Clinical Accommodation and Heterophoria Findings Preceding Juvenile Onset of Myopia

Goss, David A.

doi:10.1097/00006324-199102000-00005

Cited by 79 publications

(66 citation statements)

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“…One possibility is that children may have suboptimal accommodation during near work (accommodative lag), leading to hyperopic defocus of the retina that results in axial elongation. 15,16 This has been shown in animal studies of myopia 17 and is supported by clinical trials in humans. 18 Time spent outdoors is increasingly recognized as a protective factor for myopia development, 19 although it is possible that near work and time outdoors can act independently of each other.…”

mentioning

confidence: 83%

The Association between Time Spent Outdoors and Myopia Using a Novel Biomarker of Outdoor Light Exposure

Sherwin

Hewitt

Coroneo

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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1,5,6 PURPOSE. We sought to determine whether conjunctival ultraviolet autofluorescence (UVAF), a biomarker of outdoor light exposure, is associated with myopia.METHODS. We performed a cross-sectional study on Norfolk Island and recruited individuals aged ‡15 years. Participants completed a sun-exposure questionnaire and underwent noncycloplegic autorefraction. Conjunctival UVAF used a specially adapted electronic flash system fitted with UV-transmission filters (transmittance range 300-400 nm, peak 365 nm) as the excitation source. Temporal and nasal conjunctival UVAF was measured in both eyes using computerized photographic analysis with the sum referred to as ''total UVAF.'' RESULTS. In 636 participants, prevalence of myopia decreased with an increasing quartile of total UVAF (P trend ¼ 0.002). Median total UVAF was lower in subjects with myopia (spherical equivalent [SE] À1.0 diopter [D]) than participants without myopia: 16.6 mm 2 versus 28.6 mm 2 , P ¼ 0.001. In the multivariable model that adjusted for age, sex, smoking, cataract, height and weight, UVAF was independently associated with myopia (SE À1.0 D): odds ratio (OR) for total UVAF (per 10 mm 2 ) was 0.81, 95% confidence interval (CI) 0.69 to 0.94, P ¼ 0.007. UVAF was also significantly associated with myopia when analysis was restricted to subjects <50 years, and in moderate-severe myopia (SE À3.0 D). Prevalence of myopia decreased with increasing time outdoors (P trend ¼ 0.03), but time outdoors was not associated with myopia on multivariable analysis.CONCLUSIONS. Study authors identified a protective association between increasing UVAF and myopia. The protective association of higher UVAF against myopia was stronger than that of increased levels of time spent outdoors as measured by this study's questionnaire. Future studies should investigate the association between UVAF and incident myopia, and its relationship to myopic progression. (Invest Ophthalmol Vis Sci.

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mentioning

confidence: 83%

The Association between Time Spent Outdoors and Myopia Using a Novel Biomarker of Outdoor Light Exposure

Sherwin

Hewitt

Coroneo

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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“…It has been suggested that inadequate accommodation [134][135][136][137] and/or esophoria at near [ 136,137] are often found before development of myopia in youth. Goss [ 138] studied records of private practice patients who had been examined when they were emmetropic and then later after they had become myopic. Their data were compared to children examined in the same practices who had remained emmetropic over a span of time.…”

Section: Differences In Accommodation and Convergence Function In Myopesmentioning

confidence: 99%

Retinal-image mediated ocular growth as a mechanism for juvenile onset myopia and for emmetropization

Goss

Wickham

1995

Doc Ophthalmol

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The very common ocular clinical ocular condition in children juvenile onset myopia results from axial elongation of the eye. In humans, some studies have found an association of myopia with greater levels of nearpoint activity and with differences in accommodation and convergence function. This paper reviews a variety of laboratory and clinical studies which are consistent with the hypothesis that retinal image defocus is biochemically transformed into an axial elongation expressed through increased posterior segment growth, and thus myopia. This paper also reviews theories of emmetropization, and classifies them as correlational, feedback, and combination. Evidence is presented to suggest that a combination theory, which combines both correlation of the ocular dioptric components and some feedback mechanism for growth of the eye, is the most correct. Current laboratory research suggests that quality and/or focus (defocus) of retinal imagery is involved in this feedback mechanism and that experimentally induced myopia might be enhanced, reduced or eliminated by pharmaceutical application. Direction of defocus may affect the rate of posterior segment growth, and thus the rate of ocular axial elongation.

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“…The bidirectional modulation of eye growth by hyperopic and myopic defocus in disparate species suggests that the same may occur in children. [55][56][57] Although three earlier studies in humans suggest that increases in accommodative lag occur before the onset of myopia, 58,59 the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study concluded that increased hyperopic defocus from accommodative lag may be a consequence rather than a cause of myopia. 60 Increased accommodative lag relative to model estimates of lag in emmetropes did not occur in children who became myopic before the onset of myopia or during the year of onset.…”

Section: Animal Modelsmentioning

confidence: 99%

139: An evidence-based update on myopia and interventions to retard its progression

Leo¹,

Young²

2009

Journal of American Association for Pediatric Ophthalmology and

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SummaryMyopia is the most common human eye disorder. With its increasing prevalence and earlier ageof-onset in recent birth cohorts, myopia now affects almost 33% of adult individuals in the United States, and epidemic proportions of 85% to 90% adult individuals in Asian cities. Unlike children in Western populations, where the prevalence of myopia is very low (less than 5%), Asian children have prevalences as high as 29% in 7-year-olds. In addition to the direct economic and social burdens of myopia, associated ocular complications may lead to substantial vision loss. This workshop summarizes the current literature regarding myopia epidemiology, genetics, animal model studies, risk factors, and clinical treatments. Published treatment strategies to retard the progression of myopia in children, such as pharmacologic agents, progressive addition lenses, neural adaptation programs are outlined.Myopia, or near-sightedness, is the state of refraction in which parallel rays of light are brought to focus in front of the retina of a resting eye. 1 It is measured by the spherical power in diopters of the diverging lens needed to focus light onto the retina, which can be expressed as the spherical equivalent (SE), that is, sphere + half negative cylinder. Most commonly used definitions of myopia in epidemiologic studies include SE of at least −0.50D, −0.75D, and −1.0D. 2 Myopia is the most common human eye disorder in the world, affecting 85% to 90% of young adults in some Asian countries such as Singapore and Taiwan,3,4 and between 25% and 50% of older adults in the United States and Europe. [5][6][7] Epidemiological studies in Western populations have collectively shown the prevalence of myopia to be low (<5%) in children aged 8 years or younger. [8][9][10][11][12][13][14] However, studies in Asian children suggest a significantly higher prevalence of myopia, affecting 9% to 15% of preschool children 15,16 and 29% of primary school children in Singapore. 17 A study of 10,000 Taiwanese school children found that the prevalence of myopia was 6% in 6-yearolds, with the prevalence increasing to more than 70% by age of 15 years. 18

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Clinical Accommodation and Heterophoria Findings Preceding Juvenile Onset of Myopia

Cited by 79 publications

References 0 publications

The Association between Time Spent Outdoors and Myopia Using a Novel Biomarker of Outdoor Light Exposure

The Association between Time Spent Outdoors and Myopia Using a Novel Biomarker of Outdoor Light Exposure

Retinal-image mediated ocular growth as a mechanism for juvenile onset myopia and for emmetropization

139: An evidence-based update on myopia and interventions to retard its progression

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