Chinese Eye Exercises and Myopia Development in School Age Children: A Nested Case-control Study

Kang, Meng-Tian; Li, Shiming; Peng, Xiaoxia; Li, Lei; Ran, Anran; Meng, Bo; Sun, Yu; Liu, Luo-Ru; Li, He; Millodot, Michel; Wang, Ke

doi:10.1038/srep28531

Cited by 42 publications

(59 citation statements)

References 20 publications

(29 reference statements)

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“…Our finding that the self-reported regular practice of traditional Chinese eye exercises has no protective effect with regard to visual acuity is consistent with the majority of recent reports [11,23]. A sufficiently-powered randomized controlled trial would be needed to provide a more definitive answer.…”

Section: Discussionsupporting

confidence: 86%

“…These have generally found no clinically significant association between correctly-performed eye exercises and a reduction in accommodative lag in children, a factor implicated in myopia progression [10]. One study reported no association between eye exercises and the risk of myopia onset or myopia progression [11]. A significant concern for confounding in existing studies lies in the fact that children choosing to practice eye exercises and families encouraging such behavior may differ in important ways from those who do not, including possible differences in refractive error and its determinants.…”

Section: Introductionmentioning

confidence: 99%

“…In 1963, the Ministry of Education introduced Chinese eye exercises as a proposed method for myopia treatment and/or prevention among school-aged children [10]. In Chinese eye-exercises, pressure is applied to acupoints present around the eyes, with the objective of increasing blood circulation, reducing ocular fatigue, and slowing down the development of myopia [11].…”

Section: Introductionmentioning

confidence: 99%

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Effect of Chinese eye exercises on change in visual acuity and eyeglasses wear among school-aged children in rural China: a propensity-score-matched cohort study

Wang

Qian

Congdon

et al. 2020

BMC Complement Med Ther

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Background: Daily "eye exercises," massaging of periocular acupuncture pressure points, have been part of China's national vision care policy in schools for some 50 years. However, the effect of eye exercises on myopia progression and eyeglasses wear has not been definitively investigated. This study evaluates the effectiveness of eye exercises on visual acuity and the propensity of rural children to wear eyeglasses. Methods: Cohort study in 252 randomly-selected rural schools with baseline in September 2012 and follow up surveys 9 and 21 months later. Outcomes were assessed using propensity-score matching (PSM), multivariate linear regression and logistic regression to adjust for differences between children performing and not performing eye exercises. Results: Among 19,934 children randomly selected for screening, 2374 myopic (spherical equivalent refractive error ≤ − 0.5 diopters in either eye) children (11.9%, mean age 10.5 [Standard Error 1.08] years, 48.5% boys) had VA in either eye ≤6/12 without eyeglasses correctable to > 6/12 with eyeglasses. Among these who completed the 21month follow up, 1217 (58.2%) children reported practicing eye exercises on school days and 874 (41.8%) did not. After propensity-score matching, 1652 (79%) children were matched: 826 (50%) in the Eye Exercises group and 826 (50%) in the No Exercise group. Performing eye exercises was not associated with change in LogMAR uncorrected visual acuity and wear of eyeglasses, using either logistic regression or PSM at 9 or 21 months. Conclusions: We found no evidence for an effect of eye exercises on change in vision or eyeglasses wear.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of Chinese eye exercises on change in visual acuity and eyeglasses wear among school-aged children in rural China: a propensity-score-matched cohort study

Wang

Qian

Congdon

et al. 2020

BMC Complement Med Ther

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“…Search results and study features Figure 1 outlines the study selection process in a PRISMA-sanctioned flowchart (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Initial search resulted in 60 citations, followed by a series of omissions that eventually yielded eight articles for inclusion [47][48][49][50][51][52][53][54]. Characteristics of the included studies Table 1 shows the year span of the included articles (2011-2019) and ethnic composition, Chinese (n = 6) and Indian (n = 2).…”

Section: Resultsmentioning

confidence: 99%

Influence of Chinese eye exercises on myopia control in an East Asian population: a meta-analysis

Sangvatanakul

Tangthianchaichana

Tasanarong

et al. 2019

Preprint

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Objective: The rates of myopia (−0.50 diopter), and high myopia (≥ −6.0 diopter) have been increasing in East Asian populations; the reasons for which may include the combinations of genetic, environment and behavioural factors. The most affected demography point to the young elite population of intellectuals produced from universities. Of the several recommendations to address the myopia epidemic, the influence of Chinese eye exercises (CEE) have been examined. However, reports have been inconsistent, prompting a meta-analysis to obtain more precise estimates. Methods: Eight articles were included in the meta-analysis where we operated on the hypothesis that CEE either increased or reduced myopia control. We compared the subjects that performed CEE against those that did not. We used and estimated odds ratios [ORs] and 95% confidence intervals (CIs) using the generic inverse variance method. Subgroup analysis involved quality (high/serious and low/non-serious) and frequency (> 5 times/week) of performing CEE comprised. Heterogeneity was subjected to outlier treatment which split the findings into pre- (PRO) and post- (PSO) outlier. The strength of evidence in our findings were based on high significance (Pa < 10-5), surviving the Bonferroni correction and homogeneity (I2 = 0%). Outcomes with these features comprised our core findings. Results: Our core findings were found in the PSO overall indicating elevated myopia control (OR 0.72, 95% CI 0.61-0.86, Pa = 0.0002) and CEE subgroups (Serious: OR 0.75, 95% CI 0.68-0.84, Pa < 10-5; Frequent: OR 0.55, 95% CI 0.45-0.68, Pa < 10-5). The low quality subgroup outcome was null in PRO (OR 0.97, 95% CI 0.50-1.86, Pa = 0.92) but conveyed significantly less myopia control in PSO (OR1.57, 95% CI 1.24-2.01, Pa = 0.0002). Conclusions: This meta-analysis found that CEE afforded 28% greater control of myopia. Enabled by outlier treatment, this finding was homogeneous and consistent. Subgroup effects elevated myopia control to 62% when CEE was done up to 5 times a week. Improper CEE performance implied reduced myopia control of up to 57%.

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“…He concluded that good quality practice of the extraocular muscles in children will delay myopia progressivity. [21] …”

Section: Eye Exercisementioning

confidence: 99%

Literature Review: Yoga Eye Exercise Effect on Visual Acuity

2017

IJSR

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Increased prevalence of myopia has become a worldwide health problem. Progressivity of myopia is increased by digital eye strain. Digital eye strain is a repetitive strain injury and occurs among 70% computer user. Usually it has strain on the extraocular muscle and a decreased of visual acuity. Digital eye strain should be reduced to improve visual acuity. Yoga and eye exercises can improve visual acuity. Goal of this review paper is to know the effect of yoga eye exercise on visual acuity. It can be concluded that practicing yoga eye exercises for one hour, twice daily in eight weeks will reduce fatigue of the extraocular muscles and improve visual acuity. Further research required to determine the magnitude of improvement of visual acuity due to practicing yoga eye exercises.

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Chinese Eye Exercises and Myopia Development in School Age Children: A Nested Case-control Study

Cited by 42 publications

References 20 publications

Effect of Chinese eye exercises on change in visual acuity and eyeglasses wear among school-aged children in rural China: a propensity-score-matched cohort study

Effect of Chinese eye exercises on change in visual acuity and eyeglasses wear among school-aged children in rural China: a propensity-score-matched cohort study

Influence of Chinese eye exercises on myopia control in an East Asian population: a meta-analysis

Literature Review: Yoga Eye Exercise Effect on Visual Acuity

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