Both concentric ring bifocal and peripheral add multifocal soft contact lenses are clinically effective for controlling myopia in school-aged children, with an overall myopia control rates of 30~50% over 2 years. Concentric ring bifocal soft contact lenses seem to have greater effect than peripheral add multifocal soft contact lenses.

PURPOSE.To test the hypothesis that relative peripheral hyperopia predicts development and progression of myopia. METHODS.Refraction along the horizontal visual field was measured under cycloplegia at visual field angles of 08, 6158, and 6308 at baseline, 1 and 2 years in over 1700 initially 7-year-old Chinese children, and at baseline and 1 year in over 1000 initially 14-year olds. One refraction classification for central refraction was ''nonmyopia, myopia'' (nM, M), consisting of nM greater than À0.50 diopters (D; spherical equivalent) and M less than or equal to À0.50 D. A second classification was ''hyperopia, emmetropia, low myopia, and moderate/high myopia'' (H, E, LM, MM) with H greater than or equal to þ1.00 D, E, À0.49 to þ0.99 D, LM, À2.99 to À0.50 D, and MM less than or equal to À3.00 D. Subclassifications were made on the basis of development and progression of myopia over the 2 years. Changes in central refraction over time were determined for different groups, and relative peripheral refraction over time was compared between different subgroups. RESULTS.Simple linear regression of central refraction as a function of relative peripheral refraction did not predict myopia progression as relative peripheral refraction became more hyperopic: relative peripheral hyperopia and relative peripheral myopia predicted significant myopia progression for 0% and 35% of group/visual field angle combinations, respectively. Subgroups who developed myopia did not have more initial relative peripheral hyperopia than subgroups who did not develop myopia.CONCLUSIONS. Relative peripheral hyperopia does not predict development nor progression of myopia in children. This calls into question the efficacy of treatments that aim to slow progression of myopia in children by ''treating'' relative peripheral hyperopia.

Chinese eye exercises have been implemented in China as an intervention for controlling children’s myopia for over 50 years. This nested case-control study investigated Chinese eye exercises and their association with myopia development in junior middle school children. Outcome measures were the onset and progression of myopia over a two-year period. Cases were defined as 1. Myopia onset (cycloplegic spherical equivalent ≤ −0.5 diopter in non-myopic children). 2. Myopia progression (myopia shift of ≥1.0 diopter in those who were myopic at baseline). Two independent investigators assessed the quality of Chinese eye exercises performance at the end of the follow-up period. Of 260 children at baseline (mean age was 12.7 ± 0.5 years), 201 were eligible for this study. There was no association between eye exercises and the risk of myopia-onset (OR = 0.73, 95%CI: 0.24–2.21), nor myopia progression (OR = 0.79, 95%CI: 0.41–1.53). The group who performed high quality exercises had a slightly lower myopia progression of 0.15 D than the children who did not perform the exercise over a period of 2 years. However, the limited sample size, low dosage and performance quality of Chinese eye exercises in children did not result in statistical significance and require further studies.

ImportanceMyopia in school-aged children is a public health issue worldwide; consequently, effective interventions to prevent onset and progression are required.ObjectiveTo investigate whether SMS text messages to parents increase light exposure and time outdoors in school-aged children and provide effective myopia control.Design, Setting, and ParticipantsThis randomized clinical trial was conducted in China from May 2017 to May 2018, with participants observed for 3 years. Of 528 965 primary school–aged children from Anyang, 3113 were randomly selected. Of these, 268 grade 2 schoolchildren were selected and randomly assigned to SMS and control groups. Data were analyzed from June to December 2021.InterventionsParents of children in the SMS group were sent text messages twice daily for 1 year to take their children outdoors. All children wore portable light meters to record light exposure on 3 randomly selected days (2 weekdays and 1 weekend day) before and after the intervention.Main Outcomes and MeasuresThe co–primary outcomes were change in axial length (axial elongation) and change in spherical equivalent refraction (myopic shift) from baseline as measured at the end of the intervention and 3 years later. A secondary outcome was myopia prevalence.ResultsOf 268 grade 2 schoolchildren, 121 (45.1%) were girls, and the mean (SD) age was 8.4 (0.3) years. Compared with the control group, the SMS intervention group demonstrated greater light exposure and higher time outdoors during weekends, and the intervention had significant effect on axial elongation (coefficient, 0.09; 95% CI, 0.02-0.17; P = .01). Axial elongation was lower in the SMS group than in the control group during the intervention (0.27 mm [95% CI, 0.24-0.30] vs 0.31 mm [95% CI, 0.29-0.34]; P = .03) and at year 2 (0.39 mm [95% CI, 0.35-0.42] vs 0.46 mm [95% CI, 0.42-0.50]; P = .009) and year 3 (0.30 mm [95% CI, 0.27-0.33] vs 0.35 mm [95% CI, 0.33-0.37]; P = .005) after the intervention. Myopic shift was lower in the SMS group than in the control group at year 2 (−0.69 diopters [D] [95% CI, −0.78 to −0.60] vs −0.82 D [95% CI, −0.91 to −0.73]; P = .04) and year 3 (−0.47 D [95% CI, −0.54 to −0.39] vs −0.60 D [95% CI, −0.67 to −0.53]; P = .01) after the intervention, as was myopia prevalence (year 2: 38.3% [51 of 133] vs 51.1% [68 of 133]; year 3: 46.6% [62 of 133] vs 65.4% [87 of 133]).Conclusions and RelevanceIn this randomized clinical trial, SMS text messages to parents resulted in lower axial elongation and myopia progression in schoolchildren over 3 years, possibly through increased outdoor time and light exposure, showing promise for reducing myopia prevalence.Trial RegistrationChinese Clinical Trial Registry Identifier: ChiCTR-IOC-17010525

To analyze the components of young Chinese eyes with special attention to differences in corneal power, anterior segment length and lens power. Cycloplegic refractions and ocular biometry with LENSTAR were used to calculate lens power with Bennett’s method. Mean refraction and mean values for the ocular components of five different refractive groups were studied with ANOVA and post-hoc Scheffé tests. There were 1889 subjects included with full data of refraction and ocular components. As expected, mean axial length was significantly longer in myopic eyes compared to emmetropes. Girls had steeper corneas, more powerful lenses and shorter eyes than boys. Lens power was lower in boys and also lower in myopic eyes. Lens thickness was the same for both genders but was lower in myopic eyes. Although cornea was steeper in myopic eyes in the whole sample, this was a gender effect (more girls in the myopic group) as this difference disappeared when the analysis was split by gender. Anterior segment length was longer in myopic eyes. In conclusion, myopic eyes have lower lens power and longer anterior segment length, that partially compensate their longer axial length. When analyzed by gender, the corneal power is not greater in low and moderate myopic eyes.

Our findings suggest that myopic defocus slows the progression of myopia in already myopic children, supporting previous findings from animal studies.

Retinal nerve fibre layer thickness decreased with increasing AL, higher myopia, bigger cup area, smaller disc and rim area, and a smaller nerve head volume, but the coefficient of determination for all these associations was small. The RNFL in myopes was significantly thinner than emmetropes or hyperopes, but with small absolute differences. The study provides RNFL values for healthy 7-year-old Chinese children. Follow up of this cohort to observe the change of RNFL thickness with myopia and possible change in detected associations with age is planned.

BackgroundMyopic foveoschisis (MF) is among the leading causes of visual loss in high myopia. However, it remains controversial whether internal limiting membrane (ILM) peeling or gas tamponade is necessary treatment option for MF.MethodsPubMed, EMBASE, CBM, CNKI, WANFANG DATA and VIP databases were systematically reviewed. Outcome indicators were myopic foveoschisis resolution rate, visual acuity improvement and postoperative complications.ResultsNine studies that included 239 eyes were selected. The proportion of resolution of foveoschisis was higher in ILM peeling group than non-ILM peeling group (OR = 2.15, 95% CI: 1.06–4.35; P = 0.03). The proportion of postoperative complications was higher in Tamponade group than non-Tamponade group (OR = 10.81, 95% CI: 1.26–93.02; P = 0.03). However, the proportion of visual acuity improvement (OR = 1.63, 95% CI: 0.56–4.80; P = 0.37) between ILM peeling group and non-ILM peeling group and the proportion of resolution of foveoschisis (OR = 1.80, 95% CI: 0.76–4.28; P = 0.18) between Tamponade group and non-Tamponade group were similar.ConclusionsVitrectomy with internal limiting membrane peeling could contribute to better resolution of myopic foveoschisis than non-peeling, however it does not significantly influence the proportion of visual acuity improvement and postoperative complications. Vitrectomy with gas tamponade is associated with more complications than non-tamponade and does not significantly influence the proportion of visual acuity improvement and resolution of myopic foveoschisis.Electronic supplementary materialThe online version of this article (10.1186/s12886-017-0562-8) contains supplementary material, which is available to authorized users.