Refractive Errors, Amplitude of Accommodation, and Myopia Progression in Kazakhstani Medical Students: 5-Year Follow-Up

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Refractive Errors, Amplitude of Accommodation, and Myopia Progression in Kazakhstani Medical Students: 5-Year Follow-Up
by Yuliya Semenova 1,*ORCID,Malika Urazhanova 2,Lisa Lim 3 andNazerke Kaiyrzhanova 4
1
Department of Surgery, Nazarbayev University School of Medicine, Astana 010000, Kazakhstan
2
Department of Neurology, Ophthalmology, and Otorhinolaryngology, Semey Medical University, Semey 071400, Kazakhstan
3
Nazarbayev University Graduate School of Public Policy, Astana 010000, Kazakhstan
4
SemeyOFTUM Ophthalmology Clinic, Semey 071400, Kazakhstan
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2024, 13(13), 3985; https://doi.org/10.3390/jcm13133985
Submission received: 26 May 2024 / Revised: 4 July 2024 / Accepted: 6 July 2024 / Published: 8 July 2024
(This article belongs to the Special Issue Advanced Research in Myopia and Other Visual Disorders)
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Abstract
Background/Objectives: this longitudinal study aimed to investigate the refractive errors, the amplitude of accommodation, and myopia progression in Kazakhstani medical students as they progressed from the first to the fifth course of their studies. Methods: A total of 696 students from Semey Medical University underwent non-cycloplegic and cycloplegic autorefraction in the first course, and 655 were available for examination in the fifth year of study. The amplitude of accommodation was measured before the instillation of cycloplegics using the push-up and push-down methods. A self-administered questionnaire was applied to evaluate the risk factors associated with myopia progression. Results: In the first course, the median spherical equivalent was −0.75 Diopters before cycloplegia and −0.25 Diopters after cycloplegia. In the fifth course, it constituted −1.125 Diopters before cycloplegia and −0.5 Diopters after cycloplegia. The proportion of students with myopia following cycloplegic refraction increased from 44.7% in the first course to 47.5% in the fifth course. The proportion of emmetropic students declined from 31.5% to 30.3%, and hyperopia decreased from 23.8% to 16.8%. The dioptric power of accommodative excess increased from 0.375 in the first year to 0.50 in the fifth year. The hours spent on near-work activities, such as reading books, writing, working at a computer, and using a mobile device, were significantly associated with a myopia progression of ≥0.5 Diopters. Conclusions: the findings of this study suggest implications for public health policy and educational practice.