{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T10:00:25Z","timestamp":1775210425967,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","license":[{"start":{"date-parts":[[2020,12,23]],"date-time":"2020-12-23T00:00:00Z","timestamp":1608681600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Capital Health Development Special Fund of China Major Project","award":["SF-2018-1\u20132051"],"award-info":[{"award-number":["SF-2018-1\u20132051"]}]},{"name":"Capital Health Development Special Fund of China Major Project","award":["2018-4-1083"],"award-info":[{"award-number":["2018-4-1083"]}]},{"name":"Capital Health Development Special Fund of China Major Project","award":["2015-3-023"],"award-info":[{"award-number":["2015-3-023"]}]},{"name":"Capital Health Development Special Fund of China Major Project","award":["Z171100001017066"],"award-info":[{"award-number":["Z171100001017066"]}]},{"name":"Youth Project","award":["SF-2018-1\u20132051"],"award-info":[{"award-number":["SF-2018-1\u20132051"]}]},{"name":"Youth Project","award":["2018-4-1083"],"award-info":[{"award-number":["2018-4-1083"]}]},{"name":"Youth Project","award":["2015-3-023"],"award-info":[{"award-number":["2015-3-023"]}]},{"name":"Youth Project","award":["Z171100001017066"],"award-info":[{"award-number":["Z171100001017066"]}]},{"name":"High-Level Health Technical Talent Training Program of Beijing Municipal Health Bureau","award":["SF-2018-1\u20132051"],"award-info":[{"award-number":["SF-2018-1\u20132051"]}]},{"name":"High-Level Health Technical Talent Training Program of Beijing Municipal Health Bureau","award":["2018-4-1083"],"award-info":[{"award-number":["2018-4-1083"]}]},{"name":"High-Level Health Technical Talent Training Program of Beijing Municipal Health Bureau","award":["2015-3-023"],"award-info":[{"award-number":["2015-3-023"]}]},{"name":"High-Level Health Technical Talent Training Program of Beijing Municipal Health Bureau","award":["Z171100001017066"],"award-info":[{"award-number":["Z171100001017066"]}]},{"DOI":"10.13039\/501100009592","name":"Beijing Municipal Science and Technology Commission","doi-asserted-by":"publisher","award":["SF-2018-1\u20132051"],"award-info":[{"award-number":["SF-2018-1\u20132051"]}],"id":[{"id":"10.13039\/501100009592","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009592","name":"Beijing Municipal Science and Technology Commission","doi-asserted-by":"publisher","award":["2018-4-1083"],"award-info":[{"award-number":["2018-4-1083"]}],"id":[{"id":"10.13039\/501100009592","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009592","name":"Beijing Municipal Science and Technology Commission","doi-asserted-by":"publisher","award":["2015-3-023"],"award-info":[{"award-number":["2015-3-023"]}],"id":[{"id":"10.13039\/501100009592","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009592","name":"Beijing Municipal Science and Technology Commission","doi-asserted-by":"publisher","award":["Z171100001017066"],"award-info":[{"award-number":["Z171100001017066"]}],"id":[{"id":"10.13039\/501100009592","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Beijing Hoson Foundation","award":["SF-2018-1\u20132051"],"award-info":[{"award-number":["SF-2018-1\u20132051"]}]},{"name":"Beijing Hoson Foundation","award":["2018-4-1083"],"award-info":[{"award-number":["2018-4-1083"]}]},{"name":"Beijing Hoson Foundation","award":["2015-3-023"],"award-info":[{"award-number":["2015-3-023"]}]},{"name":"Beijing Hoson Foundation","award":["Z171100001017066"],"award-info":[{"award-number":["Z171100001017066"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Ophthalmology"],"published-print":{"date-parts":[[2020,12,23]]},"abstract":"<jats:p>Introduction. The study aims to explore the prevalence of heterophoria and associate factors in Tibetan grade-one students. Methods. The Lhasa Childhood Eye Study (LCES) is a school-based cohort study. 1942 grade-one students from 7 elementary schools were randomly sampled by stratified cluster sampling. Ocular examinations were performed in participants, including ocular motility, distance and near visual acuity, cycloplegic autorefraction, and stereoacuity. The near (33\u2009cm) and distance (6\u2009m) fixation cover test was used to differentiate orthophoria, heterophoria, and heterotropia, and the magnitude of the phoria was measured by the Maddox rod and prisma. Results. Of 1856 grade-one students completing all the ocular examinations, 1852 participants finished the ocular alignment test. The mean age was 6.82\u2009\u00b1\u20090.46 years (range 6\u223c10 years); 981 (52.97%) were males, and 871 (47.03%) were females. The prevalence of phoria was 22.89% (n\u2009=\u2009424). At distance fixation, the prevalence of heterophoria, exophoria, and esophoria was 4.64%, 4.21%, and 0.43% separately, while at near fixation, the prevalence was 22.73%, 22.35%, and 0.38%. No vertical phoria was detected. The mean magnitude of heterophoria at near and distance fixation was \u22127.63\u2009\u00b1\u20095.15 PD (exo: \u22127.83\u2009\u00b1\u20094.91 PD, eso: +5.67\u2009\u00b1\u20093.61 PD) and \u22124.84\u2009\u00b1\u20095.94 PD (exo: \u22126.26\u2009\u00b1\u20094.20 PD, eso: +8.13\u2009\u00b1\u20093.04 PD). The prevalence of esophoria was associated with hyperopia (OR\u2009=\u20096.38, 95% CI: 1.15\u201335.28,<jats:inline-formula><a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><a:mi>P<\/a:mi><\/a:math><\/jats:inline-formula>\u2009=\u20090.03; OR\u2009=\u20095.42, 95% CI: 1.04\u201328.24,<jats:inline-formula><c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><c:mi>P<\/c:mi><\/c:math><\/jats:inline-formula>\u2009=\u20090.04) and amblyopia (OR\u2009=\u200916.02, 95% CI: 1.81\u223c141.96,<jats:inline-formula><e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><e:mi>P<\/e:mi><\/e:math><\/jats:inline-formula>\u2009=\u20090.01; OR\u2009=\u200911.37, 95% CI: 1.34\u223c96.52,<jats:inline-formula><g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\"><g:mi>P<\/g:mi><\/g:math><\/jats:inline-formula>\u2009=\u20090.03) at near and distance fixation. The prevalence of exophoria was associated with myopia at near fixation (OR\u2009=\u20092.43, 95% CI: 1.47\u20134.00,<jats:inline-formula><i:math xmlns:i=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\"><i:mi>P<\/i:mi><\/i:math><\/jats:inline-formula>&lt;0.01). In the near heterophoria group, the proportion of children with abnormal stereoacuity was 23.26% (n\u2009=\u200997), significantly higher (\u03c72\u2009=\u20095.70,<jats:inline-formula><k:math xmlns:k=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\"><k:mi>P<\/k:mi><\/k:math><\/jats:inline-formula>\u2009=\u20090.017) than that in orthophoria (17.99%, n\u2009=\u2009244). Conclusions. In Lhasa, grade-one pupils have a lower prevalence of heterophoria. Near exophoria was associated with myopia, while esophoria was related to hyperopia and amblyopia both near and distance. Heterophoria may be one of the affected factors for reducing stereoacuity.<\/jats:p>","DOI":"10.1155\/2020\/9570908","type":"journal-article","created":{"date-parts":[[2020,12,24]],"date-time":"2020-12-24T20:51:08Z","timestamp":1608843068000},"page":"1-7","source":"Crossref","is-referenced-by-count":8,"title":["Prevalence of Heterophoria in Tibetan Grade-One Students: The Lhasa Childhood Eye Study"],"prefix":"10.1155","volume":"2020","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3981-4143","authenticated-orcid":true,"given":"Han","family":"Su","sequence":"first","affiliation":[{"name":"Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2939-9479","authenticated-orcid":true,"given":"Jing","family":"Fu","sequence":"additional","affiliation":[{"name":"Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3157-1389","authenticated-orcid":true,"given":"Weiwei","family":"Chen","sequence":"additional","affiliation":[{"name":"Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China"},{"name":"Beijing Institute of Ophthalmology, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2916-5004","authenticated-orcid":true,"given":"Zhaojun","family":"Meng","sequence":"additional","affiliation":[{"name":"Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3661-4808","authenticated-orcid":true,"given":"Lei","family":"Li","sequence":"additional","affiliation":[{"name":"Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3722-1312","authenticated-orcid":true,"given":"Wei","family":"Dai","sequence":"additional","affiliation":[{"name":"Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7947-2833","authenticated-orcid":true,"given":"Yao","family":"Yao","sequence":"additional","affiliation":[{"name":"Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-199006000-00010"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1080\/09273972.2017.1317820"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2009.163709"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1111\/aos.13650"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.2147\/opth.s84976"},{"issue":"2","key":"6","doi-asserted-by":"crossref","first-page":"63","DOI":"10.3109\/09273972.2016.1159234","article-title":"Variability of fusion vergence measurements in heterophoria","volume":"24","author":"C. C. Lanca","year":"2016","journal-title":"Strabismus"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1046\/j.1475-1313.2002.00010.x"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1111\/aos.12476"},{"issue":"1","key":"9","first-page":"44","article-title":"Cross-sectional study of heterophoria among primary, middle and high school students in Shantou District, China","volume":"32","author":"S. B. Lin","year":"2017","journal-title":"Yan Ke Xue Bao"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-1313.1987.tb00759.x"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1016\/s0275-5408(99)00056-3"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-1313.1989.tb00829.x"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.15-17877"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.14-14649"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-199604000-00009"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1186\/s12886-020-01572-0"},{"issue":"7","key":"17","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1016\/j.ophtha.2007.08.001","article-title":"Prevalence of amblyopia and strabismus in African American and Hispanic children ages 6 to 72 months the multi-ethnic pediatric eye disease study","volume":"115","author":"Multi-ethnic Pediatric Eye Disease Study Group","year":"2008","journal-title":"Ophthalmology"},{"key":"18","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0420.2005.00615.x"},{"key":"19","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9394(75)90679-0"},{"key":"20","doi-asserted-by":"crossref","first-page":"348","DOI":"10.3928\/0191-3913-19951101-05","article-title":"20th annual frank eostenhader lecture adult strabismus","volume":"32","author":"W. E. Scott","year":"1995","journal-title":"Journal of Pediatric Ophthalmology and Strabismus"},{"key":"21","doi-asserted-by":"publisher","DOI":"10.18240\/ijo.2018.04.22"},{"issue":"11","key":"22","first-page":"825","article-title":"Nearpoint visual stress: a physiological model","volume":"55","author":"M. H. Birnbaum","year":"1984","journal-title":"Journal of the American Optometric Association"},{"issue":"6","key":"23","first-page":"480","article-title":"Nearpoint visual stress: clinical implications","volume":"56","author":"M. H. Birnbaum","year":"1985","journal-title":"Journal of the American Optometric Association"},{"key":"24","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjo.2016.07.001"},{"key":"25","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-196309000-00003"},{"key":"26","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2007.116905"},{"key":"27","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2009.10.009"},{"key":"28","volume-title":"System of Ophthalmology: Ocular Motility and Strabismus","author":"S. S. Duke-Elder","year":"1973"},{"key":"29","doi-asserted-by":"publisher","DOI":"10.1016\/j.optm.2011.02.020"},{"key":"30","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-199407000-00001"}],"container-title":["Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/joph\/2020\/9570908.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/joph\/2020\/9570908.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/joph\/2020\/9570908.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T05:03:55Z","timestamp":1670562235000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/joph\/2020\/9570908\/"}},"subtitle":[],"editor":[{"given":"Michele","family":"Figus","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2020,12,23]]},"references-count":30,"alternative-id":["9570908","9570908"],"URL":"https:\/\/doi.org\/10.1155\/2020\/9570908","relation":{},"ISSN":["2090-0058","2090-004X"],"issn-type":[{"value":"2090-0058","type":"electronic"},{"value":"2090-004X","type":"print"}],"subject":[],"published":{"date-parts":[[2020,12,23]]}}}