM-5500 beam was converging and the effective size of its outer diameter at the cornea were determined. Grand-Seiko refraction was calculated from R_x  = (θ + α)/h₁ , where θ is the angle of the ingoing radiation beam, h₁ is the height of the beam at the anterior cornea and α is the angle of the beam emerging from the eye following reflection at the retina. Two eye models were used: a Navarro schematic eye and a Navarro schematic eye with a contact lens having a highly positive aspheric front surface.</p><p><strong>Results: </strong>The instrument beam was determined to be converging towards the eye to a distance of 24.4 mm behind the corneal vertex, with a 2.46 mm effective size outer diameter of the beam at the anterior cornea. The Grand-Seiko refractions provided accurate estimates of peripheral refraction for the model eyes. The results were closer to Zernike refractions than to Zernike paraxial refraction. Spherical aberration influenced refraction by up to 0.5 D, and peripheral coma had limited influence.</p><p><strong>Conclusion: </strong>Grand-Seiko autorefractors in current use, and having a circular annulus with an ingoing effective outer diameter at the front of the eye of about 2.4 mm, are likely to give valid peripheral refractions.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":"293-300"},"PeriodicalIF":2.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39740918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technical notes on prism-dioptre and Prentice's rule.","authors":"Sidney J Faria-E-Sousa","doi":"10.1111/opo.12924","DOIUrl":"https://doi.org/10.1111/opo.12924","url":null,"abstract":"<p><strong>Purpose: </strong>To show an alternative interpretation for prism-dioptre and access Prentice's rule accuracy.</p><p><strong>Methods: </strong>Algebraic calculation.</p><p><strong>Results: </strong>The prism-dioptre can be expressed as a percentage of the distance between the prism and the plane of prismatic dislocation. Prentice's rule is an imprecise mathematical expression prone to expressive errors.</p><p><strong>Conclusions: </strong>The prism-dioptre seems to be more informative when interpreted as a percentage. Prentice's rule is more effective as a pedagogical approach for introducing the concept of spherical lenses' prismatic image dislocation rather than a method for calculating its actual value.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":"410-413"},"PeriodicalIF":2.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39779234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-intensity, long-wavelength red light slows the progression of myopia in children: an Eastern China-based cohort.","authors":"Lei Zhou,&nbsp;Chao Xing,&nbsp;Wei Qiang,&nbsp;Chaoqun Hua,&nbsp;Liyang Tong","doi":"10.1111/opo.12939","DOIUrl":"https://doi.org/10.1111/opo.12939","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the effect of low-intensity, long-wavelength red light therapy (LLRT) on the inhibition of myopia progression in children.</p><p><strong>Methods: </strong>A retrospective study was conducted. One hundred and five myopic children (spherical equivalent refractive error [SER] -3.09 ± 1.74 dioptres [D]; mean age, 9.19 ± 2.40 years) who underwent LLRT treatment (power 0.4 mW, wavelength 635 nm) twice per day for 3 min each session, with at least a 4-h interval between sessions, and a control group of 56 myopic children (SER -3.04 ± 1.66 D; mean age, 8.62 ± 2.45 years) were evaluated. Both groups wore single-vision distance spectacles. Each child returned for a follow-up examination every 3 months after the initial measurements for a total of 9 months.</p><p><strong>Results: </strong>At 9 months, the mean SER in the LLRT group was -2.87 ± 1.89 D, significantly greater than that of the control group (-3.57 ± 1.49 D, p < 0.001). Axial length (AL) changes were -0.06 ± 0.19 mm and 0.26 ± 0.15 mm in the LLRT group and control group (p < 0.001), respectively. The subfoveal choroidal thickness changed by 45.32 ± 30.88 μm for children treated with LLRT at the 9-month examination (p < 0.001). Specifically, a substantial hyperopic shift (0.31 ± 0.24 D and 0.20 ± 0.14 D, respectively, p = 0.02) was found in the 8-14 year olds compared with 4-7 year old children. The decrease in AL in subjects with baseline AL >24 mm was -0.08 ± 0.19 mm, significantly greater than those with a baseline AL ≤24 mm (-0.04 ± 0.18 mm, p = 0.03).</p><p><strong>Conclusions: </strong>Repetitive exposure to LLRT therapy was associated with slower myopia progression and reduced axial growth after short durations of treatment. These results require further validation in randomised controlled trials.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":"335-344"},"PeriodicalIF":2.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39783164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why are refractive corrections excluded from the public benefit packages in the UK and in Sweden?","authors":"Joakim Färdow","doi":"10.1111/opo.12926","DOIUrl":"https://doi.org/10.1111/opo.12926","url":null,"abstract":"To the Editor, I read with great interest the guest editorial by Ramke and Logan on visual impairments caused by refractive errors and the challenges of providing accessible and affordable refractive care to all individuals with refractive errors. I share many of the authors' views and would like to add some further reflections focusing a question that is seldom asked: why are refractive corrections excluded from public benefit packages? What are the reasons for this exclusion in countries like the United Kingdom and Sweden? Health care needs related to refractive errors are diverse and range from the rather modest needs of individuals with presbyopia or mild myopia to the highly significant needs of individuals with prominent refractive errors resulting in low uncorrected visual acuity. Refractive errors belong to the field of medical science, and they are provided with diagnostic codes in the ICDsystem. Interventions to correct refractive errors are performed by medical means and require the skills of registered health care professionals. However, in the United Kingdom and Sweden health care needs associated with refractive errors are not covered or assessed in the public health benefit packages on the same terms as other medical conditions affecting the visual system. This exclusion has received surprisingly little attention in these two countries, which are otherwise known for high shares of publicly funded health care and ambitious commitments of allocating health care resources based on health care needs. In the UK, individuals who belong to certain eligible groups are entitled to free eye tests and optical vouchers provided by the National Health Service (NHS). However, people with refractive errors who do not fit into any of these groups must finance refractive corrections themselves. In Sweden, conditions are even more stringent: only individuals under the age of 19 years are eligible for grants for glasses. All other individuals with refractive errors must finance corrections themselves, regardless of the degree of the refractive error and its impact on the individual's visual acuity. In ethical theory, needs depict states of dependency. Health care needs relate to some sort and degree of disability. Individuals with refractive errors need refractive corrections, and individuals with high degrees of refractive errors need corrections to manage most things in their lives: to perform certain jobs, to carry out everyday tasks and to accomplish various life goals. The health care interventions needed to correct refractive errors, such as spectacles, contact lenses or refractive surgical procedures, are very efficient and have a potential to move individuals from a state of severe visual impairment to a state of perfect visual acuity. When assessing needs and health care resources in prioritisation and allocation processes, it is important to regard the noninterventional state relative to the postinterventional state. The noninterventional s","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":"414-415"},"PeriodicalIF":2.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39801682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the visual image quality provided by refractive corrections during keratoconus progression.","authors":"Jos J Rozema,&nbsp;Gareth D Hastings,&nbsp;Marta Jiménez-García,&nbsp;Carina Koppen,&nbsp;Raymond A Applegate","doi":"10.1111/opo.12931","DOIUrl":"https://doi.org/10.1111/opo.12931","url":null,"abstract":"<p><strong>Purpose: </strong>To expand the SyntEyes keratoconus (KTC) model to assess the Visual Image Quality (VIQ) of sphero-cylindrical spectacle and rigid contact lens corrections as keratoconus progresses.</p><p><strong>Methods: </strong>The previously published SyntEyes KTC eye model to determine best sphero-cylindrical spectacle and rigid contact lens correction in keratoconic eyes was expanded to include the natural progression of keratoconus, thus allowing the assessment of corrected VIQ with disease progression.</p><p><strong>Results: </strong>As keratoconus progresses, the pattern of visual Strehl ratio (VSX) in correction space for spectacles alters from a typical hourglass into a shell pattern. The former would guide the subjective refraction towards the optimal correction while the latter is relatively insensitive to large dioptric steps. In 15 out of the 20 SyntEyes, the shell pattern eventually produces two foci on different sides of the correction space separated by a clinically significant dioptric difference with a similar, albeit lower VIQ. Wearing the best possible spectacle corrections provided an average gain of up to 3.5 lines of logMAR visual acuity compared to the uncorrected cases, which increased to 5.5 lines for the best rigid contact lens correction. Continuing to wear a spectacle correction as the disease progresses often leads to a VIQ that is almost as bad as the uncorrected case. Continuing to wear a rigid contact lens correction as the disease progresses maintains a relatively high level of VIQ, albeit in the low range for typically well-corrected normal eyes.</p><p><strong>Conclusions: </strong>The results reflect the clinical experience that subjective refraction is difficult in highly-aberrated keratoconic eyes, the benefit of spectacle correction is short lived and that rigid contact lenses provide better and more stable VIQ with disease progression. Other aspects, such as the presence and behaviour of the second focus in some cases, remain to be confirmed clinically.</p>","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":"358-366"},"PeriodicalIF":2.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39804715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison between estimated and measured myopia progression in Hong Kong Children without myopia intervention.","authors":"Thomas Naduvilath,&nbsp;Padmaja Sankaridurg","doi":"10.1111/opo.12942","DOIUrl":"https://doi.org/10.1111/opo.12942","url":null,"abstract":"To the Editor, We read with interest the original article “Comparison between estimated and measured myopia progression in Hong Kong children without myopia control intervention” by Yang et al. The authors compared myopia progression estimates for children without myopia management with the BHVI myopia calculator (bhvi.org/myopiacalculatorresources/) to rates measured in approximately 216 Hong Kong children wearing single vision spectacles (using spherical equivalent refraction (SER) data). They graphically estimated the 95% confidence limits to ascertain if the measured values fell within the calculator's range. They concluded that: (a) their measured cycloplegic SER was in close agreement to the estimated SER from the calculator, but (b) the measured individual progression fell within the 95% confidence intervals (CI) for only 32– 38% of children, and the remainder fell equally above and below the limits. They concluded that that the data should be interpreted with caution and that inclusion of additional data and larger sample sizes should be considered. We disagree with their method of applying confidence intervals to estimate individual progression and hence their conclusions for the reasons explained below. Childhood myopia is progressive, and there is substantial evidence on the benefits of reducing the risk of the eye reaching higher levels of myopia. Many of the current myopia control strategies slow but do not arrest myopia. The BHVI myopia calculator was designed to be a simple tool to illustrate the progressive nature of myopia, and to help practitioners demonstrate to patients and parents the benefits of myopia control treatments. The calculator was not designed to monitor the progression of myopia for each eye of an individual. As the authors rightly suggest, such evaluation of progression may require more than one parameter. The calculator's “without management” estimates for the Asian population was derived using data from 4504 myopic eyes, and provides the mean refractive error with increasing age (each year) and the 95% CI for the mean refractive error. Thus, the CI is the range within which the “mean refractive error” for a given age will lie. The fact that the authors report that the mean refractive error values are closely aligned with the “without management” values proves that the calculator provides a close approximation of the mean refractive error at that age, and indicates that the calculator is functioning as intended. In this regard, increasing the sample size as the authors suggest will likely narrow and not expand this CI. For diverse populations, Published online: 7 January 2022","PeriodicalId":520731,"journal":{"name":"Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)","volume":" ","pages":"418-419"},"PeriodicalIF":2.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39654088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}