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Updated: Jun 5, 2026
Binocular Dynamic Visual Acuity in Eyeglass-Corrected Myopic Patients
Published on: March 29, 2022
Corneal biomechanics, refractive error, and axial length in Chinese primary school children
Yuqiang Huang1, Chukai Huang, Liping Li
1Joint Shantou International Eye Center, Shantou, China.
Insights
Low corneal hysteresis (CH) in young children is linked to longer axial length (AL), a key factor in myopia development. This finding suggests CH may be an early indicator of myopia progression in primary school students.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Corneal Biomechanics
Background:
- Low corneal hysteresis (CH) is associated with longer axial length (AL) in older Chinese children.
- Understanding this relationship in younger populations is crucial for early myopia detection.
Purpose of the Study:
- To investigate the association between corneal hysteresis and axial length in primary school children.
- To assess the feasibility of CH measurement in young children for myopia research.
Main Methods:
- Ocular biometry, including axial length (AL) and central corneal thickness (CCT), was measured in primary school students.
- Corneal hysteresis (CH) was assessed using tonometry.
- Data were analyzed using correlation and generalized estimating equation models, adjusting for age, gender, and CCT.
Main Results:
- A significant association was found between lower corneal hysteresis (CH) and longer axial length (AL) in primary school children (P < 0.001).
- Lower CH was also significantly associated with more myopic refractive error (P = 0.001).
- CH measurement was found to be practical in this young cohort.
Conclusions:
- Corneal hysteresis measurement is feasible and practical in young children.
- Lower CH is significantly associated with longer AL and myopia in primary school students.
- Further prospective studies are needed to determine if low CH predicts or results from increased AL.
Purpose:
Low corneal hysteresis is associated with longer axial length in Chinese secondary school children. The authors sought to explore this association in primary school children.
Methods:
LogMAR presenting visual acuity, cycloplegic refractive error, ocular biometry, central corneal thickness (CCT), and corneal hysteresis (CH) was assessed for children in grades 1 to 3 at an academically competitive urban school in Shantou, China.
Results:
Among 872 eligible children (mean age, 8.6 ± 2.1 years), 651 (74.7%) completed the examination. Among 1299 examined eyes, 111 (8.5%) had uncorrected vision ≤6/12. Mean spherical equivalent refractive error for all eyes was +0.26 ± 1.41 D, and axial length (AL) was 22.7 ± 0.90 mm. CH for the lowest (mean AL, 21.7 ± 0.39 mm), two middle (mean AL, 22.4 ± 0.15 and 22.9 ± 0.15 mm), and highest quartiles (mean AL, 23.7 ± 0.74 mm) of AL were 10.6 ± 2.1 mm Hg, 10.4 ± 2.1 mm Hg, 10.3 ± 2.3 mm Hg, and 10.2 ± 2.3 mm Hg respectively (age- and gender-adjusted Pearson's correlation coefficient r = -0.052; P = 0.001). In generalized estimating equation models adjusting for age, gender, and CCT, lower CH was significantly associated with longer AL (P < 0.001) and more myopic refractive error (P = 0.001).
Conclusions:
CH measurement is practical in young children because this is when myopia undergoes its most rapid progression. Prospective follow-up of this cohort at high risk for myopia is under way to determine whether low CH is predictive, or a consequence, of long AL.
