Aim: The aim of this study was to determine whether students' exposure to digitally projected, multimedia teaching material under naturally varying classroom lighting conditions is associated with myopia risk and severity.
Design: A population-based, cross-sectional study in 2012 of children in grades 4-6 across 87 schools in Taiwan.
Methods: Students (N = 3,686) reported demographic information, outdoor time, physical activity and near work. Parents provided their myopia status. Student-reported multimedia teaching frequency and classroom lighting levels were confirmed with direct observation. School nurses conducted vision screening and ophthalmologist referral. Myopia status and severity were measured by spherical equivalent refraction; SE ≤-0.5 dioptres was coded as myopic. Binary logistic and tobit regression were used to estimate the contributions of classroom multimedia exposure and lighting to myopia risk and severity controlling for risk factors.
Results/findings: Age, parental myopia and hours of near work increased the odds of myopia and predicted greater severity. Physical activity and outdoor time predicted lower risk and severity. Multimedia exposure in relatively bright classrooms was associated with greater odds of myopia. Classroom lighting levels during multimedia teaching were inversely related to severity; exposure frequency was unrelated.
Conclusions: Multimedia exposure under brighter classroom conditions may contribute to the myopia incidence in schoolchildren.
Impact: Teaching with digital projection technology is increasingly prevalent. This may increase children's odds of developing myopia, which has far-reaching and lifelong deleterious effects. School nurses should raise awareness of and promote strategies that reduce this risk, including working with children, parents, school personnel and system leaders to adopt eye-healthy behaviours, practices and policies.
目的: 本研究旨在确定学生在自然变化的教室照明条件下面对数字投影的多媒体教材是否与近视风险和近视严重程度有关。 设计: 在2012年,对台湾87所学校4-6年级学生进行的一项基于人口的横断面研究。 方法: 学生(N = 3686)报告了人口统计信息、户外时间、体育锻炼和近距离用眼机会。父母提供了他们的近视状况。通过直接观察确认了学生报告的多媒体教学频率和教室照明度。学校护士进行了视力普查以及转诊至眼科医生处。通过等效球镜度数衡量了近视状况和近视严重程度;近视度数大于50屈光度(SE≤-0.5)则被编码为近视。使用二元逻辑和tobit回归估算教室多媒体暴露和照明对近视风险和风险因素导致的严重程度。 结果/发现: 年龄、父母近视和近距离用眼时长增加了患近视的几率,并预示着严重程度更高。进行体育锻炼和户外活动可降低风险和严重程度。在相对明亮的教室里使用多媒体,学生患近视的几率更大。使用多媒体进行教学过程中的教室照明度与近视严重程度呈反比。使用多媒体频率与近视严重程度无关。 结论: 在较明亮的教室环境中,使用多媒体可能导致学生患上近视。 影响: 数字投影教学技术日益普遍。这可能会增加儿童患近视的几率,而近视会会产生深远并且终生有害的影响。驻校护士应提高意识并推广可降低此风险的策略,包括儿童、家长、学校工作人员和教育系统管理者共同努力,采取有益于眼睛的行动、方法和策略。.
Keywords: Taiwan; myopia; nurses children; prevention; school nursing; vision screening.
© 2019 John Wiley & Sons Ltd.