A longitudinal study of ocular biometry and vision-related quality of life in Singapore young adults

  • Heng Kuen Kwan

Student thesis: Doctoral ThesisOphthalmic Doctorate


Myopia is a serious health problem that has reached epidemic levels in Asian cities such as Taiwan, South Korea, and Singapore. However, there is a lack of cross-sectional and longitudinal data on refractive error and ocular biometry in young adults, especially in Singapore. Despite the high prevalence of myopia in Singapore, vision-related quality of life (VRQOL) is also inadequately examined.

This longitudinal study sets out to examine the refraction, ocular biometry and VRQOL over a 24-month period. Participants were recruited from the student pool of a tertiary education institution. Subjective refraction, ocular biometry, and accommodative response measurements were performed for participants. The NEI-RQL-42 questionnaire and a bespoke questionnaire were completed by participants.

Out of 99 participants (age range 16 to 22 year) at the baseline visit, 86.8 % were myopic. The age of initial refractive correction was significantly associated with refractive error, while near work, sports activities, outdoor activities, accommodative responses, and
primary school leaving examinations were not. Among the 88 participants who completed the 24 month visit, the percentage of myopes remained stable, with no increase in myopia. Ocular biometric parameters also remained stable, with only a non-clinically
significant increase of 0.02mm in axial length.

Non-Myopes exhibited the highest VRQOL, while Mod/High-Myopes had the lowest VRQOL. Myopia and contact lens wear were found to be the main contributors towards poorer VRQOL. VRQOL remained stable over the 24 month period, with the exception
that moderate and high myopes exhibited an improvement in VRQOL on their dependence of correction.

In conclusion, this study presented novel findings on stable refraction and ocular biometry in Singapore young adults over a 24 month period, which was contrary to previous findings on university students. In addition, VRQOL remained unchanged over a 24 month period, where myopia and contact lens wear were found to cause poorer VRQOL in participants.
Date of Award20 Feb 2017
Original languageEnglish
SupervisorAmy Sheppard (Supervisor)


  • myopia
  • refractive error
  • axial length
  • tertiary students

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