Development of the University of Houston near work, environment, activity, and refraction (UH NEAR) survey for myopia

ABSTRACT

Clinical Relevance

There is a need to better elucidate demographic and behavioural factors that are contributing to the rising prevalence of myopia. Doing so will aid in developing evidence-based recommendations for behavioural modifications to prevent onset and slow progression of myopia in children.

Background

The contributions of environmental and behavioural factors in myopia remain unclear. The goal of this work was to provide a standardised survey to better understand risk factors for myopia.

Methods

Development of the survey was carried out in 4 phases. In phase 1, three methods (direct, lay terms, and indirect) of parental reporting for the presence of myopia in their child were investigated through a questionnaire (N = 109) to determine sensitivity and specificity. The best method determined from phase 1 was used in phase 2, where questions regarding demographics, ocular history, and visual behaviour were compiled and refined. In phase 3, the survey was administered to focus groups of parents (N = 9). In phase 4, a scoring system was developed.

Results

The highest sensitivity for parental reporting for myopia of their child was the indirect method (0.84), and the lowest sensitivity was the direct method (0.41). The highest specificity was the direct method (0.86), once excluding the ‘do not know’ responses, and the lowest specificity was the indirect method (0.53). The direct method yielded a 53.2% ‘do not know’ response rate, 50.5% for the lay method, and 1.8% for the indirect method. Time to complete the survey was 10:09 ± 2:45 minutes.

Conclusion

This study provides a comprehensive and up-to-date myopia risk factor survey that can be utilised by researchers and clinicians. Parents found the survey to be easy to understand and relatively quick to answer, and the scoring system allows quantification of behaviours across different categories using provided equations.

KEYWORDS:

• Myopia
• near work
• refractive error
• survey

Acknowledgements

The authors thank Rachel Williams, Shawn Tripputi, and Amanda Piña for contributing to the design of the survey and Amy Cantrell and Christina Su for distributing the parent validation survey.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Financial support was provided by NIH [T35 EY07088].