Relationship Between After-school Learning and School Myopia in Elementary School Students

Chen Shyan-Tarng ； Chang Shun-Chan ； Tsai Lung-Hui ； Hsi-Pao Hsieh ； Cheng Ching-Ying

《中山醫學雜誌》 28卷2期 (2017/12) Pp. 59-68

摘要

Purpose: Curricula and learning environments are relatively uniform throughout the school system. However, the duration and intensity of after-school learning are quite disparate and depend largely on the extent of urbanization. The purpose of the present study was to investigate the possible correlation between after-school learning and school myopia. Methods: A total of 1,067 students from one urban and three rural schools, aged 7 to 12 years, participated in this study. Ocular examination included uncorrected visual acuity and non-cycloplegic refraction to obtain the best corrective visual acuity (BCVA). In addition, a multi-item questionnaire related to after-school learning was completed by parents and students. Statistical analyses included independent-sampling t-test, X^2 Spearman correlation, and linear regression analysis. Results: This cross-sectional study confirmed that students in each grade were on the average more myopic than those in the previous grade. A significant difference was also noted between urban and rural students in Grades 4, 5 and 6. Holistically, the degree of myopia correlated well with after-school environment, placement, and parental accompaniment, as well as with learning of English as a foreign language; computer, tablet or smart phone use; and outdoor physical activities. On linear regression analysis, 6 modulating factors of myopization were found. The most prominent was learning of English as a second language. Conclusion: Since the length of the school day and curricula are identical or nearly identical across all elementary schools, the variations in the degree of myopia may be related to after-school learning. Factors that favor lower myopic refraction error include larger indoor space, less stressful learning environment, and less digital device use, as well as more outdoor activities. Surprisingly, in addition to medical intervention, family education is the starting point for myopia control.

關鍵字

After-school learning ； after-school environment ； learning intensity ； school myopia