Near Work and Juvenile Onset Myopia

Introduction
Myopia is a significant public health issue recently. Past few decades, myopia developed mostly
in adult people. However, recently this issue developed on school-aged children. In Singapore,
cumulative incidence rates of myopia within 3 years of follow-up study of children aged 7-,8-, and
9-year-old-children were 47.7%, 34.4%, and 32.4%, respectively (1). In longitudinal study
conducted in Hong Kong indicated that annual incidence rate of myopia in children aged 5 to 16
years old was 14.4% (2), while in China was 14.1% in 5- to 12-year-old children (3). Moreover,
study showed that juvenile onset of myopia progressed into high myopia rapidly in adult life
which lead to the more severe of ocular condition, such as retinal detachment, cataract,
glaucoma, and blindness (4). It therefore warranties to be explored modifiable risk factors to
prevent development and progression of myopia in school-aged children.
To date, there has no systematic review or meta-analyses to explore the association between
near work and juvenile onset myopia. I therefore intend to perform meta-analyses to summarize
and quantitatively combine all relevant studies on association between near work and juvenile
onset myopia.

Methods
Search Strategy
I will conduct searches in PubMed, Web of Science, and Cochrane Library to identify eligible
studies. The following keywords will be used: (myopia OR near-sightedness OR refractive errors
OR juvenile onset myopia OR school-aged myopia) AND (near work OR reading OR watching TV
OR playing videogame OR playing hand-held games OR playing musical instrument).
Selection of Studies
This studies will include studies with explored associations between myopia and near-work
activities, reported an effect estimate such as Odds Ratio (OR) and 95% Confidence Interval (CI).
Near work activities is defined with any reported associations reading/writing, playing video,
playing hand-held games, watching TV, and playing musical instruments with myopia. I will
exclude animal studies, studies with provided abstracts only and non-English articles. Studies
with subject aged>12 years will also be excluded.
Data Extraction
Information of eligible studies that will be extracted for data analysis will include last name of
first author, publication year, study name, ethnicity, number of participation, age of subjects,
definition of myopia, definition of near work, effect estimates, and confounding factors adjusted
for.
References
1. Saw, S.M., et al. (2005). Incidence and Progression of Myopia in Singaporean School Children.
Invest Ophthalmol Vis Sci 46:51-57
2. Fans, D.S., et al. (2004). Prevalence, Incidence, and Progression of Myopia of School Children
in Hong Kong. Invest Ophthalmol Vis Sci 45:1071-1075
3. Zhao, J., et al. (2002). The Progression of Refractive Error in School-age Children: Shunyi
District, China. Am J Ophthalmol 134:735-743.
4. Saw S.M., et al. (2005). Myopia and Associated Pathological Complications. Ophthalmic Physiol
Opt 25:381-391