Abstract
BackgroundDaily “eye exercises,” massaging of periocular acupuncture pressure points, have been part of China’s national vision care policy in schools for some 50 years. However, the effect of eye exercises on myopia progression and eyeglasses wear has not been definitively investigated. This study evaluates the effectiveness of eye exercises on visual acuity and the propensity of rural children to wear eyeglasses.MethodsCohort study in 252 randomly-selected rural schools with baseline in September 2012 and follow up surveys 9 and 21 months later. Outcomes were assessed using propensity-score matching (PSM), multivariate linear regression and logistic regression to adjust for differences between children performing and not performing eye exercises.ResultsAmong 19,934 children randomly selected for screening, 2374 myopic (spherical equivalent refractive error ≤ − 0.5 diopters in either eye) children (11.9%, mean age 10.5 [Standard Error 1.08] years, 48.5% boys) had VA in either eye ≤6/12 without eyeglasses correctable to > 6/12 with eyeglasses. Among these who completed the 21-month follow up, 1217 (58.2%) children reported practicing eye exercises on school days and 874 (41.8%) did not. After propensity-score matching, 1652 (79%) children were matched: 826 (50%) in the Eye Exercises group and 826 (50%) in the No Exercise group. Performing eye exercises was not associated with change in LogMAR uncorrected visual acuity and wear of eyeglasses, using either logistic regression or PSM at 9 or 21 months.ConclusionsWe found no evidence for an effect of eye exercises on change in vision or eyeglasses wear.Trial registrationThe original trial (Registration site: http://isrctn.org. Registration number: ISRCTN03252665) was retrospectively registered 25/09/2012.
Highlights
“eye exercises,” massaging of periocular acupuncture pressure points, have been part of China’s national vision care policy in schools for some 50 years
We aim to investigate the association between self-reported regular practice of eye exercises and change in uncorrected visual acuity over the course of two school years, using propensity score matching to account for differences between compliant and non-compliant children
Practicing eye exercises regularly, if it does reduce progression of myopia, would be expected to slow the decline in uncorrected distance visual acuity (VA) resulting from increased myopia commonly observed among children with aging
Summary
“eye exercises,” massaging of periocular acupuncture pressure points, have been part of China’s national vision care policy in schools for some 50 years. The effect of eye exercises on myopia progression and eyeglasses wear has not been definitively investigated. This study evaluates the effectiveness of eye exercises on visual acuity and the propensity of rural children to wear eyeglasses. Spectacles provide safe and inexpensive correction for refractive error, but among children requiring correction in rural and urban migrant populations in China, spectacle wear is as low as 15% [5,6,7]. The situation is due in part to a wide-spread perception among parents, teachers and even some healthcare providers that eyeglasses wear harms children’s vision by worsening myopia [8, 9]. In 1963, the Ministry of Education introduced Chinese eye exercises as a proposed method for myopia treatment and/or prevention among school-aged children [10]. In Chinese eye-exercises, pressure is applied to acupoints present around the eyes, with the objective of increasing blood circulation, reducing ocular fatigue, and slowing down the development of myopia [11]
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