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For the want of an appropriate pair of glasses about 153 million people around the world are visually impaired. Myopia is the most common refractive error, with a prevalence of 10–30% in Western countries but up to 80% in some parts of Asia. A study in rural China (BMJ 2011;343:d4767; see also editorial, ibid: d4793) has shown that the use of adjustable spectacles (with adjustable, fluid filled lenses) could lead to good visual correction for many young people. A total of 648 young people aged 12–18 years were assessed with self refraction using adjustable spectacles, automated refraction and subjective refraction by an ophthalmologist with use of cycloplegia. The resulting visual correction with self refraction was within one line on the chart of that provided by the ophthalmologist in 98% of subjects. Adjustable spectacles are not suitable for everyday use because they are unattractive and too expensive (up to US $20) for developing countries, but they could be used to help choose a pair of ‘off the shelf’ spectacles costing as little as 50 cents a pair. Potential concerns include non-diagnosis of eye disease or of astigmatism or hyperopia but sheer numbers point to the usefulness of self refraction.
Routine infant vaccination with pentavalent rotavirus vaccine (RV5) was introduced in the USA in February 2006. In previous years there were about 400 000 physician's office visits annually across the nation among children under 5 years old for rotavirus …