Fu-Gong Lin

Background/Objectives: Myopia is a major global public health concern, particularly in East Asia. Taiwan’s exceptionally high prevalence of childhood myopia provides a valuable population model for investigating refractive development and prevention. This study examined geographic disparities in visual acuity, refractive errors, and optometric resources among Taiwanese elementary school children. Methods: This retrospective nationwide study analyzed anonymized screening data from 10,610 elementary school children collected from 2014 to 2023. Children were classified as urban, rural, remote, or especially/extremely remote according to governmental criteria. Comprehensive vision examinations were performed by licensed optometrists. Refraction was assessed using autorefraction and retinoscopy without cycloplegia. Refractive errors and healthcare resources were compared across regions using multivariable logistic and linear regression analyses. Results: Myopia was present in 86.4% of male and 87.0% of female children, while measurable astigmatism (≥0.25 D) was present in 98.4% of both sexes. High myopia and high astigmatism affected 2.3% and 4.5% of children, respectively. Myopia prevalence varied across grade levels and was 88.9% among sixth-grade children. Compared with urban children, those living in especially or extremely remote areas and rural areas had higher odds of measurable astigmatism (OR = 2.81 and 1.63, respectively; p < 0.01). Rural children had significantly lower odds of myopia, while no significant association with myopia was observed among children living in specially or extremely remote areas. Optometry clinics were more concentrated in urban areas, and a higher density of optometry clinics was associated with lower odds of myopia. Conclusions: Taiwan provides a valuable model population for understanding geographic, environmental, and healthcare-related factors in childhood myopia. Better visual acuity does not necessarily indicate lower refractive risk. Region-specific strategies should strengthen comprehensive screening and referral, improve optometric access and affordable correction in remote areas, and promote lifestyle and environmental interventions in urban settings.

Purpose: Prior studies in monofocal intraocular lenses (IOLs) suggest that larger Nd:YAG posterior capsulotomies may reduce straylight and photic phenomena, but generalizability to extended depth-of-focus (EDOF) optics is uncertain. We evaluated whether capsulotomy size affects optical quality, higher-order aberrations (HOAs), and patient-reported outcomes in eyes with EDOF IOLs. Patients and Methods: In this prospective single-center study, 106 pseudophakic eyes with visually significant posterior capsule opacification and EDOF IOLs underwent Nd:YAG laser posterior capsulotomy. Capsulotomy size was measured at the slit lamp using a calibrated reticule in the horizontal and vertical meridians; the effective diameter was defined as the mean of these two measurements. Eyes were prospectively assigned to a small opening (S group, n=47), created to slightly exceed the IOL's central diffractive zone (≈1.6-1.8 mm), or a large opening (L group, n=59), extended to the margin of the outermost diffractive ring (≈4 mm). At 1-month post-treatment, visual acuity, HOAs, defocus curves, and optical quality metrics were assessed. Subjective outcomes were evaluated using the APPLES and Catquest-9SF-CN questionnaires. Results: Both groups showed improved visual acuity, with greater corrected distance visual acuity (CDVA) gain in the L group (-0.15 vs-0.06 logMAR; P = 0.024). Trefoil aberration increased more in the S group than in the L group (+0.15 vs +0.02; P = 0.021), while spherical aberration decreased more in the S group than in the L group (-0.20 vs-0.09; P = 0.024). The APPLES questionnaire showed a greater reduction in starburst severity and frequency in the L group (Δ-0.43 vs +0.07; P = 0.010). Multivariate analysis identified pre-treatment spherical equivalent, trefoil, mesopic pupil size, and CDVA as significant predictors of satisfaction. Conclusion: Capsulotomy size significantly influences optical quality and patient satisfaction in eyes with EDOF IOLs. Larger openings improve CDVA and photic symptoms, while smaller ones better reduce spherical aberration but increase trefoil. Personalizing capsulotomy size may optimize outcomes.

Background: Non-communicable Diseases (NCDs) present a substantial challenge in low- and middle-income nations, especially in the Southeast Asia region. Health literacy (HL) is vital for managing NCDs and improving health outcomes by enhancing individuals' abilities to seek, understand, assess, and utilize health information. Methods: A systematic review followed PRISMA guidelines, and relevant articles were sourced from PubMed, ProQuest, CINAHL, Scopus, Cochrane, and Google Scholar without limiting the publication year. Studies included were from Southeast Asia that examined the connection between HL and NCD outcomes. Sixteen cross-sectional studies from five countries were chosen for the final analysis. Results: The review observed that higher HL was linked to better health outcomes for individuals with NCDs. Communicative and critical HL were found to be more impactful than functional HL in obtaining, analysing, and applying health information. Additionally, HL was influenced by sociodemographic aspects (age, gender, education, location, and marital status, socioeconomic factors (income and employment), and societal influences (patient-doctor relationships, cultural context, and family support). HL was important in managing NCDs and for better health outcomes. Conclusion: Further studies are called for the evaluation of all three HL skills to comprehensively understand the HL of populations. Furthermore, the link between limited HL and employment status remains under-explored and deserves further attention.

Background: To conduct a city‐wide survey and investigate the risk factors of ocular disorders among institutionalised adults with intellectual disabilities (ID) in Taipei City. Method: A cross‐section city‐wide ophthalmic survey was conducted in Taipei City from 2016 to 2017, involving full‐day residents with ID aged over 18. Participant characteristics, including age, gender, ID severity and associated diseases, were collected for multiple logistic regression analysis to identify ocular disorder risk factors. Result: A total of 687 participants, comprising 70.9% of the eligible individuals, were included. Refractive errors (73.8%), strabismus (32.6%), ocular hypertension (26.0%) and cataract (15.3%) were the most common ocular disorders. Myopia (73.2%) is the most common refractive error, with 14.6% being high myopia. Down's syndrome (DS) was a common risk factor for developing strabismus (OR, 2.87; 95% confidence interval [CI], 1.54 to 3.35), nystagmus (OR, 6.50; 95% CI, 2.22 to 19.0), high myopia (OR, 2.62; CI, 1.85 to 3.09), high astigmatism (OR, 3.06; CI, 1.65 to 5.69) and cataracts (OR, 8.00; CI, 3.50 to 18.30), while it served as a protective factor against ocular hypertension (OR, 0.14; CI, 0.03 to 0.62). Cerebral palsy (CP) was identified as a common risk factor for strabismus (OR, 2.17; CI, 1.16 to 4.05), nystagmus (OR, 4.22; CI, 1.51 to 11.8) and high myopia (OR, 2.22; CI, 1.04 to 4.73). Conclusion: High prevalence of myopia, strabismus, ocular hypertension and cataract was observed in institutionalised adults with ID. DS and CP were more significant risk factors than ID severity for ocular disorders. Regular ophthalmic exams, particularly monitoring intraocular pressure, are crucial for this population.

Visual impairment (VI) is common among people with intellectual disabilities, with rates up to 19%. This study assessed the prevalence and risk factors for ocular disorders in 341 institutionalised adults with intellectual disabilities in Taipei City from January 2016 to December 2017. The cross-sectional survey included visual acuity testing, cycloplegic refraction, strabismus evaluation, slit-lamp biomicroscopy, tonometry, and retinal exams. Most participants were aged 20-39 years (72.9%), and 57.6% were male. VI or blindness was found in 19.7%, with strabismus (28.0%) and high myopia (23.6%) as key risk factors. Logistic regression indicated strabismus and high myopia significantly increased VI risk (OR 2.32 and 4.86). In participants with Down syndrome, the strabismus-VI association was stronger (OR 4.83 vs 1.73 without DS), with an interactive effect increasing VI risk sixfold. Early ocular screening and targeted interventions are crucial to reduce VI risk in adults with intellectual disabilities.

Background: Hyperopia is a significant refractive error in children, often leading to vision impairment. This study aimed to investigate whether partial or full spectacle correction is benefit for hyperopia in preschool-aged children.

The Binge Eating Scale (BES) is a widely used measuring tool to assess binge eating problems in Western countries. However, the psychometric properties of such scales among cross-cultural youth groups are insufficient, and the factor structure continues to be debated; therefore, further research is needed. The aim of this study was to examine the properties of BES among overweight college students in Taiwan. A cross-sectional design and convenience sampling were adopted to recruit 300 overweight students from five universities. A translated Traditional Chinese version of BES was used for the survey, and the validity of the scale was tested using the Confirmatory Factor Analysis (CFA) and Bulimic Investigatory Test, Edinburgh (BITE). The reliability was evaluated using internal consistency and test–retest reliability. The CFA results showed a reasonable model fit. The first-order two-factor model was consistent with that of the original BES and significantly correlated with the criterion of BITE score. Cronbach’s α value, representing internal consistency reliability, and the intraclass correlation coefficient of repeated measures made one month apart were both 0.83, indicating good reliability and stability. Significant correlations were observed between the BES score and sex and BMI; however, no correlation was observed between BES scores and age. The BES presents sound psychometric properties, has good cross-cultural applicability, and can be used as a first-line screening tool by mental health professionals to identify the severity of binge eating behavior among overweight college students in Taiwan. It is recommended that participant diversity and obesity indicators be incorporated into the scale in the future to establish a universal psychometric tool.

Caregiving for mental health among people with intellectual disabilities (IDs) in the ID services was reported as insufficient. The purposes of this study were to investigate five types of peer victimization (PV) experiences among adults with ID using ID services, and to gain a deeper understanding of the influence of PV experience on adults with ID’s long-term mental health status. A one-year longitudinal follow-up study was conducted from eight long-term care ID services (n = 176). Logistic regression analysis was applied to variables comprising personal characteristics, various types of PV experience and polyvictimization to predict period prevalence of psychiatric symptoms. The data indicated that nearly one-third of individuals with ID experienced at least one psychiatric symptom. The three most common psychiatric symptoms prevalent after one year were adjustment disorder, anxiety disorder, and somatoform disorder. Over the 1-year study period, approximately 40% of adults with ID reported experiencing PV. The most frequently reported types of PV were physical force (26%) and verbal victimization (22%). Polyvictimization was experienced by approximately a quarter of adults with ID. The findings suggest that PV is a common experience among adults in ID services. Thus, for a clearer understanding of mental health risks, caregivers should pay attention to adults with ID who experienced PV.