The association between time spent on screens and reading with myopia, premyopia and ocular biometric and anthropometric measures in 6- to 7-year-old schoolchildren in Ireland

Purpose More time spent on near tasks has consistently been associated with the promotion of myopia. The World Health Organization advises limiting daily screentime to less than 2 h for children aged five and over. This study explored the relationship between time spent on screens and reading/writing with refractive status, ocular biometric and anthropometric factors in 6-to 7-year- olds in Ireland. Methods Participants were 723 schoolchildren (377 boys [51.8%]), mean age 7.08 (0.45) years. The examination included cycloplegic autorefraction (1% cyclopentolate hydrochloride), ocular biometry (Zeiss IOLMaster), height (cm) and weight (kg). Screentime and reading/writing time were reported by parents/legal guardians by questionnaire. Myopia (≤−0.50D) and premyopia (\u3e−0.50D ≤ 0.75D) risk assessments were performed using logistic regression, and multivariate linear regression was used to analyse continuous variables. Results Reported daily screentimes were 31% \u3c1 h, 49.5% 1–2 h, 15.6% 2–4 h and 3.9% \u3e4 h. Reading/writing times were 42.2% frequently, 48.0% infrequently and 9.8% seldom/never. Linear regression, controlling for age and ethnicity, revealed \u3e2 h/day on screens was associated with a more myopic spherical equivalent [β = −1.15 (95% confidence intervals {CIs}: 1.62–0.69, p \u3c 0.001)], increased refractive astigmatism (β = 0.29, CI: 0.06–0.51, p = 0.01), shorter corneal radius (β = 0.12, CI: 0.02–0.22, p = 0.02), higher axial length/corneal radius (β = 0.06, CI: 0.03–0.09, p \u3c 0.001), heavier weight (β = 1.60, CI: 0.76–2.45, p \u3c 0.001) and higher body mass index (BMI) (β = 1.10, CI: 0.28–1.12, p \u3c 0.001). Logistic regression, controlling for age and ethnicity, revealed daily screentime \u3e2 h was associated with myopia (OR = 10.9, CI: 4.4–27.2, p = 0.01) and premyopia (OR = 2.4, CI: 1.5–3.7, p \u3c 0.001). Frequent reading/writing was associated with screentime ≤2 h/day (OR = 3.2, CI: 1.8–5.8, p \u3c 0.001). Conclusion Increased screentime was associated with a more myopic refraction, higher axial length/corneal radius ratio, increased odds of myopia, premyopia, higher degrees of astigmatism, increased weight, BMI and decreased reading/writing time. Dedicated education programmes promoting decreased screentime in children are vital to prevent myopia and support eye and general health

Primary School Children\u27s Vision Screening Project

In the final year of the BSc in Optometry, students work with children in local schools to do vision screenings, supervised by DIT lecturers. This project enhances students’ experience of working with children, and ensures that any local children with eye problems are swiftly referred to a specialist.https://arrow.tudublin.ie/civpostbk/1009/thumbnail.jp

Ocular biometry, refraction and time spent outdoors during daylight in Irish schoolchildren

Background: Previous studies have investigated the relationship between ocular biometry and spherical equivalent refraction in children. This is the first such study in Ireland. The effect of time spent outdoors was also investigated. Methods: Examination included cycloplegic autorefraction and non-contact ocular biometric measures of axial length, corneal radius and anterior chamber depth from 1,626 children in two age groups: six to seven years and 12 to 13 years, from 37 schools. Parents/guardians completed a participant questionnaire detailing time spent outdoors during daylight in summer and winter. Results: Ocular biometric data were correlated with spherical equivalent refraction (axial length: r = −0.64, corneal radius: r = 0.07, anterior chamber depth: r = −0.33, axial length/corneal radius ratio: r = −0.79, all p \u3c 0.0001). Participants aged 12–13 years had a longer axial length (6–7 years 22.53 mm, 12–13 years 23.50 mm), deeper anterior chamber (6–7 years 3.40 mm, 12–13 years 3.61 mm), longer corneal radius (6–7 years 7.81 mm, 12–13 years 7.87 mm) and a higher axial length/corneal radius ratio (6–7 years 2.89, 12–13 years 2.99), all p \u3c 0.0001. Controlling for age: axial length was longer in boys (boys 23.32 mm, girls 22.77 mm), and non-White participants (non-White 23.21 mm, White 23.04 mm); corneal radius was longer in boys (boys 7.92 mm, girls 7.75 mm); anterior chamber was deeper in boys (boys 3.62 mm, girls 3.55 mm, p \u3c 0.0001), and axial length/corneal radius ratios were higher in non-White participants (non-White 2.98, White 2.94, p \u3c 0.0001). Controlling for age and ethnicity, more time outdoors in summer was associated with a less myopic refraction, shorter axial length, and lower axial length/corneal radius ratio. Non- White participants reported spending significantly less time outdoors than White participants (p \u3c 0.0001). Conclusion: Refractive error variance in schoolchildren in Ireland was best explained by variation in the axial length/corneal radius ratio with higher values associated with a more myopic refraction. Time spent outdoors during daylight in summer was associated with shorter axial lengths and a less myopic spherical equivalent refraction in White participants. Strategies to promote daylight exposure in wintertime is a study recommendation

Prevalence of colour vision deficiency in the Republic of Ireland schoolchildren and associated socio-demographic factors

Clinical relevance: Early screening is essential to counsel schoolchildren with congenital colour vision deficiency (CVD) in determining their future career path and to advise teachers of the impact of CVD on classroom difficulties. Background: Congenital CVD is an X-linked genetic abnormality relatively commonplace in humans. This study aimed to determine the prevalence of congenital CVD in the Republic of Ireland schoolchildren and associated socio-demographic factors. Methods: A total of 1,626 schoolchildren (882 boys and 744 girls), in two age groups (728 aged 6–7 years and 898 aged 12–13 years) were examined from randomly selected schools. Colour vision testing was carried out using the Richmond Hardy-Rand-Rittler pseudoisochromatic test for colour vision (fourth edition); diagnostic plates were used to determine CVD type and extent if participants failed to identify symbols on the screening plates. Results: CVD was detected in 73 boys (8.3 per cent, 95% confidence interval (CI) 6.6–10.3) and in 13 girls (1.8 per cent, 95% CI 1.0–3.1, p \u3c 0.001). As expected, deutan (boys 4.8 per cent, girls 0.8 per cent) was the most common type of CVD, followed by protan (boys 1.7 per cent, girls 0.1 per cent), unclassified red/green CVD (boys 1.2 per cent, girls 0.8 per cent) and then tritan (boys 0.5 per cent). One case of achromatopsia was detected based on failure on all diagnostic plates. Traveller participants (boys 21.0 per cent, girls 8.6 per cent) had a higher CVD prevalence than their White non-Traveller (boys 7.2 per cent, girls 1.0 per cent) and non-White (boys 5.4 per cent, girls 1.1 per cent) counterparts (odds ratio 3.00, 95% CI 1.1–8.1, p = 0.006). In boys, CVD was also associated with twin birth (odds ratio 2.7, 95% CI 1.1–6.7, p = 0.03) and low birthweight (p = 0.04). Conclusion: This investigation of CVD in the Republic of Ireland schoolchildren should alert clinicians to the association between CVD and Traveller ethnicity, twin birth and lower birthweight. The prevalence of CVD found was similar to previous studies involving predominantly White populations and higher among Traveller participants; hence, counselling regarding inherited anomalies in the Traveller community is recommended. Early screening is essential to counsel schoolchildren with CVD in determining their future career path and to advise teachers of the impact of CVD on classroom difficulties

Risk factors associated with myopia in schoolchildren in Ireland

Aim To examine the demographic and social factors associated with myopia in schoolchildren in Ireland. Methods Thirty-seven schools participated, representing a mix of urban and rural schools and schools in socioeconomically disadvantaged and non-disadvantaged areas in Ireland. Examination included cyclopleged autorefraction (1% cyclopentolate hydrochloride). Height and weight of participants were measured. Parents filled in a participant’s lifestyle questionnaire, including questions on daily screen time use and daylight exposure. Myopia was defined as spherical equivalent ≤−0.50 D. Results Data from 1626 participants (881 boys, 745 girls) in two age groups, 6–7 years (728) and 12–13 years (898), were examined. Myopia prevalence was significantly higher in children aged 12–13 years old (OR=7.7, 95%CI 5.1 to 11.6, p\u3c0.001) and significantly associated with non-white ethnicity (OR=3.7, 95% CI 2.5 to 5.3, p\u3c0.001). Controlling for age group and ethnicity, myopia prevalence was also significantly linked with height (p\u3c0.001) and higher in participants in the following groups: using screens \u3e3 hours per day (OR=3.7, 95% CI 2.1 to 6.3, p\u3c0.001), obesity (OR=2.7, 95% CI 1.9 to 3.9, p\u3c0.001), sedentary lifestyle (OR=2.9, 95% CI 1.9 to 4.4, p\u3c0.001), frequently reading/writing (OR=2.2, 95% CI 1.4 to 3.5, p=0.001), less daylight exposure during summer time (OR=5.00, 95% CI 2.4 to 10.3, p\u3c0.001), spring season births (OR=1.9, 95% CI 1.1 to 3.3, p=0.02), paternal history of myopia (OR=2.4, 95% CI 1.8 to 3.3, p\u3c0.001) and bottle fed for the first three months of life (OR=1.7, 95% CI 1.3 to 2.5, p=0.02). Conclusions The associations found between myopia prevalence in schoolchildren in Ireland and demographic and lifestyle factors suggest that longitudinal research investigating the associations between myopia prevalence and these factors may be beneficial in advising preventative public health programmes

School performance and undetected and untreated visual problems in schoolchildren in Ireland; a population-based cross-sectional study

This study explored the association between children’s vision and their school academic progress as reported by parents/guardians. Participants were 1,612 schoolchildren (722 6-7-year-olds, 890 12-13-year-olds) in randomly selected schools in Ireland. In advance of data collection, parents/guardians reported school performance as (a) much better than classmates (high-performance) (b) about the same as classmates (average-performance) (c) not as well as classmates (low-performance). Measurements included logMAR monocular visual acuities (with spectacles if worn, and pinhole) in the distance (3 m) and near (40 cm); the amplitude of accommodation; stereoacuity, colour vision assessment, and cyclopleged autorefraction. Controlling for confounders, children presenting with visual impairment (vision poorer than 0.3logMAR (6/12) in the ‘better eye’), amblyopia (‘lazy eye’), uncorrected refractive error (hyperopia ≥+3.50D and astigmatism ≥1.50DC), reduced for age ability to adjust focus from distance to near tasks (accommodation), impaired three-dimensional vision (stereoacuity), and defective colour vision were more likely to report low-performance in school. The majority of low-performing participants (68%) did not have an eye examination within the 12 months before data collection. Children with academic performance challenges ought to have a comprehensive eye examination, to detect potential vision problems for early intervention minimising any negative impact they may have on educational outcomes

Risk factors associated with myopia in schoolchildren in Ireland

Aim To examine the demographic and social factors associated with myopia in schoolchildren in Ireland. Methods Thirty-seven schools participated, representing a mix of urban and rural schools and schools in socioeconomically disadvantaged and non-disadvantaged areas in Ireland. Examination included cyclopleged autorefraction (1% cyclopentolate hydrochloride). Height and weight of participants were measured. Parents filled in a participant’s lifestyle questionnaire, including questions on daily screen time use and daylight exposure. Myopia was defined as spherical equivalent ≤−0.50 D. Results Data from 1626 participants (881 boys, 745 girls) in two age groups, 6–7 years (728) and 12–13 years (898), were examined. Myopia prevalence was significantly higher in children aged 12–13 years old (OR=7.7, 95%CI 5.1 to 11.6, p\u3c0.001) and significantly associated with non-white ethnicity (OR=3.7, 95% CI 2.5 to 5.3, p\u3c0.001). Controlling for age group and ethnicity, myopia prevalence was also significantly linked with height (p\u3c0.001) and higher in participants in the following groups: using screens \u3e3 hours per day (OR=3.7, 95% CI 2.1 to 6.3, p\u3c0.001), obesity (OR=2.7, 95% CI 1.9 to 3.9, p\u3c0.001), sedentary lifestyle (OR=2.9, 95% CI 1.9 to 4.4, p\u3c0.001), frequently reading/writing (OR=2.2, 95% CI 1.4 to 3.5, p=0.001), less daylight exposure during summer time (OR=5.00, 95% CI 2.4 to 10.3, p\u3c0.001), spring season births (OR=1.9, 95% CI 1.1 to 3.3, p=0.02), paternal history of myopia (OR=2.4, 95% CI 1.8 to 3.3, p\u3c0.001) and bottle fed for the first three months of life (OR=1.7, 95% CI 1.3 to 2.5, p=0.02). Conclusions The associations found between myopia prevalence in schoolchildren in Ireland and demographic and lifestyle factors suggest that longitudinal research investigating the associations between myopia prevalence and these factors may be beneficial in advising preventative public health programmes

Normative data on the foveal avascular zone in a young healthy Irish population using optical coherence tomography angiography

Purpose: To establish normative data on the size, shape and vascular profile of the foveal avascular zone (FAZ) in a young, healthy, Irish population, using the Cirrus 5000 HD-OCT. Certain diseases may alter FAZ appearance. Normative databases provide normal baseline values for comparison, thus improving diagnostic ability. Methods: One hundred and fifty-four subjects aged 18–35 years old were recruited. Superficial FAZ area, diameter, circularity, ganglion cell layer, central macular thickness (CMT), vascular perfusion and density were measured using the Cirrus 5000. Axial length was measured with the IOL Master and blood pressure was measured using the Omron sphygmomanometer. Results: Mean FAZ area was 0.22±0.07 mm2, mean CMTwas 263.08±18.73μm. Both were larger in females than males (p =0.022, p=0.000). Mean vessel density and perfusion central were 14.11±2.77 mm/mm2 and 24.70±4.96% respectively. Both were lower in females (p =0.010, p=0.019). Vessel density and perfusion inner correlated positively with minimum ganglion cell layer plus inner plexiform layer (GCL+IPL) thickness (p=0.001, p=0.019). CMT correlated positively with vessel density and perfusion central (p =0.000 for both) and negatively with FAZ area (p =0.000). Conclusions: This study provides normative data for FAZ appearance and vascularity for the first time in a young, healthy, Irish population, using the Cirrus 5000 HD-OCT. Establishing machine and population specific normative data, particularly in relation to vessel density and perfusion is paramount to the early identification of ocular disease using Optical Coherence Tomography Angiography

The Efficacy of Warm Compresses in the Treatment of Meibomian Gland Dysfunction and Demodex Folliculorum Blepharitis

Purpose: To investigate and compare the effect of warm compresses on meibomian gland dysfunction and Demodex folliculorum blepharitis. Methods: Forty-two subjects (13 males, 29 females; mean age of 56.45 years) enrolled and completed the two-month warm compress treatment study. Three warm compress therapies were compared: Warm face cloth, MGDRx EyeBag® and OPTASETM Moist Heat Mask. Subjects attended for four visits: baseline, two weeks, four weeks, and eight weeks. Subjective symptoms, osmolarity, non-invasive tear break-up time, ocular surface staining, Schirmer I test, meibum expressibility and clarity, and eyelash manipulation and epilation to assess for the presence of Demodex folliculorum, were measured at each visit. Results: Meibomian gland dysfunction, based on a composite score of meibum quality and expressibility, reduced significantly with the MGDRx EyeBag® and the OPTASETM Moist Heat Mask (p \u3c .05). There was no significant difference in efficacy for treating meibomian gland dysfunction between the two devices (p = .29). No improvement in meibomian gland dysfunction was detected with the warm face cloth. Only the OPTASETM Moist Heat Mask significantly reduced the quantity of Demodex folliculorum over eight-weeks of treatment (p = .036, only baseline to week eight significant p = .008). Symptoms and ocular surface staining improved significantly in all three groups (p \u3c .05). There was no significant change observed in osmolarity, non-invasive tear break-up time or Schirmer I test within each group (p \u3e .05, respectively). Conclusion: TheMGDRx EyeBag® and the OPTASETM Moist Heat Mask exhibited superior efficacy in treating signs and symptoms of meibomian gland dysfunction, compared to the use of a warm face cloth, over the eight-week period. The OPTASETM Moist Heat Mask demonstrated dual therapeutic abilities, treating both meibomian gland dysfunction and Demodex folliculorum blepharitis. Repeated application of heat for the treatment ofmeibomian gland dysfunctionmay continue to present a good home-remedy option for patients

The Prevalence of Demodex Folliculorum on Eyelashes of Symptomatic and Asymptomatic Normal Patients

Purpose To examine the prevalence of Demodex Folliculorum (DF) on the eyelashes of symptomatic and asymptomatic patients. DF is an eight legged ectoparasite present in humans. It is most commonly found on the face; cheeks, nose, chin and eyelashes. Ocular symptoms of DF infestation on the eyelashes include itching, dryness, surface irritation, burning, foreign body sensation, photophobia and reduced vision1 Method Students and patients of the National Optometry Centre (NOC) (n=54), aged 19 – 78 years of age were assessed and sub-divided into 4 groups; Group (1) Control (n=12), Group (2) Signs, no symptoms (n = ?), Group (3) Symptoms, no signs (n = ?) and Group (4) Signs and symptoms (n = ?). Each subject completed a novel DF questionnaire on ocular symptoms and lifestyle. Habitual distance visual acuity was assessed and a slit lamp examination was conducted. 8 lashes – 2 from each eyelid were manipulated and epilated for microscopic examination. Presence of DF was noted and adult DF count was recorded using the modified Coston method2. Results A two-way ANOVA was used to analyse the prevalence of DF (significance level p ≤ 0.05). The DF count significantly increased with age (p = 0.000), contact lens wear (p = 0.037), skin conditions (p = 0.025) and frequency of cleaning pillow case (p = 0.005). There was no significant link (p ≥ 0.05) between the DF count and gender, wearing make-up, allergies, the method of washing and drying pillow cases, method and frequency of lid hygiene routine. A two-way ANOVA was also used to analyse the age and lifestyle of patients who were more symptomatic (significance level p ≤ 0.05). Patient were more symptomatic with age (p = 0.000), contact lens wear (p = 0.032), less frequent lid hygiene routine (p = 0.001), method of lid hygiene (p = 0.000), less frequent pillow case cleaning (p = 0.032), air dried pillow case (p = 0.025), allergies (p = 0.000), skin conditions (p = 0.011), wearing mascara (p = 0.000). Conclusion The prevalence of DF and symptoms increase with age, contact lens wear, skin conditions and frequency of cleaning pillow cases. Whilst patients with less frequent lid hygiene routine, different method of lid hygiene routine, allergies and who air dried their pillow case were more symptomatic, the DF count did not increase. Therefore some patients can be symptomatic without an increase in DF count. Further data collection is ongoing