Wydanie 2/2011
str. 22

Wykształcenie a krótkowzroczność

Education and Myopia

Czepita Damian A.

Doctoral Studies, Faculty of Humanities, University of Szczecin
Studia Doktoranckie, Wydział Humanistyczny Uniwersytetu Szczecińskiego
Head: Professor Maria Czerepaniak-Walczak, PhD
Kierownik: prof. dr hab. Maria Czerepaniak-Walczak

Summary: Purpose: The aim of this paper was to assess the level of education on the prevalence of myopia.
Material and methods: Existing literature on the relationship between education and myopia was presented and discussed.
Results: In many works it was revealed that a higher level of education leads to a frequenter occurrence of myopia. Currently, it is assumed that the higher incidence of myopia among people with a higher level of education is the result of intensive near visual work and especially reading, writing and visual work at the computer. This correlation may be related to changes in the shape of the cornea or accommodation.
Conclusions: Level of education has an influence on the prevalence of myopia. This is probably associated with intense near visual work: reading, writing and visual work at the computer.

Słowa kluczowe: wykształcenie, krótkowzroczność.

Keywords: education, myopia.


Introduction
Over the past period of time it was observed that along with the development of civilization myopia is more and more common. This refractive error may lead to the decrease of visual acuity or even blindness (1).
In the past myopia was rare (2). Currently, it occurs more frequently. So far, the highest prevalence of myopia has been reported in medical students of the National Taiwan University, where 95.8% of the students had myopia -4.94 ± 2.70 Dsph (3).
Most likely factors like intensive reading, writing or working on a computer have an influence on such a state. Although, the occurrence of myopia also depends on other environmental and genetic factors (4).
Thus, in this work it was decided to verify if there is a relationship between education and myopia.

Purpose
The aim of this paper was to assess the level of education on the prevalence of myopia.

Material and methods
Existing literature concerning the relationship between education and myopia was presented and discussed.

Education and myopia
It has long been known that reading and writing leads to a higher occurrence of myopia. However, research on the effects of educational level on the occurrence of myopia were launched in 1907 by Fleischer (2), who observed that in Tuebingen, Germany 7.5% of students had myopia.
Richler and Bear (5) from Newfoundland after examining 971 people aged 5 years and above showed that the level of education and near visual work lead to a higher occurrence of myopia.
Ashton (6) obtained slightly different results, after examining 723 families living in Hawaii. He found that higher levels of education leads to higher occurrence of myopia. However, he did not observe the relationship between near work and myopia.
The most widely-ranging research on this topic was conducted in 1987, by Rosner and Belkin (7). The authors studied 157.748 17-19-year-old Israeli male recruits. They demonstrated that an increase in the level of education leads to increased prevalence of myopia.
Extensive research on the impact of educational level on the occurrence of myopia was carried out in 1988 by Teasdale and Goldschmidt (8). After examining 7.950 men 18 years old appearing before the draft board in eastern Denmark, they have found that myopia is more common in people with higher education. However, the data was not statistically significant.
Saw et al. (9) among 429 18-23-year-old military conscripts from Singapore found that myopia is more common in people with higher education, which they explained by the increased near vision workload and the influence of genetic factors.
Recent studies on the impact of educational level on the occurrence of myopia were published in 2008 by Konstantopoulos et al. (10). After examining 200 17-31-year-old Greek conscripts, the researchers showed that those with higher education tend to have myopia (tab. I).

Near work and myopia
Currently, it is assumed that the higher occurrence of myopia in people with higher educational level is the result of intensive visual work, especially of reading, writing and visual work at the computer.
Correlation between reading and writing and the occurrence of myopia has been demonstrated in the works carried out in China (11), Hong Kong (12), Norway (13), Poland (4), and the USA (14). It has not been demonstrated in studies conducted in Singapore (15), and the USA (16,17). This was most likely caused by conducting the research on different populations and by using different examination methods.
However, the impact of using a computer on the development of myopia is controversial. Some researchers believe that visual work on the computer leads to a higher prevalence of myopia (4,18). However, other consider that there is no such relation and the published results are the consequence of research on adults in whom the eyeball is fully developed and does not come under the influence of visual work on a computer (19-21) (tab. II).

Mechanism of changes
Despite intensive research the underlying mechanism that links myopia development to near work is not ascertained. Retinal image-mediated ocular growth is the most extensively proposed hypothesis for near work-induced human myopia. The natural lags of accommodation found during near visual tasks and the associated retinal blur during near work are regarded to operate as cues for myopia development.
Recently, it was shown that lid forces during reading can change the lower and higher order aberrations of the eye
 

and that these alterations are significantly larger in progressing myopes than emmetropes. Similar reasoning can be applied to computer work. While working on a computer, the user usually adopts only a slight downward gaze (but at much less of an angle than in reading) and the working distance to the monitor is 50-90 cm. As a result of the eyelid position during computer tasks, the cornea shows the least changes in topography and aberrations when compared with reading (4,22).
Conclusions
1. Level of education has an influence on the prevalence of myopia.
2. This is probably associated with intense near visual work: reading, writing and visual work at the computer.
References:
1. Czepita D, Palacz O: Występowanie wad refrakcji u uczniów w Polsce. Kontaktologia i Optyka Okulistyczna, 2, 9-11.
2. Fleisher: Ueber Vererbung von Kruzsichtigkeit. Klinische Monatsblätter für Augenheilkunde 1907, 45, 337-338.
3. Lin LL, Shih YF, Lee YC, Hung PT, Hou PK: Changes in ocular refraction and its components among medical students – a 5-year longitudinal study. Optometry and Vision Science 1996, 73, 495-498.
4. Czepita D, Mojsa A, Ustianowska M, Czepita M, Lachowicz E: Reading, writing, working on a computer or watching television, and myopia. Klinika Oczna 2010, 112, 293-295.
5. Richler A, Bear JC: Refraction, nearwork and education. A population study in Newfoundland. Acta Ophthalmologica 1980, 58, 468-478.
6. Ashton GC: Nearwork, school achievement and myopia. Journal of Biosocial Science 1985, 17, 223-233.
7. Rosner M, Belkin M: Intelligence, education, and myopia in males. Archives of Ophthalmology 1987, 105, 1508--1511.
8. Teasdale TW, Goldschmidt E: Myopia and its relationship to education, intelligence and height. Preliminary results from an on-going study of Danish draftees. Acta Ophthalmologica 1988, Suppl 185, 41-43.
9. Saw SM, Wu HM, Seet B, Wong TY, Yap E, Chia KS, Stone RA, Lee L: Academic achievement, close up work parameters, and myopia in Singapore military conscripts. British Journal of Ophthalmology 2001, 85, 855-860.
10. Konstantopoulos A, Yadegarfar G, Elgohary M: Near work, education, family history, and myopia in Greek conscripts. Eye 2008, 22, 542-546.
11. Saw SM, Hong RZ, Zhang MZ, Fu ZF, Ye M, Tan D, Chew SJ: Near-work activity and myopia in rural and urban schoolchildren in China. Journal of Pediatric Ophthalmology & Strabismus 2001, 38, 149-155.
12. Wong L, Coggon D, Hwang CH: Education, reading, and familial tendency as risk factors for myopia in Hong Kong fishermen. Journal of Epidemiology and Community Health1993, 47, 50-53.
13. Kinge B, Midelfart A, Jacobsen G, Rystad J: The influence of near-work on development of myopia among university students. A three-year longitudinal study among engineering students in Norway. Acta Ophthalmologica Scandinavica 2000, 78, 26-29.
14. Mutti DO, Mitchell LG, Moeschberger ML, Jones LA, Zadnik K: Parental myopia, near work, school achievement, and children’s refractive error. Investigative Ophthalmology and Visual Science 2002, 43, 3633-3640.
15. Saw SM, Shankar A, Tan SB, Taylor H, Tan DTH, Stone RA, Wong TY: A cohort study of incident myopia in Singaporean children. Investigative Ophthalmology and Visual Science 2006, 47, 1839-1844.
16. Jones LA, Sinnott LT, Mutti DO, Mitchell GL, Moeschberger ML, Zadnik K: Parental history of myopia, sports and outdoor activities, and future myopia. Investigative Ophthalmology and Visual Science 2007, 48, 3524-3532.
17. Loman J, Quinn GE, Kamoun L, Ying GS, Maguire MG, Hudesman D, Stone RA: Darkness and near work. Myopia and its progression in third-year law students. Ophthalmology 2002, 109, 1032-1038.
18. Cole BL, Maddocks JD, Sharpe K: Effect of VDUs on the eyes: report of a 6-year epidemiological study. Optometry and Vision Science 1996, 73, 512-528.
19. Nyman KG: Occupational near-work myopia. Acta Ophthalmologica 1988, Suppl 185, 167-171.
20. Rechichi C, Scullica L: Trends regarding myopia in video terminal operators. Acta Ophthalmologica Scandinavica 1996, 74, 493-496.
21. Toppel L, Neuber M: Beurteilung der Refraktionswerte von Personen, die am Bildschirmsichtgerät über mehrere Jahre tätig waren. Eine Langzeitstudie. Ophthalmologe 1994, 91, 103-106.
22. Collins MJ, Buehren T, Bece A, Voetz SC: Corneal optics after reading, microscopy and computer work. Acta Ophthalmologica Scandinavica 2006, 84, 216-224.

 


 

Author/ Autor

Country/ Kraj

n

Age (years)/ Wiek (lata)

Correlation between education and myopia/
Korelacja między wykształceniem a krótkowzrocznością

Richler 1980

Canada/ Kanada

971

>5

+

Ashton 1985

U.S.A./ USA

723 families/ 723 rodziny

13-33

+

Rosner 1987

Israel/ Izrael

157.748

17-19

+

Teasdale 1988

Denmark/ Dania

7.950

18

-

Saw 2001

Singapore/ Singapur

429

18-23

+

Konstantopoulos 2008

Greece/ Grecja

200

17-31

+

Tab. I. Correlation between education and myopia.
Tab. I. Korelacja między wykształceniem a krótkowzrocznością.

 

Author/
Autor

Country/
Kraj

n

Age (years)/
Wiek (lata)

Correlation between reading, writing and myopia/
Korelacja między czasem przeznaczonym na czytanie i pisanie a krótkowzrocznością

Correlation between working on a computer and myopia/
Korelacja między czasem przeznaczonym na pracę przy komputerze a krótkowzrocznością

Nyman

Sweden/ Szwecja

1.069

Adult dorośli

-

Wong 1993

Hong Kong/ Hong Kong

408

15-39

+

Toppel 1994

Germany/ Niemcy

176

20-54

-

Rechichi 1996

Italy/ Włochy

24.000

Adult dorośli

-

Cole 1996

Australia/ Australia

1.316

<20-64

+

Kinge 2000

Norway/ Norwegia

224

19-22

+

Saw 2001

China/ Chiny

210

8-9

+

Mutti 2002

U.S.A./ USA

366

13-14

+

Loman 2002

U.S.A./ USA

177

21-45

-

Saw 2006

Singapore/ Singapur

994

7-9

-

Jones 2007

U.S.A./ USA

514

8-9

-

Czepita 2010

Poland/ Polska

5.865

6-18

+

+

Tab. II. Correlation between reading, writing, working on a computer and myopia.
Tab. II. Korelacja między czasem przeznaczonym na czytanie, pisanie, pracę na komputerze a krótkowzrocznością.

 

 

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