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Jan Johansson, Tony Pansell, Saber Abdi; Treatment Of Asthenopia In Children With And/or Without Neck-shoulder Muscular Pain. Invest. Ophthalmol. Vis. Sci. 2011;52(14):839.
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To evaluate the association between asthenopia and neck-shoulder muscular pain associated to near work and computer use in children and young adults.
65 children and adolescents (7-18 years of age) had been referred for optometric/orthoptic examination by school doctors, school nurses and physiotherapists due to asthenopia and/or neck-shoulder pain. Group 1: with neck-shoulder pain but without asthenopia. Group 2: with neck-shoulder pain and asthenopia. Group 3: with asthenopia but without neck-shoulder pain. Group 4: without neck-shoulder pain and without asthenopia. A complete orthoptical and ophthalmological examination was done for all subjects. All four groups underwent an eight week treatment. Group 2 and 3 received optometric/orthoptic treatment of their asthenopia. Group 1 and 4 received placebo treatment, i.e. a pair of plano or +0.25D glasses. After the 8-week treatment period all subjects were re-examined.
Group 1 (neck-shoulder pain only) have a statistically significant reduced accommodative amplitude compared to the expected level according to Hofstetters formula (18.5-0.3age). In terms of accommodative amplitude there was a significant difference between group 1 and 4 (p<0.05), between group 2 and 4 (p<0.001) and between group 3 and 4 (p<0.001). At the comparison of accommodative amplitude for group 1 and 4 to the expected accommodative amplitude according to Hofstetters formula it was found that group 1 differed significantly (p<0.0001) while group 4 did not differ significantly (p=0.8311).The difference in subjective symptoms (VAS) before and after treatment for group 1 was not significant (p=0.3125). For group 2 and 3 the difference in VAS before and after was significant (p<0.0001). For group 4 the difference was not significant. At a comparison of the actual reduction in VAS measure between group 2 and 3 there was no significant difference to be found (p=0.1616).
The results of this study show that there is a statistically significant reduction in symptoms after the treatment of asthenopia. Furthermore the results for group 2 (asthenopia and neck-shoulder) strongly suggests the occurrence of functional cross-talk between oculomotor- and musculoskeletal system.
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