With increasing use of axial length to monitor myopia progression, the ratio of refractive error change to axial elongation has important clinical implications. This systematic review determines this ratio and explores factors that influence it.
The age of onset of myopia influences the annual progression rate and is also race dependent. Delaying the onset of myopia can save approximately 0.75D a year on the final prescription reached, similar to the saving offered by myopia control methods.
Atropine 0.01% combined with orthokeratology slows axial elongation to less than 0.1mm/year over two years in Chinese children aged 6-11 years. This is the equal-longest study on this topic and first to measure potential mechanisms of pupil size and choroidal thickness. The largest effect of the combination occurred in the first 6 months.
In young adult myopes, Biofinity centre-distance +2.50 Add and NaturalVue multifocal contact lenses both showed reduced visual acuity in lower lighting and low contrast conditions, and especially with a glare source, compared to single vision. Reading rate under normal lighting was also reduced by 4-8%. The multifocal designs performed similarly, although Biofinity required more over-refraction for best distance acuity.
Caffeine-based eye drops created hyperopic shifts in baby rhesus monkeys during the emmetropization process, and protected against myopia development due to induced hyperopic defocus. The serum level of caffeine was similar to one cup of coffee in a human adult. This potential future myopia treatment requires further research on dosage, benefits and side effects before use in humans.
This study investigated the working distance and head posture of Chinese myopic children while reading, writing and playing video games. The average working distance across all tasks was 24.5cm, with the shortest working distance and largest head declination observed while children played video games. There was no influence of level of myopia or accommodative lag on working distance or head position.
The IMI 2021 Yearly Digest summarized recent updates and progress in research of myopia, taking in all publications since the IMI Volume One reports published in early 2019. Each of the Volume One reports included an update – definitions, interventions, genetics, experimental models, clinical trial guidance, ethical considerations and clinical management. While further research is needed, the strengthening evidence base indicates eye care practitioners should embrace proactive myopia management.
In myopic children, interventions to slow progression are warranted to prevent the development of high myopia and subsequent pathology and also to reduce the economic burden caused by uncorrected and pathologic myopia. This IMI Report describes the latest advice on preventing the development and progression of myopia – read the summary here.
This paper has found there are numerous correlations but only weak evidence to demonstrate a causal link between accommodation and myopia development. Assessment of the young myope’s accommodation and binocular vision function is still important. More understanding of the underlying mechanisms for myopia is needed in order to develop evidence-based interventions.
This report details non-modifiable and modifiable risk factors for myopia. Of the latter, Increasing the time children spend outside is an evidence-based intervention for myopia management. Near work is also a risk factor, although the causal relationship is less clear and future research with objective measures will provided more guidance on targeted clinical interventions.
