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The authors prospectively collected the refractive data of myopic adults attending recruiting dispensing optician or ophthalmologist sites. Participants were recruited consecutively, giving verbal informed consent. Sites included a mix of urban and rural areas across eight sites. The following data were collected for analysis: sphere, cylinder, spherical equivalent, age of myopia onset, years in education, school schedule, tutorial classes, time spent doing near work and time outdoors (as an adult and during childhood) by online survey. Individuals blind in one eye, a diagnosis of ocular pathology, astigmatism >2 dioptres or high myopia >6 dioptres were excluded. The definition of obligatory education used by the authors was 12 years of study with more than four hours per day. A total of 274 myopic adults who meet the inclusion / exclusion criteria were recruited. Mean spherical equivalent was -3 dioptres and mean age of onset was 14-years-old. No significant difference was found between males and females. Of the cohort, the majority (80%) attended school for four hours per day with the remainder attending for eight hours per day. No significant difference between these groups was identified for the duration of time spent on near work. However, the group that spent four hours per day at school had significantly more time outside than those spending eight hours per day at school. No significant difference in the spherical equivalent or timing of onset based on the time of day attending school. However, the mean age of onset of myopia was over two years earlier for those attending school for eight hours per day. Later onset of myopia was associated with less near work time. The risk factor for level of adult myopia identified in a multiple linear regression was age of onset. The authors acknowledge some limitations of the study including the reliance on retrospective self-reporting. The school system provided the opportunity to compare different lengths of school day. Further studies are required including cross-sectional and longitudinal methodologies.

Role of tutorial classes and full day schooling on self-reported age of myopia onset: findings in a sample of Argentinian adults.    
Lanca C, Szeps A, Iribarren R, et al.
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Lauren R Hepworth

University of Liverpool; Honorary Stroke Specialist Clinical Orthoptist, Northern Care Alliance NHS Foundation Trust; St Helen’s and Knowsley NHS Foundation Trust, UK.

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