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Myopia, Lifestyle, and Schooling in Students of Chinese Ethnicity in Singapore and Sydney
Kathryn A. Rose, PhD;
Ian G. Morgan, BSc, PhD;
Wayne Smith, BMed, MPH, PhD;
George Burlutsky, MStat;
Paul Mitchell, PhD;
Seang-Mei Saw, PhD
Arch Ophthalmol. 2008;126(4):527-530.
Objective To compare the prevalence and risk factors for myopia in 6- and 7-year-old children of Chinese ethnicity in Sydney and Singapore.
Methods Two cross-sectional samples of age- and ethnicity-matched primary school children participated: 124 from the Sydney Myopia Study and 628 from the Singapore Cohort Study on the Risk Factors for Myopia. Cycloplegic autorefraction was used to determine myopia prevalence (spherical equivalent  –0.5 diopter). Lifestyle activities were ascertained by questionnaire.
Results The prevalence of myopia in 6- and 7-year-old children of Chinese ethnicity was significantly lower in Sydney (3.3%) than in Singapore (29.1%) (P < .001). The prevalence of myopia in 1 or more parents was 68% in Sydney and 71% in Singapore. Children in Sydney read more books per week (P < .001) and did more total near-work activity (P = .002). Children in Sydney spent more time on outdoor activities (13.75 vs 3.05 hours per week; P < .001), which was the most significant factor associated with the differences in the prevalence of myopia between the 2 sites.
Conclusions The lower prevalence of myopia in Sydney was associated with increased hours of outdoor activities. We hypothesize that another factor contributing to the differences in the prevalence of myopia may be the early educational pressures found in Singapore but not in Sydney.
Author Affiliations: Discipline of Applied Vision Sciences, Faculty of Health Sciences, University of Sydney, Lidcombe, Australia (Dr Rose); ARC [Australian Research Council] Centre of Excellence in Vision Science, Research School of Biological Sciences, Australian National University, Canberra (Dr Morgan); Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Callaghan, Australia (Dr Smith); Centre for Vision Research, Westmead Hospital, Department of Ophthalmology, University of Sydney, and the Westmead Millennium Institute, Westmead, Australia (Mr Burlutsky and Dr Mitchell); and Department of Community, Occupational, and Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (Dr Saw).
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