Six Year Refractive Change among White Children and Young Adults: Evidence for Significant Increase in Myopia among White UK Children

OBJECTIVE:To determine six-year spherical refractive error change among white children and young adults in the UK and evaluate differences in refractive profiles between contemporary Australian children and historical UK data. DESIGN:Population-based prospective study. PARTICIPANTS:The Northern Ireland Childhood Errors of Refraction (NICER) study Phase 1 examined 1068 children in two cohorts aged 6-7 years and 12-13 years. Prospective data for six-year follow-up (Phase 3) are available for 212 12-13 year olds and 226 18-20 year olds in each cohort respectively. METHODS:Cycloplegic refractive error was determined using binocular open-field autorefraction (Shin-Nippon NVision-K 5001, cyclopentolate 1%). Participants were defined by spherical equivalent refraction (SER) as myopic SER ≤-0.50D, emmetropic -0.50D<SER<+2.00 or hyperopic SER≥+2.00D. MAIN OUTCOME MEASURES:Proportion and incidence of myopia. RESULTS:The proportion of myopes significantly increased between 6-7 years (1.9%) and 12-13 years (14.6%) (p<0.001) but not between 12-13 and 18-20 years (16.4% to 18.6%, p = 0.51). The estimated annual incidence of myopia was 2.2% and 0.7% for the younger and older cohorts respectively. There were significantly more myopic children in the UK at age 12-13 years in the NICER study (16.4%) than reported in Australia (4.4%) (p<0.001). However by 17 years the proportion of myopia neared equivalence in the two populations (NICER 18.6%, Australia 17.7%, p = 0.75). The proportion of myopic children aged 12-13 years in the present study (2006-2008) was 16.4%, significantly greater than that reported for children aged 10-16 years in the 1960's (7.2%, p = 0.01). The proportion of hyperopes in the younger NICER cohort decreased significantly over the six year period (from 21.7% to 14.2%, p = 0.04). Hyperopes with SER ≥+3.50D in both NICER age cohorts demonstrated persistent hyperopia. CONCLUSIONS:The incidence and proportion of myopia are relatively low in this contemporary white UK population in comparison to other worldwide studies. The proportion of myopes in the UK has more than doubled over the last 50 years in children aged between 10-16 years and children are becoming myopic at a younger age. Differences between the proportion of myopes in the UK and in Australia apparent at 12-13 years were eliminated by 17 years of age

Asthenopia in schoolchildren

Manuel AP Vilela,1,2 Victor D Castagno,2,3 Rodrigo D Meucci,3,4 Anaclaudia G Fassa3,4 1Postdoctoral Program in Epidemiology, 2Department of Specialized Medicine &ndash; Ophthalmology, 3Doctoral Program in Epidemiology, 4Department of Social Medicine, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil Objective: To assess asthenopia prevalence and associated factors in schoolchildren aged 6&ndash;16. Methods: This was a cross-sectional study of all children attending the first to eighth grades at two public schools in the urban region of a medium-sized town in Southern Brazil between April and December 2012. A questionnaire on socioeconomic and cultural matters was answered by parents, while the children answered a questionnaire on asthenopia-related symptoms. The children underwent a complete visual function examination, including measurement of visual acuity, refraction test, cover test, stereopsis, heterophoria assessment, near point of convergence, and accommodative convergence/accommodation ratio. Results: Asthenopia prevalence was 24.7% in a total sample of 964 children. Visual acuity of 20/25 or better in both eyes was found in 92.8% of the children. The stereopsis test was normal in 99.4% of them, and some kind of strabismus was found in 3.5%. About 37.8% had astigmatism, 71.6% had mild hyperopia, 13.6% had moderate hyperopia, and 6.1% were myopic. Near point of convergence was abnormal in 14.0% of the children, and the accommodative convergence/accommodation ratio was found to be altered in 17.1% of them. Conclusion: Children and adolescents have expressive prevalence of asthenopia. The prevalence of visual function alterations does not differ from the general population, and, therefore, they are not prerequisites. It is very important that its mechanisms and risk factors be better defined. Health professionals need to be on the lookout for complaints of visual fatigue because of its potential to influence learning and school performance. Keywords: asthenopia, eyestrain, fatigue, visual, visual fatigue, eye fatigu

Tempo privato e tempo sociale nei cristianesimi dei primi secoli

Nel contributo si prendono in considerazione i passi evangelici in cui si accenna al tempo privato di Gesù. Si fa in particolare riferimento a Mc 4,34 come filo conduttore per cogliere l’interpretazione in due autori (Tertulliano e Origene) operanti nello stesso cinquantennio in due contesti differenti (Cartagine e Alessandria-Cesarea), ma accomunati da problematiche e sollecitazioni non dissimili. L’analisi ha dimostrato come l’interpretazione del versetto e del tempo privato di Gesù sia apparsa problematica agli occhi dei due autori e più in generale delle loro comunità in cui erano inseriti. Entrambi, spinti dalle esigenze polemiche e dal contesto nel quale operavano, sono pervenuti a posizioni che non si possano identificare né tra loro né in senso stretto con quelle della Grande Chiesa