Myopia in Humans: Can Progression be Arrested?

Abstract

The multiplicity of theories regarding the aetiology of myopia has led to numerous and partly contradictory methods of therapy. Interest has been focused on accommodation because of the established association between myopia and close work. In studies of drug treatment of myopia, the treatment is often reported to be effective but the lack of randomization and high drop-out rates make the results questionable. In the Soviet Union, scleral reinforcement is said to be highly successful. Bifocal spectacle lenses reduce the accommodative demand, but studies on the effect of bifocal lenses have shown widely varying results. Whether contact lenses are effective in the control of myopia is still uncertain. In a Danish prospective study on the effect of treatment with bifocal lenses and beta-blocker eye drops a lower rate of progression was found among children wearing bifocal lenses but the difference from the control group was too small to warrant the use of such lenses in every myopic child. The progression rate in the group treated with the beta-blocker timolol maleate was not different from that in the control group. There thus seems to be no simple way of stopping or reducing the progression of myopia. Epidemiological data indicate that the maximum incidences of myopia are associated with educational systems in which the demands on the ability of the child to learn are stringent. One might introduce the term 'ocular stress' but this is clearly difficult to define and even more difficult to measure.