Approach Not Very Valid
The article draws attention to myopia as a risk factor for eye diseases in Germany—that is, in a society that is increasingly urban with digitalized education (1). To a large extent, the trend is behavioral: continuous close-up work activities and too little daylight in childhood are the most important triggers. Reliable data on incidence and prevalence are desirable, but the survey approach in the KiGGS study is not very valid if one considers that the parents’ self-reporting about their own or their child’s vision problems can be unreliable. Farsightedness and nearsightedness (myopia) are regularly confused, as I have observed in my office hours for many years. To quantify this uncertainty, it is advantageous to compare the statements of the parents with the actual corrective values of their child’s glasses, at least in a random sample, and to determine the error rate from this. This is the only way to detect whether significant changes have occurred in a later survey with respect to the first survey, or to determine which conclusions can be drawn given the methodological uncertainties.
The usefulness of the follow-up study from 2014 to 2017 must therefore be questioned.
At most, this gives an indication that hardly anything has improved since 2003–2006 to the period under review. To bring about a change in this trend, pediatricians should cooperate with kindergartens, as these can best reach parents of preschool-age children and convey the recommendation that children should receive one to two hours of daylight per day.
This further supports other development goals, be it motor, social, or cognitive. While staying outdoors is primarily free, pediatricians and ophthalmologists should be well paid for their educational work. It would be promising to examine the influence of preschool programs on the incidence of myopia and to evaluate it from a health economic perspective, provided that the methodology is valid.
PD Dr. med. Jean-Cyriaque Barry
|1.||Schuster AK, Krause L, Kuchenbäcker C, Prütz F, Elflein HM,Pfeiffer N, Urschitz MS: Prevalence and time trends in myopia among children and adolescents—results of the German KiGGS study. Dtsch Arztebl Int 2020; 117: 855–60 VOLLTEXT|