The use of PALs slowed myopia progression, although the treatment effect was small, as previously reported in ethnically diverse children in the United States. The significant treatment-by-period interaction suggests that early application of PALs would probably be more beneficial for these age and refraction ranges (isrctn.org number, 28611140).

The IOLMaster provides high repeatability in AL measurement in myopic children. The associations between AL and each refractive component found in this study were consistent with those in previous studies that used the ultrasound A-mode method, except for slightly higher AL/CR ratios in our study.

The measurement method used in this study provided good test-retest repeatability and ease of application. The characteristics of torsional eye movements that we observed after minimizing the false-torsion factors agree with previous reports supporting the existence of s-OCR.

The insignificant magnitude of RA indicated that the mixed eye drop is an acceptable and useful cycloplegic agent in Japanese schoolchildren with a wide range of myopic refractive errors.

Conventional treatment may improve the visual acuity of amblyopic eyes even in adult patients.