Component dependent risk factors for ocular parameters in Singapore Chinese children



      To examine the risk factors for variations in ocular biometry parameters in Singapore Chinese children, a population with a known high prevalence rate of myopia at an early age.


      Cross-sectional study.


      Children aged 7 to 9 years (n = 1453) from three schools in Singapore.


      The children underwent A scan biometry and cycloplegic autorefraction measurements. Questions were asked regarding number of books read per week, night lighting, and parental myopia.

      Main outcome measures

      Axial length, vitreous chamber depth, lens thickness, anterior chamber depth, refraction, and corneal curvature radius measurements were made.


      After controlling for several factors, the axial lengths were found to be longer and vitreous chambers deeper in children who were older, male, read more than two books per week, or taller, and those who had at least one parent who was myopic. In these models, children who read more than two books per week had axial lengths that were 0.17 mm longer and vitreous chambers that were 0.15 mm deeper compared with children who read two or fewer books per week. Anterior chambers were deeper in males and taller children, whereas corneal curvature was steeper in female, older, and shorter children.


      Increases of axial length and vitreous cavity depth were associated with older age, being male, reading more than two books per week, increased height, and parental history of myopia. Of these risk factors, however, neither reading nor parental myopia history were associated with values for anterior chamber depth, corneal curvature, or lens thickness. These findings confirm that conventional risk factors for myopia associated with the vitreous cavity, but suggest that anterior segment parameters such as corneal curvature and lens thickness may be subject to unrelated postnatal growth control mechanisms.
      To read this article in full you will need to make a payment


      Subscribe to Ophthalmology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Mutti D.O.
        • Bullimore M.A.
        Optom Vis Sci. 1999; 76 ([editorial]): 257-258
        • Saw S.M.
        • Katz J.
        • Schein O.D.
        • et al.
        Epidemiology of myopia.
        Epidemiol Rev. 1996; 18: 175-187
        • Wallman J.
        • Gottlieb M.D.
        • Rajaram V.
        • Fugate-Wentzek L.A.
        Local retinal regions control local eye growth and myopia.
        Science. 1987; 237: 73-77
        • Zadnik K.
        • Mutti D.O.
        • Friedman N.E.
        • et al.
        Ocular predictors of the onset of juvenile myopia.
        Invest Ophthalmol Vis Sci. 1999; 40: 1936-1943
        • McBrien N.A.
        • Adams D.W.
        A longitudinal investigation of adult-onset and adult-progression of myopia in an occupational group.
        Invest Ophthalmol Vis Sci. 1997; 38: 321-333
        • Jiang B.C.
        • Woessner W.M.
        Vitreous chamber elongation is responsible for myopia development in a young adult.
        Optom Vis Sci. 1996; 73: 231-234
        • Lin L.L.K.
        • Shih Y.F.
        • Lee Y.C.
        • et al.
        Changes in ocular refraction and its components among medical students—a 5-year longitudinal study.
        Optom Vis Sci. 1996; 73: 495-498
        • Tan N.W.H.
        • Saw S.M.
        • Lam D.S.C.
        • et al.
        Temporal variations in myopia progression in Singaporean children within an academic year.
        Optom Vis Sci. 2000; 77: 466-472
        • Ferris 3rd, F.L.
        • Kassoff A.
        • Bresnick G.H.
        • Bailey I.
        New visual acuity charts for clinical research.
        Am J Ophthalmol. 1982; 94: 91-96
        • Zhang M.Z.
        • Saw S.M.
        • Hong R.Z.
        • et al.
        Refractive errors in Singapore and Xiamen, China—a comparative study in school children aged 6 to 7 years.
        Optom Vis Sci. 2000; 77: 302-308
        • Stata
        Stat Statistical Software: Release 7.0. Stata Corp, College Station, TX2001
        • McBrien N.A.
        • Millodot M.
        A biometric investigation of late onset myopic eyes.
        Acta Ophthalmol. 1987; 65: 461-468
        • Lin L.L.K.
        • Shih Y.F.
        • Tsai C.B.
        • et al.
        Epidemiologic study of ocular refraction among schoolchildren in Taiwan in 1995.
        Optom Vis Sci. 1999; 76: 275-281
        • Richler A.
        • Bear J.C.
        Refraction, nearwork and education. A population study in Newfoundland.
        Acta Ophthalmol. 1980; 58: 468-478
        • Zadnik K.
        • Satariano W.A.
        • Mutti D.O.
        • et al.
        The effect of parental history of myopia on children’s eye size.
        JAMA. 1994; 271: 1323-1327
        • Wong T.Y.
        • Foster P.J.
        • Hee J.
        • et al.
        Prevalence and risk factors for refractive errors in adult Chinese in Singapore.
        Invest Ophthalmol Vis Sci. 2000; 41: 2486-2494
        • Goss D.A.
        Nearwork and myopia.
        Lancet. 2000; 356: 1456-1457
        • Saw S.M.
        • Wu H.M.
        • Seet B.
        • et al.
        Academic achievement, close up work parameters, and myopia in Singapore military conscripts.
        Br J Ophthalmol. 2001; 85: 855-860
        • Zhao J.L.
        • Pan X.J.
        • Sui R.F.
        • et al.
        Refractive error study in children.
        Am J Ophthalmol. 2000; 129: 427-435
        • Fledelius H.C.
        • Stubgaard M.
        Changes in refraction and corneal curvature during growth and adult life. A cross-sectional study.
        Acta Ophthalmol. 1986; 64: 487-491
        • Grosvenor T.
        • Scott R.
        Three-year changes in refraction and its components in youth-onset and early adult-onset myopia.
        Optom Vis Sci. 1993; 70: 677-683
        • Fledelius H.C.
        Corneal curvature radius. Oculometric considerations with reference to age and refractive change.
        Acta Ophthalmol Suppl. 1988; 185: 74-77
        • Adams A.J.
        Axial length elongation, not corneal curvature, as a basis of adult onset myopia.
        Am J Optom Physiol Opt. 1987; 64: 150-152
        • Zadnik K.
        • Jones L.A.
        • Irvin B.C.
        • et al.
        Myopia and ambient night-time lighting. CLEERE Study Group. Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error.
        Nature. 2000; 404 ([comment]): 143-144
        • Gwiazda J.
        • Ong E.
        • Held R.
        • Thom F.
        Myopia and ambient night-time lighting.
        Nature. 2000; 404 ([comment]): 144
        • Quinn G.E.
        • Shin C.H.
        • Maguire M.G.
        • Stone R.A.
        Myopia and ambient lighting at night.
        Nature. 1999; 399 ([letter]): 113-114