FINAL YEAR PROJECT The Relationship Between Near Work Induced Transient Myopia and Accommodative Response in Young Adult. DONE BY: MADINAH, EE PEI CHIN, SAKINAH, HENG IRENE INTRODUCTIONphoto-A-cartoon-style-man-giving-an- introduction.html ABOUT MYOPIA. refractive error visual degradation blinding complication Glaucoma Myopia degeneration Retinal detachment WHAT IS NITM ??? Temporary myopic shift in far point following a period of sustained near visual task. WHEN WE READ.. LITERATURE REVIEW MYOPIA PROGRESSION S.M. Saw et. al had conducted a demonstrated the incidence and progression rates of myopia are high in Singaporean children.as the results showed that the average myopia progression rates over 3 years were 2.40Ds in 7-year-old myopic children, 1.97Ds in 8-year-olds, and 1.71Ds in 9-year-olds (S.M. Saw et. al 2005). FAMILY HISTORYpecial-diets/heart-health/getting-a-grip- on-genes-and-heart-disease A study in 2001 done by Saw, S.M et.al A study done by Donald O. et. al Myopia development in the childhood by Zadnik Conclusion : parental history of myopia was the predominant role in the etiology of myopia. There was no association or weak relationship between close work and myopia progression. EFFECT OF NEAR WORK ON MYOPIA PROGRESSION Gross DA and Rainey BB investigated the relationship of childhood myopia progression rates to time of year myopia progression rate is dependent on the amount of near task perform. (Gross DA and Rainey BB, 1998). According to Seang- Mei et.al study, faster myopia development in younger children and for children who have higher myopia at baseline(Seang-Mei Saw et.al 2000). Socioeconomic status, outdoor activity and near-work activity did not have any impact on myopia development. NITM Study carried out by Vasudevan B. and Ciuffreda K.J. results showed that almost 90% of the myope refractive group showed initial NITM while only 20% of the emmetropic and hyperopic refractive group showed initial NITM (Ciuffreda, K.J. & Wallis, D.M, 1998). Study by Ver-Diax, F.A., Strang, N.C.and Winn, B significant NITM in progressing myopes longer NITM was manifested during the period of myopia progression (Ver-Diax, F.A., Strang, N.C., & Winn, B. 2002) ACCOMMODATIVE RESPONSE Previous studies by Gwiazda and Thorn(1993), and Jiang B.C(1997) myopes exhibited significantly greater lag of accommodation at near, compared to emmetropes accommodative response was shown to be significantly reduced in myopes (Gwiazda and Thorn,1993),( Jiang B.C1997). HYPOTHESIShmps/Hypothesis%20Driven%20History %20Taking.htm Objective: to investigate the relationship between near work-induced transient myopia and accommodative response in young adult. Hypothesis: to investigate if there is a the relationship between near work-induced transient myopia and accommodative response in young adult. The objective of the study will be achieved by: Comparing the NITM between high accommodative response participants and low a accommodative response participants Comparing the NITM decay time between high accommodative response participants and low a accommodative response participants METHODOLOGYcontent/uploads/2010/10/method.jpg METHODOLOGY Ethical clearance approval granted by Institutional Review Board(IRB) of Ngee Ann Polytechnic - Briefed beforehand on adequacy - Informed consent - Minimum risk evaluation - Tests done - Things to take note on the handling of research data - Maintaining confidentiality Ensured patients adequately informed of tests to be performed Consent form and information sheet - Aware of time taken - Discomfort that will be experienced during the procedures - Understand that they can withdraw from the research study at any point of time METHODOLOGY Sampling method Convenience sampling Research design Cross-sectional study Need not follow participants over a period of time No manipulating variables METHODOLOGY Sampling criteria Between 17 to 25 years Able to understand and undertake the informed consent process with no cognitive impairments BCVA at least 6/6 No systemic health problems No ocular diseases such as glaucoma, diabetic retinopathy, cataract. No history of ocular surgery No accommodation or binocular vision problems942.jpg PROCEDURES 1. Sit in front of Grand Seiko WAM look at distance (6 metres), look at one line above smallest letter they can see without any correction. 2. After getting refractive error, use their correction 3. Acquire baseline - look at one line better than the smallest line they can see for 10 seconds 4. Key in their refractive error into the system- process their distance required to measure their accommodative response for 2 dioptres, 2.5 dioptres, 3 dioptres and 4 dioptres. 5. Look at the near distance stimulating 2.5 dioptres for 5 minutes - iPad with a text passage 6. After 5 minutes, iPad flipped down immediately 7. Instructed to look at one line better than the smallest letter they can see at distance for 3 minutes. INSTRUMENT USED Dorothy M. Win-Hall(2010) Open field autorefractor capable of measuring accommodation and pupil diameter dynamically High speed mode for measurement of NITM Laptop and through WCS-1 software Measure the spherical equivalent (SE) value and Pupil Diameter at 0.2 seconds step. Analyze data with Microsoft Excel INSTRUMENT USED Results: Slight difference between the dynamically and statically recorded responses Dynamic measurement of accommodation and pupil constriction potentially provides additional useful information on the accommodative response other than simply the response amplitude Precisely ascertain whether the subjects eyes are accommodating or not INSTRUMENT USED Amy L. Sheppard Refractive error determined almost similar (p = 0.77) to subjective refraction Results Pupil size determination & easy conversion into high-speed mode Concluded that instrument accurate over a range of refractive errors (-6.38 to D)ploads/images/products/wam- 5500/WAM- 5500_Advanced_Accommodat ing_Binocular_Autorefractor.j pg STATISTICAL ANALYSIS Through SPSS Statistics Base Tests done: Comparing NITM in dioptres between participants with high accommodative response (AR) and low AR Correlation between AR and NITM Comparison of NITM decay time between participants with high AR and low AR.content/uploads/2012/12/iStock_ Small.jpg OUR RESULTSntimg_17.jpeg COMPARISON OF NITM IN DIOPTRES BETWEEN PARTICIPANTS WITH HIGH AR AND LOW AR Kolmogorov-Smirnov, P value of