{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T13:03:32Z","timestamp":1784898212623,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To assess the proportions and progression of refractive errors (spherical equivalent, astigmatism and anisometropia) in preschool children, to examine associations with demographic and environmental factors and to describe emmetropisation by providing normative reference values for early refractive development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included children in Flanders, Belgium undergoing routine vision screening, with non\u2010cycloplegic refractive measurements at 12, 24 and 30\u2009months using the PlusoptiX photoscreener, linked to maternal and child epidemiological data. Refractive errors were classified using predefined thresholds. Linear models assessed associations between SE and demographic, perinatal and socio\u2010economic variables. Emmetropisation was evaluated using paired measurements, with rates defined as monthly changes in SE or cylinder power.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean SE remained mildly hyperopic across all ages, with clinically negligible sex differences. Higher maternal education and more privileged socio\u2010economic status were associated with slightly lower SE, particularly at 30\u2009months. We observed clear ethnic differences in both SE and astigmatism type, with African children showing the highest SE, followed by Asian children and European children the lowest, highlighting ethnicity as a possible confounding factor for epidemiological studies. We observed evidence of emmetropisation for both SE and astigmatism, with faster rates of change in eyes with higher initial refractive errors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study provides normative data on refractive development and proportions of early refractive errors in a multi\u2010ethnic cohort of preschool children. The inclusion of normative emmetropisation tables offers practical guidance for paediatric ophthalmologists in clinical assessment. Observed ethnic differences highlight the importance of considering ethnicity in both clinical practice and future epidemiological research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aos.70204","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T12:21:53Z","timestamp":1784895713000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Epidemiology of refractive error and refractive changes in preschool children in Belgium"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0605-9262","authenticated-orcid":false,"given":"Joseph Van","family":"Aerschot","sequence":"first","affiliation":[{"name":"Department of Ophthalmology UZ Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanne","family":"Otto","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology UZ Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maaike","family":"Deschoemaeker","sequence":"additional","affiliation":[{"name":"Medical Policy\/Preventive Healthcare Opgroeien  Brussel Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diederik","family":"Vancoppenolle","sequence":"additional","affiliation":[{"name":"Medical Policy\/Preventive Healthcare Opgroeien  Brussel Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingele","family":"Casteels","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology UZ Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos","family":"Rozema","sequence":"additional","affiliation":[{"name":"Visual Optics Lab Antwerp (VOLANTIS), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Department of Ophthalmology Antwerp University Hospital; Institute for Medical Informatics, Statistics and 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