Please use this identifier to cite or link to this item: http://hdl.handle.net/10397/70460
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Title: Childhood exposure to constricted living space : a possible environmental threat for myopia development
Authors: Choi, KY 
Yu, WY 
Lam, CHI 
Li, ZC 
Chin, MP 
Lakshmanan, Y 
Wong, FSY 
Do, CW 
Lee, PH 
Chan, HHL 
Issue Date: Dec-2017
Source: Ophthalmic and physiological optics, Dec. 2017, v. 37, no. 5, p. 568-575
Abstract: PurposePeople in Hong Kong generally live in a densely populated area and their homes are smaller compared with most other cities worldwide. Interestingly, East Asian cities with high population densities seem to have higher myopia prevalence, but the association between them has not been established. This study investigated whether the crowded habitat in Hong Kong is associated with refractive error among children. MethodsIn total, 1075 subjects [Mean age (S.D.): 9.95years (0.97), 586 boys] were recruited. Information such as demographics, living environment, parental education and ocular status were collected using parental questionnaires. The ocular axial length and refractive status of all subjects were measured by qualified personnel. ResultsOcular axial length was found to be significantly longer among those living in districts with a higher population density (F-2,F-1072=6.15, p=0.002) and those living in a smaller home (F-2,F-1072=3.16, p=0.04). Axial lengths were the same among different types of housing (F-3,F-1071=1.24, p=0.29). Non-cycloplegic autorefraction suggested a more negative refractive error in those living in districts with a higher population density (F-2,F-1072=7.88, p<0.001) and those living in a smaller home (F-2,F-1072=4.25, p=0.02). After adjustment for other confounding covariates, the population density and home size also significantly predicted axial length and non-cycloplegic refractive error in the multiple linear regression model, while axial length and refractive error had no relationship with types of housing. ConclusionsAxial length in children and childhood refractive error were associated with high population density and small home size. A constricted living space may be an environmental threat for myopia development in children.
Keywords: Childhood refractive error
Constricted living space
Epidemiology
Living environment
Myopia
Myopia prevalence
Publisher: Wiley-Blackwell
Journal: Ophthalmic and physiological optics 
ISSN: 0275-5408
EISSN: 1475-1313
DOI: 10.1111/opo.12397
Rights: © 2017 The Authors Ophthalmic & Physiological Optics © 2017 The College of Optometrists
This is the peer reviewed version of the following article: Choi, KY, Yu, WY, Lam, CHI, Li, ZC, Chin, MP, Lakshmanan, Y, Wong, FSY, Do, CW, Lee, PH & Chan, HHL. Childhood exposure to constricted living space: a possible environmental threat for myopia development. Ophthalmic Physiol Opt 2017; 37: 568– 575, which has been published in final form at https://doi.org/10.1111/opo.12397. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
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