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A vision care-based community service subject is offered to general university students for fulfillment of a service-learning compulsory credit requirement. Here, a professional health subject is taught in a way that caters to generalist learners. Students gain basic skills they can apply to provide vision screenings for the needy population. All enrolled undergraduates had no background in eye health-related subjects. The teaching was not content-driven, requiring students' direct recall of facts. Rather, the teaching focused on Socratic teaching of logical theories and applications. The objective was to increase awareness of current eye care problems using case examples. Students learned to appreciate ways to promote active outreach services. Through activities and project work, students learned and practiced strong teamwork and direct application of knowledge in community-based eye care services. This learning experience demonstrates emergence of authentic practice from theory.

Purpose: To investigate the effect of COVID‐19 home confinement on the efficacy of the interventions for controlling myopia, and to select effective therapies to control myopia during COVID‐19 confinement. Method: Children (n = 164) aged 8–12 years with spherical equivalent refraction of −1.00 to −6.00 diopters were stratified into two age subgroups and randomly allocated into the control, 0.01% atropine, orthokeratology (ortho‐k) and atropine combined ortho‐k (ACO) groups. Axial length (AL) was measured at baseline, 6‐, 12‐, 18‐ and 24‐month visits. The follow‐up spanned the period before the COVID‐19 outbreak, the period of the home confinement, and the period of the school reopening. Hence, the AL change in different periods was collected and compared. Data analysis was performed following the criteria of intention to treat (ITT). Results: All 164 children were involved in the ITT analysis. Compared to control, all interventions can still reduce the AL elongation during the COVID‐19 home confinement period (all p < 0.05). However, the efficacy was compromised: individuals experienced more AL elongation during the COVID‐19 home confinement period in the control, 0.01% atropine and ACO groups (all p < 0.05). Interestingly, in the ortho‐k group, the difference was insignificant (p = 0.178), and the interaction between the intervention type (control vs. ortho‐k) and the confinement severity was significant (p for interaction = 0.041), which is different from the atropine (p for interaction = 0.248) or ACO group (p for interaction = 0.988). These results were stable after being adjusted by other variables based on the multivariable regression model. Conclusion: Ortho‐k was less affected by the COVID‐19 home confinement, which is potentially a better therapy for children in this high‐risk environment. Further investigations are warranted to validate this issue. [ABSTRACT FROM AUTHOR]

Objective: To characterize and compare the ciliary muscle thickness (CMT) between low and high myopes using swept-source anterior segment optical coherence tomography (AS-OCT). Methods: Forty visually healthy young Chinese adults aged 18–25 years were divided into two groups based on refractive errors: low myopia (n = 20, spherical-equivalent refractive error (SER) between −0.50 D to −3.00 D) and high myopia (n = 20, SER ≤ -6.00 D). Cycloplegic refractions were performed before axial length (AL) and CMT were measured using a partial coherence laser interferometer and an AS-OCT respectively. CMT was measured perpendicularly to the sclera-ciliary muscle interface at 1 mm (CMT_1), 2 mm (CMT_2), and 3 mm (CMT_3) posterior to the scleral spur, and at the location with maximal thickness (CMT_MAX). Results: High myopes demonstrated thicker CMT at 2 mm (CMT_2, p = 0.035) and 3 mm (CMT_3, p = 0.003) posterior to the scleral spur, but thinner maximal CMT (CMT_MAX, p = 0.005) than low myopes. The apical CMT_1 and CMT_MAX were also thinner in high myopes than in low myopes (both p< 0.001). CMT_MAX, apical CMT_1, and apical CMT_MAX correlated directly with SER and inversely with AL; in contrast, CMT_2 and CMT_3 showed inverse correlations with SER but direct correlations with AL. Conclusion: Our findings revealed significant differences in CMT between low and high myopes, with high myopes showing thicker CMT at 2 mm and 3 mm posterior to the scleral spur, but thinner maximal CMT. These results provide new evidence of the potential structural differences in ciliary muscles during myopia development and progression. [ABSTRACT FROM AUTHOR]

Evaluating changes in refractive astigmatism after 'study at home' during the COVID pandemic may shed light on the aetiology of refractive errors. To investigate whether there has been a change in the proportion of astigmatism among primary school children after the school closure period during the COVID-19 pandemic. This observational study compared cross-sectional (2018: n = 112; 2020: n = 173) and longitudinal data (n = 38) collected from two vision screenings, one in 2018 and the other after the school closure period in 2020, in the same primary school for children aged 8–10 years. Non-cycloplegic refraction and axial length were measured using an open‐field auto‐refractometer and IOL Master, respectively. A questionnaire focusing on demographic information, near-work time, and outdoor activities was administered to parents of all participants. While there were no significant differences in age, gender, or monthly family income between the two cohorts, astigmatism proportion (Cyl ≥ 0.75 D) in 2020 was 1.5-fold higher than that in 2018 (49.1% vs. 33.9%). The median cylindrical power was significantly higher in 2020 in older children (9 or 10 years old). More importantly, the children participating in both vision screenings had cylindrical power and J0 astigmatism significantly increased by 0.35 ± 0.40 D and 0.21 ± 0.25 D, respectively. A significant increase in astigmatism (both proportion and magnitude) was found after the school closure period. Further studies are needed to investigate the origin of this increased astigmatism. [ABSTRACT FROM AUTHOR]