title: Spectacle use and reduced unaided vision in third grade students: a comparative study in different educational settings.
abstract: BACKGROUND
  The development of myopia is influenced by hereditary factors, environmental factors and gene-environment interaction. Reading and near-work activity are associated with myopia and myopic progression. This study sought to determine and compare the prevalence of reduced unaided vision and spectacle use among third grade Israeli students from three different educational settings.
  
  
  METHODS
  A sample of 917 students (mean age 8.5 years, range seven to 10 years) was drawn from the three Israeli educational streams: secular, Orthodox and ultra-Orthodox. Children in the ultra-Orthodox education pathway begin studying at the age of three years and their daily reading involves sustained near work with increased accommodative effort accompanied by head-rocking movements. Reduced distance vision was used to indicate the likely development of or an increase in the amount of myopia. Spectacle lenses were measured to determine the prevalence of myopia.
  
  
  RESULTS
  Of the 917 students studied, 103 (11.2 per cent) wore spectacles (14.2 per cent of the males and eight per cent of the females); 82.5 per cent of those who wore spectacles were myopic. Males from ultra-Orthodox schools had the highest rate of reduced unaided vision (72.5 per cent) compared with males from secular schools (27.3 per cent), males from Orthodox schools (59.3 per cent) or with females from all three groups (average of 34.8 per cent, p < 0.0001, chi squared). Males had a higher rate of reduced unaided vision, especially in the Orthodox and ultra-Orthodox schools.
  
  
  CONCLUSIONS
  Our study suggests that Jewish ultra-Orthodox males have a higher prevalence and degree of myopia. The study habits of young children, including exposure to prolonged near tasks, high accommodative demands and possibly optical defocus induced by body sway, may contribute to the development of myopia.
authors.affiliation: Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Guy J
authors.initials: GJ
authors.lastname: Ben-Simon
authors.forename: Miriam
authors.initials: M
authors.lastname: Peiss
authors.forename: Emilia
authors.initials: E
authors.lastname: Anis
authors.forename: Tanuj
authors.initials: T
authors.lastname: Nakra
authors.forename: Ayala
authors.initials: A
authors.lastname: Luski
authors.forename: Abraham
authors.initials: A
authors.lastname: Spierer
mesh_terms: D000065:Accommodation, Ocular; D002648:Child; D002652:Child Behavior; D004493:Education; D005139:Eyeglasses / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D007585:Jews; D007858:Learning; D008297:Male; D009216:Myopia / Q000208:ethnology* / Q000523:psychology / Q000628:therapy; D015995:Prevalence; D014786:Vision Disorders / Q000208:ethnology* / Q000523:psychology / Q000628:therapy; D014937:Work