Management Of Myopia Research Articles

A Review of Pathologic Myopia.

Pathologic myopia is a leading cause of vision loss worldwide and is most prevalent in developed nations in East and Southeast Asia. Although the pathophysiologic mechanisms behind pathologic myopia have yet to be elucidated, the process is thought to stem from excessive axial elongation of the globe and subsequent degeneration of vital structures within the posterior segment. The array of complications that arise from this condition can lead to significant visual impairment. The purpose of this article is to review the classification, pathophysiology, complications, and management of pathologic myopia.

Will treating progressive myopia overwhelm the eye care workforce? A workforce modelling study

PurposeTreatments for myopia progression are now available, but implementing these into clinical practice will place a burden on the eye care workforce. This study estimated the full‐time equivalent (FTE) workforce required to implement myopia control treatments in the UK and Ireland.MethodsTo estimate the number of 6‐ to 21‐year‐olds with myopia, two models utilising separate data sources were developed. The examination‐based model used: (1) the number of primary care eye examinations conducted annually and (2) the proportion of these that are for myopic young people. The prevalence‐based model used epidemiological data on the age‐specific prevalence of myopia. The proportion of myopic young people progressing ≥0.25 dioptres (D)/year or ≥0.50 D/year was obtained from Irish electronic health records and the recommended review schedule from clinical management guidelines.ResultsUsing the examination and prevalence models, respectively, the estimated number of young people with myopia was 2,469,943 and 2,235,713. The extra workforce required to provide comprehensive myopia management for this target population was estimated at 226–317 FTE at the 0.50 D/year threshold and 433–630 FTE at the 0.25 D/year threshold. Extra visits required for myopia control treatment represented approximately 2.6% of current primary eye care examinations versus 13.6% of hospital examinations.ConclusionsImplementing new myopia control treatments in primary care settings over the medium‐term is unlikely to overwhelm the eye care workforce completely. Further increases to workforce, upskilling of current workforce and tools to reduce chair time will help to ensure sustainability of the eye care workforce into the future.

Size and position of the optic disc crescent in a white European population with myopia.

SignificanceOne of the first clinically observed changes in the retina with progressing myopia is in the form of optic disc crescents. If such a change is predictive of myopia progression, it could aid in myopia management interventions to target those at greatest risk of progression and subsequent ocular morbidity.PurposeTo investigate the type, dimension and appearance of optic disc crescents and how they relate to the level of myopia.MethodsRetrospective data collection analysing retinal photographs of healthy children and adults with a refractive error of ≤−0.50 D sphere and astigmatism ≤2.00 D. Crescent location, maximum crescent width and vertical disc diameter were measured from retinal images of right eyes only.ResultsFour‐hundred eyes with a mean spherical error (SER) of −0.50 to −14.00 D (aged 7–81 years) were included (83.5% exhibited a discernible crescent). Mean (SD) maximum crescent width was 0.24 (0.24) mm. Univariate analysis showed a significant correlation between crescent width and age (r = 0.26, p < 0.001). SER was correlated with crescent width when controlling for age (r = −0.45, p < 0.001) and to the ratio of crescent width to vertical disc diameter (r = −0.43, p < 0.001). Temporal crescents were the most frequently observed (74%), followed by inferior temporal crescents (17%). One‐way between‐groups analysis of variance showed a significant difference between crescent locations (F = 5.2, p < 0.001). Post‐hoc analysis revealed significant differences in SER between those with no crescent versus an inferior‐temporal crescent, as well as differences between those with temporal versus inferior‐temporal crescents. Other crescent locations did not differ significantly in the level of myopia. Participants not exhibiting a crescent had the lowest level of myopia (mean [SD] −3.03 [1.97)] D), while those with inferior temporal crescents had a mean (SD) SER of −5.01 (2.37) D.ConclusionIn this white European population, higher levels of SER were associated with increasing crescent size. Eyes with inferior temporally located crescents were more myopic.

Clinical Outcomes of Toric Implantable Collamer Lens (T-ICL) and Toric Implantable Phakic Contact Lens (IPCL) for High Myopia with Astigmatism: A Comparative Study

Background: Our study aimed to compare the clinical, visual outcomes, and efficacy of toric Implantable Collamer Lens (T-ICL) and toric implantable phakic contact lens (IPCL) in patients with high myopia and astigmatism over a follow-up period of 6 months. Methods: A prospective interventional randomized comparative study included 60 myopic eyes divided into 2 groups, group A including 30 eyes that were implanted with T-ICL, and group B, including 30 eyes that were implanted with toric IPCL. The refractive results, visual acuity, central corneal endothelial cell count, and intraocular pressure (IOP) were evaluated at baseline and at 1 and 6 months post-surgery. Any complications either during or after surgery were assessed. Results: In both study groups, the mean central corneal endothelial cell count was significantly decreased after 1 month and improved to reach near pre-operative values after 6 months postoperatively, indicating good lens biocompatibility. A statistically significant increase in IOP was found in both groups during the early follow-up, and a significant decrease after 6 months postoperatively (p=0.036) was reported in group A. A significant reduction in both spherical and cylindrical refractive errors with good predictability was reported in both groups compared with pre-operative values. Regarding the predictability, In T-ICL group (A), the median spherical and cylindrical errors were significantly improved from (-10 D &amp; -4.5 D) pre-operatively to (-0.3 D &amp; - 0.3 D) at the end of 6 months follow up period. Similarly, in the toric IPCL group (B), the median spherical and cylindrical errors were significantly improved from (-11 D &amp; -4.5 D) pre-operatively to (-0.3 D &amp; - 0.3 D) by the end of follow up period. A statistically significant improvement of UCDVA at 6 months postoperatively was found in both groups, as median preoperative LogMAR UCDVA was 1.1 and 1.3 in groups A and B respectively, which was improved to 0.3 in both groups at the end of follow-up period. There were no reported intra- or postoperative complications such as cataract, keratitis, or lens decentration. Conclusion: Toric IPCL is a suitable alternative to T-ICL for the management of high myopia with astigmatism, especially in developing countries, as it is cheaper and easier to implant than T-ICL. However, data over longer follow-up periods are needed to confirm its safety and stability.

Barriers to family intervention to promote child and adolescent vision health: A qualitative study based on community practice in China

PurposeChild and adolescent myopia is a widespread public health problem worldwide, with high incidence, low age at onset, and severe symptoms. Family management plays a very important role in the prevention and management of myopia in children and adolescents; however, even with knowledge of the health risks of myopia, parents still continue to selectively ignore the importance of visual health, resulting in difficulties with family care related to childhood and adolescent myopia. The purpose of this study was to explore the barriers to family intervention for child and adolescent vision. MethodsThis was a qualitative phenomenological research study that used in-depth semi-structured interviews to explore the experiences of 20 parents whose children had been diagnosed with myopia in Shenzhen, China. Data were analyzed using thematic analysis methods. ResultsThree themes emerged: Vision health: neglected care, Going outdoors: the forgotten activity, Education: the top priority. ConclusionsOur analysis revealed that several factors contributed to barriers to promotion of visual health. One was an incorrect perception of myopia, including the effects of myopia, its non-lethality, and a view that it has minimal impact on daily life. Additionally, when parents faced a conflict between education and vision care, they tended to choose current education and ignore future development of visual problems. Practice implicationsThe findings suggest that future family intervention for child and adolescent myopia can be based on the perspective of parental health education, Simultaneously, it should also focus on the balance between education and vision care.

Practice patterns in managing myopia differs among Indian eye care practitioners

Dear Editor, Literature has shown that the prevalence of myopia in India has increased from 4.5% in 1999 to 21.2% in 2019 among children aged 5–15 years.[1] A prediction model using studies done in India estimated an overall 10.53% increase in myopia prevalence over the next three decades.[1] Hussaindeen et al. (2021)[2] cautioned that due to COVID-19 lockdown, the progression of myopia may further accelerate as children spend more time indoors and less time outdoors. Akerman[3] conducted a survey in early 2021 among eye care practitioners (ECPs) in the USA and reported the current attitudes and behaviors regarding myopia management. About 40.0% of the practitioners prescribed single-vision spectacles as the primary mode of correction for myopic patients. More than 50.0% of the ECPs had prescribed multifocal contact lens, visual hygiene, and increased time outdoors. Low-dose atropine (0.01%) and Ortho-K were recommended by about 35.0% of the ECPs, and combinations of treatments were suggested by around 20.0%. The authors used a similar survey to understand the current attitudes and behaviors regarding myopia management among ECPs in India [Fig. 1]. A total of 147 ECPs responded via an online survey, and 81.0% of the ECPs were involved in myopia management among children. Though plethora of treatments are available for managing myopia, about 95.0% of them were still prescribing single-vision spectacles. Increased time outdoors and visual hygiene were suggested by more than 80.0% of the ECPs. Though studies have shown that low-dose atropine[4] and Ortho-K[5] are efficacious in retarding myopia, more than 80.0% of the ECPs have not started practicing these two strategies.Figure 1: Current practice pattern in managing myopia by ECPs in IndiaIn conclusion, this survey of current trends among ECPs in myopia management revealed that despite growing evidence of the increasing prevalence of myopia in India, uptake of appropriate anti-myopia strategies is poor. Low awareness about available products and lack of training among the ECPs in India could be the reasons for the low uptake of anti-myopia strategies. Thus, there is an immediate need to conduct frequent continuing medical education programs focused on myopia management, which should help ECPs to embrace the anti-myopia strategies and tackle this myopia menace.

A Review of Concepts of Etiology and Management of Myopia

This article reviews the literature concerning etiology of myopia. Myopic boom in this 21st century is of concern for parents of myopic children. The article reviews the literature regarding several modalities attempting to profile ocular findings in myopes. The prevalence of myopia remains higher in Asia and hence myopic studies have gained their importance in epidemiology. Younger age group with early onset of myopia are at a higher risk of complications associated myopic refractive error, as progression of the refractive error over time might result in high myopia and also cause retinal especially macular changes. Environment and genetics are known contributing factors to the increasing prevalence of myopia. Along with the evaluation of refractive error frequently it is also important to profile the ocular parameters associated in progression of myopia. The aim of this study is to explore the role of ocular biometers in myopia management.

Trends in myopia management attitudes and strategies in clinical practice: Survey of eye care practitioners in Africa

PurposeThere remains a lack of information on the perception and adoption of myopia control strategies among African eye care practitioners (ECPs). This study provides an African perspective to similar previous studies conducted in other parts of the world. MethodsA self-administered survey in English and French was distributed to ECPs across Africa. The items on the questionnaire assessed their level of concern about the increasing prevalence of paediatric myopia, perceived efficacy, opinions on, and adoption of various myopia management modalities. ResultsResponses were obtained from 330 ECPs working in 23 African countries. Respondents were highly concerned about the increasing prevalence of paediatric myopia in their clinic (median 8/10) and perceived approved myopia control soft contact lenses as the most effective at slowing myopia progression (mean perceived reduction in myopia progression ± SD; 53.9 ± 27.1%), followed by single vision spectacles (53.1 ± 30.9%), and orthokeratology (52.8 ± 28.0%). Multifocal soft contact lenses (40.4 ± 25.8%) and pharmaceutical agents such as topical atropine drops (39.5 ± 27.1%) were perceived as least effective in slowing myopia progression. Although ECPs reported being aware of various myopia control strategies, they still mainly prescribed single vision spectacles to a large proportion (64.3 ± 29.9%) of young progressing myopes. Nearly one-third (27%) of ECPs who prescribed single vision lenses stated they were concerned about the cost implications to patients. Other reported concerns included safety of, and inadequate information about myopia control options. ConclusionsAfrican ECPs continue to prescribe single vision lenses for progressing myopes despite being aware of the various myopia control options. Practitioners’ perceptions of the efficacy of several modalities to slow myopia progression do not align with the current best evidence. Clear practice guidelines and continuing education on myopia control are warranted to inform and guide the management of myopic patients in Africa.

Integration of Myopia Management into a Behavioral Vision Practice: How and Why?

It is predicted that half of the world’s population (nearly 5 billion) will be myopic by 2050. There is a large unmet need for myopia prevention in this population. This perspective piece discusses integration of myopia management into a practice that embraces a behavior/developmental vision care philosophy. We outline the 7 foundational steps that have allowed us to develop a successful myopia management practice.

Bewertung der Wirksamkeit verschiedener Behandlungsmethoden in einer Fallserie bei Patienten mit Myopie

Purpose. This patient case series describes the response to myopia control contact lens treatments and compares the use of five methods evaluating the efficacy of the treatments. Material and Methods. Data from the myopia management clinic, Glasgow Caledonian University included age, axial length (AL) spherical equivalent refraction (SER) and treatment (orthokeratology (OK), dual focus (DF) and multifocal (MF) contact lenses (n = 5 for each treatment)). Treatment effectiveness was evaluated by five methods (1 - 4 used AL and 5 used SER): 1. Percentile Method using AL growth curve data, 2. Mean Efficacy Method using AL mean values from literature, 3. Cumulative Absolute Reduction in axial Elongation (CARE) method and 4. Emmetropic Growth Method using emmetropic AL growth as a target. 5. Decrease in rate of SER progression. Results. The Percentile Method indicated that treatment was effective in 53 % of patients: three OK, two MF and four DF patients. The Mean Efficacy and CARE methods indicated treatment effectiveness in 33 % and 27 % of patients respectively: two OK, one MF and one DF patients. None of the patients met the target for the Emmetropic Growth Method. SER method indicated treatment effectiveness for 20 % of patients: one DF and MF patient.. Conclusion. In this case series, emmetropic growth as a target was unobtainable due to modest treatment effects. Using SER alone was not sufficient to detect small treatment effects. Growth curve data were limited when evaluating those with a longer AL and short term treatment effects. The Mean Efficacy and CARE Methods are more suitable method for short term clinical decision making in this case series.. Keywords Myopia, contact lenses, growth charts

Eye Care Practitioners Are Key Influencer for the Use of Myopia Control Intervention.

BackgroundThe study sought to investigate the self-reported practices of Singaporean eye care practitioners on myopia management and the interaction between eye care practitioners and parents.MethodsSelf-reported questionnaire (1) to eye care practitioners to understand their clinical practice behavior, their opinion in myopia management (2) to parents on their knowledge of myopia control products and interaction with eye care practitioners.Results80.0% of eye care practitioners prescribe myopia control in their practice but only 33.1% of eye care practitioners prescribed myopia control interventions during the first visit, and only 41.4% of parents were recommended myopia control interventions by eye care practitioners, of which 75.6% followed the recommendations of eye care practitioners. Eye care practitioners (53.1%) prefer atropine the most and parents prefer controlling the amount of time doing near work (54.5%) and outdoor activities (52.5%). Eye care practitioners had the highest influence on the choice of vision correction with 78.8% of parents choosing to follow them. 66.9% of eye care practitioners did not prescribe myopia control interventions during the first visit as they lack myopia progression data from the patient. Eye care practitioners felt that more education on myopia control products (57.7%), hands-on workshops (47.7%) and management of children (44.6%) would encourage them to use myopia control interventions more frequently. 40.0% of the eye care practitioners were concerned about the cost of myopia control products.ConclusionsEye care practitioners strongly influence parents to uptake myopia control interventions. More education and hands-on workshops on myopia and children management can help encourage the use of myopia control interventions by eye care practitioners.

Strategies and attitudes on the management of myopia in clinical practice in Spain

ObjectiveIn 2019, an international survey was conducted to evaluate strategies and attitudes in the management of myopia in clinical practice worldwide. This study reports on the results found in Spain and how these results compare with those from other regions of the world. MethodsA self-administrated, internet-based questionnaire was distributed to eye care professionals around the world through professional associations. The questions examined were based on the available strategies and their use. ResultsA total of 173 Spanish optometrists, of the 1,336 practitioners from the five different continents who participated in the study, responded to the online survey. Spain, Asia and South America were found among the regions with the highest concern regarding the increased incidence of myopia (p ≤ 0.001). However, in these regions, the prescription of single-vision spectacles and single-vision contact lenses continues to be the main methods of visual correction prescribed to young myopic patients (p ≤ 0.001). Spanish practitioners, like those from other regions, considered orthokeratology to be the most effective treatment to control myopia progression (p ≤ 0.001). The major reasons why Spanish practitioners were not prescribing myopia control strategies were increased cost, inadequate information and unpredictable outcomes (p < 0.05). ConclusionsThe uptake of myopia control methods by Spanish practitioners is relatively low, despite the increase in the prevalence of paediatric myopia as well as increased concern and perceived clinical activity in the area in recent years.

Knowledge, Perspectives and Practice Patterns of Eye Care Providers in Pakistan Regarding Myopia

Aim: To survey eye-care professionals in Pakistan, including optometrists, ophthalmologists, and residents from either, on their knowledge, opinions, and clinical practice patterns. We also looked to see if their myopia-related practice habits were in accordance with current standards of care and guidelines. Methods: An online survey was created and shared with eyecare providers from all provinces in Pakistan. The responses were collected over a span of 8 weeks. Results: 173 professionals took part in the survey and 146 were able to complete the survey (based on their response to specific questions). Most common method of refraction was cycloplegic refraction, and most tended to under-correct myopia. Only 1/4th of clinicians were measuring axial length and 21% never performed binocular testing and checked lag of accommodation in myopes. Most common method of myopic fundus examination was dilated fundus biomicroscopy and criteria for peripheral fundus examination was myopia greater than 6 diopters. Almost half have not attended a course/ workshop on myopia (control) in past 6 months and 1/4th tended to rarely read a myopia related journal article. Progression of more than 1 diopter a year was criteria for initiation of control strategies for most clinicians and 0.01% atropine was the preferred initial concentration and almost half of them believed the control strategies to be moderately effective. Conclusion: A substantial proportion of eyecare providers do not appear to be aware of current concepts and do not incorporate recent guidelines into their practices regarding myopia management. Keywords: Practice patterns, Eye care providers, Myopia

The Role of Orthokeratology in Myopia Management.

Intervention to slow axial elongation and progressing degree of myopia has become an important public health issue. Although orthokeratology (OrthoK) has been prescribed to temporarily reduce or eliminate refractive error, myopic children undergoing OrthoK have shown significant slowing of axial elongation and myopic progression. This review presents data on the efficacy, benefits, and risks of the use of OrthoK to slow axial elongation in myopic children. It also discusses how OrthoK fits into an overall strategy of myopia management in practice compared with alternative prescribed interventions to slow myopic progression. Other factors discussed are patient candidacy, impact on vision-related quality of life, and use of OrthoK in combination with pharmaceutical agents. With precise fitting, careful follow-up, and patient compliance with recommended lens cleaning and disinfection, OrthoK is a safe and effective method to slow axial elongation in children.

LMS parameters, percentile, and Z-score growth curves for axial length in Chinese schoolchildren in Wuhan

Understanding the ocular structural changes are fundamental to defining strategies for myopia prevention and management. This study aimed to establish age-gender specific normative LMS parameters for axial length to generate percentile and Z-score growth curves in a population of Chinese schoolchildren. A total of 14,760 individuals aged 6 to 15 years from Wuhan, central China, contributed to this study. The LMS method was used for the calculation of LMS parameters and the generation of percentile and Z-score growth curves for axial length. Growth curves derived from the LMS parameters were compared with those originally calculated. Axial elongation was age- and percentile-dependent. The highest elongation rate occurred at the 98th percentile in the range 6 to 9 years, being up to 1.46 mm in boys and 1.42 mm in girls. The largest differences between original and newly generated growth curves were detected at the 98th percentile at age 15; 0.78 mm (females) and 0.63 mm (males). Multinomial logistic regression and receiver operating characteristic analyses revealed Z-scores as a good predictor for estimating high myopia development. The axial length growth curves presented in this study provide a technically solid instrument that depicts the best description of physiological eye growth for Chinese schoolchildren aged 6 to 15 years.

Changes in accommodation and behavioural performance with a contact lens for myopia management: A comparison between a dual-focus and a single-vision soft contact lens.

IntroductionDual‐focus soft contact lenses for myopia management have demonstrated to be an effective strategy to reduce myopia progression. However, this optical design has been shown to alter visual quality and accommodative function. The aim of this study was to examine the accommodative and behavioural performance during the execution of a psychomotor vigilance task (PVT) while wearing dual‐focus and single‐vision soft contact lenses.MethodsThe steady‐state accommodative response was recorded with the WAM‐5500 binocular open‐field autorefractor during the execution of a 10‐min PVT at 50 cm either with the dual‐focus (MiSight 1‐day) or single‐vision (Proclear 1‐day) soft contact lenses, using a sample of 23 healthy young adults. Each experimental session was performed on two different days in a counterbalanced order.ResultsA greater lag of accommodation, variability of accommodation and reaction time was found while wearing dual‐focus in comparison with single‐vision soft contact lenses (mean differences during the 10‐min PVT were 0.58 ± 0.81 D, p < 0.001; 0.31 ± 0.17 D, p < 0.001 and 15.22 ± 20.93 ms, p = 0.002, respectively). Also, a time‐on‐task effect was found for the variability of accommodation and reaction time (p = 0.001 and p < 0.001, respectively), observing higher values over time. However, the lag of accommodation did not change significantly as a function of time‐on‐task (p = 0.33).ConclusionDual‐focus soft contact lens wear influences the steady‐state accommodative response and behavioural performance during the execution of a visual vigilance task in the short‐term. Eye care practitioners should be aware of these effects when prescribing these lenses for myopia management, and provide specific recommendations according to the individual visual needs.

Applications of Artificial Intelligence in Myopia: Current and Future Directions.

With the continuous development of computer technology, big data acquisition and imaging methods, the application of artificial intelligence (AI) in medical fields is expanding. The use of machine learning and deep learning in the diagnosis and treatment of ophthalmic diseases is becoming more widespread. As one of the main causes of visual impairment, myopia has a high global prevalence. Early screening or diagnosis of myopia, combined with other effective therapeutic interventions, is very important to maintain a patient's visual function and quality of life. Through the training of fundus photography, optical coherence tomography, and slit lamp images and through platforms provided by telemedicine, AI shows great application potential in the detection, diagnosis, progression prediction and treatment of myopia. In addition, AI models and wearable devices based on other forms of data also perform well in the behavioral intervention of myopia patients. Admittedly, there are still some challenges in the practical application of AI in myopia, such as the standardization of datasets; acceptance attitudes of users; and ethical, legal and regulatory issues. This paper reviews the clinical application status, potential challenges and future directions of AI in myopia and proposes that the establishment of an AI-integrated telemedicine platform will be a new direction for myopia management in the post-COVID-19 period.

Temporal properties of positive and negative defocus on emmetropization

Studying the temporal integration of visual signals is crucial to understand how time spent on different visual tasks can affect emmetropization and refractive error development. In this study we assessed the effect of interrupting positive and negative lens-imposed defocus with brief periods of unrestricted vision or darkness. A total of forty-six marmosets were treated monocularly with soft contact lenses for 4 weeks from 10 weeks of age (OD: + 5D or − 5D; OS: plano). Two control groups wore + 5D (n = 5) or − 5D (n = 13) lenses continuously for 9 h/day. Two experimental groups had lens-wear interrupted for 30 min twice/day at noon and mid-afternoon by removing lenses and monitoring vision while marmosets sat at the center of a viewing cylinder (normal vision interruption, + 5D: n = 7; − 5D: n = 8) or while they were in the dark (dark interruption, + 5D: n = 7; − 5D: n = 6). The interruption period (30 min/day) represented approx. 10% of the total stimulation time (9 h/day). On-axis refractive error (RE) and vitreous chamber depth (VCD) were measured using an autorefractor and high frequency A-scan ultrasound at baseline and after treatment. Wearing + 5D lenses continuously 9 h/day for 4 weeks induced slowed eye growth and hyperopic shifts in RE in treated relative to contralateral control eyes (relative change, VCD: − 25 ± 11 μm, p > 0.05; RE: + 1.24 ± 0.58 D, p > 0.05), whereas − 5D lens wear resulted in larger and myopic eyes (relative change, VCD: + 109 ± 24 μm, p < 0.001; RE: − 2.03 ± 0.56 D, p < 0.05), significantly different from those in the + 5D lens-treated animals (p < 0.01 for both). Interrupting lens induced defocus with periods of normal vision or darkness for approx. 10% of the treatment time affected the resulting compensation differently for myopic and hyperopic defocus. Interrupting defocus with unrestricted vision reduced − 5D defocus compensation but enhanced + 5D defocus compensation (− 5D, VCD: + 18 ± 33 μm; RE: − 0.93 ± 0.50 D, both p > 0.05; + 5D, VCD: − 86 ± 30 μm; RE: + 1.93 ± 0.50 D, both p < 0.05). Interrupting defocus with darkness also decreased − 5D defocus compensation, but had little effect on + 5D defocus compensation (− 5D, VCD: + 73 ± 34 μm, RE: − 1.13 ± 0.77 D, p > 0.05 for both; + 5D, VCD: − 10 ± 28 μm, RE: + 1.22 ± 0.50 D, p > 0.05 for both). These findings in a non-human primate model of emmetropization are similar to those described in other species and confirm a non-linear model of visual signal integration over time. This suggests a mechanism that is conserved across species and may have clinical implications for myopia management in school-aged children.

Wearing Experience with A Novel Myopia Management Spectacle Lens Technology

Purpose: To ensure usability of myopia management therapies, vision performance, satisfaction, and usability with activities of daily living must be thoroughly assessed. Novel spectacle lenses that incorporate light scattering features (DOT lenses) are being evaluated in a three-year, randomised, controlled clinical trial and have been shown to be highly effective at reducing myopic progression through 12 months. The purpose of this research was to evaluate visual acuity (VA), compliance, and the subjective experience during the first trial year.

Evaluation of children in the Netherlands fitted with custom made ortho-k contact lenses

Purpose: Studies on Ortho-K (OK) lenses for myopia management have demonstrated efficacy on children in controlled studies. However, performance and wearer acceptance in a real-world practice environment is also important. A retrospective chart review was conducted to evaluate myopia progression in children who were fitted with OK for myopia correction.